A Prediction Model for Unmet Needs of Elders with Dementia and Caregiving Experiences of Family Caregivers

재가치매 환자의 미충족요구와 가족부양자의 돌봄경험 예측모형

  • Choi, Sora (Department of Nursing, Chungbuk Health & Science University) ;
  • Park, Myonghwa (College of Nursing, Chungnam National University)
  • 최소라 (충북보건과학대학교 간호학과) ;
  • 박명화 (충남대학교 간호대학)
  • Received : 2016.01.24
  • Accepted : 2016.06.19
  • Published : 2016.10.31


Purpose: The purposes of this study were to develop and test a prediction model for caregiving experiences including caregiving satisfaction and burden in dementia family caregivers. Methods: The stress process model and a two factor model were used as the conceptual frameworks. Secondary data analysis was done with 320 family caregivers who were selected from the Seoul Dementia Management Survey (2014) data set. In the hypothesis model, the exogenous variable was patient symptomatology which included cognitive impairment, behavioral problems, dependency in activity of daily living and in instrumental activity of daily living. Endogenous variables were caregiver's perception of dementia patient's unmet needs, caregiving satisfaction and caregiving burden. Data were analysed using SPSS/WINdows and AMOS program. Results: Caregiving burden was explained by patient symptomatology and caregiving satisfaction indicating significant direct effects and significant indirect effect from unmet needs. The proposed model explained 37.8% of the variance. Caregiving satisfaction was explained by patient symptomatology and unmet needs. Mediating effect of unmet needs was significant in the relationship between patient symptomatology and caregiving satisfaction. Conclusion: Results indicate that interventions focusing on relieving caregiving burden and enhancing caregiver satisfaction should be provided to caregivers with high levels of dementia patients' unmet needs and low level of caregiving satisfaction.


