Coping strategies and psychological distress in family carers of frail older people: A longitudinal study

Abstract

Background. Carers of dependent older people experience high levels of psychological distress. However, little is known about the effects of coping on carer distress over time. In this one year longitudinal study we investigated the relationship between distress, and coping strategies in a representative sample of family carers living in Spain. Methods. Primary carers of older people were recruited (N = 200). We used probability sampling and collected data via individual interviews from 2013 to 2015. Variables investigated included psychological distress, coping, and levels of objective and subjective burden. Panel data analysis was used to test a model of association of psychological distress, and coping strategies controlling for key confounders. Results. Acceptance and emotional support were the most frequently used strategies, whereas behavioural disengagement and humour were the least used. In the panel data regressions, positive reframing (B = -0.79, p < 0.001), self-distraction (B = -0.46, p = 0.034), substance use (B = 0.57, p < 0.001) and denial (B = 0.57, p = 0,049) were significantly related to psychological distress at one year follow-up. Limitations. Limitations include participant drop out and assessing substance use coping via a brief measure. Conclusions. Positive reframing and self-distraction were longitudinally associated with lower levels of carer psychological distress. Using denial and substance use coping increased distress long-term. Our results suggest that interventions that focus on positive reframing and assisting carers in decreasing dysfunctional coping may be useful therapeutic targets mitigating carer psychological morbidity.

“This Life is Normal for Me”: A Study of Everyday Life Experiences and Coping Strategies of Live-in Carers in Taiwan

“…Coping has long been a key concept in studies of caregivers' cognitive or behavioral efforts to counteract the impact of harm or stress (Del-pino-casado et al, 2019). Coping is also used as a significant perspective in social work research, e.g., in studies on how to support international students in their acculturation process in a foreign country (Park et al, 2017), on how to support widows (Ng et al, 2016), or on how to empower victims of trauma (Gil & Weinberg, 2015).…”

“…When developing one of the first models for understanding coping practices, Lazarus andFolkman (1984, referenced in Gil &Weinberg, 2015, p. 552) distinguished between problem-focused coping modes, which mainly deal with a problem as such, vs. emotion-focused coping modes, which primarily address the emotional outcomes of a problem. Over the years, coping strategy theories have been further developed, but they generally include three types of strategies: a) problem-or solution-focused strategies, sometimes referred to as active behavioral coping strategies; b) emotion-focused strategies, also referred to as active cognitive coping strategies; and c) passive or avoiding coping strategies (Del-pino-casado et al, 2019). Kartalova-o'doherty and Doherty (2008) studied coping strategies among family carers.…”

Estratégias de Coping utilizadas por cuidadores de idosos frágeis e não frágeis

“…Alterações psíquicas como ansiedade e depressão são eventos comumente identificados nos cuidadores (DEL- PINO-CASADO et al, 2019;HARTMANN et al, 2019;ROCHE;MACCANN;CROOT, 2016). Desse modo, a utilização de estratégias adequadas de enfrentamento favorece a relação cuidador/receptor de cuidados e seus resultados, suavizando a sobrecarga (ROCHE; MACCANN; CROOT, 2016).…”

“…O processo de fragilização é caracterizado por uma interação complexa envolvendo fatores biológicos, psicológicos e sociais, requerendo do cuidador uma aclimatação sobre o cuidar nessas condições. Dessa forma, a utilização da Aceitação de responsabilidade como fator de enfrentamento pode ser um reflexo natural ou um feedback adaptativo ao cuidado (DEL- PINO-CASADO et al, 2019).…”

“…A utilização de estratégias de enfrentamento eficazes por cuidadores pode contribuir para diminuição do nível de sobrecarga. A identificação e a compreensão dos fatores que prenunciam o sofrimento do cuidador são relevantes, pois permitem a detecção prévia e a prevenção de sintomas envolvidos na sobrecarga do cuidar (DEL- PINO-CASADO et al, 2019).…”