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Oleas Rodríguez DA, Yong Peña C, Garza Olivares X, Teixeira Filho FS, Lucero Córdova JE, Salas Naranjo AJ. Emotional Coping Strategies for Informal Caregivers of Hospitalized Patients: A Study of Distress and Overload. Psychol Res Behav Manag 2024; 17:725-734. [PMID: 38410381 PMCID: PMC10895987 DOI: 10.2147/prbm.s443200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/08/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose Informal caregivers constitute a vulnerable population group that has forsaken their activities and life projects with the sole purpose of caring for a dependent individual without receiving any form of compensation in return. Emotionally, this population has been neglected by both the state and family members, exacerbating distress levels among them. The objective is to analyze the impact of emotional coping strategies on the experiences of distress and emotional burden among adult informal caregivers tending to hospitalized individuals. Sample and Methods The role of emotional coping strategies in caregiver burden and psychological distress was examined in 460 informal adult caregivers from Guayaquil, Ecuador, who participated in an online survey. The instruments used included the Depression, Anxiety, and Stress Scale (DASS 21), the Zarit Burden Inventory (ZBI), and the Emotional Coping Questionnaire (Cuestionario de Afrontamiento Emocional). The analysis involved a multiple regression to iteratively select variables, aiming to build a simpler and more explanatory model. Results Employing multiple regression analysis with a stepwise model selection procedure, it was found that 16.5% of the variance in depression, 19.5% of the variance in anxiety, 19.8% of the variance in stress, and 32% of the variance in burden were predicted by specific coping strategies. Additionally, the impact of burden was estimated by the participants' gender, with greater burden observed among males due to societal role expectations. Conclusion This study underscores the importance of emotional coping in the experience of informal caregivers and suggests that psychological interventions should focus on developing adaptive strategies to manage the stress and emotional burden associated with caregiving.
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Affiliation(s)
| | | | - Xochitl Garza Olivares
- Department of Clinical and Health Psychology, Tecnológico de Monterrey, Monterrey, NL, México
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Navarro Prados AB, Jiménez García‐Tizón S, Meléndez JC. Sense of coherence and burnout in nursing home workers during the COVID-19 pandemic in Spain. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:244-252. [PMID: 33894094 PMCID: PMC8250978 DOI: 10.1111/hsc.13397] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 05/11/2023]
Abstract
Care staff in nursing homes work in a challenging environment, and the COVID-19 pandemic has exacerbated those challenges in an unprecedented way. On the other hand, the sense of coherence (SOC) is a competence that could help these professionals perceive the situation as understandable, manageable and meaningful. This study aims to analyse the extent to which potential risk and protective factors against burnout have affected nursing home workers during the COVID-19 pandemic and to assess the contribution of these factors to their burnout. Three hundred forty professionals who worked in nursing homes in Spain completed a survey and reported on their sociodemographic characteristics and their organisational characteristics of the job related to COVID-19, SOC and burnout. Multiple linear regression analyses were performed. The results showed that the SOC is highly related to the dimensions of burnout and is a protective factor against this. In addition, the increase in hours has a negative effect, facilitating inadequate responses to stressful situations; and whereas perceived social support and availability of resources have a protective effect, the deterioration in mental and physical health is the most important risk factor. This study could help better understand the psychological consequences of the effort that nursing home workers and can also help design mental health prevention and care interventions for workers that provide them with resources and supports that foster their coping skills.
