Alzheimer's disease care-giving : psychological outcome, coping style and causal attributions
Literature Review: With Alzheimer's disease on the increase, family members are increasingly interacting with nursing home care services. This relationship with nursing staff is felt to be crucial to the overall care-giving experience, and the review sets out to examine how different family carer variables may affect this. Attribution theory is utilised to present a conceptual model, then examined for its potential usefulness. Research Report: Objectives: To examine the psychological outcome, coping style, and causal attributions, for both family and nurse carers of people with Alzheimer's disease (of 'Late Onset'). Method: The study recruited 57 participants, 27 family and 30 nurse carers. Each completed a demographic questionnaire, the Hospital Anxiety and Depression Scale (HADS), the Brief COPE inventory, and the Causal Dimensions Scale-Revised (CDS-II). Results: Positive correlations were found between anxiety, depression, and dysfunctional coping style for both groups of carers. Comparisons revealed that family carers suffered significantly greater levels of anxiety and depression, with nearly two-thirds (63%) of the family carers reporting some psychological morbidity. In comparing coping styles, family carers were significantly more likely to utilise acceptance, whereas nurse carers utilise more positive reframing and humour. In terms of attributions, family carers reported significantly lower levels of external control compared to nurses, and empathically family carers were significantly better at describing the feelings of nurses than vice-a-versa. Conclusions: Identifying associations can potentially improve the identification of poor coping and outcome in carers, and the implications of this are discussed for both family-inclusive assessment and nurse job satisfaction. Family and nurse carer differences are discussed in terms of improving the interactions, interventions, communication, and the overall care environment. Critical Appraisal: The appraisal details a personal account of the research origins, some management issues, and an explanation of subsequent learning outcomes.