Date on Master's Thesis/Doctoral Dissertation

5-2013

Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department

Nursing

Committee Chair

Robinson, Karen M.

Author's Keywords

Alzheimer's disease; Self-care; Dementia; Caregiver; Caregiving; Self-management

Subject

Caregivers--Health and hygiene; Caregivers--Psychology; Dementia--Patients--Care

Abstract

BACKGROUND: Caring for a person with Alzheimer’s disease and related dementia (ADRD) is very stressful. Chronic stress which increases the risk for the development of disease and chronic illness is prevalent in caregivers of persons with ADRD. However, how caregiving affects self-care management of caregivers of persons with ADRD has not been well defined. PURPOSE: The purpose of this study is to examine relationships among care demands, caregiving appraisal, coping and caregiver self-care management and to investigate whether care demands, caregiving appraisal and coping are predictors of caregiver self-care management. METHODS: A cross-sectional study design was conducted among 45 primary informal caregivers of persons with ADRD in the southern part of the Midwest. Following an informed consent, paper-and-pencil questionnaires were administered for data collection. Quantitative data were analyzed with descriptive analysis, correlations, and multiple regressions, while responses to open-ended questions were analyzed using the principles of thematic analysis (Morse & Field, 1995). RESULTS: Three categories of predictors (caregiver demographic variables, care demands and active coping) uniquely explained caregiver self-care management. Care-recipients ADL/IADL dependency and duration of caregiving, reflecting care demands, explained the most variance for caregiver self-care, followed by caregiver demographic variables (education, female gender and financial status) and active coping. Total explained variance in each self-care activity was considerable, ranging from 37% to 57%. Our qualitative findings indicated that caregivers’ physical self-care and well-being were jeopardized given the needed care of care-recipients. In addition to self-care efforts by caregivers themselves, outside help and support as well as improved access to quality health care are essential to help caregivers improve health. CONCLUSIONS: Findings of this study help fill the gap in the literature by demonstrating the effects of caregiving on caregiver self-care management. This result is especially significant when viewed in conjunction with the high risk of chronic diseases among caregivers. Caregivers in poor health are more likely to stop caregiving. Interventions are imperative to help caregivers manage care-recipient’s needs so as to allow the needed time to the caregiver for essential medical treatment and follow-up as well as such health promotion activities as rest, sleep, relaxation, exercise, nutrition and socialization.

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