Two models of caregiver strain and bereavement adjustment: a comparison of husband and daughter caregivers of breast cancer hospice patients

Abstract

Purpose: Caregiver bereavement adjustment literature suggests opposite models of impact of role strain on bereavement adjustment after care-recipient death-a Complicated Grief Model and a Relief Model. This study tests these competing models for husband and adult-daughter caregivers of breast cancer hospice patients.

Design and methods: This study used secondary data from the National Hospice Study ( Greer & Mor, 1987). Stepwise multiple regression analyses, using caregiver's age and two formulations of prebereavement caregiver role strain as independent variables, predicted grief and despair bereavement adjustment as dependent variables.

Results: Data from husbands supported a Complicated Grief Model, as greater empirically derived (anxiety and depression symptoms) and theoretically derived (psychological and health strain) caregiver role strain formulations both predicted more difficult bereavement adjustment for husbands. Neither model was supported for adult daughters, as neither formulation of caregiver role strain predicted daughters' bereavement adjustment. Older caregiver age predicted better bereavement adjustment for both husbands and daughters. Adult daughters experienced more caregiver role strain than husbands did.

Implications: The family role relationship between caregiver and patient (husband-wife vs. daughter-mother relationship) affects how caregiving factors influence bereavement adjustment.