López-Martínez Catalina, Orgeta Vasiliki, Frías-Osuna Antonio, Del-Pino-Casado Rafael
Department of Nursing, Faculty of Health Sciences, University of Jaén, Jaén, Spain.
Division of Psychiatry, University College London, London, UK.
Int J Geriatr Psychiatry. 2021 May;36(5):722-730. doi: 10.1002/gps.5472. Epub 2020 Nov 21.
Sense of coherence (SOC) is an important protective factor for carer well-being but research to date remains cross-sectional, focusing primarily on the direct effects of SOC on carers' mental health. The study's aim was to investigate the mediating role of SOC in the longitudinal relationship between caregiver strain and carers' psychological health, and its stability over time.
Prospective longitudinal study conducted in Jaén (Spain) with a probabilistic sample of 132 carers of older people, with data collected at baseline and at 1-year follow-up. We measured SOC, caregiver strain, anxiety and depressive symptoms, and several care-recipient characteristics and intensity of care provided. We used multiple linear regression modelling and the Sobel test to analyse mediation effects.
SOC was significantly negatively longitudinally associated with both anxiety (β = -0.38, p = 0.001) and depressive symptoms (β = -0.28, p = 0.023), after controlling for several confounders. SOC mediated both the relationship between caregiver strain and anxiety, and caregiver strain and depressive symptoms (Sobel test: p < 0.001 for anxiety and p < 0.001 for depressive symptoms). Differences between baseline and 1-year follow-up SOC scores were not statistically significant (p = 0.617).
SOC appears to buffer the impact of caregiver strain on symptoms of depression and anxiety in informal carers of older people. Our data showed that SOC is an important psychological resource for carers that remained relatively stable under non-experimental conditions over a period of 1 year in this sample. The findings suggest that interventions aimed at strengthening SOC may protect carer psychological well-being.
连贯感（SOC）是照顾者幸福感的一个重要保护因素，但迄今为止的研究仍为横断面研究，主要关注SOC对照顾者心理健康的直接影响。本研究的目的是调查SOC在照顾者压力与照顾者心理健康的纵向关系中的中介作用及其随时间的稳定性。
在西班牙哈恩进行的前瞻性纵向研究，对132名老年人照顾者进行概率抽样，在基线和1年随访时收集数据。我们测量了SOC、照顾者压力、焦虑和抑郁症状，以及一些受照顾者特征和提供的护理强度。我们使用多元线性回归模型和索贝尔检验来分析中介效应。
在控制了几个混杂因素后，SOC在纵向与焦虑（β = -0.38，p = 0.001）和抑郁症状（β = -0.28，p = 0.023）均呈显著负相关。SOC介导了照顾者压力与焦虑之间的关系以及照顾者压力与抑郁症状之间的关系（索贝尔检验：焦虑p < 0.001，抑郁症状p < 0.001）。基线和1年随访时SOC分数的差异无统计学意义（p = 0.617）。
SOC似乎缓冲了照顾者压力对老年人非正式照顾者抑郁和焦虑症状的影响。我们的数据表明，SOC是照顾者的一种重要心理资源，在本样本中，在非实验条件下1年内保持相对稳定。研究结果表明，旨在增强SOC的干预措施可能会保护照顾者的心理健康。
