Willingness to continue caregiving among informal caregivers of community-dwelling older persons in southwestern Nigeria

Willingness to continue caregiving among informal caregivers of community-dwelling older persons in southwestern Nigeria | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Willingness to continue caregiving among informal caregivers of community-dwelling older persons in southwestern Nigeria Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, and 3 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7398719/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background Informal caregiving of older persons is a time-consuming and demanding role often undertaken without preparation. Understanding a caregiver's willingness to continue is crucial for long-term care, especially in low-resource settings such as Nigeria. This study examined the factors influencing the willingness of informal caregivers of community-dwelling older persons to continue in their roles. Methods A cross-sectional study was carried out in Oyo State, southwestern Nigeria. Data were collected from 554 informal caregivers using a semi-structured interviewer-administered questionnaire. The Caregiver Continuation Desire Scale (CCDS) questionnaire, Zarit Burden Interview, and a 15-item adopted physical status assessment tool for older persons were used to collect data and analysed using SPSS version 25 at p < 0.05. Results The mean age of the informal caregivers was 37.24 (± 12.54) years, most were female (83.6%), married (76.9%), and employed (93.5%). The mean age of the care recipients was 79.81 (± 12.28) years, and they were predominantly females (76.5%). Most of the informal caregivers (80.3%) were willing to continue caregiving. The predictors of this willingness were caregivers' perceived ability to care (OR = 4.36; 95% CI [2.19, 8.68]) and their satisfaction with the role (OR = 5.75; 95% CI [2.98, 11.08]). Conclusion The willingness of the informal caregivers to continue caregiving was strongly predicted by their perceived ability to care and their satisfaction with the role. This finding highlights the need for programs and resources that support and equip informal caregivers with skills and knowledge necessary to manage the demands of their roles effectively. Willingness to continue caregiving Community-dwelling older persons informal caregivers Introduction Globally, there is an increase in the population of older persons aged 60 years and above [ 1 ]. Nigeria is not left out of this trend, having the highest population of older persons in Africa [ 2 ]. Older persons often need to be cared for. Unlike other climes where there are accessible options of care facilities, the care for older persons in Southwestern Nigeria, as in many parts of sub-Saharan Africa, falls on informal caregivers [ 3 ]. However, informal caregiving of older persons is a time-consuming and demanding role often entered into with little to no preparation [ 4 ]. Studies in Nigeria have shown that family members, community members, including those of the religious community, usually provide the needed care for these older persons [ 5 ]. These informal caregivers often become caregivers based on necessity, having no formal training or prior skill set in caregiving [ 6 ]. Hence, there may be a perceived lack of capacity for caregiving among these informal caregivers. In Nigeria, strong filial piety and community bonds make informal caregivers see the act of caregiving for their older persons as a moral and cultural responsibility [ 7 ], irrespective of their capacity for caregiving. Also, emotional bonds and attachment between older persons and caregivers can further strengthen the decision to continue caregiving [ 8 ]. Hence, the older persons are dependent on their informal caregivers for their daily needs, medical support, emotional support and well-being [ 3 ]. It is therefore crucial for older persons to have a caregiver willing to continue caregiving, as an abrupt stop can negatively impact the daily activity, health and well-being of the older person. While ongoing caregiving is crucial for the health of older adults, it also presents many challenges for informal caregivers. Informal caregivers experience a significant burden in discharging their duties [ 9 ]. Many studies have looked into caregivers' burden, as it often impacts the quality of life and well-being of the caregivers [ 10 – 12 ]. Caregiver burden has also been linked with caregiver satisfaction, and these two have been shown to contribute to the willingness to continue caregiving in other climes [ 13 , 14 ]. However, there is a paucity of research in Southwestern Nigeria on how these factors interplay with the willingness to continue caregiving among the informal caregivers. Understanding the willingness of informal caregivers to continue in this role is essential for ensuring long-term care provision for older persons, especially in low-resource settings such as Nigeria. Also, understanding the factors associated with the willingness to continue caregiving among these informal caregivers is crucial for developing sustainable support interventions for both the caregivers and the older persons. This study assessed the willingness to continue caregiving and its predictors among informal caregivers of community-dwelling older persons in Oyo State, Southwestern Nigeria, identifying ways to enhance their capacity and willingness to continue caregiving. Methods A community-based cross-sectional study was carried out using quantitative methods to understand the willingness to continue caregiving among informal caregivers in Oyo State. Study area The study was conducted in Ibadan, the capital of Oyo State, Southwestern Nigeria. Oyo State is one of the 36 states of the Federal Republic of Nigeria, located in the Southwestern geopolitical zone of Nigeria. There are 12 urban, 9 semi-urban and 12 rural Local Government Areas (LGAs) in the State. The National population census figures for 2006 indicated that the State had a population of 5,580,894, with a 2025 projection of 10,153,553 assuming an annual growth rate of 3.2% [ 15 ]. The proportion of older persons in Oyo State is 6% [ 16 ]. Study site The study was conducted in Yemetu Alaadorin, a settlement in Ibadan North, an urban LGA in Oyo State. The residents are mainly of the Yoruba ethnic group. The study site is under the purview of the Department of Community Medicine, College of Medicine, University of Ibadan, and has been geographically mapped and listed [ 16 ]. Ibadan North LGA (IBNLGA) is a densely populated urban area with a population of 432,900. About 4% (18,524) of the people of Ibadan North LGA are aged 60 years and above [ 17 ]. Study participants Study participants must have resided in the community for at least a year before the study, be aged 18 years or above, and have provided unpaid care for a person aged 60 years and above for a minimum of 6 months. Informal caregivers unable to read and write were excluded from the study. Sample size and sampling technique Using the formula for estimating proportions, assuming a difference of 10%, power of 80%, α of 5% and adjusting for a 10% non-response rate, the calculated minimum sample size for the survey was 426 participants. However, 554 informal caregivers of community-dwelling older persons were recruited for the study using a multistage sampling technique. Data collection Data were collected using a semi-structured interviewer-administered questionnaire. The questionnaire consisted of the Caregiver Continuation Desire Scale (CCDS), the Zarit Burden Interview, and a 15-item physical status assessment tool for older persons. The survey was deployed using the Research Electronic Data Capture (REDCap) on mobile devices (tablets). The Caregiver Continuation Desire Scale (CCDS) tool was used to assess and understand the positive aspects of caregiving [ 18 ]. It focuses on recognising the beneficial aspects of providing care to others, which can be essential in supporting caregivers. This tool aims to assess the caregiver's emotional attachment, perceived obligation, satisfaction, confidence, and overall desire to continue with caregiving, providing valuable insights into their motivation and needs. The scale covers four main positive aspects, including caregiving personal gains, motivation for the caregiving role, caregiver satisfaction, self-esteem and social aspects of caring. Caregiver burden was assessed using the 22-item standardised, validated Zarit Burden Interview (ZBI) tool. This tool reflects how people sometimes feel when caring for other people. The ZBI scale is a 22-item questionnaire with each item rated from 0–88 (a higher score denotes a higher burden for a particular item) [ 13 ]. The total burden for a subject is the sum of the scores in all the items endorsed. The scores were categorised as follows: 0–20, little or no burden; 21–30, mild burden; 31–40, moderate burden; and 41–88, severe burden. The research instrument was translated into the local Yoruba language for easy communication. It was back-translated to English to ensure the original meanings were maintained