Health-Related Internet as a Caregiver Resource for Informal Caregivers of Individuals with Dementia.

摘要

Background: Caregiving is a multidimensional process that affects both the health and well-being of caregivers. Although the Internet is an emerging resource, Internet use has rarely been investigated in the context of caregiving by informal caregivers of individuals living with dementia (hereafter dementia caregivers).;Purpose: This study aimed to identify the specific vulnerabilities of informal caregivers related to sleep disturbances and caregiver burden. It sequentially evaluated how general health-related Internet use mediates the relationship between caregiver stress and health outcomes in dementia caregivers.;Methods: A systematic literature review was completed of articles related to sleep disturbances in family caregivers, with 44 studies selected through November 2009 using three databases. Following two projects of secondary data analyses were conducted with data from the National Alliance for Caregiving and the American Association of Retired Persons in 2004 and 2009. Telephone surveys collected self-reported socio-demographic and clinical information from randomly selected adult dementia caregivers in seven U.S. states (Study 2: N=302; and Studies 3: N=450). Guided by Pearlin's Stress Process model, descriptive analyses, hierarchical multiple regression analyses and two-step approach modeling were performed using SPSS, version 19.0, and Amos, version 19.0.;Results: The systematic literature review found that particular issues of concept and methodology in caregiver research should be improved for better understanding of caregiving. Multidimensional factors interdependently influence caregiving burden and health-related Internet use in dementia caregivers. After controlling for caregivers' demographics, a strong direct effect of caregiver stress was observed on caregivers' perception of poor health status. However, health-related Internet use did not mediate this relationship effectively, despite an evidently indirect effect of health-related Internet use on self-rated health.;Conclusion: This research extends the growing literature on health-related Internet use in vulnerable dementia caregivers. These findings will assist healthcare providers, researchers, and policy makers in identifying those caregivers least likely to access Internet-based resources and in providing guidance on how Internet-based strategies can best be designed, implemented, and distributed to meet dementia caregivers' unmet needs.