Taiwanese Caregivers Research Articles

Parenting stress, anxiety, and sources of acquiring knowledge in Taiwanese caregivers of children with attention-deficit/hyperactivity disorder

BackgroundThis survey study investigated the types of sources other than medical professionals (e.g., social media) that the caregivers of children with attention-deficit/hyperactivity disorder (ADHD) use to acquire knowledge about ADHD and investigated the association between the use of such information sources and caregiver parenting stress and anxiety in Taiwan.MethodsA total of 213 caregivers of children with ADHD participated in this study. The sources that the caregivers used to acquire knowledge about ADHD other than medical professionals were investigated. Caregiver parenting stress was assessed using the Parenting Stress Index, and caregiver anxiety was assessed using the Beck Anxiety Inventory. The associations of the types of sources used and total number of source use with caregiver parenting stress and anxiety were investigated using multivariate linear regression analysis.ResultsThe most common source of knowledge other than medical professionals was teachers (55.4%), followed by social media (52.6%), traditional media (50.7%), friends (33.8%), caregivers of other children (21.1%), and family members (18.3%). The caregivers’ mean total number of using sources of knowledge about ADHD other than medical professionals was 2.32. Acquiring knowledge about ADHD from social media was significantly associated with caregiver parenting stress. Additionally, acquiring knowledge about ADHD from caregivers of other children was significantly associated with caregiver parenting stress and anxiety, as was the frequency of using sources of knowledge about ADHD other than medical professionals.ConclusionThe caregivers of children with ADHD acquired knowledge about ADHD from multiple sources. Acquiring knowledge about ADHD from social media was significantly associated with caregiver parenting stress. The number of sources of knowledge about ADHD was significantly associated with caregiver parenting stress and anxiety.

Abstract 11202: A Biomarker of Stress and Self-Reported Stress Related to Caregiving Predict Poor Quality of Life in Caregivers of Patients With Heart Failure

Introduction: Caregivers of patients with heart failure (HF) are at high risk of low quality of life due to stress-related to caregiving. Self-reported measures are commonly used to assess relatively long-term stress related to caregiving. Still, biological markers of stress, a short-term stress measure, are rarely used. There is limited knowledge on whether both can predict the quality of life in caregivers of patients with HF. Hypothesis: The stress biomarker (serum cortisol) and subjective distress related to caregiving (Caregiver Burden Inventory) predict the quality of life in caregivers of patients with HF. Methods: In this cross-sectional study, Taiwanese caregivers of patients with HF completed surveys including stress-related caregiving and quality of life measured by the Caregiving Burden Inventory and the Short Form-36, respectively. A blood sample for serum cortisol was collected between 9 and 12 AM. Independent t-test and multivariable linear regression analysis were conducted adjusting for age, gender, education, marital status, relationship with care-recipient and depressive symptoms (Patient Health Questionnaire). Results: Of the 113 caregivers (mean age 54.5 years, 70.8% female, 78% married/cohabitated), 59% cared for patients with NYHA class III/V. Single caregivers had higher serum cortisol levels than married caregivers (11.4 vs. 8.5, p =.002). Males had a significantly higher serum cortisol level than females (10.7 vs. 8.5, p =.010), but males reported a lower caregiver burden than females (1.3 vs. 1.6, p =.049). Both serum cortisol (β =-.36, P=.012) and caregiver burden (β = -.29, P= .018) were significant predictors of physical well-being. Serum cortisol (β= -.28, p=.026) and caregiver burden (β =-.25, p =.027) also significantly predicted mental well-being. Conclusions: Although stress levels are different by caregivers’ characteristics, both cortisol level and self-report caregiver burden have similar predictability of quality of life in caregivers of patients with HF. Reducing stress and caregiver burden is necessary to improve the quality of life in this population.

Second Wave of the Study of Taiwanese Caregivers of Children with ADHD in the COVID-19 Pandemic: Intentions to Vaccinate Their Children for COVID-19, and Related Factors.