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Affiliation(s)
- Ana Belén Navarro Prados
- Departamento de Psicología Evolutiva y de la EducaciónFacultad de PsicologíaUniversidad de SalamancaSalamancaSpain
| | - Sara Jiménez García‐Tizón
- Departamento de Psicología Evolutiva y de la EducaciónFacultad de PsicologíaUniversidad de SalamancaSalamancaSpain
| | - Juan Carlos Meléndez
- Departamento de Psicología Evolutiva y de la EducaciónFacultad de PsicologíaUniversidad de ValenciaValenciaSpain
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3
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Sołtys A, Bidzan M, Tyburski E. The Moderating Effects of Personal Resources on Caregiver Burden in Carers of Alzheimer's Patients. Front Psychiatry 2021; 12:772050. [PMID: 34916974 PMCID: PMC8669799 DOI: 10.3389/fpsyt.2021.772050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Caring for persons with Alzheimer's disease can be an extremely difficult experience. To date, there has been a lack of research into the role of intermediary variables in the relationship between caregiver personality and psychosocial functioning. The growing numbers of dementia patients worldwide mean that more people are involved in their care, making research into this area a pressing concern. Both a caregiver's personality and personal resources play a key role in their capacity to cope with stressful situations. In order to determine how personal resources moderate the relationship between personality and burden of care, a total of 100 caregivers of Alzheimer's patients (78 women and 22 men) were asked to complete a set of questionnaires to assess personality, personal resources (sense of coherence, generalized self-efficacy, and perceived social support), as well as their levels of stress, depression, and commitment to care. Structural equation modeling and latent growth analysis suggest that personal resources explain the mechanisms underlying burden of care and moderate its relationship with personality. Our findings indicate that personal resources are a critical predictor of burden of care. Therefore, caregivers must be provided with appropriate support, taking into account their resources and personality profiles.
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Affiliation(s)
- Anna Sołtys
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, Gdansk, Poland
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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Karlstedt M, Winnberg U, Winnberg E. Sense of Coherence in partners to persons with Huntington's disease. Acta Neurol Scand 2021; 144:576-584. [PMID: 34224135 DOI: 10.1111/ane.13498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Huntington's disease (HD) is a progressive neuropsychiatric disease characterized by involuntary movements and behavioural symptoms. This study aimed to explore the association between the level of Sense of Coherence (SOC) and health problems, and psychological distress factors in partners to HD affected persons and their need of support. MATERIALS & METHODS A cross-sectional, descriptive, correlational design was used. Data was generated from 94 HD partners from almost all networks, outpatient clinics and nursing homes specialized in HD across Sweden. HD partners filled out questionnaires with scales measuring SOC, health problems, psychological distress factors and the Total Functional Capacity Scale (TFC). Non-parametric analysis was used to analyse group differences. RESULTS Huntington's disease partners with a lower level of SOC experienced more health problems than those with a higher level. Health problems among HD partners were most common among HD affected in TFC stage 3, indicating that the partners need most support during this period. Lower level of SOC was associated with loneliness in the relationship; less possibilities to socialize with friends; worries about the future as well as being subjected to physical aggression. The experience of physical aggression from the HD affected person was common (44.7%) and 28.6% of the partners expressed worries about being subjected to physical aggression. CONCLUSION Our findings suggest that knowledge about the partners' SOC score may be a helpful indicator identifying HD partners who are more vulnerable and need additional help caring for the person with HD and can be a complementary tool in assessment protocols.
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Affiliation(s)
- Michaela Karlstedt
- Department of Neurobiology, Care Sciences and Society Karolinska Institutet Stockholm Sweden
| | - Ulrika Winnberg
- Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
| | - Elisabeth Winnberg
- Department of Health Care Sciences Ersta Sköndal Bräcke University College Stockholm Sweden
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5
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Gómez-Gallego M, Gómez-Gallego JC. Predictors of Caregiver Burden of Patients with Alzheimer Disease Attending Day-Care Centres. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010707. [PMID: 34682452 PMCID: PMC8535802 DOI: 10.3390/ijerph182010707] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 10/01/2021] [Accepted: 10/07/2021] [Indexed: 11/29/2022]
Abstract
Nowadays, there are plenty of programs and resources to prevent caregiver burden of patients with Alzheimer’s disease. In spite of that, many caregivers suffer high levels of burden and stress, which leads to an earlier institutionalization of patients. This study aimed to explore the predictors of burden in relative caregivers of patients attending day-care centers and the moderating role of caregiver kinship in these associations. A sample of a hundred and two patient–caregiver dyads was recruited. Burden was measured with a Zarit Burden Interview. Measures of patients’ cognition, insight, depression, behavioral disturbances, functional ability and overall physical health were considered as predictors. We found that apathy, irritability and delusions and, patients’ mobility are the main determinants of caregivers’ burden. The strength of relationship between delusions and irritability was higher in spouse caregivers. Interventions to reduce burden should be adapted to the specific needs of a particular type caregiver.
