Abstract
The concept of caring appraisal, which includes positive and negative aspects of care, has been considered as one of the key concepts in caregivers’ studies and is affected by the knowledge, attitudes, values, beliefs, and social norms in their society. In this respect, the perception of family caregivers’ can be studied from a cultural perspective. The aim of the present study was to explore the self-appraisal concept of caring based on the experience of family caregivers of older adults with dementia in Iran. In this qualitative study, data were collected through in-depth, semi-structured interviews. Twelve participants (family caregivers of elderly with dementia) were interviewed between January and September 2016. The transcribed texts were analyzed using inductive qualitative content analysis recommended by Graneheim and Lundman (2004). Six main categories were extrapolated: “Perceived burden,” “Satisfaction with care,” “Personal growth,” “Caregiving gains,” “Philosophy of care” and “Loss and threat.” According to the findings, the family caregivers’ appraisal of their care not only included negative aspects, but also covered a number of positive aspects, which in them the cultural and social factors prevailing in Iranian society played a significant role.
Similar content being viewed by others
REFERENCES
Alzheimer’s Association, Alzheimer’s disease facts and figures, Alzheimer’s and Dementia, 2018, vol. 14, no. 3, pp. 367–429.
Aranda, S.K. and Hayman-White, K., Home caregivers of the person with advanced cancer: an Australian perspective, Cancer Nursing, 2001, vol. 24, no. 4, pp. 300–307.
Bauer, J.M. and Sousa-Poza, A., Impacts of informal caregiving on caregiver employment, health, and family, J. Population Ageing, 2015, pp. 1–33.
Bavishi, S., Exploring the Experiences of Indian Gujarati People in the London Area Supporting a Person with Dementia, Univ. East London, 2013.
Blandin, K. and Pepin, R., Dementia grief: a theoretical model of a unique grief experience, Dementia, 2015, vol. 16, no. 1, pp. 67–78.
Butcher, H.K., Holkup, P.A., and Buckwalter, K.C., The experience of caring for a family member with Alzheimer’s disease, West. J. Nurs. Res., 2001, vol. 23, no. 1, pp. 33–55.
Carbonneau, H., Caron, C., and Desrosiers, J., Development of a conceptual framework of positive aspects of caregiving in dementia, Dementia, 2010, vol. 9, pp. 327–353.
Chan, S.-C., Family caregiving in dementia: the Asian perspective of a global problem, Dementia Geriatr. Cognit. Disord., 2011, vol. 30, no. 6, pp. 469–478.
Chan, W.-C., Ng, C., and Mok, C.C.-M., et al., Lived experience of caregivers of persons with dementia in Hong Kong: a qualitative study, East Asian Arch. of Psychiatry, 2010, vol. 20, no. 4, pp. 163–168.
Deljavan, S., Exploring the Iranian–Canadian family experience of dementia caregiving: a phenomenological study, Doctoral Dissertation, Univ. Western Ontario, 2013. https://ir.lib.uwo.ca/etd/1590.
Farhadi, A., Noroozian, M., Mohammadi, F., et al., Positive experiences of caregiving in family caregivers of older adults with dementia: a content analysis study, Iran South Med. J., 2018, vol. 21, no. 4, pp. 319–334.
Farran, C.J., Paun, O., and Elliott, M.H., Spirituality in multicultural caregivers of persons with dementia, Dementia, 2003, vol. 2, no. 3, pp. 353–377.
Gholamzadeh, S., Heshmati, B., Mani, A., et al., The prevalence of Alzheimer’s disease: its risk and protective factors among the elderly population in Iran, Shiraz E-Med. J., 2017, vol. 18, no. 9, p. 57576.
Graneheim, U. H. and Lundman, B., Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness, Nurse Educ. Today, 2004, vol. 24, no. 2, pp. 105–112.
Harwood, D.G., Barker, W.W., Ownby, R.L., et al., Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer’s disease patients, Int. J. Geriatr. Psychiatry, 2000, vol. 15, no. 6, pp. 481–487.
Hazavehei, S., Dashti, S., Moeini, B., et al., Factors related to self-care behaviors in hypertensive individuals based on Health Belief Model, Koomesh, 2015, vol. 17, no. 1, pp. 37–44.
Hebert, L.E., Weuve, J., Scherr, P.A., and Evans, D.A., Alzheimer disease in the United States (2010–2050) estimated using the 2010 census, Neurology, 2013, vol. 80, no. 19, pp. 1778–1783.