The second wave of the Study of Taiwanese Caregivers of Children with Attention-Deficit/Hyperactivity Disorder (ADHD) in the COVID-19 Pandemic was conducted at the time of a severe COVID-19 outbreak. The aims of this study were to compare the level of the intentions of caregivers of children with ADHD to vaccinate their children between the first and second waves of study, as well as to examine the COVID-19 pandemic and non-COVID-19 pandemic factors related to caregivers’ intentions. In total, 252 caregivers of children with ADHD completed the structured questionnaires, including the Drivers of COVID-19 Vaccination Acceptance Scale; the Risk Perception of the COVID-19 Scale; caregivers’ Difficulties in Asking Their Children to Adopt Self-Protective Behavior Scale; the Brief Symptom Rating Scale; the Parental Bonding Instrument; the Swanson, Nolan, and Pelham version IV Scale; and the questionnaires for the intentions to vaccinate their children and child’s medication use for treating ADHD. The results demonstrated that 82.5% of caregivers reported their willingness to vaccinate their children definitely or under doctors’ recommendation; the level of intentions to vaccinate significantly increased compared with that of caregivers in the first wave of the study. Caregivers’ drivers of COVID-19 vaccination uptake, namely, values, impact, and autonomy but not knowledge; being male caregivers; being caregivers of girls; and the older age of the children were positively associated with caregiverscaregivers’ intentions. The specific intervention programs for enhancing caregivers’ intentions should be specified according to the sex and age of caregivers and of the children with ADHD. The Drivers of COVID-19 Vaccination Uptake should be also the target of intervention for enhancing caregivers’ intentions through strengthening caregivers’ acceptance of the COVID-19 vaccines’ values, positive impact and autonomy to vaccinate their children.

Finding a balance in family caregiving for people with dementia: A correlational longitudinal study.

The "Finding a Balance Point" framework was used to explore the caregiving process over time for family caregivers of people with dementia in Taiwan. This study aimed to: (a) identify Taiwanese caregivers' different balance trajectories; (b) explore predictors of trajectory group membership; and (c) examine associations of different balance trajectories with caregiving outcomes. A correlational longitudinal design was used. Data were collected from 200 family caregivers' self-completed questionnaires and they were followed over 2years (June 2015-May 2017). Discrete balance trajectories were identified by group-based trajectory modelling. Predictors of trajectory group membership were identified from potential predictors of caregiving characteristics and caregiving factors using multivariate logistic regression. Associations of trajectory groups with caregiving outcomes (depressive symptoms and health-related quality of life) were explored using the generalized estimating equation. Balance trajectories best fit a two-group trajectory model (poor and good). Caregivers with a poor sense of balance between competing needs were more likely to have more depressive symptoms (b=11.71, 95% CI [9.04, 14.38], p<.001), worse physical health (b=-6.22, 95% CI [-8.71, -3.74], p<.001), and worse mental health (b=-11.1, 95% CI [-13.58, -8.63], p<.001) than caregivers with a good sense of balance. Caregivers experiencing lower role strain (b=-1.45, SE=0.48, p=.003) or higher predictability (b=2.83, SE=0.76, p<.001) were more likely to belong to the good-balance group. Caregivers with poor balance between competing needs are more likely to have worse caregiving outcomes. Role strain and predictability significantly predicted balance trajectory groups. Family caregivers with lower caregiving task difficulty and/or better knowledge of the care receiver were more likely to be in the good balance trajectory group. Our findings support the framework, "Finding a Balance Point," and clarify the family caregiving process for people with dementia. This framework could be used to tailor interventions for home care nurses to improve family caregivers' caregiving outcomes.

