We also note some limitations related to

We also note some limitations related to our data. First, the caregiving question in 2009 captured ‘sick’ and ‘disabled’ family members, however in 2013 this question was rephrased and captured ‘chronically ill’, ‘disabled’, but also ‘frail’ family members. However, it should be noted that the English nitric oxide for the caregiving questions between 2009 and 2013 suggests greater disparity than the Thai translation, in which the word for ‘frail’ (ชราภาพ) is closely tied in meaning to sickness or disability (ป่วย/ ทุพพลภาพ). Therefore in Thai, the disparity in meaning between the two surveys is less than in English. Comparisons in caregiver status and ‘years caregiving’ between the 2009 and 2013 surveys suggest the caregiving role was interpreted similarly despite differences in terminology. Second, we did not gather information on the relationship between caregiver and recipient in 2013. Although, we did record caregiving activities, length of care, and time spent caring, and so were able to gain an understanding of care intensity. In 2012, phone interviews were conducted with a subsample of caregivers (n=115) and results showed that about 60% (n=68) reported caring for parents and 15% (n=17) cared for grandparents. Third, we noted approximately 30% attrition between 2009 and 2013. However, when comparing those who dropped-out (n=17,453) to those who did not (n=43,116) the proportion of caregivers in 2009 were similar (26.2% full-time and 5.7% part-time caregivers vs 28.1% vs 6.9%). Further qualitative investigation could provide insight into the needs of caregivers and may help design interventions to improve their mental health. Detailed information on the nature of work, social support and leisure time is not available longitudinally in this study. Future follow-up could repeat the key caregiving status and mental health measures to monitor medium and long-term relationships between caregiving and mental health among Thai workers.
Funding This study was supported by the International Collaborative Research Grants Scheme with joint Grants from the Wellcome Trust UK (GR071587MA) and the Australian National Health and Medical Research Council (268055), and as a global health Grant from the NHMRC (585426).
Acknowledgements
Introduction Delays between recognition of symptoms suggesting breast malignancy and seeking help or advice from healthcare professionals vary between different communities and countries (O׳Mahony & Hegarty, 2009). Various factors such as culture, gender roles and socio-economic status influence the decision making of women to seek medical attention (O׳Mahony & Hegarty, 2009). BC is a disease cell body has improved prospects for survival if detected and treated early. Any delay in presentation for symptomatic BC is associated with larger tumors, more advanced stages of disease and consequently poorer prospects for survival (Richards, Westcombe, Love, Ramirez, & Johns, 1999). Delay in BC treatment has been categorized into: Among the top ten sites for cancer diagnosed in the United Arab Emirates (UAE), BC is at the top of the list. It constitutes 43% of cancers diagnosed among females and 25% of all cases of cancer (Cancer Registry Report, 2012). It is the second leading cause of death among women with an incidence rate of approximately 38 per 100,000 (Cancer Registry Report, 2012). The annual incidence is more than 130 new cases of BC diagnosed in the emirate of Abu Dhabi (Cancer Registry Report, 2012). Despite having access to the national screening programs and the coverage of cancer screening by the health insurance, only around 75% of BC patients in the United Arab Emirates (UAE) seek medical advice after experiencing a sign or symptom of the disease (Cancer Registry Report, 2009). The introduction of mandatory health insurance in 2007 in the emirate of Abu Dhabi has provided all residents access to high quality care (Taher, Al Neyadi, & Sabih, 2008). Late detection of BC has historically led to significant increases in mortality. Female adult nationals between 40 and 69 are being given an option for BC screening as part of their insurance card renewal process. For non-UAE nationals, screening campaigns have helped in early detection of BC, however, screening is not performed on an organized basis and some insurance companies do not cover screening cost (Taher et al., 2008). Some preventive medicine centers provide free screening, but its availability is not widely publicized.