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DOI :10.26650/SP2018-0012   IUP :10.26650/SP2018-0012    Full Text (PDF)

Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients

Ayşenur Aktaş, Hanife Özlem Sertel Berk

Chronic renal failure (CRF) is a long, progressive, and chronic condition that requires care. In hemodialysis treatment, which is the most preferred treatment method in CRF, caregivers (informal caregivers) and health teams (formal caregivers) have difficulties as much as patients during the period of illness, and treatment. The aim of this study is to investigate the caregiving process of hemodialysis patients’ informal and formal caregivers within the frame of the “Caregiver Stress Model”. Informal (N = 50, mean of age: 48.5, 92% of which were woman), and formal (N = 63, mean of age: 33.4, 84%of which were woman) caregivers from various dialysis units in Istanbul participated in the study. The Resilience Scale for Adults, The Caregiver Well-Being Scale, The Multidimensional Scale of Perceived Social Support, The Ways of Coping Inventory, and the Maslach Burnout Inventory were used. The results showed that the unconfident coping factor of The Ways of Coping Inventory was a moderator of the relationship between the vital activities and personal success which is sub-dimension of Maslach Burnout Inventory was revealed. Also, the findings suggested that resilience, self-confident and unconfident coping factors were significant mediators of the relationships between the vital activities and personal success. The importance of this study is that the caregiver stress model being tested on caregivers of hemodialysis patients has never appeared in the literature before. In the literature, psychological resilience, coping and social support variables, whose formative effects are frequently discussed, contributed to the mediator effects that partially supported the model. Our findings are discussed in light of other published studies in the field.
Keywords: Caregiving, hemodialysis, caregiver stress model, chronic renal failure
DOI :10.26650/SP2018-0012   IUP :10.26650/SP2018-0012    Full Text (PDF)

Hemodiyaliz Hastalarına Bakım Verenlerde Bakıcı Stres Modelinin Test Edilmesi

Ayşenur Aktaş, Hanife Özlem Sertel Berk

Kronik Böbrek Yetmezliği (KBY), uzun süren, ilerleyici ve bakım almayı gerekli kılan, kronik bir hastalıktır. Sıklıkla hemodiyaliz tedavisi ile izlenen KBY hastalığına ve tedavisine ait süreçte hastalar kadar onlara bakım veren yakınları (informal bakım veren) ve sağlık ekibi de (formal bakım veren) hastalık ve tedavi sürecinin zorluğunu yaşamaktadırlar. Bu çalışma kapsamında hemodiyaliz hastalarının informal ve formal bakım verenlerinin bakım verme süreçlerinin ‘Bakıcı Stres Modeli’ çerçevesinde incelenmesi amaçlanmıştır. İstanbul’daki çeşitli diyaliz birimlerinden 50 informal (yaş Ort. = 48.5, %92 kadın) ve 63 formal (yaş Ort. = 33.4, %84 kadın) bakım verenin katıldığı araştırmada Yetişkinler için Psikolojik Dayanıklılık Ölçeği, Çok Boyutlu Algılanan Sosyal Destek Ölçeği, Bakıcı İyilik Ölçeği, Stresle Baş Etme Tarzları Ölçeği, Maslach Tükenmişlik Ölçeği kullanılmıştır. Sonuçlara bakıldığında Bakıcı İyilik Ölçeği’nin faktörlerinden yaşamsal faaliyetler ile Maslach Tükenmişlik Ölçeği kişisel başarı faktörü arasında Stresle Baş Etme Tarzları Ölçeği kendine güvensiz faktörünün biçimlendirici; psikolojik dayanıklılık, Stresle Baş Etme Tarzları Ölçeği kendine güvenli ve kendine güvensiz faktörlerinin ise tam aracı etkiye sahip oldukları görülmektedir. Bu çalışma ile Bakıcı Stres Modeli ilk defa hemodiyaliz hastalarının hem informal hem de formal bakım verenleri üzerinde test edilmiştir. Ayrıca, alan yazında sıklıkla biçimlendirici etkileri ele alınan psikolojik dayanıklılık, baş etme ve sosyal destek değişkenlerinin modeli kısmen destekleyen aracı etkilerine katkı sunulmuştur.
Keywords: Bakım verme, hemodiyaliz, bakıcı stres modeli, kronik böbrek yetmezliği

EXTENDED ABSTRACT


In the literature, the concept of caregiving is explained as the provision of support for physical, social, economic, and emotional dimensions, which are handled across a wide spectrum of time frames (Toseland, Smith, & McCallion, 2001). 

The literature on caregiving consists of various models which try to define the concept of caregiving within the frame of the biopsychosocial perspective (Pearlin, Mullan, Semple, & Skaff, 1990). Lazarus and Folkman’s (1984) transactional stress and coping paradigm constitutes the theoretical basis of these models. The Caregiver Stress Model (Pearlin et al., 1990) which is handled in this study addresses the positive and negative concepts affecting caregivers of patients with a chronic illness as an interaction rather than a situation.

The aim of this study is to examine the outcomes of the caregiving process on informal and formal caregivers of hemodialysis patients within the frame of the Caregiver Stress Model. Although social support and coping variables were frequently examined as a moderator variable in the literature, they were suggested as mediator variables within this model. Additionally, while it is not covered in the model, resilience - which is another variable considered to be important in the context of the caregiver literature - was also discussed in this study. 

