Self-esteem in carers of frail older people: Resentment predicts anxiety and depression

Aggar, Christina; Ronaldson, Susan; Cameron, Ian D.

doi:10.1080/13607863.2011.562176

Cited by 36 publications

(31 citation statements)

References 64 publications

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“…Aim was to assess whether intervention (program) was more effective than usual geriatric care in preventing falls in frail communitydwelling older fallers, with and without cognitive impairment, and in alleviating subjective caregiver burden in subjects’ CGs.33 dyads consisting of community dwelling older adults who had fallen at least once in the last 6 months and who met at least 2 of the FFS criteria, and their informal caregivers.No sociodemographic characteristics (e.g., age) reported.All CRs able to walk at least 15 m independently with or without walking aid.All CRs had life expectancy >12 months.All CRs had MMSE >15.Mean age (intervention/control); 67.3 ± 13.1/64.3 ± 14.3Female gender (intervention/control); 50/67%Living with CR (intervention/control); 55/47%Baseline ZBI (intervention/control); 5.2/6.0Total caregiving hours per week (intervention/control); 8.0/10.5Kim 2008 [30]USACross-sectionalTele-survey-based study comparing caregiving burden and distress, among CGs of 4 types of CRs: cancer, diabetes, dementia, frail older adults.606 CGs across all 4 groups, including 135 caregivers (“frail elderly” group) of CRs whom their CG described as “frail due to age.”(“Frail elderly” group only)Mean age; 81.69 ± 9.77(“Frail elderly” group only)Mean age; 46.23 ± 14.99Female gender; 47.4%Relationship to CR;Spouse/partner; 0.7%Child/in-law; 50.4%Sibling/in-law; 1.5%Grandchild/in-law; 18.5%Friend/neighbor/nonrelative; 17.8%Other; 11.1%

*This publication represents the index study for a series of five papers by a single set of investigators [22–26]. An explanation of the relationship between these articles appears in the “Results” section of the manuscript** Care recipient demographics were not reported in this paper [25]; these details were extracted from Aggar 2011b, which involves the same population [24].

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Section: Resultsmentioning

confidence: 99%

“…An explanation of the relationship between these articles appears in the “Results” section of the manuscript** Care recipient demographics were not reported in this paper [25]; these details were extracted from Aggar 2011b, which involves the same population [24]. …”

Section: Resultsmentioning

confidence: 99%

“…** Care recipient demographics were not reported in this paper [25]; these details were extracted from Aggar 2011b, which involves the same population [24]. …”

Section: Resultsmentioning

confidence: 99%

“…The remaining three papers describe cross-sectional analyses which were conducted at a later point and involved caregivers of 119 participants in the same RCT. Because each paper reflects a different analysis of essentially the same questionnaire responses from the same population, but was published separately, we have designated one paper as the index study for purposes of extraction and appraisal and refer to it hereinafter as “the Aggar study” [25] and term the remaining publications “the related papers” [22–24, 26]. …”

Section: Resultsmentioning

confidence: 99%

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Relationship between family caregiver burden and physical frailty in older adults without dementia: a systematic review

et al. 2017

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BackgroundPhysical frailty is a prevalent syndrome in older adults that increases vulnerability for a range of adverse outcomes including increased dependency and death. Caregivers of older adults experience significant physical, emotional, and financial burden, which is associated with poor physical and mental health. While it is known that care recipients’ dementia is associated with burden, the literature regarding the impact of physical frailty on burden has yet to be synthesized. We conducted a systematic review to assess the state of the evidence regarding the relationship between these two prominent concepts in the geriatric literature.MethodWe used a structured search of databases to identify original English-language articles. Two researchers screened the titles and abstracts of all 1202 retrieved studies and then full-text versions of 265 retained studies. Screening was based on a priori inclusion criteria, which included discussion of physical frailty, caregiver burden, and a population of community-dwelling older adults without dementia. Nine included papers underwent data abstraction and critical appraisal using the Cochrane Risk of Bias Tool or the Newcastle-Ottawa Scale (for randomized controlled trials or cross-sectional studies, respectively). Heterogeneity of the included studies precluded meta-analysis.ResultsFive publications had the same author and drew from the same population; these were treated as a single study. Three of our studies were of limited value since they did not include a validated measure of frailty. While caregivers of frail older adults experience burden, the scarce available evidence and lack of studies comparing this population with normative values does not allow conclusions to be drawn about the strength or nature of the relationship. Judging from excluded studies, the term “frailty” is often used without reference to a clear definition or is treated as synonymous with functional impairment or advanced age.ConclusionsOur review suggests that caregivers of frail older adults experience burden and that the degree of burden may differ from that of other caregiver populations. The limited evidence does not allow conclusions to be drawn or to inform clinical practice. Further research is needed, given the salience of physical frailty and burden.Systematic review registrationPROSPERO CRD42015019198Electronic supplementary materialThe online version of this article (doi:10.1186/s13643-017-0447-1) contains supplementary material, which is available to authorized users.

