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caregiver, caregiving process, dementia



  1. Liu, Yu
  2. Insel, Kathleen C.
  3. Reed, Pamela G.
  4. Crist, Janice D.


Background: The process of taking care of older people with dementia at home is complex and influenced by cultural factors, necessitating a better understanding of the interrelationships of factors within the context of culture.


Objectives: The aim of this study was to test the proposed Dementia Caregiving Model, specifying how caregiving appraisal, coping, perceived social support, and familism influence the impact of caregiving stressors on the psychological health of caregivers.


Methods: A cross-sectional correlational design with a convenience sample (n = 96) from three outpatient clinics of hospitals in China was used. Questionnaires were utilized to measure the variables in the model. Path analysis was used to assess model fit and paths.


Results: The original proposed model did not fit the data, butminor modifications produced a very good model fit ([chi]2(10, n = 96) = 8.14, p = .62; goodness-of-fit index = .98, comparative fit index = 1.00, and root mean square error of approximation < .001). Care recipients' behavioral problems had direct and indirect negative effects on caregivers' psychological health. Perceived social support had direct and indirect positive effects on caregivers' psychological health. Familism had indirect positive effects on caregivers' psychological health in relation with caregiving satisfaction and coping. Caregiving appraisal and coping were mediators in the model.


Conclusions: The model findings lend support that caregivers' cognitive appraisal and coping explain some observed individual differences in stress response and outcomes. The findings broaden understanding of the effects of familism on caregivers' psychological health. In the future, programs should include interventions for caregivers, as well as interventions for care recipients.