A Relação Entre as Habilidades Sociais de Cuidadores de Idosos e seu Ajustamento Psicossocial

Queluz, Francine Náthalie Ferraresi Rodrigues; Barham, Elizabeth Joan; Prette, Zilda Aparecida Pereira Del

Francine Náthalie Ferraresi Rodrigues Queluz

Universidade São Francisco, Campinas-SP, Brazil

http://orcid.org/0000-0002-8869-6879

Elizabeth Joan Barham

Universidade Federal de São Carlos, São Carlos-SP, Brazil

http://orcid.org/0000-0002-7270-4918

Zilda Aparecida Pereira Del Prette

Universidade Federal de São Carlos, São Carlos-SP, Brazil

Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição e Ensino, São Carlos-SP, Brazil

http://orcid.org/0000-0002-0130-2911

Corresponding address: Francine Náthalie Ferraresi Rodrigues Queluz. Universidade São Francisco. Psicologia. Campinas-SP, Brazil. E-mail: francine.queluz@gmail.com

Francine Náthalie Ferraresi Rodrigues Queluz is a Postdoc Researcher of the Universidade São Francisco, Campinas-SP, Brazil.

Elizabeth Joan Barham is a Professor of Universidade Federal de São Carlos, São Carlos-SP, Brazil.

Zilda Aparecida Pereira Del Prette is a Professor of Universidade Federal de São Carlos at the Instituto Nacional de Ciência e Tecnologia sobre Comportamento, Cognição e Ensino, São Carlos-SP.

Authors’ Contribution: All authors made substantial contributions to the conception and design of this study, to data analysis and interpretation, and to the manuscript revision and approval of the final version. All the authors take public responsibility for the content of the manuscript.

