Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-13T01:05:42.243Z Has data issue: false hasContentIssue false
  • English
  • Français

Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving

Published online by Cambridge University Press:  22 March 2012

Chetna Malhotra ,
Rahul Malhotra ,
Truls Østbye ,
David Matchar  and
Angelique Chan
Chetna Malhotra*
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
Rahul Malhotra
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
Truls Østbye
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore Department of Community and Family Medicine, Duke University, Durham, North Carolina, USA
David Matchar
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
Angelique Chan
Affiliation:
Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore Department of Sociology, National University of Singapore, Singapore
*
Correspondence should be addressed to: Dr. Chetna Malhotra, Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, 8 College Road, Level 4, 169857Singapore. Phone: +65 6516 5692; Fax: +65 6534 8632. Email: chetna.malhotra@duke-nus.edu.sg.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: This paper determines care recipient and caregiver characteristics and caregiving dimensions – associated with depression among caregivers of older adults, using path analysis and assesses whether the identified path model differs between spousal and adult child caregivers.

Methods: Data from 1,190 dyads comprising care recipients (community-dwelling adults aged ≥75 years with at least one activity of daily living (ADL) limitation) and caregivers (family member/friend most involved in providing care/ensuring provision of care to care recipient), who were interviewed through the Singapore Survey on Informal Caregiving (2010–2011), were used. Using path analysis, we assessed the direct and indirect associations between primary stressors (care recipient's ADL and instrumental ADL status, and memory and behavior problems), caregiver health status, receipt of assistance from a foreign domestic worker/maid, amount of caregiving, negative reaction to caregiving, caregiver's self-esteem, perceived emotional support, and caregiver depressive symptoms.

Results: Our analysis showed that primary stressors, receipt of assistance from a foreign domestic worker/maid, perceived emotional support, and caregiver health status were directly or indirectly associated with caregiver depressive symptoms, and this association was mediated by negative reaction to caregiving. Caregiver self-esteem mediated the relationship between perceived emotional support and negative reaction to caregiving only among adult child caregivers.

Conclusions: The results provide insights into factors associated with depressive symptoms among spousal and adult child caregivers, and help identify targeted interventions for improving caregiver mood.

