Skip to main content
Top
Published in: The journal of nutrition, health & aging 10/2018

Open Access 01-12-2018

Relationship between Mastery and Caregiving Competence in Protecting against Burden, Anxiety and Depression among Caregivers of Frail Older Adults

Authors: Ee-Yuee Chan, G. Glass, K.-C. Chua, N. Ali, W.-S. Lim

Published in: The journal of nutrition, health & aging | Issue 10/2018

Login to get access

Abstract

Objective

Studies suggest the protective effect of mastery and caregiving competence against psychological stressors of caregiving in the context of dementia, although the interplay between the two with caregiver outcomes is not well understood. This study examines the independent and moderating impact of mastery and caregiving competence on burden, anxiety and depression among caregivers of older adults with frailty-related care needs.

Design, Setting and Participants

This is a cross-sectional study of 274 older adults-family caregiver dyads from a hospital in Singapore. Mean ages of the older adults and their caregivers were 85 and 59 years respectively.

Measurements

We performed hierarchical linear regression models to examine the independent influence of mastery and caregiving competence on caregiver burden, anxiety and depression. We also examined the interaction effect between mastery and caregiving competence for each outcome.

Results

Mastery and caregiving competence were independently negatively associated with caregiver burden, anxiety and depression. Mastery explained more variance than caregiving competence and had a stronger correlation with all outcomes. There was a statistically significant interaction between mastery and caregiving competence for depression (interaction term beta=.14, p<0.01), but not burden and anxiety. High levels of mastery are associated with less depression. particularly among caregivers with below-average levels of caregiving competence. Likewise, high levels of caregiving competence are associated with less depression. particularly among caregivers with below-average levels of mastery.

