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Daughters with a parent in a care facility: a stress and coping model Krause, Allison Mary

Abstract

The purpose of this study was to test Lazarus and Folkman's (1984) theoretical framework of stress and coping as it applied to daughters who have parents living in care facilities. Specifically, the effects of personal and environmental influences, cognitive appraisals, and coping on positive affect and depression were examined in two subsamples of daughters: daughters with parents with dementia (n=100) and daughters with parents with other health difficulties (n=89). The data were collected from a volunteer sample of 189 daughters (M age 51.3) in the Greater Vancouver region. Daughters completed three parts of a questionnaire over a six-week period. Specific variables of interest included prior communal behaviors, support satisfaction, care satisfaction, appraisals (perceived control and perceived stress), coping strategies (relationship-focused, problem-focused, emotionfocused), positive affect, and depression. Negative affectivity (NA) was examined as a confounding variable. Path analysis using LISREL VIII (Joreskog & Sorbom, 1993) was undertaken to examine the hypothesized relationships between antecedent, mediating, and outcome variables that are central to Lazarus and Folkman's (1984) theoretical framework. Initial results revealed a poor fitting model for both the dementia and other health groups. However, a revised model, taking into account theoretical and empirical support for a direct relationship between support satisfaction and emotion-focused coping, provided an acceptable fit for both groups. The overall pattern of relationships for the variables in the model offer some support for the hypothesized model and for Lazarus and Folkman's theoretical assumptions. For both groups, greater control over the stressful aspect of facility care was related to more problem-focused coping, which in turn was related to more positive affect. For the other health group, greater appraised stress was related to more emotion-focused coping, which was in turn was related to greater depression. Among daughters with parents with dementia, low levels of care satisfaction and high communal behaviors were associated with greater perceived control. The hypothesized mediational role of appraisals and coping was not supported. The results point to the importance of understanding caregiving in the context of chronic stress and the unique contribution of personality, health type, and positive aspects of caregiving to a daughter's stress process.

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