Department of Human Development and Family Studies, The Pennsylvania State University, University Park, USA.
J Gerontol B Psychol Sci Soc Sci. 2013 Mar;68(2):202-14. doi: 10.1093/geronb/gbs063. Epub 2012 Sep 5.
The current study examined how a key component of caregiving stress processes, global mastery perceptions, changes with placing the care recipient in a nursing home or institution. We also explored the role of primary stressors in accounting for mastery changes with placement and whether characteristics of the caregiver and care recipient moderate reactions to placement.
We applied multiphase growth curve models to prospective longitudinal data from 271 caregivers in the Caregiver Stress and Coping Study who experienced placement of their care recipient.
Using a time-to/from-placement metric, we found that caregivers typically experienced declines in mastery preceding placement, followed by a significant increase within 1 year after placement and further increases thereafter. Corresponding changes in primary stressors (role overload) mediated the placement-related increase in mastery. Caregivers who reported more depressive symptoms and activities of daily living/instrumental activities of daily living dependencies of the care recipient were more likely to experience larger placement-related increases in mastery perceptions.
Our findings suggest that placement alters psychological resources of caregivers and this effect is driven by corresponding changes in primary stressors. Findings also underscore the importance of examining change processes across salient life events and transitions.
本研究考察了照顾压力过程的一个关键组成部分——全球掌握感是如何随着将照顾对象安置在养老院或机构中而发生变化的。我们还探讨了主要压力源在解释与安置相关的掌握感变化中的作用，以及照顾者和照顾对象的特征是否对安置的反应起调节作用。
我们应用多阶段增长曲线模型对照顾者压力和应对研究中的 271 名经历照顾对象安置的照顾者的前瞻性纵向数据进行分析。
使用从/到安置的时间度量，我们发现照顾者在安置前通常会经历掌握感的下降，随后在安置后 1 年内会出现显著增加，此后进一步增加。主要压力源（角色过载）的相应变化中介了与安置相关的掌握感的增加。报告照顾对象有更多抑郁症状和日常生活活动/工具性日常生活活动依赖的照顾者更有可能经历与安置相关的掌握感的更大增加。
我们的研究结果表明，安置改变了照顾者的心理资源，这种效应是由主要压力源的相应变化驱动的。研究结果还强调了在重要生活事件和过渡中检验变化过程的重要性。
