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Chen CY, Chen JH, Ree SC, Chen CH, Yu SH. Attributional styles are associated with care burden in geriatric depression: older adults and their caregivers in Taiwan. Aging Clin Exp Res 2024; 36:106. [PMID: 38714627 PMCID: PMC11076353 DOI: 10.1007/s40520-024-02762-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/19/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND Given the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers' attributional styles, that is, how individuals interpret the causes of life events, on their care burden. AIM This study examined the relationship between caregivers' attributional styles and their care burden for older patients with depression. METHODS This cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers' depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver's subjectively assessed care burden. RESULTS The sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers' gender (β = - 0.14, p = .044), educational level (β = 0.19, p = .008), caregivers' own depression assessed by the Center for Epidemiological Studies Depression Scale (β = 0.41, p < .001), and attributional styles, particularly manipulation (β = 0.29, p < .001) and illness/stress attributional style (β = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles. CONCLUSIONS Certain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jian-Hong Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Chun Ree
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hui Chen
- Department of Nursing, Chang Gung Hospital, Keelung, Taiwan
| | - Sheng-Hsiang Yu
- Department of Psychology and Counseling, National Taipei University of Education, No. 134, Sec. 2, Heping E. Rd., Da'an Dist, Taipei, Taiwan.
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Mangas P, Sierra JC, Granados R. Effects of Subjective Orgasm Experience in Sexual Satisfaction: A Dyadic Analysis in Same-Sex Hispanic Couples. JOURNAL OF SEX & MARITAL THERAPY 2023; 50:346-368. [PMID: 38140887 DOI: 10.1080/0092623x.2023.2295960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2023]
Abstract
Subjective orgasm experience (SOE) is a component of sexual health that refers to the perception, sensation and/or appraisal of orgasm at a psychological level. This construct has scarcely been studied in non-heterosexual individuals and couples, and never before from a dyadic perspective. In this study, in which 104 same-sex Hispanic couples participated (48 male-male and 56 female-female), we explored the dyadic influence of SOE dimensions on sexual satisfaction, the mediating role of relationship satisfaction on the association of both phases of sexual response, as well as the explanatory capacity that discrepancies in these dimensions had on sexual satisfaction. The results indicated that the orgasmic dimensions that gained more prominence were Affective and Sensory. A dyadic influence of both on sexual satisfaction was observed only in male couples, as well as a detriment of sexual satisfaction when there were discrepancies in them, especially in women. Moreover, relationship satisfaction was a significant mediator between all dimensions of SOE and sexual satisfaction in both types of couples. This work highlights the need to take into account the SOE of both partners and how this individual experience can affect other dimensions of a more interpersonal nature, such as sexual or relationship satisfaction.
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Affiliation(s)
- Pablo Mangas
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Juan Carlos Sierra
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Reina Granados
- Department of Nursey, Health Sciences Faculty, University of Granada, Granada, Spain
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Competência do cuidar e seu impacto na qualidade de vida de cuidadores. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao02132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fu W, Li J, Fang F, Zhao D, Hao W, Li S. Subjective burdens among informal caregivers of critically ill patients: a cross-sectional study in rural Shandong, China. BMC Palliat Care 2021; 20:167. [PMID: 34674691 PMCID: PMC8532289 DOI: 10.1186/s12904-021-00858-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal caregivers are the main source of care for the critically ill, especially after discharge or during the terminal stages at home. However, the concern for informal caregivers is often overshadowed by critically ill patients. The purpose of this study is to determine the influencing factors of the subjective burden of informal caregivers and to seek solutions accordingly. METHODS Between July and August 2019, a cross-sectional study was conducted in Shandong, China, focusing on family caregivers and critically ill patients. Subjective caregiver burden was measured by the Chinese version of Zarit Burden Interview (ZBI). The stress process model was used to identify conditions relevant to the caregiving burden and to assess their impact on family caregivers. RESULTS 554 samples were selected for analysis. The average scores of Zarit Caregiver Burden Interview (ZBI) scores in this study was 30.37±19.04 (n=554). ZBI scores of older, less educated, and spouse caregivers were significantly lower (4.12; 95%CI, 0.42 to 7.81; P =0.029). Objective and subjective burdens increased proportionally. Secondary role stress factors included the higher out-of-pocket (OOP) costs of critical diseases and lower household income, both of which increased caregivers' subjective burdens (1.28; 95%CI, -0.06 to 2.63; p=0.062). Formal medical aid systems played a positive role in reducing subjective caregiving burdens (-7.31; 95%CI, -13.23 to -1.40; p=0.016). CONCLUSIONS Health policies should address both the direct medical burdens and the intangible psychological burdens of critical diseases.
