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Published in: Journal of General Internal Medicine 9/2018

01-09-2018 | Original Research

Variability in spousal perceptions of caregiving and its relationship to older caregiver health outcomes

Authors: Wesley B. Godfrey, MD, Jeremy B. Yorgason, PhD, Yue Zhang, PhD, Bret L. Hicken, PhD, Wei Chen, MS, Randall W. Rupper, MD, MPH

Published in: Journal of General Internal Medicine | Issue 9/2018

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Abstract

Background

The transition to later-life caregiving roles, especially for couples caring for each other, can be rife with ambiguity. The incident discordance in spousal perceptions of one another’s role and its relationship to mental health outcomes have not been well-described.

Objectives

(1) To describe the range of daily agreement between older adult spouses’ perceptions of care given and care received; (2) to explore associations between caregiving agreement and daily caregiver depression, anxiety, and marital satisfaction; and (3) to evaluate differential effects for male and female caregivers.

Design

Cross-sectional, ecological assessment (daily diary).

Participants

Sample of 191 couples aged 60–64 (total 5196 daily surveys) drawn from the longitudinal Life and Family Legacies study.

Main Measures

During 2011–2012, spouses independently completed 14 consecutive daily surveys about their mood, marital interactions, and support exchanges. Caregiving agreement was defined as the daily ratio of spouse-reported care received to self-reported care given. Using generalized linear mixed effect modeling, we examined associations between spousal care agreement and outcomes of depression, anxiety, and marital satisfaction.

Key Results

Sample data demonstrated broad variability in spousal agreement, with couples exhibiting substantial disagreement on nearly one-third of couple days (780/2598 days). On days where care was exchanged, higher caregiving agreement was associated with lower caregiver depression (p < 0.01) and anxiety (p < 0.01) in male caregivers, and higher marital satisfaction (p = 0.03) in female caregivers. When care recipients reported receiving more support than their spouse reported giving, these associations did not persist.

