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25.03.2024 | Original Article

Stressor, Coping, Resources and Potentially Harmful Behaviors by Family Caregivers of Cognitively Impaired Older Adults in China: The Mediation Role of Caregiver Burden

verfasst von: Xiang Gao, Yaofeng Chen, Lin Guo, Fei Sun

Erschienen in: Journal of Family Violence

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Abstract

Purpose

As an early warning indicator of elder abuse, caregiver potentially harmful behaviors (PHB) are well studied in developed countries. However, very little is known about PHB in developing countries among caregivers of older adults with cognitive impairment. Applying the Double ABCX model, this study aimed to explain how caregiver PHB are affected by stressor (care recipients’ memory and behavioral disturbance), coping (positive coping and negative coping), and resources (social support and family income), with a focus on the mediating role of perceptions of stress (caregiver burden).

Method

The survey sample included 300 family caregivers of cognitively impaired older adults from three urban communities in Wuhan, China. We used hierarchical multiple regressions to examine the relationship between PHB and associated factors. Baron and Kenny’s approach and bootstrap analysis were applied to examine the mediating effects of caregiver burden.

Results

PHB was positively associated with care recipient’s memory and behavioral disturbance and negative coping, and negatively related to family income. Additionally, care recipient’s memory and behavioral disturbance, negative coping, and social support had an indirect effect on PHB through caregiver burden. But the direct and indirect effect of positive coping strategies on PHB are mixed and complicated.

Conclusions

This study affirms the applicability of a comprehensive framework (i.e., Double ABCX model) to explain PHB. The dynamic roles of different factors in relation to PHB provided multiple points that intervention measures can target to assist implications for Chinese family caregivers to prevent abusive behaviors.

Andrén, S., & Elmståhl, S. (2007). Relationships between income, subjective health and caregiver burden in caregivers of people with dementia in group living care: A cross-sectional community-based study. International Journal of Nursing Studies, 44(3), 435–446. https://doi.org/10.1016/j.ijnurstu.2006.08.016CrossRefPubMed

Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. https://doi.org/10.1037/0022-3514.51.6.1173CrossRefPubMed

Beach, S. R., Schulz, R., Williamson, G. M., Miller, L. S., Weiner, M. F., & Lance, C. E. (2005). Risk factors for potentially harmful informal caregiver behavior. Journal of the American Geriatrics Society, 53(2), 255–261. https://doi.org/10.1111/j.1532-5415.2005.53111.xCrossRefPubMed

Bean, M. K., Gibson, D., Flattery, M., Duncan, A., & Hess, M. (2009). Psychosocial factors, quality of life, and psychological distress: Ethnic differences in patients with heart failure. Progress in Cardiovascular Nursing, 24(4), 131–140. https://doi.org/10.1111/j.1751-7117.2009.00051.xCrossRefPubMed

Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A., & O’Donnell, M. (2001). The Zarit Burden interview: A new short version and screening version. The Gerontologist, 41(5), 652–657. https://doi.org/10.1093/geront/41.5.652

Burnes, D., Pillemer, K., Caccamise, P. L., Mason, A., Henderson Jr, C. R., Berman, J., & Powell, M. (2015). Prevalence of and risk factors for elder abuse and neglect in the community: A population-based study. Journal of the American Geriatrics Society, 63(9), 1906–1912. https://doi.org/10.1111/jgs.13601CrossRefPubMed

Carver, C. S. (1997). You want to measure coping but your protocol’too long: Consider the brief cope. International Journal of Behavioral Medicine, 4(1), 92–100. https://doi.org/10.1207/s15327558ijbm0401_6CrossRefPubMed

Chang, Q., Sha, F., Chan, C. H., & Yip, P. S. (2018). Validation of an abbreviated version of the Lubben Social Network Scale (LSNS-6) and its associations with suicidality among older adults in China. PLoS One, 13(8), e0201612. https://doi.org/10.1371/journal.pone.0201612CrossRefPubMedPubMedCentral

Cooper, C., Manela, M., Katona, C., & Livingston, G. (2008). Screening for elder abuse in dementia in the LASER-AD study: Prevalence, correlates and validation of instruments. International Journal of Geriatric Psychiatry, 23(3), 283–288. https://doi.org/10.1002/gps.1875CrossRefPubMed

