Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T06:57:14.800Z Has data issue: false hasContentIssue false
  • English
  • Français

The roles of unmet needs and formal support in the caregiving satisfaction and caregiving burden of family caregivers for persons with dementia

Published online by Cambridge University Press:  28 September 2017

Myonghwa Park ,
Sora Choi ,
Song Ja Lee ,
Seon Hwa Kim ,
Jinha Kim ,
Younghye Go  and
Dong Young Lee
Myonghwa Park
Affiliation:
Research and Education Center for Evidence Based Nursing, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
Sora Choi*
Affiliation:
Department of Nursing, Chungbuk Health & Science University, Cheongju, Chungcheongbukdo, Republic of Korea
Song Ja Lee
Affiliation:
Seoul Metropolitan Center for Dementia, Seoul, Republic of Korea
Seon Hwa Kim
Affiliation:
Seoul Metropolitan Center for Dementia, Seoul, Republic of Korea
Jinha Kim
Affiliation:
Seoul Metropolitan Center for Dementia, Seoul, Republic of Korea
Younghye Go
Affiliation:
Research and Education Center for Evidence Based Nursing, College of Nursing, Chungnam National University, Daejeon, Republic of Korea
Dong Young Lee
Affiliation:
Seoul Metropolitan Center for Dementia, Seoul, Republic of Korea Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
*
Correspondence should be addressed to: Sora Choi, Department of Nursing, Chungbuk Health & Science University, 10 Deogam-gil, Nesu-eup, Cheongwon-gu, Cheongju, Chungcheongbukdo 28150, Republic of Korea. Phone: +043-210-8296; Fax: +043-210-8252. Email: sorady@chsu.ac.kr.
Get access

Abstract

Background:

A growing number of studies are emphasizing the importance of positive and negative appraisals of caregiving and the utilization of social resources to buffer the negative effects of caring for persons with dementia. By assessing the roles of unmet needs and formal support, this study tested a hypothesized model for Korean family caregivers’ satisfaction and burden in providing care for persons with dementia.

Methods:

The stress process model and a two-factor model were used as the conceptual framework for this study. Data for 320 family caregivers from a large cross-sectional survey, the Seoul Dementia Management study, were analyzed using structural equation modeling. In the hypothesized model, the exogenous variables were patient symptoms, including cognitive impairment, behavioral problems, and dependency on others to help with activities of daily living and with instrumental activities of daily living. The endogenous variables were the caregiver's perception of the unmet needs of the patient, formal support, caregiving satisfaction, and caregiving burden.

Results:

The adjusted model explained the mediating effect of unmet needs on the relationship between patient symptoms or formal support and caregiving satisfaction. Formal support also had a mediating effect on the relationship between patient symptoms and unmet needs. Patient symptoms and caregiving satisfaction had a significant direct effect on caregiving burden.

Conclusion:

The level of unmet needs of persons with dementia and their family caregivers must be considered in the development of support programs focused on improving caregiving satisfaction.

Keywords

dementiacarersneedsupportperson-centered
Type
Research Article
Information
International Psychogeriatrics , Volume 30 , Issue 4: Issue Theme: Delirium , April 2018 , pp. 557 - 567
Copyright
Copyright © International Psychogeriatric Association 2017 

