Hostname: page-component-76fb5796d-x4r87 Total loading time: 0 Render date: 2024-04-26T06:44:09.930Z Has data issue: false hasContentIssue false
  • English
  • Français

The Role of Social and Psychological Resources in the Evolution of Depression in Caregivers*

Published online by Cambridge University Press:  31 March 2010

Maria-Victoria Zunzunegui ,
Alicia LlácerCentro  and
François Béland
Maria-Victoria Zunzunegui*
Affiliation:
Université de Montréal
Alicia LlácerCentro
Affiliation:
Nacional de Epidemiología, Madrid
François Béland
Affiliation:
Université de Montréal
*
Requests for offprints should be sent to:/Les demandes de tirés-a-part doivent être adressées à : Maria-Victoria Zunzunegui, Ph.D., Département de Médecine sociale et préventive, Faculté de Médecine, P.O. Box 6128, Centre-Ville Postal Station, Montreal, QC, H3C 3J7. (maria.victoria.zunzunegui@umontreal.ca).
Get access Rights & Permissions [Opens in a new window]

Abstract

This article discusses a longitudinal study of caregivers (n = 195) from a representative sample of caregivers pf Spanish, ADL-disabled persons, aged 65 and over carried out to assess the role of social support and religiosity in the development of depression. Depressive symptomatology was assessed using the Center for Epidemiologic Studies Depression (CES-D) scale. One year later, 119 of the caregivers were contacted again. Stability of depression over 1 year was observed in most participants. Poor physical health and low self-esteem, as well as incontinence in the care recipients, were significant predictors of the development of depressive symptoms. Social support had a differential effect on the development of depression, depending on how much assistance with activities of daily living the caregivers had to provide. Religiosity seemed to have no effect. Depression in caregivers is related more to their health and psychosocial resources than to the amount of care they provide. Poor health status, low self-esteem, and lack of emotional support may be useful indicators in identifying caregivers at high risk for depression.

Résumé

Le présent article commente une étude longitudinale de fournisseurs de soins (n = 195) tirée d'un échantillonnage représentatif de fournisseurs de soins auprès de personnes espagnoles invalides âgées de 65 ans et plus et dont le but était d'évaluer le rôle du soutien social et des croyances religieuses dans le développement de la dépression. La symptomatologie dépressive a été évaluée en utilisant l'échelle CES (Center for Epidemiologic Studies) pour mesurer la dépression. Un an plus tard, 119 personnes parmi ces fournisseurs de soins ont été contactées de nouveau. On a constaté, chez la plupart des participants, l'état stable de leur dépression sur une période continue d'une année. Une mauvaise santé physique, un sentiment de dévalorisation ainsi que l'incontinence des bénéficiaires des soins constituaient des signes avantcoureurs du développement de symptômes dépressifs. Le soutien social a produit un effet différent sur le développement de la dépression, selon le niveau d'aide devant être prodigué par les fournisseurs de soins dans l'accomplissement des diverses activités quotidiennes. Les croyances religieuses semblent n'avoir eu aucune incidence. La dépression chez les fournisseurs de soins dépend plus de leur santé et de leurs ressources psychosociales que du niveau de soins qu'ils prodiguent. Un mauvais état de santé, un sentiment de dévalorisation et l'absence de soutien émotif peuvent constituer des indices utiles dans l'identification des fournisseurs de soins qui courent un plus grand risque de dépression.

Keywords

depressionsocial supportfamily caregiverslongitudinal studiesdépressionsoutien socialfournisseurs de soinsétudes longitudinales
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 21 , Issue 3 , Fall/Automne 2002 , pp. 357 - 369
Copyright
Copyright © Canadian Association on Gerontology 2002

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

This work was financed by the Fondo de Investigaciones Sanitarias: Project 95/549.