Conclusion

Our findings suggest potential benefits adressing targeted interventions for mastery and caregiving competence of caregivers to older adults as they independently influence caregiver outcomes and moderate each other’s effect on depression. Mastery-based interventions should be incorporated into current caregiver training which traditionally has focused on caregiver competence alone.
Literature
1.
go back to reference He W, Goodkind D and Kowal P. International Population Reports, 2016; P95/16–1, An Aging World: 2015. Washington D.C., U.S. Government Publishing Office. He W, Goodkind D and Kowal P. International Population Reports, 2016; P95/16–1, An Aging World: 2015. Washington D.C., U.S. Government Publishing Office.
3.
go back to reference Drubbel I, Numans ME, Kranenburg G, Bleijenberg N, de Wit NJ and Schuurmans MJ. Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people. BioMed Central Geriatrics 2014;14:27.CrossRefPubMed Drubbel I, Numans ME, Kranenburg G, Bleijenberg N, de Wit NJ and Schuurmans MJ. Screening for frailty in primary care: a systematic review of the psychometric properties of the frailty index in community-dwelling older people. BioMed Central Geriatrics 2014;14:27.CrossRefPubMed
5.
go back to reference Adelman RD, Tmanova LL, Delgado D, Dion S and Lachs MS. Caregiver burden: a clinical review. JAMA 2014;311:1052–1060.CrossRefPubMed Adelman RD, Tmanova LL, Delgado D, Dion S and Lachs MS. Caregiver burden: a clinical review. JAMA 2014;311:1052–1060.CrossRefPubMed
6.
go back to reference Beinart N, Weinman J, Wade D and Brady R. Caregiver Burden and Psychoeducational Interventions in Alzheimer’s Disease: A Review. Dementia and Geriatric Cognitive Disorders EXTRA 2012;2:638–648.CrossRefPubMedPubMedCentral Beinart N, Weinman J, Wade D and Brady R. Caregiver Burden and Psychoeducational Interventions in Alzheimer’s Disease: A Review. Dementia and Geriatric Cognitive Disorders EXTRA 2012;2:638–648.CrossRefPubMedPubMedCentral
7.
go back to reference Hobfoll SE. Conservation of resources. A new attempt at conceptualizing stress. Am Psychol 1989;44:513–524.CrossRefPubMed Hobfoll SE. Conservation of resources. A new attempt at conceptualizing stress. Am Psychol 1989;44:513–524.CrossRefPubMed
8.
go back to reference Kim Y. Stress, Caregiver. In: Gellman MD and Turner JR: Encyclopedia of Behavioral Medicine, ed 1st. Springer New York, New York, 2013;pp 1901–1903.CrossRef Kim Y. Stress, Caregiver. In: Gellman MD and Turner JR: Encyclopedia of Behavioral Medicine, ed 1st. Springer New York, New York, 2013;pp 1901–1903.CrossRef
9.
go back to reference Zarit SH, Todd PA and Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260–266.CrossRefPubMed Zarit SH, Todd PA and Zarit JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260–266.CrossRefPubMed
10.
go back to reference Heok KE and Li TS. Stress of caregivers of dementia patients in the Singapore Chinese family. International Journal of Geriatric Psychiatry 1997;12:466–469.CrossRefPubMed Heok KE and Li TS. Stress of caregivers of dementia patients in the Singapore Chinese family. International Journal of Geriatric Psychiatry 1997;12:466–469.CrossRefPubMed
11.
go back to reference Miller EA, Rosenheck RA and Schneider LS. Caregiver burden, health utilities, and institutional service costs among community-dwelling patients with Alzheimer disease. Alzheimer Dis Assoc Disord 2010;24:380–389.CrossRefPubMedPubMedCentral Miller EA, Rosenheck RA and Schneider LS. Caregiver burden, health utilities, and institutional service costs among community-dwelling patients with Alzheimer disease. Alzheimer Dis Assoc Disord 2010;24:380–389.CrossRefPubMedPubMedCentral
12.
go back to reference Lawton MP, Kleban MH, Moss M, Rovine M and Glicksman A. Measuring caregiving appraisal. J Gerontol 1989;44:P61–71.CrossRefPubMed Lawton MP, Kleban MH, Moss M, Rovine M and Glicksman A. Measuring caregiving appraisal. J Gerontol 1989;44:P61–71.CrossRefPubMed
13.
go back to reference Pearlin LI and Bierman A. Current Issues and Future Directions in Research into the Stress Process. In: Aneshensel CS, Phelan JC, and Bierman A: Handbook of the Sociology of Mental Health, ed Springer Netherlands, Dordrecht, 2013;pp 325–340.CrossRef Pearlin LI and Bierman A. Current Issues and Future Directions in Research into the Stress Process. In: Aneshensel CS, Phelan JC, and Bierman A: Handbook of the Sociology of Mental Health, ed Springer Netherlands, Dordrecht, 2013;pp 325–340.CrossRef
