Examinando por Autor "López-Martínez, Catalina"
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Ítem A systematic review and meta-analysis of the association between anxiety symptoms and coping in family carers of dependent people aged 18 and over(Wiley, 2023-08-02) Muñoz-Cruz, Juan Carlos; López-Martínez, Catalina; Orgeta, Vasiliki; Del-Pino-Casado, RafaelAnxiety symptoms are prevalent in family carers of dependent people. Despite accumulating evidence in the area, there are still inconsistent findings on the association between carer anxiety symptoms and coping strategies. The aim of our study was to systematically analyse the relationship between anxiety symptoms and coping strategies in carers of dependent adults aged 18 years and older, and examine possible sources of heterogeneity in the results. The study design was a systematic review and meta-analysis. We searched several international databases (Pubmed, CINAHL, PsycINFO and LILACS) from June 2022 up to February 2023. We followed the preferred reporting items for systematic reviews and meta-analyses statement and performed several subgroup analyses to examine whether study design, cause of dependency and whether or not controlling for various biases influenced results. Forty-one studies were included in the review. We found significant associations between greater use of dysfunctional coping and higher anxiety symptoms. Greater use of problem-focused coping was associated with lower anxiety symptoms in carers of frail older people, but higher anxiety in carers of people surviving cancer. Emotion-focused coping and some of its individual strategies, such as acceptance and positive reappraisal, in probabilistic samples, were associated with lower anxiety symptoms across all groups. Most of the studies included in this review were cross-sectional. Evidence overall indicates that only specific dimensions and strategies of coping are significantly associated with anxiety symptoms in family carers. These findings should be considered when developing future interventions supporting carers.Ítem Afrontamiento y consecuencias emocionales negativas del cuidado en personas cuidadoras familiares: Revisión sistemática con metaanálisis(2024-09-04) Muñoz-Cruz, Juan Carlos; Del Pino, Rafael; López-Martínez, Catalina; Universidad de Jaén. Departamento de EnfermeríaCuidar a familiares en situación de dependencia se asocia con consecuencias emocionales negativas. La forma en la que las personas cuidadoras familiares afrontan la situación del cuidado puede influir en dichas consecuencias. El objetivo fue estudiar la relación existente entre las distintas dimensiones y estrategias de afrontamiento con síntomas de ansiedad, de depresión y sobrecarga subjetiva en personas cuidadoras familiares. Empleamos una revisión sistemática con metaanálisis y realizamos análisis por subgrupos para estudiar la heterogeneidad de los resultados. Encontramos que un mayor empleo de afrontamiento disfuncional se relacionó con más síntomas de ansiedad, depresión y sobrecarga subjetiva mientras que el uso de más afrontamiento activo como dimensión se asociaba con menos de estos síntomas de manera general, sobre todo, las estrategias de afrontamiento centradas en las emociones. Concluyentemente, el afrontamiento parece ser un factor a tener en cuenta para salud mental de la población cuidadora familiar. Caring for dependent family members is associated with negative emotional consequences. The way in which family carers cope with the caregiving situation may influence these consequences. The aim was to study the relationship between different dimensions and coping strategies with symptoms of anxiety, depression and subjective burden in family carers. We used a systematic review with meta-analysis and conducted subgroup analyses to study the heterogeneity of the results. We found that more use of dysfunctional coping was associated with more symptoms of anxiety, depression and subjective burden while more use of active coping as a dimension was associated with fewer of these symptoms overall, especially emotion-focused coping strategies. Conclusively, coping seems to be a factor to be taken into account for the mental health of the family caregiving population.