ABSTRACT
OBJECTIVES: The purpose of this study is to clarify causal relations between coping strategies and burnout in family caregivers of frail elders in Japan. METHODS: Baseline and 1-year follow-up interviews were conducted with 546 caregivers living in suburban Tokyo. Using newly refined measures, five coping strategies of caregivers (Keeping Their Own Pace, Positive Acceptance of Caregiving Role, Diversion, Informal Support Seeking, and Formal Support Seeking), and caregiver burnout were measured, as well as several confounding factors. RESULTS: After controlling for these confounding factors, results of cross-lagged effects modelling showed that adoption of a Diversion coping strategy decreased caregiver burnout, while increases in burnout decreased caregiver Positive Acceptance of Caregiving Role. CONCLUSIONS: The beneficial effect of an Adaptive Avoidance Coping strategy, Diversion, on caregiver mental health was confirmed in this two-wave longitudinal study. The mechanism by which Diversion appears to work is by containing caregiving stressors from completely spilling over into caregivers' personal lives. In addition, we also show that preventing a decline in caregiver mental health (i.e. an increase in burnout) allowed caregivers to more easily embrace the caregiving role and, as a result, elder care-recipients were better positioned to receive high quality care.
Subject(s)
Adaptation, Psychological , Caregivers/psychology , Fatigue/psychology , Frail Elderly , Aged , Data Collection , Female , Humans , Interviews as Topic , Longitudinal Studies , Male , Middle Aged , TokyoABSTRACT
This study examines stress-buffering effects of coping strategies among caregivers for Japanese impaired elderly. Eight hundred thirty-two valid responses obtained from primary caregivers of impaired persons aged 65 years old and over living in the community were analyzed. A path model was constructed with physical disability and cognitive impairment of the elderly as the primary stressor, caregiving captivity as the secondary stressor, followed by burnout. Main and interaction effects of five coping strategies were examined by regression analysis with interaction terms between the primary stressor, the secondary stressor, and five coping strategies. Four main effects of coping strategies were found: "Diversion" decreased caregiving captivity; "Keeping their own pace," "Positive acceptance of caregiving role," and "Diversion" decreased burnout. Two buffering effects were found: "Diversion" decreased caregiving captivity only at low level of Activities of Daily Living (ADL) impairment; "Keeping their own pace" buffered the detrimental effects of caregiving captivity for burnout.
