Emotional competences as predictors of psychological wellbeing and quality of life of supplementary grandparents caregivers.

Introduction: Grandparents are increasingly becoming key figures in the supplementary care of grandchildren. Based on the Resilience Model of Family Stress, Adjustment and Adaptation, the present study aims to analyze the emotional competences that canpl predict higher levels of psychological wellbeing and quality of life in supplementary grandparents caregivers. Methods: A sample of 270 supplementary grandparents caregivers living in Spain participated. Most participants were women (71.1%), and the mean age was 67.83 years (SD = 6.26). Most participants were occasional caregivers, that is, they care for less than 10 h per week (76.3%). We conducted hierarchical multiple regression analysis, one for psychological wellbeing and the other for quality of life. Results: The regression model for psychological wellbeing identified that age, management of caregiving stress, self-confidence in the caregiving role, management of work-life balance difficulties and emotional self-regulation explained 32.8% of its variance. The regression model for quality of life showed that age, type of grandparent caregiver, management of caregiving stress, management of work-life balance difficulties and emotional self-regulation explained 31.2% of its variance. Conclusion: This study focuses on supplementary grandparents caregivers, whereas literature has tended to look at primary grandparents caregivers. The results highlight the role of emotional competences as predictors of supplementary grandparents caregivers' psychological wellbeing and quality of life, overcoming the usual tendency in the literature to focus on the negative consequences of grandparents caregiving for grandchildren, and emphasizing the competences that grandparents have to cope with this care in a satisfactory way, which, moreover, can be trained.

Prevention of Older Adult Infantilization by Nursing Home Professionals: An Intervention Program.

This study analyzes the efficacy of a brief psychoeducational program aimed at preventing older adult infantilization by nursing home professionals. We examined whether an experimental group of professionals reported less infantilization than those of a control group. Changes in stereotypes and humanization were regarded as sub-targets. The sample comprised 154 staff members. Infantilization, humanization, and negative stereotypes toward older adults were assessed before and after the intervention, and repeated measures of ANOVA and one-way ANCOVAs were conducted. Infantilization and negative stereotypes decreased in the experimental group. Significant post-intervention differences were found between the experimental and control groups both in infantilization and negative stereotypes but not in humanization. Results reflect the relevance of developing specific interventions focused on preventing infantilization as well as the need for professionals' training and education to generate a culture of change.

Resilience Among Direct Care Staff in Nursing Homes: Validation of the CD-RISC2.

OBJECTIVES: Caring for older adults is a demanding task. Some professionals may find themselves in complex situations for which they may not be prepared. However, the repercussions of these difficult experiences will depend on personal factors. Resilience acts as a buffer against difficulties and experiences. However, its study with first-line caregivers in nursing homes is limited. This study aimed to validate the Connor-Davidson Resilience Scale-2 (CD-RISC2), examine its psychometric properties, and analyze the variables associated with resilience (sociodemographic and professionals´ variables). METHODS: 312 nursing home professionals participated in the study. Besides the Connor-Davidson Resilience Scale-2, they answered questionnaires about good care, burnout, quality of life, person-centered care, and well-being. RESULTS: The CD-RISC2 showed adequate reliability and test-retest reliability. Good support was found for convergent validity with perceived health, person-directed care, personal growth, life purpose, quality of life and good care, and for discriminant validity with burnout. CONCLUSIONS: To our knowledge, this is the first study that validates the CD-RISC2 Spanish version with front-line workers in nursing homes showing adequate psychometric properties. CLINICAL IMPLICATIONS: An abbreviated, simpler, self-assessed version may be more useful than longer versions, especially with professionals with a heavy workload, such as direct care staff in nursing homes.

Burnout and Quality of Life in Professionals Working in Nursing Homes: The Moderating Effect of Stereotypes.

