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Multidimensional determinants of family caregiver burden in Alzheimer's disease

Published online by Cambridge University Press:  08 April 2015

Myonghwa Park*
Affiliation:
College of Nursing, Chungnam National University, Daejeon, Republic of Korea
Mira Sung
Affiliation:
Department of Nursing, Yong-In Songdam College, Yong-In, Republic of Korea
Sun Kyung Kim
Affiliation:
College of Nursing, Chungnam National University, Daejeon, Republic of Korea
Sungjin Kim
Affiliation:
Department of Nursing, Masan University, Changwon, Republic of Korea
Dong Young Lee
Affiliation:
Department of Neuropsychiatry, Seoul National University Hospital, and Seoul Metropolitan Center for Dementia (SMCD), Seoul, Republic of Korea
*
Correspondence should be addressed to: Myonghwa Park, PhD, RN, Associate Professor, College of Nursing, Chungnam National University, 55 Munhwa-ro Jung-gu, Daejeon, 301-747, Republic of Korea. Phone: +82-42-580-8328. Email: [email protected].

Abstract

Background:

Caregiver burden is a complex and multidimensional construct. Although previous studies have explored numerous factors associated with caregiver burden, these factors have not been identified with a large population-based sample in a theory-based multidimensional way. This study explores multidimensional determinants associated with family caregiver burden to determine the main contributors of caregiver burden in Alzheimer's disease (AD) using a large community dataset.

Methods:

A retrospective secondary data analysis was conducted on 1,133 patients with AD and 1,133 primary caregivers who were registered in a metropolitan city dementia center in South Korea. The patient data included socio-demographic and disease profiles. The caregiver data consisted of socio-demographic and caregiving profiles.

Results:

The study results identified that dementia-related factors were the most significant factors, representing 25.6% of caregiver burden and were followed by caregiving-related factors explaining caregiver burden significantly. Behavioral problems and instrumental activities of daily living (IADL) dependency of the patient, spousal relationship, hours of caregiving, and the number of diseases associated with the caregiver were found to be significant individual variables.

Conclusions:

It is vital to develop a service and support program with a greater emphasis on the behavioral problems and IADL deficiency of patients with AD as well as on improving the competence ability of caregivers to deal with such difficulties.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2015 

