바로가기메뉴

본문 바로가기 주메뉴 바로가기

Korean Journal of Psychology: General

  • KOREAN
  • P-ISSN1229-067X
  • E-ISSN2734-1127
  • KCI

Spousal Caregiving Stress: Towards a Conceptualization of a Psychological Model

Korean Journal of Psychology: General / Korean Journal of Psychology: General, (P)1229-067X; (E)2734-1127
2010, v.29 no.2, pp.389-414


Abstract

Examining the psychological effects of spousal caregiving is an important step to a broader understanding of spousal caregiving stress in Korea where rapid demographic shift to an aged society is currently taking place. In this review article, the authors not only provided evidence of the direct effects of objective stressors such as the type and extent of disability but also the influence of demographic variables ( age, gender, economic status, and health), psychological variables (emotional stability, optimism, self-perceived control, self-efficacy, and marital satisfaction), and contextual variables (social , cultural, and familial ). The authors then propose a model of spousal caregiver stress with a focus on psychological variables. Finally, the authors provide direction for future research to expand understanding of spousal caregiving and discuss implications for clinical interventions and education to alleviate spousal caregiving burden.

keywords
spousal caregiving, caregiving stress, caregiving model, psychological variables, contextual variables, spousal caregiving, caregiving stress, caregiving model, psychological variables, contextual variables, 배우자 부양, 부양 스트레스, 부양 모델, 심리적 요인, 맥락 요인

Reference

1.

김용희, 안정신 (2009). 장기요양보호 노인 및 부양자특성이 부양자의 스트레스에 미치는 영 향. 한국노년학, 29(3). 1183-1196.

2.

김수영, 김진선, 윤현숙 (2004). 치매노인을 돌보는 가족부양자의 우울과 삶의 만족 예측 요인. 한국노년학, 24(2), 111-128.

3.

김윤정, 최혜경 (1993). 치매노인의 장애기간과 부양자의 대처자원이 부양자의 부담 및 부양 만족감에 미치는 영향, 한국노년학, 13(2), 63-83.

4.

김재민, 신일선, 윤진상, 이형영 (2001). 지역사회 거주노인의 인지기능에 따른 한국형 노인우울검사의 타당도. 정신병리학, 10(2), 126-131.

5.

김정현, Knight (2009). 문화적 가치가 수발부담 및 사회적 지지를 통해 남가주 한인 가족수발자의 신체적 건강에 미치는 영향 -사회문화적 스트레스 대처모델을 적용하여. 한국노년학, 29(2), 377-394.

6.

김혜경 (2004). 일본 재가 요보호노인과 부양자간의 관계의 질과 부양자의 정신건강. 한국노년학, 24(2), 129-144.

7.

백주희 (2007). 부양 전 부부관계의 질과 결혼기간이 치매노인 부양자의 스트레스 평가, 복지감, 삶의 질에 미치는 영향, 한국노년학, 27(1), 255-272.

8.

백주희, Zarit (2009). 미극 치매노인 부양자의 우울증에 영향을 미치는 요소: 배우자 부양자와 딸 부양자 비교 연구. 한국노년학, 29(4), pp. 1591-1609.

9.

송미영, 최경구 (2007), 치매노인 주부양자의 부양부담에 영향을 미치는 요인, 노인복지연구, 37, 131-160.

10.

우국희 (1997). 치매노인 수발인의 수발 및 사회적 지지에 대한 주관적 경험 - 가족갈등과 부정적 지지를 중심으로. 한국노년학, 10, 383- 413.

11.

윤현숙, 류삼희 (2007). 장기요양보호노인 가족수발자의 수발부담에 영향을 미치는 요인-배우자와 자녀 비교, 한국노년학, 27(1), 195-211.

12.

윤현숙, 차흥봉, 조양순 (2000). 뇌졸중 노인 부양가족의 부양부담과 우울에 미치는 영향요인에 관한 연구, 한국노년학, 20(2), 137-153.

13.

이가옥, 이미진 (2000). 장기요양보호노인 가족수발자의 정서적 부양부담에 관한 연구, 한국노년학, 20(2), 215-228.

14.

