Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer's disease

I-Shou University, Yanchao Shiang, Kaohsiung County, Taiwan.
Journal of Clinical Nursing (Impact Factor: 1.26). 03/2009; 18(4):502-11. DOI: 10.1111/j.1365-2702.2008.02443.x
Source: PubMed


This study examined the relationships among stressors, social support, depressive symptoms and the general health status of Taiwanese caregivers of individuals with stroke or Alzheimer's disease.
Caring for a disabled or cognitively impaired person can be extremely stressful and often has adverse effects on caregivers' health. While research on caregiving in Taiwan has examined caregivers' characteristics, caregivers' need and caregivers' burden in caring for older people in general, little is known about Taiwanese caregivers of individuals with stroke or Alzheimer's disease.
Cross-sectional, descriptive correlation design.
Data were obtained from a convenience sample of 103 Taiwanese informal caregivers in the South of Taiwan and analysed using descriptive statistics, Pearson's correlations, multiple and hierarchical regressions and t-tests.
Caregivers who had lower household incomes and were taking care of individuals with more behaviour problems had more depressive symptoms. In addition, caregivers who were older and were taking care of individuals with more behaviour problems had worse general health. Caregivers who had more emotional support had less depressive symptoms.
Caregivers of persons with Alzheimer's disease had more depressive symptoms and worse general health than caregivers of persons with stroke. Only emotional support moderated the relationship between one of the stressors (household income) and depressive symptoms.
The findings of this study may be helpful for nurses and other health care professionals in designing effective interventions to minimise the negative impacts of stressors on the psychological and general health of caregivers in Taiwan.

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    • "Moreover, previous research also suggests that each chronic disease poses distinct caregiving challenges (Molloy et al., 2005). For instance, chronic diseases characterized by cognitive impairments (e.g., Alzheimer's disease) and/or unpredictable courses (e.g., cancer) have been described as more stressful (Kim and Schulz, 2008, Huang et al., 2009). However, COPD-specific characteristics, such as the patient's breathlessness and the difficulty in predicting when exacerbations will occur and how they will end, might pose other distinct care demands (Grant et al., 2012). "
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    ABSTRACT: Background: Chronic Obstructive Pulmonary Disease (COPD) can be highly incapacitating, imposing a significant burden on family members, however, limited research has been conducted on psychological health of family carers. Thus, this study examined anxiety and depression symptoms in family carers of people with COPD and their predictors. Methods: A cross-sectional study was conducted with family carers and respective patients with COPD. The caregiving situation and the perceived burden, through the Carers' Assessment of Difficulties Index, were collected from family carers. Patients' COPD severity and activities limitation were assessed. The Hospital Anxiety and Depression Scale (HADS) was used to assess anxiety and depression symptoms in family carers and patients. Scores ≥8 were considered clinically significant. Results: A total of 203 family carers (58.2 ± 14.8 years old; 75.4% female) and respective patients with COPD (69.2 ± 11.5 years old; 36.5% female) were included. Clinically significant anxiety symptoms (HADS-anxiety ≥8) were present in 63.5% (n = 129) of family carers, depression symptoms (HADS-depression ≥8) were in 34% (n = 69) and both were in 27.1% (n = 55). Perceived burden [odds ratio (OR) 1.04, 95% confidence intervals (CI) = 1.01-1.06; 1.05, 95% CI = 1.03-1.07] and patients' activities limitation (OR 1.32, 95% CI = 1.01-1.79; 1.41, 95% CI = 1.01-1.96) were significant predictors of anxiety and depression symptoms. Anxiety symptoms were also predicted by female gender (OR 0.33, 95% CI = 0.16-0.66) and depression symptoms by older age (OR 1.03, 95% CI = 1.01-1.06). Conclusion: Family carers of patients with COPD experience anxiety and depression symptoms. Perceived burden, female gender, older age, and patient's activities limitation were predictors of these distressing symptoms. These findings highlight the need to address family carers' needs, namely by investigating the effectiveness of supportive interventions on family's psychological health.
    International Psychogeriatrics 03/2014; 26(7):1-9. DOI:10.1017/S1041610214000337 · 1.93 Impact Factor
    • "In Singapore, an economically developed Southeast Asian nation, traditional norms and government expectations , stemming from a cultural ideology steeped in filial piety, have been to care for the elderly adults at home (Mehta, 2006). Singapore's national policies promote the family as the principal support system for the elderly adults (Yeoh & Huang, 2009). Under the concept " Many Helping Hands, " the government assists families with older persons: Government housing programs prioritize applications of multigenerational families for public housing (Mehta, 2006), and volunteer welfare organizations focusing on the needs and concerns of caregivers receive funding from the government (Mehta, 2006). "
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    ABSTRACT: Objectives: To assess the instrumental support from a foreign domestic worker (FDW) as a moderator of the association of 4 types of impairments (physical function, memory, behavior, and mood) among older persons (OPs) with caregiving-related outcomes among their informal caregivers (CGs). Method: Data from a national survey of 1,190 Singaporeans aged 75 and older receiving human assistance for functional limitations and their CGs were used. Severity scores for the four OP impairments were calculated. A modified version of the Caregiver Reaction Assessment (CRA) assessed the impact of caregiving in four domains: disturbed schedule and poor health, lack of finances, lack of family support, and CG esteem. Linear regression models, one for each CRA domain, with interaction terms of the four impairment severity scores with FDW support, were developed. Results: FDW instrumental support, reported for 50% of the OPs, moderated the direct association of OP physical impairment with disturbed schedule and poor health (p = .009), OP memory impairment with disturbed schedule and poor health (p < .0001) and lack of finances (p = .02), and OP behavior impairment with lack of family support (p = .001). Although such support buffered the inverse association of OP behavior impairment with CG esteem (p = .01), it also buffered the positive association of OP mood impairment with CG esteem (p = .02). Discussion: FDW support is associated with better caregiving outcomes. Given its aging population, the number of FDWs in Singapore is likely to increase as families try to cope with caregiving for their older members. This has policy implications for (a) immigration patterns into Singapore and (b) training of and support networks for FDWs.
    The Journals of Gerontology Series B Psychological Sciences and Social Sciences 05/2013; 68(4). DOI:10.1093/geronb/gbt042 · 3.21 Impact Factor
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