Journal of Korean Academy of Nursing (대한간호학회지)

Korean Society of Nursing Science (한국간호과학회)
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Structural Equation Model for Caregiving Experience of Families Providing Care for Family Members with Mental Disorders

정신질환자 가족의 돌봄경험 구조모형

  • Oh, In Ohg (National Health Insurance Service Ilsan Hospital) ;
  • Kim, Sunah (College of Nursing, Yonsei University.Nursing Policy Research Institute, College of Nursing, Yonsei University)
  • 오인옥 (국민건강보험 일산병원) ;
  • 김선아 (연세대학교 간호대학.연세대학교 간호대학 간호정책연구소)
  • Received : 2014.07.22
  • Accepted : 2014.12.31
  • Published : 2015.02.28
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Abstract

Purpose: This study was done to develop and test a structural model for caregiving experience including caregiving satisfaction and caregiving strain in families providing care for family members with a mental disorder. Methods: The Stress-appraisal-coping model was used as the conceptual framework and the structural equation model to confirm the path that explains what and how variables affect caregiving experience in these families. In this hypothesis model, exogenous variables were optimism, severity of illness and uncertainty. The endogenous variables were self efficacy, social support, caregiving satisfaction and caregiving strain. Data were collected using structured questionnaires. Results: Optimism and caregiving self-efficacy had significant direct and indirect effects on caregiving satisfaction. Optimism, severity of illness and uncertainty had significant direct and indirect effects on caregiving strain. The modified path model explained effects of optimism on caregiving self-efficacy with social support in the path structure as a mediator. Also, there were direct and indirect effects of optimism and uncertainty on caregiving satisfaction with social support and caregiving self-efficacy in the path structure as a mediators. Conclusion: Results suggest the need to improve caregiving self-efficacy of these families, establish support systems such as a mental health professional support programs for caregiving self-efficacy. Optimism, severity of illness and uncertainty perceived by families need to be considered in the development of support programs in order to increase their effectiveness.

