Caregiving experience and its influencing factors : adult child versus spousal caregivers caring for people with dementia in China

Abstract

China has the world's largest cohorts of dementia population. 96% of this population in China were cared for by their family members, with adult children (59%) and spouses (31%) as the main caregivers (Zhang et al., 2004). Adult child and spousal caregivers had different needs and struggled with different issues (Pinquart & S?rensen, 2011). It is important to explore the difference presented in their caring adaptation process and understand more about the protective mechanisms for them, in order to develop effective interventions for the two caregiver groups.

This research focused on two aims 1) to explore the differences existing in the mechanism of caregivers?appraisals (appraisal of strain and appraisal of gain) during the caregiving adaptation process between the adult child and spousal dementia caregivers in China and 2) to explore the potential differences that exist in the influencing effect of caregivers?internal subjective resources (self-efficacy and coping strategies) during the caregiving adaptation process between adult child and spousal dementia caregivers in China. Cross-sectional data was collected and the compare was conducted to achieve the aims of the study. A questionnaire was completed by 195 convenience participants: 123 adult child and 72 spousal dementia caregivers recruited from four hospitals and communities in the Guangdong Province, P.R. China. T-test and Chi-Square test were conducted to compare the difference between adult children and spouses; a series of hierarchical multiple regression as recommended by Judd & Kenny (1986) were conducted in order to test the mediating effect of caregivers?appraisals and their internal subjective resource.

For the first research aim, the current study indicated that the stressors significantly predicted the appraisal of strain for both the adult child and spousal caregivers, while it only predicted the appraisal of gain for adult children but not for spouses. Meanwhile, the appraisal of gain played a more important role for the adult child caregivers, with great impact on both aspects of psychological well-being (positive affect and negative affect). On the other hand, the influence of the appraisal of strain (burden) among spousal caregivers was more pervasive in that it not only added to negative affect but also diminished the positive affect.

For the second research aim, this study revealed that the internal resources presented as self-efficacy and coping strategy did have impact in the caregiving adaptation process. The effect was different across the different domains of self-efficacy and in use of different types of coping strategies. Moreover, the effect of self-efficacy was differ between the adult child and spousal caregiver groups, while the effect was similar in adopting different coping strategies across the two caregiver groups. The results provided more information about the difference of the adult child and spousal caregivers?caring experience and their adaptation process to guide the future research on dementia caregiving in China. It provided valuable information for developing different effective intervention for the two caregiver groups.