title: Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving.
abstract: BACKGROUND
  We attempted to determine the factors that influence the continuation of in-home caregiving for patients with dementia.
  
  
  METHODS
  The participants were family caregivers of dementia patients who received home care services. Data were collected via a questionnaire completed by caregivers and then returned in the mail. Of the 705 caregivers who received the questionnaire, 405 completed and returned it (response rate: 57.4%).
  
  
  RESULTS
  The average age of the caregivers was 63.9 ± 11.5 years, and they had been providing care for an average of 5.1 ± 4.1 years. The average age of the patients was 84.7 ± 7.4 years. We analyzed the path model. Caregivers' current feelings about continuing caregiving were directly affected by a positive appraisal of caregiving (β = 0.20, P < 0.001) and by the burden they experienced (β = -0.39, P < 0.001). The continuation of caregiving of patients with worsening symptoms was directly affected by a positive appraisal of caregiving (β = 0.15, P < 0.01) and by the burden experienced by the caregivers (β = -0.46, P < 0.001). The continuation of caregiving was indirectly affected by the patients' cognitive impairment and by the behavioral and psychological symptoms of dementia score.
  
  
  CONCLUSIONS
  The continuation of in-home caregiving among caregivers of patients with dementia was affected by both positive appraisal and caregiver burden. In addition, the present study revealed that behavioral and psychological symptoms of dementia score indirectly affects the continuation of caregiving by directly affecting caregiver burden.
authors.affiliation: Department of Health Sciences, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Kajiwara
authors.forename: Hisae
authors.initials: H
authors.lastname: Nakatani
authors.forename: Mitsu
authors.initials: M
authors.lastname: Ono
authors.forename: Yukiko
authors.initials: Y
authors.lastname: Miyakoshi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000523:psychology* / Q000628:therapy*; D018450:Disease Progression; D005260:Female; D006699:Home Care Services; D006801:Humans; D033182:Intention; D007564:Japan; D008134:Long-Term Care / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D009042:Motivation; D011795:Surveys and Questionnaires
keywords: continuation of caregiving; dementia; family caregiver; positive appraisal