Keywords

References

  1. Perlick DA, Hohenstein JM, Clarkin JF, Kaczynski R, Rosenheck RA. Use of mental health and primary care services by caregivers of patients with bipolar disorder: A preliminary study. Bipolar Disorders. 2005;7(2):126-135. http://dx.doi.org/10.1111/j.1399-5618.2004.00172.x
  2. Park S, Park KS. Family stigma: A concept analysis. Asian Nursing Research. 2014;8(3):165-171. https://doi.org/10.1016/j.anr.2014.02.006
  3. Perlick DA, Rosenheck RA, Miklowitz DJ, Kaczynski R, Link B, Ketter T, et al. Caregiver burden and health in bipolar disorder: A cluster analytic approach. The Journal of Nervous and Mental Disease. 2008;196(6):484-491. http://dx.doi.org/10.1097/NMD.0b013e3181773927
  4. Lazarus RS, Folkman S. Stress, appraisal, and coping. Kim JH, translator. Seoul: Dae-gwang Publishing Company; 1991.
  5. Baronet AM. The impact of family relations on caregivers' positive and negative appraisal of their caretaking activities. Family Relations. 2004;52(2):137-142. http://dx.doi.org/10.1111/j.1741-3729.2003.00137.x
  6. Folkman S, Moskowitz JT. Positive affect and the other side of coping. The American Psychologist. 2000;55(6):647-654. https://doi.org/10.1037/0003-066X.55.6.647
  7. Hilgeman MM, Allen RS, DeCoster J, Burgio LD. Positive aspects of caregiving as a moderator of treatment outcome over 12 months. Psychology and Aging. 2007;22(2):361-371. http://dx.doi.org/10.1037/0882-7974.22.2.361
  8. Kim YS. A study on caregiving appraisal and psychological well-being of family caregivers of a person with mental disorder [dissertation]. Seoul: Ewha Womans University; 2005.
  9. Gottlieb BH, Rooney JA. Validation of the RIS Eldercare Self-Efficacy scale. Canadian Journal on Aging. 2003;22(1):95-107. http://dx.doi.org/10.1017/S0714980800003767
  10. Lockenhoff CE, Duberstein PR, Friedman B, Costa PT, Jr. Five-factor personality traits and subjective health among caregivers: The role of caregiver strain and self-efficacy. Psychology and Aging. 2011;26(3):592-604. http://dx.doi.org/10.1037/a0022209
  11. Post RM. The impact of bipolar depression. The Journal of Clinical Psychiatry. 2005;66(Suppl 5):5-10. https://doi.org/10.4088/JCP.v66n0101
  12. Rose LE, Mallinson RK, Gerson LD. Mastery, burden, and areas of concern among family caregivers of mentally ill persons. Archives of Psychiatric Nursing. 2006;20(1):41-51. http://dx.doi.org/10.1016/j.apnu.2005.08.009
  13. Bauer R, Gottfriedsen GU, Binder H, Dobmeier M, Cording C, Hajak G, et al. Burden of caregivers of patients with bipolar affective disorders. The American Journal of Orthopsychiatry. 2011;81(1):139-148. http://dx.doi.org/10.1111/j.1939-0025.2010.01081.x
  14. Mishel MH, Padilla G, Grant M, Sorenson DS. Uncertainty in illness theory: A replication of the mediating effects of mastery and coping. Nursing Research. 1991;40(4):236-240.
  15. Chien WT, Chan SW, Morrissey J. The perceived burden among Chinese family caregivers of people with schizophrenia. Journal of Clinical Nursing. 2007;16(6):1151-1161. http://dx.doi.org/10.1111/j.1365-2702.2007.01501.x
  16. Reinhard SC. Living with mental illness: Effects of professional support and personal control on caregiver burden. Research in Nursing and Health. 1994;17(2):79-88. https://doi.org/10.1002/nur.4770170203
  17. Chen FP, Greenberg JS. A positive aspect of caregiving: The influence of social support on caregiving gains for family members of relatives with schizophrenia. Community Mental Health Journal. 2004;40(5):423-435. https://doi.org/10.1023/B:COMH.0000040656.89143.82
  18. Steffen AM, McKibbin C, Zeiss AM, Gallagher-Thompson D, Bandura A. The revised scale for caregiving self-efficacy: Reliability and validity studies. The Journals of Gerontology Series B Psychological Sciences and Social Sciences. 2002;57(1):P74-P86. https://doi.org/10.1093/geronb/57.1.P74
  19. Cheng ST, Lam LC, Kwok T, Ng NS, Fung AW. Self-efficacy is associated with less burden and more gains from behavioral problems of Alzheimer's disease in Hong Kong Chinese caregivers. The Gerontologist. 2013;53(1):71-80. http://dx.doi.org/10.1093/geront/gns062
  20. Romero-Moreno R, Losada A, Mausbach BT, Marquez-Gonzalez M, Patterson TL, Lopez J. Analysis of the moderating effect of self-efficacy domains in different points of the dementia caregiving process. Aging & Mental Health. 2011;15(2):221-231. http://dx.doi.org/10.1080/13607863.2010.505231
  21. Semiatin AM, O'Connor MK. The relationship between self-efficacy and positive aspects of caregiving in Alzheimer's disease caregivers. Aging & Mental Health. 2012;16(6):683-688. http://dx.doi.org/10.1080/13607863.2011.651437
  22. Majer JM, Jason LA, Olson BD. Optimism, abstinence self-efficacy, and self-mastery: A comparative analysis of cognitive resources. Assessment. 2004;11(1):57-63. https://doi.org/10.1177/1073191103257139
  23. Bandura A. Self-efficacy: The exercise of control. Kim UC, Park YS, Yang KM, translator. Paju: Kyoyookbook; 1999.
  24. Oh HS. Health promoting behaviors and quality of life of Korean women with arthritis. The Journal of Nurses Academic Society. 1993;23 (4):617-630. https://doi.org/10.4040/jnas.1993.23.4.617
  25. Lee DS. Social support need and perceived social support of patients having gastric cancer [master's thesis]. Seoul: Seoul National University; 1996.
  26. Kim I, Suh MJ. The prediction model of adaptation in patients with rheumatoid arthritis: Propositional synthesis of Roy's and Lazarus & Folkman's theory. Journal of Muscle and Joint Health. 1997;4(2):197-220.
  27. Orbell S, Hopkins N, Gillies B. Measuring the impact of informal caring. Journal of Community & Applied Social Psychology. 2006;3(2):149-163. http://dx.doi.org/10.1002/casp.2450030207
  28. Scheier MF, Carver CS, Bridges MW. Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the life orientation test. Journal of Personality and Social Psychology. 1994;67(6):1063-1078. https://doi.org/10.1037/0022-3514.67.6.1063
  29. Kim SH. Psychological characteristics of realistic and unrealistic optimists [master's thesis]. Seoul: The Catholic University of Korea; 2003.
  30. Au A, Lai MK, Lau KM, Pan PC, Lam L, Thompson L, et al. Social support and well-being in dementia family caregivers: The mediating role of self-efficacy. Aging & Mental Health. 2009;13(5):761-768. http://dx.doi.org/10.1080/13607860902918223

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