Predictors of depression among wife caregivers

The relationship of caregiver health, past marital adjustment, and received social support to depression was studied in 78 wives who served as primary caregivers to husbands with irreversible memory impairment. In addition, socioeconomic status and attitudes toward seeking help were investigated. The mean age of the wives was 68 years, and the mean length of time they had been caring for their husbands in the home was 4 years, 10 months. Only caregiver health and attitude toward asking for help were significant, p = .001, predictors of depression and accounted for 27% of the total explained variance.     

Predictors of depression and life satisfaction in visually impaired people

Background: Visual impairment can lead loss of functional ability, necessity of accommodations and assistive technologies or having to rely on others for help. This can bring about feelings of sadness, dependency, inadequacy, and fear, which can put a person at risk for depression and affect one’s satisfaction with life.

Purpose: The aim of this study was to examine the effects of socio-demographic factors, disability-related factors, optimism, pessimism, self-esteem and social support on depression, and life satisfaction in visually impaired people.

Methods: A total of 94 visually impaired people completed the measures of socio-demographic and disability-related characteristics, optimism and pessimism, self-esteem, social support, depression and life satisfaction, administered by the authors. Correlational and hierarchical regression analysis was used to examine the relations and test the model for predicting depression and life satisfaction.

Results: The results have shown that depression was negatively related to the level of education, optimism, self-liking, self-competence, support from friends, family and coworkers, and positively related to comorbidity and pessimism. Life satisfaction was positively related to education, socio-economic status, optimism, self-liking, self-competence and support from friends, family and coworkers, and negatively to pessimism. Results have further shown that depression levels were predicted by education, comorbidity, optimism and self-liking, and that self-liking mediated the relationship between optimism and depression. Life satisfaction was predicted by optimism, pessimism, self-liking, friends’ support, and depression. Further analysis suggested that the path from optimism to life satisfaction goes through self-liking, friends’ support, and depression. Pessimism showed indirect effects through self-liking but also had direct effects on life satisfaction.

Conclusions: Focusing on optimism, pessimism, self-esteem, and social functioning of visually impaired is important in preventing depression and promoting life satisfaction, and should be a part of rehabilitation practices.

• Implications for Rehabilitation

• Screening for depression and mental health problems should be a part of rehabilitation process.

• Changes in the perception of future outcomes should be monitored and addressed throughout rehabilitation process in order to boost realistic optimism and prevent discouragement and hopelessness.

• Frequent feedback and positive reinforcement about a persons’ progress and ability should be given throughout rehabilitation process in order to promote positive view of oneself and prevent self-esteem problems.

• Visually impaired people should be encouraged to socialise outside of their families and participate in social activities. This can be integrated in rehabilitation process as a part of everyday homework.

     

Concerns about analgesics among patients and family caregivers in a hospice setting

Patients receiving curative treatment for cancer have concerns about reporting pain and using analgesics. These concerns are associated with underutilization of analgesics. To extend knowledge about such concerns to the context of palliative care, the concerns of hospice patients and family caregivers were compared. Within 5 days of admission to hospice, 35 patients with cancer and their caregivers each completed a measure of eight concerns such as fear of addiction, worry about tolerance, and worry about side effects. There was no correlation between caregiver and patient concerns and means for the two groups were similar, indicating that within a given dyad either the patient or the caregiver may have greater concerns. The findings highlight the need for patient and caregiver education about reporting pain and using analgesics. © 1996 John Wiley & Sons, Inc.     

Loneliness and depression in spousal caregivers of those with Alzheimer's disease versus non-caregiving spouses

Loneliness as a factor in the development of depression in Alzheimer's disease (AD) spousal caregivers has been given little attention. In this sample, 49 AD caregiving spouses reported significantly higher levels of loneliness and depression than did 52 non-caregiving spouses. AD caregiving wives reported greater loss of self and significantly higher levels of loneliness and depression than did AD caregiving husbands. Loneliness was the only predictive variable for AD caregiver depression, explaining 49% of the total variance. To meet the mental health needs of AD caregiving spouses, loneliness must be addressed along with the development of nursing interventions.     