Ítem Association between Sense of Coherence and Mental Health in Caregivers of Older Adults(MDPI, 2019-10-09) López-Martínez, Catalina; Serrano-Ortega, Natalia; Moreno-Cámara, Sara; del-Pino-Casado, RafaelThe purpose of this study was to analyze association between sense of coherence and perceived burden, anxiety, depression, and quality of life in caregivers of older adults. A cross-sectional study was carried out with a probabilistic sample of 132 caregivers of older relatives from the regions of Jaén, Spain. The measures assessed were sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index of Robinson), anxiety and depression (Goldberg Scale), and quality of life (Health Questionnaire SF-12). The main analyses included bivariate analysis using Pearson’s correlation coefficient and multivariate analysis through canonical correlation analysis. Our findings show that the sense of coherence explained 50.8% of the variance shared between subjective burden, anxiety, depression, and quality of life. We highlighted manageability as the variable within the dimensions of the sense of coherence with the greatest participation in the model. The sense of coherence may be an important protective factor for the mental health of the caregiver of dependent elderly relatives.Ítem Burden and anxiety in family caregivers in the hospital that debut in caregiving(MDPI, 2019-10-18) Pérez-Cruz, Margarita; Parra-Anguita, Laura; López-Martínez, Catalina; Moreno-Cámara, Sara; Del-Pino-Casado, RafaelThis cross-sectional study aims to determine the level of subjective burden and anxiety of caregivers of dependent older relatives that start providing care in the hospital and to analyse the relationship between objective burden, subjective burden and anxiety in these caregivers. Seventy-two caregivers of dependent older relatives were recruited in a medium–long stay hospital. Sociodemographic variables, number of basic activities of daily living (ADLs) attended, hours of surveillance, burden, and anxiety were collected from caregivers. A trajectory analysis was used to analyse the relationship between variables. Of the caregivers, 36.1% had subjective burden and 14.9% had anxiety. Subjective burden was positively associated with the number of basic ADLs attended, the hours of surveillance, and the cognitive impairment of the care recipient. Anxiety was also positively associated with subjective burden. Subjective burden mediated the effects of the number of basic ADLs attended, hours of surveillance and the cognitive impairment of the care recipient on anxiety. The levels of subjective burden and anxiety in caregivers debuting in hospital care are elevated, showing the need for these caregivers to be cared for. Subjective burden is a possible risk factor for anxiety, independent of the objective burden; it may buffer the effects of objective burden on anxiety.Ítem Caregiving Satisfaction, Psychological Distress and Caregiver Burden in Family Caregivers of Dependent Older People: A Longitudinal Study(Wiley, 2025-01-10) López-Martínez, CatalinaBackground and Objectives Although a substantial amount of research has focused on negative aspects of caregiving, less research has been conducted investigating positive aspects of providing informal care. The aim of this study was to investigate the longitudinal association between caregiving satisfaction and psychological distress in informal carers of dependent older people, and whether this relationship is mediated by caregiver burden. Research Design and Methods Prospective longitudinal study with a probabilistic sample of 332 caregivers of older relatives, with data collected at baseline and at 1-year follow-up. We measured caregiving satisfaction, psychological distress, subjective caregiver burden and several covariates (caregivers' sex, age and objective caregiver burden). Data were analysed using generalised estimation equations with multiple imputation. The STROBE checklist was used to support the writing of this document. Results After controlling for covariates, caregiving satisfaction was significantly negatively associated with lower levels of subjective caregiver burden (B = −0.17, 95% CI: −0.23, −0.11) and emotional distress (B = −0.23, 95% CI: −0.36, −0.11). When subjective burden was included in the model, the relationship between caregiving satisfaction and psychological distress was no longer significant (B = −0.11, 95% CI: −0.23, 0.02), whereas the association between subjective burden and psychological distress remained (B = 0.75, 95% CI: 0.57, 0.92). The Sobel test confirmed these results (p < 0.001), indicating that subjective caregiver burden mediates the relationship between caregiving satisfaction and psychological distress (complete mediation) over time. Discussion and Implications Caregiving satisfaction exerts a longitudinal protective effect on carers' psychological distress via subjective burden. Our findings indicate that interventions aimed at strengthening caregiving satisfaction may play a significant role in maintaining positive mental health outcomes for informal caregivers.