title: Coping and subjective burden in caregivers of older relatives: a quantitative systematic review.
abstract: OBJECTIVE
  This article is a report on a review of the effect of coping strategies on subjective burden in informal caregivers of older adults.
  
  
  BACKGROUND
  Informal care has negative effects on caregivers' health, and subjective burden is one of these. It has been linked with other effects (e.g. anxiety and depression). Thus, greater prevention of subjective burden will mean increased prevention of these effects. To achieve this, identification of factors related to subjective burden is essential.
  
  
  METHODS
  Electronic databases and manual searches of scientific journals.
  
  
  METHODS
  A quantitative systematic review was conducted including: (a) original studies (b) that related caregiver subjective burden to coping strategies compatible with the classifications of Lazarus & Folkman or Moos et al. (c) in informal caregivers of older relatives. The searches ranged from the first year included in each database until January 2010. After quality appraisal, ten studies were included; these, care-recipients living at home and having cognitive impairment.
  
  
  RESULTS
  Four coping categories have been related to subjective burden: problem-focused, emotion-focused, approach and avoidance. Interesting results were only found for avoidance coping (positive association). In other categories, results were heterogeneous (problem-focused and approach) or we found few valid studies (emotion-focused).
  
  
  CONCLUSIONS
  We found some evidence for a positive association between avoidance coping and subjective burden in home caregivers of older relatives with cognitive impairment. It is probable that avoidance coping either mediates or moderates the relationship between subjective burden and its outcomes, or that avoidance coping precedes subjective burden, which in turn leads to the coping outcomes. In both situations, avoidance coping is an ineffective coping.
authors.affiliation: Department of Nursing, School of Health Sciences, University of Jaén, Spain. rdelpino@ujaen.es
authors.forename: Rafael
authors.initials: R
authors.lastname: Del-Pino-Casado
authors.forename: Antonio
authors.initials: A
authors.lastname: Frías-Osuna
authors.forename: Pedro A
authors.initials: PA
authors.lastname: Palomino-Moral
authors.forename: Pedro L
authors.initials: PL
authors.lastname: Pancorbo-Hidalgo
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001290:Attitude; D017028:Caregivers / Q000523:psychology*; D003072:Cognition Disorders / Q000451:nursing* / Q000523:psychology; D017281:Cost of Illness; D003430:Cross-Sectional Studies / Q000706:statistics & numerical data; D016206:Databases, Bibliographic; D004644:Emotions; D006801:Humans; D011340:Problem Solving