Skip to main content

Advertisement

SpringerLink
Log in

Caregiving Tasks in Caring for an Adult with Mental Illness and Associations with Adjustment Outcomes

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Background

Carers of persons with mental illness engage in many caregiving tasks and spend considerable time on these activities. This caregiving is of immense social and economic value, but often at a high cost to carers. Investigation of the specific caregiving tasks these carers undertake and how these may affect their adjustment has been neglected.

Purpose

This study examines: (1) the dimensional and psychometric structure of the Caregiving Tasks in Caring for an Adult with Mental Illness Scale (CTiCAMIS), (2) relations between caregiving tasks and various caregiving parameters, and (3) associations between caregiving tasks and adjustment cross-sectionally and over 12 months.

Method

Participants were 114 carers of adults with a mental illness who completed questionnaires at time 1 and 12 months later (time 2).

Results

Factor analyses showed that the CTiCAMIS could be represented by a single dimension or three caregiving domains: instrumental care, activities of daily living care, psychosocial care. The CTiCAMIS factors were psychometrically sound and evidenced differential relations with most carer, care recipient and caregiving context variables, and were correlated with adjustment outcomes concurrently and over 12 months after controlling for initial adjustment.

Conclusion

Findings delineate the key dimensions of mental health caregiving and show the differential links between caregiving activities and caregiving parameters and carer adjustment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. van Exel J, de Graaf G, Brouwer W. Care for a break? an investigation of informal. caregivers' attitudes toward respite care using Q-methodology. Health Policy. 2007;83:332–42.

    Article  PubMed  Google Scholar 

  2. Brodaty H, Thompson C, Thompson C, Fine M. Why caregivers of people with dementia and memory loss don't use services. Int J Geriatr Psychiatry. 2005;20:537–46. doi:10.1002/gps.1322.

    Article  PubMed  Google Scholar 

  3. Brodaty H. Meaning and measurement of caregiver outcomes. Int Psychogeriatr. 2007;19:363–81. doi:10.1017/S1041610207005182.

    Article  PubMed  Google Scholar 

  4. Holmes AM, Deb P. The effect of chronic illness on the psychological health of family members. J Ment Health Policy Econ. 2003;6:13–22.

    PubMed  Google Scholar 

  5. Møller T, Gudde CB, Folden GE, Linaker OM. The experience of caring in relatives to patients with serious mental illness: gender differences, health and functioning. Scand J Caring Sci. 2009;23:153–60.

    Article  PubMed  Google Scholar 

  6. Maurin JT, Boyd CB. Burden of mental illness on the family: a critical review. Arch Psychiatr Nurs. 1990;4:99–107. doi:10.1016/0883-9417(90)90016-E.

    Article  PubMed  CAS  Google Scholar 

  7. Awad AG, Voruganti LNP. The burden of schizophrenia on caregivers: a review. Pharmacoeconomics. 2008;26:149–62.

    Article  PubMed  Google Scholar 

  8. van der Voort TYG, Goossens PJJ, van der Bijl JJ. Burden, coping and needs for support of caregivers of patients with a bipolar disorder: a systematic review. J Psychiatr Ment Health Nurs. 2007;14:679–87.

    Article  PubMed  Google Scholar 

  9. Crombie IK, Irvine L, Elliott L, Wallace H. Carers of people with mental health problems: proposals embodied in current public mental health policy in nine countries. J Public Health Policy. 2007;28:465–81. doi:10.1057/palgrave.jphp.3200146.

    Article  PubMed  Google Scholar 

  10. Perlick DA, Rosenheck RA, Miklowitz DJ, Chessick C, Wolff N, Kaczynski R, et al. STEP-BD Family Experience Collaborative Study Group. Prevalence and correlates of burden among caregivers of patients with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder. Bipolar Disord. 2007;9:262–73.

    Article  PubMed  Google Scholar 

  11. Hoskins S, Coleman N, McNeely D. Stress in carers of individuals with dementia and community mental health teams: an uncontrolled evaluation study. J Adv Nurs. 2005;50:325–33. doi:10.1111/j.1365-2648.2005.03396.x.

    Article  PubMed  Google Scholar 

  12. Östman M, Hansson L. Appraisal of caregiving, burden and psychological distress in relatives of psychiatric inpatients. Eur Psychiatry. 2004;19:402–7. doi:10.1016/j.eurpsy.2004.06.030.

    Article  PubMed  Google Scholar 

  13. van Wijngaarden B, Schene AH, Koeter MWJ. Family caregiving in depression: impact on caregivers' daily life, distress, and help seeking. J Affect Disord. 2004;81:211–22. doi:10.1016/S0165-0327(03)00168-X.

