Physical limitations and loneliness: the role of guilt related to self-perception as a burden

Background: Limitations in performing physical activities have been associated with greater loneliness in older adults. This association could be moderated by maladaptive social cognition or feelings, such as guilt related to perceiving oneself as a burden. This study analyzes the effect of guilt related to self-perception as a burden on the relationship between physical limitations and loneliness in older adults. Methods: Participants were 190 community-dwelling people aged over 60 years who did not show cognitive or functional limitations in daily life activities. We used linear regression to test the influence of guilt related to self-perception as a burden on the association between physical limitations and loneliness. Results: The interaction between physical limitations and guilt related to selfperception as a burden was found to be significant in the explanation of loneliness, explaining 18.10% of the variance. Specifically, the relationship between physical limitations and loneliness was stronger when levels of guilt related to selfperception as a burden were high or medium than when these levels were low. Conclusions: The findings suggest that feelings of loneliness are more frequent in people who report more physical limitations and, at the same time, report guilt for perceiving themselves as a burden. Guilt related to perceiving oneself as a burden seems to be a relevant modulator variable for understanding the effects of physical limitations on lonelinessUniversidad Autónoma de Madri

"We're staying at home". Association of self-perceptions of aging, Personal and family resources and loneliness with psychological distress during the lock-down period of COVID-19

Families are going through a very stressful time because of the COVID-19 outbreak, with age being a risk factor for this illness. Negative self-perceptions of aging, among other personal and relational variables, may be associated with loneliness and distress caused by the pandemic crisis. Method: Participants are 1,310 Spanish people (age range: 18–88 years) during a lock-down period at home. In addition to specific questions about risk for COVID-19, self-perceptions of aging, family and personal resources, loneliness, and psychological distress were measured. Hierarchical regression analyses were done for assessing the correlates of loneliness and psychological distress. Results: The measured variables allow for an explanation of 48% and 33% of the variance of distress and loneliness, respectively. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, more contact with relatives different to those that co-reside, fewer positive emotions, less perceived self-efficacy, lower quality of sleep, higher expressed emotion, and higher loneliness were associated with higher distress. Being female, younger, having negative self-perceptions about aging, more time exposed to news about COVID-19, lower contact with relatives, higher self-perception as a burden, fewer positive emotions, lower resources for entertaining oneself, lower quality of sleep, and higher expressed emotion were associated with higher loneliness. Discussion: Having negative self-perceptions of aging and lower chronological age, together with other measured family and personal resources, are associated with loneliness and psychological distress. Older adults with positive self-perceptions of aging seem to be more resilient during the COVID-19 outbrea

El conocimiento sobre la enfermedad de Alzheimer, la cognición disfuncional y el afrontamiento en la tensión arterial del cuidador

Dysfunctional ways of thinking and coping with caregiving have been associated with worse caregivers’ cardiovascular health. The objective of this study is to analyze the associations between caregivers’ knowledge about Alzheimer’s disease, dysfunctional thoughts, experiential avoidance, and blood pressure. Participants were 123 family caregivers of a relative with dementia. Path analysis was used to analyze the association between the assessed variables. The obtained model shows that there is a significant and negative relationship between caregivers’ knowledge about Alzheimer’s disease and systolic blood pressure, potentially mediated by caregivers’ dysfunctional thoughts and experiential avoidance. The findings of this study provide support to the idea that a lack of knowledge about Alzheimer’s disease may contribute to maladaptive ways of thinking about caregiving, increasing caregivers’ cardiovascular risk.El pensamiento disfuncional acerca del cuidado o el inadecuado afrontamiento del mismo han sido asociados con una peor salud física de los cuidadores. El objetivo de este estudio es analizar las asociaciones entre el conocimiento de los cuidadores sobre la enfermedad de Alzheimer, los pensamientos disfuncionales, la evitación experiencial y la presión arterial. Los participantes de este estudio fueron 123 cuidadores de un familiar con demencia. Un modelo de senderos fue empleado para analizar la relación entre las variables. El modelo obtenido muestra que existe un relación negativa y significativa entre el conocimiento de los cuidadores acerca de la enfermedad d Alzheimer y la presión arterial sistólica, potencialmente medida por los pensamientos disfuncionales y la evitación experiencial de los cuidadores. Los resultados de este estudio apoyan la idea de que una falta de conocimiento acerca de la enfermedad de Alzheimer puede contribuir a cogniciones desadaptativas acerca del cuidado, incrementando el riesgo cardiovascular de los cuidadoresThe preparation of this paper was supported in part by grants from the Spanish Ministry of Economy and Competitiveness under grants PSI2012-31239 and PSI2015- 65152-C2-1-R, and by the Comunidad Autónoma de Madrid, through a pre-doctoral scholarship for the first author of this work. Samara Barrero was supported by a FPU grant from the Spanish Ministry of Education, Culture and Spor