Conclusions

Findings suggest that spousal agreement about the amount of care given and received varies broadly and is an important consideration for primary care providers who counsel these patients day-to-day. Furthermore, agreement appears to predict mental health and relationship outcomes and should be further evaluated in this growing population of mid-to-late life adults emerging into caregiving.
Literature
5.
go back to reference Ugalde A, Krishnasamy M, Schofield P. Role recognition and changes to self-identity in family caregivers of people with advanced cancer: a qualitative study. Support Care Cancer 20:1175–1181, 2012.CrossRefPubMed Ugalde A, Krishnasamy M, Schofield P. Role recognition and changes to self-identity in family caregivers of people with advanced cancer: a qualitative study. Support Care Cancer 20:1175–1181, 2012.CrossRefPubMed
6.
go back to reference O’Connor DL. Self-identifying as a caregiver: exploring the positioning process. J Aging Studies 21:165–74, 2007.CrossRef O’Connor DL. Self-identifying as a caregiver: exploring the positioning process. J Aging Studies 21:165–74, 2007.CrossRef
7.
go back to reference Menaghan EG, Lieberman MA. Changes in depression following divorce: a panel study. J Marriage Family 48:319–328, 1986.CrossRef Menaghan EG, Lieberman MA. Changes in depression following divorce: a panel study. J Marriage Family 48:319–328, 1986.CrossRef
8.
go back to reference Yorgason JB, Roper SO, Sandberg JG et al. Stress spillover of health symptoms from healthy spouses to patient spouses in older married couples managing both diabetes and osteoarthritis. Families, Systems, & Health 30:330–343, 2012.CrossRef Yorgason JB, Roper SO, Sandberg JG et al. Stress spillover of health symptoms from healthy spouses to patient spouses in older married couples managing both diabetes and osteoarthritis. Families, Systems, & Health 30:330–343, 2012.CrossRef
9.
go back to reference Tschanz JT, Corcoran CD, Schwartz S et al. Progression of cognitive, functional and neuropsychiatric symptom domains in a population cohort with Alzheimer’s dementia: the Cache County Dementia Progression Study. Am J Geriatr Psychiatry 19:532–542, 2011.CrossRefPubMedPubMedCentral Tschanz JT, Corcoran CD, Schwartz S et al. Progression of cognitive, functional and neuropsychiatric symptom domains in a population cohort with Alzheimer’s dementia: the Cache County Dementia Progression Study. Am J Geriatr Psychiatry 19:532–542, 2011.CrossRefPubMedPubMedCentral
10.
go back to reference Rook KS. Social support vs. companionship: effects on life stress, loneliness, and evaluations by others. J Personality Social Psych 52:1132–1147, 1987.CrossRef Rook KS. Social support vs. companionship: effects on life stress, loneliness, and evaluations by others. J Personality Social Psych 52:1132–1147, 1987.CrossRef
11.
go back to reference Emotion B. E. In: Kelley HH, Berscheid E, Christensen A et al., eds. Close Relationships. New York: W. H. Freeman, 1983, pp 110–168. Emotion B. E. In: Kelley HH, Berscheid E, Christensen A et al., eds. Close Relationships. New York: W. H. Freeman, 1983, pp 110–168.
12.
go back to reference Coyne JC, Bolger N. Doing without social support as an explanatory concept. J Soc Clinic Psychol 9:148–158, 1990.CrossRef Coyne JC, Bolger N. Doing without social support as an explanatory concept. J Soc Clinic Psychol 9:148–158, 1990.CrossRef
13.
go back to reference Pinquart M, Sörensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 18:250–267, 2003.CrossRefPubMed Pinquart M, Sörensen S. Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychol Aging 18:250–267, 2003.CrossRefPubMed
14.
go back to reference Zarit SH. Assessment of family caregivers: a research perspective. In: Kelly KA, Feinberg LF, editors. Caregiver Assessment: Voices and Views from the Field. Report from A National Consensus Development Conference, Vol 2. Report from a National Consensus Development Conference (Vol 2); 2005 Sept 7–9; San Francisco, California. Family Caregiving Alliance, pp 12–37, 2006. Zarit SH. Assessment of family caregivers: a research perspective. In: Kelly KA, Feinberg LF, editors. Caregiver Assessment: Voices and Views from the Field. Report from A National Consensus Development Conference, Vol 2. Report from a National Consensus Development Conference (Vol 2); 2005 Sept 7–9; San Francisco, California. Family Caregiving Alliance, pp 12–37, 2006.
15.
go back to reference Savundranayagam MY, Montgomery RJV, Kosloski K. A dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist 51:321–331, 2011.CrossRefPubMed Savundranayagam MY, Montgomery RJV, Kosloski K. A dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist 51:321–331, 2011.CrossRefPubMed
16.