Covinsky, K. E., Newcomer, R., Fox, P., Wood, J., Sands, L., Dane, K., & Yaffe, K. (2003). Patient and caregiver characteristics associated with depression in caregivers of patients with dementia. Journal of General Internal Medicine, 18(12), 1006–1014. https://doi.org/10.1111/j.1525-1497.2003.30103.xCrossRefPubMedPubMedCentral

Dong, X. (2015). Elder abuse in Chinese populations: A global review. Journal of Elder Abuse & Neglect, 27(3), 196–232. https://doi.org/10.1080/08946566.2015.1039154CrossRef

Dong, X., & Simon, M. A. (2008). Is greater social support a protective factor against elder mistreatment? Gerontology, 54(6), 381–388. https://doi.org/10.1159/000143228CrossRefPubMed

Fritz, H. L. (2022). Caregiving in quarantine: Humor styles, reframing, and psychological well-being among parents of children with disabilities. Journal of Social and Personal Relationships, 39(3), 615–639. https://doi.org/10.1177/02654075211043515CrossRef

Fuh, J. L., Liu, C. Y., Wang, S. J., Wang, H. C., & Liu, H. C. (1999). Revised memory and behavior problems checklist in Taiwanese patients with Alzheimer’s disease. International Psychogeriatrics, 11(2), 181–189. https://doi.org/10.1017/S1041610299005736CrossRefPubMed

Fundinho, J. F., Pereira, D. C., & Ferreira-Alves, J. (2021). Theoretical approaches to elder abuse: A systematic review of the empirical evidence. The Journal of Adult Protection. https://doi.org/10.1108/JAP-04-2021-0014CrossRef

Gil, A. P. M., Kislaya, I., Santos, A. J., Nunes, B., Nicolau, R., & Fernandes, A. A. (2015). Elder abuse in Portugal: Findings from the first national prevalence study. Journal of Elder Abuse & Neglect, 27(3), 174–195. https://doi.org/10.1080/08946566.2014.953659CrossRef

Giraldo-Rodríguez, L., & Rosas-Carrasco, O. (2013). Development and psychometric properties of the geriatric mistreatment scale. Geriatrics & Gerontology International, 13(2), 466–474. https://doi.org/10.1111/j.1447-0594.2012.00894.xCrossRef

Huang, M. F., Huang, W. H., Su, Y. C., Hou, S. Y., Chen, H. M., Yeh, Y. C., & Chen, C. S. (2015). Coping strategy and caregiver burden among caregivers of patients with dementia. American Journal of Alzheimer’s Disease & Other Dementias®, 30(7), 694–698. https://doi.org/10.1177/1533317513494446CrossRef

Johannesen, M., & LoGiudice, D. (2013). Elder abuse: A systematic review of risk factors in community-dwelling elders. Age and Ageing, 42(3), 292–298. https://doi.org/10.1093/ageing/afs195CrossRefPubMed

Ko, K. T., Yip, P. K., Liu, S. I., & Huang, C. R. (2008). Chinese version of the Zarit caregiver burden interview: A validation study. The American Journal of Geriatric Psychiatry, 16(6), 513–518.CrossRefPubMed

Lafferty, A., Fealy, G., Downes, C., & Drennan, J. (2016). The prevalence of potentially abusive behaviours in family caregiving: Findings from a national survey of family carers of older people. Age and Ageing, 45(5), 703–707. https://doi.org/10.1093/ageing/afw085CrossRefPubMed

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

Lee, M. (2008). A path analysis on elder abuse by family caregivers: Applying the ABCX model. Journal of Family Violence, 24(1), 1–9. https://doi.org/10.1007/s10896-008-9192-5CrossRef

Lee, M., & Kolomer, S. (2005). Caregiver burden, dementia, and elder abuse in South Korea. Journal of Elder Abuse & Neglect, 17(1), 61–74. https://doi.org/10.1300/j084v17n01_04CrossRef