Objective: This study aimed to analyse how stereotypes towards older people moderate the relationship between burnout and quality of life (QoL) of professionals working in nursing homes. Method: A total of 312 professionals were asked to complete questionnaires of burnout Maslach Burnout Inventory quality of Life (QPL-35) and aging stereotypes (CENVE). The moderation effects were tested using linear regression models. Results: A negative association was observed between burnout and QoL. It was also found a statistically significant moderator effect of the total score of stereotypes and the health stereotypes, besides a marginally statistically significant moderator effect for motivational stereotypes. The moderator effects were different for people with low and high negative stereotypes. QoL was more affected under conditions of high burnout, in which people with more negative stereotypes tended to present higher QoL than people with lower negative stereotypes. Conclusion: Highly burned-out professionals in nursing homes may avoid their negative feelings projecting them to residents through stereotypes, as a way of coping with burnout and increasing their QoL. However, this mechanism is an "aggressive reaction" and may have negative effects for both the older adult and the professional. The comprehension of these variables is essential for developing adequate intervention programs.

Longitudinal Impact of the COVID-19 Pandemic on Older Adults' Wellbeing.

Background: The COVID-19 pandemic is a major stressful life event. This pandemic is causing significant changes in older adults' daily life affecting their physical and mental health. Psychological wellbeing is a protective variable when facing adverse circumstances, like the COVID-19 pandemic. This study analyzes the impact of COVID-19 on older adults' psychological wellbeing (personal growth and purpose in life) over time. Materials and Methods: One hundred ninety-two people over 60 years old participated in a longitudinal study. Data were collected in three time points: during the lockdown on March 2020, when the lockdown finished (4 months after baseline), and during the third wave (10 months after baseline). We used latent growth curve models to assess the linear longitudinal trajectories of psychological wellbeing. Results: Older adults did not show worse psychological wellbeing over time. Age has a positive impact on purpose in life. Furthermore, being a male, worrying about adverse effects of COVID-19, family functioning, resilience, personal growth, and acceptance associated with purpose in life. Discussion: These results suggest that despite the difficult circumstances experienced during the COVID-19 pandemic, older adults have used protective variables for their psychological wellbeing.

Emotional distress among older adults during the COVID-19 outbreak: understanding the longitudinal psychological impact of the COVID-19 pandemic.

BACKGROUND: Older adults have proven their ability to overcome adversities throughout their life. This study aims to assess the impact of the COVID-19 pandemic on older adults' psychological distress (anxiety and depression) over time. METHODS: A community-dwelling Spaniard population (N = 192) completed a survey and reported on their sociodemographic characteristics, appraisal and personal resources. Older adults took part in a longitudinal online survey collected in April 2020 (during the lockdown restrictions) and at two subsequent time points 3 and 9 months after baseline (without lockdown restrictions and during the third wave of the pandemic respectively). RESULTS: Older adults did not evidence higher emotional distress than during the initial lockdown. Furthermore, depression remained stable and anxiety significantly decreased. Results also suggest that some sociodemographic characteristics, appraisals and personal resources are relevant. Older participants showed less anxiety than younger ones. Furthermore, being a male, resilience, and acceptance were related with the decrease of anxiety. Otherwise, fear of the COVID-19 outbreak and depression were related with the increase of anxiety. CONCLUSION: Older adults may adapt to the adverse pandemic impact by using more adaptive resources that reduce their distress. Efforts to ameliorate older adults' anxiety by focusing on older adults' personal resources should be considered.

Older People's Personal Strengths During the First Wave of the COVID-19 Pandemic.