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Affiliation(s)
- María Gómez-Gallego
- Clinical Neuroscience Research Group, Faculty of Health Sciences, Catholic University of Murcia, 30107 Murcia, Spain;
| | - Juan Cándido Gómez-Gallego
- Department of Applied Economics, Faculty of Economic, Espinardo Campus, University of Murcia, 30100 Murcia, Spain
- Correspondence:
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6
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Gonçalves-Pereira M, Zarit SH, Papoila AL, Mateos R. Positive and negative experiences of caregiving in dementia: The role of sense of coherence. Int J Geriatr Psychiatry 2021; 36:360-367. [PMID: 32944997 DOI: 10.1002/gps.5433] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 09/16/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Sense of coherence (SOC) is increasingly recognized as an important health determinant, particularly for mental health. Part of the evidence comes from informal caregivers in diverse clinical conditions. The extent to which SOC influences caregiving outcomes, however, is relatively under-researched in dementia, particularly regarding positive experiences. We analysed the association of SOC with dementia caregivers' subjective burden, psychological distress and positive aspects of care. METHODS/DESIGN This is a secondary analysis of cross-sectional data from the Lisbon study of Families of Persons with Dementia, involving a convenience sample of 99 primary caregivers of community-dwelling patients of neurology and psychiatry services. SOC was assessed with the Orientation for Life Scale. Measures of caregivers' outcomes were: the Zarit Burden Interview, the General Health Questionnaire for psychological distress and the Positive Aspects of Caregiving scale. Analyses controlled for demographics, caregiving arrangements, objective burden, social support, patients' neuropsychiatric symptoms and dementia stage. RESULTS Lower SOC was associated with higher psychological distress (p = 0.001). No significant associations were found for subjective burden (p = 0.081) or positive aspects of caregiving (p = 0.688). Additional analyses showed that lower SOC was associated with less emotional support (p < 0.001) and past psychiatric illness (p = 0.044). CONCLUSIONS These findings support previous research suggesting that SOC is protective for psychological distress, and extend evidence to the positive aspects of care in dementia. The cross-sectional design and small-scale convenience sampling preclude both causality presumptions and generalizability. SOC assessments may be useful to define subgroups of dementia caregivers at risk for anxiety and depression.
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Affiliation(s)
- Manuel Gonçalves-Pereira
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,Comprehensive Health Research Centre (CHRC), Lisbon, Portugal
| | - Steven H Zarit
- Department of Human Development and Family Studies, Penn State University, University Park, Pennsylvania, USA
| | - Ana L Papoila
- Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal.,Centre of Statistics and its Applications, University of Lisbon (CEAUL), Lisbon, Portugal
| | - Raimundo Mateos
- Department of Psychiatry, University of Santiago de Compostela (USC), Santiago de Compostela, Spain.,Psychogeriatric Unit, CHUS University Hospital, Santiago de Compostela, Spain
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7
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Na L, Singh S. Disparities in mental health, social support and coping among individuals with mobility impairment. Disabil Health J 2020; 14:101047. [PMID: 33309536 DOI: 10.1016/j.dhjo.2020.101047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 11/22/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND CDC estimated that 19.4 million (7.8%) US adults are living with mobility impairment, who are unable to walk a quarter mile. Individuals with physical disability reported greater depression and, in some cases, insufficient social support. OBJECTIVES This study explores the extent of disparities in psychological health, social support, and coping mechanisms among those with mobility impairment as compared to those without such impairment, and the longitudinal effect of onset of mobility impairment on subsequent psychosocial health and coping. METHODS Individuals with mobility impairment were matched to controls from a nationally representative sample, using the propensity score method. The final sample included 345 matched pairs. Regression models with robust standard errors were used to assess disparities in outcomes by mobility status. Autoregressive models were used to assess the longitudinal effect of the onset of mobility limitation on these outcomes. RESULTS Those with impaired mobility fared significantly higher on negative affect (p < .05) and pessimism (p < .05), and significantly lower on life satisfaction (p < .05) and positive affect (p = .001). In terms of coping, they showed disparities in health locus of control (self) (p < .05), planning (p < .05), active coping (p < .05), and problem-focused coping (p < .05), as compared to those without mobility limitation. The onset of mobility impairment had significant effects in similar psychological and coping domains. CONCLUSION Our work revealed a piece of reality of individuals living with mobility impairment and will inform designing effective interventions to mitigate psychosocial health disparities in this population.