References

1.Zarit, SH, Todd, PA, Zarit, JM. Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986;26:260–266.Google Scholar
2.Rabins, PV, Fitting, MD, Eastham, J, Zabora, J. Emotional adaptation over time in caregivers for chronically ill elderly people. Age Ageing 1990;19:185–190.Google ScholarPubMed
3.Ballard, CG. A follow up study of depression in the care-givers of dementia sufferers. BMJ 1996;312:947–948.CrossRefGoogle ScholarPubMed
4.Schulz, R, Williamson, GM. A 2-year longitudinal study of depression among Alzheimer's caregivers. Psychol Aging 1991;6:569–578.CrossRefGoogle ScholarPubMed
5.Redinbaugh, EM, MacCallum, RC, Kiecolt-Glaser, JK. Recurrent syndromal depression in caregivers. Psychol Aging 1995;10:358–368.CrossRefGoogle ScholarPubMed
6.Baumgarten, M, Hanley, JA, Infante-Rivard, C, Battista, R, Becker, R, Gauthier, S. Health of family members caring for elderly persons with dementia: a longitudinal study. Ann Intern Med 1994;120:126–32.Google Scholar
7.Pruchno, RA, Kleban, MH, Michaels, JE, Dempsey, NP. Mental and physical health of caregiving spouses: development of a causal model. J Gerontol 1990;45:P192–P199.CrossRefGoogle ScholarPubMed
8.Pearlin, LI, Mullan, JT, Semple, SJ, Skaff, MM. Caregiving and the stress process: an overview of concepts and their measure. Gerontologist 1990;30:583–91.CrossRefGoogle Scholar
9.Rabins, PV, Mace, NL, MJ Lucas.. The impact of dementia in the family. JAMA 1982;248:333–335.Google Scholar
10.Sanford, JRA. Tolerance of debility in elderly dependants by supporters at home: its significance for hospital practice. BMJ 1975;3:471–473.Google Scholar
11.Haley, WE, Roth, DL, Coleton, MI, Ford, GR, West, CAC, Collins, RP, Isobe, TL. Appraisal, coping and social support as mediators of well being in black and white family caregivers of patients with Alzheimer's disease. J Consulting Clin Psychol 1996;64:121–129.Google Scholar
12.Nijboer, C, Tempelaar, R, Triemstra, M, van den Bos, GAM, Sanderman, R. The role of social and psychologic resources in caregiving of cancer patients. Cancer 2001;91:1029–1039.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
13.Cohen, S, Wills, T. Stress, social support, and the buffering hypothesis. Psychol Bull 1985;98:31–57.Google Scholar
14.Levin, JS. How religion influences morbidity and health: reflections on natural history, salutogenesis and host resistance. Soc Sci Med 1996;43:849–864.CrossRefGoogle ScholarPubMed
15.Chang, BH, Noonan, AE, Tennstedt, SL. The role of religion/spirituality in coping with caregiving for disabled elders. Gerontologist 1998;38:463–470.Google Scholar
16.Strawbridge, WJ, Shema, SJ, Cohen, RD, Roberts, RE, Kaplan, G. Religiosity buffers effects of some stressors on depression but exacerbates others. J Gerontol 1998;53B: S118–S126.Google Scholar
17.Krause, N. Stress, religiosity and psychological well-being among older blacks. J Aging & Health 1992;4:412–439.CrossRefGoogle Scholar
18.Ellison, CG. Religious involvement and subjective well being. J Health Soc Behav 1991;32:80–99.CrossRefGoogle ScholarPubMed
19.Aneshensel, CS, Pearlin, LI, Mullan, JT, Zarit, SH, Whitlach, CJ, editors. Profiles in caregiving. New York: Academic Press; 1995.Google Scholar
20.Schulz, R, Newsom, J, Mittelmark, M, Burton, L, Hirsch, C, Jackson, S. Health effects of caregiving: The caregiving health effects study: an ancillary study of the cardiovascular health study. Ann Behav Med 1997;19:110–116.CrossRefGoogle ScholarPubMed
21.Lawton, MP, Rajagopal, D, Brody, E, Kleban, MH. The dynamics of caregiving for a demented elder among black and white families. J Gerontol 1992;47:S156–S164.CrossRefGoogle ScholarPubMed
22.Instituto de Servicios Sociales (INSERSO). Las personas mayores en España. Perfiles. Reciprocidad familiar. Madrid: Ministerio de Asuntos Sociales; 1995.Google Scholar
23.Béland, F, Zunzunegui, MV. The elderly in Spain: the dominance of family and the wherewithal of the state. In: Litwin, H, editor. Social networks of older people. London: Praeger; 1996. p. 55–76.Google Scholar
24.Bazo, MT. El cuidado familiar en las personas ancianas con enfermedades cronicas. El caso de los pacientes con enfermedad de Alzheimer. Rev Esp Geriatr Gerontol 1998;33:49–56.Google Scholar
