# Illness Integration in Caregivers’ Identity: Associations with Care-Burden, Well-Being, and Attachment Orientation

## TL;DR

Caregivers who accept a loved one's illness into their identity experience better well-being and less burden, but attachment styles influence these outcomes.

## Contribution

This study introduces illness integration as a key psychological mechanism linking identity processes to caregiver burden and well-being.

## Key findings

- Caregivers who accepted the illness into their identity reported better well-being and lower care-burden.
- High attachment anxiety was linked to feelings of engulfment and increased burden.
- Avoidant attachment was associated with difficulty accepting the illness and higher burden.

## Abstract

Caregiving can provide purpose and life satisfaction but is often linked to increased burden and reduced quality of life. Understanding mechanisms influencing caregivers’ experiences is crucial for effective support. One key factor is illness integration—the extent to which caregivers incorporate the patient’s illness into their identity. Caregivers may feel engulfed, reject, accept, or find enrichment in the illness, shaping their psychological outcomes. This study examines the relationships between illness integration, care burden, well-being, and attachment orientation to illuminate identity processes in caregiving and guide interventions to reduce strain and foster resilience. The results from our cross-sectional online survey of 162 informal caregivers indicated that caregivers predominantly accepted their loved ones’ illness into their identity, and this acceptance was in turn associated with both their well-being and care-burden. Caregivers high on attachment anxiety reported greater feelings of engulfment by the illness, leading to increased burden and diminished well-being. On the other hand, caregivers high on avoidant attachment struggled to accept the illness, and also experienced heightened burden. This study underscores the significance of illness integration in shaping caregivers’ experiences. The findings highlight the need to promote adaptive integration processes and address attachment-related challenges, reducing caregiver strain and enhancing resilience.