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Affiliation(s)
- Ling Na
- University of Toledo, School of Population Health, 2801 W Bancroft St., Mail Stop 119, Toledo, OH, 43606, USA.
| | - Shipra Singh
- University of Toledo, School of Population Health, 2801 W Bancroft St., Mail Stop 119, Toledo, OH, 43606, USA
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8
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Turró-Garriga O, Conde-Sala JL, Viñas V, Turon-Estrada A, Cullell-Juncà M, Calvó-Perxas L, Juvinyà-Canal D, Mioshi E, Garre-Olmo J. Antonovsky's sense of coherence and resistance resources reduce perception of burden in family carers of people with Alzheimer's disease. Aging Ment Health 2020; 24:1717-1725. [PMID: 31559837 DOI: 10.1080/13607863.2019.1667297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Taking care of people with dementia (PWD) has been associated with some degree of burden. The variability of the carer's burden can be partially explained by their personal characteristics. Antonovsky's model of health defined the resistance resources (RRs) as essential mechanisms to cope with stressors, and to shape the personal sense of coherence (SOC). This study identifies the RRs related with carer's SOC, and their implications in the perception of burden in family dementia carers.Methods: A sample of 308 participants from the 'SOC & DEM study' (154 carers and 154 PWD) was recruited from two memory clinics. Carer's personal characteristics of burden, SOC, self-efficacy, coping strategies, perceived social support, and depression were evaluated using standardized instruments. PWD's degree of dependence and behaviour and psychological symptoms of dementia (BPSD) were assessed too. A path analysis was used to test the relationship between caregiver burden and SOC including the personal RRs of the carers and clinical data of PWD.Results: The path model identified SOC as a major factor related to carer's burden perception (r = -.327). Self-efficacy (r = .285), two coping strategies, 'use instrumental support' (r = -.235) and 'behavioural disengagement' (r = -.219), and social support perceived (r = .304) were the main carer's personal characteristics directly related with SOC. Caring experience (r = -.281) was the main carer factor related with burden while dependence (r = .156) and BPSD (r = .157) were the dementia factors.Conclusion: The SOC has previously related with carer's burden. The results contributed to identify relevant and modifiable personal characteristics as RRs that could reduce this burden.
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Affiliation(s)
- Oriol Turró-Garriga
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain
| | - Josep Lluís Conde-Sala
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Faculty of Psychology, University of Barcelona, Barcelona, Catalonia, Spain
| | - Vanesa Viñas
- Faculty of Psychology, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antoni Turon-Estrada
- Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain
| | | | - Laia Calvó-Perxas
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain
| | | | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Josep Garre-Olmo
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain.,Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
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9
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Sołtys A, Tyburski E. Predictors of mental health problems in formal and informal caregivers of patients with Alzheimer's disease. BMC Psychiatry 2020; 20:435. [PMID: 32887576 PMCID: PMC7487573 DOI: 10.1186/s12888-020-02822-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caring for a person with Alzheimer's disease (AD) is associated with significant mental burden e.g., depression and anxiety, and difficulties with social, familial, and professional functioning. To date, few studies have examined variables which would allow for a comprehensive and detailed study of the relationship between personal resources and caregiver health status, with a majority of studies focusing on factors that contribute to increased caregiver's burden. Moreover, the available evidence fails to address differences in the functioning of formal and informal carers. Paying proper attention to the problems of nursing home staff can help identify important risk factors. Therefore, this study compared mental health problems in informal and formal caregivers and examined the relationship between mental resources and mental health problems in both groups of caregivers. METHODS This cross-sectional study examined 100 formal (n = 50) and informal (n = 50) caregivers of AD patients. Personal resources were measured with the Social Support Questionnaire (SSQ), the Generalized Self-Efficacy Scale (GSES), and the Sense of Coherence Questionnaire (SCQ), while mental health was assessed with the Depression Assessment Questionnaire (DAQ) and the General Health Questionnaire (GHQ). Multivariate stepwise regression was performed separately for both investigated groups. RESULTS There were no significant differences between informal and formal caregivers in terms of psychological variables, i.e., sense of coherence, social support, self-efficacy, or mental health problems. In contrast, there were different significant predictors of mental health problems in both groups. Comprehensibility (SCQ) was a significant predictor of mental health problems measured by DAQ and self-efficacy (GSES) was a significant predictor of mental health problems measured by GHQ in informal caregivers. For formal caregivers, emotional support (SSQ) and comprehensibility (SCQ) were significant predictors of mental health problems measured by DAQ, while tangible support (SSQ) and meaningfulness (SCQ) were significant predictors of mental health problems measured by GHQ. CONCLUSIONS Personal resources are significant predictors of mental health outcomes in caregivers of AD patients. Preventive actions should therefore include assessment of factors affecting caregivers' mental health in order to provide them with necessary care and create appropriate support groups.