Predictors of life satisfaction: a spinal cord injury cohort study

OBJECTIVE: To determine unique demographic, medical, perceived health, and handicap predictors of life satisfaction 2 years after spinal cord injury (SCI), as well as the predictors of change in life satisfaction from year 1 to year 2. DESIGN: Prospective predictive study performed by using longitudinal data from 18 Spinal Cord Injury Model Systems. SETTING: University physical medicine and rehabilitation department. PARTICIPANTS: Adults with traumatic onset SCI (N = 940) evaluated at 1 and 2 years' postinjury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Satisfaction with Life Scale (SWLS) 2 years post-SCI. Predictor variables: demographic characteristics, impairment and disability classifications, and 1 year post-SCI measures of life satisfaction (SWLS), medical complications, self-perceived health (Medical Outcomes Study 12-Item Short-Form Health Survey), and extent of handicap (Craig Handicap Assessment and Reporting Technique). RESULTS: The factors uniquely associated with an increased risk of lower self-reported life satisfaction at year 2 post-SCI included being male and unemployed, with poor perceived health, decreased mobility, and decreased social integration. After controlling for year 1 estimates of life satisfaction (ie, examining change in life satisfaction), only mobility and perceived health were uniquely related to life satisfaction 2 years post-SCI. CONCLUSION: Mobility and perceived health appear to be the consistent predictors of life satisfaction at year 2 post-SCI, as well as change in satisfaction from year 1 to year 2. Because both factors are amenable to change, they are reasonable targets of intervention programs. Identifying specific mechanisms of perceived health and mobility associated with life satisfaction should be an important area of continued research.     

Sources of satisfaction and stress in nursing home caregivers: preliminary results

A study of nursing staff on two units of a long-term nursing facility examined their reasons for enjoying and disliking their jobs, and daily reports of positive and negative events experienced along with their rating of the emotional intensity of those events. Each of the 30 members of the nursing staff responded to a brief demographic questionnaire. The nursing staff expressed strong positive attitudes towards their jobs. They described a wide range of concerns, both positive and negative, relating to institutional, unit management, and direct patient care issues. The mean intensities associated with positive and negative events at each of the areas of concern were above 7.5 on a 10-point scale (10 = highest intensity), with the exception of the intensity of negative events at the patient level (mean = 6.2). The intensity for positive events at the patient level was among the highest (mean = 9.2). The difference between the two means at the patient level suggests that nursing staff have adjusted to their work by focusing on positive patient events and by tempering their reaction to negative patient events.     

A comparison of sources of nursing stress and job satisfaction among mental handicap and hospice nursing staff

This study compares sources of nursing stress and job satisfaction among 181 mental handicap and 24 hospice nurses. It was hypothesized that nursing stress varies as a consequence of nursing specialty. Analysis of variance revealed differing features of nursing stress between the two specialties. Hospice nurses reported stress as primarily associated with death and dying and inadequate preparation to meet the emotional needs of patients and their families, while mental handicap nurses reported stress related to workload, conflict with other nurses and nursing environment. The results suggest that two additional factors that did not differ between specialties require further examination, namely patient behaviour and purposelessness of nursing care. Job satisfaction also differed between specialties with hospice nurses reporting higher satisfaction with supervision, co-workers, and pay, and lower satisfaction with promotion in comparison to mental handicap nurses. Within the mental handicap groups nursing stress correlated with job satisfaction, state-trait anxiety and non-psychotic psychiatric disturbance in predicted directions. Analysis of the above variables with respect to mental handicap nursing grade was also undertaken. Overall results indicate the importance of nursing specialty as a major factor influencing nursing stress.     

