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A high sense of coherence protects from the burden of caregiving in older spousal caregivers
Affiliation:1. Tel-Hai College, Department of Education, Upper Galilee 12210, Israel;2. University of Haifa, Faculty of Education, Department of Counseling and Human Development, Haifa, Israel;1. Division of Hematology/Oncology, Department of Medicine, James P Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA;2. Department of Surgery, Cancer Control, University of Rochester Medical Center, Rochester, NY, USA;3. School of Nursing, University of Rochester Medical Center, Rochester, NY, USA;4. Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY, USA;6. Geisinger Cancer Institute NCORP, Danville, PA, USA;7. Cancer Research of Wisconsin and Northern Michigan (CROWN), Green Bay, WI, USA;8. Northwell Health, New York, USA;9. Department of Health Behavior, Society, and Policy, Rutgers School of Public Health, Piscataway, NJ, USA
Abstract:ObjectivesCaregiving is often associated with burden and chronic stress. Sense of coherence (SOC) may help the caregivers in coping with their stress and was identified as a positive factor for health outcomes and quality of life. We aimed to study the links between SOC, burden, depression and positive affects among caregivers of frail older patients.MethodsSeventy-nine spousal caregivers were recruited via the geriatric outpatient clinic. Data collected: Zarit Burden Inventory, SOC-13, Geriatric Depression Scale, Caregiver Reaction Assessment (CRA), sleep, time of supervision, Katz Index, Global Deterioration Scale and Neuropsychiatric Inventory. Analyses: Caregiver’s characteristics were analyzed by burden severity and SOC level. Multivariable logistic regressions were used in order to identify the variable that best predict caregiver burden and high SOC.ResultsThe mean age was 79.4 ± 5.3; 53% were women. Among care-recipient, 82% had cognitive impairment and the median Katz Index was 3. Caregivers with a high SOC and an older age reported a lower burden (Odds Ratio (OR) 0.18, 95% confidence interval (CI) 0.04–0.65 and OR 0.87, 95% CI 0.76–0.98, respectively). A higher burden was associated with patient functional limitations (OR 8.69, 95% CI 2.28–40.46).DiscussionHaving a high sense of coherence seems to be a protective factor against the burden. To support caregivers, health providers should recognize the expertise of the caregivers and the meaningfulness of this care situation.
Keywords:Salutogenesis  Informal care  Self-fulfillment  Meaningfulness
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