Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-10-30T10:09:16.076Z Has data issue: false hasContentIssue false

Self-efficacy moderation and mediation roles on BPSD and social support influences on subjective caregiver burden in Chinese spouse caregivers of dementia patients

Published online by Cambridge University Press:  16 June 2014

Shuying Zhang
Affiliation:
Tongji University School of Medicine, Shanghai, China
Qihao Guo
Affiliation:
Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology, Shanghai Medical College, Fudan University, Shanghai, China
Helen Edwards
Affiliation:
Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
Patsy Yates
Affiliation:
Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
Chunbo Li*
Affiliation:
Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Institute of Mental Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
*
Correspondence should be addressed to: Chunbo Li, Shanghai Mental Health Center, 600 Wan Ping Nan Rd, Shanghai 200030, China. Phone: 86-213477 3243; Fax: 86-21-6438 7986. Email: chunbo_li@163.com

Abstract

Background:

This study aims to explore moderation and mediation roles of caregiver self-efficacy between subjective caregiver burden and (a) behavioral and psychological symptoms (BPSD) of dementia; and (b) social support.

Methods:

A cross-sectional study with 137 spouse caregivers of dementia patients was conducted in Shanghai. We collected demographic information for the caregiver–patient dyads, as well as information associated with dementia-related impairments, caregiver social support, caregiver self-efficacy, and SF-36.

Results:

Multiple regression analysis showed that caregiver self-efficacy was a moderator both between BPSD and subjective caregiver burden, and social support and subjective caregiver burden. Results also showed a partial mediation effect of caregiver self-efficacy on the impact of BPSD on subjective caregiver burden, and a mediation effect of social support on subjective caregiver burden. Caregiver self-efficacy and subjective burden significantly influenced BPSD and social support.

Conclusion:

