FOCUS on the Family Caregiver: A Problem‐Solving Training Intervention

Rehabilitation Psychology

Grant

et al. 2012

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Objective To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients. Design Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year. Participants Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate. Main Outcome Measures Caregivers completed the Social Problem-Solving Inventory–Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale. Results Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training. Conclusions PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect.

Section: Methodsmentioning

confidence: 99%

Does problem-solving training for family caregivers benefit their care recipients with severe disabilities? A latent growth model of the Project CLUES randomized clinical trial.

Berry

Rehabilitation Psychology

Grant

et al. 2012

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“…Kurylo, Elliott, & Shewchuk, 2001;Rivera, Shewchuk, & Elliott, 2003). To be eligible to participate in this study, individuals had to be in a caregiving role for a family member who had an admitting diagnosis of SCI.…”

Section: Methodsmentioning

confidence: 99%

Family caregivers of persons with spinal cord injury: Predicting caregivers at risk for probable depression.

Dreer

Rehabilitation Psychology

Shewchuk

et al. 2007

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Objective-To determine the percentage of family caregivers of persons with spinal cord injury (SCI) with probable depression and to test the hypothesis that dysfunctional problem-solving abilities would be significantly predictive of risk status after taking into account important demographic characteristics and caregiver health.Design-Correlational and logistic regression analyses of data collected in a cross-sectional design.Participants-Eighteen men and 103 women caregivers (mean age of caregivers = 45.66 years, SD = 12.88) of individuals with SCI. Main Outcome Measure-The Inventory to Diagnose Depression.Results-Nineteen caregivers (15.7%) met criteria on the Inventory to Diagnose Depression for a major depressive disorder. A dysfunctional problem-solving style was significantly predictive of caregiver depression, regardless of the severity of physical impairment of the care recipient or the physical health of the caregiver and caregiver demographic variables.Conclusions-The percentage of caregivers with probable depressive disorder may parallel that observed among persons with SCI, using a more conservative self-report measure designed to assess symptoms associated with a depressive syndrome. Family caregivers with a dysfunctional problemsolving style and assisting individuals with more severe injuries may have probable depression. As a result of recent advances in medical technology, persons surviving a spinal cord injury (SCI) are living longer lives and often require varied degrees of assistance over their life span (DeVivo & Stover, 1995;Eisenberg & Saltz, 1991;Lasfargues, Custis, Carswell, & Nguyen, 1995). In response, family members often become the primary sources of assistance for various activities of daily living, such as feeding, dressing, transfers, and bowel and bladder care (Robinson-Whelen & Rintala, 2003;Weitzenkamp, Gerhart, Charlifue, Whiteneck, & Savic, 1997). However, caregivers enter into this new role without formal preparation or training . As a result, family caregivers of persons with severe disabilities encounter a host of problems, including role overload, lack of information, financial strain, impaired quality of life, changes in health status, and emotional problems Vitaliano, Zhang, & Scanlan, 2003). Caregiver depression has been consistently associated with poor quality of life and other adverse outcomes (Covinsky, Fortinsky, Palmer, Kresevic, & Landefeld, 1997;Han & Haley, 1999;Schulz & Beach, 1999).For many individuals, the traumatic onset of a severe physical disability may be experienced as an "off time," nonnormative life event (Neugarten, 1979) that abruptly interferes with the routine pursuit of normative personal, social, and vocational roles (Moen, Robison, & Dempster-McClain, 1995). Family caregivers of persons with SCI may experience a wide range of lifestyle and quality of life changes after assuming the role as primary caregiver (Boschen, Tonack, & Gargaro, 2005;Kolakowsky-Hayner & Kishore, 1999;Unalan et al., 2001). Although descriptive studies have found...

“…Social problem-solving abilities are an important predictor of caregiver physical and emotional health [12] and caregiver problem-solving may also be predictive of care-recipient outcomes (e.g., pressure sores [13]). Three of these studies relied on a protocol [21] that solicited specific problems unique to each caregiver and followed and outlined specific steps for training caregivers in problem-solving strategies to address these problems [9,11,27]. …”

Section: Current Practicesmentioning

confidence: 99%

“…This problem-solving intervention was an extension of the Project FOCUS [21] protocol studied by Elliott and colleagues [9,11]. Caregivers assigned to the PST group received four face-to-face in-home sessions and 8 telephone sessions with an interventionist over a 12-month period.…”

Section: Current Practicesmentioning

confidence: 99%

Family caregiving of persons following neurotrauma: Issues in research, service and policy

Ramkumar

2010

NRE

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Family caregivers of persons following neurotrauma function as de facto extensions of our health care system. Their challenges may result in negative consequences for their physical and mental health, which directly impacts the well-being of their care-recipient. In this paper, we survey current practices in providing caregiver support, outline considerations for developing collaborative interventions, and make recommendations for assessing intervention effectiveness consistent with the nature of the adjustment processes among caregivers and care recipients.