Huang, S.-S., Lee, M.-C., Liao, Y.-C., et al., Caregiver burden associated with behavioral and psychological symptoms of dementia (BPSD) in Taiwanese elderly, Arch. Geront. Geriat., 2012, vol. 55, no. 1, pp. 55–59.
Kate, N., Grover, S., Kulhara, P., and Nehra, R., Scale for positive aspects of caregiving experience: development, reliability, and factor structure, East Asian Arch. Psychiatry, 2012, vol. 22, pp. 62–69.
Kiani, S. and Bayanzadeh, M., The Iranian population is graying: are we ready?, Arch. Iran. Med., 2010, vol. 13, no. 4, pp. 333–339.
Kramer, B.J., Gain in the caregiving experience: Where are we? What next?, Gerontologist, 1997, vol. 37, no. 2, pp. 218–232.
Lawton, M.P., Kleban, M.H., Moss, M., et al., Measuring caregiving appraisal, J. Gerontol., 1989, vol. 44, no. 3, pp. 61–71.
Lawton, M.P., Moss, M., Hoffman, C., and Perkinson, M., Two transitions in daughters’ caregiving careers, Gerontologist, 2000, vol. 40, no. 4, pp. 437–448.
Lee, J., Yoo, M., and Jung, D., Caregiving appraisal of family caregivers for older stroke patients in Korea, Int. Nurs. Rev., 2010, vol. 57, no. 1, pp. 107–112.
Leipold, B., Schacke, C., and Zank, S., Personal growth and cognitive complexity in caregivers of patients with dementia, Eur. J. Ageing, 2008, vol. 5, no. 3, pp. 203–214.
Lincoln, Y.S. and Guba, E.G., Naturalistic Inquiry, Newbury Park, CA: Sage, 1985.
Lloyd, J., Patterson, T., and Muers, J., The positive aspects of caregiving in dementia: a critical review of the qualitative literature, Dementia, 2014, vol. 15, no. 6, pp. 1534–1561.
Meuser, T.M. and Marwit, S.J., A comprehensive, stage-sensitive model of grief in dementia caregiving, Gerontologist, 2001, vol. 41, no. 5, pp. 658–670.
Morano, C.L., The role of appraisal and expressive support in mediating strain and gain in Hispanic Alzheimer’s disease caregivers, J. Ethn. Cult. Diversity Soc. Work, 2003, vol. 12, no. 2, pp. 1–18.
Mortazavi, S.S., Shati, M., Ardebili, H.E., et al., Comparing the effects of group and home-based physical activity on mental health in the elderly, Int. J. Preventive Med., 2013, vol. 4, no. 11, pp. 1282–1289.
Moyle, W., Clinton, M., and Edwards, H., Living with loss: dementia and the family caregiver, Aust. J. Adv. Nurs., 2002, vol. 19, no. 3, pp. 25–31.
Navab, E., Lived Experiences of Family Caregivers of Persons with Alzheimer’s Disease, Tehran Univ. Med. Sci., 2011.
Nijboer, C., Triemstra, M., Tempelaar, R., et al., Measuring both negative and positive reactions to giving care to cancer patients: psychometric qualities of the Caregiver Reaction Assessment (CRA), Soc. Sci. Med., 1999, vol. 48, no. 9, pp. 1259–1269.
Noroozian, M., The elderly population in Iran: an ever growing concern in the health system, Iran. J. Psych. Behav. Sci., 2012, vol. 6, no. 2, pp. 1–6.
Ott, C.H., Sanders, S., and Kelber, S.T., Grief and personal growth experience of spouses and adult-child caregivers of individuals with Alzheimer’s disease and related dementias, Gerontologist, 2007, vol. 47, no. 6, pp. 798–809.
Papastavrou, E., Kalokerinou, A., Papacostas, S.S., et al., Caring for a relative with dementia: family caregiver burden, J. Adv. Nurs., 2007, vol. 58, no. 5, pp. 446–457.
Pearlin, L.I., Mullan, J.T., Semple, S.J., and Skaff, M.M., Caregiving and the stress process: an overview of concepts and their measures, Gerontologist, 1990, vol. 30, no. 5, pp. 583–594.
Qualls, S.H. and Zarit, S.H., Aging Families and Caregiving, John Wiley, 2009, vol. 3.
