The relationship of caregiver strain with resilience and hardiness in family caregivers of older adults with chronic disease: a cross-sectional study (original) (raw)
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Frontiers in Psychology , 2022
Objective: Caring for patients with Alzheimer’s disease (AD) is a stressful situation and an overwhelming task for family caregivers. Therefore, these caregivers need to have their hardiness empowered to provide proper and appropriate care to these older adults. From the introduction of the concept of hardiness, few studies have been conducted to assess the hardiness of caregivers of patients with AD. Presumably, one reason for this knowledge gap is the lack of a proper scale to evaluate hardiness in this group. This study was conducted to develop a reliable and valid Family Caregivers’ Hardiness Scale (FCHS) to measure this concept accurately among Iranian family caregivers sample. Methods: This study is a cross-sectional study with a sequential-exploratory mixed-method approach. The concept of family caregivers’ hardiness was clarified using deductive content analysis, and item pools were generated. In the psychometric step, the samples were 435 family caregivers with a mean age of 50.26 (SD ± 13.24), and the data were gathered via an online form questionnaire. In this step, the items of the FCHS were evaluated using face and content validity. Then, the factor structure was determined and confirmed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) followed by convergent and divergent validity, respectively. Finally, scale reliability, including stability, and internal consistency were evaluated. Results: The finding revealed that FCHS consists of five factors, namely, “Religious Coping” (5 items), “Self-Management” (6 items), “Empathic Communication” (3 items), “Family Affective Commitment” (3 items), and “Purposeful Interaction” (4 items) that explained 58.72% of the total variance. The results of CFA showed a good model fit. Reliability showed acceptable internal consistency and stability. Conclusion: Based on the results of the psychometric evaluation of the FCHS, turned out that the concept of hardiness in Iranian family caregivers is a multidimensional concept that is most focused on individual-cultural values, emotional family relationships, and social relationships. The designed scale also has acceptable validity and reliability features that can be used in future studies to measure this concept in family caregivers.
2011
Background. Little attention has been given to the resiliency process of family caregivers for older people hospitalized with congestive heart failure. Aims. The purpose of this study was to examine the influences of older peoples' activities of daily living dependency, family caregivers' spiritual well-being, quality of relationship, family support, coping and care continuity on the burden of family caregivers of hospitalized older people with congestive heart failure using the Resiliency Model of Family Stress, Adjustment, and Adaptation. Design and sample. A descriptive, correlational research design was used. There were 50 family caregivers and 50 older people diagnosed with congestive heart failure recruited from medical and surgical units of two Midwest medical centres. Methods. Data on activities of daily living dependence of older people, family caregiver burden, spiritual well-being, coping strategies, quality of older people-caregiver relationship and care continuity were collected using structured questionnaires. Results. The findings indicated that there were significant positive associations between patients' activities of daily living dependence and family caregiver burden and between lack of family support and family caregiver burden. There were significant negative associations between quality of relationship and family caregiver burden, between care continuity and family caregiver burden, between coping and family caregiver burden and between spiritual well-being and burden. In hierarchical multiple regression, the model variables accounted for 66% of the variance in family caregiver burden. Patients' activities of daily living dependence, quality of relationship and lack of family support are significant predictors of family caregiver burden. Conclusions. The best predictors of family caregiver burden, using the resiliency model, were the older persons' activities of daily living dependence, family support, quality of relationship, care continuity, coping strategies and spiritual well-being. Implications for practice. It is vital for nurses to assess family caregivers' needs and resources and the quality of the older person-family caregiver relationship in developing a plan of care that reduces family caregiver burden.
Effects of individual and family hardiness on caregiver depression and fatigue
Research in Nursing & Health, 2002
Hardiness is de®ned as commitment to life, viewing change as challenge, and having control over one's life. Previous research suggests that hardiness is related to better outcomes in stressful situations. The effects of individual and family hardiness on depression and fatigue of caregivers of disabled older adults (DA) were examined using a descriptive, cross-sectional design. The sample was 67 caregivers of DA with high functional impairment. One-third of caregivers reported moderate to high fatigue, and 40% had scores indicating possible clinical depression. Memory and behavior problems of the DA were positively correlated with caregiver depression and fatigue. Family hardiness was negatively related to memory and behavior problems of the DA. Controlling for covariates, individual hardiness was negatively associated with depression and fatigue; coping strategies did not mediate the relationship. Caregivers with low individual and family hardiness had more depression than those high in both resources. Additional research is needed to determine the relevance of hardiness theory in caregiving research. ß
International journal of older people nursing, 2012
Little attention has been given to the resiliency process of family caregivers for older people hospitalized with congestive heart failure. The purpose of this study was to examine the influences of older peoples' activities of daily living dependency, family caregivers' spiritual well-being, quality of relationship, family support, coping and care continuity on the burden of family caregivers of hospitalized older people with congestive heart failure using the Resiliency Model of Family Stress, Adjustment, and Adaptation. DESIGN AND SAMPLE. A descriptive, correlational research design was used. There were 50 family caregivers and 50 older people diagnosed with congestive heart failure recruited from medical and surgical units of two Midwest medical centres. Data on activities of daily living dependence of older people, family caregiver burden, spiritual well-being, coping strategies, quality of older people-caregiver relationship and care continuity were collected using str...