Supported by : 한국연구재단


  1. Ministry of Health & Welfare. National dementia strategy 2013- 2015 [Internet]. Seoul: Author; 2012 [cited 2015 March 10]. Available from:
  2. Sung MR, Yi M, Lee DY, Jang HY. Overcoming experiences of family members caring for elderly patients with dementia at home. Journal of Korean Academy of Nursing. 2013;43(3):389-398.
  3. Cho E, Cho E, Kim SS. Effects of family relationship on burden of family caregivers of older adult with dementia. Journal of the Korean Gerontological Society. 2010;30(2):421-437.
  4. Lawton MP, Moss M, Kleban MH, Glicksman A, Rovine M. A two-factor model of caregiving appraisal and psychological well-being. Journal of Gerontology. 1991;46(4):P181-P189.
  5. Pearlin LI, Mullan JT, Semple SJ, Skaff MM. Caregiving and the stress process: an overview of concepts and their measures. The Gerontologist. 1990;30(5):583-594.
  6. Bass DM, Judge KS, Snow AL, Wilson NL, Looman WJ, McCarthy C, et al. Negative caregiving effects among caregivers of veterans with dementia. The American Journal of Geriatric Psychiatry. 2012;20(3):239-247. e31824108ca
  7. Orrell M, Hancock G. CANE: Camberwell assessment of need for the elderly. London, UK: Gaskell; 2004. p. 1-208.
  8. Gaugler JE, Mittelman MS, Hepburn K, Newcomer R. Identifying at-risk dementia caregivers following institutionalization: The nursing home admission-burden and nursing home admission-depression prognostic tools. Journal of Applied Gerontology. 2014;33(5):624-646.
  9. Lee YW, Lim JY, Kim JY, Cho HI, Ko GJ. A prediction model for caregiver burden and life satisfaction: Caring for a patient with dementia. Journal of Korean Gerontological Nursing. 2011;13(3): 204-214.
  10. Contador I, Fernandez-Calvo B, Palenzuela DL, Migueis S, Ramos F. Prediction of burden in family caregivers of patients with dementia: A perspective of optimism based on generalized expectancies of control. Aging & Mental Health. 2012;16(6):675-682.
  11. de Labra C, Millan-Calenti JC, Bujan A, Nunez-Naveira L, Jensen AM, Peersen MC, et al. Predictors of caregiving satisfaction in informal caregivers of people with dementia. Archives of Gerontology and Geriatrics. 2015;60(3):380-388.
  12. Hodge DR, Sun F. Positive feelings of caregiving among Latino Alzheimer's family caregivers: Understanding the role of spirituality. Aging & Mental Health. 2012;16(6):689-698.
  13. Hwang SS, Chang VT, Alejandro Y, Osenenko P, Davis C, Cogswell J, et al. Caregiver unmet needs, burden, and satisfaction in symptomatic advanced cancer patients at a Veterans Affairs(VA) medical center. Palliative & Supportive Care. 2003;1(4):319-329.
  14. Lim YM, Son GR, Song JA, Beattie E. Factors affecting burden of family caregivers of community-dwelling ambulatory elders with dementia in Korea. Archives of Psychiatric Nursing. 2008;22(4):226-234.
  15. Lee DY, Park M, Lee SJ, Kim YH, Kim JH, Kim HJ, et al. Dementia management survey for registered elders with dementia on the Seoul dementia management project. Seoul: Seoul Metropolitan Center for Dementia; 2014.
  16. Yu JP. The concept and understanding of structural equation modeling. Seoul: Hannare Publishing Co.; 2012. p. 1-567.
  17. Reynolds T, Thornicroft G, Abas M, Woods B, Hoe J, Leese M, et al. Camberwell Assessment of Need for the Elderly(CANE). Development, validity and reliability. The British Journal of Psychiatry. 2000;176:444-452.
  18. Nolan M, Grant G, Keady J. Assessing the needs of family carers: A guide for practitioners. Brighton, UK: Pavilion Publishing; 1998. p. 1-39.
  19. Andren S, Elmstahl S. Family caregivers' subjective experiences of satisfaction in dementia care: Aspects of burden, subjective health and sense of coherence. Scandinavian Journal of Caring Sciences. 2005;19(2):157-168.
  20. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: Correlates of feelings of burden. The Gerontologist. 1980;20(6):649-655.
  21. Bae KY, Shin IS, Kim SW, Kim JM, Yang SJ, Mun JU, et al. Care burden caregivers according to cognitive function of elderly persons. Journal of the Korean Society of Biological Therapies in Psychiatry. 2006;12(1):66-75.
  22. Park M, Sung M, Kim SK, Kim S, Lee DY. Multidimensional determinants of family caregiver burden in Alzheimer's disease. International Psychogeriatrics. 2015;27(8):1355-1364.
  23. Han EJ, Lee JM, Kwon JH, Shin SB, Lee JS. Factors related to family caregivers' burden with the community-dwelling disabled elderly under the long-term care insurance system. Health Policy and Management. 2014;24(1):71-84.
  24. Holst G, Edberg AK. Wellbeing among people with dementia and their next of kin over a period of 3 years. Scandinavian Journal of Caring Sciences. 2011;25(3):549-557.
  25. Goetzinger AM. Predictors of caregiver well-being and satisfaction: The development of a comprehensive model [dissertation]. Kansas City, MO: University of Missouri-Kansas City; 2008. p. 1-165.
  26. National Collaborating Centre for Mental Health. Dementia: A NICE-SCIE guideline on supporting people with dementia and their carers in health and social care [Internet]. London, UK: The British Psychological Society, The Royal College of Psychiatrists; 2007 [cited 2015 December 21]. Available from:
  27. Bass DM, Judge KS, Snow AL, Wilson NL, Morgan R, Looman WJ, et al. Caregiver outcomes of partners in dementia care: Effect of a care coordination program for veterans with dementia and their family members and friends. Journal of the American Geriatrics Society. 2013;61(8):1377-1386.
  28. Kajiwara K, Nakatani H, Ono M, Miyakoshi Y. Positive appraisal of in-home family caregivers of dementia patients as an influence on the continuation of caregiving. Psychogeriatrics. 2015;15 (1):26-31.
  29. Park M, Park MH, Kim HH. Effects of a multimodal psychoeducational program on burden, depression, and problem coping behaviors in family caregivers of patients with dementia. Journal of Korean Gerontological Nursing. 2015;17(1):10-19.
  30. Shim B, Barroso J, Gilliss CL, Davis LL. Finding meaning in caring for a spouse with dementia. Applied Nursing Research. 2013 ;26(3):121-126.