Influence of family dynamics on mental health and quality of care of family caregivers of individuals with dementia in Latin America

Resumen

The present study applied the Stress Process Model in conjunction with concepts derived from structural family theory to create and test a multidimensional model of dementia caregiver family dynamics and mental health functioning, as well as their interplay which ultimately impacts quality of care provision in a convenience sample of 130 family caregivers from Latin America. The obtained results revealed that caregiver family dynamics and mental health are positively related, with a large effect size. Regression analyses indicated that family dynamics variables of cohesion, general functioning, and empathy were significant predictors of caregiver depression, anxiety, and satisfaction with life, respectively; low care recipient cognitive functioning was found to be the only predictor of greater caregiver burden, which was not independently associated with family functioning variables. Hierarchical regression analyses suggested that higher quality of informal care was related to greater levels of empathy and reduced levels of overall dysfunction in caregivers’ families. Evaluation of the theory-driven model confirmed a significant interrelationship between lower patient cognitive status and higher subjective burden, which in turn negatively impacted on caregiver mental health and family dynamics. Healthy family functioning was found to be significantly and positively associated with greater quality of care provision directly, as well as indirectly via mental health. Dementia caregiver interventions in Latin America would likely benefit from addressing difficulties experienced when providing care to a patient with greater cognitive decline. Additionally, interventions may be more effective if they incorporate programming or techniques to improve family dynamics, particularly family empathy and general functioning, which were found to impact both caregiver mental health and quality of care provision.