Comparison of the Effectiveness of Self-care Education and Process Emotion Regulation in the Mitigation of Depression Symptoms among the Caregivers of Older Adults with Dementia

Document Type : Original Article

Authors

1 Department of Health Psychology, UAE Branch, Islamic Azad University, Dubai, United Arab Emirates

2 Department of Psychology, Faculty of Education and Psychology, Kharazmi University, Tehran, Iran

3 Department of Neurology, University of Medical Sciences, Kerman, Iran

Abstract

Background: The long-term, demanding nature of caring for dementia patients leaves a detrimental impact on carers' physical and emotional well-being.
 
Objectives: The present study aimed to compare the effectiveness of self-care education and process emotion regulation in the mitigation of depression symptoms among the caregivers of older adults with dementia.
 
Methods: This quasi-experimental study was conducted based on a pre-test-post-test design and a four-month follow-up period with a control group. The statistical population consisted of all caregivers who cared for dementia patients in their homes or institutions and were referred to Dr. Rostam Seifaldini's center in Kerman in 2021. The statistical sample consisted of 45 people who were selected via convenience sampling. Thereafter, 15 subjects were randomly assigned to the control group, and 30 cases were allocated to two experimental groups. The experimental group received self-care training and process emotion regulation interventions in eight 45-minute sessions once a week. Data were collected using the Beck Depression Inventory (1961) and analyzed in SPSS software (version 26) using repeated measures analysis of variance.
 
Results: The results demonstrated that self-care education and emotion process regulation training were effective in depression and quality of life among the caregivers of older adults with dementia (P<0.01). The findings also pointed out that there was no significant difference between the effectiveness of the two interventions (self-care education and emotion process regulation training) in reducing depression symptoms among the caregivers of older adults with dementia.
 
Conclusion: It can be concluded that self-care and emotion regulation training are effective in the mitigation of depression symptoms in caregivers.

Keywords


1. Amani, M., Movadi, M. The Effectiveness of Emotional Regulation Skills Training on Emotional Regulation Strategies and Quality of Life in Family Head Females. Quarterly Journal of Woman and Society, 2018; 9(34): 1-18.
 
2. Azimi M. Effectiveness of Process Emotion Regulation Strategies in Cognitive Emotion Regulation Strategies and General Health Problems among Adolescent Girls with Addicted Parents. etiadpajohi 2019; 12 (49) :189-208
 
3. Baker FA, Lee YE, Sousa TV, Stretton-Smith PA, Tamplin J, Sveinsdottir V, Geretsegger M, Wake JD, Assmus J, Gold C. Clinical effectiveness of music interventions for dementia and depression in elderly care (MIDDEL): Australian cohort of an international pragmatic cluster-randomised controlled trial. The Lancet Healthy Longevity. 2022 Mar 1;3(3):e153-65.
https://doi.org/10.1016/S2666-7568(22)00027-7
PMid:36098290
 
4. Basso JC, McHale A, Ende V, Oberlin DJ, Suzuki WA. Brief, daily meditation enhances attention, memory, mood, and emotional regulation in non-experienced meditators. Behavioural brain research. 2019 Jan 1;356:208-20.
https://doi.org/10.1016/j.bbr.2018.08.023
PMid:30153464
 
5. Cece V, Guillet-Descas E, Nicaise V, Lienhart N, Martinent G. Longitudinal trajectories of emotions among young athletes involving in intense training centres: Do emotional intelligence and emotional regulation matter?. Psychology of Sport and Exercise. 2019 Jul 1;43:128-36.
https://doi.org/10.1016/j.psychsport.2019.01.011
 
6. Charlton RA, McQuaid GA, Wallace GL. Social support and links to quality of life among middle-aged and older autistic adults. Autism. 2023 Jan;27(1):92-104.
https://doi.org/10.1177/13623613221081917
PMid:35362329 PMCid:PMC9806477
 
