Appraisal, coping, hardiness, and self-perceived health in spouse home caregivers of persons with dementia

Abstract

The purpose of this study was to examine the relationships among selected antecedent variables, caregiver appraisal, coping, hardiness, and self-perceived health in a convenience sample of 72 spouse home caregivers for individuals with dementia. The theoretical framework used for this investigation was Lazarus and Folkman's (1984) theory of stress and coping. A descriptive correlational design was used to examine the relationships among the variables. Date were collected by mailed survey from a variety of sources including the Alzheimer's Association and its affiliated support groups, dementia clinics, adult day care centers, and other community-based senior agencies. Caregiver (primary) appraisal was measured using Lawton's (1989) Caregiver Appraisal Scale. Coping methods were assessed using Vitaliano's (9185) Revised Ways of Coping Checklist while hardiness was measured using Pollock's (1990) Health-Related Hardiness Scale. Descriptive statistics were reported for several demographic and antecedent variables. Correlational and multiple regression analyses were performed to determine significant relationships among the variables, as well as, identify predictors of appraisal, coping, methods and self-perceived health. The potential moderating effects of health-related hardiness were explored using heirarchical regression analysis. There were some significant findings of interest. The antecedent variables (age, gender, ethnicity, education, duration of caregiving, perceived quality of marital relationship, and support group attendance) predicted 27% of the variance in caregiver appraisal, 23% of the variance in emotion-focused coping, and 22% of the variance in self-perceived health. Hardiness was not a moderator of caregiver appraisal on the three types of coping. However in addition to its significant main effects in enhancing caregiver appraisal (t = 3.922, p = .000), hardiness functioned as a significant moderator of the set of seven antecedent variables on caregiver appraisal, accounting for 48.9% of the total variance [F (15, 56) = 3.572, p = .000] and a significant increment of explained variance (R2 change = .073, p = .000]. Findings support the belief that nurses can play an important role in identifying caregivers who are at risk for negative appraisal which can impact coping and subsequent adaptation to caregiving stress. Spouse caregivers, who may be more vulnerable to adverse consequences, may require additional support, education, and other targeted interventions to assist them in the challenging role of dementia caregiving. More studies are needed to further explore the main effects of hardiness, as well as, its interactions with other key variables in this specific population.