    Article  PubMed  Google Scholar 

  14. Kersten P, McLellan L, Georges S, Smith JAE, Mullee MA. To what extent are the needs of severely disabled people met by community rehabilitation services? A follow-up study. Disabil Rehabil. 2000;22:855–61. doi:10.1080/09638280050207901.

    Article  PubMed  CAS  Google Scholar 

  15. Patterson TL, Grant I. Interventions for caregiving in dementia: physical outcomes. Curr Opin Psychiatry. 2003;16:629–33. doi:10.1097/00001504-200311000-00005.

    Article  Google Scholar 

  16. van Exel J, Morée M, Koopmanschap M, Goedheijt TS, Brouwer W. Respite care: an explorative study of demand and use in Dutch informal caregivers. Health Policy. 2006;78:194–208. doi:10.1016/j.healthpol.2005.11.002.

    Article  PubMed  Google Scholar 

  17. Gallagher SK, Mechanic D. Living with the mentally ill: effects on the health and functioning of other household members. Soc Sci Med. 1996;42:1691–701. doi:10.1016/0277-9536(95)00296-0.

    Article  PubMed  CAS  Google Scholar 

  18. Pinquart M, Sorensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol Psychol Sci. 2007;62B:P126–37.

    Article  Google Scholar 

  19. Perlick DA, Hohenstein JM, Kaczynski R, Rosenheck RA. Use of mental health and primary care services by patients with bipolar disorder: a preliminary study. Bipolar Disord. 2005;7:126–35. doi:10.1111/j.1399-5618.2004.00172.x.

    Article  PubMed  Google Scholar 

  20. Dyck DG, Short R, Vitaliano PP. Predictors of burden and infectious illness in schizophrenia caregivers. Psychosom Med. 1999;61:411–9.

    PubMed  CAS  Google Scholar 

  21. Zauszniewski JA, Suresky JM. Psychometric assessment of the depressive cognition scale in women family members of adults with serious mental illness. Issues Ment Health Nurs. 2010;31:483–90. doi:10.3109/01612841003602687.

    Article  PubMed  Google Scholar 

  22. Sim M, Kim JH, Yim SJ, Kwon OH, Cho SJ, Kim SJ. Depressive symptoms in caregivers of schizophrenic patients. J Affect Disord. 2008;107:S116. doi:10.1016/j.jad.2007.12.131.

    Article  Google Scholar 

  23. Song L, Biegel DE, Milligan SE. Predictors of depressive symptomatology among lower social class caregivers of persons with chronic mental illness. Community Ment Health J. 1997;33:269–86. doi:10.1023/A:1025090906696.

    Article  PubMed  CAS  Google Scholar 

  24. Song L-Y, Singer M. Life stress, social support, coping and depressive symptoms: a comparison between the general population and family caregivers. Int J Soc Welf. 2006;15:172–80. doi:10.1111/j.1468-2397.2006.00386.x.

    Article  Google Scholar 

  25. Steptoe A. Depression and physical illness. New York: Cambridge University Press; 2007.

    Google Scholar 

  26. Pakenham KI, Stebbins P, Cannon T, Samios C. Carers in contemporary Australia: relations among carer illness/disability groups, biographics, caring context, coping, and distress. Brisbane: PsyHealth Media; 2005.

    Google Scholar 

  27. Hoenig J, Hamilton MW. Schizophrenia in an extramural service. Compr Psychiatry. 1966;7:81–91. doi:10.1016/S0010-440X(66)88018-4.

    Article  Google Scholar 

  28. Chang H, Chiou C, Chen N. Impact of mental health and cargiver burden on family caregivers' physical health. Arch Gerontol Geriatr. 2010;50:267–71. doi:10.1016/j.archger.2009.04.006.

    Article  PubMed  Google Scholar 

  29. Wittmund B, Wilms HU, Mory C, Angermeyer MC. Depressive disorders in spouses of mentally ill patients. Soc Psychiatry Psychiatr Epidemiol. 2002;37:177–82. doi:10.1007/s001270200012.

    Article  PubMed  Google Scholar 

  30. Braithwaite VA. Caregiving burden: making the concept scientifically useful and policy relevant. Res Aging. 1992;14(1):3–27.

    Article  Google Scholar 

  31. Visser-Meily JMA, Post MWM, Riphagen II, Lindeman E. Measures used to assess burden among caregivers of stroke patients: a review. Clin Rehabil. 2004;18:601–23.