Raver, S.A. and Michalek, A.M., Gains, losses, and life goals identified by caregivers of individuals with disabilities in the United States, Soc. Welfare: Interdiscip. Approach, 2011, vol. 2, no. 1, pp. 78–84.
Sanders, S., Is the glass half empty or half full? Reflections on strain and gain in caregivers of individuals with Alzheimer’s disease, Soc. Work Health Care, 2005, vol. 40, no. 3, pp. 57–73.
Shaji, K.S., Smitha, K., Lal, K.P., and Prince, M.J., Caregivers of people with Alzheimer’s disease: a qualitative study from the Indian 10/66 Dementia Research Network, Int. J. Geriatr. Psychiatry, 2003, vol. 18, no. 1, pp. 1–6.
Skaff, M.M. and Pearlin, L.I., Caregiving: role engulfment and the loss of self, Gerontologist, 1992, vol. 32, no. 5, pp. 656–664.
Smith, R., Drennan, V., Mackenzie, A., and Greenwood, N., The impact of befriending and peer support on family carers of people living with dementia: a mixed methods study, Arch. Gerontol. Geriatr., 2018, vol. 76, pp. 188–195.
Tarlow, B.J., Wisniewski, S.R., Belle, S.H., et al., Positive aspects of caregiving contributions of the REACH Project to the development of new measures for Alzheimer’s caregiving, Res. Aging, 2004, vol. 26, no. 4, pp. 429–453.
Upton, D., Upton, P., and Alexander, R., The complexity of caring (Part 2): moderators of detrimental health and well-being outcomes for caregivers of people with chronic wounds, Wound Pract. Res., J. Aust. Wound Manage. Assoc., 2015, vol. 23, no. 3, pp. 110–114.
Vellone, E., Sansoni, J., and Cohen, M.Z., The experience of Italians caring for family members with Alzheimer’s disease, J. Nurs. Scholarship, 2002, vol. 34, no. 4, pp. 323–329.
Wallhagen, M.I. and Yamamoto-Mitani, N., The meaning of family caregiving in Japan and the United States: a qualitative comparative study, J. Transcult. Nurs., 2006, vol. 17, no. 1, pp. 65–73.
Wassman, M.E., The experiences of caregivers: caring for loved ones with dementia, Master’s Thesis, Univ. St. Thomas, 2012. https://sophia.stkate.edu/msw_papers/100.
Wilks, S.E., Bates, S.M., and Wright, A.L., Spirituality, coping, and psychological resilience among Alzheimer’s caregivers, in Spirituality: Global Practices, Societal Attitudes and Effects on Health, Roberts, E.C., Ed., Nova, 2015.
Yamamoto-Mitani, N., Sugishita, C., Ishigaki, K., et al., Development of instruments to measure appraisal of care among Japanese family caregivers of the elderly, Res. Theory Nurs. Pract., 2001, vol. 15, no. 2, pp. 113–135.
Yamamoto-Mitani, N., Tamura, M., Deguchi, Y., et al., The attitude of Japanese family caregivers toward the elderly with dementia, Int. J. Nurs. Stud., 2000, vol. 37, no. 5, pp. 415–422.
Yamamoto-Mitani, N., Ishigaki, K., Kawahara-Maekawa, N., et al., Factors of positive appraisal of care among Japanese family caregivers of older adults, Res. Nurs. Health, 2003, vol. 26, no. 5, pp. 337–350.
ACKNOWLEDGMENTS
This research was funded by the Research Center on Aging at the University of Social Welfare and Rehabilitation Sciences (Tehran, Iran). The authors wish to thank all study participants, especially family caregivers, who collaborated with us in this project.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest. The authors declare that they have no conflicts of interest.
Statement of compliance with standards of research involving humans as subjects. This study was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (USWR, REC1393.187). Principles such as taking informed consent, obtaining written permission to record the interviews, the right to withdraw at any time that the participant was inclined, maintaining anonymity, and observing the secrecy principle were considered throughout the study.
Rights and permissions
About this article
Cite this article
Farhadi, A., Mohammadi-Shahboulaghi, F., Rassouli, M. et al. Perceptions of Caregiving by Family Caregivers of Older Adults with Dementia in Iran: A Qualitative Study. Adv Gerontol 12, 184–193 (2022). https://doi.org/10.1134/S2079057022020060
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1134/S2079057022020060