Demanslı Hastalarla İlgilenen Aile Üyelerinin Bakım Veren Yükünün İncelenmesi

Bu araştırma demans hastası bireylere bakım veren aile üyelerinin stresle başa çıkma düzeylerinin, özyeterliklerinin ve psikolojik dayanıklılıklarının bakım veren yükü ile gösterdikleri ilişkiyi ortaya koymak amacıyla yapılmıştır. Araştırma İzmir ilinde sağlık hizmeti veren üniversite hastanelerinde tedavi gören demans hastalarının yakınları ve Alzheimer Derneği üyesi olan hasta yakınlarından oluşan 134 kişi üzerinden yürütülmüştür. Araştırmada demans hastasına bakım veren aile üyelerinin bakım veren yükleri Bakım Veren Yükü Envanteri, stresle başa çıkma tarzları Stresle Başa Çıkma Tarzları Ölçeği, psikolojik dayanıklılıkları Yetişkinler için Psikolojik Dayanıklılık Ölçeği, özyeterlikleri ise Genelleştirilmiş Algılanan Özyeterlik Ölçeği ile belirlenmiştir. Bakım veren ve hasta arası yakınlığın düzeyi ve bakım verene yönelik demografik bilgiler araştırmacılar tarafından geliştirilen Kişisel Bilgi Formu ile elde edilmiştir. Korelasyon analizi sonuçlarına göre baş etme becerisi ve psikolojik dayanıklılığın bakım veren yükü ile negatif ilişkisi olduğu, öz yeterliliğin stresle baş etme ve psikolojik dayanıklılık ile pozitif ilişkisi istatistiksel olarak anlamlı bulunmuştur. Çoklu regresyon analiz sonuçlarına göre Bakım Veren Yükü ölçeğinin alt boyutlarının değişkenlerden en az biri tarafından yordandığı bulunmuştur. Bakım veren aile üyelerine yönelik geliştirilecek psikolojik destek programlarında bu faktörlerin göz önüne alınması önerilmektedir.

Anahtar Kelimeler:

Demans, Bakım Veren Yükü, Psikolojik Dayanıklılık, Öz Yeterlilik, Stresle Başa Çıkma

Investigation of Caregiver Burdens of Family Members Who Looks After Patients With Dementia

This study was carried out to determine the relationship between caregiver burden, coping levels, self-efficacy and psychological resilience of family caregivers of persons with dementia. The research was carried out on 134 family caregivers of persons with dementia who received health care from university hospitals in Izmir and members of İzmir Branch of Alzheimer Solidarity Association. In the study, family caregivers of dementia patients’ caregiver burden, ways of coping with stress, self efficacy and psychological resilience were measured by Caregiver Burden Inventory, Ways of Coping Inventory, Generalized Perceived Self Efficacy Scale, and Resilience Scale for Adults respectively. Relevant demographic information about caregivers and patients was collected by using Demographic Information Form which was developed by the researchers. According to the results of correlational analysis, the relationship of caregiver burden with coping skills and resilience and the relationship of self efficacy with time dependence burden and social burden were found statistically significant. The multiple regression analysis indicated that the Caregiver Burden Inventory Sub Scales was estimated by at least one of the independent variables. It is recommended that these factors are considered in support programs developed for caregiving family members.

Keywords:

