Predicting longitudinal changes in caregiver physical and mental health: A stress process model.

Goode, Kathryn T.; Haley, William E.; Roth, David L.; Ford, Greg R.

doi:10.1037/0278-6133.17.2.190

Cited by 237 publications

(192 citation statements)

References 44 publications

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“…In addition, our research adds to the literature by replicating findings from Patterson et al [20] and Goode et al [21] on the effectiveness of the Stress Process Model to account for the complex nature of the effects of caregiving. Furthermore, the present study provides information regarding the experience of male caregivers.…”

Section: Discussionsupporting

confidence: 65%

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Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model

Bigatti¹,

Lydon²,

Brothers³

2008

TOFAMSJ

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Spouses of patients experience role strains as a result of informal caregiving, which has been associated with mood in numerous research studies. However, most research is on female caregivers, and little is known about the experience of male spouses, or of the caregiving provided to fibromyalgia patients. The Stress Process Model was used to examine mediators and moderators of the relation between role strain and mood among 135 husbands of women with fibromyalgia. Results indicated that the more activities of daily living and instrumental activities of daily living performed by the husband, the greater the role strain. Role strain was associated with worse mood. A test of the Stress Process Model supported a partial mediation model, where social support and emotion-focused coping partially mediated the relation between role strain and mood. No evidence was found for a moderation model or for problem-focused coping as a mediator. Our research suggests significant impairment and caregiving needs among this patient population, which in turn relates to the mood of the husband who is also an informal caregiver. Our findings also support the Stress Process Model in explaining the complexity of caregiving effects. The results of the study suggest avenues for intervention for individuals strained by their partners' illness.Spouses of chronically ill individuals have poorer mental health than comparison groups and the general population [1,2]. Spouses may be affected because the illness may require informal caregiving, including assistance with activities of daily living (ADLs; such as toileting, dressing), instrumental activities of daily living (IADLs; such as shopping), and taking over responsibilities that the patient can no longer perform (such as cleaning, cooking). These caregiving responsibilities may interfere with spouses' abilities to perform other roles, resulting in role strains.Role strains, experienced daily by most individuals, are defined as the difficulties felt by individuals who have multiple roles with accompanying obligations [3]. For caregivers, the additional responsibility of helping a patient with a health condition may divert much needed resources from the other roles currently fulfilled by the individual, causing role strain. Roles typically examined for strain include work, domestic environment, sexual relations, family relations, and social relations. Of the employed caregiving husbands in a national study of frail elderly, 32% reported working fewer hours, 28% indicated they rearranged their schedule, and 24% took time off without pay because of their wives' illness [4]. In the domestic environment, husbands report an increase in the amount of time spent on household chores as a direct result of their wives' illness or disability [5]. A chronic illness may affect the couple's sexual relations as well. For example, patients with a rheumatic disease listed pain or weakness, fatigue, and lack of interest as the top *Address correspondence to this author at the IUPUI, Department of P...

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Section: Discussionsupporting

confidence: 65%

“…Research has also supported problem focused coping as a potential mediator. For example, in a study using a modified version of the Stress Process Model, Goode, Haley, Roth and Ford [21] found that increases of approach coping led to decreases in depression.…”

mentioning

confidence: 99%

Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model

Bigatti¹,

Lydon²,

Brothers³

2008

TOFAMSJ

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“…(37;38) In our examination of mediators of the patient depression-caregiver depression relationship both impact on patient’s functioning and burden to caregiver were important. While caregiver burden has been previously shown to mediate the relationship between patient objective behavior and caregiver outcomes,(15;17;39) the role of impact on patient functioning in the causal pathway has not been previously explored. Our findings suggest that caregivers recognize the difficulty that patient depressive symptoms may cause for patients and that this mechanism may independently result in caregiver depression.…”

Section: Discussionmentioning

confidence: 99%

“…Using this model, studies report that the association between objective stressors such as BPSD and mental and physical health outcomes of caregivers are mediated by subjective stress appraisal. (15–17) Suffering may be another pathway by which BPSD results depression in caregivers(18) suggesting that perception of the patient’s quality of life and their ability to function daily may affect the caregiver by evoking empathy for the patient.…”