Title	Authors
A social skills training program for adult caregivers	Robinson (1988Robinson, K. (1988). A social skills training program for adult caregivers. Advances in Nursing Science, 10(2), 59-72. doi:10.1097/00012272-198801000-00010 https://doi.org/10.1097/00012272-1988010... )
The relationship between social skills, social support, self-esteem, and burden in adult caregivers.	Robinson (1990Robinson, K. (1990). The relationships between social skills, social support, self-esteem and burden in adult caregivers. Journal of Advanced Nursing, 15(7), 788-795. doi:10.1111/j.1365-2648.1990.tb01908.x https://doi.org/10.1111/j.1365-2648.1990... )
Effects of two caregiver training programs on burden and attitudes toward help	Robinson and Yates (1994Robinson, K., & Yates, K. (1994). Effects of two caregiver-training programs on burden and attitude toward help. Archives of Psychiatric Nursing, 8(5), 312-319. doi:10.1016/0883-9417(94)90029-9 https://doi.org/10.1016/0883-9417(94)900... )
Evaluation of assertiveness as a predictor of burden among caregivers for Alzheimer’s patients	Muela, Torres, and Peláez(2001Muela, J. A., Torres, C. J., & Peláez, E. M. (2001). La evaluación de la asertividad como predictor de carga en cuidadores de enfermos de Alzheimer [Assessment of assertiveness as a predictor of burden in caregivers of Alzheimer’s patients]. Revista Española de Geriatría y Gerontología, 36(1), 41-45. doi:10.1016/S0211-139X(01)74681-1 https://doi.org/10.1016/S0211-139X(01)74... )
Caregivers of the elderly with Alzheimer’s disease: Effects of psychoeducational groups and individualized, in-home support	Faleiros (2009Faleiros, D. A. M. (2009). Cuidadores de idosos com doença de Alzheimer: Efeitos de grupos psico-educacionais e suporte domiciliar individualizado [Caregivers of elderly people with Alzheimer’s disease: Effects of psycho-educational groups and individualized home support] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/3013/2397.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
A psycho educational intervention program for caregivers of patients with dementia	Dornelles (2010Dornelles, A. R. A. (2010). Uma intervenção psicoeducativa com cuidadores de idosos com demência [A psychoeducational intervention with caregivers of elderly people with dementia] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/6009/2969.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
Assessment of self-perceived social competency of caregivers in dementia care: Development and psychometric testing of the SOKO dementia	Franzmann, Krause, Haberstroh, and Pantel (2014Franzmann, J., Krause, K., Haberstroh, J., & Pantel, J. (2014). Assessment of self-perceived social competencies of caregivers in dementia care: Development and psychometric testing of the SOKO dementia. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 27(2), 67-73. doi:10.1024/1662-9647/a000103 https://doi.org/10.1024/1662-9647/a00010... )
Development of a psychoeducational program in emotional intelligence for primary caregivers of Alzheimer patients	Maciá and López (2014Maciá, E. S., & López, B. B. (2014). Desarrollo de un programa psicoeducativo en inteligencia emocional para cuidadores principales de enfermos de Alzheimer [Development of a psychoeducational program in emotional intelligence for primary caregivers of Alzheimer’s patients]. European Journal of Investigation in Health, Psychology and Education, 4(3), 257-266. doi:10.1989/ejihpe.v4i3.73 https://doi.org/10.1989/ejihpe.v4i3.73... )
Psychological wellbeing: Comparing caregivers who assisted dependent older adults, with and without dementia	Pinto and Barham (2014aPinto, F. N. F. R., & Barham, E. J. (2014a). Bem-estar psicológico: Comparação entre cuidadores de idosos com e sem demência [Psychological wellbeing: A comparison between caregivers of older adults, with and without dementia]. Psicologia, Saúde & Doenças, 15(3), 635-655. doi:10.15309/14psd150307 https://doi.org/10.15309/14psd150307... )
Social skills and coping strategies: Relationships with psychological wellbeing among caregivers of elderly people with high dependency	Pinto and Barham (2014bPinto, F. N. F. R., & Barham, E. J. (2014b). Habilidades sociais e estratégias de enfrentamento de estresse: Relação com indicadores de bem-estar psicológico em cuidadores de idosos de alta dependência [Social skills and coping strategies: Their relationship with psychological wellbeing among caregivers of highly dependent elderly people]. Revista Brasileira de Geriatria e Gerontologia , 17(3), 525-539. doi:10.1590/1809-9823.2014.13043 https://doi.org/10.1590/1809-9823.2014.1... )
Interpersonal conflicts among family caregivers of the elderly: The importance of social skills	Pinto et al. (2016Pinto, F. N. F. R., Barham, E. J., & Del Prette, Z. A. P. (2016). Interpersonal conflicts among family caregivers of the elderly: The importance of social skills. Paidéia (Ribeirão Preto), 26(64), 161-170. doi:10.1590/1982-43272664201605 https://doi.org/10.1590/1982-43272664201... )