이경자 (1995). 치매노인의 간호 문제와 돌보는 가족원의 부담감에 관한 연구. 한국노년학, 15(2), 30-51.

15.

이미애 (2006). 주부양제공자의 하위집단별 부양부담 및 특정수발항목에 대한 부담도-성별, 거주지역별, 노인과의 관계별 변이, 노인복지연구, 33, 279-300.

16.

이해정, 송라윤 (2000). 노인대상자를 돌보는 비전문 간호제공자의 대응기전과 건강반응 예측요인. 한국노년학, 30(4), 893-904.

17.

이혜자 (2006). 노인 주간 보호시설의 이용여부가 치매노인 주부양자의 부양부담에 미치는 영향, 한국노년학, 26(2), 329-346.

18.

장혜경, 홍승아, 이상원, 김영란, 강은화, 김고은 (2006). 가족 내 돌봄 노동에 대한 사회적 지원방안연구, 한국여성정책연구원.

19.

정경희, 조애저, 오영희, 선우덕 (2001). 장기요양보호대상 노인의 수발실태 및 복지욕구, 한국보건사회연구원.

20.

최경숙, 은영 (2000). 만성질환자 배우자의 돌봄 경험에 관한 이론 구축, 대한간호학회지, 301(1), 122-136.

21.

통계청 (2009). 2008 고령자통계, 통계청

22.

한경혜, 이서연 (2009). 배우자 부양자의 부양동기, 사회적 지지와 부양부담: 성별 차이를 중심으로. 한국노년학, 29(2), 683-699.

23.

Aranda, M. P., & Knight, B. G. (1997). The influence of ethnicity and culture on the caregiver stress and coping process: A sociocultural review and analysis. The Gerontologist, 37, 342–54.

24.

Alspaugh, M. E., Stephens, M. A., Townsend, A. L., Zarit, S. H., & Greene, R. (1999). Longitudinal patterns of risk for depression in dementia caregivers: Objective and subjective primary stress as predictors. Psychology and Aging, 14(1), 34-43.

25.

Beers. M. H. (2006). Dementia. In M. H. Beers & T. V. Jones(Eds.), Merck manual of geriatrics. Whitehouse Station, NJ: Merck & Co. Retrieved from www. Merck.com/ mrkshared/ mmg/ sec5/ch40/ch40a.jsp

26.

Berr, C., Wancata, J., & Ritchie, K. (2005). Prevalence of dementia in the elderly in Europe. European Neuro psycho- pharmacology, 15, 463-471.

27.

Biegel, D. E., Sales, E., Schulz, R., & Rau, M. T. (1991). Careving in Stroke, Family Caregiving in chronic Illness, CA: Sage.

28.

Bookwala & Schulz (1998). The role of neuroticism and mastery in spousal caregivers' assessment of and response to a contextual stressor. Journal of Gerontology: Psychological Sciences, 53B(3), 155-164.

29.

Braun, M., Scholz, U., Bailey, B., Perren, S., Hornung, R., & Martin, M., (2009). Dementia caregiving in spousal relationships: A dyadic perspective. Aging and Mental Health, 13(3). pp. 426-436.

30.

Brody, E. M. (1985). Parent care as a normative stress, The Gerontologist, 25, 19-29.

31.

Cantor, M. H. (1983), Strain among caregivers: A study of experience in the U. S. The Gerontologist, 23, 597-624.

32.

Chappell, N. L. & Reid, R. C. (2002). Burden and well-being among caregivers: Examining the distinction. The Gerontologist, 42(6), 772-780.

33.

Collins, C. & Jones, R. (1997). Emotional distress and morbidity in dementia carers: a matched comparison of husbands and wives. International Journal of Geriatric Psychiatry, 12(12), 1168 - 1173.

34.

Cox, T., & Ferguson, E. (1991). Individual differences, stress, and coping. In C. L. Cooper & R. Payne(Eds.), Personality and stress: Individual differences in the stress process(pp. 269-284). New York: Wiley.

35.

Danhauer, S. C., McCann, J. J., Gilley, D. W., Beckett, L. A., Bienias, J. L., & Evans, D. A. (2004). Do behavioral disturbances in persons with Alzheimer's disease predict caregiver depression over time? Psychology and Aging, 19(1), 198-202.

