Effects of Burden and Family Resilience on the Family Adaptation of Family Caregivers of Elderly with Dementia

Hye Young Jang; Myungsun Yi

doi:10.7469/KJAN.2013.25.6.725

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Jang and Yi: Effects of Burden and Family Resilience on the Family Adaptation of Family Caregivers of Elderly with Dementia

Original Research

Korean J Adult Nurs 2013;25(6):725-735.

Published online: 18 December 2013

DOI: https://doi.org/10.7469/KJAN.2013.25.6.725

Effects of Burden and Family Resilience on the Family Adaptation of Family Caregivers of Elderly with Dementia

Hye Young Jang^1,, Myungsun Yi²

^¹Graduate School, College of Nursing, Seoul National University, Seoul

^²College of Nursing ․ Research Institute of Nursing Science, Seoul National University, Seoul, Korea

Corresponding author: Jang, Hye Young College of Nursing, Seoul National University,28 Yeongeon-dong, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-740-8829, Fax: +82-2-6442-8829, E-mail: gogo0108@snu.ac.kr

Received 12 August 201312 December 2013 Accepted 19 December 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to investigate the levels of burden, family resilience and adaptation of caregivers of elderly patients with dementia, and further to identify factors influencing their adaptation.

Methods

A cross-sectional descriptive study was designed. Data were collected from questionnaires distributed to 131 family caregivers of elderly patients who visited at the Centers for Dementia in Seoul during 2012~2013. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis, and stepwise multiple regression.

Results

The average age of the care giving subjects was 63.58, and 31.3% were male, and 41.2% were the spouses. Statistically significant relationships were found between burden and adaptation (r=-.38, p<.001), and between family resilience and adaptation (r=.52, p<.001), and between burden and family resilience (r=-.35, p=.001). Thirty percent of adaptation was explained by burden and family resilience. The most influencing factor to adaptation was family resilience which explained about 27% of the variance.

Conclusion

The results of the study clearly indicate that family resilience explains better than burden on adaptation of family caregivers. Thus, to develop more effective nursing intervention for family caregivers of elderly patients with dementia, it would be necessary to integrate family resilience in the programs. 27% is not that much and I wonder if we have to do more work to identify the factors that influence care giving.

Keywords: Dependency burden, Psychological resilience, Adaptation, Dementia, Caregivers

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Table 1.

General Characteristics of the Family Caregivers and the Elderly with Dementia (N=131)

Variables	Characteristics	Categories	n (%) or M±SD
Family caregivers	Gender	Male	41 (31.3)
	Gender	Female	90 (68.7)
	Age (year)		63.6±11.3
		＜50	13 (9.9)
		50~59	38 (29.0)
		60~69	35 (26.7)
		≥70	45 (34.4)
	Education	Elementary school	30 (22.9)
		Middle school	22 (16.8)
		High school	47 (35.9)
		≥College	32 (24.4)
	Marital status	Married	104 (79.4)
	Marital status	Others	27 (20.6)
	Religion	Yes	97 (74.0)
	Religion	No	34 (26.0)
	Occupation	Employed	34 (26.0)
	Occupation	Unemployed	97 (74.0)
	Perceived economic status	High	3 (2.3)
		Middle	70 (53.4)
		Low	58 (44.3)
	Relationship	Spouse	54 (41.2)
		Child	69 (52.7)
		Others	8 (6.1)
	Caring hours per day		14.96±8.43
		＜5	20 (15.3)
		5~9	21 (16.0)
		10~14	20 (15.3)
		15~19	14 (10.7)
		≥20	56 (42.7)
	Chronic disease	Yes	61 (46.6)
	Chronic disease	No	70 (53.4)
Elderly with dementia	Gender	Male	56 (42.7)
	Gender	Female	75 (57.3)
	Age (year)		80.0±8.5
		＜70	13 (9.9)
		70~79	45 (34.4)
		80~89	56 (42.7)
		≥90	17 (13.0)
	Years since diagnosis		4.53±3.09
		＜5	78 (59.5)
		5~9	40 (30.5)
		≥10	13 (10.0)

Table 2.