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Affiliation(s)
- Anna Sołtys
- Institute of Psychology, University of Szczecin, 69 Krakowska str, 71-017 Szczecin, Poland
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 10 Kutrzeby str, 61-719 Poznan, Poland
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10
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S F Yu D, Cheng ST, Chow EOW, Kwok T, Mccormack B. Effects of strength-based intervention on health outcomes of family caregivers of persons with dementia: A study protocol. J Adv Nurs 2020; 76:2737-2746. [PMID: 32743919 DOI: 10.1111/jan.14470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 06/16/2020] [Indexed: 11/27/2022]
Abstract
AIMS This study aims at identifying the health effects of a strength-based intervention on family caregivers of persons with dementia and to explore the underlying mechanism. The perception of family caregivers on the strength-based intervention will also be explored. DESIGN This sequential mixed-method study comprises a double-blind randomized controlled trial and a descriptive qualitative study. METHODS A group of 372 family caregivers of persons with dementia will be recruited from community settings. They will be randomized to receive the strength-based intervention or a dementia education program. Based on Antonovksy's theory of salutogenesis, the strength-based intervention integrates skills of narrative therapy and empowerment strategies. It comprises 14 weekly group-based sessions and two bi-weekly follow-up telephone calls. The education program serves as the control intervention. Validated instruments are used to measure sense of coherence, coping, caregiver burden, and health-related quality of life at baseline, 14 weeks, and 22 weeks. Mixed-effects models and path analysis will be used to identify the treatment effect and the mediating mechanism. A subsample of 30 caregivers who report differential changes in the health outcome will be engaged in qualitative interviews. The study was funded in 2017. DISCUSSION This study marks the first attempt to adopt a theory-driven strength-based approach to improve the health outcomes of family caregivers of persons with dementia. The stringent and comprehensive evaluation will inform its effects and the underlying mechanism. IMPACT This study will have important theoretical and public health implications. Theoretically, the study will enhance understanding of Antonovsky's theory of salutogenesis by examining the modifiability of sense of coherence and the way it enhances health-related outcomes. In terms of public health implications, the strength-based intervention focusing on optimizing the inner strength can provide a new paradigm to promote the adjustment of family caregivers of persons with dementia. TRIAL REGISTRATION This project was registered in the Clinical Trials Registry of the Centre for Clinical Research and Biostatistics (registration number: CUHK_CCRB00551; date registered: 6 April 2017).
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Affiliation(s)
- Doris S F Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Sheung-Tak Cheng
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong, Hong Kong
| | - Esther Oi-Wah Chow
- Department of Social and Behavioural Sciences, The City University of Hong Kong, Hong Kong, UK
| | - Timothy Kwok
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Brendan Mccormack
- Division of Nursing, Occupational Therapy & Arts Therapies, Queen Margaret University, Edinburgh, UK
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11
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Childers KM. Sense of Coherence and Caregivers of Persons with Dementia. Behav Sci (Basel) 2019; 9:E14. [PMID: 30696071 PMCID: PMC6406261 DOI: 10.3390/bs9020014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 01/07/2023] Open
Abstract
Unpaid caregivers (CG) provide most of the assistance to persons with dementias (PWD) living in the community. This study explores the current state of knowledge regarding the concept of sense of coherence (SOC) and CG of PWD via a concept analysis. The identified defining attributes were health, health-related quality of life (HRQoL), CG burden, CG stress, coping as a strength, gender, and decreasing sense of CG coherence over the progression of the disease (dementia). Further study by health care professionals using clinical observations, large samples of respondents, a consistent theory, valid and reliable instruments used to measure defining attributes consistently, and critical reviews of the literature are needed.
