Analysis of the concept of caregiver role strain in informal caregivers: an approach according to Meleis.

Abstract

Introduction: Caregivers provide assistance to people with physical, emotional, and cognitive problems; however, they often do not receive the necessary support, leading to the occurrence of Caregiver Role Strain.

Objective: To analyze the concept of caregiver role strain theoretically and operationally to favor the instrumentalization of its use in research and clinical practice.

Materials and methods: This is an analysis of the concept of Caregiver Role Strain based on the Afaf Meleis model (2018). Operationalized in the following steps: (1) definition; (2) differentiation; (3) outlining of antecedents; (4) outlining of consequences; (5) modeling; (6) analogy, and (7) synthesis. A scoping review was performed to enable the execution of the four initial steps.

Results: The literature review identified 67 studies capable of integrating the final sample. Based on its findings, a theoretical definition and empirical references of the concept were evidenced, in order to instrumentalize clinical inference. Furthermore, 29 antecedents and 21 consequences of the concept were recognized. Some attributes that differentiate Caregiver Role Strain from other similar concepts were also highlighted, such as a stressor that contributed to the suffering, the degree of extension of the patient's disabilities, the caregiver's perception of the patient's suffering, and the quality and quantity of the care burden to be provided.

Discussion: Caregiver Role Strain can provide outcomes for informal caregivers and care recipients, manifesting worsening of symptoms, cognitive impairment, decreased quality of life, and physical, psychological, social, and financial aspects of both.

Conclusion: A theoretical definition for Caregiver Role Strain emerges as a complex and multidimensional construct that includes subjective and objective factors, in which the demands of care, the impact of the patient's disease process, and the physical, psychological, social, and financial implications accompany a negative reaction to care-related activities. The analysis is useful in the process of inference and distinction of the concept of Tension and its similarities with synonymous terms, with the aim of adequately addressing the instruments used to observe the phenomenon, in an accurate and comprehensive manner, and the distinction from other commonly used definitions.