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References

American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Bae, K. I.et al. (2006). Care burden of caregivers according to cognitive function of elderly persons. Journal of the Korean Society of Biological Therapies in Psychiatry, 12, 6675.Google Scholar
Cheon, S. H. (2011). The relationship among perceived entrapment, depression and subjective well-being of women as family caregivers caring for dementia elderly. Korean Journal of Women Health Nursing, 17, 285293. doi:10.4069/kjwhn.2011.17.3.285.CrossRefGoogle ScholarPubMed
Cho, E., Cho, E. and Kim, S. S. (2010). Effects of family relationship on burden of family caregivers of older adult with dementia. Journal of Korea Gerontological Society, 30, 421437.Google Scholar
Choi, E. S. and Kim, K. S. (2010). Factors affecting on caregiving self-efficacy among dementia caregivers. Journal of Korean Academy of Community Health Nursing, 21, 210219. doi:10.12799/jkachn.2010.21.2.210.CrossRefGoogle Scholar
Conde-Sala, J. L., Garre-Olmo, J., Turro-Garriga, O., Vilalta-Franch, J. and Lopez-Pousa, S. (2010). Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer's disease: an exploratory comparative design. International Journal of Nursing Studies, 47, 12621273. doi:10.1016/j.ijnurstu.2010.03.001.CrossRefGoogle ScholarPubMed
Connell, C. M., Janevic, M. R. and Gallant, M. P. (2001). The costs of caring: impact of dementia on family caregivers. Journal of Geriatric Psychiatry and Neurology, 14, 179187. doi:10.1177/089198870101400403.CrossRefGoogle ScholarPubMed
Etters, L., Goodall, D. and Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: a review of the literature. Journal of the American Academy of Nurse Practitioners, 20 (8), 423428.CrossRefGoogle ScholarPubMed
Farias, S. T.et al. (2009). Longitudinal changes in memory and executive functioning are associated with longitudinal change in instrumental activities of daily living in older adults. The Clinical Neuropsychologist, 23, 446461. doi:10.1080/13854040802360558.CrossRefGoogle Scholar
Gallagher, D.et al. (2011). Dependence and caregiver burden in Alzheimer's disease and mild cognitive impairment. American Journal of Alzheimer's Disease & Other Dementias, 26, 110114. doi:10.1177/1533317510394649.CrossRefGoogle ScholarPubMed
Gonyea, J., O’Connor, M., Carruth, A. and Boyle, P. (2005). Subjective appraisal of Alzheimer's disease caregiving: the role of self-efficacy and depressive symptoms in the experience of burden. American Journal of Alzheimer's Disease & Other Dementias, 20, 273280. doi:10.1177/153331750502000505.CrossRefGoogle ScholarPubMed
Haley, W. E., Levine, E. G., Brown, S. L. and Bartolucci, A. A. (1987). Stress, appraisal, coping, and social support as predictors of adaptational outcome among dementia caregivers. Psychology and Aging, 2, 323330. doi:10.1037/0882-7974.2.4.323.CrossRefGoogle ScholarPubMed
Han, J. W.et al. (2014). Effects of social supports on burden in caregivers of people with dementia. International Psychogeriatrics, 26, 16391648. doi:10.1017/S1041610214001331.CrossRefGoogle ScholarPubMed
Joling, K. J.et al. (2010). Incidence of depression and anxiety in the spouses of patients with dementia: a naturalistic cohort study of recorded morbidity with a 6-year follow-up. American Journal of Geriatric Psychiatry, 18, 146153. doi:10.1097/JGP.0b013 e3181.CrossRefGoogle Scholar
Kim, H., Chang, M., Rose, K. and Kim, S. (2011). Predictors of caregiver burden in caregivers of individuals with dementia. Journal of Advanced Nursing, 68, 846855. doi:10.1111/j.1365-2648.2011.05787.x.CrossRefGoogle ScholarPubMed
Lazarus, R. S. and Folkman, S. (1984). Stress, Appraisal, and Coping. New York: Springer.Google Scholar
Lee, D. Y. (2007). Seoul dementia management project and Seoul metropolitan center for dementia. Journal of Korean Geriatric Psychiatry, 11, 811.Google Scholar
Lee, D. Y., Lee, K. U., Lee, J. H., Kim, K. W., Jhoo, J. H. and Youn, J. C. (2002). A normative study of the mini-mental state examination in the Korean elderly. Journal of Korean Neuropsychiatric Association, 41, 508525.Google Scholar
Lee, H. S., Kim, D. K. and Kim, J. (2006). Stress in caregivers of demented people in Korea—-a modification of Pearlin and colleagues’ stress model. International Journal of Geriatric Psychiatry, 21, 784791. doi:10.1002/gps.1563.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadian, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer's disease. Neurology, 34, 939944. doi:10.1212/WNL.34.7.939.CrossRefGoogle ScholarPubMed
Minaker, K. L. (2011). Common clinical sequelae of aging. In Goldman, L. and Schafer, A. I. (eds.), Goldman's Cecil Medicine, 24th edn, Philadelphia, PA: Elsevier Saunders.Google Scholar
Miyamoto, Y., Ito, H., Otuska, T. and Kurita, H. (2002). Caregiver burden in mobile and non-mobile demented patients: a comparative study. International Journal of Geriatric Psychiatry, 17, 765773. doi:10.1002/gps.694.CrossRefGoogle ScholarPubMed
Papastavrou, E., Kalokerinou, A., Papacostas, S. S., Tsagari, H. and Sourtzi, P. (2007). Caring for a relative with dementia: family caregiver burden. Journal of Advanced Nursing, 58, 446457. doi:10.1111/j.1365-2648.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, 583594. doi:10.1093/geront/30.5.583.CrossRefGoogle ScholarPubMed
Poulshock, S. W. and Deimling, G. T. (1984). Families caring for elders in residence: issues in the measurement of burden. Journal of Gerontology, 39, 230239. doi:10.1093/geronj/39.2.230.CrossRefGoogle ScholarPubMed
Sussman, T. and Regehr, C. (2009). The influence of community-based services on the burden of spouses caring for their partners with dementia. Health & Social Work, 34, 2939. doi:10.1093/hsw/34.1.29.CrossRefGoogle ScholarPubMed
Tremont, G., Davis, J. D. and Bishop, D. S. (2006). Unique contribution of family functioning in caregivers of patients with mild to moderate dementia. Dementia and Geriatric Cognitive Disorders, 21, 170174. doi:10.1159/000090699.CrossRefGoogle ScholarPubMed
Van der Lee, J., Bakker, T. J. E. M., Duivenvoorden, H. J. and Droes, R M. (2014). Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing Research Reviews, 15, 7693. doi:10.1016/j.arr.2014.03.003.CrossRefGoogle ScholarPubMed
Vernooij-Dassen, M. and Downs, M. (2008). Cognitive and behavioral interventions for carers of people with dementia. The Cochrane Library. doi:10.1002/14651858CD005318.Google Scholar
Won, C. W.et al. (2002). The development of Korean activities of daily living (K-ADL) and Korean instrumental activities of daily living (K-IADL) scale. Journal of the Korean Geriatrics Society, 6, 107120.Google Scholar
Zarit, S. H. and Zarit, J. M. (1987). Instructions for the Burden Interview. Philadelphia: Pennsylvania State University.Google Scholar