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Affiliation(s)
- Wenhao Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Jiajia Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| | - Feng Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Wenting Hao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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Polenick CA, Struble LM, Stanislawski B, Turnwald M, Broderick B, Gitlin LN, Kales HC. "The Filter is Kind of Broken": Family Caregivers' Attributions About Behavioral and Psychological Symptoms of Dementia. Am J Geriatr Psychiatry 2018; 26:548-556. [PMID: 29373300 PMCID: PMC6619504 DOI: 10.1016/j.jagp.2017.12.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 11/15/2017] [Accepted: 12/07/2017] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Behavioral and psychological symptoms of dementia (BPSD) are common, often challenging to manage, and may erode caregivers' well-being. Few studies have explored caregivers' perspectives of what causes these behaviors, but such attributions may be important-particularly if they negatively impact the care dyad. This study examined causal attributions about BPSD among individuals caring for a family member with dementia. DESIGN In-depth qualitative data were obtained from family caregivers of older adults with dementia. SETTING As part of a larger study (NINR R01NR014200), four focus groups were conducted with caregivers by an experienced facilitator. PARTICIPANTS A total of 26 family caregivers participated in the four focus groups. MEASUREMENTS Caregivers reported their own attributions about the causes of their care recipient's BPSD. Sessions were audio-recorded. Data were transcribed, coded to determine relevant concepts, and reduced to identify major categories. RESULTS Five categories were determined. Caregivers attributed BPSD to: 1) neurobiological disease factors; 2) physical symptoms or comorbid health conditions; 3) psychological reactions to dementia; 4) shifting social roles and relationships following dementia onset; and 5) environmental changes such as lack of routine and medical transitions (e.g., hospitalization). Despite this seemingly multifactorial attribution to BPSD etiology, a number of respondents also indicated that BPSD were at least partly within the care recipient's control. CONCLUSIONS Family caregivers attribute BPSD to a range of care recipient and environmental factors. Caregivers' own causal beliefs about BPSD may reflect unmet educational needs that should be considered in the development of targeted interventions to minimize caregiving stress.
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Affiliation(s)
| | | | | | - Molly Turnwald
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Brianna Broderick
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109
| | - Laura N. Gitlin
- Department of Community Public Health, School of Nursing, Johns Hopkins University, Baltimore, Maryland,Division of Geriatrics and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, Maryland,Center for Innovative Care on Aging, Johns Hopkins University, Baltimore, Maryland
| | - Helen C. Kales
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48109,Department of Veterans Affairs, HSR&D Center for Clinical Management Research (CCMR), Ann Arbor, MI 48109,Geriatric Research, Education and Clinical Center (GRECC), VA Ann Arbor Healthcare System, Ann Arbor, MI 48109
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Ayalon L, Roziner I. Satisfaction with the relationship from the perspectives of family caregivers, older adults and their home care workers. Aging Ment Health 2016; 20:56-64. [PMID: 25793662 DOI: 10.1080/13607863.2015.1020412] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Given the increasing reliance on both formal (paid) and informal (unpaid) assistance for the care of older adults and the close relationships which are often formed with home care workers, the present study evaluated satisfaction with the relationship from the perspectives of the three members that make up the home caregiving triad: older adults, their family members and their home care workers. METHODS We relied on a representative sample of 223 complete caregiving triads composed of an older adult, a family member and a home care worker. Each of the members rated his or her level of satisfaction with all other members in the unit, using a seven-item self-report satisfaction with the relationship scale (e.g., satisfaction with communication, intimacy). The Social Relations Model (SRM) was used to partial out the specific variance associated with each of the members as either an actor (i.e., the average satisfaction as a rater, unrelated to whom the person rates) or a partner (i.e., the unique satisfaction level elicited by a person, which is consistent across all ratings of this person). RESULTS The structural equations model yielded acceptable results: χ²(3) = 6.94, p = .07. Our analysis revealed that the variability associated with the worker as partner was significantly greater than the variability associated with the older adult as partner (∆χ² [1] = 9.21, p = .002) or with the family member as partner (∆χ² [1] = 8.46, p = .004). CONCLUSIONS The study highlights the importance of studying satisfaction with the relationship in the home care setting and calls for further examination of the entire caregiving triad. The home care worker plays a key role in ensuring the overall satisfaction in the caregiving triad.
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Affiliation(s)
- Liat Ayalon
- a Louis and Gabi and Weisfield School of Social Work , Bar Ilan University , Ramat Gan , Israel
| | - Ilan Roziner
- a Louis and Gabi and Weisfield School of Social Work , Bar Ilan University , Ramat Gan , Israel
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Fortune DG, Rogan CR, Richards HL. A structured multicomponent group programme for carers of people with acquired brain injury: Effects on perceived criticism, strain, and psychological distress. Br J Health Psychol 2015; 21:224-43. [DOI: 10.1111/bjhp.12159] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 07/27/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Dónal G. Fortune
- Centre for Social Issues; Department of Psychology; University of Limerick; Ireland
- Acquired Brain Injury Ireland; Dun Laoghaire Co Dublin Ireland
| | - Carol R. Rogan
- Acquired Brain Injury Ireland; Dun Laoghaire Co Dublin Ireland
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Nakken N, Spruit MA, Wouters EF, Schols JM, Janssen DJ. Family caregiving during 1-year follow-up in individuals with advanced chronic organ failure. Scand J Caring Sci 2015; 29:734-44. [DOI: 10.1111/scs.12204] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 11/05/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Nienke Nakken
- Program Development Centre; CIRO+, Centre of Expertise for Chronic Organ Failure; Horn The Netherlands
| | - Martijn A. Spruit
- Program Development Centre; CIRO+, Centre of Expertise for Chronic Organ Failure; Horn The Netherlands
| | - Emiel F.M. Wouters
- Program Development Centre; CIRO+, Centre of Expertise for Chronic Organ Failure; Horn The Netherlands
- Department of Respiratory Medicine; Maastricht University Medical Centre+ (MUMC+); Maastricht The Netherlands
| | - Jos M.G.A. Schols
- Department of Family Medicine; Faculty of Health Medicine and Life sciences/CAPHRI; Maastricht University; Maastricht The Netherlands
| | - Daisy J.A. Janssen
- Program Development Centre; CIRO+, Centre of Expertise for Chronic Organ Failure; Horn The Netherlands
- Centre of Expertise for Palliative Care; Maastricht University Medical Centre+ (MUMC+); Maastricht The Netherlands
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