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…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…** Care recipient demographics were not reported in this paper [25]; these details were extracted from Aggar 2011b, which involves the same population [24]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Relationship between family caregiver burden and physical frailty in older adults without dementia: a systematic review

et al. 2017

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“…12-16 Similar findings are reported in caregivers of frail older people and cancer patients. 17, 18 Optimism is defined as a general expectation for positive rather than negative experiences in the future. 8, 19 Optimism and psychological distress have been found to be related in persons with a variety of medical conditions (e.g.…”

Section: Introductionmentioning

confidence: 99%

Effects of Self-esteem, Optimism, and Perceived Control on Depressive Symptoms in Stroke Survivor-Spouse Dyads

Chung

Bakas

Plue

et al. 2016

Journal of Cardiovascular Nursing

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Background Depressive symptoms are common in stroke survivors and their family caregivers. Given the interdependent relationship between the members of dyads in post-stroke management, improving depressive symptoms in dyads may depend on their partner's characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depressive symptoms in an individual, may also contribute to their partner's depressive symptoms. Purpose The purpose of this study was to examine actor and partner effects of self-esteem, optimism, and perceived control on depression in the stroke survivors and their spousal caregivers. Methods A total of 112 ischemic stroke survivors (78% white, 34% female, mean age 62.5 ± 12.3) and their spouses (mean age 60.6 ±12.9) completed surveys in which depressive symptoms, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model regression was used to determine influences on depressive symptoms within the dyad. Results Individuals with lower self-esteem, optimism, and perceived control had higher levels of depressive symptoms. Stroke survivors whose spouses had lower levels of self-esteem (B= −.338, P<.001) and optimism (B= −.361, P<.027) tended to have higher levels of depressive symptoms. Spouses whose stroke survivors had lower levels of self-esteem (B= −.047, P=.036) also had higher levels of depressive symptoms. Conclusion We found significant partner effects of self-esteem on depression for both members and partner effect of optimism on patient's depressive symptoms. These findings suggest that further research is needed to determine if dyadic interventions may help to improve self-esteem, optimism, and depressive symptoms in both patients and their caregivers.

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Outcomes for family carers of a nurse-delivered hospital discharge intervention for older people (the Further Enabling Care at Home Program): Single blind randomised controlled trial

Toye

Parsons

Slatyer

et al. 2016

International Journal of Nursing Studies

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Background:Hospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers' self-identified support needs. Objectives:This study tested the hypothesis that the extent to which family caregivers of older people discharged home from hospital felt prepared to provide care at home would be positively influenced by their inclusion in the new Further Enabling Care at Home program. Design:This single-blind randomised controlled trial compared outcomes from usual care alone with those from usual care plus the new program. The program, delivered by a specially trained nurse over the telephone, included: support to facilitate understanding of the patient's discharge letter; caregiver support needs assessment; caregiver prioritisation of urgent needs; and collaborative guidance, from the nurse, regarding accessing supports. Setting and participants:Dyads were recruited from the medical assessment unit of a Western Australian metropolitan public hospital. Each dyad comprised a patient aged 70 years or older plus an English speaking family caregiver. Methods:The primary outcome was the caregiver's self-reported preparedness to provide care for the patient. Data collection time points were designated as: Time 1, within four days of discharge; Time 2, 15 to 21 days after discharge; Time 3, six weeks after discharge. Other measures included caregivers' ratings of: their health, patients' symptoms and independence, caregiver strain, family well-being, caregiver stress, and positive appraisals of caregiving. Data were collected by telephone. FECH and caregiver impacts 2Results:Complete data sets were obtained from 62 intervention group caregivers and 79 controls. Groups were equivalent at baseline. Needs prioritised most often by caregivers were: to know whom to contact and what to expect in the future and to access practical help at home. Support guidance included how to: access help, information, and resources; develop crisis plans; obtain referrals and services; and organise legal requirements.Compared to controls, preparedness to care improved in the intervention group from Time 1 to Time 2 (effect size=0.52; p=0.006) and from Time 1 to Time 3 (effect size=0.43; p=0.019). These improvements corresponded to a change of approximately 2 points on the Preparedness for Caregiving instrument. Small but significant positive impacts were also observed in other outcomes, including caregiver strain. Conclusions:These unequivocal findings provide a basis for considering the Furthering Enabling Care at Home program's implementation in this and other similar settings. Further testing is required to determine the generalisability of results. KeywordsAged, community health care, family caregivers, hospitals, patient discharge. FECH and caregiver impacts

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Self-esteem in carers of frail older people: Resentment predicts anxiety and depression

Abstract: The results of this study indicate that those carers who resent having to care for their frail older relative are susceptible to anxiety and depressive symptoms. This study supports the notion that there is a need for assessment of caregiving reactions in carers of frail older people.

Cited by 36 publications

References 64 publications

Relationship between family caregiver burden and physical frailty in older adults without dementia: a systematic review

Relationship between family caregiver burden and physical frailty in older adults without dementia: a systematic review

Effects of Self-esteem, Optimism, and Perceived Control on Depressive Symptoms in Stroke Survivor-Spouse Dyads

Outcomes for family carers of a nurse-delivered hospital discharge intervention for older people (the Further Enabling Care at Home Program): Single blind randomised controlled trial

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