Considerable research has documented that caring for a person with dementia is highly stressful. Much of this research has been conducted within a transactional model of stress, which emphasizes the importance of people's interpretations or appraisals of events as the source of stress. Two frameworks grounded in the transactional model form the basis of the proposed investigation: Pearlin's (1980, 1983) and Lazarus and Folkman's (1984). Both frameworks view stress as situationally determined by the individual. These approaches provide a useful theoretical guide for the study of perceived stress in caring for a person affected by Alzheimer's disease. Although we know that such caregiving is very stressful at times, we do not yet understand either how this perceived stress varies across problem domains, nor how it evolves over time. The proposed study incorporates key aspects of both frameworks (role, mastery, appraisal, coping and adjustment) in an attempt to address several aspects of the stress associated with caregiving over time. Specifically, the focus of the proposed investigation is on the longitudinal course of the appraisal- coping-adjustment process, especially regarding the extent of intra- and interindividual differences in this process. Participants will be 200 spouse caregivers of persons with Alzheimer's disease or a related dementia. Caregivers will be assessed monthly for six consecutive months to determine the stability of stressors in their situations. Aspects to be assessed include: mastery (the degree to which people fell in control of situations), daily hassles associated with caregiving, appraisals of the most significant stressors in each of five areas of caregiving, coping attempts, perceptions of change in the caregiving situation over time, and physical and mental health adjustment. This design will permit examination of the degree of stability or change in different aspects of caregiving and their relationship to changes in perceived stress, topic that has not been adequately researched to date. Periodically, care-recipients will be re- evaluated to ascertain their current cognitive and functional status. These assessment permit examination of possible relationships (and changes therein) between care-recipient status and caregivers' perceived stress. Data analyses will examine the replicability and generalizability of previous findings concerning stress, the extent of inter- and intraindividual differences in the appraisal-coping-adjustment process over time, and longitudinal relationships among the variables. A combination of complex, multivariate techniques will be used to analyze these data.
| Cavanaugh, J C; Kinney, J M (1998) Accuracy of caregivers' recollections of caregiving hassles. J Gerontol B Psychol Sci Soc Sci 53:P40-2 |
