Influence of dementia literacy and caregiving appraisal on the psychological wellbeing of informal caregivers of people with dementia: A cross-sectional study

Shanshan Wang; Qiuju Shan; Daphne Sze Ki Cheung; Xinyi Xu; Isaac Sze Him Leung; Angela Yee Man Leung

doi:10.3389/fmed.2022.971481

Influence of dementia literacy and caregiving appraisal on the psychological wellbeing of informal caregivers of people with dementia: A cross-sectional study

Front Med (Lausanne). 2022 Sep 14:9:971481. doi: 10.3389/fmed.2022.971481. eCollection 2022.

Authors

Shanshan Wang^{1

2

3}, Qiuju Shan⁴, Daphne Sze Ki Cheung¹, Xinyi Xu^{5

6}, Isaac Sze Him Leung⁷, Angela Yee Man Leung^{1

3}

Affiliations

¹ School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China.
² School of Nursing and Health, Zhengzhou University, Henan, China.
³ WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China.
⁴ The Second Affiliated Hospital of Zhengzhou University, Henan, China.
⁵ School of Nursing, Hebei Medical University, Hebei, China.
⁶ Postdoctoral Research Station in Basic Medicine, Hebei Medical University, Hebei, China.
⁷ Department of Statistics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China.

Abstract

Background: Dementia informal caregiving is a global phenomenon. It is well documented that caregivers' psychological health is often affected by busy caregiving schedules. Lawton's two-factor model indicates that caregivers' psychological wellbeing is influenced by caregiving appraisal and other caregiver factors. Our review also identified the significance of dementia literacy, which was an essential caregiver factor. However, it is imperative for a clear understanding of the mechanism of how psychological wellbeing is influenced by them.

Objectives: To explore the association among dementia literacy, caregiving appraisal, and psychological wellbeing and the influencing mechanisms between them.

Methods: Two hundred and twenty-three informal caregivers of people with dementia were involved in this cross-sectional study. Dementia literacy was measured by the Alzheimer's Disease Knowledge Scale and Dementia Attitude Scale. Caregiving appraisal and psychological wellbeing were measured with the Caregiving Appraisal Scale and Ryff's Psychological wellbeing Scale, respectively. Descriptive statistics were used to describe the characteristics of participants and key outcome variables. Pearson's correlation analysis was used to analyze the correlation among the variables. Structural equation modeling was used to examine the hypothetical mediating role of caregiving appraisal in the relationship between dementia literacy (i.e., knowledge of dementia and attitude toward dementia) and caregivers' psychological wellbeing.

Results: The hypotheses were partially confirmed. Attitude toward dementia was significantly associated with caregiving appraisal (r = 0.312, p < 0.01) and psychological wellbeing (r = 0.311, p < 0.01). However, knowledge of dementia was only significantly associated with psychological wellbeing (r = 0.136, p < 0.05). The structural equation modeling fitted well (p = 0.078, CFI = 0.987, RMSEA = 0.038). In the fitted model, caregiving appraisal partially mediated the association between attitude toward dementia and psychological wellbeing. In contrast, attitude toward dementia and caregiving appraisal fully mediated the association between knowledge of dementia and psychological wellbeing.

Conclusion: Efforts can be exerted to improve dementia caregivers' caregiving appraisal and attitude toward dementia to improve their psychological wellbeing.

Keywords: caregiver; caregiving appraisal; dementia; literacy; wellbeing.