Dementia, Caregiver Burden, Resilience, Self Efficacy, Coping with Stress,

PDF

___

Bağcı, S.C (2016). Does everyone benefit equally from self- efficacy Beliefs? The moderating role of perceived social support on motivation. Journal of Early Adolescence, 38(2), 204–219 doi:10.1177/0272431616665213
Bandura, A. (1977). Toward a Unifying theory of behavioral change. Psychological Review, 84, 191-215 doi:10.1037/0033-295X.84.2.191
Bandura, A. (1982), Self-efficacy mechanism in human agency. American Psychologists, 37(2), 122-147 doi:10.1037/0003-066X.37.2.122
Basım, H. N. ve Çetin, F. (2011). Yetişkinler için Psikolojik Dayanıklılık Ölçeğinin güvenilirlik ve geçerlik çalışması. Türk Psikiyatri Dergisi, 22(2), 104-114.
Bekhet, A. K. (2013), Effects of positive cognitions and resourcefulness on caregiver burden among caregivers of persons with dementia. International Journal of Mental Health Nursing, 22(4), 340–346 doi:10.1111/j.1447-0349.2012.00877
Borhaninejad, V., Shati, M., Bhalla, D., Iranpour, A., & Fadayevatan, R. (2017). A population-based survey to determine association of perceived social support and self- efficacy with self-Care among elderly with Diabetes Mellitus (Kerman City, Iran). The International Journal of Aging and Human Development, 85(4), 504–517 doi:10.1177/0091415016689474
Chun, M., Knight, B.G., & Youn, G. (2007). Differences in stress and coping models of emotianal distress among Korean, Korean-American and White American caregivers. Aging and Mental Health, 11(1), 20-29 doi:10.1080/13607860600736232
Compas, B. E. (1987). Coping with stress during childhood stress and adolescence. Psychological Bulletin, 101(3), 393-403
Connell, C. M., Janevic, M. J., & Gallant, M. P. (2001). The costs of caring: impact of dementia on family caregivers. Journal of Geriatric Psychiatry and Neurology, 14, 179-187 doi:10.1177/089198870101400403
Cummings, J. L. (2007). Dementia and social work practice: Research and intervention. NewYork: Springer Publishing
Davison, C. D., & Neale, J. M (2004). Anormal Psikolojisi (7. Basım) (İ. Dağ, Çev. Ed.). Ankara: Türk Psikologlar Derneği Yayınları
Deeken, J. F., Taylor, K. L., Mangan, P., Yabroff, K. R., & Ingham, J. M. (2003). Care for the caregivers: A review of self-report instruments developed to measure the burden, needs, and quality of life of informal caregivers. Journal of Pain and Symptom Management, 26(4), 922-953 doi:10.1016/S0885-3924(03)00327-0
Dias, R., Santos, R. L., Barroso, de Sousa M. F., Lima Nogueira, M. M, Torres, B., Belfort T., & Nascimento Dourado, M. C. (2015). Resilience of caregivers of people with dementia: A sistematic review of biolagical and psychosocial determinanats. Trends Psychiatry Psychother, 37(1), 12-19. doi:10.1590/2237-6089-2014-0032
Erci B. (2006), Genelleştirilmiş algılanan öz yeterlik ölçeğinin Türkçe versiyonu. Atatürk Üniversitesi Hemşirelik Yüksekokulu Dergisi, 9(2), 57-62
Etters, L., Goodall D., & Harrison, B. (2008), Caregiver burden among dementia patient caregivers: a rewiev of the literatüre. Journal of The American Association of Nurse Practitioners, 20(8), 423-428. doi:10.1111/j.1745-7599.2008.00342.x.
Friborg, O., Barlaug, D., Martinussen, M., Rosenvinge, J. H., & Odin, H. (2005). Resilience in relation to persononality and intellengence. International Journal of Methods Psychiatri Research, 14(1), 29-42
Gallagher, D., Mhaloin, A. N, Crosby L:, Ryan, D., Lacey, L., Coen, R.F., Walsh, C., Coakley, D., Walsh, J. B., Cunningham, C., & Lawlor A. B. (2011). Self-efficacy for managing dementia may protect against burden and depression in Alzheimer's caregivers. Aging & Mental Health, 15(6), 663-670. doi:10.1080/13607863.2011.562179
Gallant, M. P., & Connell, C. M. (1997). Predictors of decreased self-care among spouse caregivers of older adults with dementing illness. Journal of Aging Health, 9(3), 373-395. doi:10.1177/089826439700900306
Geiger, J. R., Wilks, S. E., Lovelace, L. L., & Spivey, C. A. (2015). Burden among male Alzheimer’s caregivers: effects of distinct coping strategies. American Journal of Alzheimer’s Disease and Other Dementias, 30(3), 238-246 doi:10.1177/1533317514552666
