Abstract
Ways of coping, appraisals, distress (anxiety/depression) symptoms and expressed emotion were assessed in 67 caregivers of people with dementia at baseline. A total of 29 of these caregivers went on to receive a coping with dementia training course of 8 weeks duration and were compared for effects both within and between subjects over time. A subset of caregivers (N=18) were assessed on 4 occasions over time consisting of a baseline, preintervention, post-intervention and follow-up series of measurements. Main effects for time were found for problem-focused coping, stressfulness appraisals and knowledge in those caregivers who attended the course, but no effects for measures of distress or efficacy were found. Symptoms of anxiety improved during the “waiting list” for the course. The group of “completers” (N=18) were split into high/low psychiatric symptoms at baseline and results showed that caregivers high in initial symptoms showed the greatest change over time consistent with the impact on distress being influenced by “floor effects” in the sample. There was little evidence for the “goodness of fit” hypothesis that links appraisals of changeability with choice of coping style or for the capacity of the course to change such appraisals. Expressed emotion was not found to be associated with ways of coping although some problems were experienced with the measure of expressed emotion employed. A measure of “sense of coherence” (psychological health) did not distinguish between users and non-users of the service. Results were related to the outcomes of previous similar intervention studies and the implications for future practice and research considered.