before administration. A pre-test was conducted among the older persons in a different LGA from those selected for the study. Following the pre-test, ambiguous questions were rephrased or removed where necessary. Each of the interviews lasted between 30 minutes to 45 minutes. Data analysis The primary outcome variable was the willingness to continue care, and it was categorised as yes or no. Data were analysed using SPSS version 25. Descriptive statistics were done to summarise the variables using proportions, means and standard deviations. Bivariate analysis measured associations between the outcome and independent variables, using the chi-square test. The variables which were found to be significantly associated with the willingness to continue caregiving at 5% level of significance were entered into a logistic regression model. These variables included the caregiver's age, marital status, relationship to recipient, duration of care, caregiver burden, emotional attachment to recipient, obligation to care, perceived ability to care and caregiver satisfaction. This regression model was used to identify the predictors of the willingness to continue caregiving at a confidence interval of 95%. Ethical considerations Ethical approval was obtained from the University of Ibadan/University College Hospital (UI/UCH) Ethical Review Committee (UI/EC/18/024). All participants gave written consent for the survey before participating. Participants were assured that their identities would remain anonymous in all study reporting and that their personal information would be kept confidential. All methods in this study followed relevant guidelines and regulations in the Ethical Declarations. Results A total of 554 informal caregivers completed the study with a mean age of 37.24 (± 12.54) years. The majority of the caregivers were of the Yoruba tribe (527, 95.1%), females (463, 83.6%), married (426, 76.9%), completed secondary school (12 years of education) (323, 58.3%), and employed (518, 93.5%). (Table 1 ). Most of the caregivers (410, 74%) belonged to households with only one care recipient (Table 2 ). Almost two-thirds of the informal caregivers (361, 65.2%) were children of the recipients, followed by other relatives (147, 26.5%). The majority of the informal caregivers (365, 65.9%) had been taking care of the care recipients for less than 5 years, and they provided care and support daily (326, 58.8%). The mean age of the older persons being cared for was 79.81 (± 12.28) years, and they were mostly females (424, 76.5%). Table 1 Socio-demographic Characteristics of Informal Caregivers (N = 554) Variable n (%) Age (in years) 18–39 328 (59.2) 40–59 195 (35.2) ≥ 60 31 (5.6) Mean (S.D) 37.24 (± 12.54) Gender Male 91 (16.4) Female 463 (83.6) Marital Status Single 94 (17.0) Married 426 (76.9) Divorced 10 (1.8) Widowed 24 (4.3) Ethnicity Yoruba 527 (95.1) Others 27 (4.9) Education Primary 145 (26.2) Secondary 323 (58.3) Tertiary 86 (15.5) Employment Status Unemployed 36 (6.5) Employed 518 (93.5) Table 2 Characteristics of Care Recipient and Circumstances of Care (N = 554) Variable Frequency (%) Age of Care Recipient (in years) 60–74 184 (33.2) ≥ 75 370 (66.8) Mean (S.D) 79.81 (± 12.28) Gender of Care Recipient Male 130 (23.5) Female 424 (76.5) Relationship of Informal Caregiver Spouse 20 (3.6) Child 361 (65.2) Relatives 147 (26.5) Others* 26 (4.7) Number of Years of Care ≤ 5 365 (65.9) ≥ 6 189 (34.1) Frequency of Care/Support Daily 326 (58.8) Several times a week 124 (22.4) At least once a week 68 (12.3) Less Often 36 (6.5) Number of Older Persons in Household 1 410 (74.0) ≥ 2 144 (26.0) *Others include friends, neighbours, and religious members As shown in Table 3 , the majority of care recipients (530, 95.7%) were reported to have a high functional ability. Among the informal caregivers, the majority had caregiver satisfaction (412, 74.4%), perceived ability to care (412, 74.4%), obligation to render caregiving (442, 76.2%), and an emotional attachment to the recipient (501, 90.4%). Caregiver burden assessed showed that the majority (378, 68.2%) had little to no burden, while severe burden was only found among a few (20, 3.6%) participants. Table 3 Caregiving dynamics, Caregiver wellbeing and perception Variable (N = 554) Frequency (%) Care Recipient Functional Ability High 530 (95.7) Low 24 (4.3) Caregiver Satisfaction Yes 412 (74.4) No 142 (25.6) Emotional Attachment to Recipient Yes 501 (90.4) No 53 (9.6) Obligation to Care Yes 442 (76.2) No 132 (23.8) Ability to Care Yes 412 (74.4) No 142 (25.6) Caregiver Burden Little to No 378 (68.2) Mild 124 (22.4) Moderate 32 (5.8) Severe 20 (3.6) A high proportion of the respondents (445, 80.3%) were willing to continue care. Those more willing to continue caregiving were older, married, close relatives, with a little to mild caregiver burden, and of a prolonged duration of care. The informal caregivers also had emotional attachment to the recipient, obligation to care, perceived ability to care and caregiver satisfaction. However, the predictors for the willingness to continue caregiving were perceived ability to care and caregiver satisfaction (Table 4 ). Respondents who had the perceived ability for caregiving were about 4 times more willing to continue caregiving (OR = 4.36; 95% CI [2.19, 8.68]) when compared with respondents with no perceived caregiving ability. Also, respondents who experienced caregiver satisfaction were about 6 times more willing to continue caregiving (OR = 5.75; 95% CI [2.98, 11.08]) when compared with respondents who did not experience caregiver satisfaction. Table 4 Logistic Regression for Predictors of the Willingness to Continue Caregiving Variables Adjusted OR* 95% C.I for OR p- Value Lower Upper Caregiver's Age 18–39 (ref) 1 40–59 1.67 0.85 3.28 0.14 ≥ 60 2.35 0.38 14.60 0.36 Caregiver Burden Little to No (ref) 1 Mild 1.71 0.82 3.54 0.15 Moderate 0.58 0.21 1.61 0.29 Severe 0.33 0.10 1.05 0.06 Caregiver Satisfaction No (ref) 1 Yes 5.75 2.98 11.08 < 0.001 Emotional Attachment to Recipient No (ref) 1 Yes 1.45 0.63 3.34 0.39 Obligation to Care No (ref) 1 Yes 1.51 0.77 2.95 0.23 Ability to Care No (ref) 1 Yes 4.36 2.19 8.68 < 0.001 Discussion This study determined the factors associated with the willingness to continue caregiving among informal caregivers in an urban setting in southwestern Nigeria. In this study, most care recipients had high functional ability, which is consistent with other community-based research. This contrasts with hospital-based studies, where older persons are typically more functionally dependent [ 19 , 20 ]. Ojifinni and Uchendu, in a community-based study among urban and rural respondents in southwestern Nigeria, also found a high level of functional ability among the older persons being cared for [ 21 ]. Filial care for older persons is seen as an altruistic behaviour, and it is considered the most culturally acceptable option for older persons in Africa, especially in Nigeria [ 7 , 22 – 24 ]. This finding is consistent with our study results, which show a high proportion of familial relationships among the study participants, and most of them acknowledge an obligation to provide caregiving and an emotional attachment to the recipient. Despite the obligation to care among the respondents, a majority of the informal caregivers expressed satisfaction with their role and felt a strong perceived ability to care and little caregiver burden. Zarzycki and Morrison have posited that, where filial caregiving is concerned, the obligation to care is not mutually exclusive from caregiving satisfaction [ 14 ]. Two key psychological constructs emerged as predictors for the willingness to continue caregiving in this study, which are the perceived ability for caregiving and caregiver satisfaction. This is similar to a study in China, which found that functional ability did not contribute to the willingness to care for older persons, but rather psychological factors, for example, caring out of love and relationship quality [ 25 ]. In a study in Germany, respondents attributed their willingness to care for their parents and closest relatives to love, reciprocity, and the desire to give something back to these individuals; and these are also all psychological motivations not dependent on caregiver burden or the functional ability of care recipients [ 26 ]. Evidence from a systematic review listed multiple factors contributing to the willingness to continue caregiving, among which are the obligation to care, caregiver appreciation by the community, avoidance of care homes and potential cost [ 27 ]. Findings in Nigeria also show that cultural norms and the avoidance of care homes are reasons to continue caregiving [ 3 ]. It is of note that these factors are not related to the functioning of the care recipient, and this further corroborates the findings of this study. Whereas the willingness to continue caregiving is not affected by the care recipient, the ability to continue caregiving is associated with functional and cognitive decline of the care recipient, as well as the caregiver burden [ 28 ]. Limitations of the study While the study provides valuable