BACKGROUND: Although several biopsychosocial variables could play an important role as risk and protective factors of mental health, COVID-19 outbreak studies among older people have seldom focused on protective factors. The purpose of this study was to analyze how older adults' personal strengths predict their well-being and emotional distress. METHOD: 783 Spanish people aged 60 and over completed a survey that included sociodemographic characteristics, perceived health, direct or indirect infection by COVID-19, resilience, gratitude, experiential avoidance, family functioning, emotional distress and well-being. Structural Equation Modelling (SEM) was performed. SEM invariance was also used to analyze whether there were differences between older people affected by COVID-19 and those not affected. RESULTS: The best model supports the mediation effect of resilience, gratitude and experiential avoidance on older people's well-being and emotional distress. Whether participants or relatives had been infected by the virus or not did not affect the results. CONCLUSIONS: Variables used as criteria in older adults are related to well-being and emotional distress, but only indirectly and mediated by resilience, gratitude and experiential avoidance. This confirms the importance of considering psychological strengths in older people's well-being. Interventions focused on these personal resources should be considered.

Validation of the professional good care scale in nursing homes (GCS-NH).

BACKGROUND: There is extensive concern about older people's care in institutions, especially recently in the past years. One of the reasons is linked to the cases of elder abuse, not only shown by academic and scientific sources, but also by social and mass media and their impact on public perception of the institutional setting. What is more, current COVID-19 pandemic consequences on older people have provoked alarm and worry especially about what is happening in institutions. METHODS: The sample for this study consists of 286 staff working in nursing homes in Spain. This study aimed to assess the psychometric properties of the Professional Good Care Scale in Nursing Homes (GCS-NH). RESULTS: Results of parallel analyses and exploratory factor analyses (EFAs) showed a four-factor model for the 32-item scale: humanization (9 items), non-infantilization (10 items), respect (7 items) and empowerment (6 items). Then, psychometric properties were tested analysing internal consistency (reliability) and convergent, divergent and criterion validity. High internal consistency (reliability) and different validity evidence were obtained for the total scores of the GCS-NH and its subscales. GCS-NH scores were also capable of detecting risk of probable institutional elder abuse. CONCLUSIONS: Results show that this scale is an appropriate, valid, and reliable multidimensional instrument to evaluate good care in older institutionalized people by staff. Good care is an outcome of a complex construct in which a wide range of factors converge (staff, older people, and environmental characteristics). The GCS-NH has potential to be used as a multidimensional tool to assess good care.

Personal and Work-Related Factors Associated with Good Care for Institutionalized Older Adults.

Despite efforts to promote good care, many institutionalized older adults (IOA) experience elevated neglectful conditions and reduced person-centered care approaches. Based on the job demand-control model, this study aimed to analyze the relationship between nursing home professionals' personal and organizational factors and good care provided to institutionalized older people. Data was collected through a self-administered survey completed by 208 nursing home staff members. Three dimensions of personal factors (i.e., personal accomplishment, depersonalization, and negative old age stereotypes) were significant predictors of good care. Depersonalization and negative old age stereotypes were negatively associated with IOA, and both good care and personal accomplishment were positively associated with good care in nursing homes. Only one work-related factor (i.e., management support) was positively associated with good care. Personal factors may play a significant role in good care. Management support offers a promising mechanism to promote good care among nursing home professionals. The findings support the need to change the focus on entirely completing care tasks to providing good care of residents in nursing homes that promotes management support, personal accomplishment, personalization and positive old age consideration, attitudes, and behaviors. Policies and interventions should be developed to address in a more humanized way.

Psychometric properties of the CASP-12 in a Spanish older community dwelling sample.

OBJECTIVE: Current studies have shown that older people's quality of life (QoL) is more associated to individual's sense of happiness and subjective life satisfaction than to objective problems. CASP scale conceptualizes QoL based on a psycho-sociological perspective. Originally, CASP consisted of 19 items (four factors: Control, Autonomy, Self-realization and Pleasure). Later, it was proposed a shorter version (12 items and three factors). The aim of this study was to assess the structure of the CASP-12 SHARE version using confirmatory factor analysis. METHOD: The CASP structures traditionally proposed were checked and tested in a sample of 1108 people aged 60 years and over. RESULTS: The three factor model (1) pleasure, (2) self-realization and (3) autonomy and control showed a good overall fit (CFI = .932; TLI = .912; RMSEA = .067). An adequate internal consistency was also obtained. CONCLUSION: This is the first study that explored the psychometric properties and validated the well-fitting three factor structure for the CASP-12 in a large population sample of older people from Spain. The results support a multidimensional model for the CASP-12 composed by three factors. It has potential to be used as a multidimensional tool to assess QoL in older people.