Predictors of life satisfaction: perceptions of older community-dwelling adults

The purpose of this study was to investigate variables that predict life satisfaction in elderly individuals. A convenience sample of 70 older community-dwelling adults participated in the study. Instruments used included the Life Satisfaction Index A Scale, three subscales from the Self-Evaluation of Life Function Scale, the Perceived Control Scale, Hollingshead's Two Factor Index of Social Position, and the Self-Rated Health Subscale of the Philadelphia Geriatric Center Multilevel Assessment Instrument. When the influence of health and social position was held constant, social interaction was the only additional significant predictor of life satisfaction. When health and social position were not held constant, social interaction, perceived control, and social position were significant predictors of life satisfaction. The findings indicate that nursing practice, education, and research should focus on assessment and interventions relative to promoting and maintaining health, perceived control, and social interaction among elderly individuals living in the community.     

Quality of life among older grandparent caregivers: a pilot study

Title.  Quality of life among older grandparent caregivers: a pilot study.
Aim.  This article is a report of a study conducted to compare quality of life and levels of depressive symptoms among older grandparent caregivers and non-caregivers in Taiwan.
Background.  Little is known about grandparenthood in modern Chinese society. In particular, no research has been conducted to explore the consequences among Chinese grandparent caregivers of caring for grandchildren.
Methods.  A cross-sectional comparative pilot study was conducted in 2007 in a city in Taiwan. A convenience sample of 45 grandparent caregivers and 48 grandparent non-caregivers was interviewed using a questionnaire including Taiwanese versions of the Short Form-36 Health Survey and Geriatric Depression Scale.
Results.  No statistically significant differences in measures of quality of life or depression were found between the caregiver and non-caregiver groups. Physical health was poorer than mental health in both caregiver and non-caregiver groups. Among caregivers, 55·6% reported psychological distress, even though 86·7% had support from family members.
Conclusion.  Nurses in community settings should be aware of the physical burdens on older grandparent caregivers and offer advice to protect their health. Further studies with larger sample sizes are required to generate more complete results on the consequences of caregiving by grandparents. The buffering role of family support on caregiving stress should also be further studied using validated measurement tools.     

Predictors of life satisfaction in HIV-positive Nepali women.

In a cross-sectional design, the authors examined the degree to which indicators of physical, mental, and social domains and perceived health predicted life satisfaction in 98 HIV-positive women who were former commercial sex workers in Nepal. Measures included the Quality of Life Inventory, Medical Outcomes Study 36-Item Short-Form Survey, Center for Epidemiologic Studies Depression Scale, and the anxiety subscale of the Symptom Checklist-90-Revised. Life satisfaction was significantly associated with physical functioning (r = .32), role-physical (r = .31), bodily pain (r = .32), mental health (r = .39), anxiety (r = -.66), depression (r = -.47), social functioning (r = .47), and health transition (r = .49). Anxiety (beta = -.75), health transition, (beta = .45), role-physical (beta = -.43), physical function (beta = .24), and mental health (beta = -.23) explained 60% of the variance in life satisfaction. The authors discuss the challenges of international studies, including salience of the concept of quality of life, conceptual and cultural equivalence of instruments, identification of culturally relevant concerns, disclosure of private information, and instrument format.     

Functional impairment, depression, and life satisfaction among older hemodialysis patients and age-matched controls: a prospective study

OBJECTIVE: To compare change over time in functional impairment, depression, and life satisfaction among older dialysis patients and age-matched controls. DESIGN: Prospective cohort study over 3 years. SETTING: Urban and rural communities throughout Georgia. SUBJECTS: One hundred thirteen prevalent renal failure patients on in-center hemodialysis and 286 controls. MAIN OUTCOME MEASURES: Ordinal functional impairment index and life satisfaction rating, and Center for Epidemiologic Studies Depression Scale. RESULTS: Dialysis patients, compared with controls, reported significantly more functional impairment at baseline, and also at follow-up after adjusting for baseline impairment and covariates. Dialysis patients had higher depression scores at baseline, and also at follow-up after adjusting for baseline depression and covariates. In contrast, dialysis patients reported lower life satisfaction at baseline than did controls, but the two cohorts were not significantly different on reported life satisfaction at follow-up, after adjusting for baseline life satisfaction and race. In both cohorts, functional impairment and depression were significantly related. CONCLUSION: Older dialysis patients' life satisfaction at a 3-year follow-up, which was similar to life satisfaction among age-matched controls, indicates the value of delivered dialysis care; the value of this care would be increased by reducing excess functional impairment in these patients.     

