A Disproportionate Burden of Care: Gender Differences in Mental Health, Health-Related Quality of Life, and Social Support in Mexican Multiple Sclerosis Caregivers.

BACKGROUND: Multiple sclerosis (MS) rates in Latin America are increasing, and caregivers there experience reduced mental and physical health. Based on rigid gender roles in Latin America, women more often assume caregiving duties, yet the differential impact on women of these duties is unknown. METHODS: This study examined gender differences in mental health (Patient Health Questionnaire-9, Satisfaction with Life Scale, Rosenberg Self-Esteem Scale, State-Trait Anxiety Inventory, and Zarit Burden Inventory), health-related quality of life (HRQOL; Short Form-36), and social support (Interpersonal Support Evaluation List-12) in 81 (66.7% women) Mexican MS caregivers. RESULTS: As compared to men caregivers, women had lower mental health (p = 0.006), HRQOL (p < 0.001), and social support (p < 0.001). This was partially explained by women caregivers providing care for nearly twice as many hours/week as men (79.28 versus 48.48, p = 0.018) and for nearly three times as many months (66.31 versus 24.30, p = 0.002). CONCLUSIONS: Because gender roles in Latin America influence women to assume more substantial caregiving duties, MS caregiver interventions in Latin America-particularly for women caregivers-should address the influence of gender-role conformity on care and psychosocial functioning.

Predictors of resourcefulness in African American women.

UNLABELLED: Although resourcefulness may facilitate coping with caregiver stress and burden, it has not been among African American women for whom caregiving is culturally prescribed. OBJECTIVE: Using Rosenbaum's theory of resourcefulness, this study examined situational (socioeconomic status, social support, daily hassles), physiological (age, body mass index, number of health problems, systolic blood pressure), and psychological factors (positive cognitions) as predictors of resourcefulness. METHODS: A random sample of 97 African American caregivers and 110 noncaregivers provided data via structured interviews and 24-hour ambulatory blood pressure monitoring. RESULTS: No physiological indicators predicted resourcefulness; however, daily hassles, social support, and positive cognitions were significant predictors. Age, number of health problems, daily hassles, and social support had indirect effects on resourcefulness through positive cognitions. DISCUSSION: These findings suggest a need to further examine the impact of daily hassles, social support, and positive cognitions on caregiving and continued review of models for predicting resourcefulness in African American women.

Assessing cross-cultural equivalence through confirmatory factor analysis.

This article presents a study in which Picot's caregiver rewards scale (PCRS), originally developed in English, was cross-culturally validated with 137 Chinese adult children family caregivers in the United States using confirmatory factor analysis. A one-factor structure of the 21-item revised Chinese PCRS was supported as indicated by goodness-of-fit index = .94, adjusted goodness-of-fit index = .93, standardized root mean square residual = .09, and chi-square to df ratio = 2.7. Chi-square for this model was (chi(2) [189, n = 137] = 514, p < .05). The standardized alpha was .90. All factor loadings were significant (p < .00) and above .30. Construct validity was supported by significant associations with caregivers' filial beliefs (r = .32, p < .01) and caregivers' filial affection toward parents (r = .23, p < .05). Results suggest that the Chinese PCRS is a summative measure of perceived caregiver rewards with potential for evaluating interventions to reduce perceived burden among adult children family caregivers.

Involving rural, older African Americans and their female informal caregivers in research.

OBJECTIVE: This article presents the methodology, procedures, and results for involving rural, older African Americans and recruiting their female informal caregivers for a well-being and service use study. METHODS: Using a list of 1,994 Medicare enrollees, this study adapted a reversed screening telephone methodology tested on urban African American elders and their caregivers. It used trained screeners, local African American female interviewers, and a mixed-mode procedure (i.e., telephone and canvassing) to screen elders and recruit caregivers. RESULTS: Adequate information for 1,547 listings allowed screeners to contact qualified elders meeting the study criteria. Using chi-square analysis, significant differences were found between telephone and canvassing screening methods on nonreferral cases and referral cases. Elders or a proxy referred 286 caregivers. Interviewers obtained 265 of 300 proposed caregiver interviews. DISCUSSION: Knowledge about the involvement of rural, older African Americans and recruitment of their female informal caregivers in research is essential to understanding recruitment successes and pitfalls in ethnic minority research.

Psychometric characteristics of the Depressive Cognition Scale in African American women.

Depression in African-American women frequently goes unnoticed and untreated since commonly used depression scales fail to focus on early symptom recognition, do not address contextual factors, and lack adequate psychometric testing in African-American women. This analysis of the Depressive Cognition Scale was conducted with 213 African-American female caregivers and noncaregivers. Alpha coefficients for both groups (alpha 's = .75 and .87) showed internal consistency. Correlations with resourcefulness, depression, and daily hassles scales in the expected directions demonstrated construct validity (R's = -.36, .26, and .31, respectively). Factor structures for caregivers and noncaregivers differed, suggesting certain depressive cognitions were strongly integrated into the caregiver role. As a reliable and valid measure of depressive cognitions, the DCS would be useful for early detection of depression in African-American women.