Antonovsky’s sense of coherence and resistance resources reduce perception of burden in family carers of people with Alzheimer’s disease

Abstract

Objectives: Taking care of people with dementia (PWD) has been associated with some degree of burden. The variability of the carer’s burden can be partially explained by their personal characteristics. Antonovsky’s model of health defined the resistance resources (RRs) as essential mechanisms to cope with stressors, and to shape the personal sense of coherence (SOC). This study identifies the RRs related with carer’s SOC, and their implications in the perception of burden in family dementia carers.

Methods: A sample of 308 participants from the ‘SOC & DEM study’ (154 carers and 154 PWD) was recruited from two memory clinics. Carer’s personal characteristics of burden, SOC, self-efficacy, coping strategies, perceived social support, and depression were evaluated using standardized instruments. PWD’s degree of dependence and behaviour and psychological symptoms of dementia (BPSD) were assessed too. A path analysis was used to test the relationship between caregiver burden and SOC including the personal RRs of the carers and clinical data of PWD.

Results: The path model identified SOC as a major factor related to carer’s burden perception (r = –.327). Self-efficacy (r = .285), two coping strategies, ‘use instrumental support’ (r = –.235) and ‘behavioural disengagement’ (r = –.219), and social support perceived (r = .304) were the main carer’s personal characteristics directly related with SOC. Caring experience (r = –.281) was the main carer factor related with burden while dependence (r = .156) and BPSD (r = .157) were the dementia factors.

Conclusion: The SOC has previously related with carer’s burden. The results contributed to identify relevant and modifiable personal characteristics as RRs that could reduce this burden.

Keywords:

• Alzheimer’s Disease
• stress/burden
• sense of coherence
• caregiving
• coping

Acknowledgments

We thank Glòria Mas, Margarida Flaqué, and Dr. Secundino López-Pousa for their support in recruitment and their enthusiastic commitment in this study.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The project received a research grant from the Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain), awarded on the 2017 call under the Health Strategy Action 2013-2016, within the National Research Program oriented to Societal Challenges, within the Technical, Scientific and Innovation Research National Plan 2013-2016, with reference PI17/00029, co-funded with European Union ERDF funds (European Regional Development Fund)”. EM is supported by a grant from the Alzheimer's Society (UK).