Objectives	Authors
To verify if caregivers in a group that received SS training had lower perceptions of burden than caregivers in a control group.	Robinson (1988Robinson, K. (1988). A social skills training program for adult caregivers. Advances in Nursing Science, 10(2), 59-72. doi:10.1097/00012272-198801000-00010 https://doi.org/10.1097/00012272-1988010... )
To verify the relationship between social skills and self-esteem, social support and burden.	Robinson (1990Robinson, K. (1990). The relationships between social skills, social support, self-esteem and burden in adult caregivers. Journal of Advanced Nursing, 15(7), 788-795. doi:10.1111/j.1365-2648.1990.tb01908.x https://doi.org/10.1111/j.1365-2648.1990... )
To verify what type of intervention gave more benefits to the caregivers: a behavioral management program or a SS training program.	Robinson & Yates (1994Robinson, K., & Yates, K. (1994). Effects of two caregiver-training programs on burden and attitude toward help. Archives of Psychiatric Nursing, 8(5), 312-319. doi:10.1016/0883-9417(94)90029-9 https://doi.org/10.1016/0883-9417(94)900... )
To verify if there was a relationship between caregivers’ assertiveness and their perceptions of burden.	Muela et al.(2001Muela, J. A., Torres, C. J., & Peláez, E. M. (2001). La evaluación de la asertividad como predictor de carga en cuidadores de enfermos de Alzheimer [Assessment of assertiveness as a predictor of burden in caregivers of Alzheimer’s patients]. Revista Española de Geriatría y Gerontología, 36(1), 41-45. doi:10.1016/S0211-139X(01)74681-1 https://doi.org/10.1016/S0211-139X(01)74... )
To verify if a group that received psychoeducational support (including SS training) and help in using these concepts would have lower perceptions of burden, fewer symptoms of depression and better quality of life, compared to a control group.	Faleiros (2009Faleiros, D. A. M. (2009). Cuidadores de idosos com doença de Alzheimer: Efeitos de grupos psico-educacionais e suporte domiciliar individualizado [Caregivers of elderly people with Alzheimer’s disease: Effects of psycho-educational groups and individualized home support] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/3013/2397.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
To evaluate the impact of an in-home intervention program on perceptions of burden, social skills and stress reported by caregivers.	Dornelles (2010Dornelles, A. R. A. (2010). Uma intervenção psicoeducativa com cuidadores de idosos com demência [A psychoeducational intervention with caregivers of elderly people with dementia] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/6009/2969.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
To evaluate the psychometric evidence of a questionnaire to measure social competence among paid caregivers of institutionalized older adults with dementia.	Franzmann et al. (2014Franzmann, J., Krause, K., Haberstroh, J., & Pantel, J. (2014). Assessment of self-perceived social competencies of caregivers in dementia care: Development and psychometric testing of the SOKO dementia. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 27(2), 67-73. doi:10.1024/1662-9647/a000103 https://doi.org/10.1024/1662-9647/a00010... )
To identify the influence of social skills and emotional intelligence on caregivers of older adults with Alzheimer’s disease, and evaluate the impact of an intervention program offered to caregivers.	Maciá & López (2014Maciá, E. S., & López, B. B. (2014). Desarrollo de un programa psicoeducativo en inteligencia emocional para cuidadores principales de enfermos de Alzheimer [Development of a psychoeducational program in emotional intelligence for primary caregivers of Alzheimer’s patients]. European Journal of Investigation in Health, Psychology and Education, 4(3), 257-266. doi:10.1989/ejihpe.v4i3.73 https://doi.org/10.1989/ejihpe.v4i3.73... )
To compare two groups of caregivers (one with people who were taking care of a dependent but lucid, older family member, and a second with people who took care of older relatives who were dependent and had dementia), regarding their perceptions of burden, quality of their relationship with their older relative, coping strategies and SS of the caregivers.	Pinto & Barham (2014aPinto, F. N. F. R., & Barham, E. J. (2014a). Bem-estar psicológico: Comparação entre cuidadores de idosos com e sem demência [Psychological wellbeing: A comparison between caregivers of older adults, with and without dementia]. Psicologia, Saúde & Doenças, 15(3), 635-655. doi:10.15309/14psd150307 https://doi.org/10.15309/14psd150307... )
To verify the relationship between SS and coping strategies, perceptions of burden, and quality of the relationship.	Pinto & Barham (2014bPinto, F. N. F. R., & Barham, E. J. (2014b). Habilidades sociais e estratégias de enfrentamento de estresse: Relação com indicadores de bem-estar psicológico em cuidadores de idosos de alta dependência [Social skills and coping strategies: Their relationship with psychological wellbeing among caregivers of highly dependent elderly people]. Revista Brasileira de Geriatria e Gerontologia , 17(3), 525-539. doi:10.1590/1809-9823.2014.13043 https://doi.org/10.1590/1809-9823.2014.1... )
To identify the main conflicts involved in the task of caring for an older relative and to identify the SS considered to be important to accomplish this task.	Pinto et al. (2016Pinto, F. N. F. R., Barham, E. J., & Del Prette, Z. A. P. (2016). Interpersonal conflicts among family caregivers of the elderly: The importance of social skills. Paidéia (Ribeirão Preto), 26(64), 161-170. doi:10.1590/1982-43272664201605 https://doi.org/10.1590/1982-43272664201... )

