Advanced Search Abstract This review revises the sociocultural stress and coping model for culturally diverse family caregivers proposed in by Aranda and Knight. Familism as a cultural value appears to be multidimensional in its effects, with obligation values often being more influential than family solidarity. The effects of cultural values and other ethnic differences in stress and coping appear to involve social support and coping styles rather than burden appraisals.
Abstract Adverse—and even positive—outcomes in a chronic stress experience. The associations between physical and psychological health and being an informal caregiver are well established. Clinical observation and early empirical research showed that assuming a caregiving role can be stressful and burdensome.
It creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in multiple life domains such as work and family relationships, and frequently requires high levels of vigilance.
Caregiving fits the formula for chronic stress so well that it is used as a model for studying the health effects of chronic stress. Families often are a primary source of home care and support for older relatives, contributing services that would cost hundreds of billions of dollars annually if they had to be purchased.
Similarly, social workers now play a critical role in providing advice and support to caregivers. Evidence on the health effects of caregiving gathered over the last two decades has helped convince policymakers that caregiving is a major public health issue.
Professional advocacy group, including nurses and social workers, have been instrumental in raising awareness about this issue. Therefore, the framework of stress-coping models can be used to study caregiving. In caregivers, these objective stressors lead to psychological stress and impaired health behaviors, which stimulate physiologic responses resulting in illness and mortality.
A broad range of outcome measures has been examined, including cellular and organ-based physiologic measures, global physical and psychiatric health status indicators, and self-reports on health habits. These outcomes have been linked to primary stressors, such as the duration and type care provided and the functional and cognitive disabilities of the care recipient, as well as to secondary stressors, such as finances and family conflict.
As How do caregiving and culture affect later emotional control result of these stressors, the caregiver may experience effects such as psychological distress, impaired health habits, physiologic responses, psychiatric illness, physical illness, and even death.
Although relatively few studies have focused on the association between caregiving and health habits, researchers have found evidence of impaired health behaviors, such as neglecting their own health care appointments and eating a poor-quality diet, among caregivers who provide assistance with basic activities of daily living ADLs like toileting and eating.
This research has consistently shown relatively large effects, which are moderated by age, socioeconomic status, and the availability of informal support. Older caregivers, people of low socioeconomic status, and those with limited support networks report poorer psychological and physical health than caregivers who are younger and have more economic and interpersonal resources.
Caring for a patient with dementia is more challenging than caring for a patient with physical disabilities alone. People with dementia typically require more supervision, are less likely to express gratitude for the help they receive, and are more likely to be depressed.
All of these factors have been linked to negative caregiver outcomes. Patient suffering is manifested in three related and measurable ways: We recently found that two types of patient suffering—emotional and existential distress—were significantly associated with caregiver depression and use of antidepressant medication.
They report that caregiving makes them feel good about themselves and as if they are needed, gives meaning to their lives, enables them to learn new skills, and strengthens their relationships with others. Even large, longitudinal, or case—control studies are subject to biases.
For example, differences in illness rates between caregivers and noncaregivers may not be the result of the caregiving experience, but may instead reflect differences that existed prior to assuming the caregiving role. One example may be socioeconomic status; individuals of low socioeconomic status are more likely to take on the caregiving role, and low socioeconomic status is a risk factor for poor health.
As a result of these factors, older spouses tend to develop illnesses and disabilities at about the same time; one partner may have health problems that require a caregiver, but chances are the other partner also has health problems, although they may be less severe.
Transitions into and out of caregiving Prospective studies that link declines in caregiver health to increasing care demands provide compelling evidence of the health effects of caregiving. Improved patient functioning is associated with reductions in caregiver distress. Caregivers first experience distress and depression, which are followed by physiologic changes and impaired health habits that ultimately lead to illness and possibly to death.
Although researchers have demonstrated the predicted effects for isolated components of this model, they have not shown how illness progresses sequentially or how one condition, such as depression, leads to changes in health habits or physiology. Many studies show that caregiving causes psychological distress, but virtually none have demonstrated that stress results in physiologic dysregubrion, such as increased cortisol secretion or changes in immune function, within individual caregivers over time.
Similarly, researchers have not yet demonstrated that such physiologic responses are directly linked to illness outcomes in caregivers. Demonstrating sequential causal relationships among variables considered critical in the path from caregiver stress to illess is certainly challenging.
Nevertheless, these efforts should be of high priority. Moderating factors The literature clearly shows that the intensity of caregiving, whether it is measured by the type or the quantity of assistance provided, is associated with the magnitude of health effects.
Emerging evidence suggests that other factors, such as the level of patient suffering, may contribute just as much to a health decline in the caregiver. It is important to disentangle the effects of helping from those of other aspects of the caregiving context, such as patient suffering.
We also need a better understanding of the different types of caregiving experiences and their effects on health. Providing help that fails to enhance the quality of the patients life may lead to frustration, resignation, and negative health effects for the caregiver.
But it is likely that providing help that significantly addresses the needs and desires of a patient is uplifting to the caregiver and contributes to positive health effects. Because research on the positive aspects of caregiving is relatively new, we know little about how these good experiences moderate the stress response and affect health.
Researchers in nursing and social work need to develop and test interventions designed to maintain and enhance the health of caregivers. Depression is one of the common negative effects of caregiving.
Caring for a person with dementia is particularly challenging, causing more severe negative health effects than other types of caregiving.Children’s Emotional Development Is Built into the Architecture of Their Brains 1 From birth, children rapidly develop their abilities to experience and express different.
Different coping styles can affect the caregiving stress process through efforts to modify the stressful circumstances and also regulate the emotional and varying ways of expressing emotional distress. How Culture Affects Stress and Coping Processes The Centers for Disease Control and Prevention National Center on Birth Defects and.
Issues of Race, Ethnicity, and Culture in Caregiving Research: A Year Review (–). JSTOR is a digital library of academic journals, books, and primary sources.
The security of attachment is an important cornerstone of social and personality development, because infants and young children who are securely attached have been found to develop stronger friendships with peers, more advanced emotional understanding and early conscience development, and more positive self-concepts, .
During the formative years of contemporary psychiatry much attention was paid to the continuing role of past traumatic experiences on the current lives of people.