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Affiliation(s)
- Kristina M Childers
- School of Nursing Student in Ph. D Nursing Program, West Virginia University Morgantown, WV 26506-9600, USA.
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12
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Del-Pino-Casado R, Espinosa-Medina A, López-Martínez C, Orgeta V. Sense of coherence, burden and mental health in caregiving: A systematic review and meta-analysis. J Affect Disord 2019; 242:14-21. [PMID: 30170234 DOI: 10.1016/j.jad.2018.08.002] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/17/2018] [Accepted: 08/01/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Informal caregiving is associated with a number of negative effects on carers' physical and psychological well-being. The salutogenic theory argues that sense of coherence (SOC) is an important factor in psychological adjustment to stress. The main aim of this study was to systematically review current evidence on the association between SOC, burden and mental health outcomes in informal carers. METHOD A systematic search was carried out up to September 2017 in the following databases: PubMed, CINAHL (EBSCO), PsychInfo (OVID) and Scopus. Studies were included if they evaluated the relationship between sense of coherence and subjective caregiver burden and/or mental health outcomes, specifically symptoms of depression and anxiety. Meta-analyses were performed and subgroup analyses were carried out to explore if methodological factors influenced findings. RESULTS Thirty-five studies were included in the meta-analysis, which provided 40 independent samples with 22 independent comparisons for subjective caregiver burden, 26 for symptoms of depression and 7 for symptoms of anxiety. Higher levels of SOC were associated with lower levels of subjective caregiver burden and better mental health outcomes. Publication bias did not change the estimate of the effect. LIMITATIONS Most of the studies included in this review were cross-sectional. CONCLUSIONS Findings suggest that SOC is an important determinant of carer well-being and may protect carers from high levels of psychological distress and caregiver burden.
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Affiliation(s)
| | | | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, United Kingdom
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13
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Voutilainen A, Ruokostenpohja N, Välimäki T. Associations Across Caregiver and Care Recipient Symptoms: Self-Organizing Map and Meta-analysis. THE GERONTOLOGIST 2018; 58:e138-e149. [PMID: 28329837 DOI: 10.1093/geront/gnw251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study The main objective of this study was to reveal generalizable associations across caregiver burden (CGB), caregiver depression (CGD), care recipient cognitive ability (CRCA), and care recipient behavioral and psychological symptoms of dementia (BPSD). Design and Methods Studies published between 2004 and 2014 and reporting CGB and/or CGD together with CRCA and/or BPSD were included. Only 95 out of 1,955 studies provided enough data for data clustering with the Self-Organizing Map (SOM) and 27 of them for meta-analyses based on correlation coefficients. Results Caregiver and care recipient symptoms were not tightly associated with each other, except for the CGB-BPSD interaction at the individual level. SOM emphasized the cluster comprising studies reporting low CGB, low CGD, high CRCA, and few BPSD. Meta-analyses indicated high heterogeneity between the original studies. Implications Relationships between caregiver and care recipient symptoms should be treated as situation-specific phenomena, at least when the symptoms are moderate at most. Dementia caregiving per se should not be understood as a source of stress and mental health problems. More systematic and coherent use of measures is necessary to enable a comprehensive analysis of caregiving.