Evaluated variables	Authors
Burden, self-esteem and social support	Robinson (1988Robinson, K. (1988). A social skills training program for adult caregivers. Advances in Nursing Science, 10(2), 59-72. doi:10.1097/00012272-198801000-00010 https://doi.org/10.1097/00012272-1988010... )
Burden, self-esteem and social support	Robinson (1990Robinson, K. (1990). The relationships between social skills, social support, self-esteem and burden in adult caregivers. Journal of Advanced Nursing, 15(7), 788-795. doi:10.1111/j.1365-2648.1990.tb01908.x https://doi.org/10.1111/j.1365-2648.1990... )
Burden	Robinson and Yates (1994Robinson, K., & Yates, K. (1994). Effects of two caregiver-training programs on burden and attitude toward help. Archives of Psychiatric Nursing, 8(5), 312-319. doi:10.1016/0883-9417(94)90029-9 https://doi.org/10.1016/0883-9417(94)900... )
Burden	Muela et al.(2001Muela, J. A., Torres, C. J., & Peláez, E. M. (2001). La evaluación de la asertividad como predictor de carga en cuidadores de enfermos de Alzheimer [Assessment of assertiveness as a predictor of burden in caregivers of Alzheimer’s patients]. Revista Española de Geriatría y Gerontología, 36(1), 41-45. doi:10.1016/S0211-139X(01)74681-1 https://doi.org/10.1016/S0211-139X(01)74... )
Burden, depression and quality of life	Faleiros (2009Faleiros, D. A. M. (2009). Cuidadores de idosos com doença de Alzheimer: Efeitos de grupos psico-educacionais e suporte domiciliar individualizado [Caregivers of elderly people with Alzheimer’s disease: Effects of psycho-educational groups and individualized home support] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/3013/2397.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
Burden and stress	Dornelles (2010Dornelles, A. R. A. (2010). Uma intervenção psicoeducativa com cuidadores de idosos com demência [A psychoeducational intervention with caregivers of elderly people with dementia] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/6009/2969.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
Stress	Franzmannet al. (2014Franzmann, J., Krause, K., Haberstroh, J., & Pantel, J. (2014). Assessment of self-perceived social competencies of caregivers in dementia care: Development and psychometric testing of the SOKO dementia. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 27(2), 67-73. doi:10.1024/1662-9647/a000103 https://doi.org/10.1024/1662-9647/a00010... )
Emotional intelligence	Maciá and López (2014Maciá, E. S., & López, B. B. (2014). Desarrollo de un programa psicoeducativo en inteligencia emocional para cuidadores principales de enfermos de Alzheimer [Development of a psychoeducational program in emotional intelligence for primary caregivers of Alzheimer’s patients]. European Journal of Investigation in Health, Psychology and Education, 4(3), 257-266. doi:10.1989/ejihpe.v4i3.73 https://doi.org/10.1989/ejihpe.v4i3.73... )
Burden, coping and quality of the relationship	Pinto and Barham (2014aPinto, F. N. F. R., & Barham, E. J. (2014a). Bem-estar psicológico: Comparação entre cuidadores de idosos com e sem demência [Psychological wellbeing: A comparison between caregivers of older adults, with and without dementia]. Psicologia, Saúde & Doenças, 15(3), 635-655. doi:10.15309/14psd150307 https://doi.org/10.15309/14psd150307... )
Burden, coping and quality of the relationship	Pinto and Barham (2014bPinto, F. N. F. R., & Barham, E. J. (2014b). Habilidades sociais e estratégias de enfrentamento de estresse: Relação com indicadores de bem-estar psicológico em cuidadores de idosos de alta dependência [Social skills and coping strategies: Their relationship with psychological wellbeing among caregivers of highly dependent elderly people]. Revista Brasileira de Geriatria e Gerontologia , 17(3), 525-539. doi:10.1590/1809-9823.2014.13043 https://doi.org/10.1590/1809-9823.2014.1... )
Conflicts	Pinto et al. (2016Pinto, F. N. F. R., Barham, E. J., & Del Prette, Z. A. P. (2016). Interpersonal conflicts among family caregivers of the elderly: The importance of social skills. Paidéia (Ribeirão Preto), 26(64), 161-170. doi:10.1590/1982-43272664201605 https://doi.org/10.1590/1982-43272664201... )