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

Andrén, S. and Elmståhl, S. (2005). Family caregivers' subjective experiences of satisfaction in dementia care: aspects of burden, subjective health and sense of coherence. Scandinavian Journal of Caring Sciences, 19, 157–168. doi:10.1111/j.1471-6712.2005.00328.x.CrossRefGoogle ScholarPubMed
Andrén, S. and Elmståhl, S. (2008). Psychosocial intervention for family caregivers of people with dementia reduces caregiver's burden: development and effect after 6 and 12 months. Scandinavian Journal of Caring Sciences, 22, 98–109. doi:10.1111/j.1471-6712.2007.00498.x.Google Scholar
Bae, K. Y. et al. (2006). Care burden caregivers according to cognitive function of elderly persons. Journal of the Korean Society of Biological Therapies in Psychiatry, 12, 66–75.Google Scholar
Bakker, C. et al. (2014). The relationship between unmet care needs in young-onset dementia and the course of neuropsychiatric symptoms: a two-year follow-up study. International Psychogeriatrics, 26, 1991–2000. doi:10.1017/s1041610213001476.CrossRefGoogle ScholarPubMed
Black, B. S., Johnston, D., Rabins, P. V., Morrison, A., Lyketsos, C. and Samus, Q. M. (2013). Unmet needs of community-residing persons with dementia and their informal caregivers: findings from the maximizing independence at home study. Journal of American Geriatric Society, 61, 2087–2095. doi:10.1111/jgs.12549.Google Scholar
Chan, S. W. C. (2011). Family caregiving in dementia: the Asian perspective of a global problem. Dementia and Geriatric Cognitive Disorders, 30, 469–478. doi:10.1159/000322086.Google Scholar
Cleary, M., Freeman, A., Hunt, G. E. and Walter, G. (2006). Patient and carer perceptions of need and associations with care-giving burden in an integrated adult mental health service. Social Psychiatry and Psychiatric Epidemiology, 41, 208–214. doi:10.1007/s00127-005-0017-z.Google Scholar
Contador, I., Fernandez-Calvo, B., Palenzuela, D. L., Miguéis, S. and Ramos, F. (2012). Prediction of burden in family caregivers of patients with dementia: a perspective of optimism based on generalized expectancies of control. Aging & Mental Health, 16, 675–682. doi:10.1080/13607863.201-2.684666.Google Scholar
Crespo, M. and Fernandez-Lansac, V. (2014). Factors associated with anger and anger expression in caregivers of elderly relatives. Aging & Mental Health, 18, 454–462. doi:10.1080/1360786-3.2013.856857.Google Scholar
de Labra, C. et al. (2015). Predictors of caregiving satisfaction in informal caregivers of people with dementia. Archives of Gerontology and Geriatrics, 60, 380–388. doi:10.1016/j.archger.2015.03.002.Google Scholar
Goetzinger, A. M. (2008). Predictors of caregiver well-being and satisfaction: the development of a comprehensive model [dissertation]. Kansas City: University of Missouri-Kansas City.Google Scholar
Han, E. J. et al. (2014). Factors related to family caregivers’ burden with the community-dwelling disabled elderly under the long-term care insurance system. Health Policy and Management, 24, 71–84. doi:10.4332/KJHPA.2014.24.1.71.CrossRefGoogle Scholar
Hodge, D. R. and Sun, F. (2012). Positive feelings of caregiving among Latino Alzheimer's family caregivers: understanding the role of spirituality. Aging & Mental Health, 16, 689–698. doi:10.1080/13607863.2012.678481.Google Scholar
Hughes, T. B. et al. (2014). Correlates of objective and subjective measures of caregiver burden among dementia caregivers: influence of unmet patient and caregiver dementia-related care needs. International Psychogeriatrics, 26, 1875–1883. doi:10.1017/S10416-10214001240.Google Scholar
Hwang, S. S. et al. (2003). Caregiver unmet needs, burden, and satisfaction in symptomatic advanced cancer patients at a Veterans Affairs (VA) Medical Center. Palliative & Supportive Care, 1, 319–329. doi:10.1017/S1478951503030475.CrossRefGoogle Scholar
