Gender differences in primary home caregivers of older relatives in a Mediterranean environment: A cross-sectional study.

A cross-sectional study was developed in Spain to analyse gender differences in intensity of care, care recipient needs and subjective burden, as well as the moderating effects of kinship on the relationship between gender and subjective burden. A probabilistic sample of 200 primary caregivers (100 male and 100 female) of older relatives was interviewed by expert nurses. Socio-demographic data and several scales regarding objective and subjective burden were used to collect data. Descriptive statistics, Student's t-test, ANOVA and multiple linear regression were used to analyse the data. There were gender differences in subjective burden, with female caregivers having more subjective burden than male caregivers, but not in objective burden (intensity of care and care recipients' needs). Kinship moderated the relationship between gender and subjective burden, as gender differences were found in spouses (wives had more subjective burden than husbands) but not in offspring.

The Association of Satisfaction and Perceived Burden With Anxiety and Depression in Primary Caregivers of Dependent Elderly Relatives.

Some researchers have viewed caregiver burden and satisfaction as two ends of the same continuum rather than as independent aspects of the caregiving experience. We conducted a cross-sectional study of primary caregivers of dependent elderly relatives in Spain (N = 200; probabilistic sample), to determine whether satisfaction and perceived burden coexisted in caregivers, and whether these variables, considered separately and in combination, were associated with anxiety and depression, while controlling for objective aspects of care recipients' needs. Data on satisfaction with care, perceived burden, objective burden, anxiety, and depression were gathered in 2013 by interviews in caregivers' homes. Descriptive, bivariate, and multivariate analyses were performed. Of the 200 primary caregivers, 12.5% reported both high satisfaction with care and high perceived burden. Anxiety and depression levels were lower in caregivers with high satisfaction and low perceived burden than in those with low satisfaction and high burden or with high satisfaction and high burden. Our findings support the following conclusions: (1) Satisfaction may be experienced despite the presence of stressful factors; (2) the combination of high satisfaction and low burden might have protective effects on anxiety and depression in caregivers.

Subjective burden and cultural motives for caregiving in informal caregivers of older people.

PURPOSE: The aims of this study were to investigate variables related to cultural caregiving motives (obligation and reciprocity) and to analyze the relationship between these cultural caregiving motives and subjective burden in informal caregivers of disabled older people. DESIGN AND METHODS: A secondary analysis of the last cross-sectional Spanish survey of informal caregivers of older people (n= 1,284, probability sample) was performed. Measurements included sociodemographic characteristics of caregivers (gender, age, relationship with care recipient, primary caregiver status, and duration of caregiving), intensity of care (hours per week, type of care, and number of activities of daily living [ADL] assisted), cultural motives for caregiving (obligation and balanced reciprocity), and caregiver subjective burden. Statistical analyses included descriptive (means, percentages, and 95% confidence intervals), bivariate (chi-square test), and multivariate (binary logistic regression) analyses. FINDINGS: Obligation and reciprocity were higher in spouses than in other relatives and in nonrelatives and obligation increased with age as well as providing help with ADL. Balanced reciprocity was high in men. Obligation was not related with subjective burden, whereas balanced reciprocity was positively related. CONCLUSIONS: Reciprocity had a protective effect on subjective burden. No cultural differences have been found on this issue. Obligation may be a multidimensional concept that encompasses personal beliefs and social demands. CLINICAL RELEVANCE: Balanced reciprocity is useful for early prevention and early intervention of subjective burden and must be included in nursing care plans for caregivers. Cultural factors support the comprehension of the caregiving process.

Coping and subjective burden in caregivers of older relatives: a quantitative systematic review.

AIM: This article is a report on a review of the effect of coping strategies on subjective burden in informal caregivers of older adults. BACKGROUND: Informal care has negative effects on caregivers' health, and subjective burden is one of these. It has been linked with other effects (e.g. anxiety and depression). Thus, greater prevention of subjective burden will mean increased prevention of these effects. To achieve this, identification of factors related to subjective burden is essential. DATA SOURCES: Electronic databases and manual searches of scientific journals. REVIEW METHODS: A quantitative systematic review was conducted including: (a) original studies (b) that related caregiver subjective burden to coping strategies compatible with the classifications of Lazarus & Folkman or Moos et al. (c) in informal caregivers of older relatives. The searches ranged from the first year included in each database until January 2010. After quality appraisal, ten studies were included; these, care-recipients living at home and having cognitive impairment. RESULTS: Four coping categories have been related to subjective burden: problem-focused, emotion-focused, approach and avoidance. Interesting results were only found for avoidance coping (positive association). In other categories, results were heterogeneous (problem-focused and approach) or we found few valid studies (emotion-focused). CONCLUSION: We found some evidence for a positive association between avoidance coping and subjective burden in home caregivers of older relatives with cognitive impairment. It is probable that avoidance coping either mediates or moderates the relationship between subjective burden and its outcomes, or that avoidance coping precedes subjective burden, which in turn leads to the coping outcomes. In both situations, avoidance coping is an ineffective coping.