The relationship between health and social support in caregiving wives as perceived by significant others

This study explored the relationship between health and social support in wives who care for husbands with dementia In order to understand how significant others begin mobilizing help for caregivers, the significant others' views of the carers' health and social support were analysed Subjects comprised 75 significant others identified as being familiar with the caregiving situation of a like number of caregiving wives Hypotheses, which were rejected, predicted that wife caregivers perceived as ill by the significant other would be seen as needing and receiving more social support as reported by the significant other Findings indicated that healthy caregivers were perceived to have significantly more people in their social network     

The association between caregiving satisfaction, difficulties and coping among older family caregivers

Aims and objectives. The aim was to study the association between gender, extent and content of care, satisfaction, coping and difficulties in the caregiving situation among older (75+) caregivers and to identify clusters of caregivers. The aim was also to explore psychometrically two instruments assessing satisfaction and difficulties in family caregivers. Background. Caregiving is a complicated phenomenon. Much of the research has focused on negative aspects, such as the burden, stress and emotional strain. Caregiving is known to affect health negatively for the caregivers. Little is known about satisfaction and motivation in voluntary work, such as informal caregiving, especially among older persons. Design and methods. Cross‐sectional. The sample for this study consisted of 171 informal caregivers aged 75 and over, identified from an age‐stratified sample in a postal survey among older people in the southern part of Sweden. Results. Male caregivers proved to be more satisfied than female caregivers; caregiving had seemingly widened their horizon and had helped them to grow as persons. Based on satisfaction scores, those satisfied had a higher proportion of male caregivers and a significantly higher amount of caregiving hours per week. They used other coping strategies than the respondents in the other cluster, i.e. less satisfied in using more problem‐solving strategies. Conclusions. The instruments tested were appropriate for work in clinical and research settings, although the internal dropout indicates that a shorter version would be more useful. Those who found satisfaction in care used more problem‐focused coping strategies and were more often men than women. From a salutogenic point of view, this may give important knowledge about factors that can promote health. The findings indicate that women deserve extra attention as informal caregivers as they did not find caregiving as rewarding as the men did. This may in turn make them less protected against the negative consequences of caregiving. Relevance to clinical practice. Reinforcing the health‐promoting qualities in caregivers who are not feeling well, with women as a particularly vulnerable group, may restrict unnecessary suffering for both the caregiver and the person cared for.     

Coping and health outcomes in spouse caregivers of persons with dementia

The effects of different coping patterns on the physical health, depression, and anxiety experienced by 60 spouse caregivers of persons with dementia were examined, using Lazarus and Folkman's cognitive model of stress and coping. In addition to coping, the model included the following predictors: severity of the patient's memory and behavior problems, caregiver's appraisal of the stressfulness of those problems, and caregiver's appraisal of their options for managing caregiving. The predictors did not explain a significant amount of the variance in caregivers' physical health, but they did explain 43% of the variance in both depression and anxiety. The only coping pattern that added to the explanations was Wishing-Emotive coping, which consisted of the coping subscales of escape-avoidance, confrontive coping, and accepting responsibility. Caregivers' appraisal of stress was a significant predictor of depression and anxiety, but neither the severity of the patients' problems nor caregivers' appraisal of options was a significant predictor of any of the health outcomes.     

The competing demands of employment and informal caregiving to disabled elders

The competing demands of work and elder care are the subject of this study. The employment decisions of the informal caregivers of a nationally representative sample of disabled elders were examined using a nested multinomial logit model. Findings from the work accommodation model demonstrated that primary caregivers and those caring for elders with greater care needs are more likely to take unpaid leave, reduce work hours, or rearrange their work schedules to assume elder care responsibilities. Being female, white, and in fair-to-poor health also increased the likelihood of work accommodation. The model predicting employment of a caregiver revealed that the prospect of having to accommodate work to the demands of caregiving keeps some people from work entirely. However, not all caregivers would choose to work in the absence of caregiving responsibilities. After controlling for the probability of work accommodation, need for care, and availability of others to care, it is more likely that younger, white and more highly educated caregivers will be employed. The self-selection of working caregivers observed in this study should be considered when forecasting changes in caregiving costs associated with changes in the labor force participation of caregivers as a result of deliberate policies or social and demographic trends.     

The association between meaning of caregiving, perceived social support and level of depression of Taiwanese caregivers of mentally ill patients

Caregiving is a demanding responsibility. Because of the de-institutionalization movement, much of the care provided by hospitals has been shifted to the community. Caregivers' issues cannot be overlooked. The purposes of the study are: (a) to understand meaning of caregiving, perceived social support and level of depression of caregivers during the transition phase immediately following a family members' discharge from the hospital to the community; (b) to determine the association between determinants and meaning of caregiving, perceived social support level of depression; (c) to determine the association between meaning of caregiving, perceived social support level of depression. Fifty five caregivers of schizophrenic patients were recruited from a private hospital in Taipei, Taiwan. Certain characteristics of caregivers were found to be associated with lower levels of depression, meaning of caregiving and perceived social support. Perceived social support was shown to be a mediator between the meaning of caregiving and caregivers' level of depression. Despite the small sample size, the findings can serve as a reference for mental health professionals as they develop mental health care program for patients and also for caregivers.     