7. Chen G, Chen P, Gong J, Jia Y, Zhong S, Chen F, Wang J, Luo Z, Qi Z, Huang L, Wang Y. Shared and specific patterns of dynamic functional connectivity variability of striato-cortical circuitry in unmedicated bipolar and major depressive disorders. Psychological Medicine. 2022 Mar;52(4):747-56.
https://doi.org/10.1017/S0033291720002378
PMid:32648539
 
8. Chen TY, Kao CW, Cheng SM, Liu CY. Factors influencing self-care among patients with primary hypertension: path analysis of mediating roles of self-efficacy and depressive symptoms. European Journal of Cardiovascular Nursing. 2023 Jan 13:zvad011.
https://doi.org/10.1093/eurjcn/zvad011
PMid:36637099
 
9. Lu F, Wong CK, Tse ET, Ng AP, Li L, Lam JS, Bedford L, Fong DY, Ip P, Lam CL. The Impact of a Health Empowerment Program on Self-Care Enablement and Mental Health among Low-Income Families: Evidence from a 5 Year Cohort Study in Hong Kong. International Journal of Environmental Research and Public Health. 2023 Mar 15;20(6):5168.
https://doi.org/10.3390/ijerph20065168
PMid:36982089 PMCid:PMC10049337
 
10. Matcham F, Leightley D, Siddi S, Lamers F, White KM, Annas P, de Girolamo G, Difrancesco S, Haro JM, Horsfall M, Ivan A. Remote Assessment of Disease and Relapse in Major Depressive Disorder (RADAR-MDD): recruitment, retention, and data availability in a longitudinal remote measurement study. BMC psychiatry. 2022 Feb 21;22(1):136.
https://doi.org/10.1192/j.eurpsy.2022.315
PMCid:PMC9564033
 
11. Kim J, You SY. What perception do families have of person-centered care for patients with dementia in nursing homes?. NPG Neurologie-Psychiatrie-Gériatrie. 2022 Aug 1;22(130):237-44.
https://doi.org/10.1016/j.npg.2022.03.001
 
12. Drigas A, Mitsea E, Skianis C. Subliminal Training Techniques for Cognitive, Emotional and Behavioral Balance. The Role of Emerging Technologies. Technium Soc. Sci. J.. 2022;33:164.
https://doi.org/10.47577/tssj.v33i1.6881
 
13. Esmaeilishad B. The Effectiveness of Self-Care Training on Quality of Life, Self-Care Behaviors and Blood Sugar in Elderly Without Self-Care Behaviors. Aging Psychology. 2020; 6(1), 1-11.
 
14. Fisher PM, Ozenne B, Ganz M, Frokjaer VG, Dam VN, Penninx BW, Sankar A, Miskowiak K, Jensen PS, Knudsen GM, Jorgensen MB. Emotional faces processing in major depressive disorder and prediction of antidepressant treatment response: A NeuroPharm study. Journal of Psychopharmacology. 2022 May;36(5):626-36.
https://doi.org/10.1177/02698811221089035
PMid:35549538
 
15. García Márquez MF, Rivera Reyes MF, Parrado Corredor F. Neurological foundations of mindfulness and its influence with the loneliness feeling in elderly. 2022;3(2):11-23.
 
16. Gehlawat M, Thumati G, Gundala S. Role of diabetes self-management education in improving self-care behavior among adult type 2 diabetics: A systematic review and meta-analysis. MRIMS Journal of Health Sciences. 2023 Jan 1;11(1):9-16.
https://doi.org/10.4103/mjhs.mjhs_71_22
 
17. Gross JJ. Emotion regulation: Current status and future prospects. Psychological inquiry. 2015 Jan 2;26(1):1-26.
https://doi.org/10.1080/1047840X.2014.940781
 
18. Hazzan AA, Dauenhauer J, Follansbee P, Hazzan JO, Allen K, Omobepade I. Family caregiver quality of life and the care provided to older people living with dementia: Qualitative analyses of caregiver interviews. BMC geriatrics. 2022 Dec;22(1):1-1.
https://doi.org/10.1186/s12877-022-02787-0
PMid:35101000 PMCid:PMC8802743
 