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Affiliation(s)
- Ari Voutilainen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Nora Ruokostenpohja
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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A high sense of coherence protects from the burden of caregiving in older spousal caregivers. Arch Gerontol Geriatr 2018; 75:76-82. [DOI: 10.1016/j.archger.2017.11.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 11/20/2017] [Accepted: 11/23/2017] [Indexed: 11/21/2022]
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Koyama A, Matsushita M, Hashimoto M, Fujise N, Ishikawa T, Tanaka H, Hatada Y, Miyagawa Y, Hotta M, Ikeda M. Mental health among younger and older caregivers of dementia patients. Psychogeriatrics 2017; 17:108-114. [PMID: 26968528 DOI: 10.1111/psyg.12200] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/25/2016] [Accepted: 02/03/2016] [Indexed: 02/02/2023]
Abstract
AIM Caregiver burden in dementia is an important issue, but few studies have examined the mental health of younger and older family caregivers by comparing them with age- and gender-matched community residents. We aimed to compare the mental health of dementia caregivers with that of community residents and to clarify factors related to mental health problems in younger and older caregivers. METHODS We studied 104 dementia caregivers; 46 were younger (<65 years) and 58 were older (≥65 years). A total of 104 community residents who were matched for age and gender were selected. We compared depression (Center for Epidemiologic Studies Depression Scale for younger participants; Geriatric Depression Scale for older participants), health-related quality of life (QOL) short-form health survey (SF-8), sleep problems, and suicidal ideation between the caregivers and community residents by age. Behavioural and psychological symptoms of dementia, activities of daily living (ADL), and instrumental ADL were assessed among patients with dementia using the Neuropsychiatric Inventory, Physical Self-Maintenance Scale, and Lawton Instrumental ADL Scale, respectively. RESULTS According to SF-8 results, both younger and older caregivers had significantly worse mental QOL than community residents (younger caregivers: 46.3 vs community residents: 49.7, P = 0.017; older caregivers: 48.2 vs community residents: 51.1, P = 0.024) but were not more depressive. Sleep problems were significantly more frequent in younger caregivers (39.1%) than in community residents (17.0%) (P = 0.017). Multiple regression analysis revealed that caregivers' deteriorated mental QOL was associated with patients' behavioural and psychological symptoms of dementia in younger caregivers and with dementia patients' instrumental ADL and female gender in older caregivers. CONCLUSIONS Dementia caregivers had a lower mental QOL than community residents. To maintain caregivers' mental QOL, it is necessary to provide younger caregivers with skills or professional interventions for dealing with behavioural and psychological symptoms of dementia, and older caregivers must be offered adequate care support.
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Affiliation(s)
- Asuka Koyama
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | | | - Mamoru Hashimoto
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Noboru Fujise
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | | | - Hibiki Tanaka
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Yutaka Hatada
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Yusuke Miyagawa
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Maki Hotta
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
| | - Manabu Ikeda
- Department of Neuropsychiatry, Kumamoto University, Kumamoto, Japan
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Lo Sterzo E, Orgeta V. Illness representation and sense of coherence in dementia caregiving. J Health Psychol 2015; 22:722-732. [DOI: 10.1177/1359105315613132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to describe illness representations in dementia caregiving and examine the relationship between illness perceptions and carers’ sense of coherence. Illness perceptions were assessed by the Brief Illness Perception Questionnaire. We measured sense of coherence, symptoms of anxiety and depression and carer burden. Regression analyses indicated that after controlling for demographic factors, burden and psychological distress in carers, illness coherence and emotional responses to the disease independently contributed towards explaining variance in carers’ sense of coherence. Results provide support for the usefulness of the self-regulation model in understanding dementia caregiving.
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Affiliation(s)
- Elena Lo Sterzo
- Studi Cognitivi, Cognitive Psychotherapy School, Modena, Italy
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Hsieh S, Leyton CE, Caga J, Flanagan E, Kaizik C, O’Connor CM, Kiernan MC, Hodges JR, Piguet O, Mioshi E. The Evolution of Caregiver Burden in Frontotemporal Dementia with and without Amyotrophic Lateral Sclerosis. J Alzheimers Dis 2015; 49:875-85. [DOI: 10.3233/jad-150475] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Sharpley Hsieh
- Brain and Mind Research Centre, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Australia
| | - Cristian E. Leyton
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Australia
- Faculty of Health Sciences, The University of Sydney, Australia
| | | | | | | | | | | | - John R. Hodges
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Australia
| | - Olivier Piguet
- Neuroscience Research Australia, Sydney, Australia
- ARC Centre of Excellence in Cognition and its Disorders, University of New South Wales, Australia
| | - Eneida Mioshi
- Brain and Mind Research Centre, Sydney, Australia
- Department of Psychiatry, Cambridge University, Cambridge, UK
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Dias R, Santos RL, Sousa MFBD, Nogueira MML, Torres B, Belfort T, Dourado MCN. Resilience of caregivers of people with dementia: a systematic review of biological and psychosocial determinants. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2015; 37:12-9. [DOI: 10.1590/2237-6089-2014-0032] [Citation(s) in RCA: 103] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 09/10/2014] [Indexed: 11/22/2022]
Abstract
Introduction: Although caregivers of people with dementia may face difficulties, some positive feelings of caregiving may be associated with resilience.Objective: This study systematically reviewed the definitions, methodological approaches and determinant models associated with resilience among caregivers of people with dementia.Methods: Search for articles published between 2003 and 2014 in ISI, PubMed/MEDLINE, SciELO and Lilacs using the search terms resilience, caregivers and dementia.Results and conclusions: Resilience has been defined as positive adaptation to face adversity, flexibility, psychological well-being, strength, healthy life, burden, social network and satisfaction with social support. No consensus was found about the definition of resilience associated with dementia. We classified the determinant variables into biological, psychological and social models. Higher levels of resilience were associated with lower depression rates and greater physical health. Other biological factors associated with higher levels of resilience were older age, African-American ethnicity and female sex. Lower burden, stress, neuroticism and perceived control were the main psychological factors associated with resilience. Social support was a moderating factor of resilience, and different types of support seemed to relieve the physical and mental overload caused by stress.