    Article  PubMed  Google Scholar 

  32. George LK. Caregiver burden and well-being: an elusive distinction. Gerontologist. 1994;34(1):6–7.

    Article  PubMed  CAS  Google Scholar 

  33. Pakenham KI. The nature of caregiving in multiple sclerosis: development of the caregiving tasks in multiple sclerosis scale. Mult Scler. 2007;13:929–38.

    Article  PubMed  CAS  Google Scholar 

  34. Rose L, Mallinson RK, Walton-Moss B. A grounded theory of families responding to mental illness. West J Nurs Res. 2002;24:16–36. doi:10.1177/019394502400446397.

    Google Scholar 

  35. Muhlbauer SA. Navigating the storm of mental illness: phases in the family's journey. Qual Health Res. 2002;12:1076–92. doi:10.1177/104973202129120458.

    Article  PubMed  Google Scholar 

  36. Ohaeri JU. The burden of caregiving in families with mental illness: a review of 2002. Curr Opin Psychiatry. 2003;16:457–65. doi:10.1097/01.yco.0000079212.36371.c0.

    Google Scholar 

  37. Schulze B, Rössler W. Caregiver burden in mental illness: review of measurement findings and interventions in 2004–2005. Curr Opin Psychiatry. 2005;18:684–91. doi:10.1097/01.yco.0000179504.87613.00.

    Article  PubMed  Google Scholar 

  38. Lazarus RS, Folkman S. Stress, appraisal, and coping. NY: Springer; 1984.

    Google Scholar 

  39. Pakenham KI, Bursnall S, Chiu J, Cannon T, Okochi M. The psychosocial impact of caregiving on young people who have a parent with an illness or disability: comparisons between young caregivers and non-caregivers. Rehabil Psychol. 2006;51(2):113–26.

    Article  Google Scholar 

  40. Mangen DJ, Bengsten VL, Landry PH. Measurement of intergenerational relations. Beverly Hills: Sage; 1998.

    Google Scholar 

  41. Lawrence P, Tennestedt S, Assmann S. Quality of the caregiver-care recipient relationship: does it offset negative consequences of caregiving for family relationships. Psychol Aging. 1998;13:150–8.

    Article  PubMed  CAS  Google Scholar 

  42. Bakas T, Burgener SC. Predictors of emotional distress, general health, and caregiving outcomes in family caregivers of stroke survivors. Top Stroke Rehab Special Issue: Stress and Coping after Stroke. 2002;9:34–5. doi:10.1310/GN0J-EXVX-KX0B-8X43.

  43. Pakenham KI. Application of a stress and coping model to caregiving in multiple sclerosis. Psychol Health Med. 2001;6(1):13–27.

    Article  Google Scholar 

  44. Reinhard SC, Gubman GD, Horwitz AV, Minsky S. Burden assessment scale for families of the seriously mentally ill. Eval Program Plann. 1994;17:261–9. doi:10.1016/0149-7189(94)90004-3.

    Article  Google Scholar 

  45. Ivarsson A, Sidenvall B, Carlsson M. The factor structure of the burden assessment scale and the perceived burden of cargivers for individuals with severe mental disorders. Scand J Caring Sci. 2004;18:396–401.

    Article  PubMed  Google Scholar 

  46. Reinhard S, Horwitz A. Caregiver burden: differentiating the content and consequences of family caregiving. J Marriage Fam. 1995;57:741–50.

    Article  Google Scholar 

  47. Lovibond SH, Lovibond PF. Manual for the depression anxiety stress scales. 2nd ed. Sydney: Psychology Foundation of Australia; 1995.

    Google Scholar 

  48. Antony M, Bieling P, Cox B, Enns M, Swinson R. Psychometric properties of the 42 item and the 21 item versions of the depression, anxiety and stress scales in clinical groups and a community sample. Psychol Assess. 1998;10:176–81.

    Article  Google Scholar 

  49. Watson D, Clarke AL. Manual for the positive and negative affect schedule—expanded form. USA: The University of Iowa; 1994.

    Google Scholar 

  50. Diener E, Emmons R, Larsen J, Griffiths S. The satisfaction with life scale. J Pers Assess. 1985;49:71–5. doi:10.1207/s15327752jpa4901_13.

    Article  PubMed  CAS  Google Scholar 

  51. Pavot W, Diener E, Colvin C, Sandvik E. Further validation of the satisfaction with life scale: evidence for cross-method convergence of well-being measures. J Pers Assess. 1991;57:149–61.

