The factor structure of coping strategies and their effects on burnout among primary caregivers of impaired elderly.

A longitudinal study of coping and burnout among Japanese family caregivers of frail elders

“…Although findings from other literature we have reviewed so far showed an inconsistent relationship between problem-focused coping – a part of which corresponded to our Support Seeking Coping – and caregiver mental health, our previous work (Okabayashi et al, 1999) showed that contrary to intuition, Support Seeking Coping (especially Informal Support Seeking) had a negative relationship with caregiver mental health. It should not be interpreted to mean that seeking more support worsens caregiver mental health, but that exhausted caregivers desire more informal support.…”

“…First, possible confounding factors might not be controlled for when examining these relationships. In our previous cross-sectional study (Okabayashi et al, 1999), we found an indirect detrimental effect of Approach Coping on caregiver mental health through caregiving captivity. However, because there was a negative correlation between Approach Coping and caregiver burnout, we might have misinterpreted it as direct beneficial effect unless we estimated its indirect detrimental effect through caregiving captivity simultaneously.…”

“…Okabayashi, Sugisawa, Takanashi, Nakatani and Shibata (1999) developed an original coping scale consisting of actual behavioural content in caregiving situations and that eliminated emotional stress response items. This coping scale has five first-order factors which were consolidated into three second-order factors (Adaptive Avoidance, Approach, and Support Seeking).…”

“…Though we examine all 1-year cross-lagged effects between coping strategies and caregiver burnout, we can construct the following three main hypotheses based on our previous cross-sectional findings (Okabayashi et al, 1999; Okabayashi et al, 2003), and other findings reviewed above.…”

“…Using our original coping scale, we found that a strategy of ‘Keeping Their Own Pace’ decreased caregivers’ burnout directly, while a strategy of ‘Diversion’ decreased it indirectly through caregiving captivity, which was a measure of the degree and intensity of the caregiver’s involvement in the caregiving role (Okabayashi et al, 1999). We also found stress-buffering effects of Keeping Their Own Pace, which buffered the detrimental effects of caregiving captivity on burnout (Okabayashi et al, 2003).…”