Academic journal article International Journal of Clinical and Health Psychology

Inventory of Overburden in Alzheimer's Patient Family Caregivers with No Specialized Training

Academic journal article International Journal of Clinical and Health Psychology

Inventory of Overburden in Alzheimer's Patient Family Caregivers with No Specialized Training

Article excerpt

At the present time, Alzheimer-type dementia continues to be one of the most frequent causes of dependence of the older population, posing a challenge for public health (World Health Organization & Alzheimer's Disease International, 2012), and therefore, requiring coordinated worldwide action by responsible agencies (Prince et al., 2015) (World Health Organization, 2015). According to recent reports (Alzheimer's Association, 2016), caregivers of Alzheimer's Disease and other dementia patients provide continued attention during a longer period than caregivers of persons who are dependent for other causes. The considerable demand on caregivers of a dependent relative, for example, on the activities of daily life (Gázquez, Pérez-Fuentes, Mercader, & Molero, 2011) have negative consequences to the health of the caregiver (Berglund, Lytsy, & Westerling, 2015) and their quality of life (Díaz-Prieto & García-Sánchez, 2015; Flores, Jenaro, Moro, & Tomsa, 2014). The volume of research work analyzing the profile of the family caregiver has multiplied in recent years (Brown & Brown, 2014) mediated by the boost in quality of publications in social sciences (García-Pereira & Quevedo-Blasco, 2015). In this field, the concept of caregiver burden is of special interest and requires conceptual and dimensional consensus. However, Martín-Carrasco, Domínguez-Panchón, Muñoz-Hermoso, González-Fraile, and Ballesteros-Rodríguez (2013) warned that the burden on the family caregiver is being evaluated from different approaches, impeding comparison of the results of research.

Since the first definition of caregiver burden (Grad & Sainsbury, 1963), many attempts have been made at delimiting the concept using different models to include its possible dimensions. Poulshockand Deimling (1984) proposed a multidimensional approach to this burden, where different dimensions were interrelated (patient problems, burden and its impact on the caregiver). Montgomery, Stull & Borgatta (1985) differentiated between the ''objective burden'' or facets related to caregiving, and ''subjective burden'' or the caregiver's perception of the impact the objective burden has on their physical, psychological and social condition.

Caregiver stress is often considered a powerful predictive factor of burden. The Transactional Model of Stress and Coping by Lazarus and Folkman (1984) established a relationship between the caregiver's evaluation of the situation (demand) and their ability to cope with it. In other cases, the caregiving burden is related to the patient's problems and deterioration. Pearlin, Mullan, Semple, and Skaff (1990) defined burden as the caregiver's subjective evaluation of the objective demands made by the patient (patient's physical and cognitive deterioration, functional disability and behavioral problems). Later, Sandín (1999), in his stress process model, included variables that maintain a modulating function of the response to stress, among them, psychosocial demands and state of health. In other dependent populations, daily stress is referred to as a risk to mental health (Schönfeld, Brailovskaia, Bieda, Zhang, & Margraf, 2016). Several personal resources having a protective effect against the negative influence of stress on family caregivers have been identified (Gázquez, Pérez-Fuentes, Molero, & Mercader, 2015; Lanzón & Díaz, 2015; OteroLópez, Villardefrancos, Castro, & Santiago, 2014).

The goal, as stated by Zarit, Femia, Kim and Whitlatch (2010), should therefore be to design evaluation instruments which fit to the caregiver's reality and enable intervention to be directed at specific targets, and not a generic problem, which is only theoretically common to all caregivers. Thus, the heterogeneity of the caregivers' profiles and their needs (Rosa et al., 2010) requires studies testing intervention effectiveness (Chacón, Sanduvete, Portell, & Anguera, 2013) and the inclusion of new therapeutic variables (Bornas, Noguera, Pincus, & Buela-Casal, 2014; Vives, Orte, & Sánchez, 2016). …

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