Modeling Pathways by which the Caregiver TLC Psychoeducational Program Impacts Psychological Health of Caregivers.

Abstract

Background and objectives: The study seeks to elucidate the pathways by which the Caregiver TLC psycho-educational program impacts the psychological health of caregivers by examining the degree to which changes in self-efficacy, personal gains, and emotional support mediate the changes on perceived depression, anxiety and burden.

Research design and methods: Using pre-post data from the Caregiver TLC randomized controlled trial (n = 81) for each outcome and mediator pair, a series of multiple regression models were executed to test the degree to which the program's total effects on changes in depression, burden and anxiety from baseline to post-intervention are due to changes in each mediator variable from pre- and post-intervention assessments. Caregivers were primarily female (85%), White (62 %), Black (38%), with a median age of 62 and household income of $75,000+. Caregivers reported caring for a person with dementia (69%) or chronic health conditions (31%).

Results: Mediation path modeling indicated that changes in self-efficacy affected by participation in the Caregiver TLC program, mediating between 32% and 63% of the total treatment effect on the outcome variables. Change in personal gains and change in emotional support also demonstrated meaningful mediation effects, albeit smaller in magnitude.

Discussion and implications: Results confirm that the observed positive impact of the Caregiver TLC program is due to changes in self-efficacy (in particular) and to a lesser degree to changes in personal gains and emotional support. These results confirm that strengthening caregivers perceived self-efficacy to manage stress plays a significant role in improving psychosocial functioning.