Caregivers’ resilience is independent from the clinical symptoms of dementia

Rachel Dias; José Pedro Simões-Neto; Raquel Luiza Santos; Maria Fernanda Barroso de Sousa; Maria Alice Tourinho Baptista; Isabel Barbeito Lacerda; Nathalia Ramos Santos Kimura; Marcia Cristina Nascimento Dourado

doi:10.1590/0004-282X20160162

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2016; 74(12): 967-973
DOI: 10.1590/0004-282X20160162

ARTICLE

Caregivers’ resilience is independent from the clinical symptoms of dementia

A resiliência dos cuidadores independe dos sintomas clínicos da demência

Rachel Dias

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

José Pedro Simões-Neto

²Universidade Federal de Santa Catarina, Departamento de Sociologia e Ciência Política, Florianópolis SC, Brasil.

,

Raquel Luiza Santos

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

Maria Fernanda Barroso de Sousa

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

Maria Alice Tourinho Baptista

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

Isabel Barbeito Lacerda

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

Nathalia Ramos Santos Kimura

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

,

Marcia Cristina Nascimento Dourado

¹Universidade do Rio de Janeiro, Instituto de Psiquiatria, Centro para Doenças de Alzheimer e outras Desordens Mentais na Velhice, Rio de Janeiro RJ, Brasil;

› Author Affiliations

Abstract

ABSTRACT

Resilience is the capacity for successful adaptation when faced with the stress of adversity. We aimed to investigate the relationship between caregivers’ resilience and the sociodemographic and clinical factors of people with dementia. Cross-sectional assessment of 58 people with dementia and their caregiver dyads showed that most caregivers were female adult children. The caregivers reported moderate to higher levels of resilience, lower levels of anxiety and depressive symptoms and moderate levels of burden. Resilience was not related to the caregiver’s gender (p = 0.883), nor clinical (p = 0.807) or emotional problems (p = 0.420). The regression showed that resilience was related to the caregiver’s quality of life (p < 0.01) and inversely associated with their depressive symptoms (p < 0.01). There was no relationship between caregivers’ resilience and the sociodemographic and clinical characteristics of people with dementia. We can assume that resilience is an individual characteristic. Support groups should also focus on the factors that may increase resilience among caregivers.

RESUMO

Resiliência é a capacidade de adaptação bem-sucedida, quando confrontado com o estresse da adversidade. Nosso objetivo foi investigar a relação entre a resiliência dos cuidadores e fatores sociodemográficos e clínicos de pessoas com demência. A avaliação transversal de 58 pessoas com demência e suas duplas de cuidadores, mostrou que a maioria dos cuidadores eram do sexo feminino e filhas adultas. Os cuidadores relataram níveis moderados a altos de resiliência, níveis mais baixos de ansiedade e sintomas depressivos e níveis moderados de sobrecarga. Resiliência não estava relacionada ao gênero (p = 0.883) e problemas clínicos (p = 0.807) e emocionais (p = 0.420) dos cuidadores. A regressão mostrou que a resiliência foi relacionada à qualidade de vida (p < 0,01) dos cuidadores e inversamente associada com os sintomas depressivos (p < 0,01). Não havia uma relação significativa entre a resiliência dos cuidadores e as características sociodemográficos e clínicas das pessoas com demência. Podemos supor que a resiliência é uma característica individual. Os grupos de apoio devem enfatizar os fatores que podem aumentar a resiliência entre os cuidadores.

