Page 68 - Encyclopedia of Nursing Research

CAREGIvER n 35

Wilkins, Bruce, & Sirey, 2009). Caregivers mortality, and cardiovascular disease;
also must be prepared for emergencies and be Beach, Schultz, Yee, & Jackson, 2000; Federal
capable of responding appropriately. Usually, Interagency Forum on Aging, 2000; Given & C
the caregiver must also manage their personal Given, 1998; Schulz & Sherwood 2008; Silver
responsibilities, whether as a breadwinner, a & Wellman, 2002; Silver, Wellman, Galindo-
housekeeper, or both. The caregiver’s rela- Ciocon, & Johnson, 2004). In addition, the
tionship with the patient, the caregiver’s age majority of caregivers experience depression,
and life developmental stage, the patient’s social isolation, financial strain, sleep depri-
illness severity, and the suddenness and vation with daytime sleepiness, and ineffi-
amount of the change in the patient’s need for cient use of family resources (Smith, 1996).
caregiving have been predictive of caregiver Smith’s (1994) research indicated care-
burnout in various illness populations, such givers’ motives for helping consistently
as chronic obstructive pulmonary disease explain the variance in their depression, cop-
(Caress, Luker, Chalmers, & Salmon, 2009), ing, and quality of life (Smith, Kleinbeck,
kidney disease (Tong, Sainsbury, & Craig, Boyle, Kochinda, & Parker, 2002). In another
2008), heart failure (Bakas, Pressler, Johnson, clinical trial (Smith, 2006), Smith et al. (2010)
nauser, & Shaneyfelt, 2006; Molloy, Johnston, reported significant relationships among
& Witham, 2005; Pressler et al., 2009), and family income adequacy and patients’ and
stroke survivors (Rigby, Gubitz, & Phillips, caregivers’ quality of life as well as patients’
2009). The indirect familial caregiver tasks clinical outcomes and caregivers’ mental
include designating others to assist with health. Qualitative data supported these
patient care, exchanging information, main- findings that economic stress was the stron-
taining decision making among appropriate gest factor affecting quality of life of patients
persons, and coping with psychosocial stres- and caregiver (Smith et al., 2010). This find-
sors (Whitlatch, 2008). ing was consistent and confirmed the Smith’s
Because the caregiver by definition (1994) family home caregiving model, which
is laden with tasks and expectations, the was replicated across two decades (Smith,
major area of research has been caregiver 1999; Smith et al., 2002; Winkler, Ross,
burden and negative outcomes on care- Piamjariyakul, Gajewski, & Smith, 2006).
givers’ physical, mental, and financial In each model, caregiver characteristics of
health (Piamjariyakul et al., 2010; Schulz & esteem, depression, and physical and men-
Sherwood, 2008; Smith, Piamjariyakul, tal health and in the context of caregiving
Yadrich, Ross & Gajewski, 2010). The majority (e.g., family income adequacy) have pre-
of burden studies have been descriptive and dicted patient outcomes (Smith, 2007; Smith,
correlational and have resulted in identifica- Leenerts, & Gajewski, 2003).
tion of multiple factors recognized as being Problem-solving ability is lauded as
significant problems: complexity of the care essential and the caregiver’s ability to
needed by the patient that is often measured solve problems can avert patient problems
as illness demands. numerous variables (national Family Caregivers Association,
(e.g., demographic information, develop- 2002; Schulz, 2000), yet only a handful of
mental stage, social support) that have been studies on problem solving in caregiving
studied in relation to caregiver experience were found. Unique research on the posi-
are influential yet not universally predictive tive aspects of caregiving is being conducted
of caregiver burden (Biegel, Sales, & Schulz, by Smith (2007) under the concept of care-
1991). Research across disciplines identifies giving effectiveness. Effective caregiving
significant negative health outcomes of care- is defined as family provision of technical,
giving (reduced physical function, immune physical, and emotional care that results
status, wound healing, greater fatigue, in optimal patient health and quality of