Ítem Coping and anxiety in caregivers of dependent older adult relatives(MDPI, 2019-05-12) Pérez-Cruz, Margarita; Parra-Anguita, Laura; López-Martínez, Catalina; Moreno-Cámara, Sara; Del-Pino-Casado, RafaelThe aim of this study was to analyze the relationship between coping and anxiety in caregivers of dependent older adult relatives. A cross-sectional study was carried out in the province of Jaén (Andalusia, Spain). The convenience sample consisted of 198 family caregivers of dependent older adults. The main measurements were anxiety (Hamilton scale), coping (Brief COPE), subjective burden (Caregiver Strain Index), objective burden and sex of the caregiver. The main analyses were bivariate analysis using the Pearson correlation coefficient, and multivariate analysis using multiple linear regression. An independent regression model was developed for anxiety and each type of coping, adjusting for sex, subjective burden and objective burden. Our results demonstrate that anxiety was negatively associated with planning (partial r = −0.18), acceptance (partial r = −0.22) and humor (partial r = −0.20), and it was positively associated with self-distraction (partial r = 0.19), venting (partial r = 0.22), denial (partial r = 0.27) and self-blame (partial r = 0.25). Planning, acceptance and humor coping strategies may be protective factors of anxiety. Strategies such self-management, relief, denial and self-blame may be risk factors for anxiety.Ítem Coping and anxiety symptoms in family carers of dependent older people: Mediation and moderation effects of subjective caregiver burden(Wiley, 2024-01-05) López-Martínez, Catalina; Orgeta, Vasiliki; Frías-Osuna, Antonio; Del-Pino-Casado, RafaelIntroduction: Coping responses influence anxiety symptoms experienced by informal carers. However, only a few studies have investigated the longitudinal association between coping responses and anxiety symptoms in family carers. We also currently have limited knowledge on the mediating or moderating influence of subjective caregiver burden on this relationship over time. The aim of the present study was to investigate the longitudinal relationship between coping and anxiety symptoms in family carers of dependent older people, and examine the mediating or moderating role of subjective caregiver burden over time.Design: Prospective longitudinal study.Methods: We recruited and enrolled participants from a probability sample of 132 family carers of older dependent relatives. We measured coping strategies, anxiety symptoms, subjective caregiver burden, and several covariates (sex and intensity of care) at baseline and at 1-year follow-up. We used generalized estimating equations with multiple imputations to examine associations over time.Results: Considering both direct and indirect effects through subjective burden, anxiety symptoms were positively associated with proactive coping (B = 0.13), planning(B = 0.15), self-distraction (B = 0.24), denial (B = 1.15), venting (B = 0.94) and self-blame(B = 0.90), and negatively associated with positive reframing (B = −0.83) and acceptance (B = −0.75). Subjective caregiver burden moderated the relationship between anxiety symptoms and planning, and the use of denial as a form of coping.Conclusions: Our results show that subjective caregiver burden is an important moderator and mediator of the longitudinal association between coping responses and anxiety symptoms in carers.Clinical Relevance: Proactive coping and planning when subjective burden is low, self-distraction, denial, venting, and self-blame significantly increase levels of anxiety and caregiver burden in carers over time. Acceptance and positive reframing however as coping responses are associated with lower levels of anxiety and caregiver burden long-term. Our findings highlight the need for a multi-dimensional approach in future caregiving interventions.Ítem Coping and anxiety symptoms in family carers of dependent older people: Mediation and moderation effects of subjective caregiver burden(Wiley, 2024-01-28) López-Martínez, Catalina; Orgeta, Vasiliki; Frías-Osuna, Antonio; Del-Pino-Casado, RafaelINTRODUCTION: Coping responses influence anxiety symptoms experienced by informal carers. However, only a few studies have investigated the longitudinal association between coping responses and anxiety symptoms in family carers. We also currently have limited knowledge on the mediating or moderating influence of subjective caregiver burden on this relationship over time. The aim of the present study was to investigate the longitudinal relationship between coping and anxiety symptoms in family carers of dependent older people, and examine the mediating or moderating role of subjective caregiver burden over time. DESIGN: Prospective longitudinal study. METHODS: We recruited and enrolled participants from a probability