Susan Silverberg Koerner

Caregiving for elder relatives: Which caregivers experience personal benefits/gains?

The present study asks whether the positive, rewarding experiences of caregiving (benefits/gains) emerge merely as a function of caregiver personality, or whether, after personality traits (agreeableness, conscientiousness, extroversion, neuroticism) are taken into account, other interpersonal factors make a difference. Survey data were collected from 63 family caregivers. Bivariate analyses revealed that caregiving benefits/gains were significantly and positively associated with two personality traits (agreeableness, extroversion), family and spouse/partner socio-emotional support, and prior relationship quality. Hierarchical regressions indicated that whereas neither family socio-emotional support nor prior relationship quality significantly predicted variance in caregiving benefits/gains beyond that accounted for by agreeableness and extroversion, spouse/partner socio-emotional support did. Implications for research and practice are discussed.

Adolescent Women's Sports Involvement and Sexual Behavior/Health: A Process-Level Investigation.

This multimethod study explored the promising link between organized sports involvement during the high school years and sexual behavior/health among 176 adolescent women. Using more sensitive and appropriate measures than those in existing studies and directed, in part, by cultural resource theory, this study helped to fill a gap in the literature by exploring potential mediators (i.e., functional body orientation and self-empowerment/efficacy) of that link. Results from the quantitative data indicated that adolescent womens involvement in organized team sports was favorably associated with each of the following: (a) sexual-risk-taking behavior, (b) sexual/reproductive health-seeking behavior, and (c) sexual/reproductive health. In addition, both functional body orientation and self-empowerment/efficacy emerged as mediators in the associations between sports involvement and sexual behavior/health among adolescent women. Content analysis of participant responses to open-ended items provided further confirmation of those mediating effects. Implications for the development of sports and community programs focused on the prevention of teenage pregnancy and STDs are discussed.

Reaping caregiver feelings of gain: The roles of socio-emotional support and mastery

Objectives: Existing studies indicate that the presence of social support increases the likelihood of caregivers experiencing feelings of gain from caregiving; however, researchers have not yet investigated the mechanism through which social support is linked to caregiver feelings of gain. Informed by Banduras Social Cognitive Theory, the present study investigated whether a sense of caregiving mastery serves as a key mechanism. Method: Sixty-three family caregivers of dependent elders completed surveys to assess caregiver feelings of gain, socio-emotional support (from family, friends, spouse/partner) and mastery. To evaluate the hypothesized mediation model, a series of structural equation modeling (SEM) analyses were conducted with the maximum likelihood method by Lisrel 8.8. Results: Socio-emotional support from family members was found to be an important resource for caregiver feelings of gain. SEM analyses further revealed that the mechanisms by which socio-emotional support influences caregiver feelings of gain vary depending on its source (i.e. family members, friends, and partners). Conclusion: As hypothesized, caregiving mastery played a mediating role for non-partner family socio-emotional support whereas it did not for partner socio-emotional support. Based on availability or absence of specific sources of support, caregiver intervention programs should be individually tailored to enhance their potential impact.

Sociocontextual Circumstances in Daily Stress Reactivity Among Caregivers for Elder Relatives

Using a daily diary design, we examined whether emotional and physical reactivity in the face of care-related stressors is more intense for caregivers (CGs) living with lower levels of available socioemotional support and higher numbers of extrinsic stressors. Sixty-three CGs reported their experiences based on the past 24 hr (i.e., number of caregiving tasks, care recipient problem behaviors, family disagreements regarding care, depressive symptoms, feelings of burden, physical symptoms) on eight consecutive survey days; they also reported on extrinsic stressors and available socioemotional support. Multilevel analyses indicated significant moderator effects: within-person patterns of reactivity to care-related stressors were especially strong for CGs with lower levels of available socioemotional support and higher numbers of extrinsic stressors. For example, managing additional care recipient problem behaviors on a given day was more strongly associated with increased depressive and physical health symptoms as well as feelings of burden for CGs with relatively high numbers of extrinsic stressors. Implications for intervention are discussed.

The negative impact of global perceptions of and daily care-related family conflict on Hispanic caregivers: Familism as a potential moderator

Objectives: Using selected concepts from Pearlins care giving stress model and incorporating a daily stress-reactivity perspective, the current study surveyed Hispanic family caregivers (HCGs) to: (a) document the occurrence of family disagreements regarding care; (b) examine the impact of family disagreements regarding care on HCGs’ emotional/physical well being; and (c) determine the moderating role of familism – whether strong familism beliefs buffer or exacerbate the negative impact of family disagreements on HCGs. Methods: Participants (n = 67) reported their daily experiences of family disagreements regarding care, depressive symptoms, feelings of burden, and physical health symptoms on eight consecutive survey days; and, in a separate survey, reported their global perceptions of family disagreements regarding care and their familism beliefs. Results: Multilevel-modeling indicated (a) a significant link between global perceptions of family disagreement regarding care and greater depressive symptoms, feelings of burden, and physical health symptoms and (b) significant moderating (i.e., exacerbating) effects of familism at the daily level suggesting that HCGs with stronger familism beliefs are more reactive to daily care-related family disagreement occurrences. Conclusions: The findings from the current study suggest that family disagreement regarding care is a salient aspect of the context of care giving for HCGs, and is linked to depressive symptoms, feelings of burden, and physical health symptoms. Familism may play an exacerbating role in this link. Interpretations of the results and implications for research and intervention are offered.

