Relationship between Mastery and Caregiving Competence in Protecting against Burden, Anxiety and Depression among Caregivers of Frail Older Adults

Abstract

ObjectiveStudies suggest the protective effect of mastery and caregiving competence against psychological stressors of caregiving in the context of dementia, although the interplay between the two with caregiver outcomes is not well understood. This study examines the independent and moderating impact of mastery and caregiving competence on burden, anxiety and depression among caregivers of older adults with frailty-related care needs.Design, Setting and ParticipantsThis is a cross-sectional study of 274 older adults-family caregiver dyads from a hospital in Singapore. Mean ages of the older adults and their caregivers were 85 and 59 years respectively.MeasurementsWe performed hierarchical linear regression models to examine the independent influence of mastery and caregiving competence on caregiver burden, anxiety and depression. We also examined the interaction effect between mastery and caregiving competence for each outcome.ResultsMastery and caregiving competence were independently negatively associated with caregiver burden, anxiety and depression. Mastery explained more variance than caregiving competence and had a stronger correlation with all outcomes. There was a statistically significant interaction between mastery and caregiving competence for depression (interaction term beta=.14, p<0.01), but not burden and anxiety. High levels of mastery are associated with less depression. particularly among caregivers with below-average levels of caregiving competence. Likewise, high levels of caregiving competence are associated with less depression. particularly among caregivers with below-average levels of mastery.ConclusionOur findings suggest potential benefits adressing targeted interventions for mastery and caregiving competence of caregivers to older adults as they independently influence caregiver outcomes and moderate each other’s effect on depression. Mastery-based interventions should be incorporated into current caregiver training which traditionally has focused on caregiver competence alone.

Enhanced coping and self‐efficacy in caregivers of stem cell transplant recipients: Identifying mechanisms of a multimodal psychosocial intervention

“…Our finding that improvements in QOL and reductions in depression symptoms may have occurred indirectly through improvements in self‐efficacy for caregivers randomly assigned to BMT‐CARE extends our understanding of the potential relationships between caregiver self‐efficacy and psychosocial outcomes 26 . A sense of mastery and caregiving competence have been associated with reduced caregiving burden and anxiety and depression symptoms in other caregiving populations; however, few studies have explored intervention mechanisms in the HCT caregiver setting 27 . In 1 study, a problem‐solving education intervention among caregivers of patients who received allogeneic HCT led to improvements in self‐efficacy, distress, and fatigue 18 .…”

“…26 A sense of mastery and caregiving competence have been associated with reduced caregiving burden and anxiety and depression symptoms in other caregiving populations; however, few studies have explored intervention mechanisms in the HCT caregiver setting. 27 In 1 study, a problem-solving education intervention among caregivers of patients who received allogeneic HCT led to improvements in self-efficacy, distress, and fatigue. 18 A meta-analysis and systematic review of family caregiver interventions in oncology showed improvement in self-efficacy with small to medium effect sizes.…”

The Well-Being of Carers of Older Aboriginal People Living in the Kimberley Region of Remote Western Australia: Empowerment, Depression, and Carer Burden

“…However, before culturally-responsive programs for carers can be developed and evaluated, the unique needs of this population must be understood. Important attributes in managing the carer role include resilience and empowerment, and the mastery of skills such as problem solving and adaptation as necessary (Chan, Glass, Chua, Ali, & Lim, 2018;Petriwskyj, Parker, O'Dwyer, Moyle, & Nucifora, 2016;Sakanashi & Fujita, 2017;Teahan et al, 2018). Conversely, depression, anxiety, and perceived burden (Petriwskyj et al, 2016), are frequently measured outcomes in carer research and inversely related to positive notions of health, resilience and empowerment.…”

Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults

“…According to Pearlin, mastery can reduce the impact of stress either via people with high mastery perceiving stressors in a less menacing way, or with it acting as a self-fulfilling prophecy (25). Recent research found that lower levels of mastery was associated with higher levels of burden, which eventually lead to higher levels of depression (26, 27). Mastery was also shown to attenuate the effects of stress on health across time, while low mastery was associated with depressive symptoms and poor health (28).…”