Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review

Abstract Background The chronic and debilitating nature of Type 2 Diabetes Mellitus (T2DM) not only places a significant burden on patients but also imposes high intangible costs on their caregivers. This review aimed to critically assess the intangible costs and their associated factors among careg...

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Main Authors: Siti Bazlina Mohd Rawi, Muhammad Ridzwan Rafi’i, Roszita Ibrahim, Norfazilah Ahmad, Rosnah Sutan, Cassidy Devarajooh
Format: Article
Language:English
Published: BMC 2025-06-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-12944-x
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author Siti Bazlina Mohd Rawi
Muhammad Ridzwan Rafi’i
Roszita Ibrahim
Norfazilah Ahmad
Rosnah Sutan
Cassidy Devarajooh
author_facet Siti Bazlina Mohd Rawi
Muhammad Ridzwan Rafi’i
Roszita Ibrahim
Norfazilah Ahmad
Rosnah Sutan
Cassidy Devarajooh
author_sort Siti Bazlina Mohd Rawi
collection DOAJ
description Abstract Background The chronic and debilitating nature of Type 2 Diabetes Mellitus (T2DM) not only places a significant burden on patients but also imposes high intangible costs on their caregivers. This review aimed to critically assess the intangible costs and their associated factors among caregivers of people with T2DM treated in primary healthcare settings. Method A systematic search using several combinations of keywords was conducted in Scopus, WoS, and PubMed databases. The primary outcome was the score or levels of intangible costs, while the secondary outcome was the factors associated with such burden. Result The review included seven cross-sectional designs (six employing a quantitative approach and one a mixed-methods approach) that adopted the Zarit Burden Interview or Zarit Caregiver Burden Scale, with four reporting a mild level, two reporting a high level, and one reporting a moderate level. Associated factors identified were characteristics of the caregiver (e.g., female, housewife, and no or low income), caregiving characteristics (longer duration and time spent in taking care of the individual with T2DM), and clinical characteristics of individuals with T2DM (i.e., presence of complication and their health status). Conclusion It was found that T2DM caregivers in primary healthcare settings experienced moderate to high levels of intangible costs. The identified vulnerable subgroup should be regularly screened for their levels of intangible costs to prevent poor outcomes in T2DM caregiving. Furthermore, the implementation of targeted support interventions for these caregivers could improve their well-being and the quality of care provided to individuals with T2DM, ultimately enhancing patient outcomes and reducing their intangible costs.
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spelling doaj-art-a84d67bf1f3940829696e5abd1ba079d2025-08-20T03:45:10ZengBMCBMC Health Services Research1472-69632025-06-0125111110.1186/s12913-025-12944-xIntangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping reviewSiti Bazlina Mohd Rawi0Muhammad Ridzwan Rafi’i1Roszita Ibrahim2Norfazilah Ahmad3Rosnah Sutan4Cassidy Devarajooh5Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaDepartment of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan MalaysiaRaub District Health Office, Pahang State Health Department, Ministry of Health MalaysiaAbstract Background The chronic and debilitating nature of Type 2 Diabetes Mellitus (T2DM) not only places a significant burden on patients but also imposes high intangible costs on their caregivers. This review aimed to critically assess the intangible costs and their associated factors among caregivers of people with T2DM treated in primary healthcare settings. Method A systematic search using several combinations of keywords was conducted in Scopus, WoS, and PubMed databases. The primary outcome was the score or levels of intangible costs, while the secondary outcome was the factors associated with such burden. Result The review included seven cross-sectional designs (six employing a quantitative approach and one a mixed-methods approach) that adopted the Zarit Burden Interview or Zarit Caregiver Burden Scale, with four reporting a mild level, two reporting a high level, and one reporting a moderate level. Associated factors identified were characteristics of the caregiver (e.g., female, housewife, and no or low income), caregiving characteristics (longer duration and time spent in taking care of the individual with T2DM), and clinical characteristics of individuals with T2DM (i.e., presence of complication and their health status). Conclusion It was found that T2DM caregivers in primary healthcare settings experienced moderate to high levels of intangible costs. The identified vulnerable subgroup should be regularly screened for their levels of intangible costs to prevent poor outcomes in T2DM caregiving. Furthermore, the implementation of targeted support interventions for these caregivers could improve their well-being and the quality of care provided to individuals with T2DM, ultimately enhancing patient outcomes and reducing their intangible costs.https://doi.org/10.1186/s12913-025-12944-xCarer burdenCaregiver strainCaregivingType 2 Diabetes MellitusHealthcare
spellingShingle Siti Bazlina Mohd Rawi
Muhammad Ridzwan Rafi’i
Roszita Ibrahim
Norfazilah Ahmad
Rosnah Sutan
Cassidy Devarajooh
Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
BMC Health Services Research
Carer burden
Caregiver strain
Caregiving
Type 2 Diabetes Mellitus
Healthcare
title Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
title_full Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
title_fullStr Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
title_full_unstemmed Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
title_short Intangible cost and its associated factors among caregivers of individuals with Type 2 Diabetes Mellitus managed at primary healthcare settings: a scoping review
title_sort intangible cost and its associated factors among caregivers of individuals with type 2 diabetes mellitus managed at primary healthcare settings a scoping review
topic Carer burden
Caregiver strain
Caregiving
Type 2 Diabetes Mellitus
Healthcare
url https://doi.org/10.1186/s12913-025-12944-x
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