Taiwanese middle-aged and older caregivers’ need for life safety instruction and its association with attitudes toward aging and proactive coping

ABSTRACT Long-term stress experienced by caregivers is often overlooked, as is their pre-planning for senior life, but helping middle-aged and older caregivers to prepare for senior life is the foundation for active aging. The purpose of this study is to elucidate middle-aged and older caregivers’ attitudes toward aging, proactive coping, and the need to learn life safety and to identify the factors influencing their need for life safety instruction. In this study, a questionnaire survey was administered to middle-aged and older caregivers with 1 year of experience or more in caring for older adults. In total, 500 questionnaires were distributed using a snowball sampling method, of which 415 valid questionnaires were recovered. The research tools included a personal information questionnaire, attitude toward aging scale, proactive coping scale, and need for life safety instruction scale. The results of this study were that: 1. Middle-aged and older caregivers had a low psychological evaluation of aging and a weak response to aging. 2. Respondents demonstrated a strong need to learn life safety. 3. Average monthly salary, aging awareness, aging behavior, attitude toward proactive coping, and proactive coping ability were strong predictors of the need to learn life safety. The principal conclusion was that the need for life safety instruction increased concurrently with unemployment, a decrease in aging awareness and behavior, an improvement in attitude toward proactive coping, and a decrease in proactive coping ability. Therefore, life safety education can be provided to the aforementioned group to satisfy their learning needs adequately.

Cross-cultural study of caregiver burden for Alzheimer's disease in Japan and Taiwan: result from Dementia Research in Kumamoto and Tainan (DeReKaT).

Caregiver burden (CB) of Alzheimer's disease (AD) in Taiwan is becoming an urgent social issue as well as that in Japan. The comparison of CB may explain how caregiver feels burden in each country. The participants were 343 outpatients with AD and their caregivers of Japan (n = 230) and Taiwan (n = 113). We assessed the CB using the Japanese and Chinese version of Zarit Caregiver Burden Interview (ZBI). The initial analysis was an exploratory factor analysis for each group to confirm the factor structure of ZBI. Then, the multiple-group structural equation modeling (MG-SEM) was used to assess the measurement invariance of ZBI such as configural, metric, and scalar invariances. Lastly, we compared the latent factor means of the ZBI between Japan and Taiwan. In both groups, the confirmatory factor analysis extracted 3 factors which were labeled "Impact on caregiver's life", "Embarrassed/anger", and "Dependency". The MG-SEM indicated an acceptable model fit, and established the partial scalar measurement invariance (comparative fit index (CFI) = 0.901, root mean square error of approximation (RMSEA) = 0.066). When we compared the latent factor means, the score of "Impact on caregiver's life" in Taiwanese caregivers was significantly higher than that in Japanese (p = 0.001). However, "Dependency" in Taiwanese caregivers was lower than that in Japanese (p < 0.001). Partial measurement invariance allowed comparing the latent factor mean across two countries. The results of comparisons suggested that there may be differences in the way of feeling CB between Japan and Taiwan.

Insiders and outsiders: policy and care workers in Taiwan's long-term care system

ABSTRACTAs in many developed countries, foreign care-givers have made up a short-term labour force to help shoulder the responsibilities of older adult care in Taiwan since 1992. This study uses the dual labour market and the occupational segregation theoretical frameworks and a mixed-method approach to examine whether foreign care-givers are supplementary or have replaced Taiwanese care-givers in Taiwan's long-term care (LTC) industry, and to understand better the status of care workers and their influx into the secondary labour market. As of 2012, 189,373 foreign workers joined the care services, compared to 7,079 Taiwanese, indicating they are no longer supplementary. The gap between the dual care system and workforce regulation has resulted in occupation segregation, and the secondary care labour market has been divided into ‘institutional’ and ‘home’ spheres, segregating care-givers into three levels: all Taiwanese care-givers, foreign institutional care-givers, and foreign home care-givers, the latter being the cheapest, most obedient and most adaptable LTC products. This case exhibits the ‘particularistic’ associations between nationality and care-givers’ workplace, which should be abolished. Only by squarely facing the changes and impacts caused by importing workers into the secondary labour market can one propose concrete, effective LTC labour plans and retention policies.