sample of 132 family carers of older dependent relatives. We measured coping strategies, anxiety symptoms, subjective caregiver burden, and several covariates (sex and intensity of care) at baseline and at 1-year follow-up. We used generalized estimating equations with multiple imputations to examine associations over time. RESULTS: Considering both direct and indirect effects through subjective burden, anxiety symptoms were positively associated with proactive coping (B = 0.13), planning (B = 0.15), self-distraction (B = 0.24), denial (B = 1.15), venting (B = 0.94) and self-blame (B = 0.90), and negatively associated with positive reframing (B = -0.83) and acceptance (B = -0.75). Subjective caregiver burden moderated the relationship between anxiety symptoms and planning, and the use of denial as a form of coping. CONCLUSIONS: Our results show that subjective caregiver burden is an important moderator and mediator of the longitudinal association between coping responses and anxiety symptoms in carers. CLINICAL RELEVANCE: Proactive coping and planning when subjective burden is low, self-distraction, denial, venting, and self-blame significantly increase levels of anxiety and caregiver burden in carers over time. Acceptance and positive reframing however as coping responses are associated with lower levels of anxiety and caregiver burden long-term. Our findings highlight the need for a multi-dimensional approach in future caregiving interventions.Ítem Coping and depressive symptoms in family carers of dependent adults aged 18 and over: A systematic review and meta-analysis(Wiley, 2023-01-12) Muñoz-Cruz, Juan Carlos; López-Martínez, Catalina; Orgeta, Vasiliki; Del-Pino-Casado, RafaelBeing a family carer is associated with increased risk of experiencing depressive symptoms. Despite many decades of research investigating the association between coping strategies and depressive symptoms in carers results across studies remain contradictory. The objective of this study was to systematically review evidence on the association between depressive symptoms and coping strategies in carers of dependent people aged 18 and over and investigate potential sources of heterogeneity of findings. The study design was a systematic review and meta-analysis. We searched Pubmed, CINAHL, PsycINFO and LILACS up to April 2021. We performed meta-analyses following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement and several subgroup analyses to investigate whether cause of caring dependency, study design, and controlling for several biases influenced results. Fifty-nine studies met our inclusion criteria. We found a robust and statistically significant association between greater use of dysfunctional coping and higher depressive symptoms. Greater use of emotion-focussed coping was associated with fewer depressive symptoms only in studies controlling for confounding bias. Use of problem-focussed coping was related to fewer depressive symptoms in carers of frail older people. The combined use of both problem-focussed and emotion-focussed coping was associated with lower symptoms of depression. Our review concludes that the broad domain of dysfunctional coping is consistently associated with higher levels of depressive symptoms in carers. After controlling for confounders, emotion-focussed coping and several of its individual strategies were consistently associated with fewer depressive symptoms. Whilst problem-focussed coping and some of its individual strategies are also associated with lower depressive symptoms, these strategies may not be as helpful in all caregiving groups.Ítem Coping strategies and psychological distress in family carers of frail older people: A longitudinal study(Elsevier, 2019) Del-Pino-Casado, Rafael; Serrano-Ortega, Natalia; López-Martínez, Catalina; Orgeta, VasilikiBackground. Carers of dependent older people experience high levels of psychological distress. However, little is known about the effects of coping on carer distress over time. In this one year longitudinal study we investigated the relationship between distress, and coping strategies in a representative sample of family carers living in Spain. Methods. Primary carers of older people were recruited (N = 200). We used probability sampling and collected data via individual interviews from 2013 to 2015. Variables investigated included psychological distress, coping, and levels of objective and subjective burden. Panel data analysis was used to test a model of association of psychological distress, and coping strategies controlling for key confounders. Results. Acceptance and emotional support were the most frequently used strategies, whereas behavioural disengagement and humour were the least used. In