insights into the willingness to continue caregiving, a few limitations affect the generalizability of its findings. The study uses a cross-sectional design which captures a snapshot in time. This design cannot confirm if the reported willingness to continue caregiving will translate into the long-term act of continued caregiving. By relying solely on quantitative data, the study was unable to explore the deeper motivations and contextual factors that influence a caregiver's decision to continue their role. A qualitative approach, could have provided richer insights. Also, a longitudinal study would have been more effective in tracking how willingness to continue caregiving might change over time, especially if the care recipient's functional ability decreases and the caregiver's burden increases with advancing age. Other issues which may affect the generalizability of our findings include the findings of low caregiver burden. This may be a reflection of the fact that the study was community-based and most care recipients had high functional ability. This limits the generalizability of the findings to situations where care recipients are more functionally dependent and the caregiver burden is significantly higher. Implications for research and practice These results have significant implications for both research, policy and practice. Given the growing demand for informal care, understanding and promoting factors that contribute to informal caregivers' willingness to continue is crucial for maintaining the sustainability of care systems. Further qualitative research can be carried out to explore the motivations contributing to the willingness to continue caregiving. Also, there is a need for prospective longitudinal designs in research examining caregiving motivations and willingness to provide and continue caregiving, as these are dynamic in nature [ 14 ]. Conclusion This study reveals that a large majority of informal caregivers of community-dwelling older persons expressed willingness to continue caregiving. However, perceived ability to care and caregiver satisfaction emerged as the strongest predictors of this willingness. Interventions aimed at enhancing caregiver' ability to care should be explored. Furthermore, fostering caregiver satisfaction through support programs, may prove impactful. Declarations Informed Consent Written informed consent was obtained from all participants prior to the interview. Consent and already available data and/or biologic material Not Applicable Data protection, confidentiality and privacy Not Applicable Consent to participate Freely-given, written informed consent was obtained from all individual participants included in the study. Consent to Publish Not applicable Funding statement This research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No—G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Centre and the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS) 's Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa's Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the Fellow. Conflicts of interest/competing interests The authors have no conflicts of interest to declare that are relevant to the content of this article. Ethical Declaration The protocol was approved by the University of Ibadan/University College Hospital (UI/UCH) Ethical Review Committee (UI/EC/18/024) in accordance with the key ethical frameworks of the Nigerian National Code for Health Research Ethics (NHREC), Belmont Report, Declaration of Helsinki and the International Council for Harmonisation (ICH) / Good Clinical Practice (GCP) guidelines . All participants gave written informed consent for the survey before participating. Participants were assured that their identities would remain anonymous in all study reporting and that their personal information would be kept confidential. All methods in this study followed relevant guidelines and regulations in the Data and/or Code availability Data supporting Tables 1–4 are publicly available in the data repository. The data that support the findings of this study are available in Figshare with the identifier https://figshare.com/articles/dataset/CARES_Project_data_Willingness_to_continue_caregiving_sav/29925338/1?file=57235418 [29] https://doi.org/10.6084/m9.figshare.29925338.v1[29] Clinical trial number Clinical Trial not applicable. Authors’ contribution statements. Substantial contributions to conception and design were made by all authors, who also performed acquisition of data, analysis, and interpretation of data. The authors included Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye . Drafting and revising the article critically for its intellectual content were done by all authors: Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye . All authors reviewed final approval of the version to be published: Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye Acknowledgements Our gratitude goes to all the research assistants for their efforts during data collection and the wonderful participants in the Yemetu Alaadorin community. References Tan MP. Healthcare for older people in lower and middle income countries. Age Ageing. 2022;51(4). Ezulike JCD, Lu S, Lu MY. Aging and Caring: Exploring Older Adults' Motivation for Informal Caregiving to Other Aging Individuals in Nigeria. Innov Aging. 2024;8(4). Ikeorji CR, Ubani TGC. Supporting informal older adult caregivers in Nigeria: Recommendations for policy. African J Soc Work. 2024;14(6):311–20. Sacco LB, König S, Westerlund H, Platts LG. Informal Caregiving and Quality of Life Among Older Adults: Prospective Analyses from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Soc Indic Res. 2022;160(2–3):845–66. Ebimgbo SO, Atama CS, Igboeli EE, Obi-keguna CN, Odo CO. Community versus family support in caregiving of older adults: implications for social work practitioners in South-East Nigeria. Community, Work Fam. 2022;25(2):152–73. Law S, Ormel I, Babinski S, Kuluski K, Quesnel-Vallée A. "Caregiving is like on the job training but nobody has the manual": Canadian caregivers' perceptions of their roles within the healthcare system. BMC Geriatr. 2021;21(1). Ene J, Agwu P, Ekoh P, Okoye U. Is filial care for older adults in Nigeria threatened? Examining concerns from adult offspring providing care. J Aging Stud. 2022;63. Rodway C, Spencer R. Attachment in Old Age: A Fundamental Pillar for Public Health and Wellbeing. Int J Public Heal . 2025;70. Ping Y, Lim-Soh J, Østbye T, A'azman S, Ting Y, Malhotra R. Trajectories of Burden or Benefits of Caregiving Among Informal Caregivers of Older Adults: A Systematic Review. Innov Aging. 2025;9(4). Liu Z, Heffernan C, Tan J. Caregiver burden: A concept analysis. Int J Nurs Sci. 2020;7(4):438–45. Bongelli R, Busilacchi G, Pacifico A, Fabiani M, Guarascio C, Sofritti F, et al. Caregiving burden, social support, and psychological well-being among family caregivers of older Italians: a cross-sectional study. Front Public Heal. 2024;12. Cui P, Yang M, Hu H, Cheng C, Chen X, Shi J, et al. The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience. BMC Public Health. 2024;24(1). Sezek I, Cubukcu M, Muderrısoglu S. Care Burden and Life Satisfaction of Caregivers Who are Providing Home Health Care to Patients. Risk Manag Healthc Policy. 2023;16:2139–50. Zarzycki M, Morrison V. Getting back or giving back: understanding caregiver motivations and willingness to provide informal care. Heal Psychol Behav Med. 2021;9(1):636–61. Aliyu A, Amadu L. Urbanization, Cities, and Health: The Challenges to Nigeria – A Review. Ann Afr Med. 2017 Oct 1;16(4):149. Cadmus EO, Adebusoye LA, Owoaje ET. Ageing in place or stuck in place: Preferred care setting for community-dwelling older persons in a low-resource country in Sub Saharan Africa. PLoS One. 2023;18(10). Cadmus EO, Adebusoye LA, Owoaje ET. Rural–urban differences in quality of life and associated factors among community-dwelling older persons in Oyo state, South-Western Nigeria. Qual Quant. 2022;56(3):1327–44. Lee Y, Li L. Evaluating the Positive Experience of Caregiving: A Systematic Review of the Positive Aspects of Caregiving Scale. Gerontologist. 2022;62(9):E493–507. Faronbi JO, Akinyoola OD, Faronbi GO, Ojo FT. Factors contributing to functional dependence among older adults in Ile–Ife, Nigeria. Int J Africa Nurs Sci. 2021;14. Fidecki WM, Kijowska A, Kachaniuk H, Dziubaszewska R, Dziura M, Jędrzejewska A, et al. Functional ability of the elderly and related factors in the Subcarpathian Region. Ann Agric Environ Med. 2025; Ojifinni OO, Uchendu OC. Experience of burden of care among adult caregivers of elderly persons in Oyo State, Nigeria: a cross-sectional study. Pan Afr Med J. 2022;42. Watts MC. Aging away from home: a cultural context and workforce challenges for African Australians; the necessity for an 'Afrocentric' care model in Australia. Front Public Heal. 2025;13. Bedford O, Yeh KH, Tan CS. Editorial: Filial piety as a universal construct: From cultural norms to psychological motivations. Front Psychol. 