36.

Duberstein, P. R., Sörensen, S., Lyness, J. M., King, D., Conwell, Y., Seidlitz, L., & Caine, E. D. (2003). Personality is associated with perceived health and functional status in older primary care patients. Psychology and Aging, 18(1), 25-37.

37.

Fitting, M., Rabins, P., Lucas, M. & Easthman, J. (1986) Caregivers for dementia patients: A comparison of husbands and wives, The Gerontologist, 26, 248–252.

38.

Fortinsky, R. H., Kercher, K., & Burant, C. J. (2002). Measurement and correlates of family caregiver self efficacy for managing dementia. Aging & Mental Health, 6, 153–60.

39.

Flynn, K. E. & Smith, M. A. (2007). Personality and health care decision-making style. Journal of Gerontology: Psychological Sciences, 62B(5), 261P267.

40.

Gaugler, J. E., Davey, A., Pearlin, L. I., & Zarit, S. H. (2000). Modeling caregiver adaptation over time: The longitudinal impact of behavior problems. Psychology and Aging. 15(3), 437-450.

41.

George, L. K., Gwyther, L. P. (1986). Caregiver well-being: A multi- dimensional examination of family caregivers of demented adults. The Gerontologist, 27, 253-259.

42.

Georgetown Center on Aging Society (2005), Caregivers of older persons profile. Retrieved on April 5, 2010 http:// ihcrp.georgetown.edu/agingsociety/pubhtml/caregiver1/caregiver1.html

43.

Gilliam, C. M. & Steffen, A. M. (2006). The relationship between caregiving self-efficacy and depressive symptoms in dementia family caregivers. Aging and Mental Heath, 10(2), 79-86.

44.

Gonyea, J.G., O’Connor, M., Carruth, A., & Boyle, P. (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 Related Dementias, 20, 273-280.

45.

Graham, C., Ballard, C., & Sham, P. (1997). Carers' knowledge of dementia and their expressed concerns. International Journal of Geriatric Psychiatry, 12(4), 470-473.

46.

Hayley, W. E., Roth, D. L., Coleton, M. I., Ford, G. R., West, C. A., Collins, R. P., & Isobe, T. L. (1996). Appraisal, coping, and social support as mediators of well-being in Black and White family caregivers of patients with Alzheimer's disease. Journal of Counseling and Clinical Psychology, 64, 121-129.

47.

Hays, J. C., Landerman, L. R., George, L. K., Flint, E. P., Koenig, H. G., Land, K. C., & Blazer, D. G. (1998). Social correlates of the dimensions of depression in the elderly. Journal of Gerontology: Psychological Scences, 53B(1), P31-P39.

48.

Hilgeman, M. M., Allen, R. S., DeCoster, J., & Burgio, L. D. (2007). Positive aspects of caregiving as a moderator of treatment outcome over 12 months. Psychology and Aging, 22(2), 361-371.

49.

Hooker, K., Monahan, D. J., Bowman, S. R., Frazier, L. D., & Shifren, K. (1998). Personality counts for a lot: Predictors of mental and physical health of spouse caregivers in two disease group. Journal of Gerontology: Psychological Sciences, 53B(2), P73-P85.

50.

Hooker, K., Monahan, D., Shifren, K., & Hutchison, C. (1992). Mental and physical health of spouse caregivers: the role of personality. Psychology and Aging, 7, 367-375.

51.

Jenkins, K. R., Kabeto, M. U., & Langa, K. M. (2009). Does caring for your spouse harm one's health? Evidence from a United States nationally-representative sample of older adults. Ageing and Society, 29, 277-293.

52.

Kabitsi, N. & Powers, D. V. (2002). Spousal motivations of care for demented older adults A cross-cultural comparison of Greek and American female caregivers. Journal of Aging Studies, 16, 383-399.

53.

Knight, B. G., Silverstein, M., McCallum, T. J., Fox, L. S. (2000). A sociocultural stress and coping model for mental health outcomes among African American caregivers in southern California. Journal of Gerontology: Psychological Sciences, 55B, P142-P150.

54.