Keywords

carersdepression
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Special Issue 8: Focus on late life depression , August 2012 , pp. 1335 - 1346
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arai, Y., Sugiura, M., Washio, M., Miura, H. and Kudo, K. (2001). Caregiver depression predicts early discontinuation of care for disabled elderly at home. Psychiatry and Clinical Neurosciences, 55, 379–382.CrossRefGoogle ScholarPubMed
Chen, F. F. (2007). Sensitivity of goodness of fit indexes to lack of measurement invariance. Structural Equation Modeling: A Multidisciplinary Journal, 14, 464–504.CrossRefGoogle Scholar
Clyburn, L. D., Stones, M. J., Hadjistavropoulos, T. and Tuokko, H. (2000). Predicting caregiver burden and depression in Alzheimer's disease. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 55, S2–S13.Google ScholarPubMed
Cohen, C. A., Colantonio, A. and Vernich, L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17, 184–188.CrossRefGoogle ScholarPubMed
Deimling, G. T., Smerglia, V. L. and Schaefer, M. L. (2001). The impact of family environment and decision-making satisfaction on caregiver depression: a path analytic model. Journal of Aging and Health, 13, 47–71.CrossRefGoogle ScholarPubMed
Doody, R. S. et al. (2001). Practice parameter: management of dementia (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, 1154–1166.CrossRefGoogle Scholar
Fillenbaum, G. G. and Smyer, M. A. (1981). The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. Journal of Gerontology, 36, 428–434.CrossRefGoogle ScholarPubMed
Given, C. W., Given, B., Stommel, M., Collins, C., King, S. and Franklin, S. (1992). The caregiver reaction assessment (CRA) for caregivers to persons with chronic physical and mental impairments. Research in Nursing and Health, 15, 271–283.CrossRefGoogle ScholarPubMed
Kohout, F. J., Berkman, L. F., Evans, D. A. and Cornoni-Huntley, J. (1993). Two shorter forms of the CES-D (Center for Epidemiological Studies Depression) depression symptoms index. Journal of Aging and Health, 5, 179–193.CrossRefGoogle ScholarPubMed
Lawton, M. P., Moss, M., Kleban, M. H., Glicksman, A. and Rovine, M. (1991). A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology, 46, P181–P189.CrossRefGoogle ScholarPubMed
Lazarus, R. S. and DeLongis, A. (1983). Psychological stress and coping in aging. American Psychologist, 38, 245–254.CrossRefGoogle ScholarPubMed
Losada, A. et al. (2006). Cross-cultural study comparing the association of familism with burden and depressive symptoms in two samples of Hispanic dementia caregivers. Aging and Mental Health, 10, 69–76.CrossRefGoogle ScholarPubMed
Miller, B., Townsend, A., Carpenter, E., Montgomery, R. V. J., Stull, D. and Young, R. F. (2001). Social support and caregiver distress. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 56, S249–S256.CrossRefGoogle ScholarPubMed
Nieboer, A. P., Schulz, R., Matthews, K. A., Scheier, M. F., Ormel, J. and Lindenberg, S. M. (1998). Spousal caregivers’ activity restriction and depression: a model for changes over time. Social Science and Medicine, 47, 1361–1371.CrossRefGoogle Scholar
Pearlin, L. I., Lieberman, M. A., Menaghan, E. G. and Mullan, J. T. (1981). The stress process. Journal of Health and Social Behavior, 22, 337–356.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Mullan, J. T., Semple, S. J. and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. Gerontologist, 30, 583–594.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sorensen, S. (2004). Associations of caregiver stressors and uplifts with subjective well-being and depressive mood: a meta-analytic comparison. Aging and Mental Health, 8, 438–449.CrossRefGoogle Scholar
Pinquart, M. and Sorensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 62, P126–P137.CrossRefGoogle ScholarPubMed
Raschick, M. and Ingersoll-Dayton, B. (2004). The costs and rewards of caregiving among aging spouses and adult children. Family Relations, 53, 317–325.CrossRefGoogle Scholar
Redinbaugh, E. M., MacCallum, R. C. and Kiecolt-Glaser, J. K. (1995). Recurrent syndromal depression in caregivers. Psychology and Aging, 10, 358–368.CrossRefGoogle ScholarPubMed
Robinson, K. (1990). The relationships between social skills, social support, self-esteem and burden in adult caregivers. Journal of Advanced Nursing, 15, 788–795.CrossRefGoogle ScholarPubMed
Savundranayagam, M. Y., Montgomery, R. J. V. and Kosloski, K. (2011). A dimensional analysis of caregiver burden among spouses and adult children. Gerontologist, 51, 321–331.CrossRefGoogle ScholarPubMed
Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A. and King, J. (2006). Reporting structural equation modeling and confirmatory factor analysis results: a review. Journal of Educational Research, 99, 323–338.CrossRefGoogle Scholar
Swearer, J. M., Drachman, D. A., O'Donnell, B. F. and Mitchell, A. L. (1988). Troublesome and disruptive behaviors in dementia: relationships to diagnosis and disease severity. Journal of the American Geriatrics Society, 36, 784–790.CrossRefGoogle ScholarPubMed
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S. and Vitaliano, P. P. (1992). Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist. Psychology and Aging, 7, 622–631.CrossRefGoogle ScholarPubMed
Ullman, J. B. and Bentler, P. M. (2003). Structural equation modeling. In Weiner, I. B. et al. (eds.), Handbook of Psychology. New York: John Wiley & Sons.Google Scholar
Vandenberg, R. J. and Lance, C. E. (2000). A review and synthesis of the measurement invariance literature: suggestions, practices, and recommendations for organizational research. Organizational Research Methods, 3, 4–70.CrossRefGoogle Scholar
Vitaliano, P. P., Zhang, J. and Scanlan, J. M. (2003). Is caregiving hazardous to one's physical health? A meta-analysis. Psychological Bulletin, 129, 946–972.CrossRefGoogle ScholarPubMed
Yates, M. E., Tennstedt, S. and Chang, B. H. (1999). Contributors to and mediators of psychological well-being for informal caregivers. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 54, P12–P22.CrossRefGoogle ScholarPubMed
Yeoh, B. S., Huang, S. and Gonzalez, J. (1999). Migrant female domestic workers: debating the economic, social and political impacts in Singapore. International Migration Review, 33, 114–136.CrossRefGoogle ScholarPubMed
Supplementary material: File

Malhotra supplementary material

Tables

Download Malhotra supplementary material(File)
File 65 KB