the panel data regressions, positive reframing (B = -0.79, p < 0.001), self-distraction (B = -0.46, p = 0.034), substance use (B = 0.57, p < 0.001) and denial (B = 0.57, p = 0,049) were significantly related to psychological distress at one year follow-up. Limitations. Limitations include participant drop out and assessing substance use coping via a brief measure. Conclusions. Positive reframing and self-distraction were longitudinally associated with lower levels of carer psychological distress. Using denial and substance use coping increased distress long-term. Our results suggest that interventions that focus on positive reframing and assisting carers in decreasing dysfunctional coping may be useful therapeutic targets mitigating carer psychological morbidity.Ítem Obligation and negative consequences in primary caregivers of dependent older relatives(2018-09-07) Del-Pino-Casado, Rafael; López-Martínez, Catalina; Serrano-Ortega, Natalia; Del Mar Pastor-Bravo, María; Parra-Anguita, LauraThe purpose of this study was to analyse the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. A secondary analysis of data from two cross-sectional studies of primary home caregivers (N = 400; probabilistic sample) of older adult relatives in Spain was conducted. Data regarding obligation (four categories basing on beliefs of obligation and social pressure: low pressure and low beliefs, low pressure and high beliefs, high pressure and low beliefs and high pressure and high beliefs), stressors, anxiety and depression were collected by interview in 2013. The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression. When the relation of behavioural problems with anxiety and depression stratified by the previous four categories of obligation was analysed, behavioural problems were associated with anxiety and depression in the subgroups with low beliefs of obligation, whereas this association disappeared in the subgroups with high beliefs of obligation.Ítem Perceptions, Motivations, and Empowerment Strategies of Midwives in Rural and Remote Areas of Northern Morocco(MDPI, 2022-11-14) Louazi, A.; Frías-Osuna, Antonio; López-Martínez, Catalina; Moreno-Cámara, SaraThe shortage of midwives is a problem in rural and remote areas. This is mainly the consequence of job insecurity and difficult living conditions. The present study aimed to identify and analyse the perceptions and motivations of midwives in rural and remote areas of northern Morocco on the quality of their working life and the motivational factors and empowerment strategies they use to maintain and develop their work. It is a qualitative study that follows Van Manen’s hermeneutic phenomenology approach. Three focus groups and in-depth interviews were conducted with 15 midwives from rural and remote areas. The results indicate that midwives in rural and remote areas have a negative perception of the quality of the work and their personal life because of the scarcity of basic resources, unfavourable working conditions, and the personal sacrifices they have to make to support themselves. However, some factors favour their efforts. Therefore, there is a need to promote intersectoral policies that focus on improving material and human resources, as well as the working and personal conditions of midwives and the factors that support and empower them.Ítem Relaciones entre el apoyo social, la sobrecarga subjetiva, la ansiedad y los síntomas depresivos en personas cuidadoras familaires(2025-02-14) Gutiérrez-Sánchez, Belén; Del Pino, Rafael; López-Martínez, Catalina; Universidad de Jaén. Departamento de enfermeríaEl apoyo social es un factor clave en la salud mental de las personas cuidadoras familiares. La evidencia científica muestra que el apoyo social percibido presenta una asociación negativa moderada con los síntomas depresivos en personas cuidadoras familiares de adultos mayores y dependientes (r = -0.35), mientras que el apoyo social recibido tiene un efecto menor (r = -0.14). Otra revisión realizada destaca que el apoyo social percibido está positivamente asociado con el apoyo recibido (r = 0.43), pero a pesar de estar relacionados son constructos diferentes. Encontramos efectos mediadores del apoyo social percibido y la sobrecarga subjetiva entre el apoyo social recibido, la ansiedad y los síntomas depresivos en personas cuidadoras familiares. Estos hallazgos resaltan la importancia de intervenciones orientadas a mejorar la percepción del apoyo social, con el fin de mitigar la sobrecarga subjetiva, la ansiedad y la depresión en personas cuidadoras familiares. Social support is a key factor in the mental health of family caregivers. Scientific evidence shows that perceived social support has a moderate negative association with depressive symptoms in family caregivers of elderly and dependent adults (r = -0.35), while received social support has a smaller effect (r = -0.14). Another review highlights that perceived social support is positively associated with received support (r = 0.43), but despite being related, they are different constructs. We found mediating effects of perceived social support and subjective overload between received social support, anxiety, and depressive symptoms in family caregivers. These findings highlight the importance of interventions aimed at improving the perception of social support, in order to mitigate subjective overload, anxiety, and depression in family caregivers.