title: Self-esteem in carers of frail older people: resentment predicts anxiety and depression.
abstract: OBJECTIVE
  Anxiety and depression are major health problems for carers of frail older people. Positive reactions to caregiving have been shown to protect people against anxiety and depression. The aims of this study are to explore specific aspects of self-esteem, termed positive caregiving reactions, and examine its relationship with caregiving anxiety and depressive symptoms.
  
  
  METHODS
  A cross-sectional study of a cohort of carers (n = 119) of community-living people (70 years) identified empirically as frail completed postal questionnaires. Positive caregiver reactions were evaluated using the self-esteem subscale (seven items) of the Caregiver Reaction Assessment (CRA). Anxiety and depressive symptoms were measured using the Hospital Anxiety and Depression Scale.
  
  
  RESULTS
  Anxiety and depressive symptoms were related significantly (p < 0.05) to six of the seven CRA self-esteem items. Caregiving resentment scores were relatively low, mean score (SD) 1.79 (0.91) on a 1-5 scale with higher scores indicating more resentment: yet regression analysis revealed that this factor was the only independent predictor of anxiety and depressive symptoms (r²  = 0.093, p = 0.044 for anxiety, and r² = 0.121, p = 0.041 for depression).
  
  
  CONCLUSIONS
  The results of this study indicate that those carers who resent having to care for their frail older relative are susceptible to anxiety and depressive symptoms. This study supports the notion that there is a need for assessment of caregiving reactions in carers of frail older people.
authors.affiliation: Sydney Nursing School, The University of Sydney, Camperdown, NSW, Australia. christina.aggar@sydney.edu.au
authors.forename: Christina
authors.initials: C
authors.lastname: Aggar
authors.forename: Susan
authors.initials: S
authors.lastname: Ronaldson
authors.forename: Ian D
authors.initials: ID
authors.lastname: Cameron
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000523:psychology*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D016330:Frail Elderly; D006791:Hostility; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D012649:Self Concept