Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-22T18:13:16.628Z Has data issue: false hasContentIssue false
  • English
  • Français

The relationship between caregiving self-efficacy and depressive symptoms in family caregivers of patients with Alzheimer disease: a longitudinal study

Published online by Cambridge University Press:  06 February 2017

Caterina Grano ,
Fabio Lucidi  and
Cristiano Violani
Caterina Grano*
Affiliation:
Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185, Rome, Italy
Fabio Lucidi
Affiliation:
Department of Social and Developmental, Sapienza University of Rome, Via dei Marsi, 78, 00185, Rome, Italy
Cristiano Violani
Affiliation:
Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185, Rome, Italy
*
Correspondence should be addressed to: Caterina Grano, Department of Psychology, Sapienza University of Rome, Via dei Marsi, 78, 00185 Rome, Italy. Phone: +39 06 4991 7632; Fax: +39 06 4991 7711. Email: [email protected].
Get access

Abstract

Background:

Caregiving for a relative with dementia has been associated with negative consequences for mental health. Self-efficacy has been shown to correlate negatively with depression but the long-term association between caregiver burden, caregiver self-efficacy, and depressive symptoms, remains still largely unexplored. The aim of the present study was to evaluate whether different self-efficacy domains partially mediated the relationship between caregiving burden and depression.

Methods:

A three-wave design was used, with initial assessment and follow-ups three months later and one year later. One hundred seventy caregivers of patients with AD responded to measures of caregiver burden, caregiving self-efficacy, and depressive symptoms. Data were analyzed by means of structural equation models.

Results:

The tested model provided support for the guiding hypothesis. Burden at the time of the first assessment (T1) significantly influenced depression one year later and the relationship between burden at time one and depressive symptoms one year later was partially mediated by self-efficacy for controlling upsetting thoughts.

Conclusions:

The findings of the present study provide evidence that, along a considerable length of time, the effects of caregiver burden on depressive symptoms can be explained by the caregivers’ efficacy beliefs in controlling upsetting thoughts related to the caregiving tasks. Interventions for caregivers of patients with AD may help them in tackling negative thoughts about the caregiving role.

Keywords

caregiving self-efficacycaregiver burdendepressiondementia
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1095 - 1103
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