Understanding Resilience Factors Among Caregivers of People with Alzheimer’s Disease in Spain
Psychology Research and Behavior Management
Introduction: Alzheimer's disease (AD) caregivers resilience involves the interaction between different risk and protective factors. Context of care, objective stressors, perceived stressors caregiver assessment, mediators factors and consequences of care were associated with resilience. We have developed a more integrated and operational conceptual model of resilience and care than previous models in our sociocultural environment. Purpose: To assess the resilience of caregivers of people with AD and the related factors grouped according to an established operational conceptual model of Alzheimer´s caregivers stress. Patients and Methods: A total of 120 primary informal caregivers of AD persons in Badajoz (Spain) were included in a cross-sectional design. The following variables have been measured on AD persons and caregivers: socio-demographic data, dependency level, cognitive decline, neuropsychiatric and behavioral symptoms, anxiety, depression, severity of somatic symptoms, level of burden, self-esteem, coping, social support, health-related quality of life (HRQOL) and resilience. Results: Most of the caregivers reported symptoms of anxiety (63.3%) and depression (62.5%). We found out higher levels of resilience in caregivers with lower dependence caring (p=0.004). Higher resilience levels of caregivers were related to minor depressive (p=0.006) and anxiety symptoms (p=0.000), and higher HRQOL (p=0.000). Coping dimension mostly used was problembased strategies such as active coping, positive reinterpretation and acceptance (p= 0.000). Conclusion: Those caregivers reporting higher levels of resilience exhibited moderate to intense indicators of burden, fewer symptoms of depression and anxiety and fewer somatic symptoms. They also used adequate problem-focused coping strategies, showed higher levels of HRQOL and demonstrated an appropriate perception of social support. Despite the fact that the characteristics relating to the care context and to social support exert an undeniable influence on caregiver resilience, it would appear that the caregiver's own intra-psychic resources reveal stronger correlations. Relevance for Clinical Practice: The early and accurate identification of caregivers with lower levels of resilience could enable the implementation of vital psychological and educative support interventions to help caregivers to improve their well-being.
Archives of Gerontology and Geriatrics, 2015
A majority of us will at some point in our lives take care of family members, relatives and friends in need of assistance. How will this affect us? Strain related to life satisfaction (LS) and health related quality of life (HRQoL) among caregivers aged 60 years and older has not been previously studied. Objectives: The main objective was to describe characteristics of non-caregivers (n = 2233) and caregivers (n = 369). Further objectives were to examine differences in HRQoL and LS between caregivers and noncaregivers, and between caregivers stratified by level of strain. Methods: We analyzed the differences in socio-demographics, social participation, locus of control and symptoms between groups. HRQoL was assessed by Short Form Health Survey (SF-12/PCS and MCS). LS was measured by the Life Satisfaction Index-A (LSI-A). Results: Caregivers were younger, had more years of formal education, more often cohabiting and relied less on powerful others than non-caregivers. One hundred and thirty-three (36%) caregivers reported high strain. In a three-group comparison including non-caregivers and caregivers stratified for strain, high strain was associated with lower SF12-PCS, SF12-MCS and LSI-A (0.014, <0.001 and <0.001, respectively). Conclusion: High strain affects caregivers' HRQoL and LS in a negative way. Practice: It is important for the health care sector to consider the possibility that symptoms in a person acting as a caregiver can be related to high perceived strain. Implications: A general policy program aiming to identify caregivers and their needs for support is much needed.
Resilience of family caregivers of elderly with Alzheimer
2016
Resilience is the capacity that people have to cope positively with adversities. A cross-sectional, quantitative study, that aimed to assess factors associated with the resilience of family caregivers of elderly with Alzheimer’s disease. Sixty-six caregivers composed the sample, who were accompanied in a neurology ambulatory. Most caregivers presented moderate resilience. Linear regression showed that some factors interfered with caregivers’ resilience, being those: overload, the increment of days dedicated to caregiving, the level of kinship daughter-in-law/son-in-law or spouse, and practice of other activities besides caregiving. The findings can be useful in care-related areas, once we identified variables interfering in resilience, and those can be worked and improved to benefit the caregiver and the patient. Descriptors: Resilience, Psychological; Alzheimer Disease; Caregivers; Dementia; Family. INTRODUCTION Dementia is a frequent health problem, and it significantly results in...
