Pronoun Use during Patient-Caregiver Interactions: Associations with Caregiver Well-Being

Connelly, Dyan E.; Verstaen, Alice; Brown, Casey L.; Lwi, Sandy J.; Levenson, Robert W.

doi:10.1159/000508095

Cited by 8 publications

(12 citation statements)

References 48 publications

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“…Existing studies that examine the links of communal coping to health focus on either spousal dyads (e.g., Badr et al, 2016; Connelly et al, 2020; Helgeson et al, 2017) or parent–child dyads (e.g., Berg et al, 2009; Helgeson et al, 2008) in which one person is the caregiver and the other person has been diagnosed with a chronic illness; there are very few studies that examine the links of communal coping in larger social network systems caring for another individual. Further, there is a dearth of research on rare disease caregivers, as these illnesses are, by definition, not common in the general population.…”

mentioning

confidence: 99%

Links of we-talk to caregiver social network systems and health.

Zajdel¹,

Davidson²,

Lea³

et al. 2022

Journal of Family Psychology

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Caring for a child, particularly one with a rare disease, presents a challenging set of stressors that can impact entire family networks. Given this shared impact, caregivers can engage in communal coping to address the caregiving process, defined as the perception of caregiving as shared and collaborative behaviors to address it. In this study, we examined one common measure of communal coping—first person plural pronouns or “we-talk”—in caregivers of either (a) children with rare or undiagnosed diseases or (b) typically developing children. We sought to examine how we-talk is linked to (a) caregiver health and well-being and (b) social network involvement in caregiving. Caregivers (n = 311) participated in (a) survey questionnaires (b) a network enumeration interview and (c) a semistructured interview of caregiving. Results indicated we-talk was unrelated to stress or self-rated health, but was linked to more benefit-finding; greater individual-focused language (I-talk) was also linked to worse self-rated health. Additionally, we-talk was unrelated to malfeasant behavior (e.g., overly critical), but was linked to less nonfeasant behavior (e.g., underinvolvement), more uplift behavior (e.g., helping with caregiving), and more health-related communication with network members. Further, these findings did not differ across caregiving context. This work highlights the role of communal coping for caregivers managing general parenting stress as well as the stress associated with caring for a child with complex medical needs. Future research should continue to examine how interpersonal coping processes operate within social networks to impact health and well-being for all involved.

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mentioning

confidence: 99%

Links of we-talk to caregiver social network systems and health.

Zajdel¹,

Davidson²,

Lea³

et al. 2022

Journal of Family Psychology

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“…For example, when anticipating an electric shock, holding the hand of a loved one was shown to reduce the brain’s threat response, especially in those who mutually cared about each other (Coan et al, 2013). In our own work, we have found caregivers have better mental health when they remained socially connected with the PWNDs, and when the PWNDs under their care are more empathically accurate and display more frequent “genuine” smiles (a type of smile that is associated with greater social connectedness; Hess & Bourgeois, 2010) during laboratory interactions (Connelly et al, 2020; Lwi et al, 2018). In the current study, caregivers with greater in‐phase activity linkage with the PWND in their care may be experiencing more instances of shared calming behaviors such as hand holding and hugging.…”

Section: Discussionmentioning

confidence: 91%

Lower activity linkage between caregivers and persons with neurodegenerative diseases is associated with greater caregiver anxiety

