Estilos de cuidados y la implicación como protector psicológico del cuidador de personas con Parkinson en España / Care styles and involvement as a psychological protective of the caregiver of people with Parkinson's disease in Spain

RESUMEN

Resumen Los familiares de personas con enfermedad de Parkinson (EP) se enfrentan a una variedad de situaciones estresantes como consecuencia del desempeño de su rol de cuidadores. Esto puede tener un impacto negativo en su calidad de vida. Un mayor conocimiento de la relación entre las variables evaluadas en los cuidadores puede ser importante de cara a implementar programas de intervención eficaces. El objetivo fue explorar la personalidad y las estrategias de afrontamiento en familiares cuidadores de personas con EP, estudiando su relación con el malestar psicológico y el grado de implicación en los cuidados. Se trabajó con una muestra de 106 cuidadores que completaron los cuestionarios de personalidad NEO-FFI, estrategias de afrontamiento COPE-28, malestar psicológico CORE-OM y un instrumento para evaluar la implicación del cuidador realizado a partir del índice Katz. El análisis de regresión logística mostró que las personas con puntuaciones por encima de la media en neuroticismo y por debajo en el resto de factores de personalidad y estrategias de afrontamiento tenían más riesgo de padecer malestar psicológico (OR = 9.250; p < .001) y una menor implicación en los cuidados (OR = 4.125; p < .001). Estos resultados sugieren que la personalidad y las estrategias de afrontamiento pueden contribuir a identificar estilos para los cuidados más eficientes, que impliquen una mayor participación en los cuidados con un menor impacto negativo.

ABSTRACT

Abstract Carers of people with Parkinson's disease (PD) experience stressful situations as a result of performing their role as caregivers. This can have a negative outcome on their quality of life. A greater understanding of the relationship between the variables assessed in caregivers can be important in implementing effective intervention programs. The aim of this study was to explore the personality and coping strategies used by family caregivers of people with PD, analyzing their relationship with psychological distress and the carer involvement. A cross-sectional study based on a sample of 106 caregivers of people with Parkinson's disease tested the hypothesis that personality and coping strategies can contribute to identifying differences in carer involvement and psychological distress. Caregiver psychological distress was assessed using the CORE-OM questionnaire. The CORE-OM is able to distinguish the population within the clinical and non-clinical range. NEO Five-Factor Inventory (NEO-FFI) was used to assess personality. Coping strategies were evaluated with the COPE-28 inventory. An operational measure of the carer involvement was also used. For this purpose, an adaptation of the Katz index assessing basic functional capacity was made. Results: First, all cases were clustered according to personality variables and coping strategies. A K-means cluster analysis was performed and two groups were requested. After this, binary logistic regression analysis was used to test the research hypothesis. The resulting clusters in the above analysis were selected as predictors. Two analyses were performed. In the first, the dependent variable in logistic regression analysis was the psychological distress of the caregivers (dichotomized variable clinical and non-clinical). Results showed that people clustered within cluster 1 had a 9.250 times higher risk of psychological distress than those included in cluster 2 (OR = 9.250; p < .001). In a second logistic regression analysis, the dependent variable was participation in care (dichotomized variable low - high carer involvement). The group of people belonging to cluster 1 showed a carer involvement 4.125 times lower than the people grouped in cluster 2 (OR = 4.125; p < .001). The results of this research suggest the existence of a relationship between psychological variables and carer involvement, showing two different styles of care, which are described based on the personality and coping strategies of the family caregivers. In addition, we found that these styles of care show clear differences in efficiency, reflected in greater carer involvement and a lower psychological distress. The results reported that the cluster of people with below-average scores on neuroticism and above-average scores on the other personality factors (extraversion, openness to experience, agreeableness, and conscientiousness) and coping strategies (planning; active coping; emotional support; social support; positive re-evaluation and acceptance) were associated with increased carer involvement and reduced risk of psychological distress. It has already been suggested that high scores in neuroticism may affect the need to take on a large number of care-related tasks or manage stressful situations in people with PD (Tew et al., 2013). However, our results indicate that the definition of different types of caregivers, where other care-related variables are also included, can help define more efficient styles of care. This is associated with increased carer involvement and minor psychological distress. We propose that in the future these variables be investigated in order to know the outcome of carer involvement and psychological distress, contributing to the description of more efficient care styles in family caregivers.