Abstract 10992: Higher Social Vulnerability is Correlated With Maladaptive Coping in Informal Caregivers of Adults With Heart Failure

Abstract

Background: Social factors are known to influence health outcomes, but the mechanism by which these factors exert their influence is unclear. We explored the relationships between social vulnerability, stress, and coping in a sample of adults caring for patients with chronic heart failure (HF). Methods: Baseline data from a sample of 212 caregivers was analyzed. Social vulnerability (SV) was measured using a modification of the PRAPARE tool with 14 categories (i.e., sex, race, ethnicity, employment, veteran status, education, income, insurance, material security, transportation, social integration, social support, need to support others, early retirement for caregiving) tallied to yield a score between 0-22; higher scores indicate higher SV. Stress was measured with the Perceived Stress Scale (higher is worse). Coping styles were measured as active (scores: 0-45), avoidant (0-30), and minimization (0-30). Higher scores indicate more use of that style. Correlation analysis was used to explore relationships between SV, stress, and coping. Multivariable regression analysis with stepwise variable selection was used to identify which SV factors were the best determinants of coping styles. Results: The sample was predominately White (61.2 %), female (84.2%) older adults ( x 55.2 + 14 years). SV scores were low (range 0-14, 4.0 ± 2.2). SV exhibited a weak correlation with stress (r = .17, p = 0.01) and was not significantly associated with active coping (r = .13, p = 0.05). SV was most strongly correlated with avoidant (r = .30, p < 0.0001) and minimization coping (r = .25, p < 0.001) styles. In multivariable analysis, race, income, and ‘supporting others’ were the strongest predictors of avoidant coping; avoidance scores were 2.5 + 0.9 units greater for non-White caregivers (p<0.0001), 3.1 + 1.3 units greater (p<0.05) for low-income caregivers, and 1.9 + 0.6 units greater (p<0.001) for each additional person supported. Race was the strongest determinant of minimization coping; minimization scores were 4.5 + 0.8 units greater for non-White caregivers (p < 0.0001). Conclusion: These results suggest that caregivers with higher social vulnerability may be avoiding and minimizing to cope with the challenges associated with caregiving.