Perceptual consistency of pain and quality of life between hospice cancer patients and family caregivers: a pilot study

AIMS: Clinicians usually adjust medical management based on caregivers' observation when caring for seriously ill or cognitive-impaired patients. The purpose of this study is to research the differences in perceptual congruence of patients and caregivers when assessing patients' global pain (GP) and quality of life (QOL) in a hospice ward. METHODS: From July 2002 to June 2004, hospice inpatients and their family caregivers were invited to participate in this study at a medical centre in Southern Taiwan. The survey was cross-sectional, incorporating patients' bio-psycho-social factors so as to understand their impacts on patients' pain perception and QOL. The bio-psycho-social factors included biological pain, physical dependence, financial difficulty, anxiety over family, existential meaning of life, uncontrolled outcome of disease and insufficient emotional support. RESULTS: Fifty-eight patient/caregiver dyads were recruited in the study. The mean of patients' self-reported GP was higher than caregivers' rating (5.9 +/- 1.7 vs. 5.1 +/- 1.9, p < 0.05); however, the score of patients' QOL was lower in the patients than in the caregivers (6.9 +/- 1.6 vs. 7.9 +/- 1.4, p < 0.001). The result of regression analyses showed that 'biological pain', 'religion' and 'gender' were independent variables for patients' GP; however, 'biological pain' and 'gender' were factors for patients' QOL. No psychosocial factor was revealed as a factor in patient's perception of GP or QOL in this survey. CONCLUSION: This study indicates that caregivers have the propensity to under-rate patients' pain and overvalue QOL; moreover, 'religion' and 'gender' influence patients' perception near the end-of-life. Therefore, reassessment and proper holistic approach are important in hospice care.     

Relationships of cognitions associated with coping reactions to depression in spousal caregivers of Alzheimer's disease patients

Attributions (globality and stability) related to the reformulated learned helplessness (RLH) model of depression, and attributes, self-evaluations, and expectancies concerning coping reactions (degree of upset, success, satisfaction, control in future, future coping success) postulated by Wortman and Dintzer (1978) were examined for their respective relations to severity and prevalence of diagnosable depression in a highly stressed sample (N =68) of spouse caregivers of Alzheimer's disease patients. Subjects' attribution-related cognitions concerning two situational contexts were obtained: (1) an unpredictable upsetting behavior by the Alzheimer patient, and (2) significant life change experienced by the caregiver as a result of his/her spouse's Alzheimer's disease. The results indicated that only globality was related to depression for the Alzheimer patient's unpredictable behavior; however, both globality and stability were related to depression for the subject's life change situation. The pattern of the other depressogenic coping cognitions was also different for the two contexts: While ratings of upset and lack of current and future control were related to depression for the Alzheimer patient's behavior, ratings of poor current and future coping, lack of coping success, and coping dissatisfaction were related to depression for the subject's life change context. The discussion of the contextual specificity of coping cognitive patterns focused on the possible significance of the intrapersonal versus the interpersonal nature of the situational context. This study was funded by National Institute of Mental Health Grant MH33779 to the third author.     

Relationship of empathy to appraisal, depression, life satisfaction, and physical health in informal caregivers of older adults

The relationship between empathy and caregiving appraisal and outcomes was examined among 140 informal caregivers of older adults. Caregivers with high cognitive empathy appraised the caregiving situation as less stressful and less threatening, were less depressed, and reported higher life satisfaction than did caregivers with low cognitive empathy. The caregivers' appraisal, along with educational levels and total household income, significantly predicted individual differences in caregiver depression, life satisfaction, and perceived physical health. Emotional empathy was negatively related to life satisfaction. There appeared to be distinct roles for emotional and cognitive empathy in informal caregiving outcomes. The study supported the important role of caregiving appraisal and resources in caregiving outcomes.     