Lang, A., & Brody, E. (1983). Characteristics of middle-aged daughters and help to their elderly mothers. Journal of Marriage and the Family, 45, 193–202.

55.

Lawton, M. P., Moss, M., Kleban, M. H., Glickman, A., Rovine, M. (1991). A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology: Psychological Sciences, 46, P181–P189.

56.

Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer- Verlag.

57.

Lefcourt, H. M., & Davidson-Katz, K. (1991). Locus of control and health. In C. R. Snyder & D.R. Forsyth(Eds.), Handbook of social and clinical psychology. New York: Pergamon Press.

58.

Martire, L. M., Stephens, M. A. P., Townsend, A. L. (2000). Centrality of women's multiple roles: Beneficial and detrimental consequences for psychological well-being. Psychology and Aging, 15(1), 148-156.

59.

Matthews, F. E., Brayne, C., Lowe, J., McKeith, I., & Wharton, S. B. (2009). Epidemiological pathology of dementia: Attributable-risks at death in the medical research council cognitive function and ageing study. PLoS Med 6(11): e1000180. doi:10.1371/ journal. pmed.1000180

60.

Miller, B. (1987). Gender and control among spouse of the cognitively impaired : A research note, The Gerontologist, 27, 447-453.

61.

Miller, B. (1990). Gender differences in spouse caregiver strain: Socialization and role explanations. Journal of Marriage and the Family, 52, 311-321.

62.

Miller, B. & Cafasso, L. (1992). Gender Differences in caregiving: Fact or artifact? The Gerontologist, 32 (4), 498-507.

63.

Monin, J. K. & Schulz, R. (2009). Interpersonal effects of suffering in older adult caregiving relationships. Psychology and Aging, 24(3), 681-695.

64.

Motenko, A. K. (1989). The frustrations, gratifications, and wellbeing of dementia caregivers. The Gerontologist, 29, 166-172.

65.

Ory, M. G., Hoffman, R. R., Yee, J. L., Tennstedt, S., & Schulz, R. (1999). Prevalence and impact of caregiving: A detailed comparison between dementia and nondementia caregivers. The Gerontologist, 39(2), 177-186.

66.

Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990), Caregiving and the stress process: An overview of concepts and their measures, The Gerontological Society of America, 30, 583-594.

67.

Pinquart, M. & Sörensen, S. (2003). Differences between caregivers and noncaregivers in psychological health and physical health: A meta-analysis. Psychology and Aging, 18(2). 250-267.

68.

Pinquart, M. & Sörensen, S. (2006). Helping caregivers of persons with dementia: which interventions work and how large are their effects? International Psychogeriatrics, 18(4), 577-595.

69.

Potter, J. F. (1993). Comprehensive geriatric assessment in the outpatient setting: Population characteristics and factors influencing outcome. Experimental Gerontology, 28(4), 447-457.

70.

Poulshock, S. W., Deimling, G. T. (1984)., Families caring for elders in residence : Issues in the measurement of burden, Journal of Gerontology, 39(2), 230-239.

71.

Pohl, J. M, Boyd, C., Liang, J. & Given, C. W. (1995). Analysis of the impact of mother-daughter relationships on the commitment to caregiving. Nursing Research, 44(2), 68-75.

72.

Proctor, R., Martin, C., and Hewison, J. (2002) When a little knowledge is a dangerous thing: A study of carers' knowledge about dementia, preferred coping style and psychological distress. International Journal of Geriatric Psychiatry, 17 , 1133-1139.

73.

Pruchno, R. A., Potashnik, S. L. (1989), Caregiving spouses. Physical and mental health in perspective, Journal of American Geriatric Society, 37(8), 697-705.

74.

Pruchno, R. A., Resch, N. L. (1989). Aberrant behaviors and alzheimer's disease: Mental health effects on spouse caregivers. Journal of Gerontology, 44(5),77-182.

75.

Rodin, J., Timko, D., & Harris, S. (1985). The construct of control: Biological and psychological correlates. In C. Eisdorfer(Eds.), Annual Review of Gerontology and Geriatrics, 5. 3-55. New York: Springer.

76.

