Levels Of Neuropsychiatric Symptoms Research Articles

WHAT DETERMINES THE USE OF MEANING FOCUSED COPING IN DEMENTIA CAREGIVING?

Meaning-focused coping has been identified as an important factor contributing to more positive adjustment and health outcomes for family caregivers of persons with dementia. Yet, there is less evidence about what determines the use of this coping strategy. Based on the Meaning Making Model, this quantitative exploratory study identified the relationship between meaning focused coping and intrinsic motivation towards caregiving, quality of relationship between the care dyads and level of religiosity. Two hundreds and five family caregivers of PWD were recruited from a geriatric clinic from March 2018 – Feb 2019. A battery of questionnaires including the Meaning-Focused Coping Scale, Relationship Quality Scale, the Duke University Religion Index and Intrinsic Motivations to Care was administered in face-to-face interview. By using hierarchical regression analysis to control the effects of caregivers’ demographic profile, caregiving history, clinical severity of dementia, and level of neuro-psychiatric symptoms, the results indicated that a higher intrinsic motivation to caregiving (β = 1.457, p = 0.044), better dyadic relationship quality (β = 0.768, p = 0.004) and a higher level of religiosity (β = 0.969, p = 0.001) are independently related to a higher likelihood of using meaning-focused coping. The findings shift the paradigm of caregiver support from a deficit model to helping them to appraise the meaning of caregiving in dyadic relational, spiritual and motivational perspectives. The application of strength-based and person-centered approach to caregiver supportive program will be discussed.

How Stable Is Coping in Patients with Neuropsychiatric Symptoms after Acquired Brain Injury? Changes in Coping Styles and Their Predictors in the Chronic Phase.

The objective of the study was to examine changes in coping and their predictors in patients in the chronic phase after an acquired brain injury with prominent neuropsychiatric symptoms. Patients with brain injury were recruited from consecutive admissions to the outpatient clinics of four mental health centers in the Netherlands. Patients received psychoeducation and/or one or more individual treatment sessions that were not targeting coping styles. Forty-two patients and thirty-two significant others participated. Patients reported a significantly greater use of passive and avoidance coping than both the general population and patients with brain injury without neuropsychiatric symptoms. There were statistically significant increases in avoidance coping between T1 and T2 (t = 2.0; p < 0.05). Less neuropsychiatric symptoms at T1 were associated with increases in avoidance coping, and more neuropsychiatric symptoms were associated with decreases in avoidance coping (β = -3.3; p < 0.001). Patients' underestimation of their deficits at T1 was associated with greater increases in active coping (β = -2.33; p < 0.05) than were patients' accurate estimation and overestimation of deficits at T1. Self-reported executive functioning at T1 was not associated with changes in coping. In conclusion, avoidance coping increased in the chronic phase after brain injury. The changes in coping could partially be explained by the level of neuropsychiatric symptoms and the level of self-awareness but not by self-reported executive functioning, which should be considered in treatment programs.

Toward a Better Understanding of Psychological Well‐Being in Dementia Caregivers: The Link Between Marital Communication and Depression

Dementia research has frequently documented high rates of caregiver depression and distress in spouses providing care for a partner suffering from dementia. However, the role of marital communication in understanding caregiver distress has not been examined sufficiently. Studies with healthy couples demonstrated an association between marital communication and the partners' psychological well-being, depressiveness, respectively (e.g., Heene, Buysee, & Van Oost, 2005). The current study investigates the relationship between caregiver depression and communication in 37 couples in which the wives care for their partners with dementia. Nonsequential and sequential analyses revealed significant correlations between caregiver depression and marital communication quality. Caregivers whose husbands used more positive communication reported less depression and distress. Additionally, caregiver depression was negatively correlated with rates of positive reciprocal communication indicating dependence between the couples' interaction patterns. This study is one of the first to illustrate the relevance of spousal communication in understanding caregiver distress and depression.