Dependency Burden, Family Resilience, and Family Adaptation (N=131)

Variables	Total score	Item score	Possible range	Actual range
Variables	M±SD	M±SD	Possible range	Actual range
Dependency burden	97.32±19.79	3.48±0.71	28~140	51~140
Social activity restriction	22.53±5.45	3.76±0.91	6~30	6~30
Negative change of elderly-caregiver relationship	24.11±5.87	3.45±0.84	7~35	11~35
Negative change of family relationship	15.28±5.06	3.06±1.01	5~25	5~25
Psychological burden	12.66±4.01	3.16±1.00	4~20	4~20
Financial and job-related burden	11.17±2.93	3.72±0.98	3~15	4~15
Health-related burden	11.56±2.69	3.86±0.90	3~15	3~15
Family resilience	183.63±24.55	2.78±0.37	66~264	119~247
Belief systems	50.97±7.381	2.83±0.41	18~72	28~69
Organizational patterns	72.78±10.19	2.70±0.38	27~108	45~102
Communication processes	59.88±8.79	2.85±0.42	21~84	32~81
Family adaptation	43.03±15.91	5.38±1.99	0~80	10~80

Table 3.

Differences of Family Adaptation according to General Characteristics of the Family Caregivers and the Elderly wit Dementia (N=131

Variables	Characteristics	Categories	Family adaptation
Variables	Characteristics	Categories	M±SD	t or F	p
Family caregivers	Gender	Male	42.91±18.58	-0.07	.944
	Gender	Female	43.12±13.72	-0.07	.944
	Age (year)	＜50	46.00±14.05	0.18	.912
		50~59	42.89±16.21
		60~69	42.97±16.98
		≥70	42.33±15.73
	Education	Elementary school	36.27±16.92	2.58	.056
		Middle school	43.95±11.74
		High school	44.51±14.99
		≥College	46.56±17.50
	Marital status	Married	44.04±16.51	1.65	.105
	Marital status	Others	39.15±12.89	1.65	.105
	Religion	Yes	42.72±16.24	-0.37	.709
	Religion	No	43.91±15.14	-0.37	.709
	Occupation	Employed	47.85±17.31	2.08	.040
	Occupation	Unemployed	41.34±15.13	2.08	.040
	Perceived economic status	High	56.67±20.26	1.70	.187
		Middle	44.06±16.54
		Low	41.09±14.73
	Relationship	Spouse	42.83±17.66	0.25	.782
		Child	42.74±14.61
		Others	46.88±15.74
	Caring hours per day	＜5	41.55±16.15	0.63	.641
		5~9	46.95±15.62
		10~14	45.10±15.16
		15~19	39.71±14.12
		≥20	42.18±16.78
	Chronic disease	Yes	41.79±16.83	0.83	.406
	Chronic disease	No	44.11±15.11	0.83	.406
Elderly with dementia	Gender	Male	42.91±18.58	-0.07	.944
	Gender	Female	43.12±13.72	-0.07	.944
	Age (year)	＜70	43.77±16.39	0.21	.887
		70~79	44.07±17.33
		80~89	42.79±15.71
		≥90	40.53±13.09
	Years since diagnosis	＜5	42.45±16.14	0.13	.881
		5~9	43.88±15.07
		≥10	43.92±18.11

Table 4.

Correlation between Dependency Burden, Family Resilience, and Family Adaptation (N=131)

Variables	1	2	3	3-1	3-2	3-3
Variables	r (p)	r (p)	r (p)	r (p)	r (p)	r (p)
1. Family adaptation	1
2. Dependency burden	-.38	1
	(＜.001)
3. Family resilience	.52	-.35	1
	(＜.001)	(＜.001)
3-1. Belief systems	.46	-.31	.93	1
	(＜.001)	(＜.001)	(＜.001)
3-2. Organizational patterns	.53	-.35	.94	.81	1
	(＜.001)	(＜.001)	(＜.001)	(＜.001)
3-3. Communication processes	.45	-.32	.93	.81	.79	1
	(＜.001)	(＜.001)	(＜.001)	(＜.001)	(＜.001)

Table 5.

Factors Influencing Family Adaptation (N=131)

Variables	B	SE	β	t	p	Tolerance	VIF
(Constant)	8.55	12.86		0.67	.507
Family resilience	0.29	0.05	.44	5.61	＜.001	.88	1.14
Dependency burden	-0.18	0.06	-.23	-2.90	.004	.88	1.14

²=.31, Adjusted R²=.30, F=29.30, p＜.001, Durbin-Watson=2.05

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