14.
go back to reference Pearlin LI, Mullan JT, Semple SJ and Skaff MM. Caregiving and the Stress Process: An Overview of Concepts and Their Measures. The Gerontologist 1990;30:583–594.CrossRefPubMed Pearlin LI, Mullan JT, Semple SJ and Skaff MM. Caregiving and the Stress Process: An Overview of Concepts and Their Measures. The Gerontologist 1990;30:583–594.CrossRefPubMed
15.
go back to reference Pearlin LI and Schooler C. The structure of coping. Journal of Health and Social Behavior 1978;19:2–21.CrossRefPubMed Pearlin LI and Schooler C. The structure of coping. Journal of Health and Social Behavior 1978;19:2–21.CrossRefPubMed
16.
go back to reference Skaff MM. Stress and the Self: A study of caregiving and self-concept. Dissertation, University of California, 1990. Skaff MM. Stress and the Self: A study of caregiving and self-concept. Dissertation, University of California, 1990.
17.
go back to reference Chiu M, Wesson V and Sadavoy J. Improving caregiving competence, stress coping, and mental well-being in informal dementia carers. World journal of Psychiatry 2013;3:65–73.CrossRefPubMedPubMedCentral Chiu M, Wesson V and Sadavoy J. Improving caregiving competence, stress coping, and mental well-being in informal dementia carers. World journal of Psychiatry 2013;3:65–73.CrossRefPubMedPubMedCentral
18.
go back to reference Lazarus RS. Coping theory and research: past, present, and future. Psychosom Med 1993;55:234–247.CrossRefPubMed Lazarus RS. Coping theory and research: past, present, and future. Psychosom Med 1993;55:234–247.CrossRefPubMed
19.
go back to reference Stevens EK. Appraisal and Coping: Mediators Between Caregivers and Psychological Wellbeing. Case Western Degree, 2008. Stevens EK. Appraisal and Coping: Mediators Between Caregivers and Psychological Wellbeing. Case Western Degree, 2008.
20.
go back to reference Mausbach BT, Roepke SK, Chattillion EA, Harmell AL, Moore R, Romero-Moreno R, Bowie CRand Grant I. Multiple mediators of the relations between caregiving stress and depressive symptoms. Aging and Mental Health 2012;16:27–38.CrossRefPubMed Mausbach BT, Roepke SK, Chattillion EA, Harmell AL, Moore R, Romero-Moreno R, Bowie CRand Grant I. Multiple mediators of the relations between caregiving stress and depressive symptoms. Aging and Mental Health 2012;16:27–38.CrossRefPubMed
21.
go back to reference Roepke SK, Mausbach BT, Aschbacher K, Ziegler MG, Dimsdale JE, Mills PJ, von Kanel R, Ancoli-Israel S, Patterson TL and Grant I. Personal mastery is associated with reduced sympathetic arousal in stressed Alzheimer caregivers. The American Journal of Geriatric Psychiatry 2008;16:310–317.CrossRefPubMedPubMedCentral Roepke SK, Mausbach BT, Aschbacher K, Ziegler MG, Dimsdale JE, Mills PJ, von Kanel R, Ancoli-Israel S, Patterson TL and Grant I. Personal mastery is associated with reduced sympathetic arousal in stressed Alzheimer caregivers. The American Journal of Geriatric Psychiatry 2008;16:310–317.CrossRefPubMedPubMedCentral
22.
go back to reference Zanetti O, Frisoni GB, Bianchetti A, Tamanz;a G, Cigoli V and Trabucchi M. Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. Int J Geriatr Psychiatry 1998;13:358–367.CrossRefPubMed Zanetti O, Frisoni GB, Bianchetti A, Tamanz;a G, Cigoli V and Trabucchi M. Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. Int J Geriatr Psychiatry 1998;13:358–367.CrossRefPubMed
23.
go back to reference Henriksson A, Arestedt K, Benzein E, Ternestedt BM and Andershed B. Effects of a support group programme for patients with life-threatening illness during ongoing palliative care. Palliat Med 2013;27:257–264.CrossRefPubMed Henriksson A, Arestedt K, Benzein E, Ternestedt BM and Andershed B. Effects of a support group programme for patients with life-threatening illness during ongoing palliative care. Palliat Med 2013;27:257–264.CrossRefPubMed
24.
go back to reference Llanque SM, Enriquez M, Cheng AL, Doty L, Brotto MA, Kelly PJ, Niedens M, Caserta MS and Savage LM. The family series workshop: a community-based psychoeducational intervention. Am J Alzheimers Dis Other Demen 2015;30:573–583.CrossRefPubMedPubMedCentral Llanque SM, Enriquez M, Cheng AL, Doty L, Brotto MA, Kelly PJ, Niedens M, Caserta MS and Savage LM. The family series workshop: a community-based psychoeducational intervention. Am J Alzheimers Dis Other Demen 2015;30:573–583.CrossRefPubMedPubMedCentral
