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Chu, Tak, and Kim: Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis
Original Article

J Korean Acad Nurs 2018;48(4):454-464.

Published online: 15 January 2018

DOI: https://doi.org/10.4040/jkan.2018.48.4.454

Factors Influencing Psychosocial Well-Being in Family Caregivers of People with Amyotrophic Lateral Sclerosis

Hyeon Sik Chu1, 2, Young Ran Tak1, , Seung Hyun Kim2, 3

1College of Nursing, Hanyang University, Seoul

2Cell Therapy Center for Neurological Disorders, Hanyang University Hospital, Seoul

3Department of Neurology, College of Medicine, Hanyang University, Seoul, Korea

Address reprint requests to : Tak, Young Ran College of Nursing, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea Tel: +82-2-2220-0709 Fax: +82-2-2295-2074 E-mail: yrtak@hanyang.ac.kr

Received 13 March 2018       Revised 31 July 2018       Accepted 1 August 2018

Copyright © 2018 Korean Society of Nursing Science

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

The purpose of this study was to identify factors influencing psychosocial well-being in family caregivers of patients with amyotrophic lateral sclerosis (ALS).

Methods

A descriptive correlational design was used. The transactional model of stress and coping was used to investigate the psychosocial well-being of 137 family caregivers of patients with ALS. Data were collected through self-reported questionnaires from January to November 2016. Data were analyzed using an independent t-test, one-way ANOVA, Pearson's correlation, and hierarchical multiple regression analysis with the SPSS WIN 21.0 program.

Results

The regression model had an adjusted R2 of .49, which indicated that meaning-focused coping, social support, ALS patient-family caregiver relationship (especially a spousal relationship), and tracheostomy were significant predictors of caregivers’ psychosocial well-being.

Conclusion

Meaning-focused coping and social support significantly influenced caregivers’ psychosocial well-being. Therefore, interventions to improve caregivers’ psychosocial well-being must focus on increasing meaning-focused coping and social support resources.

Keywords: Amyotrophic lateral sclerosis, Family caregivers, Psychological adaptation, Social adjustment

References

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Figure 1.
Conceptual framework of this study.
jkan-48-454f1.tif
Table 1.
The Difference of Psychosocial Well-Being by Family Caregivers’ Socio-Demographic, Caregiving-Related and Clinical Variables (N=137)
Characteristics n (%) or M±SD Psychosocial Well-being t or F p
M±SD
Socio-demographic variables
  Age (yr) 49.41±12.59 -1.87 .063
    ≤ 54 88 (64.2) 41.52±10.63
    ≥ 55 49 (35.8) 45.33±12.70
  Gender 1.77 .079
    Male 56 (40.9) 44.96±09.82
    Female 81 (59.1) 41.44±12.40
  Marital status 0.02 .988
    Single 23 (16.8) 42.91±10.36
    Partnered 114 (83.2) 42.87±11.77
  Educational attainment 0.83 .408
    ≤ High school 76 (55.5) 43.61±12.49
    ≥ College 61 (44.5) 41.97±10.18
  Religion 2.13 .035
    Yes 73 (53.3) 44.82±12.23
    No 64 (46.7) 40.67±10.28
  Monthly household income† (10,000 won) 0.76 .469
    <100 32 (24.4) 42.38±11.34
    100~299 49 (37.4) 41.32±12.98
    ≥300 50 (38.2) 44.18±10.39
  Physical health status (0~100) 54.01±20.43
Caregiving-related variables
  Relationship to care-recipient 1.83 .165
    Spouse 100 (73.0) 42.66±11.77
    Adult-child 32 (23.4) 42.09±10.71
    Other 5 (3.6) 52.40±08.08
  Duration of caregiving (month)† 28.37±26.40 0.40 .670
    ≤12 43 (32.3) 43.07±11.16
    13~36 54 (40.6) 41.80±10.87
    ≥37 36 (27.1) 43.99±13.15
  Caregiving time (hours/day)† 13.24±7.91 2.40 .094
    ≤8 49 (36.3) 45.38±09.00
    9~16 35 (25.9) 39.89±13.26
    ≥17 51 (37.8) 42.55±12.08
  Use of formal caregiving service -1.59 .113
    Yes 58 (42.3) 41.06±12.51
     Personal assistant for disabled 31 (22.6)
     Care helper 15 (10.9)
     Private caregiver 12 (8.8)
    No 79 (57.7) 44.22±10.60
Clinical variables
  Functional status (0~48) 21.47±13.03
  Behavioral-psychological symptoms (0~36) 6.75±5.79
  ALS Type -0.10 .918
    Bulbar onset ALS 28 (20.4) 42.68±13.03
    Spinal onset ALS 109 (79.6) 42.93±11.15
  Gastrostomy -2.34 .021
    Yes 45 (32.8) 39.64±13.00
    No 92 (67.2) 44.46±10.42
  Tracheostomy -2.73 .007
    Yes 40 (29.2) 38.00±13.30
    No 97 (70.8) 44.56±10.30

