PhD in Nursing Science Program

Kuei-Ru Chou

Testing A Theoretical Model of Caregiver Burden In A Chinese Population. May 1997


Dr. Kuei-Ru Chou was the first student to graduate from the PhD in Nursing Science program at Vanderbilt University. Her dissertation, Testing A Theoretical Model of Caregiver Burden In A Chinese Population, was overseen by Dr. Lynda LaMontagne, Associate Professor at the School of Nursing. Dr. Chou investigated the effects of demands of care, caregiving self- efficacy, filial obligation, caregiving involvement, emotion-focused coping and problem-focused coping on caregiver burden. The specific aim of the study was to test a theory derived model of caregiver burden in a Chinese population.

A cross sectional design was used to examine the magnitude of the relationships among variables in a hypothesized model of caregiver burden. A convenience sample of 150 subjects diagnosed with senile dementia of the Alzheimer's type (SDAT) or multi-infarct dementia (MID) was recruited from outpatient clinics of three hospitals in Taiwan; standardized instruments were used to measure variables of interest. Multivariate structural equation modeling was used to test the originally hypothesized model and to respecify the model until an acceptable fit between variables was achieved.

Approximately 77% of caregivers in the study were women and ranged in age from 20 to 82 years (mean = 52.4 +/- 14.7). Average (mean) number of months of care giving was 43.7 (+/-30.4 months). As expected, extent of restriction on activities of daily living was associated with amount of caregiver involvement. Caregiving involvement was associated with physical burden, emotional burden, social burden and financial burden, which all were correlated with one another.

When problem-focused coping was used by the caregivers, less burden was perceived. Problem-focused coping also was associated with caregiving self-efficacy and emotion-focused coping and was negatively associated with distress. No significant relationships were seen between emotion-focused coping and physical, emotional or financial burden. Demands of care on the caregiver was determined to consist of physical demands and psychological demands. Both physical and psychological demands were found to indirectly affect caregiver burden through caregiving involvement.

Findings suggest that caregiving self-efficacy, caregiving involvement, filial obligation, emotion-focused coping and problem-focused coping are better predictors of caregiver burden than are demands of care in primary caregivers of relatives with dementia. Demands of care influences caregiver burden indirectly through caregiving involvement.