Predictors of treatment attrition and treatment length in Parent‐Child Interaction Therapy in Taiwanese families

Parent–Child Interaction Therapy (PCIT) has been used successfully in the United States and in other countries around the world, but its use in Asian countries has been more limited. The present study is the first of its kind to examine the predictors of treatment attrition and length in a sample of Taiwanese caregivers and their children. It is also the first to examine PCIT outcomes in Taiwanese families. Maladaptive personality characteristics of the caregiver were the best predictor of attrition, followed by single-parent, removal of the child from the home, and lower levels of caregiver education. Treatment length was predicted by child minority status and parent–child interactions (i.e., parent commands and negative parent talk). In terms of outcomes, statistically significant treatment changes were noted for all treatment outcome variables at post-treatment and at 3-month follow-up. These findings suggest that PCIT is a promising intervention for this population. The predictors of treatment attrition and length can be used when Taiwanese caregiver–child dyads present for services so that additional assistance can be provided prior to or during treatment to increase adherence to the recommended number of treatment sessions for maximal impact. Future studies may replicate the present study with a larger clinical sample to examine the long-term effects of PCIT and to include a no-treatment control condition to afford a more robust empirical evaluation.

Psychometric testing of the Chinese version of the Medical Outcomes Study Social Support Survey among people living with HIV/AIDS in China

PurposeThe aim of this study was to assess the psychometric properties of the Chinese (Mandarin) version of the Medical Outcomes Study Social Support Survey (MOS-SSS-CM) among people living with HIV/AIDS (PLWHA) in Mainland China. MethodsA cross-sectional study was conducted with a convenience sample of 200 Chinese PLWHA. They completed the MOS-SSS-CM along with the Chinese version of the Beck Depression Inventory Revised (BDI-II) scale, the Zung Self-Rating Anxiety Scale (SAS), the Perceived Stress Scale (PSS-10), and the World Health Organization Quality of Life Brief (WHOQOL-BREF) scale. ResultsInternal consistency (Cronbach's α) was 0.97 for the overall MOS-SSS-CM and 0.82–0.91 for the five subscales originally proposed. However, 11 of the 19 items demonstrated unsatisfactory item discriminant validity. An exploratory factor analysis yielded a two-factor solution with tangible and social-emotional dimensions, which demonstrated satisfactory reliability and better discrimination between different subscales than did the original five-factor model. The concurrent validity of the two-factor scale was further confirmed by its significant negative correlations with the BDI-II (r=−0.41, p<0.01); the SAS (r=−0.27, p<0.01); and the PSS-10 (r=−0.30, p<0.01), and significant positive correlation with the WHOQOL-BREF scale (r=0.61, p<0.01). ConclusionWe found a two-factor solution for the MOS-SSS-CM, which demonstrated good reliability and validity when applied to Chinese PLWHA. This was consistent with results from a study of Taiwanese caregivers. Further validation in other populations and disease states is warranted.

Expressed emotion and depression in caregivers of older adults with dementia: results from Taiwan

Objectives: The purpose of this study was to examine the relationship between (1) expressed emotion (EE) and characteristics of Taiwanese dementia patients and their family caregivers and (2) EE and depressed mood, burden, and perception of health in Taiwanese caregivers of elderly persons with dementia.Methods: Sixty-five primary caregivers of elderly persons with mild to severe dementia were recruited from institutions in Taiwan and they completed four standardized questionnaires: Level of Expressed Emotion (LEE) scale, Center for Epidemiologic Studies Depression (CES-D) scale, Zarit Burden Inventory (ZBI), and General Health Perceptions subscale of the Medical Outcomes Study Short Form 36 Health Survey (MOS SF-36).Results: EE was positively associated with caregiver depression (r = .543; p < .001) and burden (r = .532; p < .001), and negatively associated with caregivers’ perceived health (r = −.316; p = .010). The higher the caregivers’ depression and burden, the greater was their EE and the lower the caregivers’ perceived health, the higher was their EE. EE was negatively associated with caregiver education (r = −.279; p = .024) and income (r = −.261; p = .036). The lower the caregivers’ education and income, the higher was their EE.Conclusion: The significant relationship between EE and caregivers’ mood and perceived burden suggests that caregivers with elevated mood or burden may put persons with dementia at greater risk for toxic, negative interactions from them. Although this study's design precludes attributing directionality, more depressed caregivers are at a greater risk of higher EE which may affect care of their elderly demented family members. Additional research is warranted with a larger sample size and/or a longitudinal design.