Kajiwara, K., Nakatani, H., Ono, M. and Miyakoshi, Y. (2015). Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving. Psychogeriatrics, 15, 26–31. doi:10.1111/psyg.12074.Google Scholar
Kang, J. H. (2010). Effect of a social support program on caregivers of elders with dementia. Journal of Korean Gerontological Nursing, 12, 142–153.Google Scholar
Kim, J. E. and Choi, H. K. (2015). The effects of care recipient helpfulness on elderly family caregiver's caregiving burden and satisfaction. Social Science Research, 26, 123–150. doi:10.16881/jss.-2015.04.26.2.123.Google Scholar
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, 181–189. doi:10.1093/geronj/46.4.P181.CrossRefGoogle ScholarPubMed
Lee, D. Y. et al. (2014). Dementia Management Survey for Registered Elders with Dementia in Seoul Dementia Management Project. Seoul: Seoul Metropolitan Center for Dementia.Google Scholar
Lundh, U. (1999). Family carers 2: sources of satisfaction among Swedish carers. British Journal of Nursing, 8, 647–652. doi:10.12968/bjon.1999.8.10.6601.Google Scholar
Meiland, F. J., Kat, M. G., van Tilburg, W., Jonker, C. and Dröes, R. M. (2005). The emotional impact of psychiatric symptoms in dementia on partner caregivers: do caregiver, patient, and situation characteristics make a difference? Alzheimer Disease and Associated Disorders, 19, 195–201. doi:10.1097/01.wad.0000189035.25277.02.Google Scholar
Miranda-Castillo, C., Woods, B. and Orrell, M. (2013). The needs of people with dementia living at home from user, caregiver and professional perspectives: a cross-sectional survey. BMC Health Service Research, 13, 43. doi:10.1186/1472-6963-13-43.Google Scholar
Miranda-Castillo, C., Woods, B., Galboda, K., Oomman, S., Olojugba, C. and Orrell, M. (2010). Unmet needs, quality of life and support networks of people with dementia living at home. Health Quality of life Outcomes, 8, 132.Google Scholar
Nolan, M., Grant, G. and Keady, J. (1998). Assessing the Needs of Family Carers: A Guide for Practitioners. Brighton: Pavilion Publishing.Google Scholar
Orrell, M. and Hancock, G. (2004). CANE: Camberwell Assessment of Need for the Elderly. London: Gaskell.Google Scholar
Park, M., Sung, M., Kim, S. K., Kim, S. and Lee, D. Y. (2015). Multidimensional determinants of family caregiver burden in Alzheimer's disease. International Psychogeriatrics, 27, 1355–1364. doi:10.1017/S10416-10215000460.Google Scholar
Parveen, S. and Morrison, V. (2012). Predicting caregiver gains: a longitudinal study. British Journal of Health Psychology, 17, 711.Google Scholar
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. The Gerontologist, 30, 583–594.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2011). Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychology and Aging, 26, 1–14. doi:10.1037/a0021-863.Google Scholar
Rabins, P. V., Lyketsos, C. G. and Steele, C. D. (2006). Practical Dementia Care. New York: Oxford University Press.Google Scholar
Reynolds, T. et al. (2000). Camberwell Assessment of need for the elderly (CANE): development, validity, and reliability. British Journal of Psychiatry, 176, 444–452. doi:10.1192/bjp.176.5.444.CrossRefGoogle ScholarPubMed
Schölzel-Dorenbos, C. J. M., Meeuwsen, E. J. and Olde Rikkert, M. G. (2010). Integrating unmet needs into dementia health-related quality of life research and care: introduction of the hierarchy model of needs in dementia. Aging & Mental Health, 14, 113–119. doi:10.10-80/13607860903046495.Google Scholar
Shim, B., Barroso, J., Gilliss, C. L. and Davis, L. L. (2013). Finding meaning in caring for a spouse with dementia. Applied Nursing Research, 26, 121–126. doi:10.1016/j.apnr.2013.05.001.Google Scholar
Weber, S. R., Pirraglia, P. A. and Kunik, M. E. (2011). Use of services by community-dwelling patients with dementia: a systematic review. American Journal of Alzheimer's Disease & Other Demenentias, 26, 195–204. doi:10.1177/1533317510392564.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. The Gerontologist, 20, 649–655. doi:10.1093/geront/20.6.649.CrossRefGoogle ScholarPubMed