The role of modulating variables in caregivers¿distress (el papel de las variables moduladoras en el malestar del cuidador)
- Autores: Rosa Romero Moreno
- Directores de la Tesis: María Márquez González (dir. tes.)
- Lectura: En la Universidad Autónoma de Madrid ( España ) en 2010
- Idioma: español
- Tribunal Calificador de la Tesis: José Antonio Carrobles Isabel (presid.), Ignacio María Montorio Cerrato (secret.), Javier López Martínez (voc.), Ken Laidlaw (voc.), David Gillanders (voc.)
- Materias:
- Enlaces
- Tesis en acceso abierto en: Biblos-e Archivo
- Resumen
Drawing on the stress and coping model (e.g., Haley et al., 1987), the aim of this doctoral thesis has been to analyze, cross-sectional and longitudinally, the role of different modulating variables on dementia caregivers¿ distress. With these objectives, four different studies have been conducted, and, although they are presented independently, the obtained results may be considered jointly in the discussion. First, in order to provide a common framework for the four studies, a general introduction, based on caregiving literature review, is presented. Second, the general purpose of this research is described, followed by the specific objetives of each of the studies.Third, the main methodological characteristics of the studies are presented. Then, each of the independent studies is presented, with their own introduction, method, data analysis, results and discussion sections. Finally, a general discussion and the main conclusions of the obtained results are described. Participants in this research consisted of family caregivers of persons with dementia, who were recruited through different Social Services and Day Care centers from Madrid. Face to face interviews were conducted, assessing the following variables: stressors (frequency of behavioral problems, functional capacity, burden), resources (selfefficacy domains, motives for caring, emotional regulation strategies, rumination and cognitive reappraisal, and frequency and satisfaction with behavioral activation) and health outcomes (depression, anxiety, anger, and perceived physical health).
The objective of the first study was to analyze the moderating role of caregivers¿ self-efficacy domains in different points of the caregivers¿ stress process. Specifically, we analyzed the moderating role of self-efficacy for managing behavioral problems on the relationship between stressors (frequency of behavioral problems) and caregivers¿ burden.
In addition, we analyzed the moderating role of self-efficacy for controlling upsetting thoughts on the relationships between burden and caregivers¿ distress (depression, anxiety). Results showed no significant moderating effect of self-efficacy for managing behavioral problems in the relationship between stressors and burden. However, results showed that self-efficacy for controlling upsetting thoughts moderated the impact that burden has on caregivers¿ distress. The purpose of the second study was to analyze the effects of motives for caring on the caregiving stress process. We analyzed the dimensional structure of the Cultural Justifications for Caregiving Scale-Revised (CJCS-R), a scale which measures diverse motives for caring, and also explored the effects of these motivations on caregivers¿ stressors, resources and mental health variables. Results showed a bidimensional structure of the scale, and factors were labeled, ¿Intrinsic motives¿ and ¿Extrinsic motives¿ for caring. In addition, considering simultaneosly caregivers¿ scores (high or low) in both dimensions, four groups of caregivers were identified, finding that those caregivers with low scores on intrinsic motives and high scores on extrinsic motives reported having worse caregivers¿ resources (more rumination and less cognitive reappraisal) and worse consequences of caregiving (depression, anxiety and anger). The third study was aimed at analyzing the effects of considering simultaneosly the frequency and satisfaction with behavioral activation in caregiver¿s stressors, resources, outcomes and risk of institutionalization. Results showed that caregivers with high levels of both frequency and satisfaction with behavioral activation showed better resources (rumiation and cognitive reappraisal) and outcomes (depression, anxiety, and, perceived physcial health) and low levels of risk of institutionalization. However, those caregivers with low levels of both frequency and satisfaction with behavioral activation were at greater risk of reporting poorer resources and outcomes. The purpose of the fourth study was to analyze, longitudinally, if changes in caregivers¿ modulating variables predicted changes in caregivers¿ distress. Results showed that increases in caregivers¿ self-efficacy for controlling upsetting thoughts, frequency of leisure activities and cognitive reappraisal predicted decreases in caregivers¿ depression over time, even after controlling for gender and stressors. Finally, considering the results of the four studies toghether, we highlight the usefulness of considering the multidimensionality of modulating variables, as well as the joint consideration of these dimensions for identifying caregivers at greater risk of suffering negative outcomes. We found two caregivers¿ profile at risk: caregivers with high levels of extrinsic motives for caring and low levels of intrinsic motives for caring and those with low levels of both frequency and satisfaction with behavioral activation
