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Perceived Control, Coping, and Expressed Burden among Spouses of Suspected Dementia Patients: Analysis of the Goodness-of-Fit Hypothesis

Published online by Cambridge University Press:  31 March 2010

Norm O'Rourke*
Affiliation:
Simon Fraser University at Harbour Centre
Philippe Cappeliez
Affiliation:
University of Ottawa
*
Requests for offprints should be sent to: / Les demandes de tirés-a-part doivent être adressées à : Norm O'Rourke, Ph.D., Gerontology Research Centre, Simon Fraser University at Harbour Centre, #2800 - 515 West Hastings Street, Vancouver, BC, V6B 5K3. (ORourke@sfu.ca)

Abstract

The goodness-of-fit hypothesis contends that distress results due to incongruence between choice of coping strategies and perceived ability to change stressful stimuli. Goal-directed or active coping responses are believed to be most efficacious when the individual believes s/he can change or control perceived threats (i.e., problem-focused coping). Instances in which stressors must be accepted, however, would dictate reliance upon strategies to regulate distress (i.e., emotion-focused coping). Inconsistent support for this facet of Lazarus and Folkman's cognitive phenomenological model was obtained in this study of spouses of suspected dementia patients. The distinction between emotion- and problem-focused coping appears less germane than overall coping efforts relative to perceived control and caregiver burden. In addition, perceived ability to control dementia-related stressors appears to be somewhat independent of coping by caregivers. These findings are discussed in terms of the unique and chronic demands faced by spouses of persons with dementia.

Résumé

L'hypothèse de l'adéquation (goodness-of-fit) avance que la détresse résulte de l'inadéquation entre le choix de stratégies d'adaptation et la capacité subjective de changer les stimuli sources de stress. Les réponses dirigées vers des buts ou d'adaptation active sont considérées comme les plus efficaces dans les circonstances où l'individu croit qu'il peut changer ou contrôler les menaces perçues (par exemple, la stratégie de résolution de problème). Par contre, lorsque les situations stressantes doivent être acceptées, les stratégies de régulation de la détresse seraient de mise (par exemple, les stratégies centrées sur les émotions). Cette étude avec des conjoints de patients présumés déments n'apporte qu'un soutien empirique inconsistant à cette facette de la théorie cognitivo-phénoménologique de Lazarus et Folkman. Cette distinction entre adaptation centrée d'un côté sur les émotions et de l'autre sur les problèmes apparaît moins pertinente que l'effort global d'adaptation relatif au contrôle perçu et au fardeau de l'aidant naturel. De plus, la capacité perçue de contrôler les situations stressantes reliées à la démence apparaît être plutôt indépendante de l'adaptation de l'aidant naturel. Ces résultats sont discutés en termes des demandes uniques et chroniques auxquelles sont confrontés les conjoints de personnes affligées par la démence.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2002

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Footnotes

*This article was written with the support of a Social Sciences and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship awarded to the first author.

