Factors associated with the perception of services by dementia informal caregivers in Greece: the role of familism

Aim: To investigate perceptions of informal caregivers of community-dwelling persons with dementia (PwD) regarding health and social care services and their correlates using the Behavioral Model of Healthcare Utilization as the theoretical framework. Methods: This was a cross-sectional study using a purposive sampling technique to identify, through community-based health and social care services, caregivers of PwD. Face-to-face interviews were conducted with 118 informal caregivers (78.8% female, mean age = 58.9 years) via a structured questionnaire. Results: Three ‘Perceptions of Services’ subscales were identified: ‘Availability and Adequacy of Services’ (AAS), ‘Physicians’ Competence’ (COMP), and ‘Professionals' Behavior’ (PB). Predisposing factors (gender, employment, familism) and enabling/impeding factors (caregiving impedes work, quality of life aspects–environment and social relationships, information about dementia) were significant correlates of the AAS and COMP subscales. Familism was negatively associated with the AAS subscale. PwD’s perceived declined physical and behavioral functioning was related to worse perceptions regarding professionals’ behavior (PB) toward the PwD. Conclusion: Understanding the factors associated with caregivers' perceptions of health and social care community services may guide the development of interventions that facilitate the appropriate use of those services, provide increased support to PwD and their caregivers, and delay potential institutionalization.