Caregiver self-efficacy played an important role in the paths by which the two factors influenced subjective burden. Enhancing caregiver self-efficacy for symptom management (particularly BPSD) can be an essential strategy for determining interventions to support dementia caregivers in China, and possibly in other countries.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Au, A. et al. (2009). Social support and well-being in dementia family caregivers: the mediating role of self-efficacy. Aging & Mental Health, 13, 761768.CrossRefGoogle ScholarPubMed
Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York: Freeman.Google Scholar
Baron, R. M. and Kenny, D. A. (1986). The moderator-mediator distinction in social psychological research. Journal of Personality and Social Psychology, 51, 11731182.CrossRefGoogle ScholarPubMed
Clay, O. J., Roth, D. L., Wadley, V. G. and Haley, W. E. (2008). Changes in social support and their impact on psychosocial outcome over a 5-year period for African American and White dementia caregivers. International Journal of Geriatric Psychiatry, 23, 857862.CrossRefGoogle Scholar
Cooper, C., Balamurali, T. B. S. and Livingston, G. (2007). A systematic review of the prevalence and covariates of anxiety in caregivers of people with dementia. International Psychogeriatrics, 19, 175195.CrossRefGoogle ScholarPubMed
Cuijpers, P. (2005). Depressive disorders in caregivers of dementia patients: a systematic review. Aging & Mental Health, 9, 325330.CrossRefGoogle ScholarPubMed
Depp, C., Sorocco, K., Kasl-Godley, J., Thompson, L., Rabinowitz, Y. and Gallagher-Thompson, D. (2005). Caregiver self-efficacy, ethnicity, and kinship differences in dementia caregivers. The American Journal of Geriatric Psychiatry, 13, 787794.CrossRefGoogle ScholarPubMed
Etters, L., Goodall, D. and Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20, 423428.CrossRefGoogle ScholarPubMed
Finkel, S., Costa, E., Silva, J., Cohen, G., Miller, S. and Sartorius, N. (1997). Behavioral and psychological signs and symptoms of dementia: A consensus statement on current knowledge and implications for research and treatment. International Journal of Geriatric Psychiatry, 12, 10601061.3.0.CO;2-M>CrossRefGoogle Scholar
Fuh, J. L., Liu, C. Y., Wang, S. J., Wang, H. C. and Liu, H. C. (1999a). Revised memory and behavior problems checklist in Taiwanese patients with Alzheimer's disease. International Psychogeriatrics, 11, 181189.CrossRefGoogle ScholarPubMed
Fuh, J. L., Wang, S. J., Liu, H. C. and Wang, H. C. (1999b). The caregiving burden scale among Chinese caregivers of Alzheimer patients. Dementia and Geriatric Cognitive Disorders, 10, 186191.CrossRefGoogle ScholarPubMed
Gonyea, J., O’Connor, M., Carruth, A. and Boyle, P. (2005). Subjective appraisal of Alzheimer's disease caregiving: The role of self-efficacy and depressive symptoms in the experience of burden. American Journal of Alzheimer's Disease & Other Dementias, 20, 273280.CrossRefGoogle ScholarPubMed
Gottlieb, B. H., and Rooney, J. A. (2003). Validation of the RIS eldercare self-efficacy scale. Canadian Journal on Aging, 22, 95107.CrossRefGoogle Scholar
Mok, C. C. M., Siu, A. M. H., Chan, W. C., Yeung, K. M., Pan, P. C., and Li, S. W. (2005). Functional disabilities profile of Chinese elderly people with Alzheimer's disease - A validation study on the Chinese version of the Disability Assessment for Dementia. Dementia and Geriatric Cognitive Disorders, 20, 112119.CrossRefGoogle ScholarPubMed
Pearlin, L. I., Mullan, J. T., Semple, S. J., and Skaff, M. M. (1990). Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist, 30, 583594.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2003a). Differences between caregivers and noncaregivers in psychological health and physical health: a meta-analysis. Psychology and Aging, 18, 250267.CrossRefGoogle ScholarPubMed
Pinquart, M. and Sörensen, S. (2003b). Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: A meta-analysis. Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 58B, 112128.CrossRefGoogle Scholar
Pinquart, M. and Sörensen, S. (2007). Correlates of physical health of informal caregivers: a meta-analysis. Journals of Gerontology Series B: Psychological Sciences & Social Sciences, 62B, 126137.CrossRefGoogle Scholar
Rabinowitz, Y. G., Mausbac, B. T. and Gallagher-Thompson, D. (2009). Self-efficacy as a moderator of the relationship between care recipient memory and behavioral problems and caregiver depression in female dementia caregivers. Alzheimer Disease and Associated Disorders, 23, 389394.CrossRefGoogle ScholarPubMed
Shyu, Y. I. L., Tang, W. R., Liang, J. and Weng, L. J. (2006). Psychometric testing of the Social Support Survey on a Taiwanese sample. Nursing Research, 55, 411417.CrossRefGoogle ScholarPubMed
Sobel, M E. (1986) Some new results on indirect effects and their standard errors in covariance structure. Sociological Methodology, 16, 159186.CrossRefGoogle Scholar
Steffen, A. M., McKibbin, C., Zeiss, A. M., Gallagher-Thompson, D. and Bandura, A. (2002). The revised scale for caregiving self-efficacy: reliability and validity studies. The Journals of Gerontology, 57B, 7486.CrossRefGoogle Scholar
Zeiss, A., Gallagher-Thompson, D., Lovett, S., Rose, J. and McKibbin, C. (1999). Self-efficacy as a mediator of caregiver coping: development and testing of an assessment model. Journal of Clinical Geropsychology, 5, 221230.CrossRefGoogle Scholar
Zhang, S. Y., Edwards, H., Yates, P., Elder, R. and Guo, Q. H. (2012). Development of self-efficacy questionnaire for Chinese family caregivers. International Journal of Mental Health Nursing, 21, 358365.CrossRefGoogle ScholarPubMed
Zhang, S. Y., Edwards, H., Yates, P., Guo, Q. H. and Li, C. B. (2013a). Partial mediation role of self-efficacy between positive social interaction and mental health in family caregivers for dementia patients in Shanghai. PLOS One, 8.CrossRefGoogle ScholarPubMed
Zhang, S. Y., Edwards, H., Yates, P., Ruth, E. and Guo, Q. H. (2013b). Preliminary reliability and validity testing of a self-efficacy questionnaire for Chinese family caregivers. Aging & Mental Health, 17, 630637.CrossRefGoogle ScholarPubMed
Zhang, S. Y., Edwards, H., Yates, P., Li, C. B and Guo, Q. H. (2014). Self-efficacy partially mediates between social support and health-related quality of life in family caregivers for dementia patients in Shanghai. Dement Geriatric Cognitive Disorders, 37, 3444.CrossRefGoogle ScholarPubMed
Zhang, Z. X. et al. (2004) A caregiver survey in Beijing, Xian, Shanghai and Chengdu: Health service status for the elderly with dementia. Acta Academiae Medicinae Sinicae, 26, 116121.Google Scholar