Caregivers Burden of Chronic Medical Illnesses in Older Patients
A cross-sectional study was conducted with 150 adult caregivers of patients with chronic illnesses in three tertiary medical centers in Riyadh 2015.This study addresses different aspects of burden placed on caregivers of chronic older patients. Caregivers who fulfilled the inclusion criteria, were approached by consecutive sampling. Participants were interviewed using an Arabic version of the Montgomery Borgatta Burden Measure Scale. The scale measures the Subjective (SB), Objective (OB) and Stress Burden (StB). The results showed that the SB, OB and StB were found to be mild in the sampled population (7.7±3.7, 14.2±3.4, and 9.05±4.2) respectively, compared to reference values (13.5, 23 and 15) of high burden. The StB was found to be higher in females than in males (9.86±4.56 vs. 8.44±3.89 respectively, p=0.041). Furthermore, nurses were found to have a greater SB compared to relatives (11.4 ±5.29 vs. 7.58±3.34 respectively, p=0.002). Analysis also showed that the caregivers who were employed elsewhere had lower StB, and OB (p=0.004, and 0.034, respectively). No other associations were found. In Conclusions, caregivers of chronically ill patients experienced a distinct level of burden while providing care. Socio-demographic factors were predictors of the level of burden.
The generalizability of Caregiver Strain Index in family caregivers of cancer patients
International journal of nursing studies, 2002
The purpose of this study was to estimate the variance components associated with individual differences and various sources of measurement error of Caregiver Strain Index (CSI). A two-facet (item and occasion) crossed design generalizability study (G study) was conducted using a sample of 14 caregivers of cancer patients. Based on the findings of the G study, alternative decision studies were then designed to search for optimal generalizability of CSI. The measurement of CSI was not reliable with a single test. Averaging two or more measurements would make CSI scores more generalizable for either relative or absolute assessment of caregiver strain.
International Journal of Geriatric Psychiatry, 2007
PurposeMany assessment tools have been developed for evaluating caregiving programs, but the majority are too cumbersome for ongoing use. This study reports on a brief assessment tool used to monitor strain among family members caring for an impaired elder.Many assessment tools have been developed for evaluating caregiving programs, but the majority are too cumbersome for ongoing use. This study reports on a brief assessment tool used to monitor strain among family members caring for an impaired elder.Design and methodsParticipants were enrolled in the SeniorCare program, a program funded by the Administration on Aging to provide care to family caregivers. The Caregiver Risk Screen (CRS) is a 12-item measure of strain, initially developed as part of an in-home assessment procedure. Its utility for use in practice settings over time was assessed using both quantitative and qualitative methodology.Participants were enrolled in the SeniorCare program, a program funded by the Administration on Aging to provide care to family caregivers. The Caregiver Risk Screen (CRS) is a 12-item measure of strain, initially developed as part of an in-home assessment procedure. Its utility for use in practice settings over time was assessed using both quantitative and qualitative methodology.ResultsChronbach alpha levels for the CRS were 0.85 at intake and 0.84 at first follow-up. At the first follow-up, the overall index score and five of the 12 items showed statistically significant lessened strain. In subsequent follow-up evaluations, the average improvements were maintained but there was no additional decrease in strain. Individual variations in changes over time were identified by combining quantitative and qualitative information. Themes that emerged in qualitative data served to modify the measure for future use.Chronbach alpha levels for the CRS were 0.85 at intake and 0.84 at first follow-up. At the first follow-up, the overall index score and five of the 12 items showed statistically significant lessened strain. In subsequent follow-up evaluations, the average improvements were maintained but there was no additional decrease in strain. Individual variations in changes over time were identified by combining quantitative and qualitative information. Themes that emerged in qualitative data served to modify the measure for future use.ImplicationsThe brief Caregiver Risk Screen tool appears to be a reliable and valid tool for use in practice settings. It is acceptable to clients and professional staff. Modifications have been made that may further enhance the suitability of this measure for other settings. Copyright © 2006 John Wiley & Sons, Ltd.The brief Caregiver Risk Screen tool appears to be a reliable and valid tool for use in practice settings. It is acceptable to clients and professional staff. Modifications have been made that may further enhance the suitability of this measure for other settings. Copyright © 2006 John Wiley & Sons, Ltd.