2022;13. Esiaka DK, Luth E. Different Interpretations of "Honor Your Parents": Implications for Obligation of Parental Caregiving. Journals Gerontol - Ser B Psychol Sci Soc Sci. 2023;78(11):1787–95. Li J, Zhan JC, Xie CH, Han SY. Family caregiver's willingness to care from the perspective of altruism. Front Public Heal. 2023;11. de Jong L, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences. BMC Geriatr. 2021;21(1). Zarzycki M, Morrison V, Bei E, Seddon D. Cultural and societal motivations for being informal caregivers: a qualitative systematic review and meta-synthesis. Health Psychol Rev. 2023;17(2):247–76. Wang S, de Almeida Mello J, Declercq A. Factors associated with informal caregiver's ability to continue care: a subgroup analysis. Age Ageing. 2022;51(12). Ilugbo JO, Cadmus EO, Owoaje, ET, Adebusoye LA. CARES Project data Willingness to continue caregiving .sav. figshare. Dataset 2025; https://doi.org/10.6084/m9.figshare.29925338.v1. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7398719","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":512497895,"identity":"793fb86f-322b-4ac6-9a0e-059579d7b061","order_by":0,"name":"Eniola O. Cadmus","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYFACxgYGhgIQIwGIK4CYmbmBCC0GMC1nQFoYCWkBAZgWxjaYIXgAv3Rzm8QHAzt5/vbsNMmf82qj+duBWn5UbMOpRXLOwTbJGQbJhjPOvN0mzbvteO6Mw4wNjD1nbuN20o3ENmkeA+YEhhu526QZtx3LbQBqYWZsw63FHqKlPkEeqEXy55xjufMJaTGQAGs5nGAA1CLB21CTu4GQFokbic2WMwyOG24883azNc+xA7kbgVoO4vML/4z0hzc+VFTLyx3P3XjzR01d7rzzhw8++FGBWwsQsEggcQ6DyQP41AMB8wckTh0BxaNgFIyCUTASAQDpbl0Yq6cq3QAAAABJRU5ErkJggg==","orcid":"","institution":"University of Ibadan","correspondingAuthor":true,"prefix":"","firstName":"Eniola","middleName":"O.","lastName":"Cadmus","suffix":""},{"id":512497897,"identity":"8b90eaf1-17ef-4a3a-906f-efe7a2fdcd0e","order_by":1,"name":"John Oluwakayode Ilugbo","email":"","orcid":"","institution":"University College Hospital Ibadan","correspondingAuthor":false,"prefix":"","firstName":"John","middleName":"Oluwakayode","lastName":"Ilugbo","suffix":""},{"id":512497899,"identity":"a65778f2-cfbf-42a5-a707-ecf5ae1c4e28","order_by":2,"name":"Joy O. Olatunde","email":"","orcid":"","institution":"University of Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Joy","middleName":"O.","lastName":"Olatunde","suffix":""},{"id":512497901,"identity":"45eba0f0-bdc4-4c1d-b0b3-36ce721bb162","order_by":3,"name":"Aderonke A. Alabi","email":"","orcid":"","institution":"University College Hospital Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Aderonke","middleName":"A.","lastName":"Alabi","suffix":""},{"id":512497906,"identity":"0628f396-9bc8-49c3-bc5b-5aabbf0ae82a","order_by":4,"name":"Oluwaseun K. Ajayi","email":"","orcid":"","institution":"University College Hospital Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Oluwaseun","middleName":"K.","lastName":"Ajayi","suffix":""},{"id":512497909,"identity":"73e8fd44-c108-42d3-bf06-e866c7458166","order_by":5,"name":"Eme T. Owoaje","email":"","orcid":"","institution":"University of Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Eme","middleName":"T.","lastName":"Owoaje","suffix":""},{"id":512497910,"identity":"9e60edb5-2344-4dd7-a34e-0641453658fb","order_by":6,"name":"Lawrence A. Adebusoye","email":"","orcid":"","institution":"University of Ibadan","correspondingAuthor":false,"prefix":"","firstName":"Lawrence","middleName":"A.","lastName":"Adebusoye","suffix":""}],"badges":[],"createdAt":"2025-08-18 10:38:19","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7398719/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7398719/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108079378,"identity":"e1603dc3-0dc5-4001-ad21-7655169423ac","added_by":"auto","created_at":"2026-04-29 07:26:51","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":337921,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7398719/v1/9a653000-d06f-4dbb-a0b1-d16128f48a54.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Willingness to continue caregiving among informal caregivers of community-dwelling older persons in southwestern Nigeria","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGlobally, there is an increase in the population of older persons aged 60 years and above [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Nigeria is not left out of this trend, having the highest population of older persons in Africa [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Older persons often need to be cared for. Unlike other climes where there are accessible options of care facilities, the care for older persons in Southwestern Nigeria, as in many parts of sub-Saharan Africa, falls on informal caregivers [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. However, informal caregiving of older persons is a time-consuming and demanding role often entered into with little to no preparation [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Studies in Nigeria have shown that family members, community members, including those of the religious community, usually provide the needed care for these older persons [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. These informal caregivers often become caregivers based on necessity, having no formal training or prior skill set in caregiving [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Hence, there may be a perceived lack of capacity for caregiving among these informal caregivers.\u003c/p\u003e\u003cp\u003eIn Nigeria, strong filial piety and community bonds make informal caregivers see the act of caregiving for their older persons as a moral and cultural responsibility [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e], irrespective of their capacity for caregiving. Also, emotional bonds and attachment between older persons and caregivers can further strengthen the decision to continue caregiving [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Hence, the older persons are dependent on their informal caregivers for their daily needs, medical support, emotional support and well-being [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. It is therefore crucial for older persons to have a caregiver willing to continue caregiving, as an abrupt stop can negatively impact the daily activity, health and well-being of the older person.\u003c/p\u003e\u003cp\u003eWhile ongoing caregiving is crucial for the health of older adults, it also presents many challenges for informal caregivers. Informal caregivers experience a significant burden in discharging their duties [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Many studies have looked into caregivers' burden, as it often impacts the quality of life and well-being of the caregivers [\u003cspan additionalcitationids=\"CR11\" citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Caregiver burden has also been linked with caregiver satisfaction, and these two have been shown to contribute to the willingness to continue caregiving in other climes [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. However, there is a paucity of research in Southwestern Nigeria on how these factors interplay with the willingness to continue caregiving among the informal caregivers.\u003c/p\u003e\u003cp\u003eUnderstanding the willingness of informal caregivers to continue in this role is essential for ensuring long-term care provision for older persons, especially in low-resource settings such as Nigeria. Also, understanding the factors associated with the willingness to continue caregiving among these informal caregivers is crucial for developing sustainable support interventions for both the caregivers and the older persons. This study assessed the willingness to continue caregiving and its predictors among informal caregivers of community-dwelling older persons in Oyo State, Southwestern Nigeria, identifying ways to enhance their capacity and willingness to continue caregiving.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eA community-based cross-sectional study was carried out using quantitative methods to understand the willingness to continue caregiving among informal caregivers in Oyo State.\u003c/p\u003e\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eStudy area\u003c/h2\u003e\u003cp\u003eThe study was conducted in Ibadan, the capital of Oyo State, Southwestern Nigeria. Oyo State is one of the 36 states of the Federal Republic of Nigeria, located in the Southwestern geopolitical zone of Nigeria. There are 12 urban, 9 semi-urban and 12 rural Local Government Areas (LGAs) in the State. The National population census figures for 2006 indicated that the State had a population of 5,580,894, with a 2025 projection of 10,153,553 assuming an annual growth rate of 3.2% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The proportion of older persons in Oyo State is 6% [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eStudy site\u003c/h3\u003e\n\u003cp\u003eThe study was conducted in Yemetu Alaadorin, a settlement in Ibadan North, an urban LGA in Oyo State. The residents are mainly of the Yoruba ethnic group. The study site is under the purview of the Department of Community Medicine, College of Medicine, University of Ibadan, and has been geographically mapped and listed [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Ibadan North LGA (IBNLGA) is a densely populated urban area with a population of 432,900. About 4% (18,524) of the people of Ibadan North LGA are aged 60 years and above [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e].