Comorbid Mental Health Disorders Among Caregivers Experiencing Compassion Fatigue: Evidence from Caregivers of Children with Physical Disabilities in Nairobi County, Kenya

Abstract

Caregiving for children with physical disabilities is emotionally demanding and has been associated with compassion fatigue (CF), a state of physical, emotional, and social exhaustion. Although CF has been widely studied in clinical and humanitarian contexts, less is known about its co-occurrence with comorbid mental health disorders in low- and middle-income countries. This study examined comorbid mental health disorders—specifically post-traumatic stress disorder (PTSD), anxiety, and depression—among caregivers of children with physical disabilities in Nairobi County, Kenya. A mixed-methods explanatory sequential design was employed. Quantitative data were collected from a sample of 150 caregivers using standardized self-report measures for PTSD, anxiety, and depression, alongside a validated compassion fatigue scale. Descriptive statistics were computed to determine prevalence rates, and binary logistic regression was used to examine associations between CF and comorbid disorders. In the second phase, qualitative interviews explored caregivers lived experiences to provide depth and context to the quantitative results. The findings revealed a high prevalence of mental health disorders among caregivers: 82.7% reported probable PTSD, 76.7% reported at least mild anxiety, and 89.3% reported at least mild depressive symptoms. Logistic regression suggested that PTSD was significantly associated with CF (OR = 0.129, 95% CI 0.034–0.493, p = .003), though the direction of effect was counterintuitive and likely influenced by sparse data. Anxiety and depression did not emerge as significant predictors. Qualitative narratives, however, strongly reinforced the presence of PTSD-like symptoms, chronic anxiety, and depressive features as interwoven with CF. These findings underscore the urgent need for integrated mental health interventions for caregivers, addressing not only CF but also its comorbidities. The study contributes to global psychology by highlighting the multidimensional psychological burden of caregiving in sub-Saharan Africa.