Gonyea, J. G., O’Connor, M., Carruth, A., & Boyle, P. A. (2005). Subjective appraisal of Alzheimer’s disease caregiving: the role of self-efficacy and depressive symptoms in the experience of burden. American Journal of Alzheimer’s Disease and Other Dementias, 20(5), 273-280 doi:10.1177/153331750502000505
Grotberg, E. (1995). A Guide to Promoting Resilience in Children: Strengthening the Human Spirit. Early Childhood Development: Practice and Reflections, v. 8. The Hague-NO: Bernard Van Leer Foundation.
Haines, J., & Williams, C. L. (1997). Coping and Problem solving of self- mutilators. Journal of Clinical psychology, 53(2), 177-186 doi:10.1002/(SICI)1097-4679(199702)53:2<177:AID-JCLP11>3.0.CO;2-H
Hernandez, S. H. A., Morgan, B. J., & Parshall, M. B. (2006). Resilience, stress, stigma, and barriers to mental healthcare in U.S. Air Force nursing personnel. Nursing Research, 65(6), 481–486 doi:10.1097/NNR.0000000000000182
Ho B., Friedland J., Rappolt S., & Noh S (2003). Caregiving for relatives with Alzheimer disease: Feelings of Chinese-Canadian Women. Journal of Aging Studies, 17, 301-321 doi:10.1016/S0890-4065(03)00028-8
Hohenfeld, C., Nellessen, N., Dogan, I., Kuhn, H., Müller, C., Papa, F., Ketteler, S., Goebel, R., & Heinecke, A. (2017). Cognitive improvement and brain changes after real-time functional MRI neurofeedback training in healthy elderly and prodromal Alzheimer’s Disease. Frontiers in Neurology, 1-15. doi:10.3389/fneur.2017.00384
Huang, M.F., Huang, W. H., Su, Y. C., Hou, S. Y., Chen, H. M., Yeh, Y. C., & Chen, C. S. (2013). Coping strategy and caregiver burden among caregivers of patients with dementia. American Journal of Alzheimer’s Disease and Other Dementias, 30(7), 694-698. doi:10.1177/1533317513494446
Hullman, G. E, Planisek, A., McNally, J. S., & Rubin, R. B. (2010). Competence, Personality, and Self-Efficacy: Relationships in an Undergraduate Interpersonal Course. Atlantic Journal of Communication, 18, 36–49 doi:10.1080/15456870903340506
Jeffries, E. R., McLeish, A. C., Kraemer, K. M., Avallone, K. M., & Fleming, J. B. (2016). The role of distress tolerance in the use of specific emotion regulation strategies. Behavior Modification, 40(3), 439– 451 doi:10.1177/0145445515619596.
Jerusalem, M., & Schwarzer, R. (1992). Self-efficacy as a resource factor in stress appraisal processes. In R. Schwarzer (Ed.), Self-efficacy: Thought control of action. (pp. 195-213). Washington, DC: Hemisphere
Kıral, K. (2011). Demans hasta yakınlarında depresyon ve yaşam doyumu: bilişsel duygu ayarlama, sosyal destek ve adil dünya inancı ilişkisi. (Yayımlanmamış yüksek lisans tezi) Mersin Üniversitesi Sosyal Bilimler Enstitüsü, Mersin.
Küçükgüçlü, Ö., Esen, A., & Yener, G. (2009). The reliability and validity of The Caregiver Burden Inventory in Turkey. Journal of Neurological Sciences, 26(1), 60-73.
Landmark, B. T., Aasgaard, H. S., & Fagerström, L. (2013). To be stuck in It—I can’t just leave: A qualitative study of relatives’ experiences of dementia suffers living at home and need for support. Home Health Care Management & Practice 25(5), 217–223 doi:10.1177/1084822313487984
Lazarus R. S., & Folkman S. (1987) Transactional teory and research on emotions and coping. European Journal of Personality 1, 141-169 doi:10.1002/per.2410010304
Masten, A. (2001). Ordinary magic: Resilience process in development. American Psychologist, 56, 227-228. Doi:10.1037/0003-066X.56.3.227
McElroy, H. A., & Strobini, J. (2001). Male caregivers of spouses with Alzheimer’s Disease: Risk factors and health status. American Journal of Alzheimer’s Disease and Other Dementias, 16(3), 167-175. doi:10.1177/153331750101600308
Morris, C. G. (2002). Psikolojiyi Anlamak-Psikolojiye Giriş (H. B. Ayvaşık ve M. Sayıl, Çev. Ed.) (1. Basım) Ankara: Türk Psikologlar Derneği Yayınları
Novak, M., & Guest, C. (1989), Application on a Multidimensional Caregiver Burden Inventory. Gerontologist, 29(6), 798-803 doi:10.1093/geront/29.6.798
O'Rourke, N., Kupferschmidt, A. L., Claxton, A., Smith, J. Z., Chappel, N., & Beattie, B. L. (2010). Psychological resilience predicts depressive symptoms among spouses of persons with Alzheimer disease over time. Aging & Mental Health, 14(8), 984-993 doi:10.1080/13607863.2010.501063
Ory, M., Hoffman, Y., Yee, j., Teensted, S., & Shult, R. (2000). Prevelance and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. Gerontologist, 39(2), 177-185 doi.10.1093/geront/39.2.177