\u003c/p\u003e\n\u003ch3\u003eStudy participants\u003c/h3\u003e\n\u003cp\u003eStudy participants must have resided in the community for at least a year before the study, be aged 18 years or above, and have provided unpaid care for a person aged 60 years and above for a minimum of 6 months. Informal caregivers unable to read and write were excluded from the study.\u003c/p\u003e\n\u003ch3\u003eSample size and sampling technique\u003c/h3\u003e\n\u003cp\u003eUsing the formula for estimating proportions, assuming a difference of 10%, power of 80%, α of 5% and adjusting for a 10% non-response rate, the calculated minimum sample size for the survey was 426 participants. However, 554 informal caregivers of community-dwelling older persons were recruited for the study using a multistage sampling technique.\u003c/p\u003e\n\u003ch3\u003eData collection\u003c/h3\u003e\n\u003cp\u003eData were collected using a semi-structured interviewer-administered questionnaire. The questionnaire consisted of the Caregiver Continuation Desire Scale (CCDS), the Zarit Burden Interview, and a 15-item physical status assessment tool for older persons. The survey was deployed using the Research Electronic Data Capture (REDCap) on mobile devices (tablets).\u003c/p\u003e\u003cp\u003eThe Caregiver Continuation Desire Scale (CCDS) tool was used to assess and understand the positive aspects of caregiving [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. It focuses on recognising the beneficial aspects of providing care to others, which can be essential in supporting caregivers. This tool aims to assess the caregiver's emotional attachment, perceived obligation, satisfaction, confidence, and overall desire to continue with caregiving, providing valuable insights into their motivation and needs. The scale covers four main positive aspects, including caregiving personal gains, motivation for the caregiving role, caregiver satisfaction, self-esteem and social aspects of caring.\u003c/p\u003e\u003cp\u003eCaregiver burden was assessed using the 22-item standardised, validated Zarit Burden Interview (ZBI) tool. This tool reflects how people sometimes feel when caring for other people. The ZBI scale is a 22-item questionnaire with each item rated from 0\u0026ndash;88 (a higher score denotes a higher burden for a particular item) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. The total burden for a subject is the sum of the scores in all the items endorsed. The scores were categorised as follows: 0\u0026ndash;20, little or no burden; 21\u0026ndash;30, mild burden; 31\u0026ndash;40, moderate burden; and 41\u0026ndash;88, severe burden.\u003c/p\u003e\u003cp\u003eThe research instrument was translated into the local Yoruba language for easy communication. It was back-translated to English to ensure the original meanings were maintained before administration. A pre-test was conducted among the older persons in a different LGA from those selected for the study. Following the pre-test, ambiguous questions were rephrased or removed where necessary. Each of the interviews lasted between 30 minutes to 45 minutes.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eData analysis\u003c/h2\u003e\u003cp\u003eThe primary outcome variable was the willingness to continue care, and it was categorised as yes or no. Data were analysed using SPSS version 25. Descriptive statistics were done to summarise the variables using proportions, means and standard deviations. Bivariate analysis measured associations between the outcome and independent variables, using the chi-square test. The variables which were found to be significantly associated with the willingness to continue caregiving at 5% level of significance were entered into a logistic regression model. These variables included the caregiver's age, marital status, relationship to recipient, duration of care, caregiver burden, emotional attachment to recipient, obligation to care, perceived ability to care and caregiver satisfaction. This regression model was used to identify the predictors of the willingness to continue caregiving at a confidence interval of 95%.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eEthical considerations\u003c/h3\u003e\n\u003cp\u003eEthical approval was obtained from the University of Ibadan/University College Hospital (UI/UCH) Ethical Review Committee (UI/EC/18/024). All participants gave written consent for the survey before participating. Participants were assured that their identities would remain anonymous in all study reporting and that their personal information would be kept confidential. All methods in this study followed relevant guidelines and regulations in the Ethical Declarations.\u003c/p\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eA total of 554 informal caregivers completed the study with a mean age of 37.24 (\u0026plusmn;\u0026thinsp;12.54) years. The majority of the caregivers were of the Yoruba tribe (527, 95.1%), females (463, 83.6%), married (426, 76.9%), completed secondary school (12 years of education) (323, 58.3%), and employed (518, 93.5%). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). Most of the caregivers (410, 74%) belonged to households with only one care recipient (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Almost two-thirds of the informal caregivers (361, 65.2%) were children of the recipients, followed by other relatives (147, 26.5%). The majority of the informal caregivers (365, 65.9%) had been taking care of the care recipients for less than 5 years, and they provided care and support daily (326, 58.8%). The mean age of the older persons being cared for was 79.81 (\u0026plusmn;\u0026thinsp;12.28) years, and they were mostly females (424, 76.5%).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eSocio-demographic Characteristics of Informal Caregivers (N\u0026thinsp;=\u0026thinsp;554)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003en (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge (in years)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;39\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e328 (59.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u0026ndash;59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e195 (35.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e31 (5.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean (S.D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e37.24 (\u0026plusmn;\u0026thinsp;12.54)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e91 (16.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e463 (83.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eMarital Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e94 (17.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e426 (76.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDivorced\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e10 (1.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (4.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEthnicity\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYoruba\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e527 (95.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e27 (4.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePrimary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e145 (26.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSecondary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e323 (58.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eTertiary\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e86 (15.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmployment Status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eUnemployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36 (6.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e518 (93.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of Care Recipient and Circumstances of Care (N\u0026thinsp;=\u0026thinsp;554)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge of Care Recipient (in years)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e60\u0026ndash;74\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e184 (33.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;75\u003c/p\u003e \u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e370 (66.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMean (S.D)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e79.81 (\u0026plusmn;\u0026thinsp;12.28)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGender of Care Recipient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e130 (23.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e424 (76.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eRelationship of Informal Caregiver\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20 (3.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eChild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e361 (65.