Coping strategies among family caregivers of community-dwelling older adults in Lebanon amid the economic crisis

经济危机下黎巴嫩社区老年人家庭照护者的应对策略

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Abstract

BACKGROUND: Adopting effective and adaptable coping strategies can help reduce the distress associated with the caregiving burden. Studies assessing coping strategies among caregivers of older adults in the Arab world remain limited. This study aims to assess the coping strategies employed by caregivers of older adults in Lebanon, investigate factors associated with these coping mechanisms, and examine whether social support mediates the relationship between psychological distress and coping amid Lebanon's ongoing economic crisis. METHODS: In this cross-sectional study, 544 caregivers of community-dwelling older adults participated. Data were collected online via Google Forms and included several instruments: a socio-demographic questionnaire, the Brief Coping Orientation to Problems Experienced Inventory Scale, the Katz Index of Activities of Daily Living, the Autonomy in Daily Functioning-Contemporary Scale, the Depression, Anxiety, and Stress Scale, and the Multidimensional Scale of Perceived Social Support. Generalized linear models were used to identify factors associated with different coping strategies. RESULTS: Caregivers primarily relied on problem-focused coping strategies to manage stress, with an average score of 5.73 (standard deviation [SD] = 1.22). Among the various coping methods, religious coping was the most frequently used, with a mean score of 6.82 (SD = 1.50), while substance use was the least commonly adopted, scoring an average of 2.57 (SD = 1.24). Higher household income was significantly associated with greater use of problem-focused coping (B = 0.352; p-value = 0.003). Additionally, higher educational attainment was linked to increased use of problem-focused (B = 0.240; p-value = 0.044) and emotion-focused coping strategies (B = 0.284; p-value = 0.024). Psychological distress was inversely related to emotion-focused and problem-focused coping but showed a positive correlation with avoidance coping. Social support was positively correlated with both emotion-focused coping (B = 0.881; p-value < 0.001) and problem-focused coping (B = 1.005; p-value < 0.001) and partially mediated the association between coping methods and psychological distress. CONCLUSION: Lebanese caregivers primarily rely on adaptive coping strategies to manage ongoing difficulties and rarely resort to maladaptive approaches. The findings emphasize the need for caregiver support initiatives that are culturally relevant and psychologically supportive, acknowledging the significant influence of socioeconomic status, psychological distress, and social support on coping behaviors.

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