The influence of stress and coping process on depression among dementia family caregivers
| Autor: | Hsin-Yi Liu, 劉欣宜 |
|---|---|
| Rok vydání: | 2017 |
| Druh dokumentu: | 學位論文 ; thesis |
| Popis: | 105 Purpose: The families have always been the cornerstone of care for relatives with dementia. Caring for family members with dementia can be a long-term burden task resulting in physical and emotional distress. The purpose of this research was to examine the influence of stress and coping process on depression among family caregivers of relatives with dementia based on Lazarus and Folkman’s theory of stress appraisal and coping. Method: This study adopted a cross-sectional correlational design. Purposive sampling was used to recruit 314 dyads of dementia patients and family caregivers from the outpatient neurological clinics of hospitals in northern and central Taiwan. Approval for this study was obtained from the institutional review board of the medical center before collecting data. Data were gathered through interviews with a structured questionnaire, which includes demographic characteristics for caregivers and care receivers, Neuropsychiatric Inventory (NPI) and activities of daily living (ADL), University of Wisconsin family assessment caregiver scale (UWFACS) for family functioning, caregiver reaction assessment (CRA) for negative caregiving appraisals, the revised scale for caregiving self-efficacy (RSCSE), carers'' assessments of managing index for coping strategies(CAMI), and center for epidemiological studies depression scale (CES-D). The statistics analysis methods included descriptive statistics, Pearson product-moment correlation, ANOVA, and the structure equation modeling by the AMOS software. Results: 34.39% of the dementia caregivers reported to be at risk of depression (CES-D≧16 points). Family caregivers with elementary education, female, spouse, above 16 hours of daily care, job changes, poor self-rated health, poor relationship with patient, and poor economic status had higher level of depression. The results showed that the established “stress and coping process” model for family caregivers of patients with dementia has indicated good model fit (Chi-square=135.8, Chi-square/ DF=1.235, GFI=0.947, RMSEA=0.027, TLI=0.987, CFI=0.989, PGFI=0.633). The overall model fit indicators revealed that the research hypotheses and empirical results were partly coincidence. Family functioning and NPI had a significant impact on negative caregiving appraisals. Family functioning had a positive and significant impact on both self-efficacy and coping strategies. Negative caregiving appraisals, self-efficacy, and coping strategies could predict caregiver depression. However, negative caregiving appraisals and self-efficacy had no effect on coping strategies. Conclusion: Findings from the present study, self-efficacy and coping strategies have direct impact on caregiver depression. Family functioning is an important influential factor in the stress coping model. Therefore, it is strongly suggested that health professionals should develop appropriate family-centered interventions that focus on strengthening inter-family support, promoting caregiving self-efficacy and using of proactive coping to alleviate caregiver stress and depression. |
| Databáze: | Networked Digital Library of Theses & Dissertations |
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