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eRelatives\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e147 (26.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eOthers*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e26 (4.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of Years of Care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026le; 5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e365 (65.9)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge; 6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e189 (34.1)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFrequency of Care/Support\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eDaily\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e326 (58.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSeveral times a week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124 (22.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAt least once a week\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e68 (12.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLess Often\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e36 (6.5)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eNumber of Older Persons in Household\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e410 (74.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e144 (26.0)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"2\"\u003e*Others include friends, neighbours, and religious members\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, the majority of care recipients (530, 95.7%) were reported to have a high functional ability. Among the informal caregivers, the majority had caregiver satisfaction (412, 74.4%), perceived ability to care (412, 74.4%), obligation to render caregiving (442, 76.2%), and an emotional attachment to the recipient (501, 90.4%). Caregiver burden assessed showed that the majority (378, 68.2%) had little to no burden, while severe burden was only found among a few (20, 3.6%) participants.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCaregiving dynamics, Caregiver wellbeing and perception\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"2\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eVariable (N\u0026thinsp;=\u0026thinsp;554)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFrequency (%)\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCare Recipient Functional Ability\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eHigh\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e530 (95.7)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLow\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e24 (4.3)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCaregiver Satisfaction\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e412 (74.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e142 (25.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmotional Attachment to Recipient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e501 (90.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e53 (9.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eObligation to Care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e442 (76.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e132 (23.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAbility to Care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e412 (74.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e142 (25.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCaregiver Burden\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLittle to No\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e378 (68.2)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e124 (22.4)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e32 (5.8)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e\u003cp\u003e20 (3.6)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eA high proportion of the respondents (445, 80.3%) were willing to continue care. Those more willing to continue caregiving were older, married, close relatives, with a little to mild caregiver burden, and of a prolonged duration of care. The informal caregivers also had emotional attachment to the recipient, obligation to care, perceived ability to care and caregiver satisfaction. However, the predictors for the willingness to continue caregiving were perceived ability to care and caregiver satisfaction (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Respondents who had the perceived ability for caregiving were about 4 times more willing to continue caregiving (OR\u0026thinsp;=\u0026thinsp;4.36; 95% CI [2.19, 8.68]) when compared with respondents with no perceived caregiving ability. Also, respondents who experienced caregiver satisfaction were about 6 times more willing to continue caregiving (OR\u0026thinsp;=\u0026thinsp;5.75; 95% CI [2.98, 11.08]) when compared with respondents who did not experience caregiver satisfaction.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eLogistic Regression for Predictors of the Willingness to Continue Caregiving\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eVariables\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003eAdjusted OR*\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e95% C.I for OR\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003ep- Value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eLower\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eUpper\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCaregiver's Age\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e18\u0026ndash;39 \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e40\u0026ndash;59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.85\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.14\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u0026ge;\u0026thinsp;60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e14.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.36\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCaregiver Burden\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eLittle to No \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eMild\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.82\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.15\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eModerate\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.29\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSevere\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e1.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.06\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCaregiver Satisfaction\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e5.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.98\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e11.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmotional Attachment to Recipient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.39\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eObligation to Care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e0.77\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e2.95\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e0.23\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eAbility to Care\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eNo \u003cem\u003e(ref)\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e4.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2.19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e8.68\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e\u0026lt;\u0026thinsp;0.001\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis study determined the factors associated with the willingness to continue caregiving among informal caregivers in an urban setting in southwestern Nigeria. In this study, most care recipients had high functional ability, which is consistent with other community-based research. This contrasts with hospital-based studies, where older persons are typically more functionally dependent [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Ojifinni and Uchendu, in a community-based study among urban and rural respondents in southwestern Nigeria, also found a high level of functional ability among the older persons being cared for [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eFilial care for older persons is seen as an altruistic behaviour, and it is considered the most culturally acceptable option for older persons in Africa, especially in Nigeria [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan additionalcitationids=\"CR23\" citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This finding is consistent with our study results, which show a high proportion of familial relationships among the study participants, and most of them acknowledge an obligation to provide caregiving and an emotional attachment to the recipient. Despite the obligation to care among the respondents, a majority of the informal caregivers expressed satisfaction with their role and felt a strong perceived ability to care and little caregiver burden. Zarzycki and Morrison have posited that, where filial caregiving is concerned, the obligation to care is not mutually exclusive from caregiving satisfaction [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eTwo key psychological constructs emerged as predictors for the willingness to continue caregiving in this study, which are the perceived ability for caregiving and caregiver satisfaction. This is similar to a study in China, which found that functional ability did not contribute to the willingness to care for older persons, but rather psychological factors, for example, caring out of love and relationship quality [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. In a study in Germany, respondents attributed their willingness to care for their parents and closest relatives to love, reciprocity, and the desire to give something back to these individuals; and these are also all psychological motivations not dependent on caregiver burden or the functional ability of care recipients [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e].