TY - JOUR
T1 - Caregiver “objective attitude” toward patients with neurodegenerative disease
T2 - Consequences for caregiver strain and relationship closeness
AU - Zahir, Ali
AU - Staffaroni, Adam M.
AU - Wickham, Robert E.
AU - Quinn, Carson M.
AU - Sapozhnikova, Anna
AU - Seidman, Jeffrey
AU - Chiong, Winston
N1 - Publisher Copyright:
© 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2021
Y1 - 2021
N2 - Many caregivers of patients with neurodegenerative disease experience physical and psychological strain, which is associated with negative health outcomes. Caregiver strain may be partly attributable to negative emotional responses (e.g.of resentment) to the behavioral, cognitive, and physical changes associated with patients’ disease. The philosopher Peter Strawson observed that in dealing with people who have neurological impairments, we often choose to suspend such emotional responses, adopting what he labeled the “objective attitude,” though this may come at the expense of our relationships with them. In this study, we assessed the mediating effect of caregivers’ adoption of the objective attitude on caregiver strain and relationship closeness in the setting of disease progression. Caregivers of patients with neurodegenerative disorders (n = 215) completed the Clinical Dementia Rating, Relationship-Closeness scale, Caregiver Strain Index, and a novel questionnaire assessing the adoption of the objective attitude. A structural equation model assessing associations among these variables demonstrated good fit (χ2 (88)=164.621, p < 0.001; CFI = 0.929, RMSEA = 0.064.) and showed that adoption of the objective attitude mediated the association between disease progression and relationship closeness (total β= −0.233, 95% CI: −0.351, −0.113; indirect β= −0.483, 95% CI: −0.602, −0.364; direct β = 0.250, 95% CI: 0.117, 0.384), but did not mediate the association between disease progression and caregiver strain (total β = 0.323, 95% CI: 0.234, 0.412; indirect β = 0.089, 95% CI: −0.027, 0.206; direct β = 0.153, 95% CI: −0.043, 0.349). For future work, we propose longitudinal measurements of these constructs to test the directionality of associations and consideration of how models for caregiver support can draw upon interdisciplinary insights.
AB - Many caregivers of patients with neurodegenerative disease experience physical and psychological strain, which is associated with negative health outcomes. Caregiver strain may be partly attributable to negative emotional responses (e.g.of resentment) to the behavioral, cognitive, and physical changes associated with patients’ disease. The philosopher Peter Strawson observed that in dealing with people who have neurological impairments, we often choose to suspend such emotional responses, adopting what he labeled the “objective attitude,” though this may come at the expense of our relationships with them. In this study, we assessed the mediating effect of caregivers’ adoption of the objective attitude on caregiver strain and relationship closeness in the setting of disease progression. Caregivers of patients with neurodegenerative disorders (n = 215) completed the Clinical Dementia Rating, Relationship-Closeness scale, Caregiver Strain Index, and a novel questionnaire assessing the adoption of the objective attitude. A structural equation model assessing associations among these variables demonstrated good fit (χ2 (88)=164.621, p < 0.001; CFI = 0.929, RMSEA = 0.064.) and showed that adoption of the objective attitude mediated the association between disease progression and relationship closeness (total β= −0.233, 95% CI: −0.351, −0.113; indirect β= −0.483, 95% CI: −0.602, −0.364; direct β = 0.250, 95% CI: 0.117, 0.384), but did not mediate the association between disease progression and caregiver strain (total β = 0.323, 95% CI: 0.234, 0.412; indirect β = 0.089, 95% CI: −0.027, 0.206; direct β = 0.153, 95% CI: −0.043, 0.349). For future work, we propose longitudinal measurements of these constructs to test the directionality of associations and consideration of how models for caregiver support can draw upon interdisciplinary insights.
KW - attitudes
KW - caregiving
KW - Dementia
KW - relationships
KW - strain
UR - http://www.scopus.com/inward/record.url?scp=85087041679&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85087041679&partnerID=8YFLogxK
U2 - 10.1080/13607863.2020.1771541
DO - 10.1080/13607863.2020.1771541
M3 - Article
C2 - 32515603
AN - SCOPUS:85087041679
SN - 1360-7863
VL - 25
SP - 1709
EP - 1715
JO - Aging and Mental Health
JF - Aging and Mental Health
IS - 9
ER -