Background The impact of looking after children who live with complex chronic conditions is a growing public health issue. However, it is unclear whether sociodemographic and psychosocial variables can be used to predict the burden on the caregiver and how the profiles of families of children with chronic diseases are defined and structured. The objective of this study was to identify multivariate sociodemographic and psychosocial variables as well as sociocultural and familial factors to analyze the caregiver burden of family caregivers of children with chronic diseases. Methods A cross-sectional study was conducted involving 416 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to a questionnaire on sociodemographic variables and a battery of 7 instruments that examined caregiver burden, family support, parental stress, anxiety, support networks, family functioning, historic-psycho-socio-cultural premises and the World Health Organization Well-Being Index . Results A multivariate analysis using hierarchical multiple regression models showed that the variables included in the psychosocial and sociodemographic profile as a whole explained 40% of the variance in caregiver burden, taking sociocultural historical premises, stressors and anxiety into account as positive individual predictors. Negative individual predictors for caregiver burden included upper secondary education, social support networks, family support, family functioning and well-being. The sociodemographic profiles of family caregivers were as follows: female (81.7%); mean age, 31.7 years (standard deviation [SD], 8 years); married (79.3%); nuclear family (60%); basic education (62.7%); unpaid work (66.3%); and a daily household income of approximately 4 USD (61.1%). Conclusions The caregiver burden of family caregivers of children with chronic diseases is defined and structured based on personal, family, and sociocultural factors. These features provide evidence to conduct research and implement intervention strategies with regard to families facing adversity, risk and vulnerability during a child’s disease.

Resumo Foram analisadas as relações das estratégias de enfrentamento, apoio social e variáveis sócio-demográficas com o bem-estar subjetivo de uma amostra de idosos. O bem-estar foi definido pela satisfação com a vida, os afetos positivos e afetos negativos. Participaram 123 idosos (média = 67,1; desvio padrão = 6,1), residentes em João Pessoa, Brasil. Análises de regressão hierárquica revelaram que (a) a satisfação com a vida é maior em mulheres, nas pessoas que recebem pensão, as pessoas que estão satisfeitas com o apoio recebido, as pessoas que dão apoio aos outros e nas pessoas que enfrentam os problemas de forma direta e uma re-avaliação positiva; (b) os afetos positivos aumentam com a satisfação do apoio recebido e com o enfrentamento direto e re-avaliativo e a diminuição do enfrentamento de esquiva e (c) os afetos negativos diminuem ao dar apoio e aumentam com o enfrentamento de esquiva. Os resultados mostram as diferenças dos componentes cognitivo e afetivo do bem-estar e apontam a necessidade de investigar a autonomia funcional do idoso.

Background Resilience to disease is a process of positive adaptation despite the loss of health, it involves the development of vitality and skills to overcome the negative effects of adversity, risks, and vulnerability caused by disease. In Mexico, cancer is the leading cause of death in children. Both the diagnosis and the treatment of childhood cancer affect the health of family caregivers. However, resilience is a personality trait that can be protective in these situations. Therefore, resilience is an important psychological construct to measure, evaluate and develop in specific populations and contexts. In Mexico, a scale to assess this trait has been developed. This study aimed to test the reliability and factor structure of the Mexican Measurement Scale of Resilience (RESI-M), describe its distribution, evaluate its relationship with sociodemographic variables, and verify its concurrent validity with psychological well-being, depression, anxiety and parental stress and its independence from social desirability. Methods A cross-sectional study was conducted involving an intentional nonprobability sample of 330 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. The participants responded to a sociodemographic variables questionnaire, the Mexican Measurement Scale of Resilience RESI-M, and five other assessment scales. Results Overall internal consistency was very high (ordinal alpha = .976). The confirmatory factor analysis demonstrated that the five-factor model had a close fit to the data: NFI = .970, CFI = .997, SRMR = .055, and RMSEA = .019. The distributions of the RESI-M total score followed a normal distribution. The RESI-M total score correlated positively with psychological well-being and negatively with depression, parental stress and anxiety. The overall RESI-M total score also correlated positively with age, but there was no difference in means between women and men. Resilience was independent of social desirability. Conclusions The RESI-M shows reliability and construct validity in family caregivers of children with cancer and does not show a bias in relation to social desirability.

Conforme aumenta a quantidade de idosos, incrementa o número de pessoas que assumem o cuidado de um familiar idoso dependente funcional. As tarefas do cuidado demandam recursos econômicos, tempo, organização familiar e pessoal que geram uma sobrecarga que pode repercutir negativamente no cuidador. Um recurso que pode amenizar esses impactos é a existência de redes de apoio social, dentro das quais os familiares encontrem ajuda para satisfazer suas necessidades em situações cotidianas e de crise. O objetivo do estudo foi identificar as necessidades de apoio social experimentadas por cuidadores de familiares idosos com problemas de saúde. Análises de conteúdo revelaram as seguintes categorias temáticas: Necessidades emocionais pessoais e interpessoais, Necessidades de apoio econômico, Necessidades de apoio prático-instrumental, Necessidades de orientação e Percepção de recursos para responder às demandas do cuidado. Os resultados são discutidos à luz de outros estudos qualitativos sobre necessidades de cuidadores de idosos.

Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer.

Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver’s QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents’ QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.

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r e s u m e n Mediante análisis factoriales exploratorios y confirmatorios, se validó la Escala de Apoyo Social para Cuidadores Familiares de Adultos Mayores. 23 ítems con cargas factoriales ≥ 0.51, agrupados en cuatro factores explican 63% de la varianza del constructo, con valores de Alfa de Cronbach ≥0.85; se demostró que el apoyo social tiene una relación causal positiva y significativa con apoyo material (β = 0.66), apoyo práctico (β = 0.69), apoyo emocional (β = 0.6) y apoyo de orientación (β = 0.81); los valores de ajuste del modelo son ≥ 0.97. La escala validada puede ser aplicada junto con otras medidas que permitan valorar las necesidades que enfrentan las familias para generar acciones de apoyo dirigidas al adulto-mayor y a quien lo cuida. Palabras clave autores:Apoyo social, adultos mayores, cuidadores. Palabras clave adicionales:Investigación cuantitativa, psicometría, validación, análisis factorial. ABSTRACTUsing exploratory and confirmatory analysis factor, was validated the Social Support Scale for Family Caregivers of Older Adults. 23 items with factor loadings ≥ 0.51, grouped into four factors it explain 63% of the variance of the construct, with Cronbach's alpha values ≥ 0.85; was shown that social support has a positive and significant causal relationship with material support (β = 0.66), practical support (β = 0.69), emotional support (β = 0.6), and counseling support (β = 0.81), the model fit values was ≥ 0.97. The validated scale can be applied together with other measures to assess needs faced by families to generate support actions aimed at adultsenior and caregiver.