Coping Strategies and Distress in Patients and Caregivers Dealing with Neurocognitive Disorders
Maria Devita1*, Erika Ruffino1, Pasquale Anselmi2, Daniela Mapelli1, Michela Sarlo3, Giuseppe Sergi4 and Alessandra Coin4
1Department of General Psychology, University of Padua, Italy
2Department of Philosophy, Sociology, Education and Applied Psychology - FISSPA, University of Padua, Italy
3Department of Communication Sciences, Humanities and International Studies - DISCUI, University of Urbino Carlo Bo, Italy
4Geriatrics Division, Department of Medicine (DIMED), University of Padua, Italy
*Corresponding Author: Maria Devita, Department of General Psychology, University of Padua, Italy.
March 03, 2022; Published: May 16, 2022
Background and Aims: Quality of life (QoL) is described as the individual’s perception of life in relation to the cultural context and value system in which they live, and their objectives, expectations and interests. The aim of the present study is to investigate the perceptions of QoL on the part of patients with Mild Cognitive Impairment (MCI) or mild dementia and on the part of their caregivers, by examining how they are influenced by factors such as anosognosia, coping strategies, perceived stress and caregiver burden.
Methods: QoL was assessed in a sample of 30 patients with MCI or mild dementia and their caregivers using the QoL-AD. Other variables were measured with the AQ-D, PSS-10, COPE-NVI-25 and CBI instruments. We also assessed patients' levels of cognitive impairment with the MMSE.
Results: Patients’ QoL ratings were significantly higher than those of their respective caregivers. Patients’ perceptions of QoL were predicted by their caregiver’s avoidance coping strategy (β = -0.591, p < 0.01), whereas the caregivers’ perceptions of QoL were predicted by their perceived stress levels (β = -0.567, p < 0.01), the patient’s transcendent orientation (β = -0.369, p < 0.05) and the caregiver's positive attitude coping strategy (β = 0.312, p < 0.05).
Conclusions: This study shows that perception of QoL is mostly influenced by coping strategies and perceived stress, and that caregivers’ dysfunctional coping strategies can affect patients’ perceptions of QoL. Our data also highlight the crucial role of the caregiver in the treatment of neurocognitive disorders.
Keywords: Quality of Life; Neurocognitive Disorders; Coping Strategies; Perceived Stress; Caregiver Burden
- Hubanks L., et al. “Quality of life assessment: an annotated bibliography”. (No. WHO/MNH/PSF/94.1. Unpublished). Geneva: World Health Organization (1994).
- Bosboom P R., et al. “Quality of life in Alzheimer's disease: different factors associated with complementary ratings by patients and family carers”. International Psychogeriatrics5 (2012): 708-721.
- Conde-Sala J L., et al. “Clinical Differences in Patients with Alzheimer's Disease According to the Presence or Absence of Anosognosia: Implications for Perceived Quality of Life”. Journal of Alzheimer's Disease4 (2013): 1105-1116.
- Trigg R., et al. “The relationship between changes in quality of life outcomes and progression of Alzheimer's disease: results from the Dependence in AD in England 2 longitudinal study”. International Journal of Geriatric Psychiatry4 (2014): 400-408.
- Ready R E., et al. “Patient versus informant perspectives of Quality of Life in Mild Cognitive Impairment and Alzheimer's disease”. International Journal of Geriatric Psychiatry3 (2004): 256-265.
- Sands L P., et al. “What Explains Differences Between Dementia Patient’s and Their Caregiver’s Ratings of Patient’s Quality of Life?” The American Journal of Geriatric Psychiatry3 (2004): 272-280.
- Livingston G., et al. “Successful ageing in adversity: the LASER-AD longitudinal study”. Journal of Neurology, Neurosurgery and Psychiatry6 (2007): 641-645.
- Conde-Sala J L., et al. “Factors related to perceived quality of life in patients with Alzheimer's disease: the patient's perception compared with that of caregivers”. International Journal of Geriatric Psychiatry6 (2009): 585-594.
- Jonsson L., et al. “Patient- and Proxy-Reported Utility in Alzheimer Disease Using the EuroQoL”. Alzheimer Disease and Associated Disorders1 (2006): 49-55.
- Tatsumi H., et al. “Neuropsychiatric symptoms predict change in quality of life of Alzheimer disease patients: A two-year follow-up study”. Psychiatry and Clinical Neurosciences3 (2009): 374-384.
- Thorgrimsen L., et al. “Whose Quality of Life Is It Anyway?” Alzheimer Disease and Associated Disorders 4 (2003): 201-208.
- Logsdon R G., et al. “Assessing Quality of Life in Older Adults With Cognitive Impairment”. Psychosomatic Medicine3 (2002): 510-519.
- Karlawish J H T., et al. “The Relationship Between Caregiver’s Global Ratings of Alzheimer's Disease Patient’s Quality of Life, Disease Severity, and the Caregiving Experience”. Journal of the American Geriatrics Society8 (2001): 1066-1070.
- Moyle W., et al. “Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts”. Journal of Advanced Nursing10 (2001): 2237-2246.
- Naglie G. “Quality of Life in Dementia”. Canadian Journal of Neurological Sciences/Journal Canadien des Sciences NeurologiquesS1 (2007): 57-61.
- Dröes R., et al. “Effect of Integrated Family Support Versus Day Care Only on Behavior and Mood of Patients With Dementia”. International Psychogeriatrics1 (2000): 99-115.
- Tschanz J T., et al. “Caregiver Coping Strategies Predict Cognitive and Functional Decline in Dementia: The Cache County Dementia Progression Study”. The American Journal of Geriatric Psychiatry1 (2013): 57-66.
- Monteiro A M F., et al. “Coping strategies among caregivers of people with Alzheimer disease: a systematic review”. Trends in Psychiatry and Psychotherapy3 (2018): 258-268.
- Folstein M F., et al. “Mini-mental state”. Journal of Psychiatric Research3 (1975): 189-198.
- Bianchetti A., et al. “Quality of life in patients with mild dementia. Validation of the Italian version of the quality of life Alzheimer’s disease (QoL-AD) Scale”. Official Journal of the Italian Society of Gerontology and Geriatrics 137 (2017).
- Gambina G., et al. “The Italian Validation of the Anosognosia Questionnaire for Dementia in Alzheimer’s Disease”. American Journal of Alzheimer's Disease and Other Dementiasr6 (2015): 635-644.
- Cohen S., et al. “A Global Measure of Perceived Stress”. Journal of Health and Social Behavior4 (1983): 385.
- Caricati L., et al. “COPE-NVI-25: validazione italiana della versione ridotta della Coping Orientation to the Problems Experienced (COPE-NVI)”. Psicologia della salute 2 (2015): 123-140.
- Novak M and Guest C. “Application of a Multidimensional Caregiver Burden Inventory”. The Gerontologist6 (1989): 798-803.
- Cohen J. “Statistical Power Analysis for the Behavioral Sciences (2nd)”. Hillsdale, NJ: Lawrence Erlbaum Associates, Publishers (1988).
- Cohen J. “A power primer”. Psychological Bulletin1 (1992): 155-159.
- Conde-Sala J L., et al. “Discrepancies Regarding the Quality of Life of Patients with Alzheimer's Disease: A Three-Year Longitudinal Study”. Journal of Alzheimer's Disease3 (2014): 511-525.