Öz, F. ve Bahadır-Yılmaz, E. (2009). Ruh sağlığının korunmasında önemli bir kavram: Psikolojik Sağlamlık. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi Hemşirelik Dergisi, 16(3), 82-89.
Özdilek, B. F. (2008). Parkinson hastalığında motor ve motor olmayan bulguların bakım verenin yaşam kalitesi ve külfet düzeyine etkisinin değerlendirilmesi (Yayımlanmamış uzmanlık tezi). Marmara Üniversitesi Tıp Fakültesi Nöroloji Anabilim Dalı, İstanbul.
Papastavrou, E., Tsangari, H., Karayiannis, G., Papacostas, S., Efstathiou, G., & Sourtzi, P. (2011). Caring and coping: The dementia caregivers. Aging & Mental Health, 15(6), 702-711. doi:10.1080/13607863.2011.562178.
Posner, B., Sutter, B., Perrin, P. B, Hoyos, G. R, Buraye, J. A., & Arango-Lasprilla, J. C. (2015). Comparing dementia caregivers and healthy controls in mental health and health related quality of life in Cali, Colombia. Psicología desde el Caribe. Universidad del Norte, 32(1), 1-26 doi:10.14482/psdc.32.1.6273.
Schulz, R., O’Brien, A. T., Bookwala, J., & Fleissner, K. (1995). Psychiatric and physical morbidity effects of dementia caregiving: prevalence, corraletes and causes. Gerontologist, 35(6), 771-779. doi:10.1093/geront/35.6.771
Scott, C.B. (2010). Alzheimer 's disease caregiver burden: Does resilience matter? (Unpublished Dissertation). University of Tenessee, Knoxville, USA.
Schwarzer, R, Babler, J., Kwiatek, P., Schröder, K., & Zhank, J. X. (1997). The assessment of optimistic selfbeliefs: Comparison of the German, Spanish, and Chinese versions of the General Self Efficacy scale. Applied Psychology: An International Review, 46(1), 69-88. doi.org/10.1111/j.1464-0597.1997.tb01096.x.
Shankar, K. N., Hirschman, K. B., Hanlon, A. B., & Naylor, M. D. (2014). Burden in caregivers of cognitively impaired elderly adults at time of hospitalization: a cross-sectional analysis. Journal of The American Geriatrics Society, 62(2), 276-284 doi:10.1111/jgs.12657
Sun, F. (2014). Caregiving stress and coping: a thematic analysis of Chinese family caregivers of persons with dementia. Dementia, 13(6), 803-818 doi:10.1177/1471301213485593
Şahin, N. H. ve Durak, A. (1995). Stresle Başa çıkma Tarzları Ölçeği: Üniversite öğrencileri için uyarlanması. Türk Psikoloji Dergisi, 10(34), 56-73
Tutar, H., Cankurtaran, E., Tekin, P., & Çayköylü, A. (2013). The relationship between coping strategies and caregiver burden in caregivers of people with Alzheimer's dementia. The Journal of Alzheimer’s Association, 9(4), P484 doi:10.1016/j.jalz.2013.05.988
Xing, C., & Sun, J.M. (2013). The role of psychological resilience and positive affect in risky decision-making. International Journal of Psychology, 48(5), 935-943 doi:10. 1080/00207594. 2012.729840
Van denWijngaart, M. A., Vernooij-Dassen, M. J., & Felling, A. J. (2007). The influence of stressors, appraisal and personal conditions on the burden of spousal caregivers of persons with dementia. Aging Mental Health, 11(6), 626-636 doi:10.1080/13607860701368463
van der Lee J., Bakker T.J., Duivenvoorden H.J., & Dröes R.M. (2014), Multivariate models of subjective caregiver burden in dementia a systematic review. Aging Research Rewievs, 15, 76-93 doi:10.1016/j.arr.2014.03.003
Wai-Chi Chan, S. (2010). Family caregiving in dementia: the Asian perspective of a global problem. Dementia and Geriatric Cognitive Disorders, 30, 469-478 doi:10.1159/000322086
Walsh, F. (2016). Stregthening Family Resilience (3rd ed.) NewYork: The Guilford Press
Wennberg A., Dye C., Streetman-Loy B., & Pham, H. (2015) Alzheimer’s patient familial caregivers: a rewiev of burden and intervention. Health and Social Work, 40(4), 162-169 doi:10.1093/hsw/hlv062
Wilks, S. E., & Croom, B. (2008). Perceived stress and resilience in Alzheimer’s disease caregivers: Testing moderation and mediation models of social support. Aging & Mental Health, 12(3), 357–365 doi:10.1080/13607860801933323.
Yoo J. H, Jang S. A., & Choi T. (2010). Sociocultural determinants of negative emotions among dementia caregivers in the United States and in Korea: A content analysis of online support groups. Howard Journal of Communications, 21, 1-19 doi:10.1080/10646170903501195
Zimmerman, B. J. (2000). Self-efficacy: An essential motive to learn. Contemporary Educational Psychology, 25, 82-91 doi:10.1006/ceps.1999.1016