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. doi:10.1046/j.1440-1819.2001.00878.x.Google Scholar
Au, A. et al. (2010). The role of self-efficacy in the Alzheimer's family caregiver stress process: a partial mediator between physical health and depressive symptoms. Clinical Gerontologist: The Journal of Aging and Mental Health, 33, 298–315. doi:10.1080/07317115.2010.502817.CrossRefGoogle Scholar
Bandura, A. (1997). Self-efficacy: The Exercise of Control. New York, NY, US: W H Freeman/Times Books/Henry Holt & Co.Google Scholar
Cheng, S., Lam, L. W., Kwok, T., Ng, N. S. and Fung, A. T. (2012). Self-efficacy is associated with less burden and more gains from behavioral problems of Alzheimer's disease in Hong Kong Chinese caregivers. The Gerontologist, 53, 71–80. doi:10.1093/geront/gns062.CrossRefGoogle ScholarPubMed
Clipp, E. C. and George, L. K. (1993). Dementia and cancer: a comparison of spouse caregivers. The Gerontologist, 33, 534–541. doi:10.1093/geront/33.4.534.CrossRefGoogle Scholar
Epstein-Lubow, G., Davis, J. D., Miller, I. W. and Tremont, G. (2008). Persisting burden predicts depressive symptoms in dementia caregivers. Journal of Geriatric Psychiatry and Neurology, 21, 198–203. doi:10.1177/0891988708320972.CrossRefGoogle ScholarPubMed
Gallagher-Thompson, D. and Coon, D. W. (2007). Evidence-based psychological treatments for distress in family caregivers of older adults. Psychology and Aging, 22, 37. doi:10.1037/0882-7974.22.1.37.CrossRefGoogle ScholarPubMed
Gallagher, D. et al. (2011). Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers. Aging & Mental Health, 15, 663–670. doi:10.1080/13607863.2011.562179.CrossRefGoogle ScholarPubMed
George, N. R. and Steffen, A. M. (2014). Physical and mental health correlates of self-efficacy in dementia family caregivers. Journal of Women & Aging, 26, 319–331. doi: 10.1080/08952841.2014.906873.Google Scholar
Gilliam, C. M. and Steffen, A. M. (2006). The relationship between caregiving self-efficacy and depressive symptoms in dementia family caregivers. Aging & Mental Health, 10, 79–86. doi:10.1080/13607860500310658.Google Scholar
Grano, C., Lucidi, F., Crisci, B. and Violani, C. (2013). Validazione italiana della revised scale for caregiver self-efficacy: un contributo preliminare basato su un campione di caregiver di familiari con Alzheimer. Rassegna di Psicologia, 3, 9–30.Google Scholar
Hu, L. and Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55. doi:10.1080/10705519909540118.Google Scholar
Istituto Superiore di Sanità (2014). Epidemiologia delle demenze [online]. Available at: http://www.iss.it/demenze/index.php?lang=1&anno=2016&tipo=17; last accessed 22 April 2016.Google Scholar
Kraemer, H. C., Wilson, G. T., Fairburn, C. G. and Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883. doi:10.1001/archpsyc.59.10.877. Google Scholar
Mausbach, B. T. et al. (2012). Multiple mediators of the relations between caregiving stress and depressive symptoms. Aging & Mental Health, 16, 27–38. doi:10.1080/13607863.2011.615738.Google Scholar
Mioshi, E. et al. (2013). The impact of dementia severity on caregiver burden in frontotemporal dementia and Alzheimer disease. Alzheimer Disease and Associated Disorders, 27, 68–73. doi:10.1097/WAD.0b013e318247a0bc.Google Scholar
Muthén, L. K. and Muthén, B. O. (2007). Mplus. Statistical Analysis with Latent Variables. Version, 3.Google Scholar
O'Rourke, N. and Tuokko, H. A. (2004). Caregiver burden and depressive symptomatology: the association between constructs over time. Clinical Gerontologist: The Journal of Aging and Mental Health, 27, 41–52. doi:10.1300/J018v27n04_05.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. doi:10.1093/geront/30.5.583.Google Scholar
Rabinowitz, Y. G., Mausbach, B. T. and Gallagher-Thompson, D. (2009). Self-efficacy as a moderator of the relationship between care recipient memory and behavioral problems and caregiver depression in female dementia caregivers. Alzheimer Disease and Associated Disorders, 23, 389–394. doi:10.1097/WAD.0b013e3181b6f74d.CrossRefGoogle ScholarPubMed
Rabinowitz, Y. G., Mausbach, B. T., Thompson, L. W. and Gallagher-Thompson, D. (2007). The relationship between self-efficacy and cumulative health risk associated with health behavior patterns in female caregivers of elderly relatives with Alzheimer's dementia. Journal of Aging and Health, 19, 946–964. doi:10.1177/0898264307308559.CrossRefGoogle ScholarPubMed
Romero-Moreno, R., Losada, A., Mausbach, B. T., Márquez-González, M., Patterson, T. L. and López, J. (2011). Analysis of the moderating effect of self-efficacy domains in different points of the dementia caregiving process. Aging & Mental Health, 15, 221–231. doi:10.1080/13607863.2010.505231.Google Scholar
Romero-Moreno, R., Márquez-González, M., Mausbach, B. T. and Losada, A. (2012). Variables modulating depression in dementia caregivers: a longitudinal study. International Psychogeriatrics, 24, 1316–1324. doi:10.1017/S1041610211002237.Google Scholar
Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D. and Bandura, A. (2002). The revised scale for caregiving self-efficacy: reliability and validity studies. The Journals of Gerontology: Series B: Psychological Sciences and Social Sciences, 57B, 74–86. doi:10.1093/geronb/57.1.P74.Google Scholar
Tang, F., Jang, H., Lingler, J., Tamres, L. K. and Erlen, J. A. (2015). Stressors and caregivers’ depression: multiple mediators of self-efficacy, social support, and problem-solving skill. Social Work in Health Care, 54, 651–668. doi:10.1080/00981389.2015.1054058.Google Scholar
Tang, W. K. and Chan, C. J. (2015). Effects of psychosocial interventions on self-efficacy of dementia caregivers: a literature review. International Journal of Geriatric Psychiatry, 31, 475–493. doi:10.1002/gps.4352.Google Scholar
Vitaliano, P. P., Russo, J., Young, H. M., Becker, J. and Maiuro, R. D. (1991). The screen for caregiver burden. The Gerontologist, 31, 76–83. doi:10.1093/geront/31.1.76.CrossRefGoogle ScholarPubMed
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. doi:10.1037/0033-2909.129.6.946.CrossRefGoogle ScholarPubMed
Yesavage, J. A. et al. (1983). Development and validation of a Geriatric Depression Screening Scale: a preliminary report. Journal of Psychiatric Research, 17, 37–49. doi:10.1016/0022-3956(82)90033-4.Google Scholar
Zeiss, A., Gallagher-Thompson, D., Lovett, S., Rose, J. and McKibbin, C. (1999). Self-efficacy as a mediator of caregiver coping: development and testing of an assessment model. Journal of Clinical Geropsychology, 5, 221–230. doi:10.1023/A:1022955817074.CrossRefGoogle Scholar