25.
go back to reference Skaff MM, Pearlin LI and Mullan JT. Transitions in the caregiving career: effects on sense of mastery. Psychology and Aging 1996;11:247–257.CrossRefPubMed Skaff MM, Pearlin LI and Mullan JT. Transitions in the caregiving career: effects on sense of mastery. Psychology and Aging 1996;11:247–257.CrossRefPubMed
26.
go back to reference Carter PA and Acton GJ. Personality and coping: predictors of depression and sleep problems among caregivers of individuals who have cancer. J Gerontol Nurs 2006;32:45–53.CrossRefPubMed Carter PA and Acton GJ. Personality and coping: predictors of depression and sleep problems among caregivers of individuals who have cancer. J Gerontol Nurs 2006;32:45–53.CrossRefPubMed
27.
go back to reference Mausbach BT, Patterson TI, Känel RV, Mills PJ, Dimsdale JE, Ancoli-Israel S and Grant I. The attenuating effect of personal mastery on the relations between stress and Alzheimer caregiver health: a five-year longitudinal analysis. Aging and Mental Health 2007;11:637–644.CrossRefPubMed Mausbach BT, Patterson TI, Känel RV, Mills PJ, Dimsdale JE, Ancoli-Israel S and Grant I. The attenuating effect of personal mastery on the relations between stress and Alzheimer caregiver health: a five-year longitudinal analysis. Aging and Mental Health 2007;11:637–644.CrossRefPubMed
28.
go back to reference Roepke SK, Mausbach BT, von Kanel R, Ancoli-Israel S, Harmell AL, Dimsdale JE, Aschbacher K, Mills PJ, Patterson TL and Grant I. The moderating role of personal mastery on the relationship between caregiving status and multiple dimensions of fatigue. International Journal of Geriatric Psychiatry 2009;24:1453–1462.CrossRefPubMedPubMedCentral Roepke SK, Mausbach BT, von Kanel R, Ancoli-Israel S, Harmell AL, Dimsdale JE, Aschbacher K, Mills PJ, Patterson TL and Grant I. The moderating role of personal mastery on the relationship between caregiving status and multiple dimensions of fatigue. International Journal of Geriatric Psychiatry 2009;24:1453–1462.CrossRefPubMedPubMedCentral
29.
go back to reference Zarit SH, Reever KE and Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20:649–655.CrossRefPubMed Zarit SH, Reever KE and Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980;20:649–655.CrossRefPubMed
30.
go back to reference Cheah WK, Han HC, Chong MS, Anthony PV and Lim WS. Multidimensionality of the Zarit Burden Interview across the severity spectrum of cognitive impairment: an Asian perspective. International Psychogeriatrics 2012;24:1846–1854.CrossRefPubMed Cheah WK, Han HC, Chong MS, Anthony PV and Lim WS. Multidimensionality of the Zarit Burden Interview across the severity spectrum of cognitive impairment: an Asian perspective. International Psychogeriatrics 2012;24:1846–1854.CrossRefPubMed
31.
go back to reference Crawford JR, Henry JD, Crombie C and Taylor EP. Normative data for the HADS from a large non-clinical sample. British Journal of Clinical Psychology 2001;40:429–434.CrossRefPubMed Crawford JR, Henry JD, Crombie C and Taylor EP. Normative data for the HADS from a large non-clinical sample. British Journal of Clinical Psychology 2001;40:429–434.CrossRefPubMed
32.
go back to reference Collin C, Wade DT, Davies S and Horne V. The Barthel ADL Index: a reliability study. International Disability Studies 1988;10:61–63.CrossRefPubMed Collin C, Wade DT, Davies S and Horne V. The Barthel ADL Index: a reliability study. International Disability Studies 1988;10:61–63.CrossRefPubMed
33.
go back to reference Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL and DeKosky ST. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. The Journal of Neuropsychiatry and Clinical Neurosciences 2000;12:233–239.CrossRefPubMed Kaufer DI, Cummings JL, Ketchel P, Smith V, MacMillan A, Shelley T, Lopez OL and DeKosky ST. Validation of the NPI-Q, a brief clinical form of the Neuropsychiatric Inventory. The Journal of Neuropsychiatry and Clinical Neurosciences 2000;12:233–239.CrossRefPubMed
34.
go back to reference Hinkle DE, Wiersma W and Jurs SG. Book Applied Statistics for the Behavioral Sciences, ed 5th. Houghton Miffin, Boston, 2003. Hinkle DE, Wiersma W and Jurs SG. Book Applied Statistics for the Behavioral Sciences, ed 5th. Houghton Miffin, Boston, 2003.
35.