Perception of Medical Care Systems and Stress Responses in Preschoolers’ Caregivers at a Pediatric Emergency Department in Taiwan

This study was undertaken to understand caregivers' perception of medical care systems and their stress responses throughout their stay with preschoolers at a pediatric emergency department (ED). Overall, 201 preschoolers' caregivers in pediatric ED were recruited in this study. They were asked to answer self-made questionnaires regarding the perception of medical care systems and their stress responses immediately before preschoolers' release. The results show that caregivers with a low education or low income level were prone to exhibit greater appreciation for the efficiency of medical care systems and greater degree of anxiety for their lack of treatment and care knowledge than those of caregivers with a high education or high income level. Interestingly, caregivers older than 38 years reported greater emotional responses and physical exhaustion than did younger caregivers. Immigrant caregivers had higher emotional reaction and lower concentration than did Taiwanese caregivers. Paradoxically, caregivers undergoing over 3-time pediatric ED visits for observation expressed stronger stress reactions as compared with caregivers with less observation experiences. Not surprisingly, caregivers reported the highest emotional responses when their preschoolers were diagnosed as having very urgent degree in triage classification. Finally, caregivers' perception of "lack of family support" and "lack of treatment and care knowledge" correlated positively with all aspects of the stress responses. These results indicate that attention should be paid to the specific psychological weakness and need for the caregivers with certain demographic characteristics by the medical team in pediatric ED.

Percutaneous endoscopic gastrostomy placement: Caregiver decision making in Taiwan

To explore Taiwanese caregivers' decision making experiences of accepting a percutaneous endoscopic gastrostomy tube for their family member. A phenomenological approach was used for the interview and analysis. Semi-structured, in-depth interviews were conducted with a purposive sample of 26 caregivers of patients who had percutaneous endoscopic gastrostomy tube in southern Taiwan. Five themes were recognized to reflect caregivers' decision making experiences with a percutaneous endoscopic gastrostomy: awareness of suffering, awareness of options, uncertainty, opportunity, and contentment with the decision. Caregivers' decisions to proceed with a percutaneous endoscopic gastrostomy procedure were mediated by desires to relieve patients' suffering. To empower caregivers to make enteral feeding decisions, nurses must provide sufficient information about percutaneous gastrostomy tubes and their care, support decision making and help to identify an opportunity for gastrostomy tube placement.

P2‐348: Caregivers' perspectives of care problems: An exploratory study in Taiwan

Background:Caregiver burden is known as a multidimensional phenomenon and strongly influenced by sociocultural contexts. Literature reported cultural differences in the appraisals of dementia that affect caregivers’ perceived burden. This study explores the caregiver’s perspectives of the care problems in daily routine.Methods:This study adopted a qualitative approach. 30 consecutive consultation sessions from a Dementia Consultation Clinic in Taiwan were videotaped and the content transcribed. The transcripts were coded to identify the most frequent care problems identified by the caregivers. Five follow-up in-depth interviews were conducted with the caregivers who reported most care problems. The participants included one husband, one wife, two sons, and one daughter. They all lived and provided care for their relatives with dementia at home. The transcripts were analyzed with Grounded theory. Results: Four themes associated with the care problems reported by the caregivers: (1) Most of the caregiving difficulties were associated with behavioral problems associatedwith dementia. (2) These behavioral problems usually became a source of caregiver distress when they significantly affected the safety of care recipients or caregivers, and/or disrupted the daily lives of the whole family. (3) The behaviors were mostly attributed to the personality or lifelong habits of care recipient rather than the symptoms of dementia. Thus, the behaviors were often not considered modifiable. (4) The caregivers considered the management of disruptive problems as their moral responsibilitis and were reluctant to seek help. Conclusions: The results agreed with the literature that the behavioral problems of dementia were a frequent caregiving stressor. It also supports that Asian caregivers may consider caring for the elderly in the family as their destiny and responsibility that cannot be shared with others. Not discussed in previous literature was that how Taiwanese caregivers’ attribution of behavioral problems influenced their coping strategies. As the caregivers in Taiwan tend to regard the behavioral problems un-modifiable or associate the ability to manage behavioral problems with one’s morale, these considerations influences the caregiver’s decision to seek help. More caregiver educations may help them be well aware of dementia symptoms and develop more useful coping strategies.

