Relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia in Thailand

Abstract

Background: Providing care for older people with memory loss is a significantly stressful task. The caregiver experienced deterioration of the care recipients regarding their cognitive and functioning abilities, often resulting in the caregiver’s feelings of distress, stress, and unsatisfactory sleep quality. Objective: This cross-sectional study aimed to examine the relationships between caregiving stress and sleep quality among family caregivers of older adults with dementia. Methods: A simple random sampling method was used to recruit participants of seventy-two family caregivers who received care from a community long-term care facility at two primary hospitals in Thailand. Research instruments included the Relative Stress Scale and the Pittsburgh Sleep Quality Index. The data were analyzed using descriptive statistics, means, standard deviation, and simple linear regression. Results: The study revealed that caregivers had a high level of caregiving stress (M = 49.68, SD = 4.71), and poor sleep quality (M = 12.44, SD = 3.60). Caregiving stress was positively correlated with poor sleep quality (r = 0.54, p < .01) with a large relationship. Conclusion: Thai family caregivers of people with dementia reported high stress level and had poor sleep quality. The findings suggest that nurses in primary health care should focus on assessing stress levels and sleep quality as well as improving sleep quality for family caregivers by developing interventions.

The Burden of Next-of-Kin Carers of Dementia Sufferers in the Home Environment

“…The self-administrated RSS covers various aspects of burden, such as subjective emotional responses, restrictions on the social life of the nextof-kin, and negative feelings associated with the dementia sufferers and their behaviour. The result of the factor analysis turned out to be identical to those performed 40 years ago in Britain [20], 15 years ago in Norway [23], and recently in Germany [38] and Thailand [32], which displays the usefulness of the scale over time and across cultures. Being a next-ofkin carer of someone suffering from dementia of any aetiology is stressful [15][16][17][18][19][39][40][41][42][43][44].…”

“…One observation we made during the theoretical analysis of RSS as the screen instrument is the discovery of different approaches to defining the term ‘relative’. While Scandinavia uses the term ‘relatives’ stress scale [ 24 , 26 , 27 , 28 , 30 ], which can only be taken as meaning ‘a family member’, Anglo-Saxon and eastern cultures use the term ‘relative’ stress scale [ 31 , 32 , 33 ], presumably meaning that the stresses are in comparison—relative—to each other, thus focussing the attention on the role of the relative and the stress they feel [ 34 ]. In this study, we have used the term ‘RSS’ to mean ‘Relatives’ Stress Scale’.…”

Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Randomized-Controlled Trial

“…Total scores range from 0 to 60, with a higher score indicating a higher degree of stress. The RSS was translated from the original English version to the Thai language by Sanprakhon et al 8 They reported a content validity index of 0.92 and Cronbach’s alpha coefficient of 0.87 for internal reliability. In our study, Cronbach’s alpha was 0.87.…”

“…The scale has been used to measure caregiver stress, was available in the Thai language, and was used successfully in the pilot study. 8,18 The 15-item RSS has 3 dimensions: personal distress, degree of life upset, and negative feelings toward the person with dementia. Participants rate the frequency or severity of their stress on a five-point scale scored 0 to 4 (e.g., "never," "rarely," "sometimes," "frequently," and "always").…”

“…High stress in caregivers results in decreased sleep efficiency, increased sleep disturbances, increased daytime dysfunction, and unsatisfactory subjective sleep quality. 8 As a result, long-term stress and reduced sleep quality lead to caregivers having an increased risk of health problems, such as heart disease and cognitive decline. 5,9 Caregiver stress also contributes to worsening neuropsychiatric symptoms in people with dementia from the negative emotions of caregivers that can result in frustration, irritation, and anger.…”