19. Hermanns N, Ehrmann D, Shapira A, Kulzer B, Schmitt A, Laffel L. Coordination of glucose monitoring, self-care behaviour and mental health: achieving precision monitoring in diabetes. Diabetologia. 2022 Nov;65(11):1883-94.
https://doi.org/10.1007/s00125-022-05685-7
PMid:35380233 PMCid:PMC9522821
 
20. Isik E, Fredland NM. Orem's self-care deficit nursing theory to improve children's self-care: An integrative review. The Journal of School Nursing. 2023 Feb;39(1):6-17.
https://doi.org/10.1177/10598405211050062
PMid:34636684
 
21. Beck AT, Steer RA, Carbin MG. Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical psychology review. 1988 Jan 1;8(1):77-100.
https://doi.org/10.1016/0272-7358(88)90050-5
 
22. Borjali M, Naserinia S. The Effectiveness of Emotion Regulation Strategies Training on Mental Health, Self-compassion and Craving in The Addicts. Counseling Culture and Psychotherapy. 2019; 10(40), 133-154.
 
23. Khosravi larijani M, Bahjati F, Choobforoush Zade A. The Effectiveness of The Intervention Based on Informational-Motivational and Behavioral Skills (IMB)Self-Care Model on Quality of Life in Students with Diabetes. Journal of Research in Psychological Health, 2019; 13 (2):45-63
 
24. Jung SE, Kim S, Bishop A, Hermann J. Poor nutritional status among low-income older adults: examining the interconnection between self-care capacity, food insecurity, and depression. Journal of the Academy of Nutrition and Dietetics. 2019 Oct 1;119(10):1687-94.
https://doi.org/10.1016/j.jand.2018.04.009
PMid:29921540
 
25. Iovino P, Nolan A, De Maria M, Ausili D, Matarese M, Vellone E, Riegel B. The influence of social support on self-care is mediated by self-efficacy and depression in chronic illness: key findings from the 'SODALITY'observational study. Aging & Mental Health. 2023 Apr 3;27(4):820-8.
https://doi.org/10.1080/13607863.2022.2056877
PMid:35416091
 
26. Huang Z, Liu T, Chair SY. Effectiveness of nurse-led self-care interventions on self-care behaviors, self-efficacy, depression and illness perceptions in people with heart failure: a systematic review and meta-analysis. International Journal of Nursing Studies. 2022 Aug 1;132:104255.
https://doi.org/10.1016/j.ijnurstu.2022.104255
PMid:35623153
 
27. Jang I. The effects of emotional regulation between clinical practice stress and nursing professionalism in nursing students. Journal of the Korean Data and Information Science Society. 2016;27(3):749-61.
https://doi.org/10.7465/jkdi.2016.27.3.749
 
28. Kim B, Kim J. Influence of uncertainty, depression, and social support on self-care compliance in hemodialysis patients. Therapeutics and Clinical Risk Management. 2019 Oct 22:1243-51.
https://doi.org/10.2147/TCRM.S218934
PMid:31695397 PMCid:PMC6815211
 
29. Docherty-Skippen SM, Hansen A, Engel J. Teaching and assessment strategies for nursing self-care competencies in Ontario's nursing education programs. Nurse Education in Practice. 2019 Mar 1;36:108-13.
https://doi.org/10.1016/j.nepr.2019.03.011
PMid:30909099
 
30. Jiang Y, Shorey S, Seah B, Chan WX, San Tam WW, Wang W. The effectiveness of psychological interventions on self-care, psychological and health outcomes in patients with chronic heart failure-A systematic review and meta-analysis. International Journal of Nursing Studies. 2018 Feb 1;78:16-25.
https://doi.org/10.1016/j.ijnurstu.2017.08.006
PMid:28935393
 
31. Devarajooh C, Chinna K. Depression, distress and self-efficacy: The impact on diabetes self-care practices. PloS one. 2017 Mar 31;12(3):e0175096.
https://doi.org/10.1371/journal.pone.0175096
PMid:28362861 PMCid:PMC5376339
 
