title: Stress processes in caring for an end-of-life family member: application of a theoretical model.
abstract: OBJECTIVE
  Family caregivers play a vital role in maintaining the lives of individuals with advanced illness living in the community. However, the responsibility of caregiving for an end-of-life family member can have profound consequences on the psychological, physical and financial well-being of the caregiver. While the literature has identified caregiver stress or strain as a complex process with multiple contributing factors, few comprehensive studies exist. This study examined a wide range of theory-driven variables contributing to family caregiver stress.
  
  
  METHODS
  Data variables from interviews with primary family caregivers were mapped onto the factors within the Stress Process Model theoretical framework. A hierarchical multiple linear regression analysis was used to determine the strongest predictors of caregiver strain as measured by a validated composite index, the Caregiver Strain Index.
  
  
  RESULTS
  The study included 132 family caregivers across south-central/western Ontario, Canada. About half of these caregivers experienced high strain, the extent of which was predicted by lower perceived program accessibility, lower functional social support, greater weekly amount of time caregivers committed to the care recipient, younger caregiver age and poorer caregiver self-perceived health.
  
  
  CONCLUSIONS
  This study examined the influence of a multitude of factors in the Stress Process Model on family caregiver strain, finding stress to be a multidimensional construct. Perceived program accessibility was the strongest predictor of caregiver strain, more so than intensity of care, highlighting the importance of the availability of community resources to support the family caregiving role.
authors.affiliation: Juravinski Cancer Centre, Supportive Cancer Care Research Unit, Hamilton, Ontario, Canada. daryl.bainbridge@jcc.hhsc.ca
authors.forename: Daryl
authors.initials: D
authors.lastname: Bainbridge
authors.forename: Paul
authors.initials: P
authors.lastname: Krueger
authors.forename: Lynne
authors.initials: L
authors.lastname: Lohfeld
authors.forename: Kevin
authors.initials: K
authors.lastname: Brazil
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005190:Family / Q000523:psychology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D009864:Ontario; D012044:Regression Analysis; D012111:Residence Characteristics; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*