Abstract:
Background:Mental illness is a widespread issue that affects millions of people worldwide. 
Its impact is not only limited to the individuals suffering from it but also extends to their 
families and communities. Family members, who often act as primary caregivers, play a 
crucial role in offering support to those with mental health conditions. However, the 
challenges that caregivers face and the effects of mental illness on their quality of life are often 
overlooked and not adequately addressed.
Objective:To assess quality of life and associated factors among caregivers of people with 
mental illness at public hospitals in Harari Regional State and Dire Dawa City Administrative, 
from January 21 to February 21, 2024.
Methods: An institutional-based cross-sectional study design was employed among 437 study 
primary caregiverswho were selected by systematic sampling technique. Data were collected 
by using semi-structured and structured interviewer administered questionnaire. The data were 
entered into EPI data version 3.1 software and were analyzed by using STATA version 14. 
Linear regression was used to determine factors that affect the quality of life by applying 
forward selection methods. An interpretation of unstandardized β - Coefficients at 95% 
confidence intervals was considered to measure the association between dependent and 
independent factors at p-value of <0.05.
Results: A total of 421 respondents participated with response rate of 96.3%. The total mean 
score of quality of life among primary caregiverswas 82.93 (±17.48) with 95% CI: (81.25 to 
84.603). Regarding the domains of quality of life, the mean score of physical domains was 
found to be 58.05 (±18.81), psychological domain was 57.29 (±16.28), environmental domain 
was 53.04 (±16.13), and social domain was 51.19 (±23.12).
Caregivers unable to read and write (β= -8.2 95% CI: (-11.83, -4.47), caregivers` depression 
(β= 4.57, 95% CI: (-7.48; - 1.66), perceived stigma (β= -.83, 95% CI: (-.99, -.62), perceived 
burden (β= -.59, 95% CI: (-.72, -.45), social support (β= .95, 95% CI: (.57,1.33), coping (β= 
.31, 95% CI: (.03,.59), and patient diagnosis being other group of mental illness (β= 4.63, 95% 
CI: (1.43,7.83) were factors significantly associated with physical domain of caregivers QOL. 
XIII
Caregivers unable to read and write (β= -4.22, 95% CI: (-7.71,-.74), caregivers depression (β= 
-3.04, 95% CI: (-5.79, -.29)perceived stigma (β= -.51, 95% CI: (-.68, -.33) , perceived burden 
(β= -.24, 95% CI: (-.36, -.11), coping (β= .35, 95% CI: (.12,.65), and social support (β= .85, 
95% CI: (.49,1.21), and patient diagnosis being other group of mental illness (β= 5.9, 95% CI: 
(2.95,8.94) were factors significantly associated with psychological domain of caregivers 
QOL.
Caregivers unable to read and write (β= -11.8, 95% CI: (17.09,6.55), widowed caregivers (β= 
-8.54, 95% CI: (-13.08,3.87), widowed patient (β= -6.06, 95% CI: (-11.85,-.27), caregivers 
depression (β= -3.58, 95% CI: (-6.37,-.80) perceived stigma (β= -.83, 95% CI: (-1.09, -.56), 
perceived burden (β= -.56, 95% CI: (-.75, -.37), coping (β= .77, 95% CI: (.37,1.17) social 
support (β= 1.01, 95% CI: (.47,1.56), daily caregiving hour (β= -.49, 95% CI: (-.96,-.02), and 
patient diagnosis being other group of mental illness (β= 5.27, 95% CI: (.75,9.79) were factors 
significantly associated with social domain of caregivers QOL.
Caregivers unable to read and write (β= -7.3, 95% CI: (-10.68, -3.89), widowed patient (β= -
4.42, 95% CI: (-7.94,-.49), caregivers depression (β= -4.30, 95% CI: (-6.98, -1.61), perceived 
stigma (β= -.69, 95% CI: (-.84, -.50), perceived burden (β= -.40, 95% CI: (-.52, -.27), coping 
(β= .39, 95% CI: (.13,.65), social support (β= .48, 95% CI: (.13,.84), and patient diagnosis 
being other group of mental illness (β= 4.15, 95% CI: (1.19,7.10) were factors significantly 
associated with environmental domain of caregivers QOL.
Conclusion:The quality of life of caregivers of patients living with mental illness was found 
to be low with the lowest mean score in social domain.Being widowed, educational status, 
caregiver‘s depression, perceived burden, perceived stigma, average daily caregiving hours, 
poor social support, and coping mechanism type were factors significantly associated with 
caregivers QOL domains.