In the first hypothesis, the mediator effects of resilience, coping, social support in the relationship between basic needs, vital activities, and burnout were examined within the caregiver stress model. In addition, in the second research question - moderator effects of resilience - coping, social support in the relationship between basic needs, vital activities, and burnout were investigated within the Caregiver Stress Model.

Method

Fifty informal and sixty three formal caregivers from various dialysis units in Istanbul participated in the study. The Resilience Scale for Adults (Friborg et al. 2003; Basım & Çetin, 2011), The Caregiver Well-Being Scale (Berg-Weger, Rubio, & Tebb, 2000; Demirtepe & Bozo, 2009), The Multidimensional Scale of Perceived Social Support (Zimet et al. 1988; Eker & Arkar, 1995), The Ways of Coping Inventory (Folkman & Lazarus, 1984; Şahin & Durak, 1994), and The Maslach Burnout Inventory (Maslach & Jackson, 1981; Ergin, 1992) were used. 

Results

In the first hypothesis of the study, resilience, self-confident, and optimistic coping styles were found to have full mediator effects on the relationship between basic needs and the personal success sub-dimension of the Maslach Burnout Inventory. The results of this analysis were similar to other studies in the literature using the Caregiver Stress Model (DemirtepeSaygılı & Bozo, 2011). Within the scope of the second research question, the results showed that only the moderator effect of the unconfident coping style was significant between the relationship of the vital activities and personal success (F(1, 109) = 6.330, p < .05). 

Discussion

When we examined the results of this research, some differences were observed with the Caregiver Stress Model - the theoretical basis of this study. Accordingly, the social support that the model suggested as being a mediator variable was not significant in both the mediator and the moderator effects in this study. When the relevant literature was examined, it was seen that social support - which was not compatible with similar studies in the field - was generally considered as a moderator (Cohen & Wills, 1985) and occasionally both a moderator and a mediator variable (Brand, Barry, & Gallagher, 2014).

The mediating effect of the coping style variable, as suggested by the model, was found to be significant, as well as the significant moderator effects of this variable. In addition, the mediating effect of the resilience which was introduced in to the model within this study attracted attention in this study.

The difficulties of reaching informal and formal caregivers is restrictive because they have limited time due to the workload of caregivers. At the same time, the scales used in the study are completely structured and highly directional. It is thought that the results of the analysis can be affected by these limitations.  

Nevertheless this study introduces important contributions to the field despite these limitations. In other countries, the caregiver stress model was studied on caregivers of cancer, Alzheimer’s, and AIDS patients (Matthews, Baker, & Spillers, 2003; Pearlin & Mullan, 1994; Stetz & Brown, 2004). In Turkey, only caregivers of children with leukemia have been studied within the frame of this model (Demirtepe-Saygılı & Bozo, 2011). This is the first time that this model has been studied on hemodialysis patients’ relatives and health care providers. Although the Caregiver Stress Model is partially supported by our results, the importance of this study is that this is the firts time that this model has been tested on hemodialysis patients’ caregivers, in the literature.


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Aktaş, A., & Sertel Berk, H.Ö. (2019). Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients. Studies in Psychology, 39(2), 401-427. https://doi.org/10.26650/SP2018-0012


AMA

Aktaş A, Sertel Berk H Ö. Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients. Studies in Psychology. 2019;39(2):401-427. https://doi.org/10.26650/SP2018-0012


ABNT

Aktaş, A.; Sertel Berk, H.Ö. Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients. Studies in Psychology, [Publisher Location], v. 39, n. 2, p. 401-427, 2019.


Chicago: Author-Date Style

Aktaş, Ayşenur, and Hanife Özlem Sertel Berk. 2019. “Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients.” Studies in Psychology 39, no. 2: 401-427. https://doi.org/10.26650/SP2018-0012


Chicago: Humanities Style

Aktaş, Ayşenur, and Hanife Özlem Sertel Berk. “Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients.” Studies in Psychology 39, no. 2 (May. 2024): 401-427. https://doi.org/10.26650/SP2018-0012


Harvard: Australian Style

Aktaş, A & Sertel Berk, HÖ 2019, 'Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients', Studies in Psychology, vol. 39, no. 2, pp. 401-427, viewed 22 May. 2024, https://doi.org/10.26650/SP2018-0012


Harvard: Author-Date Style

Aktaş, A. and Sertel Berk, H.Ö. (2019) ‘Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients’, Studies in Psychology, 39(2), pp. 401-427. https://doi.org/10.26650/SP2018-0012 (22 May. 2024).


MLA

Aktaş, Ayşenur, and Hanife Özlem Sertel Berk. “Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients.” Studies in Psychology, vol. 39, no. 2, 2019, pp. 401-427. [Database Container], https://doi.org/10.26650/SP2018-0012


Vancouver

Aktaş A, Sertel Berk HÖ. Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients. Studies in Psychology [Internet]. 22 May. 2024 [cited 22 May. 2024];39(2):401-427. Available from: https://doi.org/10.26650/SP2018-0012 doi: 10.26650/SP2018-0012


ISNAD

Aktaş, Ayşenur - Sertel Berk, HanifeÖzlem. “Testing the Caregiver Stress Model with the Caregivers of Hemodialysis Patients”. Studies in Psychology 39/2 (May. 2024): 401-427. https://doi.org/10.26650/SP2018-0012



TIMELINE


Submitted14.08.2018
First Revision15.08.2019
Last Revision19.08.2019
Accepted20.08.2019
Published Online09.12.2019

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