Un Abrazo Para La Familia: providing low-income Hispanics with education and skills in coping with breast cancer and caregiving.

Un Abrazo Para La Familia (A Hug for the Family) is an intervention designed to increase the accessibility of cancer information to low‐income and medically underserved co‐survivors of cancer. Co‐survivors are family members or friends of an individual diagnosed with cancer. Our goal was to increase socio‐emotional support for these co‐survivors and improve skills in coping with cancer. The purpose of our pilot study was to explore the effectiveness of the intervention in increasing cancer knowledge and self‐efficacy among co‐survivors.

like a mexican wedding: Psychosocial intervention needs of predominately hispanic low-income female co-survivors of cancer

Although recent work has recognized that the influence and consequences of cancer extend beyond the individual receiving the diagnosis, no studies have focused on the specific psychosocial intervention needs of female co-survivors in low-income populations. In this qualitative study, the co-survivors, 16 women, representing 10 low-income families and predominately Hispanic, were interviewed about their experience of having someone in their family diagnosed with cancer. Several themes emerged from the data, including family stress, lack of skill in coping with the effects of cancer (e.g., depression of their loved one), a need for financial help, a willingness to share with others, and reliance on faith to see them through the cancer experience. Whereas no agreement existed as to where and how to provide an intervention, participants reported that tailoring an intervention to family needs and delivering it in a way that was accessible to them was important.

Family-Focused Preventive Interventions With Cancer Cosurvivors: A Call to Action

Health promotion and preventive action in the context of public health interventions for highly prevalent, long-term conditions such as cancer are rarely geared toward the family as a whole. Yet family members, as cancer cosurvivors, must manage their own substantial stress and multiple caregiving responsibilities and often constitute a critical nexus between individual patients and clinicians. We drew on 2 examples of cancer cosurvivorship from 2 different health service contexts, the United States and Finland. A systemic approach in public health is needed to support family members who not only have to confront the meaning of long-term conditions such as cancer but also may have to manage concurrent social life challenges and stressors such as economic hardship.

Information and support for co-survivors during or after cancer treatment: Consideration of Un Abrazo Para la Familia as a model for family-focused intervention in cancer rehabilitation

OBJECTIVE The development and evaluation of Un Abrazo Para La Familia, [A Hug for the Family] is described. Un Abrazo is discussed as an effective model of education, information-sharing, and skill-building for use with low-income co-survivors of cancer. PARTICIPANTS Sixty co-survivors participated. The majority were women and all reported being Hispanic. METHODS Using quantitative data (N=60), the needs, concerns, and characteristics of the co-survivor population served through Un Abrazo are presented. Further, we offer three qualitative case studies (with one co-survivor, one survivor, and one non-participant) to illustrate the model and its impact. RESULTS The median level of education level of co-survivors was 12 years. The majority were unemployed and/or identified as homemakers, and indicated receipt of services indicating low-income status. Half reported not having health insurance. The top four cancer-related needs or concerns were: Information, Concern for another person, Cost/health insurance, and Fears. CONCLUSIONS Recognizing the centrality of the family in addressing cancer allows for a wider view of the disease and the needs that arise during and after treatment. Key rehabilitation strategies appropriate for intervening with co-survivors of cancer include assessing and building upon strengths and abilities and making culturally-respectful cancer-related information and support accessible.

Examining the Influence of Care-Recipient Resistance on Family Caregiver Emotional and Physical Well-Being: Average Frequency Versus Daily Fluctuation.

Although existing cross-sectional research suggests that dependent older family members’ resistive behavior (care-recipient [CR] resistance: verbal or nonverbal rejection or resistance toward caregiver [CG] assistance) can be challenging for informal family CGs, we know little about the impact of the occurrence patterns of CR-resistance—average frequency versus daily fluctuation—on CG emotional and physical well-being. To document CGs’ daily experiences with CR-resistance and their emotional and physical well-being, the present study applied short-term repeated measures, collecting data on 8 consecutive days from 63 CGs in Southern Arizona, the United States. Multilevel modeling of the daily data revealed that neither average frequency nor daily fluctuation in CR-resistance alone had a significant impact on CG emotional/physical health. However, the combination of experiencing relatively high frequency and high daily fluctuation in CR-resistance was associated with significant increases in CG physical health symptoms (b = .34, p < .01). Specifically, on days when a CG faced more CR-resistance than his or her usual amount, significant increases in physical health symptoms existed for CGs with relatively high average frequency of CR-resistance, but not for CGs with relatively low average frequency of CR-resistance. Based on our results, it appears that monitoring and maintaining a reasonable level of CR-resistance are effective strategies to maintain CG resilience to the negative impact of CR-resistance daily fluctuation. The findings are interpreted in light of Stress Theory, and recommendations for future research and practical interventions are offered.