Burden experienced by caregivers of relatives with dementia in Taiwan

Background: The burden produced by caring for relatives with dementia is an increasing problem in the United States and Taiwan, necessitating a better understanding of the interrelationships of the factors that influence burd en. Objectives: To test a theoretical model specifying how the demands of care, filial obligation, caregiving self-efficacy, coping strategies, and caregi ving involvement affect caregiver burden. Method: A descriptive cross-sectional design with a convenience sample (n = 150) from outpatient clinics of three,hospitals in Taiwan was used. The Ca regiver Burden Inventory and the Cost of Care index assessed caregiver burd en. The antecedents of burden were assessed by the Physical Self; Maintenan ce Scale, Instrumental Activities of Daily Living, the Mini-Mental State Ex amination, the Revised Memory and Behavior Problem Checklist, the Montgomer y obligation subscale, Cicirelli's obligation scale, the Caregiving Self-ef ficacy Scale, the Caregiving Involvement Scale. and the Ways of Coping Ques tionnaire. Results: The original model did not fit the data well but minor respecifica tions produced a good model as evidenced by a X-2/df ratio of 2.1, a goodne ss-of-fit index of .89, and a comparative fit index of .93. Demands of care on, the caregiver and filial obligation had direct positive effects on car egiving involvement. Caregiving involvement and emotion-focused coping had direct positive effects on caregiving burden. Filial obligation, caregiving self-efficacy, and problem-focused coping had direct negative effects on c aregiving burden. Six of the seven original hypothesized structural relatio nships were-confirmed in the final model. Conclusions: The Burden Model tested in this study corroborates findings fr om other burden studies and extends our knowledge of caregiver burden. Fili al obligation, self-efficacy, demands of care, involvement in care,and copi ng were shown to predict burden in this sample of Taiwanese caregivers. Fut ure study is needed to evaluate interventions designed for family caregiver s of persons with dementia, Especially needed is research in the area of co unseling and mental health services to assist caregivers in dealing with ma nifestations of burden.