32. Lewis S, Willis K, Bismark M, Smallwood N. A time for self-care? Frontline health workers' strategies for managing mental health during the COVID-19 pandemic. SSM-Mental health. 2022 Dec 1;2:100053.
https://doi.org/10.1016/j.ssmmh.2021.100053
PMid:34913042 PMCid:PMC8660664
 
33. Miller ST, Akohoue SA, Murry VM, Tabatabai M, Wilus D, Foxx A. SISTER (Sisters inspiring sisters to engage in relevant diabetes self-care) diabetes study: Protocol for diabetes medical nutrition therapy randomized clinical trial among African American women. Contemporary Clinical Trials. 2023 Feb 1;125:107052.
https://doi.org/10.1016/j.cct.2022.107052
PMid:36526256
 
34. Pallavicini F, Ferrari A, Mantovani F. Video games for well-being: A systematic review on the application of computer games for cognitive and emotional training in the adult population. Frontiers in psychology. 2018 Nov 7;9:2127.
https://doi.org/10.3389/fpsyg.2018.02127
PMid:30464753 PMCid:PMC6234876
 
35. Puig Llobet M, Sánchez Ortega M, Lluch‐Canut M, Moreno‐Arroyo M, Hidalgo Blanco MA, Roldán‐Merino J. Positive mental health and self‐care in patients with chronic physical health problems: Implications for evidence‐based practice. Worldviews on Evidence‐Based Nursing. 2020 Aug;17(4):293-300.
https://doi.org/10.1111/wvn.12453
PMid:32762130
 
36. Qin K, Lei D, Pinaya WH, Pan N, Li W, Zhu Z, Sweeney JA, Mechelli A, Gong Q. Using graph convolutional network to characterize individuals with major depressive disorder across multiple imaging sites. EBioMedicine. 2022 Apr 1;78.
https://doi.org/10.1016/j.ebiom.2022.103977
PMid:35367775 PMCid:PMC8983334
 
37. Vigo D, Haro JM, Hwang I, Aguilar-Gaxiola S, Alonso J, Borges G, Bruffaerts R, Caldas-de-Almeida JM, de Girolamo G, Florescu S, Gureje O. Toward measuring effective treatment coverage: critical bottlenecks in quality-and user-adjusted coverage for major depressive disorder. Psychological medicine. 2022 Jul;52(10):1948-58.
https://doi.org/10.1017/S0033291720003797
PMid:33077023 PMCid:PMC9341444
 
38. Waldron DA, Coyle C, Kramer J. Aging on the autism spectrum: Self-care practices and reported impact on well-being. Journal of Autism and Developmental Disorders. 2022 Aug;52(8):3512-22.
https://doi.org/10.1007/s10803-021-05229-9
PMid:34379240
 
39. Weiss A, Beloosesky Y, Gingold-Belfer R, Leibovici-Weissman Y, Levy Y, Mulla F, Issa N, Boltin D, Koren-Morag N, Meyerovitch J, Sharon E. Association of anemia with dementia and cognitive decline among community-dwelling elderly. Gerontology. 2022 Dec 1;68(12):1375-83.
https://doi.org/10.1159/000522500
PMid:35316810 PMCid:PMC9808713
 
40. Wyatt JP, Ampadu GG. Reclaiming self-care: self-care as a social justice tool for Black wellness. Community mental health journal. 2022 Feb 1:1-9.
 
41. Zhang F, Rao S, Cao H, Zhang X, Wang Q, Xu Y, Sun J, Wang C, Chen J, Xu X, Zhang N. Genetic evidence suggests posttraumatic stress disorder as a subtype of major depressive disorder. The Journal of clinical investigation. 2022 Feb 8;132(3).
https://doi.org/10.1172/JCI145942
PMid:33905376 PMCid:PMC8803333
 
42. Kazemi Rezaei SV, Kakabraee K, Hosseini SS. The effectiveness of emotion regulation skill training based on dialectical behavioral therapy on cognitive emotion regulation and quality of life of patients with Cardiovascular Diseases. Journal of Arak University of Medical Sciences. 2019 Sep 10;22(4):98-111
https://doi.org/10.32598/JAMS.22.4.90