Caregiver Psychological Distress as a Barrier to Influenza Vaccination Among Community-Dwelling Elderly With Dementia

OBJECTIVE: This study examined whether informal caregiver psychologic distress decreases the likelihood of influenza vaccination for community-dwelling elderly with dementia. A secondary aim was to determine whether psychologic distress mediates the relationship between other predisposing, enabling, and medical need variables and vaccination. METHODS: Data were drawn from the 1998 National Longitudinal Caregiver Survey. The final sample consisted of 1406 community-dwelling male veterans with dementia and their coresiding female informal caregivers. Presence of caregiver psychologic distress was measured using the Boston Short Form of the Center for Epidemiologic Studies Depression Scale. Vaccination was identified by examining Veteran Administration Outpatient Data Files for visits indicating influenza vaccine administration during the 1998 influenza vaccine season (September 1 to December 31). Multivariate path analysis with observed variables was used to estimate direct and indirect probit path coefficients between independent variables, caregiver psychologic distress, and veteran vaccination. RESULTS: As hypothesized, caregiver distress was significantly associated with a decreased likelihood of care-recipient vaccination (unstandardized coefficient [b] = -0.023, P < 0.01). Adjusted for other variables, the predicted probability of vaccination was 37.7% for care-recipients with nondistressed caregivers compared with 29.4% for care-recipients with distressed caregivers. Furthermore, a number of factors significantly influenced vaccination via their influence on psychologic distress. CONCLUSION: We conclude that caregiver psychologic distress may interfere with access to influenza vaccination in persons with dementia. Access to vaccination may be improved directly by detecting and treating emotional health problems in caregivers and indirectly by addressing precursors to caregiver distress

Caregiver burden · Dementia · Depression (economics) · Disease · Distress · Multivariate analysis · Path analysis (statistics) · Psychiatry · Vaccination · Clinical Psychology · Dementia and Cognitive Impairment Research · Family Caregiving in Mental Illness · Immunology · Influenza Virus Research Studies · Internal Medicine · Medicine · Gerontology

• Racial and Ethnic Disparities in the Treatment of Dementia Among Medicare Beneficiaries

  Ilene H Zuckerman, Priscilla T Ryder et al.•The Journals of Gerontology…•2008

  Añadir item

• Influenza vaccine uptake among community-dwelling Italian elderly

  Open Access•Carlos Chiatti, Pamela Barbadoro et al.•BMC Public Health•2011

  Añadir item

• Rural-Urban Differences in Preventable Hospitalizations Among Community-Dwelling Veterans With Dementia

  Open Access•Joshua M Thorpe, Courtney H Van Houtven et al.•The Journal of Rural Health•2010

  Añadir item

• Depressive Symptoms and Reduced Preventive Care Use in Older Adults

  Joshua M Thorpe, Carolyn T Thorpe et al.•Medical Care•2012

  Añadir item

• The Association of Age and Depression Among the Elderly

  Dan G Blazer, D Blazer et al.•Journal of Gerontology•1991

  Añadir item

• Psychiatric and Physical Morbidity Effects of Dementia Caregiving

  R Schulz, Alison T O'Brien et al.•The Gerontologist•1995

  Añadir item

• Collaborative Care Management of Late-Life Depression in the Primary Care Setting

  Jürgen Unützer, Wayne Katon et al.•JAMA•2002

  Añadir item

• Depression Is a Risk Factor for Noncompliance With Medical Treatment

  M Robin Dimatteo, Heidi S Lepper et al.•A.M.A. Archives of Internal…•2000

  Añadir item

• Racial, Ethnic, and Cultural Differences in Dementia Caregiving

  Christian M Connell, G D Gibson•The Gerontologist•1997

  Añadir item

• Validation of a Caregiver Strain Index

  Betsy C Robinson•Journal of Gerontology•1983

  Añadir item

• Multiple Imputation of Missing Values

  Open Access•Patrick Royston•The Stata Journal: Promoting…•2004

  Añadir item

• Mortality Associated With Influenza and Respiratory Syncytial Virus in the United States

  W Thompson, William W Thompson et al.•JAMA•2003

  Añadir item

• The CES-D Scale

  Open Access•Lenore Sawyer Radloff•Applied Psychological Measurement•1977

  Añadir item

• Two Shorter Forms of the CES-D Depression Symptoms Index

  Open Access•Frank J Kohout, Lisa F Berkman et al.•Journal of Aging and Health•1993

  Añadir item

• Alternative models of the stress buffering hypothesis

  Open Access•Richard Landerman, L K George et al.•American Journal of Community…•1989

  Añadir item

• Psychological Distress as a Barrier to Preventive Care in Community-Dwelling Elderly in the United States

  Joshua M Thorpe, Carolyn T Kalinowski et al.•Medical Care•2006

  Añadir item

• Influenza Vaccination, Hospitalizations, and Costs Among Members of a Medicare Managed Care Plan

  James W Davis, Eugene Lee et al.•Medical Care•2001

  Añadir item

• Equity of Access to Medical Care

  Lu Ann Aday, Ronald Andersen et al.•Medical Care•1981

  Añadir item

• Older Patients with Serious Mental Illness

  John F Mccarthy, Frederic C Blow•Medical Care•2004

  Añadir item

• Sociological Methodology 1980

  Lewis F Carter, Karl F Schuessler et al.•Contemporary Sociology A Journal…•1981

  Añadir item

• Caregiving and the Stress Process

  Leonard I Pearlin, Joseph T Mullan et al.•The Gerontologist•1990

  Añadir item

• Distance and health care utilization among the rural elderly

  Open Access•Gregory F Nemet, Adrian J Bailey•Social Science & Medicine•2000

  Añadir item