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Affiliation(s)
- Rachel Dias
- Universidade Federal do Rio de Janeiro, Brazil
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Wood SK, Bhatnagar S. Resilience to the effects of social stress: evidence from clinical and preclinical studies on the role of coping strategies. Neurobiol Stress 2015; 1:164-173. [PMID: 25580450 PMCID: PMC4286805 DOI: 10.1016/j.ynstr.2014.11.002] [Citation(s) in RCA: 115] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The most common form of stress encountered by people stems from one's social environment and is perceived as more intense than other types of stressors. One feature that may be related to differential resilience or vulnerability to stress is the type of strategy used to cope with the stressor, either active or passive coping. This review focuses on models of social stress in which individual differences in coping strategies produce resilience or vulnerability to the effects of stress. Neurobiological mechanisms underlying these individual differences are discussed. Overall, the literature suggests that there are multiple neural mechanisms that underlie individual differences in stress-induced resilience and vulnerability. How these mechanisms interact with one another to produce a resilient or vulnerable phenotype is not understood and such mechanisms have been poorly studied in females and in early developmental periods. Finally, we propose that resilience may be stress context specific and resilience phenotypes may need to be fine-tuned to suit a shifting environment. Resilience is considered positive adaptation in the face of adversity. Coping strategy impacts one's susceptibility to social stress-induced psychopathology. Neurobiological substrates such as CRF, NPY and DA may impact stress susceptibility. Individual differences within females and during adolescence are poorly understood.
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Affiliation(s)
- Susan K. Wood
- Department of Pharmacology Physiology and Neuroscience, University of South Carolina School of Medicine, Columbia, SC 29209, USA
- Corresponding author. Department of Pharmacology, Physiology & Neuroscience, Basic Science Bldg 1, 3rd Floor, Rm D28A, 6439 Garners Ferry Rd, Columbia, SC 29209, USA.
| | - Seema Bhatnagar
- Department of Anesthesiology and Critical Care, Children's Hospital of Philadelphia and the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104-4399, USA
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Abstract
PURPOSE OF REVIEW Carers of people with dementia are at increased risk of experiencing psychological distress. This article reviews recent findings on the role of personality traits for psychological outcomes for carers of people with dementia. RECENT FINDINGS Several studies have now established that personality influences the caregiving experience, carer well-being and outcomes such as coping ability, burden and caregiving style. Several moderators of these associations have also been identified such as the effect of kinship and type of dementia. There is consistent evidence that carer personality characteristics influence the progression of the disease such as cognitive decline and severity. Most of the recent studies identified in this review are cross-sectional. SUMMARY Taken together, these results indicate that personality is an important psychological resource for carers. Recent findings indicate that personality traits are associated with and influence both carer and patient outcomes. Future research is necessary to guide interventions and to expand further on our understanding of how personality factors shape adjustment to the caregiving role and how these impact on the progression of the disease.
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Uemura S, Sekido K, Tanioka T. Characteristics of Male Family Caregivers in Japan and Their Sense of Care Burden, Capacity to Deal with Stress, and Subjective Sense of Well-Being. Health (London) 2014. [DOI: 10.4236/health.2014.618281] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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