The development and testing of a scale of Taiwanese caregiver meaning

The purpose of this study was to develop and test a scale of Taiwanese caregiver meaning. The meaning of care-giving is defined as the beliefs one holds about oneself and the care-giving experiences that affect adjustment to the care-giving role. An existing tool, the Meaning in Care-giving Scale, has been tested in Taiwan, but it showed that the construct validity was unreliable. The study was a cross-sectional study with purposive sampling. The instrument was developed through 20 semi-structured interviews of caregivers of mentally ill patients. A comparative method was used to analyse the text and field notes. According to the results, 29 items were designed and 318 caregivers of mentally ill patients were recruited from a psychiatric outpatient department in central Taiwan. Content and back direct content validity tests were conducted. Internal consistency, Chronbach's alpha, was used to examine the reliability, and exploratory factor analysis was used to examine the construct validity. Twenty items were kept after exploratory factor analysis. They represent four factors: the benefits of care-giving, a belief in Karma, personal responsibility and a reflection on life. Cronbach's alpha value for a subscale increased from 0·68-0·84, and the total scale was 0·84. A sixty per cent (59·55%) cumulative variance can be explained by four factors. A Taiwanese caregiver meaning can be considered a useful scale for assessing the meaning of care-giving for Taiwanese caregivers of mentally ill patients. A good scale and instrument take years to develop. This study takes the first step to examine the structure of the scale, and it is worth continued testing, modification and improvements. The scale of Taiwanese caregiver meaning was developed based on certain aspects of contemporary Taiwanese culture. It can be used to provide mental health professionals new counselling knowledge to assist caregivers of mentally ill patients to adjust to their circumstances.

Psychological Health of Primary Caregivers of Home-Based Older Adults With Dementia in India, Taiwan, and the United States

This article is part II of a study of the psychological health of primary caregivers of home-based older adults with dementia in India, Taiwan, and the United States. Indian caregivers had the lowest level of all aspects of adverse psychological health, whereas Taiwanese caregivers exhibited the worst outcomes. Predictors for psychological health in each country were distinct. After adjusting for an indicator of caregivers' residence in India, education about caregivers' needs and governmental financial support were identified as necessary interventions. These findings suggest the need for separate prediction models for psychological health for caregivers in developing and developed countries.

A theory of meaning of caregiving for parents of mentally ill children in Taiwan, a qualitative study

The aim of this study is to generate a theory of meaning of care-giving for parents of mentally ill children in Taiwan. Studies indicate that the meaning of care-giving plays an important role in the psychological adjustment of care-givers to care-giving. With a positive meaning of care-giving, care-givers can accept their roles and adapt to them more readily. The research employs the qualitative method of grounded theory, the inquiry is based on symbolic interactionism. Twenty parental care-givers of children with schizophrenia were recruited at a private hospital in central Taiwan. Semi-structured interviews were conducted. A comparative method was used to analyse the text and field notes. Responsibility (zeren) emerges as the core category or concept. Responsibility expresses broadly the behavioural principles that are culturally prescribed and centred on familial ethics and values. Related concepts and principles that influence caregiver actions and affections include a return of karma, challenges from local gods and fate. By maintaining their culturally prescribed interpretations of care-giving, parents hope to give care indefinitely without complaints. The findings clearly suggest that the meaning of care-giving is determined through a process of internal debate that is shaped by culturally specific concepts. The paper attempts to explain some of these culturally specific determinants and explanations of care-giving behaviour. The theory contributes knowledge about the meaning of care-giving for parents of mentally ill children in Taiwan. It should be useful reference for mental health professionals, who provide counselling services to ethnically Taiwanese care-givers.