go back to reference McMillan SC, Moody LE. Hospice patient and caregiver congruence in reporting patients’ symptom intensity. Cancer Nurs 26:113–118, 2003.CrossRefPubMed McMillan SC, Moody LE. Hospice patient and caregiver congruence in reporting patients’ symptom intensity. Cancer Nurs 26:113–118, 2003.CrossRefPubMed
17.
go back to reference Shega JW, Hougham GW, Stocking CB et al. Pain in community-dwelling persons with dementia: frequency, intensity, and congruence between patient and caregiver report. J Pain Symptom Manage 28:585–592, 2004.CrossRefPubMed Shega JW, Hougham GW, Stocking CB et al. Pain in community-dwelling persons with dementia: frequency, intensity, and congruence between patient and caregiver report. J Pain Symptom Manage 28:585–592, 2004.CrossRefPubMed
18.
go back to reference Gardner DS, Kramer BJ. End-of-life concerns and care preferences: congruence among terminally ill elders and their family caregivers. OMEGA-Journal of Death and Dying 60:273–297, 2010.CrossRef Gardner DS, Kramer BJ. End-of-life concerns and care preferences: congruence among terminally ill elders and their family caregivers. OMEGA-Journal of Death and Dying 60:273–297, 2010.CrossRef
19.
go back to reference Biehle SN, Mickelson KD. Provision and receipt of emotional spousal support: the impact of visibility on well-being. Couple Fam Psychol: Research Pract 1:244–251, 2012.CrossRef Biehle SN, Mickelson KD. Provision and receipt of emotional spousal support: the impact of visibility on well-being. Couple Fam Psychol: Research Pract 1:244–251, 2012.CrossRef
20.
go back to reference Call VRA, Otto LB, Spenner KI. Tracking respondents: a multi-method approach. Massachusetts: Lexington Books, 1982. Call VRA, Otto LB, Spenner KI. Tracking respondents: a multi-method approach. Massachusetts: Lexington Books, 1982.
21.
go back to reference Otto LB, Call VRA, Spenner KI. Design for the study of entry into careers. Lexington, MA: Lexington Books, 1981. Otto LB, Call VRA, Spenner KI. Design for the study of entry into careers. Lexington, MA: Lexington Books, 1981.
22.
go back to reference Yorgason JB, Godfrey WB, Call VRA et al. Daily sleep predicting marital interactions as mediated through mood. J Gerontol B Psychol Sci Soc Sci 000–000, 2016. Yorgason JB, Godfrey WB, Call VRA et al. Daily sleep predicting marital interactions as mediated through mood. J Gerontol B Psychol Sci Soc Sci 000–000, 2016.
23.
go back to reference Rafaeli E, Cranford JA, Green AS et al. The good and bad of relationships: how social hindrance and social support affect relationship feelings in daily life. Personality Soc Psychol Bull 34:1703–1718, 2008.CrossRef Rafaeli E, Cranford JA, Green AS et al. The good and bad of relationships: how social hindrance and social support affect relationship feelings in daily life. Personality Soc Psychol Bull 34:1703–1718, 2008.CrossRef
24.
go back to reference McNair DM, Lorr M, Droppleman LF et al. Manual for the profile of mood states. San Diego, CA: Educational and Industrial Testing Service, 1971. McNair DM, Lorr M, Droppleman LF et al. Manual for the profile of mood states. San Diego, CA: Educational and Industrial Testing Service, 1971.
25.
go back to reference McNulty JK, Karney BR. Attributions in marriage: integrating specific and global evaluations of a relationship. Person Soc Psychol Bull 27:943–955, 2001.CrossRef McNulty JK, Karney BR. Attributions in marriage: integrating specific and global evaluations of a relationship. Person Soc Psychol Bull 27:943–955, 2001.CrossRef
26.
go back to reference Bolger N, Zuckerman A, Kessler RC. Invisible support and adjustment to stress. J Pers Soc Psychol 79:953–961, 2000.CrossRefPubMed Bolger N, Zuckerman A, Kessler RC. Invisible support and adjustment to stress. J Pers Soc Psychol 79:953–961, 2000.CrossRefPubMed
27.
go back to reference Bolger N, Amarel D. Effects of social support visibility on adjustment to stress: experimental evidence. J Pers Soc Psychol 92:458–475, 2007.CrossRefPubMed Bolger N, Amarel D. Effects of social support visibility on adjustment to stress: experimental evidence. J Pers Soc Psychol 92:458–475, 2007.CrossRefPubMed
28.
go back to reference Michalowski VI, Hoppmann CA, Gerstorf D. Associations between perceived support in older adult marriages and dyadic covariations in momentary affect and aches. J Gerontol B Psychol Sci Soc Sci 71:425–430, 2016.CrossRefPubMed Michalowski VI, Hoppmann CA, Gerstorf D. Associations between perceived support in older adult marriages and dyadic covariations in momentary affect and aches. J Gerontol B Psychol Sci Soc Sci 71:425–430, 2016.CrossRefPubMed
29.
go back to reference Stroebe W, Stroebe M. The social psychology of social support. In: Higgins ET, Kruglanski AW, eds. Socialpsychology: Handbook of Basic Principles. New York: Guilford Press, 1996, pp 597–621. Stroebe W, Stroebe M. The social psychology of social support. In: Higgins ET, Kruglanski AW, eds. Socialpsychology: Handbook of Basic Principles. New York: Guilford Press, 1996, pp 597–621.
