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Differences in stress-related ratings between research center and home environments in dementia caregivers using ecological momentary assessment

Published online by Cambridge University Press:  22 July 2011

Irina Fonareva ,
Alexandra M. Amen ,
Roger M. Ellingson  and
Barry S. Oken
Irina Fonareva
Affiliation:
Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA
Alexandra M. Amen
Affiliation:
Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
Roger M. Ellingson
Affiliation:
Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
Barry S. Oken*
Affiliation:
Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, Oregon, USA Department of Neurology, Oregon Health & Science University, Portland, Oregon, USA
*
Correspondence should be addressed to: Barry S. Oken, M.D., Oregon Health & Science University, Mail Code CR120, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA. Phone: +1 503-494-8873; Fax: +1 503-494-9520. Email: oken@ohsu.edu.
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Abstract

Background: Clinicians and researchers working with dementia caregivers typically assess caregiver stress in a clinic or research center, but caregivers’ stress is rooted at home where they provide care. This study aimed to compare ratings of stress-related measures obtained in research settings and in the home using ecological momentary assessment (EMA).

Methods: EMA of 18 caregivers (mean age 66.4 years ±7.8; 89% females) and 23 non-caregivers (mean age 66.4 years ±7.9; 87% females) was implemented using a personal digital assistant. Subjects rated their perceived stress, fatigue, coping with current situation, mindfulness, and situational demand once in the research center and again at 3–4 semi-random points during a day at home. The data from several assessments conducted at home were averaged for statistical analyses and compared with the data collected in the research center.

Results: The testing environment had a differential effect on caregivers and non-caregivers for the ratings of perceived stress (p < 0.01) and situational demand (p = 0.01). When tested in the research center, ratings for all measures were similar between groups, but when tested at home, caregivers rated their perceived stress as higher than non-caregivers (p = 0.02). Overall, caregivers reported higher perceived stress at home than in the research center (p = 0.02), and non-caregivers reported greater situational demand in the research center than at home (p < 0.01).

Conclusions: The assessment method and environment affect stress-related outcomes. Evaluating participants in their natural environment provides a more sensitive measure of stress-related outcomes. EMA provides a convenient way to gather data when evaluating dementia caregivers.

Keywords

caregiversecological momentary assessmentEMAolder adultsperceived stress
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 1 , January 2012 , pp. 90 - 98
Copyright
Copyright © International Psychogeriatric Association 2011

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