title: Use of the resiliency model of family stress, adjustment and adaptation in the analysis of family caregiver reaction among families of older people with congestive heart failure.
abstract: BACKGROUND
  Little attention has been given to the resiliency process of family caregivers for older people hospitalized with congestive heart failure.
  
  
  OBJECTIVE
  The purpose of this study was to examine the influences of older peoples' activities of daily living dependency, family caregivers' spiritual well-being, quality of relationship, family support, coping and care continuity on the burden of family caregivers of hospitalized older people with congestive heart failure using the Resiliency Model of Family Stress, Adjustment, and Adaptation. DESIGN AND SAMPLE. A descriptive, correlational research design was used. There were 50 family caregivers and 50 older people diagnosed with congestive heart failure recruited from medical and surgical units of two Midwest medical centres.
  
  
  METHODS
  Data on activities of daily living dependence of older people, family caregiver burden, spiritual well-being, coping strategies, quality of older people-caregiver relationship and care continuity were collected using structured questionnaires.
  
  
  RESULTS
  The findings indicated that there were significant positive associations between patients' activities of daily living dependence and family caregiver burden and between lack of family support and family caregiver burden. There were significant negative associations between quality of relationship and family caregiver burden, between care continuity and family caregiver burden, between coping and family caregiver burden and between spiritual well-being and burden. In hierarchical multiple regression, the model variables accounted for 66% of the variance in family caregiver burden. Patients' activities of daily living dependence, quality of relationship and lack of family support are significant predictors of family caregiver burden.
  
  
  CONCLUSIONS
  The best predictors of family caregiver burden, using the resiliency model, were the older persons' activities of daily living dependence, family support, quality of relationship, care continuity, coping strategies and spiritual well-being. Implications for practice.  It is vital for nurses to assess family caregivers' needs and resources and the quality of the older person-family caregiver relationship in developing a plan of care that reduces family caregiver burden.
authors.affiliation: Department of Nursing, Missouri Western State University, St. Joseph, MO 64506, USA. pimingyeh@yahoo.com
authors.forename: Pi-Ming
authors.initials: PM
authors.lastname: Yeh
authors.forename: Margaret
authors.initials: M
authors.lastname: Bull
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D017281:Cost of Illness; D005192:Family Health; D005195:Family Relations; D005260:Female; D015577:Geriatric Assessment; D005851:Geriatric Nursing / Q000379:methods*; D006304:Health Status; D006333:Heart Failure / Q000523:psychology / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D008960:Models, Psychological; D020380:Needs Assessment / Q000706:statistics & numerical data; D011788:Quality of Life; D012069:Religion and Psychology; D055500:Resilience, Psychological; D012923:Social Class; D012944:Social Support; D013315:Stress, Psychological / Q000523:psychology*; D011795:Surveys and Questionnaires