title: Do determinants of burden and emotional distress in dementia caregivers change over time?
abstract: Caring for a patient with dementia is a real challenge and can have considerable psychological consequences in the long run. Many caregivers, mostly relatives, feel highly burdened. To develop effective caregiver support to prevent caregivers from getting overburdened, insight is needed into the determinants of burden. The objective of this study is to explore which patient and caregiver characteristics determine the different kinds of caregiver burden over time, both in the short and in the long run.
  
  
  
  The study was longitudinal. Data on patients and caregivers, general burden and emotional distress were collected at three times: at baseline, at the end of treatment and at nine months. The study was conducted in a psychiatric skilled nursing home with a unit for integrative reactivation and rehabilitation (IRR) and at different sites of home-/day care, assisted living arrangements and nursing home wards (usual care).
  
  
  
  General burden is shown to be determined by severity of patient's neuropsychiatric symptoms, caregiver's sense of competence, health-related quality of life. Emotional distress is determined by severity of patient's neuropsychiatric symptoms, caregiver's sense of competence, high affiliation and patient gender.
  
  
  
  In preventing or treating caregiver burden, professional interventions need to aim specifically at diminishing the neuropsychiatric symptoms in dementia patients and improving the sense of competence in caregivers.
authors.affiliation: a Psychiatric Skilled Nursing Home 'DrieMaasStede', Argos Zorggroep, Schiedam/VU Department of General Practice & Elderly Care Medicine , EMGO Institute for Health and Care Research VU University Amsterdam/VU University Medical Centre , Amsterdam , The Netherlands.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: van der Lee
authors.affiliation: b Stichting Wetenschap Balans (Foundation for Scientific Research Geriatric Health Care), Rotterdam/VU Department of General Practice & Elderly Care Medicine , EMGO Institute for Health and Care Research VU University Amsterdam/VU University Medical Centre , Amsterdam , The Netherlands.
authors.forename: Ton J E M
authors.initials: TJ
authors.lastname: Bakker
authors.affiliation: c Stichting Wetenschap Balans (Foundation for Scientific Research Geriatric Health Care) , Rotterdam , The Netherlands.
authors.forename: Hugo J
authors.initials: HJ
authors.lastname: Duivenvoorden
authors.affiliation: d VU Department of General Practice & Elderly Care Medicine , EMGO Institute for Health and Care Research VU University Amsterdam/VU University Medical Centre, Amsterdam/GGZ Ingeest , Amsterdam , The Netherlands.
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Dröes
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D002983:Clinical Competence; D003704:Dementia / Q000451:nursing*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009735:Nursing Homes; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D013315:Stress, Psychological / Q000517:prevention & control*
keywords: caregiving; coping; dementia and cognitive disorders; psychological and behavioural symptoms; stress/burden