go back to reference Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, Fried LP, Guralnik JM, Katz PR, Malmstrom TK, McCarter RJ, Gutierrez Robledo LM, Rockwood K, von Haehling S, Vandewoude MF and Walston J. Frailty consensus: a call to action. The Journal of the American Medical Directors Association 2013;14:392–397.CrossRefPubMed Morley JE, Vellas B, van Kan GA, Anker SD, Bauer JM, Bernabei R, Cesari M, Chumlea WC, Doehner W, Evans J, Fried LP, Guralnik JM, Katz PR, Malmstrom TK, McCarter RJ, Gutierrez Robledo LM, Rockwood K, von Haehling S, Vandewoude MF and Walston J. Frailty consensus: a call to action. The Journal of the American Medical Directors Association 2013;14:392–397.CrossRefPubMed
36.
go back to reference Lim WS, Cheah WK, Ali N, Han HC, Anthony PV, Chan M and Chong MS. Worry about performance: a unique dimension of caregiver burden. International Psychogeriatrics 2014;26:677–686.CrossRefPubMed Lim WS, Cheah WK, Ali N, Han HC, Anthony PV, Chan M and Chong MS. Worry about performance: a unique dimension of caregiver burden. International Psychogeriatrics 2014;26:677–686.CrossRefPubMed
37.
go back to reference Simpson C and Carter P. Mastery: a comparison of wife and daughter caregivers of a person with dementia. Journal of Holistic Nursing 2013;31:113–120.CrossRefPubMed Simpson C and Carter P. Mastery: a comparison of wife and daughter caregivers of a person with dementia. Journal of Holistic Nursing 2013;31:113–120.CrossRefPubMed
38.
go back to reference Bandura A. Self-efficacy In: Ramachaudran VS: Encyclopedia of Human Behavior, ed 1st. Academic Press, New York, 1994;pp 71–81. Bandura A. Self-efficacy In: Ramachaudran VS: Encyclopedia of Human Behavior, ed 1st. Academic Press, New York, 1994;pp 71–81.
39.
go back to reference Carbonneau H, Caron C and Desrosiers J. Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia 2010;9:327–353.CrossRef Carbonneau H, Caron C and Desrosiers J. Development of a conceptual framework of positive aspects of caregiving in dementia. Dementia 2010;9:327–353.CrossRef
40.
go back to reference Semiatin AM and O’Connor MK. The relationship between self-efficacy and positive aspects of caregiving in Alzheimer’s disease caregivers. Aging Ment Health 2012;16:683–688.CrossRefPubMed Semiatin AM and O’Connor MK. The relationship between self-efficacy and positive aspects of caregiving in Alzheimer’s disease caregivers. Aging Ment Health 2012;16:683–688.CrossRefPubMed
41.
go back to reference Ben-Zur H. Coping, affect and aging: the roles of mastery and self-esteem. Personality and Individual Differences 2002;32:357–372.CrossRef Ben-Zur H. Coping, affect and aging: the roles of mastery and self-esteem. Personality and Individual Differences 2002;32:357–372.CrossRef
42.
go back to reference Li LW, Seltzer MM and Greenberg JS. Change in depressive symptoms among daughter caregivers: an 18–month longitudinal study. Psychology and Aging 1999;14:206–219.CrossRefPubMed Li LW, Seltzer MM and Greenberg JS. Change in depressive symptoms among daughter caregivers: an 18–month longitudinal study. Psychology and Aging 1999;14:206–219.CrossRefPubMed
43.
go back to reference Huang HL, Kuo LM, Chen YS, Liang J, Huang HL, Chiu YC, Chen ST, Sun Y, Hsu WC and Shyu YI. A home-based training program improves caregivers’ skills and dementia patients’ aggressive behaviors: a randomized controlled trial. Am J Geriatr Psychiatry 2013;21:1060–1070.CrossRefPubMed Huang HL, Kuo LM, Chen YS, Liang J, Huang HL, Chiu YC, Chen ST, Sun Y, Hsu WC and Shyu YI. A home-based training program improves caregivers’ skills and dementia patients’ aggressive behaviors: a randomized controlled trial. Am J Geriatr Psychiatry 2013;21:1060–1070.CrossRefPubMed
44.
go back to reference Bhandari A and Wagner T. Self-reported utilization of health care services: improving measurement and accuracy. Med Care Res Rev 2006;63:217–235.CrossRefPubMed Bhandari A and Wagner T. Self-reported utilization of health care services: improving measurement and accuracy. Med Care Res Rev 2006;63:217–235.CrossRefPubMed
Metadata
Title
Relationship between Mastery and Caregiving Competence in Protecting against Burden, Anxiety and Depression among Caregivers of Frail Older Adults
Authors
Ee-Yuee Chan
G. Glass
K.-C. Chua
N. Ali
W.-S. Lim
Publication date
01-12-2018
Publisher
Springer Paris
Published in
The journal of nutrition, health & aging / Issue 10/2018
Print ISSN: 1279-7707
Electronic ISSN: 1760-4788
DOI
https://doi.org/10.1007/s12603-018-1098-1

Other articles of this Issue 10/2018

The journal of nutrition, health & aging 10/2018 Go to the issue