Stressors, social support, depressive symptoms and general health status of Taiwanese caregivers of persons with stroke or Alzheimer’s disease

This study examined the relationships among stressors, social support, depressive symptoms and the general health status of Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Caring for a disabled or cognitively impaired person can be extremely stressful and often has adverse effects on caregivers' health. While research on caregiving in Taiwan has examined caregivers' characteristics, caregivers' need and caregivers' burden in caring for older people in general, little is known about Taiwanese caregivers of individuals with stroke or Alzheimer's disease. Cross-sectional, descriptive correlation design. Data were obtained from a convenience sample of 103 Taiwanese informal caregivers in the South of Taiwan and analysed using descriptive statistics, Pearson's correlations, multiple and hierarchical regressions and t-tests. Caregivers who had lower household incomes and were taking care of individuals with more behaviour problems had more depressive symptoms. In addition, caregivers who were older and were taking care of individuals with more behaviour problems had worse general health. Caregivers who had more emotional support had less depressive symptoms. Caregivers of persons with Alzheimer's disease had more depressive symptoms and worse general health than caregivers of persons with stroke. Only emotional support moderated the relationship between one of the stressors (household income) and depressive symptoms. The findings of this study may be helpful for nurses and other health care professionals in designing effective interventions to minimise the negative impacts of stressors on the psychological and general health of caregivers in Taiwan.

Validation of the Chinese version Scale of Needs (SON) for caregivers of mentally ill patients

The purpose of this study was to develop the Chinese version Scale of Needs (SON) for Caregivers of Mentally Ill Patients. There were 23 items designed for the initial scale, and 250 Taiwanese caregivers of mentally ill patients were recruited in the study. Exploratory factor analysis and principle component analysis were conducted. The 23 items of the SON for Caregivers of Mentally Ill Patients were classified into four factors and accounted for 66.12% of the variance. Factor I was assigned as Information need, Factor II was named Supportive need, Factor III was named Break need and Factor IV was called Emotional Releasing Service.

Correlates of consequences of intergenerational caregiving in Taiwan

This paper is a report of a study to test a theoretical model of factors related to consequences of intergenerational caregiving among Taiwanese caregivers of cognitively impaired ageing relatives. With the ageing of the population worldwide, care of elders has become a pressing issue. Intergenerational caregiving behaviours may reflect cultural values and beliefs, but create conflict for adult children between traditional obligations to ageing parents and the capacity to provide care. Adult caregivers (n = 130) of cognitively impaired ageing relatives were recruited from three home care agencies in northern Taiwan between September 2003 and February 2004. Role and attachment theories were combined to extend the understanding of the consequences of intergenerational caregiving. Caregiving consequences (role strain and role reward) were not polar opposites on a unidimensional continuum. Caregiver role conflict and role performance had positive relationships with role strain, whereas caregiving resources and role expectation had an inverse relationship. For caregiver role reward, only role performance and secure-attached style were positively correlated. Role demand was not a statistically significant predictor of either role strain or role reward. Furthermore, secure-attached style explained additional variance in role strain and role reward. Moderating effects involving secure attachment with other predictors of role strain and role reward were supported. By incorporating role and attachment theories, our model gives a more complete view of intergenerational caregiving in an Asian culture. These findings may be applicable to other countries with Chinese populations.

CONCEPTUALIZATION AND PSYCHOMETRIC PROPERTIES OF THE CAREGIVER BURDEN SCALE IN TAIWAN

Families in Taiwan bear a heavy burden in caring for their elders. This paper presents a conceptualization of caregiver burden and data on the psychometric properties of the Caregiver Burden Scale. A convenient sample of 148 Taiwanese caregivers of elders with a stroke was recruited. Factor analysis showed three factors, awareness of degeneration of both care receiver and giver; time and finance constraints and readjustment; and guilt and blame, which accounted for 55.85% of the variance; Cronbach's alpha was .92. Some aspects of caregiving unique to caregivers and issues in the measurement of burden in Taiwan are presented.