\u003c/p\u003e\u003cp\u003eEvidence from a systematic review listed multiple factors contributing to the willingness to continue caregiving, among which are the obligation to care, caregiver appreciation by the community, avoidance of care homes and potential cost [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Findings in Nigeria also show that cultural norms and the avoidance of care homes are reasons to continue caregiving [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. It is of note that these factors are not related to the functioning of the care recipient, and this further corroborates the findings of this study. Whereas the willingness to continue caregiving is not affected by the care recipient, the ability to continue caregiving is associated with functional and cognitive decline of the care recipient, as well as the caregiver burden [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e].\u003c/p\u003e\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e\u003ch2\u003eLimitations of the study\u003c/h2\u003e\u003cp\u003eWhile the study provides valuable insights into the willingness to continue caregiving, a few limitations affect the generalizability of its findings. The study uses a cross-sectional design which captures a snapshot in time. This design cannot confirm if the reported willingness to continue caregiving will translate into the long-term act of continued caregiving. By relying solely on quantitative data, the study was unable to explore the deeper motivations and contextual factors that influence a caregiver's decision to continue their role. A qualitative approach, could have provided richer insights. Also, a longitudinal study would have been more effective in tracking how willingness to continue caregiving might change over time, especially if the care recipient's functional ability decreases and the caregiver's burden increases with advancing age. Other issues which may affect the generalizability of our findings include the findings of low caregiver burden. This may be a reflection of the fact that the study was community-based and most care recipients had high functional ability. This limits the generalizability of the findings to situations where care recipients are more functionally dependent and the caregiver burden is significantly higher.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eImplications for research and practice\u003c/h2\u003e\u003cp\u003eThese results have significant implications for both research, policy and practice. Given the growing demand for informal care, understanding and promoting factors that contribute to informal caregivers' willingness to continue is crucial for maintaining the sustainability of care systems. Further qualitative research can be carried out to explore the motivations contributing to the willingness to continue caregiving. Also, there is a need for prospective longitudinal designs in research examining caregiving motivations and willingness to provide and continue caregiving, as these are dynamic in nature [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e].\u003c/p\u003e\u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study reveals that a large majority of informal caregivers of community-dwelling older persons expressed willingness to continue caregiving. However, perceived ability to care and caregiver satisfaction emerged as the strongest predictors of this willingness. Interventions aimed at enhancing caregiver' ability to care should be explored. Furthermore, fostering caregiver satisfaction through support programs, may prove impactful.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eInformed Consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent was obtained from all participants prior to the interview.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent and already available data and/or biologic material\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData protection, confidentiality and privacy\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot Applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFreely-given, written informed consent was obtained from all individual participants included in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to Publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis research was supported by the Consortium for Advanced Research Training in Africa (CARTA). CARTA is jointly led by the African Population and Health Research Center and the University of the Witwatersrand and funded by the Carnegie Corporation of New York (Grant No\u0026mdash;G-19-57145), Sida (Grant No:54100113), Uppsala Monitoring Centre and the DELTAS Africa Initiative (Grant No: 107768/Z/15/Z). The DELTAS Africa Initiative is an independent funding scheme of the African Academy of Sciences (AAS) \u0026apos;s Alliance for Accelerating Excellence in Science in Africa (AESA) and supported by the New Partnership for Africa\u0026apos;s Development Planning and Coordinating Agency (NEPAD Agency) with funding from the Wellcome Trust (UK) and the UK government. The statements made and views expressed are solely the responsibility of the Fellow.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflicts of interest/competing interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors have no conflicts of interest to declare that are relevant to the content of this article.\u003c/p\u003e\n\u003cp\u003eEthical Declaration\u003c/p\u003e\n\u003cp\u003eThe protocol was approved by the University of Ibadan/University College Hospital (UI/UCH) Ethical Review Committee (UI/EC/18/024) in accordance with the key ethical frameworks of the Nigerian National Code for Health Research Ethics (NHREC), Belmont Report, Declaration of Helsinki and the International Council for Harmonisation (ICH) / Good Clinical Practice (GCP) guidelines . All participants gave written informed consent for the survey before participating. Participants were assured that their identities would remain anonymous in all study reporting and that their personal information would be kept confidential. All methods in this study followed relevant guidelines and regulations in the\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData and/or Code availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData supporting Tables 1\u0026ndash;4 are publicly available in the data repository.\u0026nbsp;The \u0026nbsp;data that support the findings of this study are available in Figshare with the identifier\u003c/p\u003e\n\u003cp\u003ehttps://figshare.com/articles/dataset/CARES_Project_data_Willingness_to_continue_caregiving_sav/29925338/1?file=57235418 [29]\u003c/p\u003e\n\u003cp\u003ehttps://doi.org/10.6084/m9.figshare.29925338.v1[29]\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical trial number\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eClinical Trial not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contribution statements.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSubstantial contributions to conception and design were made by all authors, who also performed acquisition of data, analysis, and interpretation of data. The authors included Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye\u003csup\u003e.\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eDrafting and revising the article critically for its intellectual content were done by all authors: Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye\u003csup\u003e.\u003c/sup\u003e\u003c/p\u003e\n\u003cp\u003eAll authors reviewed final approval of the version to be published: Eniola O. Cadmus, John Oluwakayode Ilugbo, Joy O. Olatunde, Aderonke A. Alabi, Oluwaseun K. Ajayi, Eme T. Owoaje, and Lawrence A. Adebusoye\u003c/p\u003e\n\u003cp\u003eAcknowledgements\u003c/p\u003e\n\u003cp\u003eOur gratitude goes to all the research assistants for their efforts during data collection and the wonderful participants in the Yemetu Alaadorin community.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eTan MP. Healthcare for older people in lower and middle income countries. Age Ageing. 