25.De Andrés, J, Pla, M. Mujer, familia, red social y cuidados a los ancianos con problemas de salud. Sabadell, Spain: Ayuntamiento de Sabadell; 1996.Google Scholar
26.Instituto de Servicios Sociales (INSERSO). Cuidados en la vejez. El apoyo informal. Madrid: Ministerio de Asuntos Sociales; 1996.Google Scholar
27.Zunzunegui, MV, Béland, F, Llacer, A, Keller, I. Family, religion and depressive symptoms in caregivers of disabled elderly. J Epidemiol Community Health 1999;53:364–369.Google Scholar
28.Zunzunegui, MV, Béland, F, Gutierrez, Cuadra P. Loss to follow-up in a longitudinal study on ageing in Spain. J Clin Epidemiol 2001;54:501–510.Google Scholar
29.Radloff, LS The CES-D scale: self report depression scale for use in the general population. Appl Psychol Meas. 1:385–401.CrossRefGoogle Scholar
30.Radloff, LS, Teri, L. Use of the Center for Epidemiological Studies Depression Scale with older adults. Clin gerontol 1986;1977;5:119–36.Google Scholar
31.Berkman, LF, Berkman, CS, Kasl, S, Freeman, DH, Leo, L, Ostfeld, AM, Coroni-Huntley, J, Brody, JA. Depressive symptoms in relation to physical health and functioning in the elderly. Am J Epidemiol 1986;124:372–38.CrossRefGoogle ScholarPubMed
32.McCallum, J, McAkinnon, A, Simmons, L, Simons, J. Measurement properties of the Center for Epidemiological Studies of Depression Scale: an Australian community study of aged persons. J Gerontol 1995;50B:S182–S189.Google Scholar
33.Moscicki, EK, Locke, B, Rae, DS. Depressive symptoms among Mexicans: The Hispanic Health and Nutrition Examination Survey. Am J Epidemiol 1989;130:348–360.Google Scholar
34.Zunzunegui, MV, Delgado, M, Perez-Perez, E, Yague, AI, Illescas, ML, Leon, V. Validacion de la escala CES-D para la medida de la sintomatologia depresiva en una poblacion de personas mayores. Rev Mult Gerontol 1998;6:156–161.Google Scholar
35.Lawton, MP, Brody, EM Assessment of older people: self-monitoring and instrumental activities of daily living. Gerontologist 1969;9:179–86.CrossRefGoogle Scholar
36.Coroni-Huntley, J, Brock, DB, Ostfeld, A, Taylor, JO, Wallace, RB, editors. Established populations for epidemiologic studies of the elderly: resource data book. Bethesda, MD: National Institute of Health; 1986. (NIH publication no. 86-2443).Google Scholar
37.Aday, LA, Anderson, R, Fleming, GR. Health care in the US: equitable for whom? Beverly Hills: Sage Publications; 1980.Google Scholar
38.Nagi, SZ. An epidemiology of disabled among adults in the United States. Milbank Q 1976;54:439–768.Google Scholar
39.Markides, KS, Levin, JS, Ray, LA. Religion, aging, and life satisfaction: an eight-year, three-wave longitudinal study. Gerontologist 1987;27,660–665.Google Scholar
40.Kielcot-Glaser, JK, Dura, JR, Specicher, CE, Trask, J, Glaser, R. Spousal caregivers of dementia victims: longitudinal changes in immunity and health. Psychosom Med 1991;53:345–362.Google Scholar
41.Stone, R, Cafferata, GL, Sangl, J. Caregivers of the frail elderly: a national profile. Gerontologist 1987;27:616–626.CrossRefGoogle ScholarPubMed
42.Zunzunegui, MV, Béland, F, Llacer, A, Leon, V. Gender differences in depressive symptoms among Spanish elderly. Soc Psychiatry Psychiatr Epidemiol 1998;33:195–205.Google Scholar
43.Wailing-Li, L, Mailick-Seltzer, M, Greenberg, JS. Social support and depressive symptoms: differential patterns in wife and daughter caregivers. J Gerontol 1997;52B:S200–S211.Google Scholar
44.Miller, B, Campbell, RT, Farran, CJ, Kaufman, JE, Davis, L. Race, control, mastery and caregiver distress. J Gerontol 1995;50B:S374–S382.Google Scholar
45.Pagel, MD, Becker, J, Coppel, DB. Loss of control, self-blame, and depression: an investigation of spouse caregivers of Alzheimer's disease patients. J Abnorm Psychol 1985;94:169–182.Google Scholar
46.Bass, DN, Noelker, LS, Rechling, LR. The moderating influences of service use on negative caregiving consequences. J Gerontol 1996;51B:S121–S131.Google Scholar
47.Bermejo, F, Rivera, J, Trincado, R, Olazarán, J, Fernandez, C, Gabriel, R. Aspectos del cuidado sociofamiliar al paciente con demencia. Datos de un estudio poblacional en dos zonas de Madrid. Rev Mult Gerontol 1997;7:92–99.Google Scholar
48.Llácer, A, Zunzunegui, MV, Béland, F. Los servicios sanitarios y sociales de apoyo al cuidador de personas may-ores con incapacidades. Rev Esp Geriatr Gerontol 1999;34:34–43.Google Scholar