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Positive and Negative Appraisals of Caregiving and Functional Performance Over Time

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2012
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dissertation
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Background: A significant aspect of the caregiving experience is how the caregiver views his or her role as a caregiver, which may be affected by the context in which they provide care. Caregiver context and appraisals may have significant effects on functional performance. Objective: To examine the correlates of positive and negative appraisals (self gain and role captivity) of the caregiving experience and the effects on functional performance over time. Methods: Using a sample of older female caregivers (N=375; mean age = 81 years; 12% Black) from the caregiving subsample of the Study of Osteoporotic Fractures, t-tests were employed to examine mean differences in the appraisals by care-related factors and race. Significant bivariate associations were included in regression models. Appraisals of caregiving were included in GEE analysis to examine associations with functional performance over time. Interactions between appraisals and the context of caregiving and use of caregiver supports were examined. Results: Caregivers of individuals with dementia and caregivers living with the care recipient felt significantly more self gain (both p<0.05) and role captivity (p<0.001; p<0.01, respectively). Spousal caregivers felt significantly higher levels of role captivity (p<0.01), and slightly higher self gain. No associations between the care-related factors and self gain remained while controlling for other variables. Dementia caregiving remained a significant predictor (p<0.001) for feelings of role captivity while controlling for other covariates. Black caregivers had higher levels of self gain (p<0.05) but showed no difference on role captivity. Race remained a significant (p<0.05) predictor in the final model for self gain. Self gain and role captivity had no direct effect on functional performance. Self gain buffered the direct negative effects of spousal, dementia, and live-in caregiving on functional performance. Role captivity dampened the positive effects of dementia caregiving on functional performance. Black caregivers had lower functional performance scores (p<0.001) regardless of self gain or role captivity. Formal support had no association with functional performance. Informal support was significantly positively associated with functional performance. Conclusions: Results highlight the contexts in which older women caregivers appraise the caregiving situation differently and how these contexts interact with appraisals to affect functional outcomes.

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University of Maryland in Baltimore. Gerontology. Ph.D. 2012
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