title: Caregiver resilience in palliative care: a research protocol.
abstract: OBJECTIVE
  To describe a research protocol designed to formulate a conceptual framework of informal caregiver resilience in palliative care.
  
  
  BACKGROUND
  Resilience is the ability to adapt or to improve one's own conditions following experiences of adversity. The end-of-life care provided by informal caregivers is a form of adversity because it entails objective difficulties, emotional involvement and deep levels of introspection that have been stimulated by the death event. Resilience has not yet been addressed in association with end-of-life care.
  
  
  METHODS
  This is a multicentre cross-sectional study.
  
  
  METHODS
  We will administer a questionnaire to a sample of informal end-of-life caregivers to collect data about the main psychological, behavioural and healthcare factors that impact resilience. Data analysis will include descriptive and correlational statistical techniques, multiple linear regressions and structural equation modelling. Data will be collected in multiple palliative care centres and statistical analysis will be carried out using software: SPSS version 19.0 and MPlus version 7.3. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship in Italy (Research Grant number 2.13.10) that was awarded in March 2013.
  
  
  CONCLUSIONS
  The study seeks to identify the predictive, mediating and moderating roles of select variables: caregivers' self-efficacy, burdens of caregiving, depression and resilience. The results of this analysis will impact the theoretical study of resilience in palliative care and will have practical implications for interventions aimed at supporting caregivers through healthcare teams.
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Limardi
authors.affiliation: Centre of Excellence for Nursing Scholarship, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Stievano
authors.affiliation: Centre of Excellence for Nursing Scholarship, Rome, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Rocco
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.affiliation: Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy.
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology*; D055500:Resilience, Psychological; D012649:Self Concept; D020377:Self Efficacy; D011795:Surveys and Questionnaires; D013727:Terminal Care / Q000523:psychology*
keywords: caregiver; clinical nursing research; nursing; palliative care; resilience; self-efficacy; self-esteem; terminal care