Acceptance and commitment improve the work–caregiving interface among dementia family caregivers.

Abstract

Although working dementia family caregivers experience negative (i.e., work-family conflict; WFC) and positive (i.e., work-family enrichment; WFE) aspects of balancing work and caregiving, little is known about factors that alleviate negative aspects and enhance positive aspects of the work-caregiving interface. The purpose of this study was to examine the moderating effect of acceptance and commitment to personal values, which are transdiagnostic in nature and key concepts of acceptance and commitment therapy, on the relationships between work/caregiving demands and WFC and between work/caregiving resources and WFE among working dementia family caregivers. Data were drawn from a three-wave 6-month interval longitudinal survey of Japanese working dementia family caregivers (N = 747). Hierarchical linear modeling was used to examine the main effect of acceptance and commitment to personal values on WFC/WFE, and their moderating effect on relationships between work/caregiving demands and WFC, and work/caregiving resources (job control, supervisor/coworker support, organizational support, caregiving support) and WFE. Acceptance was negatively associated with WFC and weakened the positive relationship between work/caregiving demands and WFC. Commitment to personal values was negatively associated with WFC and positively associated with WFE. Commitment to personal values weakened the positive relationships between work/caregiving demands and WFC and moderated the relationship between caregiving support and WFE. The findings suggest that acceptance may be effective in alleviating WFC and commitment to personal values contributes to alleviating WFC and increasing WFE. Acceptance and commitment therapy may help to improve the work-caregiving interface among dementia family caregivers. Public Significance StatementThe current findings suggest that acceptance and commitment to personal values are effective for alleviating work-family conflict and enhancing work-family enrichment among working dementia family caregivers. Acceptance and commitment therapy, which can improve acceptance and commitment to personal values, may help working dementia family caregivers to balance work and caregiving, and improve their work-caregiving interface.

Profiles of psychological flexibility and caregiving experience in dementia family caregivers: A latent profile analysis

“…These results were not consistent with previous findings of significant relationships between cognitive fusion/ commitment to personal values and life satisfaction at medium effect sizes (Romero-Moreno et al, 2014 and significant positive associations between commitment to personal values and work-family enrichment at medium effect sizes (Morimoto, 2022). Given that profiles characterized by high commitment to personal values showed moderate levels of cognitive fusion/experiential avoidance (i.e., moderate psychological flexibility with high commitment profile), cognitive fusion and experiential avoidance would be expected to attenuate the positive association between the commitment to personal values and life satisfaction/work-family enrichment.…”

“…Dementia family caregivers have also been reported to have lower life satisfaction compared with caregivers of relatives with other types of chronic disease (Karg et al, 2018). Difficulties in dementia caregiving also pose challenges for working family caregivers in balancing work and caregiving (Neubert et al, 2021), resulting in negative and positive experiences (i.e., work‐family conflict/enrichment) that are associated with caregiver health (Morimoto & Takebayashi, 2021; Morimoto et al, 2018; Morimoto, 2022). Sociocultural stress models (Knight & Sayegh, 2010; Sörensen et al, 2006) highlight the importance of caregivers' psychosocial resources (e.g., cultural values, coping, and caregiving support) for improving their psychological well‐being.…”

“…Previous studies reported that psychological flexibility, which is the ability to step back from restricting thoughts and allow painful emotions, to focus on the present, and to persist in behavior that reflects personal values (Hayes et al, 2012), is an important psychological resource affecting depression, anxiety, life satisfaction, and work‐family conflict/enrichment among dementia family caregivers (Barrera‐Caballero et al, 2021; Kishita et al, 2020, 2023; Losada et al, 2014; Morimoto, 2022; Romero‐Moreno et al, 2014, 2016, 2017; Vara‐García et al, 2021). According to acceptance and commitment therapy (ACT; Hayes et al, 2012), psychological flexibility consists of six core processes (defusion, acceptance, self as context, values, committed action, and being present) with the first three processes often categorized as higher‐level “mindfulness and acceptance,” and the latter three categorized as “commitment and behavior change”.…”

“…However, previous studies on dementia family caregivers treated psychological flexibility as a single variable (Kishita et al, 2020) or examined either one of the two higher‐level processes, with a particular focus on cognitive fusion (the opposite of defusion) and experiential avoidance (the opposite of acceptance) for the mindfulness and acceptance process (Barrera‐Caballero et al, 2021; Kishita et al, 2023; Losada et al, 2014; Romero‐Moreno et al, 2014, 2016) and commitment to personal values, which includes values and committed action, for the commitment and behavior change process (Gallego‐Alberto et al, 2017; Romero‐Moreno et al, 2017; Vara‐García et al, 2021). Few studies have addressed both higher‐level processes simultaneously (Morimoto, 2022). Thus, the relative importance of the two higher‐level processes on caregivers' psychological well‐being remains unclear.…”