title: A mixed methods study of hope, transitions, and quality of life in family caregivers of persons with Alzheimer's disease.
abstract: BACKGROUND
  Several research studies have reported the poor quality of life of family caregivers of persons with Alzheimer's disease (AD). However, factors that influence their quality of life have not been clearly defined. The purpose of this study was to examine factors associated with the quality of life of these caregivers such as demographic variables, their transition experience, and hope. A secondary aim was to explore the transition experience of family caregivers of persons with AD.
  
  
  METHODS
  A cross-sectional triangulation data transformation model mixed method design (Quant +Qual) was utilized to address the purpose of the study. Eighty family caregivers of persons with AD completed a survey with quantitative measures [demographic variables, Herth Hope Index (HHI-hope), World Health Organization Quality of Life -BREF (WHOQOL-BREF)] and a qualitative survey about their transitions experience. The qualitative data (transition open ended- survey) was converted to quantitative data using content analysis. Variables significant at the p < 0.10 level in the univariate analysis were entered in the multivariate generalized linear model used to determine significant factors associated with quality of life.
  
  
  RESULTS
  Subjects with higher hope scores (p < 0.0001) (Factor 1: temporality and future-cognitive-temporary dimension of hope) and who dealt with their transitions by actively seeking out knowledge and assistance (p = 0.02) had higher overall quality of life scores. HHI scores were associated with overall quality of life and for each of the four quality of life domains (physical psychosocial, relationships, and environment).
  
  
  CONCLUSIONS
  Hope played a significant role in the subjects' perceptions of overall quality of life as well as the 4 quality of life domains. This underscores the need to develop ways to foster hope in family caregivers. Moreover, the active engagement of families in seeking information and help, as a way to deal with their transitions, suggests encouraging this engagement is important. The findings of this study also suggest many directions for future research, such as increasing our understanding of the processes of transitions for this population.
authors.affiliation: Faculty of Nursing, University of Alberta, Edmonton, Canada. Wendy.duggleby@ualberta.ca
authors.forename: Wendy D
authors.initials: WD
authors.lastname: Duggleby
authors.forename: Jennifer
authors.initials: J
authors.lastname: Swindle
authors.forename: Shelley
authors.initials: S
authors.lastname: Peacock
authors.forename: Sunita
authors.initials: S
authors.lastname: Ghosh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology / Q000628:therapy*; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D003625:Data Collection / Q000379:methods; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*