et al. 2022

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Physiological linkage refers to the degree to which two individuals' central/peripheral physiological activities change in coordinated ways. Previous research has focused primarily on linkage in the autonomic nervous system in laboratory settings, particularly examining how linkage is associated with social behavior and relationship quality. In this study, we examined how linkage in couples' daily somatic activity (e.g., synchronized movement measured from wrist sensors)—another important aspect of peripheral physiology—was associated with relationship quality and mental health. We focused on persons with neurodegenerative diseases (PWNDs) and their spousal caregivers, whose linkage might have direct implications for the PWND–caregiver relationship and caregiver’s health. Twenty‐two PWNDs and their caregivers wore wristwatch actigraphy devices that provided continuous measurement of activity over 7 days at home. PWND–caregiver activity linkage was quantified by the degree to which activity was “in‐phase” or “anti‐phase” linked (i.e., coordinated changes in the same or opposite direction) during waking hours, computed by correlating minute‐by‐minute activity levels averaged using a 10‐min rolling window. Caregivers completed well‐validated surveys that assessed their mental health (including anxiety and depression) and relationship quality with the PWND. We found that lower in‐phase activity linkage, but not anti‐phase linkage, was associated with higher caregiver anxiety. These dyad‐level effects were robust, remaining significant after adjusting for somatic activity at the individual level. No effects were found for caregiver depression or relationship quality. These findings suggest activity linkage and wearables may be useful for day‐by‐day monitoring of vulnerable populations such as family caregivers. We offered several possible explanations for our findings.

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“…In contrast, I- and they-pronoun use was positively associated with dementia severity, albeit less robustly (e.g., I-pronouns were not correlated with dementia severity at 30 months). Given prior evidence linking I- and they-pronouns to experiences of separateness [ 13 ], these pronouns may reflect caregivers' psychological disconnection from the PLWD. As the disease progresses, caregivers and PLWDs may become disconnected because they no longer have as many shared activities, the PLWD may be more self-focused, or the caregiver takes on a more service-oriented role [ 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…In the present study, caregivers described a recent time they felt connected to the PLWD, and we measured their pronoun use to assess the quality of that connection. As in prior work [ 9 , 13 ], we conceptualized we-pronoun use as reflecting greater connection between the caregiver and PLWD and greater I- and they-pronoun use as reflecting greater perceived separateness. Given documented associations of relationship factors (e.g., satisfaction, closeness, etc.)…”

Section: Introductionmentioning

confidence: 99%

Pronoun Use among Caregivers of People Living with Dementia: Associations with Dementia Severity Using Text Analysis of a Natural Language Sample

Sideman

Wells

Merrilees

et al. 2022

Dement Geriatr Cogn Disord Extra

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Introduction: Family caregivers of persons living with dementia (PLWDs) have extensive social, physical, emotional, and financial responsibilities. However, less is known about the relationship and interpersonal connection between caregivers and PLWDs. We examined caregiver pronoun use, as an index of the connection between the caregiver and PLWD and its associations with the caregiver’s and PLWD’s health and well-being. Methods: Caregivers of PLWDs (N = 320) were asked to describe a recent time they felt connected to the PLWD in their care. Responses were transcribed and coded to quantify pronoun use by category (we-pronouns, I-pronouns, and they-pronouns). Caregivers also reported on their depression, burden, and the PLWD’s dementia severity and marital satisfaction. Sixty-eight caregivers repeated the same survey 24 months after the initial survey. Results: Caregivers used less we-pronouns when the PLWD’s dementia was more severe, at both timepoints. Spousal caregivers used more we-pronouns and less I- and they-pronouns than nonspousal caregivers. There was an interaction between spousal relationship and dementia severity, such that spousal caregivers exhibited a stronger negative association between dementia severity and we-pronoun use. There were no associations between pronoun category and caregiver burden or depression. Discussion: Caregivers may feel increasingly disconnected from the PLWD as their dementia becomes more severe, as reflected by less we-pronoun usage. This study highlights the opportunity to explore relationship connection through text analysis.

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Pronoun Use during Patient-Caregiver Interactions: Associations with Caregiver Well-Being

Cited by 8 publications

References 48 publications

Links of we-talk to caregiver social network systems and health.

Links of we-talk to caregiver social network systems and health.

Lower activity linkage between caregivers and persons with neurodegenerative diseases is associated with greater caregiver anxiety

Pronoun Use among Caregivers of People Living with Dementia: Associations with Dementia Severity Using Text Analysis of a Natural Language Sample

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