Interventions to Increase Adaptive Coping Among Family Caregivers of Dementia Victims

Interventions to Increase Adaptive Coping Among Family Caregivers of Dementia Victims: What Works Well for Latina and Anglo/Caucasian Women

David Coon, Ph.D., Anne Bechtle-Higgins, Ph.D., Ana Menendez, Ph.D., Nancy Solano, Ph.D., Lisa Kinoshita, Ph.D., Dee Haynie, Ph.D., Helena Kraemer, Ph.D., Dolores Gallagher-Thompson

Abstract

This focuses on the domain of coping skills reported to be used by the caregiver to cope with their caregiving situation, and whether or not the interventions used at our site increased the use of adaptive coping strategies. This work will be based on caregivers’ self-reported responses to the Revised Ways of Coping Checklist developed & validated by Vitaliano & associates, 1985, and the brief Religious Coping Scale of Pargament, 1995.

Hypotheses:

1)  That participants in the CWC class will evidence greater increase in their use of positive or adaptive coping strategies than participants in either the ESG or the MSC, reflecting the fact that they are learning a variety of specific skills for how to cope more effectively with caregiving stress. Participants in the other 2 intervention conditions are not being taught new coping strategies.

2)  That the same pattern of change will be found within both ethnic groups: Anglos & Latinas.

3)  That this pattern will be found both when assessing change from time 1 to time 2 (short term intervention impact) and when assessing change from time 1 to time 3 (longer term intervention impact).

Measures:

Primary Dependent Variables: change on the RWCCL and the BRCOPE scales from time 1 to time 2 and from time 1 to time 3.

Additional Measures: from the core data set we need our site specific baseline measures of a) sociodemographic status (age, education, where born, years in the US, etc.) to describe the caregivers and b) ADL/IADL and Mini-Mental Exam scores of care-receiver (to describe their levels of impairment).

Planned Analyses:

Described above on page one. However, note that since we have 2 different coping measures, we will use a MANOVA (rather than ANOVAs) here, which will take into account the correlation between the two measures. The way the RWCCL is scored, there are 5 kinds of coping inquired about: 3 are grouped together to represent positive or adaptive coping, according to the theory of Lazarus & Folkman (1981): problem solving, seeking support, and counting one’s blessings, and 2 are grouped as representing negative or avoidant coping: these are use of actual avoidant strategies, and blaming others. The 43 items are scaled from 0 to 3 (not used to regular used) and a sum is obtained for each of the two categories of coping.

The BRCOPE is a 10 item scale also scored 0 to 3 (not used to used a great deal); the items are grouped into positive religious coping (using religion to assist in the coping process) vs. negative religious coping (viewing God as punishing, etc.). By using both outcome measures in the same paper, we are examining all of the measures we have that directly assess coping in one publication. We prefer this to doing a separate paper on the religious coping scale alone. Coping is a secondary outcome domain for the Palo Alto site.