Stress-buffering Effect of Coping Strategies on Interrole Conflict among Family Caregivers of People with Dementia.

OBJECTIVES: To examine the stress-buffering effect of coping strategies on the adverse effects of interrole conflict on the mental health of employed family caregivers, and clarify the moderating role of attentional control on this stress-buffering effect. METHODS: Data were drawn from a two-wave longitudinal online survey of employed Japanese family caregivers of people with dementia (263 males, 116 females; age 51.54 ± 9.07 years). We assessed interrole conflict, coping strategies, attentional control, mental health variables (psychological strain and quality of life), and confounding factors. RESULTS: Hierarchical regression analyses controlled for sociodemographic factors found formal support seeking had a stress-buffering effect for strain- and behavior-based caregiving interfering with work (CIW) only on psychological strain, and was moderated by attentional control. Single slope analysis showed higher CIW was related to higher psychological strain in those with greater use of formal support seeking and lower attentional control, but not in those with higher attentional control. CONCLUSIONS: Greater use of formal support seeking weakens the adverse effects of strain- and behavior-based CIW on psychological strain in people with high attentional control. CLINICAL IMPLICATIONS: Attentional control is a key factor in the stress-buffering effect of formal support seeking on strain- and behavior-based CIW.

Can self-efficacy ameliorate interrole conflict among employed family caregivers? A moderated mediation approach.

OBJECTIVES: This study examined the moderation effect of different dimensions of self-efficacy on the way in which various types of interrole conflict mediate between caregiving demands and the mental health of employed family caregivers. METHOD: Using a moderated mediation approach, we examined the moderation effect of self-efficacy on interrole conflict's mediation between caregiving demands and mental health (psychological strain and quality of life) in a sample of Japanese employed family caregivers who regularly provide care at home (263 males aged 53.14 ± 8.28 years and 116 females aged 47.92 ± 9.77 years). RESULTS: Increased self-efficacy in managing dementia and in self-care were correlated with lower caregiving demands and better mental health among family caregivers. Self-efficacy in managing dementia was also positively correlated with increased interrole conflict. Increased caregiving demands were related to higher psychological strain in those with higher (+1SD), but not lower (-SD) self-efficacy in managing dementia. CONCLUSION: Self-efficacy does not play a protective role in managing the effect of caregiving demands on interrole conflict. It also does not appear to protect against any indirect effects of caregiving demands on the mental health of employed family caregivers.

Effect of anxiety on antero-posterior postural stability in patients with dizziness.

The purpose of this study was to investigate the effect of anxiety on the postural stability of a variety of dizzy patients during upright standing. To address this issue, 54 patients complaining of dizziness were enrolled in this study. The degree of anxiety in patients was evaluated on the basis of a routine vestibular examination together with their dizziness handicap inventory (DHI) scores as well as the hospital anxiety and depression scale (HADS). The patients were divided into 3 groups. If there was no vestibular dysfunction, they were defined as psychogenic (PSY) (N=16). The remaining subjects were further divided on the basis of their HADS score. If the score of A (anxiety) was less than 5, they are defined as organic (ORG) (N=25), and the rest were defined as a combination of psychogenic and organic (PSY+ORG) (N=13). Posturographic measurements were performed in a quiet and stable standing position on a force platform, as one of the vestibular examinations. The total length, the area of body sway, and the ratio of maximum perturbation of antero-posterior axis (A/P ratio) were registered. Spectrum analyses of the left-right axis and antero-posterior axis were also performed by using the fast Fourier transform (FFT) method of body sway. We found a significant correlation between anxiety and postural instability in the antero-posterior axis in all subjects as a group and in either group PSY or PSY+ORG. However, no significant correlation was found in group ORG. Using power spectrum analysis (FFT), we identified 3 frequency components of postural sway: group A (0.02-0.21Hz), group B (0.22-2.01Hz), and group C (2.01-10Hz). Statistical significance of the data was examined by ANOVA. Group C reflected somatosensory inputs, and group A reflected vestibular inputs. The power of group C decreased in the high anxiety group, whereas the power of group A increased in the high anxiety group. These phenomena disappeared in the eyes-closed condition. Our study shows that the effect of visual input on vestibular and somatosensory input is affected by anxiety. In conclusion, our results indicate that anxiety affects the postural perturbation in the antero-posterior axis and that anxiety possibly affects the interactions of visual inputs with vestibular and somatosensory inputs in the maintenance of postural balance in patients complaining of dizziness.