Comportamiento asertivo en cuidadores familiares de personas con demencia: desarrollo y validación del “Cuestionario de asertividad en el cuidado” (CAQ)

Dementia family caregivers´ assertiveness may play a significant role in the caregiving stress and coping process, but research analyzing this topic is still scarce. This study presents the psychometric properties of the Caregiving Assertiveness Questionnaire (CAQ) and analyzes the associations between assertiveness and other variables with a relevant role in the caregiving coping process. One hundred and forty-seven family dementia caregivers participated in the study. A three-factor structure (expressing discomfort, facing conflicts and setting limits) was found for the CAQ, which explained a 69.63% of the variance in assertiveness. Significant associations were found between scores in CAQ (total scale and subscales) and variables such as experiential avoidance, cognitive fusion and frequency of leisure. CAQ presents appropriate psychometric characteristics and is a useful assessment tool to take into consideration when designing comprehensive assessment protocols for dementia family caregivers, and designing interventions aimed at helping this populationLa asertividad podría tener un papel relevante en el proceso de estrés y afrontamiento del cuidado familiar de personas con demencia. Sin embargo, la investigación sobre esta cuestión es todavía escasa. Este estudio presenta las propiedades psicométricas del “Cuestionario de asertividad en el cuidado” (CAQ), y analiza las asociaciones entre esta variable y otras que presentan un papel importante en el afrontamiento del cuidado. Participaron 147 cuidadores de personas con demencia. Se identificó la estructura factorial del CAQ (expresión del malestar, hacer frente a los conflictos y poner límites), que explicaba el 69,63% de la varianza en asertividad. Se encontraron asociaciones significativas entre las puntuaciones en el CAQ (escala total y subescalas) y otras variables tales como la evitación experiencial, fusión cognitiva y frecuencia de ocio. El CAQ presenta adecuadas propiedades psicométricas y es un instrumento de potencial utilidad a tener en cuenta a la hora de diseñar protocolos de evaluación de los cuidadores familiares y diseñar intervenciones dirigidas a ayudar a estas personasThe preparation of this article was supported by the Spanish Ministry of Economy and Competitiveness under the grant PSI2012-31293 and the Ministry of Science and Innovation under the grant PID2019- 106714RB-C22. Both projects were reviewed and approved by the Ethics Committee of the Universidad Rey Juan Carlos (Registration Number: 060720166616

Sociocultural influences on the feeling of loneliness of family caregivers of people with dementia: The role of kinship

The extent to which familism, dysfunctional thoughts, and coping variables contribute to explaining feelings of loneliness in caregivers, controlling for kinship, is analyzed. Participants were 273 family caregivers of people with dementia. Sociodemographic variables, familism, dysfunctional thoughts, coping strategies for requesting and receiving help, perceived social support, and leisure activities were assessed. The fit of a theoretical model for explaining the effect of cultural and psychological variables on feelings of loneliness in each kinship group was tested. No significant differences in the distribution of loneliness by kinship were found. Higher levels of familism are associated with more dysfunctional thoughts, that are linked to more maladaptive strategies for coping with caring (e.g., less social support and fewer leisure activities). This in turn is associated with higher scores in the feeling of loneliness. The model bore particular relevance to the group of daughters, husbands, and sons, yet not in the case of wives. Sociocultural and coping factors associated with the caring process seem to play an important role in explaining feelings of loneliness in caregivers. Sociocultural factors associated with the care process seem to play an important role in explaining feelings of loneliness in caregiversThis work was supported by the Spanish Ministry of Economy and Competitiveness (PSI2015-65152-C2-1-R) and the Ministry of Science and Innovation (PID2019-106714RB-C21). Cristina Huertas and Samara Barrera were supported by a FPU grant from the Spanish Ministry of Education, Culture and Sport. María del Sequeros Pedroso-Chaparro was supported by a FPI grant from the Universidad Autónoma de Madr

Dimensiones de contenido de preocupación en población de edad avanzada

This study is aimed to analyze the main dimensions of contents of worry in the elderly, from the starting point of a broad pool of items referring to specific contents of worry relevant to this age group. The sample was composed by 105 adults aged 65 and over, who were randomly selected from the census of an urban locality. A Factor Analysis was used and 35 items, grouping into 5 subscales (Financial, Health, Family, Personal Competences, and Socio- Affective concerns) were retained. These five subscales correlated positive and significantly with worry, anxiety and depression measures. High worriers scored significantly higher in every subscale. The 35-item Worry Scale (Escala de Preocupaciones; EP), is proposed as a reliable and valid instrument to assess contents of worry among older adults, although additional validations are still required.Este estudio se dirige a analizar las principales dimensiones de contenidos de preocupación entre las personas mayores, partiendo de un amplio listado de Ítems sobre contenidos específicos relevantes en esta edad. La muestra se compuso de 105 personas mayores de 65 años, seleccionadas mediante muestreo aleatorio a partir del censo de una localidad urbana. Mediante análisis factorial se retuvieron 35 Ítems agrupados en cinco subescalas; Economía, Salud, Familia, Competencias Personales y aspectos Socio-Afectivos. Estas cinco subescalas tuvieron correlaciones positivas y significativas con medidas de preocupación, ansiedad y depresión. Las personas con niveles altos de preocupación obtuvieron puntuaciones significativamente superiores en todas las escalas. La Escala de Preocupaciones (EP) compuesta por los 35 Ítems retenidos se propone como un instrumento fiable y válido de evaluación de los contenidos de preocupación en las personas mayores, aunque son precisas validaciones adicionales

