Trends in Psychiatry and Psychotherapy
https://trends.org.br/article/doi/10.1590/2237-6089-2017-0065
Trends in Psychiatry and Psychotherapy
Review Article

Coping strategies among caregivers of people with Alzheimer disease: a systematic review

Estratégias de coping entre cuidadores de pessoas com doença de Alzheimer: uma revisão sistemática

Alexandre Magno Frota Monteiro; Raquel Luiza Santos; Nathália Kimura; Maria Alice Tourinho Baptista; Marcia Cristina Nascimento Dourado

http://dx.doi.org/10.1590/2237-6089-2017-0065 Trends Psychiatry Psychother, vol.40, n3, p.258-268, 2018
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Abstract

Abstract Introduction Caregivers of people with Alzheimer disease (PwAD) report significant stress, burden and depression compared to caregivers of people with other dementias, especially when neuropsychiatric symptoms are prominent. Adequate coping strategies can modify the impact of stressful situations and increase the caregivers’ quality of life. Objective To systematically review the different coping strategies used by caregivers of PwAD to manage neuropsychiatric symptoms. Method We carried out electronic searches using MEDLINE (PubMed), SciELO, Web of Knowledge Cross Search (Thomson Scientific/ISI Web Services) and PsycINFO databases to select studies on coping in PwAD caregivers published from January 2005 to July 2017. The search terms were coping, caregivers, strategy, onset, adaptation, family, behavior, dementia and Alzheimer. The studies were organized in three categories: problem-focused, emotion-focused and dysfunctional coping strategies. Results We found 2,277 articles. After application of exclusion criteria and exclusion of redundant references, 24 articles were analyzed. Emotion-focused coping was the most commonly used strategy among PwAD caregivers. The use of this strategy associated with religion and spirituality may help reduce symptoms of depression and anxiety. Problem-focused coping strategies were mostly used with active coping interventions. Problem-solving coping may have buffered the impact of acute psychological stressors on procoagulant activity. Dysfunctional coping strategies were associated with increase of caregiver burden. Conclusion The evaluated studies showed that the use and development of coping strategies may have ameliorated the depressive symptoms, anxiety and burden of caregivers. However, longitudinal studies are still needed that clearly describe the type of coping strategy used in relation to the presented results.

Keywords

Alzheimer disease, coping strategies, depression, caregivers

Resumo

Resumo Introdução Cuidadores de pessoas com doença de Alzheimer relatam mais estresse, sobrecarga e depressão em comparação com cuidadores de pessoas com outras patologias, especialmente quando os sintomas neuropsiquiátricos são proeminentes. Estratégias adequadas de enfrentamento podem modificar o impacto de situações estressantes e aumentar a qualidade de vida do cuidador. Objetivo Revisar sistematicamente as diferentes estratégias de enfrentamento utilizadas pelos cuidadores para lidar com sintomas neuropsiquiátricos. Método Foi realizada busca eletrônica em artigos publicados entre janeiro de 2005 e julho de 2017 nos bancos de dados MEDLINE (PubMed), SciELO, Web of Knowledge Cross Search (Thomson Scientific/ISI Web Services) e PsycINFO. Os termos utilizados foram coping, caregivers, strategy, onset, adaptation, family, behavior, dementia and Alzheimer. Os artigos avaliados foram categorizados em estratégias de enfrentamento focadas na resolução do problema, na emoção e estratégias disfuncionais. Resultados Foram encontrados 2.277 artigos. Após aplicação dos critérios de exclusão, foram incluídos 24 artigos. A estratégia de enfrentamento mais utilizada foi a focada na emoção. O uso desta estratégia associada a religião e espiritualidade pode reduzir sintomas de depressão e ansiedade dos cuidadores. As estratégias de enfrentamento focadas na resolução do problema utilizaram principalmente intervenções baseadas no enfrentamento ativo. A resolução de problemas reduz o impacto dos estressores psicológicos agudos sobre a atividade procoagulante. As estratégias disfuncionais estavam associadas ao aumento da sobrecarga dos cuidadores. Conclusão Os estudos mostraram que o desenvolvimento e uso de estratégias de enfrentamento pode aliviar sintomas depressivos, ansiosos e sobrecarga do cuidador. No entanto, ainda são necessários estudos longitudinais que descrevam claramente o tipo de estratégia de enfrentamento utilizada em relação aos desfechos das pesquisas.

Palavras-chave

Doença de Alzheimer, estratégias de enfrentamento, depressão, cuidadores

References

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). 2013.

Contador I, Fernández-Calvo B, Palenzuela DL, Miguéis S, Ramos F. Prediction of burden in family caregivers of patients with dementia: a perspective of optimism based on generalized expectancies of control. Aging Ment Health. 2012;16:675-82.

Wilks SE, Croom B. Perceived stress and resilience in Alzheimer’s disease caregivers: testing moderation and mediation models of social support. Aging Ment Health. 2008;12:357-65.

Di Mattei VE, Prunas A, Novella L, Marcone A, Cappa SF, Sarno L. The burden of distress in caregivers of elderly demented patients and its relationship with coping strategies. Neurol Sci. 2008;29:383-9.

Lazarus RS, Folkman S. Stress, appraisal, and coping. 1984.

Zaumseil M, Schwarz S. Understandings of coping: A critical review of coping theories for disaster contexts. Cultural psychology of coping with disasters: the case of an earthquake in Java, Indonesia. 2014:45-54.

Li R, Cooper C, Barber J, Rapaport P, Griffin M, Livingston G. Coping strategies as mediators of the effect of the START (strategies for RelaTives) intervention on psychological morbidity for family carers of people with dementia in a randomised controlled trial. J Affect Disord. 2014;168:298-305.