Ítem Relationship between sense of coherence and health-related behaviours in adolescents and young adults: a systematic review(Springer Nature, 2022-03-10) da-Silva-Domingues, Henrique; del-Pino-Casado, Rafael; Palomino-Moral, Pedro Ángel; López-Martínez, Catalina; Moreno-Cámara, Sara; Frías-Osuna, AntonioBackground: The sense of coherence is developed through the learning process and contributes to the positioning of individuals in the health-disease continuum, facilitating successful and adaptive personal outcomes. Health-related behaviours represent a health determinant of utmost importance for public health and the development of adolescent and youth health promotion policies, as they are related to the main risk factors and problems of morbidity and mortality in our society. Previous studies have analysed the relationship between sense of coherence and only some individual health outcomes such as oral health, the relationship of sense of coherence with smoking and alcohol consumption, concluding that salutogenic factors are related to quality of life and preventive behaviours. The aim of this systematic review was to describe the relationship of sense of coherence with diferent health-related behaviours investigated so far in the adolescent and youth population. Methods: A systematic review was carried out in databases (PubMed, CINAHL, Scopus and PsycInfo) and in the bibliographies of the retrieved articles, without limitation of time or language. Associations between sense of coherence and health-related behaviours have been assessed. Results: A total of 1214 investigations were reviewed and 21 of them were included in this systematic review. The relationship between sense of coherence and eight health-related behaviours were identifed (alcohol use, physical activity, tobacco use, eating habits, rest periods, use of illegal substances, behaviours related to oral health and time spent in games on the computer). Conclusions: Our results increase the available evidence and support the solid relationship of the sense of coherence with health behaviours both as a protective factor against risk behaviours and for its positive association with preventive and health promoting behaviours of adolescents, young adults and university students.Ítem Sense of Coherence and Adherence to Self-Care in People with Diabetes: Systematic Review and Meta-Analysis(MDPI, 2025-06-25) Vega-Martínez, María Carmen; López-Martínez, Catalina; del-Pino, RafaelBackground/Objectives: Self-care in people with diabetes requires constant physical and emotional effort, which can be a barrier to adhering to the care plan. The sense of coherence (SOC) might play a role in self-care. This study aimed to examine the relationship between sense of coherence and self-care in people with Diabetes Mellitus. Methods: A systematic review with narrative synthesis (14 studies) and with meta-analysis (seven studies) was conducted. We searched PubMed, CINAHL, PsychInfo and Scopus up to June 2025. We included original studies that assessed the relationship between SOC and self-management in people with diabetes and reported the correlation coefficient or other compatible statistic. Selection bias (probabilistic vs. non-probabilistic), classification bias (validity and reliability of the instrument) and confounding (control of sex, age and type of diabetes) were evaluated. The meta-analysis used a random-effects model with sensitivity and subgroup analyses to assess robustness. Results: Fourteen studies with 9800 participants (type 1 or 2 diabetes) were included. Of the studies, eight used probability sampling, only one had classification bias risk, and three had low bias risk. A positive, moderate association was found between SOC and adherence to self-care (r = 0.32; 95% confidence interval (CI): 0.29, 0.35; N = 3985; average per study: 569.3). Limitations: a small number of studies; all were descriptive and cross-sectional. Conclusions: A sense of coherence may play a relevant role in improving adherence to the self-care plan in people with type 1 or 2 diabetes.