resilience, psychological - caregivers - dementia - depression - quality of life

resiliência psicológica - cuidadores - demência - depressão - qualidade de vida

Full Text

References

References
1 Bekhet AK. Effects of positive cognitions and resourcefulness on caregiver burden among caregivers of persons with dementia. Int J Ment Health Nurs. 2013;22(4):340-6. doi:10.1111/j.1447-0349.2012.00877.x
2 Fernández-Lansac V, Crespo López M, Cáceres R, Rodríguez-Poyo M. [Resilience in caregivers of patients with dementia:a preliminary study]. Rev Esp Geriatr Gerontol. 2012;47(3):102-9. Spanish. doi:10.1016/j.regg.2011.11.004
3 Lavretsky H, Siddarth P, Irwin MR. Improving depression and enhancing resilience in family dementia caregivers: a pilot randomized placebo-controlled trial of escitalopram. Am J Geriatr Psychiatry. 2010;18(2):154-62. doi:10.1097/JGP.0b013e3181beab1e
4 Fitzpatrick KE, Vacha-Haase T. Marital satisfaction and resilience in caregivers of spouses with dementia. Clin Gerontol. 2010;33(3):165-80. doi:10.1080/07317111003776547
5 Gaugler J. Kane RL, Newcomer R. Resilience and transitions from dementia caregiving. J Gerontol B Psychol Sci Soc Sci. 2007;62(1):P38-44.
6 Shuter P, Beattie E, Edwards H. An exploratory study of grief and health-related quality of life for caregivers of people with dementia. Am J Alzheimers Dis Other Demen. 2014;29(4):379-85. doi:10.1177/1533317513517034
7 Sousa MF, Santos RL, Turró-Garriga O, Dias R, Dourado MC. Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer ’ s disease (AD). Int Psicogeriatria. 2016:28(8):1363-74.
8 Contador I, Fernández-Calvo B, Palenzuela DL, Miguéis S, Ramos F. Prediction of burden in family caregivers of patients with dementia: a perspective of optimism based on generalized expectancies of control. Aging Ment Health. 2012;16(6):675-82. doi:10.1080/13607863.2012.684666
9 Wilks SE, Little KG, Gough HR, Spurlock WJ. Alzheimer’s aggression: influences on caregiver coping and resilience. J Gerontol Soc Work. 2011;54(3):260-75. doi:10.1080/01634372.2010.544531
10 Reppold CT, Mayer JC, Almeida LS, Hutz CS. [Resilience assessment: controversies about the use of scales]. Psicol Reflex Crít. 2012;25(2):248-55. Portuguese. doi:10.1590/S0102-79722012000200006
11 Trapp SK, Perrin PB, Aggarwal R, Peralta SV, Stolfi ME Morelli E et al. Personal strengths and health related quality of life in dementia caregivers from Latin America. Behav Neurol. 2015;2015:507196. doi:10.1155/2015/507196
12 Dias R, Santos RL, Sousa MFB, Nogueira M, Torres B, Belfort T et al. Resilience of caregivers of people with dementia: a systematic review of biological and psychosocial determinants. Trends Psychiatry Psychother. 2015;37(1):12-9. doi:10.1590/2237-6089-2014-0032
13 Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas. 1993;1(2):165-78.
14 Yunes MAM. [Positive psychology and resilience: focus on the individual and families]. Psicol Estud. 2003;8 n esp:75-84. Portuguese. doi:10.1590/S1413-73722003000300010
15 Rohr MK, Wagner J, Lang FR. Effects of personality on the transition into caregiving. Psychol Aging. 2013;28(3):692-700. doi:10.1037/a0034133
16 American Psychiatric Association. Diagnostic and statistical manual of mental disorders: text revision. 4th ed. Washington, DC: American Psychiatric Association; 2002.
17 Maia AL, Godinho C, Ferreira ED, Almeida V, Schuh A, Kaye J et al. [Application of the Brazilian version of the CDR scale in samples of dementia patients]. Arq Neuropsiquiatr. 2006;64(2B):485-9. Portuguese. doi:10.1590/S0004-282X2006000300025
18 Bertolucci PH, Brucki SM, Campacci SR, Juliano Y. [The mini-mental state examination in a general population: impact of educational status]. Arq Neuropsiquiatr. 1994;52(1):1-7. Portuguese. doi:10.1590/S0004-282X1994000100001
19 Pesce RP, Assis SG, Avanci JQ, Santos NC, Malaquias JV, Carvalhaes R. [Cross-cultural adaptation , reliability and validity of the resilience scale]. Cad Saude Publica. 2005;21(2):436-48. Portuguese. doi:10.1590/S0102-311X2005000200010
20 Cunha JA. Manual das versões em português das escalas Beck. São Paulo: Casa do Psicólogo; 2001.
21 Novelli MM, Nitrini R, Caramelli P. Validation of the Brazilian version of the quality of life scale for patients with Alzheimer’s disease and their caregivers (QOL-AD). Aging Ment Health. 2010;14(5):624-31. doi:10.1080/13607861003588840
22 Scazufca M. Brazilian version of the Burden Interview scale for the assessment of burden of care in carers of people with mental illnesses. Rev Bras Psiquiatr. 2002;24(1):12-17. doi:10.1590/S1516-44462002000100006
23 Dutra MC, Ribeiro RS, Pinheiro SB, Melo GF, Carvalho GA. Accuracy and reliability of the Pfeffer Questionnaire for the Brazilian elderly population. Dement Neuropsychol. 2015;9(2):176-83. doi:10.1590/1980-57642015DN92000012
24 Portugal MG, Coutinho ES, Almeida C, Barca ML, Knapskog AB, Engedal K et al. Validation of Montgomery-Åsberg rating scale and Cornell scale for depression in dementia in Brazilian elderly patients. Int Psychogeriatrics. 2012;24(8):1291-8. doi:10.1017/S1041610211002250
25 Camozzato AL, Kochhann R, Simeoni C, Konrath CA, Pedro Franz A, Carvalho A et al. Reliability of the Brazilian Portuguese version of the Neuropsychiatric Inventory (NPI) for patients with Alzheimer’s disease and their caregivers. Int Psychogeriatr. 2008;20(2):383-93. doi:10.1017/S1041610207006254
26 Dourado MCN, Mograbi DC, Santos RL, Sousa MF, Nogueira ML, Belfort T et al. Awareness of disease in dementia: factor structure of the assessment scale of psychosocial impact of the diagnosis of dementia. J Alzheimer’s Dis. 2014;41(3):947-56. doi:10.3233/JAD-140183
27 O’Rourke N, Kupferschmidt AL, Claxton A, Smith JZ, Chappell N, Beattie BL. Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time. Aging Ment Health. 2010;14(8):984-93. doi:10.1080/13607863.2010.501063
28 Santos RL, Sousa MF, Simões-Neto JP, Nogueira ML, Belfort TT, Torres B et al. Caregivers’ quality of life in mild and moderate dementia. Arq Neuropsiquiatr. 2014;72(12):931-7. doi:10.1590/0004-282X20140155
29 Gallagher D, Ni Mhaolain A, Crosby L, Ryan D, Lacey L, Coen RF et al. Self-efficacy for managing dementia may protect against burden and depression in Alzheimer’s caregivers. Aging Ment Health. 2011;15(6):663-70. doi:10.1080/13607863.2011.562179
30 Gallicchio L, Siddiqi N, Langenberg P, Baumgarten M. Gender differences in burden and depression among informal caregivers of demented elders in the community. Int J Geriatr Psychiatry. 2002;17(2):154-63. doi:10.1002/gps.538