Lubben, J., Blozik, E., Gillmann, G., Iliffe, S., von Renteln Kruse, W., Beck, J. C., & Stuck, A. E. (2006). Performance of an abbreviated version of the Lubben Social Network Scale among three European community-dwelling older adult populations. The Gerontologist, 46(4), 503–513. https://doi.org/10.1093/geront/46.4.503

MacKinnon, D. P., Krull, J. L., & Lockwood, C. M. (2000). Equivalence of the mediation, confounding and suppression effect. Prevention Science, 1(4), 173–181. https://doi.org/10.1023/A:1026595011371CrossRefPubMedPubMedCentral

MacNeil, G., Kosberg, J. I., Durkin, D. W., Dooley, W. K., DeCoster, J., & Williamson, G. M. (2010). Caregiver mental health and potentially harmful caregiving behavior: The central role of caregiver anger. The Gerontologist, 50(1), 76–86. https://doi.org/10.1093/geront/gnp099CrossRefPubMed

McCubbin, H. I., & Patterson, J. M. (1983). The family stress process: The double ABCX model of adjustment and adaptation. Marriage & Family Review, 6(1–2), 7–37. https://doi.org/10.1300/J002v06n01_02CrossRef

Melchiorre, M. G., Chiatti, C., Lamura, G., Torres-Gonzales, F., Stankunas, M., Lindert, J., & Soares, J. F. J. (2013). Social support, socio-economic status, health and abuse among older people in seven European countries. PLos One, 8(1), e54856. https://doi.org/10.1371/journal.pone.0054856CrossRefPubMedPubMedCentral

Oh, J., Kim, H. S., Martins, D., & Kim, H. (2006). A study of elder abuse in Korea. International Journal of Nursing Studies, 43(2), 203–214. https://doi.org/10.1016/j.ijnurstu.2005.03.005CrossRefPubMed

Pearce, M. J. (2005). A critical review of the forms and value of religious coping among informal caregivers. Journal of Religion and Health, 44, 81–117. https://doi.org/10.1007/s10943-004-1147-4CrossRef

Pearlin, L. I., Menaghan, E. G., Lieberman, M. A., & Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22(4), 337–356. https://doi.org/10.2307/2136676CrossRefPubMed

Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. S. (2016). Elder abuse: Global situation, risk factors, and prevention strategies. The Gerontologist, 56(2), S194–S205. https://doi.org/10.1093/geront/gnw004CrossRefPubMedPubMedCentral

Pozo, P., Sarria, E., & Brioso, A. (2014). Family quality of life and psychological well-being in parents of children with autism spectrum disorders: A double ABCX model. Journal of Intellectual Disability Research, 58(5), 442–458. https://doi.org/10.1111/jir.12042CrossRefPubMed

Rodakowski, J., Skidmore, E. R., Rogers, J. C., & Schulz, R. (2012). Role of social support in predicting caregiver burden. Archives of Physical Medicine and Rehabilitation, 93(12), 2229–2236. https://doi.org/10.1016/j.apmr.2012.07.004CrossRefPubMedPubMedCentral

Sasaki, M., Arai, Y., Kumamoto, K., Abe, K., Arai, A., & Mizuno, Y. (2007). Factors related to potentially harmful behaviors towards disabled older people by family caregivers in Japan. International Journal of Geriatric Psychiatry, 22(3), 250–257. https://doi.org/10.1002/gps.1670CrossRefPubMed

Serra, L., Contador, I., Fernandez-Calvo, B., Ruisoto, P., Jenaro, C., Flores, N., & Rivera-Navarro, J. (2018). Resilience and social support as protective factors against abuse of patients with dementia: A study on family caregivers. International Journal of Geriatric Psychiatry, 33(8), 1132–1138. https://doi.org/10.1002/gps.4905CrossRefPubMed

Sethi, D., Wood, S., Mitis, F., Bellis, M., Penhale, B., Marmolejo, I., Ulvestad, I., & Kärki, F. (2011). European report on preventing elder maltreatment. World Health Organization. Regional Office for Europe.