Prevalence and predictors of compassion satisfaction,secondary traumatic stress,and burnout among Chinese hospice nurses: A cross-sectional study

AimTo explore the prevalence and predictors of compassion satisfaction, secondary traumatic stress, and burnout among Chinese hospice nurses.BackgroundBecause of prolonged and continual contact with suffering, deaths, and grief, hospice nurses may be vulnerable to emotional burdens and have difficulty maintaining their professional quality of life.MethodsA cross-sectional study was conducted. A total of 478 hospice nurses were selected from 24 medical institutions in Sichuan province. Demographic, work-related information and work-related trauma questionnaire, the Chinese version of the Interpersonal Reactivity Index, the Chinese version of the Emotion Regulation Questionnaire, and the Chinese version of the Professional Quality of Life Scale for Nurses were used for collecting data.ResultsThe mean scores of compassion satisfaction, secondary traumatic stress, and burnout were 34.89 ± 6.21, 26.35 ± 5.24, and 24.49 ± 5.01, respectively. Job satisfaction, perspective-taking, empathic concern, working in tertiary hospitals, and adopting cognitive reappraisal strategy were positively associated with compassion satisfaction, while personal distress was a negative factor, all variables explaining 50.7 % of the variance. Higher burnout was found among nurse who had higher personal distress, worked in secondary or primary hospitals, worked >8 h per day and caring for >10 dying patients last month. In addition, job satisfaction, social support, perspective-taking, empathic concern, and cognitive reappraisal were identified as significant protectors, explaining 50.1 % of the variance. We also found that lower job satisfaction, higher personal distress, higher expressive suppression, lack of social support, senior nurses, and cared for >10 dying patients last month, were positively related to secondary traumatic stress. However, cognitive reappraisal had negative associations. These seven factors explained 32.0 % of the variance.ConclusionsHospice care has specific characteristics and hospice nurses may suffer from more work-related stressors compared with other nurses. Our study may provide clues to help nursing administrators identify hospice nurses who are at higher risk of compassion fatigue and design targeted interventions focused on potential risk factors and protectors to improve hospice nurses' compassion satisfaction, while reducing compassion fatigue.     

Behavioral risk factors and use of preventive screening services among spousal caregivers of cancer patients

Purpose  

Caregiving of cancer patients is burdensome and is likely to affect health behavior and outcome of caregivers. However, there are only a small number of studies on lifestyle behavior and use of preventive services by caregivers of cancer patients, especially in Asian populations. The aim of this study was to compare the status of lifestyle behavior and use of preventive services in spousal caregivers of cancer patients and controls.     

Working life and stress symptoms among caregivers in elderly care with formal and no formal competence

engström m. , skytt b. & nilsson a. (2011) Journal of Nursing Management 19, 732–741
Working life and stress symptoms among caregivers in elderly care with formal and no formal competence Aim The aim of the present study was to describe and compare caregivers with formal and no formal competence on job satisfaction, psychosomatic health, structural and psychological empowerment and perceptions of care quality. A further aim was to study relationships among study variables. Methods A convenience sample of 572 caregivers in elderly care participated. Results Caregivers with no formal competence perceived higher workload, more communication obstacles, less competence, poorer sleep and more stress symptoms than did their colleagues. Linear regression analyses revealed that the factor self-determination was an explanatory variable of stress levels among caregivers with no formal competence, and self-determination and impact among caregivers with formal competence. Linear regression analysis revealed that different dimensions in structural and psychological empowerment explained the variance in staff job satisfaction, perceived stress symptoms and quality of care. Conclusions No formal competence seems to be a risk factor for psychosomatic health problems. Implications for nursing management Managers need to have a strategic plan for how to create a working environment for caregivers with no formal competence. Caregivers’ self-determination seems to be important for stress symptoms. Meaning, self-determination, impact and opportunities appear to be important for job satisfaction and competence, opportunities, resources and formal power for quality of care.