Validity and reliability of the Spanish version of Caregiver Abuse Screen (CASE).

Detection of elder abuse risk is a critical issue because a lot of cases remain hidden. Screening tools can be used to detect elder abuse. However, few tools have been developed for use with caregivers. The purpose was to develop a translation and adaptation of a Spanish version of the Caregiver Abuse Screen (CASE) and to assess its validity and reliability. The CASE was then used with 211 primary caregivers. Validity and reliability were evaluated, as well as the factorial structure of the instrument. This version showed good psychometric properties. It was found to have strong internal consistency and split-half reliability as well as allowing for a good replication of the original factorial structure. Additionally, several variables related to elder abuse were linked to the CASE such as depression, burden, frequency, and reactions to problem behaviors. The version developed showed sufficient validity and reliability and could be considered as a suitable instrument to assess risks of elder abuse in a Spanish-speaking context.

[Prevalence of elder abuse in Spanish dwelling in community]. / Prevalencia de malos tratos hacia personas mayores que viven en la comunidad en España.

BACKGROUND AND OBJECTIVE: Although elder abuse is not a new phenomenon, it remains hidden. There have been carried out various preliminary studies about the prevalence of elder abuse in different countries. The aim of this study is to estimate the prevalence of suspicion of elder abuse in old persons without cognitive impairment, dwelling in community, who were attended in Primary Health Care or Social Services Centres. PATIENTS AND METHOD: We carried out a transverse study in which 340 elders participated. RESULTS: We found a 12.1% prevalence of suspicion of elder abuse. Psychological abuse suspicion was the most frequent type and it was very common the simultaneous presence of different types of abuse (psychological and physical and sexual). The suspicion of elder abuse was more frequent in women and spouses were responsible in a high great frequency. CONCLUSIONS: The information obtained allows advancing in the knowledge of elder abuse in Spain, where the research about this issue is poor. However, the prevalence found neither has to be considered as a social alarm nor as a social slackness.

[Linguistic and cultural adaptation of two tools for the detecting suspected elder abuse]. / Adaptación lingüística y cultural de dos instrumentos para la detección de sospecha de maltrato hacia las personas mayores.

This work is the natural continuation of the project conducted by the Spanish Geriatrics and Gerontology Society (SEGG) and the Institute for the Elderly and Social Services (IMSERSO) and under the auspices of the World Health Organisation and Geneva University, called "Global response to abuse and neglect of the elderly: Building Primary Health Care Services capacity to deal with a worldwide problem". The carrying out of this work has been made possible due to funding by the Institute for the Elderly and Social Services (IMSERSO) in the framework of the National Plan for Scientific Research, Development and Technological Innovation 2004-2007. The general aim of this project was the validation of the tool for detecting suspected elder abuse, called (Elder Abuse Suspicion Index, EASI) as well as the Social Worker Evaluation Form (FETS) which is used for the confirmation of suspected abuse cases. After obtaining the results, the questionnaires obtained as a result of the linguistic and cultural adaptation of EASI and FETS are presented.

Optimising the diagnostic performance of the Geriatric Depression Scale.