References

Baumgarten, M. (1989). The health of persons providing care to the demented elderly: A critical review of the literature. Journal of Clinical Epidemiology, 42, 11371148.CrossRefGoogle Scholar
Brashares, H.J., & Catanzario, S.J. (1994). Mood regulation expectancies, coping responses, depression, and sense of burden in female caregivers of Alzheimer's patients. Journal of Nervous and Mental Disease, 182, 437442.CrossRefGoogle ScholarPubMed
DeLongis, A., & O'Brien, T. (1990). An interpersonal framework for stress and coping: An application to families of Alzheimer's patients. In Stephens, M.A.P., Crowther, J.H., Hobfoll, S.E., & Tennenbaum, D.L. (Eds.), Stress and coping in later-life families (pp. 221239). New York: Hemisphere.Google Scholar
Folkman, S., & Lazarus, R.S. (1980). An analysis of coping in a middle-aged community sample. Journal of Health and Social Behavior, 21, 219239.CrossRefGoogle Scholar
Folkman, S., Lazarus, R.S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R.J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50, 9921003.CrossRefGoogle ScholarPubMed
Gignac, M.A.M., & Gottlieb, B.H. (1996). Caregivers' appraisals of efficacy in coping with dementia. Psychology and Aging, 11, 214225.CrossRefGoogle ScholarPubMed
Hadjistavropoulos, T., Taylor, S., Tuokko, H., & Beattie, B.L. (1994). Neuropsychological deficits, caregivers' perceptions of deficits, and caregiver burden. Journal of the American Geriatrics Society, 42, 308314.CrossRefGoogle ScholarPubMed
Hassinger, M.J. (1986). Community-dwelling dementia patients whose relatives sought counseling services regarding patient care: Predictors of institutionalization over a one-year follow-up period. (Doctoral dissertation, University of Southern California, 1986). Dissertation Abstracts International, 47, 1-B, 376.Google Scholar
Holahan, C.J., & Moos, R.H. (1990). Life stressors, resistance factors, and improved psychological functioning: An extension of the stress resistance paradigm. Journal of Personality and Social Psychology, 58, 909917.CrossRefGoogle ScholarPubMed
Kileen, M. (1990). The influence of stress and coping on family caregivers' perceptions of health. International Journal of Aging and Human Development, 30, 197211.CrossRefGoogle Scholar
Kramer, B.J., & Vitaliano, P.P. (1994). Coping: A review of the theoretical frameworks and the measures used among caregivers of individuals with dementia. Journal of Geriatric Social Work, 23, 151174.Google Scholar
Lazarus, R.S., & Folkman, S.. (1984). Stress, appraisal, and coping. New York: Springer.Google Scholar
Lutzky, S.M., & Knight, B.G. (1994). Explaining gender differences in caregiver distress: The roles of emotional attentiveness and coping styles. Psychology and Aging, 9, 513519.CrossRefGoogle ScholarPubMed
Majerovitz, S.D. (1995). Role of family adaptability in the psychological adjustment of spouse caregivers to patients with dementia. Psychology and Aging, 10, 447457.CrossRefGoogle ScholarPubMed
Moos, R.H., Cronkite, R.C., & Finney, J.W. (1990). Health and Daily Living Form Manual (2nd ed.). Unpublished manuscript, Center for Health Care Evaluation, Stanford University Medical Center, Palo Alto, CA.Google Scholar
Moos, R.H., & Schaefer, J.A. (1993). Coping resources and processes: Current concepts and measures. In Goldberg, L. & Breznitz, S. (Eds.), Handbook of stress: Theoretical and clinical aspects (pp. 234257). New York: Free Press.Google Scholar
Niederehe, G., & Funk, J. (1987, August) Family interaction with dementia patients: Caregivers' styles and their correlates. Paper presented at the annual meeting of the American Psychological Association, New York.Google Scholar
O'Rourke, N., Haverkamp, B.E., Tuokko, H., Hayden, S., & Beattie, B.L. (1997). Hopelessness depression among spousal caregivers of suspected dementia patients. Journal of Clinical Geropsychology, 3, 173182.Google Scholar
O'Rourke, N., & Wenaus, C.A. (1998). Marital aggrandizement as a mediator of burden among spouse of suspected dementia patients. Canadian Journal on Aging, 17, 384400.CrossRefGoogle Scholar
Parker, J.D.A., Endler, N.S., & Bagby, R.M. (1993). If it changes, it might be unstable: Examining the factor structure of the Ways of Coping Questionnaire. Psychological Assessment, 5, 361368.CrossRefGoogle Scholar
Paulhus, D.L. (1991). Measurement and control of response bias. In Robinson, J.P., Shaver, P.R., & Wrightsman, L.S. (Eds.), Measurement of personality and social psychological attitudes (pp. 1759). San Diego, CA: Academic Press.CrossRefGoogle Scholar
Stephens, M.A.P., & Hobfoll, S.E. (1990). Ecological perspectives on stress and coping in later-life families. In Stephens, M.A.P., Crowther, J.H., Hobfoll, S.E., & Tennenbaum, D.L. (Eds.), Stress and coping in later-life families (pp. 287304). New York: Hemisphere.Google Scholar
Tuokko, H., Crockett, D., Beattie, B.L., Horton, A., & Wong, M. (1986, February) The use of rating scales to assess psycho-social functioning in demented patients. Paper presented at the annual meeting of the International Neuropsychological Society, Denver, CO.Google Scholar
Vitaliano, P.P., DeWolfe, D.J., Maiuro, R.P., Russo, J., & Katon, W. (1990). Appraised changeability of a stressor as a modifier of the relationship between coping and depression: A test of the hypothesis of fit. Journal of Personality and Social Psychology, 59, 582592.CrossRefGoogle ScholarPubMed
Vitaliano, P.P., Maiuro, R.P., Russo, J., & Becker, J. (1987). Raw versus relative scores in the assessment of coping strategies. Journal of Behavioral Medicine, 10, 118.CrossRefGoogle ScholarPubMed
Zarit, S.H., Orr, N.K., & Zarit, J.M. (1985). Families under stress: Caring for the patient with Alzheimer's disease and related disorders. New York: New York University Press.Google Scholar
Zarit, S.H., & Zarit, J.M. (1990). The Memory and Behavior Problems Checklist and the Burden Interview. Unpublished manuscript, Pennsylvania State University, Gerontology Center, University Park, PA.Google Scholar