Longitudinal support to the sociocultural stress and coping model. A 4-year follow-up of family caregivers of people with dementia.

IF 4.6 2区 医学 Q1 GERIATRICS & GERONTOLOGY
Andrés Losada-Baltar, María Márquez-González, Brent T Mausbach, Lucía Jiménez-Gonzalo, José A Fernandes-Pires, Javier Olazarán, Laura García-García, Laura Gallego-Alberto, Isabel Cabrera
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引用次数: 0

Abstract

Objectives: According to the sociocultural stress-and-coping model for family caregivers, caregiving stressors contribute directly to caregivers' distress. In addition, there is another path to explain this distress, as several cultural (e.g., familism) and cognitive variables (e.g., dysfunctional thoughts) have important intermediate roles in the pathway from stress to distress. In particular, coping variables appear to play important intermediary roles in this pathway. The aim of this study was to provide longitudinal support to this two-paths stress and coping model.

Methods: Participants were 304 dementia family caregivers who were interviewed yearly during a 4-year period (5 assessment points). Sociodemographic variables, stressors, familism, dysfunctional thoughts about caregiving, cognitive fusion, leisure engagement, ambivalence, guilt and depressive symptoms were measured. The paths established by the sociocultural stress and coping model were tested.

Results: Greater cognitive fusion, greater reaction to BPSD, increased ambivalence, increased guilt, and reduced engagement in leisure activities were associated with greater experience of depressive symptoms. However, cultural and cognitive variables (i.e., familism and dysfunctional thoughts) did not show a direct association with depressive symptoms but were associated with increased cognitive fusion and reduced engagement in leisure activities. Overall, the stress-and-coping model explained 52.45 % of the variance in depressive symptoms through the 4-year study period.

Discussion: This study provides longitudinal support to the two-paths proposed by the sociocultural stress and coping model. Specifically, cultural and cognitive factors are more distally related to caregiver outcomes via their association with coping variables, which in turn appear proximally related to caregiver distress (i.e., depressive symptoms).

社会文化压力与应对模式的纵向支持。对痴呆症患者的家庭照顾者进行了为期4年的随访。
目的:根据家庭照护者的社会文化压力-应对模型,照护压力源直接影响照护者的痛苦。此外,还有另一种解释这种痛苦的途径,因为一些文化(例如,家庭主义)和认知变量(例如,功能失调的思想)在从压力到痛苦的途径中起着重要的中间作用。特别是,应对变量似乎在这一途径中起着重要的中介作用。本研究的目的是为这种双路径压力和应对模型提供纵向支持。方法:研究对象为304名痴呆症家庭照顾者,在4年期间(5个评估点)每年接受一次访谈。测量了社会人口学变量、压力源、家庭主义、关于照顾的功能失调想法、认知融合、休闲参与、矛盾心理、内疚和抑郁症状。对社会文化压力和应对模式所建立的路径进行了检验。结果:更大的认知融合,更大的BPSD反应,增加的矛盾心理,增加的内疚,减少参与休闲活动与更大的抑郁症状体验相关。然而,文化和认知变量(即家族主义和功能失调思想)与抑郁症状没有直接联系,但与认知融合增加和休闲活动减少有关。总体而言,在4年的研究期间,压力-应对模型解释了52.45%的抑郁症状变异。讨论:本研究为社会文化压力和应对模式提出的两条路径提供了纵向支持。具体而言,文化和认知因素通过其与应对变量的关联,与照顾者的结果更远端相关,而应对变量又与照顾者的痛苦(即抑郁症状)近端相关。
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来源期刊
International psychogeriatrics
International psychogeriatrics 医学-精神病学
CiteScore
9.10
自引率
8.60%
发文量
217
审稿时长
3-6 weeks
期刊介绍: A highly respected, multidisciplinary journal, International Psychogeriatrics publishes high quality original research papers in the field of psychogeriatrics. The journal aims to be the leading peer reviewed journal dealing with all aspects of the mental health of older people throughout the world. Circulated to over 1,000 members of the International Psychogeriatric Association, International Psychogeriatrics also features important editorials, provocative debates, literature reviews, book reviews and letters to the editor.
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