Caregiving among families of women with substance use or dual disorders: Predictors of caregiver involvement and the role of caregiver - care-recipient quality of relationship.

摘要

The objective of this study is to enhance understanding of the caregiving stress process among families of women with substance use or co-occurring substance and mental disorders (anxiety, PTSD, depression, or dysthymia). Two central aims direct the study's inquiry. First, based on the caregiving stress model, the study aims to examine the relationship of primary caregiving stressors and caregivers' well-being on family caregivers' involvement with women with substance or dual disorders. Second, this study aims to evaluate the moderating role of the quality of caregiver-care recipient relationship in the caregiving stress process.; This study addresses significant gaps in the literature. Few studies have focused on co-morbidity between substance use disorders and mental disorders among women, and very few studies focused on the role of families of persons with dual disorders. Furthermore, little attention has been paid in the caregiving literature to the possible role of the caregiver-care recipient relationship quality on the caregiving process and its outcomes.; This study is a secondary data analysis, utilizing data collected by through a NIDA funded grant. This study utilized a non-experimental cross-sectional survey design. The subjects of the current study are 82 family members (caregivers) of women clients in a residential or outpatient substance abuse treatment program.; Results indicated that while subjective burden (i.e., well-being) had a direct effect on involvement (i.e., supervision); neither subjective burden or depressive symptomatology mediated the relationship between caregivers' primary stressors and caregivers' involvement with the client. However, subjective burden had a complete mediation effect on the relationship between caregivers' objective burden and supervision. No moderation effects were found for negative quality of relationship between the three domains of the caregiving process: caregivers' stressors, caregivers well being, and caregivers' involvement with the client. However, positive quality of relationship buffered the negative effect of care-recipients' behavioral problems and care-recipients emotional and substance use problems (i.e., stressors) on frequency of contact. Furthermore, positive quality of relationship moderated the effect of caregivers depressive symptomatology (i.e., well-being) on caregivers' supervision (i.e., involvement). The study's implications for practice, service delivery and future research are discussed.