Behavioural intervention to reduce disruptive behaviours in adult day care centres users: A randomizsed clinical trial (PROCENDIAS study)

[ENG]Aim: This study assesses the effect of an intervention to reduce the disruptive behaviours (DB) presented by care recipient users of adult day care centres (ADCC), thereby reducing caregiver overload. While ADCC offer beneficial respite for family caregivers, the DB that many care recipients show promote resistance to attending these centres, which can be a great burden on their family caregivers. Design: Randomized controlled clinical trial. Methods: The study was carried out with 130 family caregivers of people attending seven ADCC in the municipality of Salamanca (Spain), randomly distributed into intervention and control groups. The intervention was applied across eight sessions, one per week, in groups of 8–10 people where caregivers were trained in the Antecedent- Behavior-Consequence (ABC) model of functional behaviour analysis. The primary outcome was the reduction of DB measured with the Revised Memory and Behavior Problems Checklist (RMBPC). Results: An average reduction in the RMBPC of 4.34 points was obtained in the intervention group after applying the intervention (p < 0.01 (U de Mann–Whitney); Cohen d = 1.00); furthermore, differences were found in the Center for Epidemiologic Studies Depression Scale (CES-D) (U = −2.67; p = 0.008; Cohen d = 0.50) and in the Short Zarit Burden Interview (Short ZBI) (t = −4.10; p < 0.01; Cohen d = 0.98). Conclusion: The results obtained suggest that the implementation of this intervention could reduce both the frequency of DB occurrence and the reaction of the caregiver to their appearance. Improvement was also noted in the results regarding overload and emotional state of the family caregiver. Impact: To our knowledge, this is the first randomized clinical trial to show that an intervention based on the ABC model could reduce the frequency and reaction of DB of care recipients in ADCC increasing their quality of life, and improving the mental health and overload of their family caregivers

Relationships between quality of life and family function in caregiver

<p>Abstract</p> <p>Background</p> <p>There are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of this study is to analyse the relationship between the functionality of the family and the QoL of caregivers of dependent relatives.</p> <p>Methods</p> <p>We conducted a cross-sectional study including 153 caregivers. Setting: Two health centers in the city of Salamanca(Spain). Caregiver variables analysed: demographic characteristics, care recipient features; family functionality (Family APGAR-Q) and QoL (Ruiz-Baca-Q) perceived by the caregiver. Five multiple regressions are performed considering global QoL and each of the four QoL dimensions as dependent variables. The Canonical Correspondence Analysis (CCA) was used to study the influence of the family function questionnaire on QoL.</p> <p>Results</p> <p>Family function is the only one of the variables evaluated that presented an association both with global QoL and with each of the four individual dimensions (p < 0.05). Using the CCA, we found that the physical and mental well-being dimensions are the ones which present a closer relationship with family functionality, while social support is the quality dimension that is least influenced by the Family APGAR-Q.</p> <p>Conclusion</p> <p>We find an association between family functionality and the caregiver's QoL. This relation holds for both the global measure of QoL and each of its four individual dimensions.</p

Dependencia y autonomía funcional en la vejez: la profecía que se autocumple

Fundamento: A partir de este trabajo se pretende analizarla influencia de las imágenes sociales que los cuidadores informales de personas mayores dependientes mantienen sobre la autonomía funcional que muestran las personas mayores a las que cuidan, influencia hipotetizada en el modelo de Little. Método: 58 cuidadores y 45 personas mayores dependientes fueron evaluados en diferentes variables relacionadas con los planteamientos del modelo. Resultados: Los resultados muestran (a) una relación significativa entre las imágenes de los cuidadores y el bienestar de la persona mayor, relación que se encuentra mediada por variables psicológicas como la autoeficacia de la persona mayor y no por variables biológicas como la edad de la persona mayor o el número de enfermedades crónicas padecidas por ésta, y (b) una relación significativa entre los estereotipos sociales que mantienen los cuidadores y las atribuciones que realizan sobre su propio familiar de edad avanzada. Conclusión: Los datos apoyan parcialmente el modelo de Little al señalar la existencia de una relación entre las atribuciones del cuidador sobre su familiar mayor y el nivel de autonomía personal de este último