Ítem Sense of coherence, burden and mental health in caregiving: A systematic review and metaanalysis(Elsevier, 2019) del-Pino-Casado, Rafael; Espinosa-Medina, Aida; López-Martínez, Catalina; Orgeta, VasilikiAbstract Background: Informal caregiving is associated with a number of negative effects on carers’ physical and psychological well-being. The salutogenic theory argues that sense of coherence (SOC) is an important factor in psychological adjustment to stress. The main aim of this study was to systematically review current evidence on the association between SOC, burden and mental health outcomes in informal carers. Method: A systematic search was carried out up to September 2017 in the following databases: PubMed, CINAHL (EBSCO), PsychInfo (OVID) and Scopus. Studies were included if they evaluated the relationship between sense of coherence and subjective caregiver burden and/or mental health outcomes, specifically symptoms of depression and anxiety. Meta-analyses were performed and subgroup analyses were carried out to explore if methodological factors influenced findings. Results: Thirty-five studies were included in the meta-analysis, which provided 40 independent samples with 22 independent comparisons for subjective caregiver burden, 26 for symptoms of depression and 7 for symptoms of anxiety. Higher levels of SOC were associated with lower levels of subjective caregiver burden and better mental health outcomes. Publication bias did not change the estimate of the effect. Limitations: Most of the studies included in this review were cross-sectional. Conclusions: Findings suggest that SOC is an important determinant of carer well-being and may protect carers from high levels of psychological distress and caregiver burden.Ítem Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis(Public Library of Science, 2021-03-01) Del-Pino-Casado, Rafael; Priego-Cubero, Emilia; López-Martínez, Catalina; Orgeta, VasilikiThere is increasing evidence that subjective caregiver burden is an important determinant of clinically significant anxiety in family carers. This meta-analysis aims to synthesise this evidence and investigate the relationship between subjective caregiver burden and anxiety symptoms in informal caregivers. We searched PubMed, CINAHL and PsycINFO up to January 2020. Combined estimates were obtained using a random-effects model. After screening of 4,312 articles, 74 studies (with 75 independent samples) were included. There was a large, positive association between subjective caregiver burden and anxiety symptoms (r = 0.51; 95% CI = 0.47, 0.54; I2 = 0.0%). No differences were found in subgroup analyses by type of study design (cross-sectional vs. longitudinal), sampling, control of confounders or care-recipient characteristics. Subjective caregiver burden is an important risk factor for anxiety in informal caregivers. Targeting subjective caregiver burden could be beneficial in preventing clinically significant anxiety for the increasing number of family carers worldwide.Ítem Subjective caregiver burden and coping in family carers of dependent adults and older people: A systematic review and meta‐analysis(Wiley, 2024-03-16) Muñoz-Cruz, Juan Carlos; López-Martínez, Catalina; Orgeta, Vasiliki; Del-Pino-Casado, RafaelSubjective caregiver burden is highly prevalent in family caregivers. Despite several studies investigating the relationship between subjective caregiver burden and coping strategies, results remain inconsistent. The aim of our study was to systematically review current literature on the relationship between subjective caregiver burden and coping in family carers of dependent adults and older people. A secondary objective was to analyse possible sources of heterogeneity in the estimated effect. The study design was a systematic review with meta‐analysis following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses statement (PRISMA) guidelines. We searched several international databases (CINAHL, LILACS, PsycINFO and PubMed) up to February 2024. We performed several subgroup analyses to examine whether study design, methodological quality or care recipient dependency influenced results. Of the 1064 records identified in our search, a total of 80 studies met inclusion criteria. We found a significant association between greater use of dysfunctional coping and higher levels of subjective caregiver burden (r = 0.400; 95% CI = 0.315, 0.478); higher use of second‐order active coping was significantly associated with lower caregiver burden (r = −0.213; 95% CI = −0.316, −0.105). Problem‐focused coping showed no statistically significant association with levels of subjective burden; emotion‐focused coping was associated with caregiver burden only after controlling for confounding variables (r = −0.258; 95% CI = −0.441, −0.055); several individual strategies of this dimension such as acceptance (r = −0.135; 95% CI = −0.238, −0.028), positive reappraisal (r = −0.178; 95% CI = −0.255, −0.099) and religious coping (r = −0.083; 95% CI = −0.162, −0.002), were associated with lower burden. We found that several dimensions of coping strategies are significantly associated with levels of subjective caregiver burden experienced by carers. These results can inform future research evaluating the effectiveness of interventions aimed at improving carers' mental health.