Rose-Rego, S. K., Strauss, M. E., & Smyth, K. A. (1998). Differences in the perceived well-being of wives and husbands caring for persons with Alzheimer's disease. The Gerontologist, 38 (2), 224-230.

77.

Sainio, C., Eriksson, E., & Lauri, S. (2001). Patient participation in decision making about care: The cancer patient's point of view. Cancer Nursing, 24(3), 172-179.

78.

Schultz, R. & Williamson, G. (1991). A 2-Year longitudinal study of depression among Alzheimer’ caregivers. Psychology and Aging, 6, 569-578.

79.

Shurgot, G. R. & Knight, B. G. (2005) Influence of neuroticism, ethnicity, familism and social support on perceived burden in dementia caregivers: Pilot test of the transactional stress and social support model. Journal of Gerontology: Psychological Sciences, 60B, P331-P334.

80.

Sörensen, S., Duberstein, P. R., Chapman, B., Lyness, J. M., & Pinquart, M. (2008). How are personality traits related to preparation for future care needs in older adults? Journal of Gerontology: Psychological Sciences, 63B(6), P328-P336.

81.

Stoller, E. P. (1992). Gender Differences in the experiences of caregiving spouses. In J. W. Swyer & R. T. Cosard(Eds.), Gender, Families, and Elder Care(pp. 49-64). Newbury Park, CA: Sage.

82.

Sugiura K., Ito M., Kutsumi, M., & Mikami, H. (2009). Gender Differences in Spusal Caregiving in Japan. The Journal of Gerontoloty: Series B: Psychological Sciences and Social sciences, 64B(1), 147-157.

83.

Sung, K. (1994). A cross-cultural comparison of motivations for parent care: The case of Americans and Koreans. Journal of Aging Studies, 8, 195-209.

84.

Taylor, S. E., Helgeson, V. S., Reed, G. M., & Skokan, L. A.(1991). Self-generated feelings of control and adjustment to physical illness. Journal of Social Issues, 47(4), 91-109.

85.

Tennstedt S., McKnightly J., & Sullivan, L. (1989). Predictors of informal care for frail elders: The role of secondary caregivers. The Gerontologist, 29(5), 677-683.

86.

Vernooij-Dassen, M. J., Persoon, J. M., & Felling, A. J. (1996). Predictors of sense of competence in caregivers of demented persons. Social Science & Medicine, 43, 41-49.

87.

Vernooij-Dassen, M. J., Van Hout, H. P, Hund, K. L., Hoefnagels, W. H., & Grol, R. P. (2003). Information for dementia patients and their caregivers: What information does a memory clinic pass on, and to whom? Aging & Mental Health, 7(1), 34-38.

88.

Van Den Wijngaart, Vernooij-Dassen, & Feeling (2007). The influence of stressors, appraisal and personal conditins on the burden of spousal caregivers of persons with dementia. Aging and Mental Health, 11(6), 626-636.

89.

Vitaliano, P. P., Russo, J., Young, H. M., Becker, J., & Maiuro, R. D. (1991). The screen for caregiver burden. The Gerontologist, 31(1), 76-83.

90.

Walker, A. J., Acock, A. C., Bowman, S. R., & Li, F. (1996). Amount of care given and caregiving satisfaction: A latent growth curve analysis. Human Development and Family Sciences, 51B (3), 130-142.

91.

Yee, L. L., Schulz, R. (2000). Gender differences in psychiatric morbidity among family caregivers: A review and analysis, The Gerontologist, 40, 147-164.

92.

Young, R. F. & Kahana, E. (1989). Specifying caregiver outcomes: Gender and relationship aspects of caregiving strain. The Gerontologist, 29, 660-666.

93.

Zanetti, O., Frisoni, G. B., Bianchetti, A., Tamanza, G., Cigoli, V., & Trabucchi, M. (1998). Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. International Journal of Geriatric Psychiatry, 13, 358-367.

94.

Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980), Relatives of the impaired elderly, correlates of feeling of burden, The Gerontologist, 20(6), 649-655.

95.

Zarit, S. H., Todd, P. A., Zarit, J. M. (1986). Subjective burden of husbands and wives as caregivers: A longitudinal study. The Gerontologist, 26(3), 260-266.

Korean Journal of Psychology: General