Culpa y bienestar en cuidadores familiares de personas mayores dependientes institucionalizadas / Guilt and well-being in institutionalized family caregivers of dependent older adult people

Antecedentes y objetivo: La experiencia de los cuidadores familiares tras el ingreso en una residencia de personas mayores ha recibido escasa atención, probablemente porque muchos cuidadores experimentan una sensación inicial de alivio emocional inicial. Sin embargo, para algunos cuidadores el ingreso en una residencia de mayores es un factor de estrés a pesar de la reducción de la carga física de los cuidados. La angustia del cuidador tras la institucionalización se ha relacionado con las nuevas cargas y retos que se encuentran en la residencia de mayores. La ambivalencia y la culpa relacionados con la decisión de institucionalización se han identificado como fuentes de estrés. Por eso, este estudio examinó el efecto de la culpa y el bienestar en el estrés percibido de cuidadores familiares de personas dependientes institucionalizadas. Materiales y métodos: Participaron 201 cuidadores familiares de personas institucionalizadas en una residencia de mayores (La Rioja, España). Se evalúo el estrés percibido, la culpa para el cuidado y el bienestar subjetivo, variables sociodemográficas y relacionadas con el cuidado. Se realizaron análisis de regresión lineal y correlaciones entre las variables. Resultados: La culpa y 5 dimensiones de bienestar (ansiedad, vitalidad, autocontrol y depresión, excepto salud general) predijeron significativamente el estrés (R2adj=0,552 [F (6, 198)=41,71; p<0,001]). El tamaño del efecto fue grande (IC del 95%: 0,461). Conclusiones: Prestar atención a los sentimientos de culpa de los cuidadores familiares durante la institucionalización es fundamental. Ello permitirá diseñar e implementar intervenciones psicosociales que mejoren la adaptación del cuidador inmediatamente después de la institucionalización. (AU)

Introduction and objective: The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons. Materials and methods: Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed. Results: Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R2adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461). Conclusions: Paying attention to family caregivers’ feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization. (AU)

[Guilt and well-being in institutionalized family caregivers of dependent older adult people]. / Culpa y bienestar en cuidadores familiares de personas mayores dependientes institucionalizadas.

INTRODUCTION AND OBJECTIVE: The experience of family caregivers after nursing home admission has received much less attention, probably because many caregivers experience an initial sense of initial emotional relief. However, for some caregivers nursing home admission is a stressor despite the reduced physical burden of caregiving. Caregiver distress following institutionalization has been related to the new burdens and challenges encountered in the nursing home. Ambivalence and guilt related to the institutionalization decision have been identified as sources of stress. Therefore, this study examined the effect of guilt and well-being on the perceived stress of family caregivers of institutionalized dependent persons. MATERIALS AND METHODS: Two hundred and one family caregivers of institutionalized persons in a nursing home (La Rioja, Spain) participated. Perceived stress, caregiving guilt and subjective well-being, sociodemographic and caregiving-related variables were assessed. Linear regression analyses and correlations between variables were performed. RESULTS: Guilt and five dimensions of well-being (anxiety, vitality, self-control and depression, except general health) significantly predicted stress (R2adj=.552 (F (6, 198)=41.71, P<.001)). The effect size was large (95% CI=.461). CONCLUSIONS: Paying attention to family caregivers' feelings of guilt during institutionalization is important. This will enable the design and implementation of psychosocial interventions that improve caregiver adjustment immediately after institutionalization.

Coping and guilt in informal caregivers: a predictive model based on structural equations.

Caregivers experience great stress, and coping can be one of the factors, which determine the extent of stress. The aim of the present paper is to analyze the effects of coping strategies on distress of the older adult's caregiver, including guilt as a mediating factor in those maladaptive strategies. The sample consisted of 201 informal caregivers of institutionalized older adults. The three constructs measured were: stress, guilt, and coping strategies. Results showed that strategies that have a better ability to reduce stress are active, positive reframing and acceptance; on the contrary, behavioral disengagement, self-distraction, self-blame and venting positively predicted the feeling of guilt that facilitated the perception of stress. Given the important association obtained between the experience of guilt and psychological distress in caregivers, it could be relevant to develop psychoeducational interventions with caregivers including techniques to reduce this feeling of guilt and develop cognitive behavioral strategies that facilitate adaptation.