2022;51(4). \u003c/li\u003e\n\u003cli\u003eEzulike JCD, Lu S, Lu MY. Aging and Caring: Exploring Older Adults\u0026apos; Motivation for Informal Caregiving to Other Aging Individuals in Nigeria. Innov Aging. 2024;8(4). \u003c/li\u003e\n\u003cli\u003eIkeorji CR, Ubani TGC. Supporting informal older adult caregivers in Nigeria: Recommendations for policy. African J Soc Work. 2024;14(6):311\u0026ndash;20. \u003c/li\u003e\n\u003cli\u003eSacco LB, K\u0026ouml;nig S, Westerlund H, Platts LG. Informal Caregiving and Quality of Life Among Older Adults: Prospective Analyses from the Swedish Longitudinal Occupational Survey of Health (SLOSH). Soc Indic Res. 2022;160(2\u0026ndash;3):845\u0026ndash;66. \u003c/li\u003e\n\u003cli\u003eEbimgbo SO, Atama CS, Igboeli EE, Obi-keguna CN, Odo CO. Community versus family support in caregiving of older adults: implications for social work practitioners in South-East Nigeria. Community, Work Fam. 2022;25(2):152\u0026ndash;73. \u003c/li\u003e\n\u003cli\u003eLaw S, Ormel I, Babinski S, Kuluski K, Quesnel-Vall\u0026eacute;e A. \u0026quot;Caregiving is like on the job training but nobody has the manual\u0026quot;: Canadian caregivers\u0026apos; perceptions of their roles within the healthcare system. BMC Geriatr. 2021;21(1). \u003c/li\u003e\n\u003cli\u003eEne J, Agwu P, Ekoh P, Okoye U. Is filial care for older adults in Nigeria threatened? Examining concerns from adult offspring providing care. J Aging Stud. 2022;63. \u003c/li\u003e\n\u003cli\u003eRodway C, Spencer R. Attachment in Old Age: A Fundamental Pillar for Public Health and Wellbeing. Int J Public Heal . 2025;70. \u003c/li\u003e\n\u003cli\u003ePing Y, Lim-Soh J, \u0026Oslash;stbye T, A\u0026apos;azman S, Ting Y, Malhotra R. Trajectories of Burden or Benefits of Caregiving Among Informal Caregivers of Older Adults: A Systematic Review. Innov Aging. 2025;9(4). \u003c/li\u003e\n\u003cli\u003eLiu Z, Heffernan C, Tan J. Caregiver burden: A concept analysis. Int J Nurs Sci. 2020;7(4):438\u0026ndash;45. \u003c/li\u003e\n\u003cli\u003eBongelli R, Busilacchi G, Pacifico A, Fabiani M, Guarascio C, Sofritti F, et al. Caregiving burden, social support, and psychological well-being among family caregivers of older Italians: a cross-sectional study. Front Public Heal. 2024;12. \u003c/li\u003e\n\u003cli\u003eCui P, Yang M, Hu H, Cheng C, Chen X, Shi J, et al. The impact of caregiver burden on quality of life in family caregivers of patients with advanced cancer: a moderated mediation analysis of the role of psychological distress and family resilience. BMC Public Health. 2024;24(1). \u003c/li\u003e\n\u003cli\u003eSezek I, Cubukcu M, Muderrısoglu S. Care Burden and Life Satisfaction of Caregivers Who are Providing Home Health Care to Patients. Risk Manag Healthc Policy. 2023;16:2139\u0026ndash;50. \u003c/li\u003e\n\u003cli\u003eZarzycki M, Morrison V. Getting back or giving back: understanding caregiver motivations and willingness to provide informal care. Heal Psychol Behav Med. 2021;9(1):636\u0026ndash;61. \u003c/li\u003e\n\u003cli\u003eAliyu A, Amadu L. Urbanization, Cities, and Health: The Challenges to Nigeria \u0026ndash; A Review. Ann Afr Med. 2017 Oct 1;16(4):149. \u003c/li\u003e\n\u003cli\u003eCadmus EO, Adebusoye LA, Owoaje ET. Ageing in place or stuck in place: Preferred care setting for community-dwelling older persons in a low-resource country in Sub Saharan Africa. PLoS One. 2023;18(10). \u003c/li\u003e\n\u003cli\u003eCadmus EO, Adebusoye LA, Owoaje ET. Rural\u0026ndash;urban differences in quality of life and associated factors among community-dwelling older persons in Oyo state, South-Western Nigeria. Qual Quant. 2022;56(3):1327\u0026ndash;44. \u003c/li\u003e\n\u003cli\u003eLee Y, Li L. Evaluating the Positive Experience of Caregiving: A Systematic Review of the Positive Aspects of Caregiving Scale. Gerontologist. 2022;62(9):E493\u0026ndash;507. \u003c/li\u003e\n\u003cli\u003eFaronbi JO, Akinyoola OD, Faronbi GO, Ojo FT. Factors contributing to functional dependence among older adults in Ile\u0026ndash;Ife, Nigeria. Int J Africa Nurs Sci. 2021;14. \u003c/li\u003e\n\u003cli\u003eFidecki WM, Kijowska A, Kachaniuk H, Dziubaszewska R, Dziura M, Jędrzejewska A, et al. Functional ability of the elderly and related factors in the Subcarpathian Region. Ann Agric Environ Med. 2025; \u003c/li\u003e\n\u003cli\u003eOjifinni OO, Uchendu OC. Experience of burden of care among adult caregivers of elderly persons in Oyo State, Nigeria: a cross-sectional study. Pan Afr Med J. 2022;42. \u003c/li\u003e\n\u003cli\u003eWatts MC. Aging away from home: a cultural context and workforce challenges for African Australians; the necessity for an \u0026apos;Afrocentric\u0026apos; care model in Australia. Front Public Heal. 2025;13. \u003c/li\u003e\n\u003cli\u003eBedford O, Yeh KH, Tan CS. Editorial: Filial piety as a universal construct: From cultural norms to psychological motivations. Front Psychol. 2022;13. \u003c/li\u003e\n\u003cli\u003eEsiaka DK, Luth E. Different Interpretations of \u0026quot;Honor Your Parents\u0026quot;: Implications for Obligation of Parental Caregiving. Journals Gerontol - Ser B Psychol Sci Soc Sci. 2023;78(11):1787\u0026ndash;95. \u003c/li\u003e\n\u003cli\u003eLi J, Zhan JC, Xie CH, Han SY. Family caregiver\u0026apos;s willingness to care from the perspective of altruism. Front Public Heal. 2023;11. \u003c/li\u003e\n\u003cli\u003ede Jong L, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Willingness and preparedness to provide care: interviews with individuals of different ages and with different caregiving experiences. BMC Geriatr. 2021;21(1). \u003c/li\u003e\n\u003cli\u003eZarzycki M, Morrison V, Bei E, Seddon D. Cultural and societal motivations for being informal caregivers: a qualitative systematic review and meta-synthesis. Health Psychol Rev. 2023;17(2):247\u0026ndash;76. \u003c/li\u003e\n\u003cli\u003eWang S, de Almeida Mello J, Declercq A. Factors associated with informal caregiver\u0026apos;s ability to continue care: a subgroup analysis. Age Ageing. 2022;51(12). \u003c/li\u003e\n\u003cli\u003eIlugbo JO, Cadmus EO, Owoaje, ET, Adebusoye LA. CARES Project data Willingness to continue caregiving .sav. figshare. Dataset 2025; https://doi.org/10.6084/m9.figshare.29925338.v1.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Willingness to continue caregiving, Community-dwelling older persons, informal caregivers","lastPublishedDoi":"10.21203/rs.3.rs-7398719/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7398719/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground\u003c/h2\u003e\u003cp\u003eInformal caregiving of older persons is a time-consuming and demanding role often undertaken without preparation. Understanding a caregiver's willingness to continue is crucial for long-term care, especially in low-resource settings such as Nigeria. This study examined the factors influencing the willingness of informal caregivers of community-dwelling older persons to continue in their roles.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e\u003cp\u003eA cross-sectional study was carried out in Oyo State, southwestern Nigeria. Data were collected from 554 informal caregivers using a semi-structured interviewer-administered questionnaire. The Caregiver Continuation Desire Scale (CCDS) questionnaire, Zarit Burden Interview, and a 15-item adopted physical status assessment tool for older persons were used to collect data and analysed using SPSS version 25 at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eThe mean age of the informal caregivers was 37.24 (\u0026plusmn;\u0026thinsp;12.54) years, most were female (83.6%), married (76.9%), and employed (93.5%). The mean age of the care recipients was 79.81 (\u0026plusmn;\u0026thinsp;12.28) years, and they were predominantly females (76.5%). Most of the informal caregivers (80.3%) were willing to continue caregiving. The predictors of this willingness were caregivers' perceived ability to care (OR\u0026thinsp;=\u0026thinsp;4.36; 95% CI [2.19, 8.68]) and their satisfaction with the role (OR\u0026thinsp;=\u0026thinsp;5.75; 95% CI [2.98, 11.08]).\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eThe willingness of the informal caregivers to continue caregiving was strongly predicted by their perceived ability to care and their satisfaction with the role. This finding highlights the need for programs and resources that support and equip informal caregivers with skills and knowledge necessary to manage the demands of their roles effectively.\u003c/p\u003e","manuscriptTitle":"Willingness to continue caregiving among informal caregivers of community-dwelling older persons in southwestern Nigeria","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 08:32:48","doi":"10.21203/rs.3.rs-7398719/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"dc0cf0ef-2f31-450a-b502-ceaefdf6a294","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-04-29T07:26:17+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-11 08:32:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7398719","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7398719","identity":"rs-7398719","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}