ALS=Amyotrophic lateral sclerosis; M±SD=Mean standard deviation.

† Missing value was excluded.

Table 2.
Descriptive Statistics of the Measured Variables (N=137)
Variable M±SD Range Observed range
Social support 40.54±9.10 12~60 13~60
Meaning-focused coping 21.83±7.83 0~36 0~36
Psychosocial well-being 42.88±11.51 14~70 15~68

M±SD=Mean standard deviation.

Table 3.
Inter-Correlation Coefficients among the Measured Variables (N=137)
Variable 1 2 3 4 5 6 7
1. Functional status 1 -.17 (.044) -.26 (.003) .24 (.005) .13 (.131) .13 (.145) .20 (.020)
2. Behavioral-psychological symptoms 1 .12 (.157) -.17 (.054) -.11 (.198) -.30 (<.001) -.23 (.007)
3. Caregiving time 1 -.12 (.162) -.25 (.004) .03 (.717) -.06 (.481)
4. Caregiver’s physical health status 1 .20 (.017) .18 (.039) .33 (<.001)
5. Social support 1 .23 (.006) .44 (<.001)
6. Meaning-focused coping 1 .58 (<.001)
7. Psychosocial well-being 1
Table 4.
Hierarchical Regression Analysis for Psychosocial Well-Being in Family Caregivers of Patients with ALS (N=137)
Predictors Model I Model II Model III Model IV
B S.E. β (p) B S.E. β (p) B S.E. β (p) B S.E. β (p)
Constant 49.11 4.57 38.12 6.24 17.44 6.90 　 13.43 6.03
Functional status -0.05 0.14 .06 (.073) 0.02 0.14 .03 (.876) 0.02 0.13 .02 (.883) -0.04 0.11 -.04 (.738)
Behavioral-psychological -0.44 0.17 -.22 (.010) -0.28 0.17 -.14 (.091) -0.24 0.15 -.12 (.117) -0.07 0.14 -.03 (.619)
symptoms
Gastrosotmy (Ref: No) -1.62 3.37 -.07 (.632) -1.69 3.22 -.07 (.600) -0.94 2.93 -.04 (.749) 0.60 2.56 .03 (.816)
Tracheostomy (Ref: No) -5.46 3.48 -.22 (.118) -3.46 3.57 -.14 (.334) -3.36 3.25 -.13 (.303) -6.24 2.86 -.25 (.031)
Caregiver’s gender (Ref: Male) -3.79 1.98 -.16 (.059) -5.30 1.83 -.23 (.004) -2.88 1.63 -.12 (.080)
Religion (Ref: No) 2.51 0.88 .24 (.005) 1.94 0.81 .18 (.017) 1.28 0.71 .12 (.072)
Relationship to patient -3.39 2.25 -.13 (.135) -1.54 2.08 -.06 (.460) -3.93 1.85 -.15 (.035)
(Ref: Non-spousal)
Caregiving time 0.04 0.13 .03 (.767) 0.17 0.12 .11 (.172) 0.07 0.11 .05 (.488)
Physical health status 0.13 0.05 .23 (.007) 0.10 0.04 .17 (.026) 0.07 0.04 .13 (.058)
Social support 0.52 0.10 .41 (<.001) 0.36 0.09 .29 (<.001)
Meaning-focused coping 0.67 0.11 .46 (<.001)
R2 (△R2) .10 .24 (.14) .37 (.13) .53 (.16)
Adjusted R2 .07 .18 .33 .49
F(p) 3.72 (.007) 4.38 (.001) 7.54 (<.001) 12.80 (<.001)

Ref=Reference; S.E.=Standard error.

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