30.
go back to reference Frazier PA, Tix AP, Barnett CL. The relational context of social support: relationship satisfaction moderates the relations between enacted support and distress. Pers Soc Psychol Bull 29:1133–1146, 2003.CrossRefPubMed Frazier PA, Tix AP, Barnett CL. The relational context of social support: relationship satisfaction moderates the relations between enacted support and distress. Pers Soc Psychol Bull 29:1133–1146, 2003.CrossRefPubMed
31.
go back to reference Lindorff M. Is it better to perceive than receive? Social support, Stress and Strain for Managers. Psychol Hlth Med 5:271–286, 2000.CrossRef Lindorff M. Is it better to perceive than receive? Social support, Stress and Strain for Managers. Psychol Hlth Med 5:271–286, 2000.CrossRef
32.
go back to reference Seidman G, Shrout PE, Bolger N. Why is enacted social support associated with increased distress? Using simulation to test two possible sources of spuriousness. Pers Soc Psychol Bull 32:52–65, 2006.CrossRefPubMed Seidman G, Shrout PE, Bolger N. Why is enacted social support associated with increased distress? Using simulation to test two possible sources of spuriousness. Pers Soc Psychol Bull 32:52–65, 2006.CrossRefPubMed
33.
go back to reference Beach SR, Schulz R, Yee JL et al. Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. Psychol Aging 15:259–271, 2000.CrossRefPubMed Beach SR, Schulz R, Yee JL et al. Negative and positive health effects of caring for a disabled spouse: longitudinal findings from the caregiver health effects study. Psychol Aging 15:259–271, 2000.CrossRefPubMed
34.
go back to reference Sharma N, Chakabarit S, Grover S. Gender differences in caregiving among family—caregivers of people with mental illnesses. World J Psychiatry 6(1):7–17, 2016.CrossRefPubMedPubMedCentral Sharma N, Chakabarit S, Grover S. Gender differences in caregiving among family—caregivers of people with mental illnesses. World J Psychiatry 6(1):7–17, 2016.CrossRefPubMedPubMedCentral
35.
go back to reference Abraido-Lanza AF. Social support and psychological adjustment among latinas with arthritis: a test of a theoretical model. Ann Behav Med 27:162–171, 2004.CrossRefPubMedPubMedCentral Abraido-Lanza AF. Social support and psychological adjustment among latinas with arthritis: a test of a theoretical model. Ann Behav Med 27:162–171, 2004.CrossRefPubMedPubMedCentral
36.
go back to reference Collins NL, Dunkel-Schetter C, Lobel M et al. Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Pers Soc Psychol 65:1243–1258, 1993.CrossRefPubMed Collins NL, Dunkel-Schetter C, Lobel M et al. Social support in pregnancy: psychosocial correlates of birth outcomes and postpartum depression. J Pers Soc Psychol 65:1243–1258, 1993.CrossRefPubMed
37.
go back to reference Feldman SI, Downey G, Schaffer-Neitz R. Pain, negative mood, and perceived support in chronic pain patients: a daily diary study of people with reflex sympathetic dystrophy syndrome. J Conslt Clin Psychol 67:776–785, 1999.CrossRef Feldman SI, Downey G, Schaffer-Neitz R. Pain, negative mood, and perceived support in chronic pain patients: a daily diary study of people with reflex sympathetic dystrophy syndrome. J Conslt Clin Psychol 67:776–785, 1999.CrossRef
38.
go back to reference Newsom JT, Schulz R. Caregiving from the recipient’s perspective: negative reactions to being helped. Hlth Psychol 17:172–181, 1998.CrossRef Newsom JT, Schulz R. Caregiving from the recipient’s perspective: negative reactions to being helped. Hlth Psychol 17:172–181, 1998.CrossRef
39.
go back to reference Iwata N, Horiguchi K. Differences in caregivers’ psychological distress and associated factors by care recipients’ gender and kinship. Aging Ment Hlth 20:1277–1285, 2015.CrossRef Iwata N, Horiguchi K. Differences in caregivers’ psychological distress and associated factors by care recipients’ gender and kinship. Aging Ment Hlth 20:1277–1285, 2015.CrossRef
40.
41.
go back to reference Smith GC, Egbert N, Dellman-Jenkins M et al. Reducing depression in stroke survivors and their informal caregivers: a randomized clinical trial of a web-based intervention. Rehab Psychol 57:196–206, 2012.CrossRef Smith GC, Egbert N, Dellman-Jenkins M et al. Reducing depression in stroke survivors and their informal caregivers: a randomized clinical trial of a web-based intervention. Rehab Psychol 57:196–206, 2012.CrossRef
Metadata
Title
Variability in spousal perceptions of caregiving and its relationship to older caregiver health outcomes
Authors
Wesley B. Godfrey, MD
Jeremy B. Yorgason, PhD
Yue Zhang, PhD
Bret L. Hicken, PhD
Wei Chen, MS
Randall W. Rupper, MD, MPH
Publication date
01-09-2018
Publisher
Springer US
Published in
Journal of General Internal Medicine / Issue 9/2018
Print ISSN: 0884-8734
Electronic ISSN: 1525-1497
DOI
https://doi.org/10.1007/s11606-018-4408-8

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