Ítem The mediating role of sense of coherence on mental health outcomes in carers of older dependent relatives: A longitudinal study(Wiley, 2021) López-Martínez, Catalina; Orgeta, Vasiliki; Frías-Osuna, Antonio; Del-Pino-Casado, RafaelBackground: Sense of coherence (SOC) is an important protective factor for carer well-being but research to date remains cross-sectional, focusing primarily on the direct effects of SOC on carers’ mental health. The study’s aim was to investigate the mediating role of SOC in the longitudinal relationship between caregiver strain and carers’ psychological health, and its stability over time. Methods: Prospective longitudinal study conducted in Jaén (Spain) with a probabilistic sample of 132 carers of older people, with data collected at baseline and at one-year follow-up. We measured SOC, caregiver strain, anxiety and depressive symptoms, and several care recipient characteristics and intensity of care provided. We used multiple linear regression modelling and the Sobel test to analyse mediation effects. Results: SOC was significantly negatively longitudinally associated with both anxiety (β= -0.38, p= 0.001) and depressive symptoms (β= -0.28, p= 0.023), after controlling for several confounders. SOC mediated both the relationship between caregiver strain and anxiety and caregiver strain and depressive symptoms (Sobel test; p< 0.001 for anxiety and p< 0.001 for depressive symptoms). Differences between baseline and one-year follow-up SOC scores were not statistically significant (p= 0.617). Conclusions: SOC appears to buffer the impact of caregiver strain on symptoms of depression and anxiety in informal carers of older people. Our data showed that SOC is an important psychological resource for carers that remained relatively stable under non-experimental conditions over a period of one year in this sample. Findings suggest that interventions aimed at strengthening SOC may protect carer psychological well-being.Ítem The Relationship between Social Support and Anxiety Symptoms in Informal Carers: A Systematic Review and Meta-Analysis(MDPI, 2023-02-03) Priego-Cubero, Emilia; Orgeta, Vasiliki; López-Martínez, Catalina; Del-Pino-Casado, RafaelBackground: Providing care can be challenging for informal carers and increases the risk of mental health problems, such as experiencing clinical symptoms of anxiety. While strengthening social support for informal carers is a common recommendation to reduce this risk, no systematic review or meta-analysis to date has examined the relationship between social support and anxiety symptoms in informal carers. The aim of our study was to systematically review the current evidence on the association between perceived and received social support and anxiety symptoms in informal carers of dependent adults and older people, and to comment on the quality of the evidence. Methods: We searched PubMed, CINAHL (EBSCO), PsycINFO (ProQuest), Scopus, and LILACS up to 31 March 2021 for articles reporting on the association between caregiver anxiety symptoms and social support. A random-effects model was used to pool estimates, and each study was rated for quality using pre-specified criteria. Publication bias was assessed using a funnel plot and Egger’s regression test, which was adjusted using trim and fill analysis. Results: From the 2180 identified articles, 35 studies met our inclusion criteria, reporting on 5036 informal carers in total. We found a moderate negative association between perceived social support and caregiver anxiety symptoms (r = −0.31, 95% CI = −0.35, −0.27) and a small, negative association between received social support and caregiver anxiety (r = −0.15, 95% CI = −0.22, −0.08). Conclusion: The levels of perceived social support showed a significant negative association with caregiver anxiety symptoms. Policymakers and those working directly with informal carers should consider the development of targeted social support interventions that specifically enhance the levels of perceived social support to reduce symptoms of anxiety in informal carers.