The aim of this work is to empirically generate a shortened version of the Geriatric Depression Scale (GDS), with the intention of maximising the diagnostic performance in the detection of depression compared with previously GDS validated versions, while optimizing the size of the instrument. A total of 233 individuals (128 from a Day Hospital, 105 randomly selected from the community) aged 60 or over completed the GDS and other measures. The 30 GDS items were entered in the Day Hospital sample as independent variables in a stepwise logistic regression analysis predicting diagnosis of Major Depression. A final solution of 10 items was retained, which correctly classified 97.4% of cases. The diagnostic performance of these 10 GDS items was analysed in the random sample with a receiver operating characteristic (ROC) curve. Sensitivity (100%), specificity (97.2%), positive (81.8%) and negative (100%) predictive power, and the area under the curve (0.994) were comparable with values for GDS-30 and higher compared with GDS-15, GDS-10 and GDS-5. In addition, the new scale proposed had excellent fit when testing its unidimensionality with CFA for categorical outcomes (e.g., CFI=0.99). The 10-item version of the GDS proposed here, the GDS-R, seems to retain the diagnostic performance for detecting depression in older adults of the GDS-30 items, while increasing the sensitivity and predictive values relative to other shortened versions.

[Age-related differences in the effect of social desirability on self-reported emotional state]. / Diferencias asociadas a la edad en el efecto de la deseabilidad social en el autoinforme del estado emocional.

INTRODUCTION: It is usually assumed that social desirability increases with ageing, correlates with measures of emotional well-being, and represents a potential threat to research in older adults, and should therefore be systematically controlled. However, this assumption is controversial and lacks a strong empirical basis. The present study aimed to analyze the association between social desirability and measures of emotional well-being, as well as to test for age-related differences in the changes produced in emotional state after experimental anxiety induction. MATERIAL AND METHODS: We randomly assigned 149 individuals (92 university students and 52 older adults) to one of three groups: a control group and two intervention groups in which anxiety was experimentally induced. RESULTS: Social desirability scores were significantly higher in older persons (Hedges'g=1.22). No statistically significant correlations were found in any age group between social desirability and measures of emotional well-being. Likewise, in a series of univariate ANOVAs, no differences were found according to the degree of social desirability in changes in emotional state after anxiety induction. Overall, social desirability was not related to the changes produced by experimental anxiety induction. CONCLUSIONS: The present study confirms the association between social desirability and age. However, social desirability did not seem to correlate with emotional well-being in any age group. Moreover, social desirability was not related to changes in emotional state after experimental anxiety induction. These results do not support the view that social desirability is a threat to the validity of experimental studies in the elderly.

Method of recruitment and the scores of self-report measures: the example of worry in the elderly.

Due to the difficulties in recruiting elderly people for psychological studies, a wide range of recruitment methods has been used. The underlying assumption that the recruitment method does not seriously affect the results has to be tested. Results in different worry measures are compared between three samples which were recruited with different strategies: (i) randomization sampling from the census of an urban area (random sample; n=97); (ii) people involved in leisure activities in senior centers (convenience sample; n=142); and (iii) people from the close environment of psychology students (snowball sample; n=60). People from those samples, aged 65 and more, completed the Penn State Worry Questionnaire (trait-worry), and the Worry Scale (contents of worry). Differences were found for several demographic characteristics. There were marked differences between samples in the percentage of individuals endorsing cut-score criteria for generalized anxiety disorder (GAD), with a very high percentage for the snowball sample. For all of the worry measures, analyzes of variance revealed significantly higher total scores for the non-randomly selected samples (p<0.01). Comparing the latter samples, higher trait worry (p<0.01) and more worrying about health and personal competencies (p<0.01) was found in the snowball sample. These results suggest that the sample recruitment method can specifically and seriously affect the outcomes of studies with elderly people, thus limiting the generalization of their results.

[Spanish contribution to international advances in the linguistic and cultural adaptation of a screening tool for elder abuse]. / Aportación española a los avances internacionales en la adaptación lingüística y cultural de un instrumento de detección de sospecha de maltrato hacia personas mayores.

The present article describes the results of the application of the project <> in Spain. This project is a collaboration between the Spanish Society of Geriatrics and Gerontology and the Institute of the Elderly and Social Services with the World Health Organization and the University of Geneva.