Physical and psychosocial health in family caregiving: a comparison of AIDS and cancer caregivers

The objectives of this study were to compare cancer and AIDS family caregivers in regard to their physical and emotional health. The sample consisted of 26 caregivers of persons with cancer or AIDS. Study participants completed a questionnaire that included measures of depression, grief, symptoms of stress, caregiving demands, interpersonal relationships, health status, and quality of life. The data revealed that both AIDS and cancer caregivers reported high levels of stress and depression as compared to community norms. No significant differences were found between AIDS and cancer caregivers for any of the scale scores; however, the two groups differed on several individual subscales. Cancer caregivers demonstrated higher social functioning and were more likely to report that the work of caregiving itself disrupted their ability to socially engage with others. In contrast, AIDS caregivers were more likely to report that their own health limited their ability to socialize. Even though AIDS caregivers experienced less family support than cancer caregivers, they reported more rewards from caregiving. Results suggest that support delivered to caregivers emphasize a more inclusive approach to program delivery, versus a disease-specific perspective, in order to increase the depth and breath of services provided to families undertaking these challenges.     

The relationship between caregiving and employment. A study of stress in employed and unemployed caregivers of elderly persons

The need for persons to provide care on an informal basis to frail and dependent elderly persons has generated a "caregiving crisis" in this country. Middle age women, the traditional caregivers for most generations, are no longer readily available to provide informal care. Instead, they are likely to be struggling to cope with the dual demands of paid employment and family responsibilities. Significant differences exist between employed and unemployed caregivers in relation to age, marital status, gender, personal health status, and caregiver-care recipient relationships. However, no differences exist in relation to the amount of stress experienced as a consequence of caregiving responsibilities. Occupational health nurses have an ideal opportunity to help employed caregivers cope with their caregiving responsibilities both at the worksite and in their personal lives.     

Caregiving demands,job demands,and health outcomes for employed family caregivers of older adults with dementia: Structural equation modeling

Many family caregivers are also employed full- or part-time and are known to be affected by job demands. This study explored the mediating effect of job demands on the relationship between caregiving demands and caregiver health outcomes in primary family caregivers of older persons with dementia in Taiwan (N?=?214). A cross-sectional design using a self-completed structured questionnaire was implemented. Structural equation modeling analyses showed that job demands partially mediated the relationship between caregiving demands and caregiver health outcomes. The indirect effect of caregiving demands on caregiver health outcomes through job demands was 0.208 (95% confidence interval: 0.053 - 0.335). Nurses should evaluate job demands when screening for high-risk caregiver groups vulnerable to high caregiving demand. Interventions aimed at lessening both caregiving demands and job demands may improve caregiver health outcomes for family caregivers of older adults with dementia.     

The relationship among life events,dysfunctional attitudes,and depression

The purpose of the present study was to evaluate dysfunctional attitudes as a moderator variable in the relationship between negative life events and depression. On the basis of the cognitive model of depression it was predicted that, within a normal college student population, individuals who endorse highly dysfunctional attitudes would be more adversely affected by negative life stress than would their more functional counterparts. Normal and clinical college student groups were administered measures of life events, dysfunctional attitudes, and depression. As expected, in the normal sample, there was a significant interaction between dysfunctional attitudes and negative life stress, which was consistent with the cognitive model of depression. In the clinical sample, the interaction was nonsignificant, and both dysfunctional attitudes and negative life events were found to exert a more direct influence on mood. The implications of these findings for future research were reviewed, along with a suggestion that longitudinal designs might permit a more complete test of the cognitive model.Portions of this paper were presented at the annual meeting of the American Psychological Association, Washington, D.C., August 1982. We would like to express our appreciation to Thomas M. Hess, Kenneth Hardy, and the anonymous reviewer for their helpful comments.     

Caregiving at the end of life: Perceptions of health care quality and quality of life among patients and caregivers

This study explored the association between perceptions of health care quality and quality of life in patients with advanced metastatic cancer and their informal caregivers (n=39). Patients' and caregivers' perceptions of health care quality, mental health, health-related quality of life, symptoms, and burden were measured. The key findings included the following: 1) patients' mental health and depression scores correlated with those of caregivers, suggesting that the mental health of patients and their caregivers are associated; 2) patients and caregivers shared similar perceptions regarding health care quality; 3) the presence of depression in caregivers correlated with caregivers being less satisfied with the health care being given to their patients (this correlation did not exist for patients, a finding that may be due in part to the protective buffering effect that caregivers provide their patients as illness progresses); and 4) a modified Primary Care Assessment Survey, originally designed for primary care patients, was a useful measure of health care assessment for both patients and caregivers. These data suggest that patients with advanced disease and their caregivers share similar perceptions and evolve as a "unit of care," and caregivers, as unique and important members of the patient's health care team, are also in need of care. When depressed, caregivers may unilaterally lose trust by becoming less satisfied with the quality of health care being provided to their patients.     

护士工作满意度与组织支持感及工作倦怠的关系研究

目的探讨护士工作满意度、组织支持感及工作倦怠的关系。方法采用工作满意度量表、组织支持感测量问卷及工作倦怠问卷对549名护士进行调查。结果护士工作满意度、组织支持感及工作倦怠中去人格化、情感枯竭处于中等水平,个人成就感处于高度倦怠。工作年限、组织支持感及工作倦怠影响护士工作满意度(P0.01或P0.05)。结论护理管理者应提供组织支持,提高护士工作满意度,降低护士工作倦怠。     

The effects of past relationship and obligation on health and health promotion in women caregivers of adult family members

The social expectation that women will care for family members persists despite evidence that many women have difficult or abusive past relationships with their parents and partners. Little is known about how past relationship influences the health of women caring for adult family members. On the basis of earlier grounded theory research, we tested the theory that past relationship and obligation predict health outcomes and health promotion in 236 women caregivers of adult family members. Structural equation modeling demonstrated support for the theory, with 56% of the variance in health outcomes and 11% of the variance in health promotion accounted for by the model.