Goode KT, Haley WE, Roth DL, Ford GR. Predicting longitudinal changes in caregiver physical and mental health: a stress process model. Health Psychol. 1998;17:190-8.

Vitaliano PP, Russo J, Young HM, Teri L. Predictors of burden in spouse caregivers of individuals with Alzheimer’s disease. Psychol Aging. 1991;6:392-402.

Vedhara K, Shanks N, Wilcock G, Lightman SL. Correlates and predictors of self-reported psychological and physical morbidity in chronic caregiver stress. J Health Psychol. 2001;6:101-19.

Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151:264-9.

García-Alberca JM, Cruz B, Lara JP, Garrido V, Lara A, Gris E. The experience of caregiving: the influence of coping strategies on behavioral and psychological symptoms in patients with Alzheimer’s disease. Aging Ment Health. 2013;17:615-22.

Mausbach BT, Aschbacher K, Patterson TL, Ancoli-Israel S, Känel RV, Mills PJ. Avoidant coping partially mediates the relationship between patient problem behaviors and depressive symptoms in spousal Alzheimer caregivers. Am J Geriatr Psychiatry. 2006;14:299-306.

Alma AU, Shardlow SM, Teng Y, Tsien T, Chan C. Coping strategies and social support-seeking behavior among Chinese caring for older people with dementia. Aging Soc. 2013;33:1422-41.

Chun M, Knight BG, Youn G. Differences in stress and coping models of emotional distress among Korean, Korean-American and White-American caregivers. Aging Ment Health. 2007;11:20-9.

Lim J, Griva K, Goh J, Hui Chionh L, Yap P. Coping strategies influence caregiver outcomes among Asian family caregivers of persons with dementia in Singapore. Alzheimer Dis Assoc Disord. 2011;25:34-41.

Merritt MM, McCallum TJ. Too much of a good thing? Positive religious coping predicts worse diurnal salivary cortisol patterns for overwhelmed African-American female dementia family caregivers. Am J Geriatr Psychiatry. 2013;21:46-56.

Rabinowitz YG, Hartlaub MG, Saenz EC, Thompson LW, Gallagher-Thompson D. Is religious coping associated with cumulative health risk? An examination of religious coping styles and health behavior patterns in Alzheimer’s dementia caregivers. J Relig Health. 2010;49:498-512.

Tan T, Schneider MA. Humor as a coping strategy for adult-child caregivers of individuals with Alzheimer’s disease. Geriatr Nur. 2009;30:397-408.

Riedijk SR, Vugt ME, Duivenvoorden HJ, Niermeijer MF, Van Swieten JC, Verhey FRJ. Caregiver burden, health-related quality of life and coping in dementia caregivers: a comparison of frontotemporal dementia and Alzheimer’s disease. Dement Geriatr Cogn Disord. 2006;22:405-12.

Geiger JR, Wilks SE, Lovelace LL, Chen Z, Spivey CA. Burden among male Alzheimer’s caregivers: effects of distinct coping strategies. Am J Alzheimers Dis Other Demen. 2015;30:238-46.

Sun F, Hodge DR. Latino Alzheimer’s disease caregivers and depression: using the stress coping model to examine the effects of spirituality and religion. J Appl Gerontol. 2014;33:291-315.

Cooper C, Katona C, Orrell M, Livingston G. Coping strategies and anxiety in caregivers of people with Alzheimer’s disease: the LASER-AD study. J Affect Disord. 2006;90:15-20.

García-Alberca JM, Cruz B, Lara JP, Garrido V, Lara A, Gris E. Anxiety and depression are associated with coping strategies in caregivers of Alzheimer’s disease patients: results from the MÁLAGA-AD study. Int Psychogeriatr. 2012;24:1325-34.

Livingston G, Barber J, Rapaport P, Knap M, Griffin M, King D. Clinical effectiveness of a manual based coping strategy programme (START, STrAtegies for RelaTives) in promoting the mental health of carers of family members with dementia: pragmatic randomised controlled trial. BMJ. 2013;347:f6276.

Aschbacher K, Patterson TL, von Känel R, Dimsdale JE, Mills PJ, Adler KA. Coping processes and hemostatic reactivity to acute stress in dementia caregivers. Psychosom Med. 2005;67:964-71.

Williams KL, Morrison V, Robinson CA. Exploring caregiving experiences: caregiver coping and making sense of illness,. Aging Ment Health. 2014;18:600-9.

Raggi A, Tasca D, Panerai S, Neri W, Ferri R. The burden of distress and related coping processes in family caregivers of patients with Alzheimer’s disease living in the community. J Neurol Sci. 2015;358:77-81.

Romero-Moreno R, Márquez-González M, Losada A, López J. Motives for caring: relationship to stress and coping dimensions. Int Psychogeriatr. 2011;23:573-82.

Williams VP, Bishop-Fitzpatrick L, Lane JD, Gwyther LP, Ballard EL, Vendittelli AP. Video-based coping skills (VCS) to reduce health risk and improve psychological and physical well-being in Alzheimer’s disease family caregivers. Psychosom Med. 2010;72:897-904.

Bruvik F, Ranhoff AH, Ulstein I, Engedal K. The effect of psychosocial support intervention on depression in PwAD and their family caregivers: an assessor-blinded RCT. Dement Geriatr Cogn Disord Extra. 2013;3:386-97.

Cooper C, Katona C, Orrell M, Livingston G. Coping strategies, anxiety and depression in caregivers of people with Alzheimer’s disease. Int J Geriatr Psychiatry. 2008;23:929-36.

Tschanz BT, Deberard MS, Snyder C, Smith C, Lee Lester, Lyketsos CG. Caregiver coping strategies predict cognitive and functional decline in dementia: The Cache County Dementia Progression Study. Am J Geriatr Psychiatry. 2013;21:57-66.

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