Two samples of family caregivers (Study 1: N = 169; Study 2: N = 145) of cognitively impaired older adults were used to revise, extend, and evaluate a measure of perceived self-efficacy for caregiving tasks. The Revised Scale for Caregiving Self-Efficacy measures 3 domains of caregiving self-efficacy: Obtaining Respite, Responding to Disruptive Patient Behaviors, and Controlling Upsetting Thoughts. The 3 subscales show strong internal consistency and adequate test-retest reliability. Construct validity is supported by relationships between these 3 facets of perceived caregiving efficacy and depression, anxiety, anger, perceived social support, and criticism expressed in speech samples. The Revised Scale for Caregiving Self-Efficacy has potential uses for both research and clinical purposes.
These data are consistent with a growing body of evidence supporting the effectiveness of skills training, in small groups, to improve both the affective states and the type of coping strategies used by caregivers. In addition, this study underscores the need to evaluate key pretreatment variables in order to determine which form of treatment may be more compatible with caregiver characteristics and thus more likely to be beneficial to individuals.
Clinically depressed family caregivers (N = 66) of frail, elderly relatives were randomly assigned to 20 sessions of either cognitive-behavioral (CB) or brief psychodynamic (PD) individual psychotherapy. At posttreatment, 71% of the caregivers were no longer clinically depressed according to research diagnostic criteria (RDC), with no differences found between the 2 outpatient treatments. The results suggested therapy specificity; there was an interaction between treatment modality and length of caregiving on symptom-oriented measures. Clients who had been caregivers for a shorter period showed improvement in the PD condition, whereas those who had been caregivers for at least 44 months improved with CB therapy. These findings suggest that patient-specific variables should be considered when choosing treatment for clinically depressed family caregivers.
The present study was intended to replicate the findings of Steffen et al. (2002) of a negative relationship between caregiving self-efficacy and depressive symptoms among family dementia caregivers. Female family caregivers (N=74) of community-dwelling individuals diagnosed with dementia completed a telephone interview and self-report assessment packet that included measures of caregiving self-efficacy and depressive symptoms. There was a direct negative relationship between caregiving self-efficacy and depressive symptoms after controlling for objective stressors. There was no support, however, for the hypothesis that caregiving self-efficacy would operate as a moderator, such that the relationship between objective stressors (cognitive impairment and behavior problems) and caregivers' depressive symptoms would be strongest for caregivers reporting lower levels of self-efficacy. The results of this study suggest that caregiving self-efficacy has a strong, direct relationship with depressed symptoms for dementia family caregivers. Longitudinal research is needed to determine if it is an appropriate focus of future intervention research.
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