Shiba, K., Kondo, N., & Kondo, K. (2016). Informal and formal social support and caregiver burden: The AGES caregiver survey. Journal of Epidemiology, 26(12), 622–628. https://doi.org/10.2188/jea.JE20150263CrossRefPubMedPubMedCentral

Smith, G. R., Williamson, G. M., Miller, L. S., & Schulz, R. (2011). Depression and quality of informal care: A longitudinal investigation of caregiving stressors. Psychology and Aging, 26(3), 584–591. https://doi.org/10.1037/a0022263CrossRefPubMedPubMedCentral

Straus, M. A. (1979). Measuring intrafamily conflict and violence: The conflict tactics (CT) scales. Journal of Marriage and Family, 41(1), 75–88. https://doi.org/10.2307/351733CrossRef

Tang, W. P. Y., Chan, C. W., & Choi, K. (2021). Factor structure of the brief coping orientation to problems experienced inventory in Chinese (Brief-COPE-C) in caregivers of children with chronic illnesses. Journal of Pediatric Nursing, 59, 63–69. https://doi.org/10.1016/j.pedn.2021.01.002CrossRefPubMed

Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S., & Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: The revised memory and behavior problems checklist. Psychology and Aging, 7(4), 622–631. https://doi.org/10.1037/0882-7974.7.4.622CrossRefPubMed

Tiwari, A., Fong, D., Chan, K., Leung, W., Parker, B., & Ho, P. (2007). Identifying intimate partner violence: Comparing the Chinese abuse assessment screen with the Chinese revised conflict tactics scales. BJOG: An International Journal of Obstetrics & Gynaecology, 114(9), 1065–1071. https://doi.org/10.1111/j.1471-0528.2007.01441.xCrossRef

Toda, D., Tsukasaki, K., Itatani, T., Kyota, K., Hino, S., & Kitamura, T. (2018). Predictors of potentially harmful behaviour by family caregivers towards patients treated for behavioural and psychological symptoms of dementia in Japan. Psychogeriatrics, 18(5), 357–364. https://doi.org/10.1111/psyg.12328CrossRefPubMed

Tzelgov, J., & Henik, A. (1991). Suppression situations in psychological research: Definitions, implications, and applications. Psychological Bulletin, 109(3), 524–536. https://doi.org/10.1037/0033-2909.109.3.524CrossRef

Wang, S. (2022). The Chinese Communist Party’s atheistic approach to religious freedom in China. Politics Religion & Ideology, 23(2), 204–225. https://doi.org/10.1080/21567689.2022.2090930CrossRef

Wang, M., Sun, H., Zhang, J., & Ruan, J. (2019). Prevalence and associated factors of elder abuse in family caregivers of older people with dementia in central China cross-sectional study. International Journal of Geriatric Psychiatry, 34(2), 299–307. https://doi.org/10.1002/gps.5020CrossRefPubMed

Williamson, G. M., & Shaffer, D. R. (2001). Relationship quality and potentially harmful behaviors by spousal caregivers: How we were then, how we are now. Psychology and Aging, 16(2), 217–226. https://doi.org/10.1037/0882-7974.16.2.217CrossRefPubMed

Yu, J., Li, J., & Huang, X. (2012). The Beijing version of the montreal cognitive assessment as a brief screening tool for mild cognitive impairment: A community-based study. BMC Psychiatry, 12, 1–8. https://doi.org/10.1186/1471-244X-12-156

Titel: Stressor, Coping, Resources and Potentially Harmful Behaviors by Family Caregivers of Cognitively Impaired Older Adults in China: The Mediation Role of Caregiver Burden
verfasst von: Xiang Gao
Yaofeng Chen
Lin Guo
Fei Sun
Publikationsdatum: 25.03.2024
Verlag: Springer US
Erschienen in: Journal of Family Violence
Print ISSN: 0885-7482
Elektronische ISSN: 1573-2851
DOI: https://doi.org/10.1007/s10896-024-00691-2

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Stressor, Coping, Resources and Potentially Harmful Behaviors by Family Caregivers of Cognitively Impaired Older Adults in China: The Mediation Role of Caregiver Burden

Abstract

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Conclusions

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Neu im Fachgebiet Psychiatrie

Hörschwäche erhöht Demenzrisiko unabhängig von Beta-Amyloid

So wirken verschiedene Alkoholika auf den Blutdruck

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

ADHS-Medikation erhöht das kardiovaskuläre Risiko

Update Psychiatrie