Crellin, NE; (2015) The role of self-efficacy in the health-related quality of life of family carers of individuals with dementia. Doctoral thesis , UCL (University College London).

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Text CRELLIN, N. E. THESIS FINAL VERSION Copyright material removed.pdf Available under License : See the attached licence file. Download (2MB)

Abstract

Background The Self-Efficacy Theory has been widely applied to research exploring chronic stress and in recent decades has proved promising in explaining the experiences of family carers of individuals with dementia. Aim To investigate the role of self-efficacy in the health-related quality of life of family carers of individuals with dementia, with particular consideration of the positive and negative impact related to caring, coping strategies and social support. Methods The sample comprised 289 family carers and individuals with dementia. The data collected were the baseline data for the SHIELD (Support at Home: Interventions to Enhance Life in Dementia) Carer Supporter Programme and included caring domain-specific self-efficacy beliefs, coping strategies, social support, positive and negative impact related to caring, and carer health-related quality of life. Analytic methods included correlations, t-tests, ANOVA, multiple regression and path analysis. Results Carers reported experiencing positive and negative emotions related to the caring experience and self-efficacy beliefs were found to have a “dual action” in both increasing positive impact related to caring, whilst buffering against negative impact. Carer characteristics and psychosocial resources were found to be determinants of self-efficacy beliefs, although caring stressors were not. In addition, it was found that self-efficacy, particularly for obtaining respite and controlling upsetting thoughts exerts a direct effect on carer quality of life, however only self-efficacy for responding to disruptive behaviours moderates the association between behavioural and psychological symptoms of dementia and carer quality of life. Finally, mediating effects of psychosocial resources including self-efficacy, coping strategies and social support were found in the association between stressors and carer quality of life. Conclusions Theoretically, findings have implications for informing conceptual models of carer coping and support the application of Self-Efficacy Theory to the caring experience. Clinically, findings assist in the design of effective carer interventions, specifically those directed towards enhancing self-efficacy.

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