Tacit definitions of informal caregiving.
OBJECTIVE
This study describes three tacit definitions of informal caregiving and explores the extent to which differences in these tacit definitions explain variation in caregivers' negative mood over time.


BACKGROUND
There is a growing need to understand the sources of stress and gratification for informal caregivers. Tacit definitions of informal caregiving refer to caregivers' understanding of what caregiving entails. These definitions are tacit because they arise from caregivers' taken-for-granted understanding rather than formally articulated positions concerning caregiving.


METHODS
A random sample of 60 men, all of whom were caregiving partners of men with acquired immunodeficiency syndrome (AIDS), was drawn from a larger cohort of 253 participants in the University of California San Francisco (UCSF) Coping Project (1990-1997). The caregivers were assessed bimonthly for 2 years with procedures that included a semi-structured interview focusing on a recent stressful event involving caregiving, and quantitative measures of well-being.


RESULTS
Interpretive phenomenological case studies of the narrative accounts of the 60 caregivers produced three tacit definitions of caregiving - engagement, conflict and distance. These three tacit definitions were distinguished by differences in learning about caregiving, involvement in health care decisions, caregiving activities and reported sources of stress. The three groups differed on measures of dyadic adjustment, depression, anger and anxiety.


CONCLUSIONS
Better understanding of caregivers' tacit definitions can facilitate and enhance effective support and interventions for caregivers.
Wrubel
J
J
Department of Medicine, Center for AIDS Prevention Studies, University of California, San Francisco, USA. wrubel@psg.ucsf.edu
Richards
T A
TA
Folkman
S
S
Acree
M C
MC
D000223:Adaptation, Psychological; D001294:Attitude to Health; D017028:Caregivers / Q000523:psychology*; D003220:Conflict, Psychological; D017281:Cost of Illness; D015658:HIV Infections / Q000451:nursing*; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D016294:Models, Nursing; D008960:Models, Psychological; D020380:Needs Assessment; D015404:Nursing Methodology Research; D012929:Psychological Distance; D012495:San Francisco; D012747:Sexual Partners / Q000523:psychology*; D012944:Social Support; D013315:Stress, Psychological / Q000517:prevention & control / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*