    Article  PubMed  CAS  Google Scholar 

  52. Pakenham KI, Dadds MR, Terry DJ. The relationships between adjustment to hiv and both social support and coping strategies. J Consult Clin Psychol. 1994;62(6):1194–203.

    Article  PubMed  CAS  Google Scholar 

  53. Armeli S, Gunthert KC, Cohen LH. Stressor-appraisals, coping, and post-event outcomes: the dimentionality and antecedents of stress-related growth. J Soc Clin Psychol. 2001;20:366–95.

    Article  Google Scholar 

  54. Park CL, Cohen LH, Murch RL. Assessment and prediction of stress-related growth. J Pers. 1996;64(1):71–105.

    Article  PubMed  CAS  Google Scholar 

  55. Hegelson V, Reynolds K, Tomich P. A meta-analytic review of benefit finding and growth. J Consult Clin Psychol. 2006;74:797–816.

    Article  Google Scholar 

  56. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. the index of ADL: a standardised measure of biological and psychosocial function. J Am Med Assoc. 1963;185:914–9.

    Article  CAS  Google Scholar 

  57. Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9:176–86.

    Google Scholar 

  58. Mittelman M. Taking care of the caregivers. Curr Opin Psychiatry. 2005;18:633–9. doi:10.1097/01.yco.0000184416.21458.40.

    Article  PubMed  Google Scholar 

  59. Pakenham KI. Development of a measure of coping with multiple sclerosis caregiving. Psychol Health. 2002;17(1):97–118.

    Article  Google Scholar 

  60. Jungbauer J, Wittmund B, Dietrich S, Angermeyer MC. Subjective burden over 12 months in parents of patients with schizophrenia. Arch Psychiatr Nurs. 2003;17:126–34. doi:10.1016/S0883-9417(03)00056-6.

    Article  PubMed  Google Scholar 

  61. Béland F. The principal caregiver as the pivot in the relationship between sources of help. Paper presented at 44th Annual Scientific Meeting of the Gerontological Society of America; San Fransisco, SA 1991.

  62. Baronet AM. The impact of family relations on caregivers' positive and negative appraisal of their caretaking activities. Fam Relat. 2003;52:137–42. doi:0.1111/j.1741-3729.2003.00137.x.

    Article  Google Scholar 

  63. Jardim C, Pakenham KI. Respite care for carers of adults with mental disorders: a qualitative investigation. Adv Ment Health. 2010;9:84–97.

    Article  Google Scholar 

  64. Jardim C, Pakenham KI. Carers of adults with mental illness: a comparison with respite care users and non-users. Aust Psychol. 2010;45:50–8. doi:10.1080/13284200903353064.

    Article  Google Scholar 

  65. Jardim C, Pakenham KI. A pilot investigation of the effectiveness of respite care for carers of an adult with mental illness. Clin Psychol. 2009;13:87–93. doi:10.1080/13284200903353064.

    Article  Google Scholar 

  66. Cuijpers P. The effects of family interventions on relatives' burden: a meta-analysis. J Ment Health. 1999;8:275–85. doi:10.1080/09638239917436.

    Article  Google Scholar 

  67. McAuliffe D, Andriske L, Moller E, O'Brien M, Breslin P, Hickey P. 'Who cares?' An exploratory study of carer needs in adult mental health. Aust e-J Adv Ment Health. 2009;8:1–12.

    Article  Google Scholar 

  68. Andrew M, Farhall J, Ong B, Waddell F. Perceptions of mental health professionals and family caregivers about their collaborative relationships: a factor analytic study. Aust Psychol. 2009;44:94–104. doi:10.1080/00050060902733719.

    Article  Google Scholar 

  69. Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. New Jersey: Lawrence Erlbaum Associates, Inc; 1988.

    Google Scholar 

Download references

Acknowledgements

Assistance with recruitment by ARAFMI (QLD), Carers Queensland and the Redlands and Gold Coast Hospitals is greatly appreciated. Thanks are extended to Drs. Claudia Jardim and Christina Mackay for their assistance with data collection.

Author information

Authors and Affiliations

  1. School of Psychology, The University of Queensland, Brisbane, QLD, 4072, Australia

    Kenneth I. Pakenham

Authors
  1. Kenneth I. Pakenham
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kenneth I. Pakenham.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pakenham, K.I. Caregiving Tasks in Caring for an Adult with Mental Illness and Associations with Adjustment Outcomes. Int.J. Behav. Med. 19, 186–198 (2012). https://doi.org/10.1007/s12529-011-9155-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12529-011-9155-8

Keywords

Search

Navigation