Section: Introductionmentioning

confidence: 99%

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

Ornstein

Gaugler

Devanand

et al. 2013

The American Journal of Geriatric Psychiatry

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Objectives The behavioral and psychological symptoms associated with dementia (BPSD) are highly burdensome to caregivers. While BPSD consist of a wide variety of patient behaviors including depression, physical aggression and paranoid delusions, it remains unclear whether specific symptoms have a differential impact on caregivers. The aims of this study were (1) to assess how individual BPSD symptoms, categorized based on how they may affect caregivers, impact depressive symptoms for dementia patient caregivers and (2) to test the pathways by which BPSD symptom clusters impact caregiver depressive symptoms. Design Cross-sectional analysis of data from a longitudinal study of patients with Alzheimer’s disease and Dementia with Lewy Bodies. Setting Multiple U.S. dementia clinics. Participants 160 patient-caregiver dyads. Methods Using multivariate GEE logistic models, we analyzed the relationship between four BPSD symptom clusters (patient depressive symptoms, accusatory/aggressive behaviors, non-threatening psychotic symptoms, and difficult to manage behaviors) and caregiver depressive symptoms and assessed mediators of these relationships. Results Only the presence of patient depressive symptoms was associated with caregiver depression (OR=1.55; 95% CI=1.14–2.1). This relationship was mediated by both caregiver report of the symptom’s impact on the patient and perceived burden to caregivers. Conclusions Patient depressive symptoms may be the most important driver of the relationship between BPSD and caregiver depression. Research in this field should further test the effects of individual BPSD symptoms and should also consider how symptoms may negatively impact caregivers by increasing burden and evoking empathy for the patient.

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“…coresidence with the care recipient (Pinquart and Sorensen 2007), prolonged duration of the caregiver role (Matthews et al 2004), more hours of care per week (Navaie-Waliser et al 2002), being a spousal caregiver (Barnes et al 1992), advanced age of the caregiver (Strawbridge et al 1997), lower socioeconomic status (Hughes et al 1999), lower levels of social support (Goode et al 1998) and the severity of the care recipients behaviour problems and cognitive impairment (Schulz et al 1995b). …”

Section: Introductionmentioning

confidence: 99%

Health-related quality of life of family caregivers—Evidence from Hesse

Rösler-Schidlack¹,

Stummer²,

Ostermann³

2010

J Public Health

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Aim:The aim of the present study is to analyse the health-related quality of life (HRQOL) of primary family caregivers in comparison to the reference values of the average population. Subject and Methods:Data collection took place in the Werra-Meißner district in the year 2009 with a respondent rate of 102 primary family cares of frail elderly people. The health-related quality of life was measured with the Short Form 36 health survey (SF 36) and compared with the German reference values. Results:Compared to the health values of the normative sample, primary caregivers show significantly lower rates in all dimensions of the health-related quality of life. In particular caregivers between the age of 53 to 61 report extremely low health values. Caring women compared to noncaring women have highly significant differences in all subscales of the SF 36. Caregiving men as well report highly significant differences to noncaregiving men in all dimensions of the SF 36 except for Physical Functioning and General Health (p<0.01). Caregivers in general and especially caregiving women in the age of 53 to 61 (midlife) were identified as at-risk groups for poor health. The latter report lower vitality and well-being which may be a consequence of both social isolation and social impacts from multiple -role demands. Conclusion:The identified high-risk groups of family carers, caregivers in midlife and especially caring women in midlife, should be strengthened by social support e.g. training courses for family carer particular in their home setting and various types of respite care in order to sustain their health.

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Predicting longitudinal changes in caregiver physical and mental health: A stress process model.

Cited by 237 publications

References 44 publications

Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model

Role Strains and Mood in Husbands of Women with Fibromyalgia Syndrome: A Test of the Stress Process Model

The Differential Impact of Unique Behavioral and Psychological Symptoms for the Dementia Caregiver: How and Why Do Patients' Individual Symptom Clusters Impact Caregiver Depressive Symptoms?

Health-related quality of life of family caregivers—Evidence from Hesse

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