Evidence	Authors
Caregivers who received social skills training had lower perceived burden when compared to the group that received no training in SS (control group).	Robinson (1988Robinson, K. (1988). A social skills training program for adult caregivers. Advances in Nursing Science, 10(2), 59-72. doi:10.1097/00012272-198801000-00010 https://doi.org/10.1097/00012272-1988010... )
Caregivers with lower perceptions of subjective burden had a higher score on the assertiveness scale.	Robinson (1990Robinson, K. (1990). The relationships between social skills, social support, self-esteem and burden in adult caregivers. Journal of Advanced Nursing, 15(7), 788-795. doi:10.1111/j.1365-2648.1990.tb01908.x https://doi.org/10.1111/j.1365-2648.1990... )
Caregivers who were trained in SS or in behavioral management strategies had lower perceptions of burden and more positive attitudes in relation to asking for help and requesting care provider services when compared to other caregivers.	Robinson and Yates (1994Robinson, K., & Yates, K. (1994). Effects of two caregiver-training programs on burden and attitude toward help. Archives of Psychiatric Nursing, 8(5), 312-319. doi:10.1016/0883-9417(94)90029-9 https://doi.org/10.1016/0883-9417(94)900... )
Caregivers who were more assertive had lower perceptions of burden.	Muela et al. (2001Muela, J. A., Torres, C. J., & Peláez, E. M. (2001). La evaluación de la asertividad como predictor de carga en cuidadores de enfermos de Alzheimer [Assessment of assertiveness as a predictor of burden in caregivers of Alzheimer’s patients]. Revista Española de Geriatría y Gerontología, 36(1), 41-45. doi:10.1016/S0211-139X(01)74681-1 https://doi.org/10.1016/S0211-139X(01)74... )
Caregivers who received SS training and guidance on how to manage stress showed a decrease in their perceptions of burden and an increase in their perceptions of quality of life.	Faleiros (2009Faleiros, D. A. M. (2009). Cuidadores de idosos com doença de Alzheimer: Efeitos de grupos psico-educacionais e suporte domiciliar individualizado [Caregivers of elderly people with Alzheimer’s disease: Effects of psycho-educational groups and individualized home support] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/3013/2397.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
Caregivers who received SS training reported lower stress and improved their SS scores, following the training program.	Dornelles (2010Dornelles, A. R. A. (2010). Uma intervenção psicoeducativa com cuidadores de idosos com demência [A psychoeducational intervention with caregivers of elderly people with dementia] (Master’s Thesis). Retrieved from https://repositorio.ufscar.br/bitstream/handle/ufscar/6009/2969.pdf?sequence=1 https://repositorio.ufscar.br/bitstream/... )
Paid caregivers working in an institution setting who had higher scores on the social competence instrument had lower perceptions of stress.	Franzmann et al. (2014Franzmann, J., Krause, K., Haberstroh, J., & Pantel, J. (2014). Assessment of self-perceived social competencies of caregivers in dementia care: Development and psychometric testing of the SOKO dementia. GeroPsych: The Journal of Gerontopsychology and Geriatric Psychiatry, 27(2), 67-73. doi:10.1024/1662-9647/a000103 https://doi.org/10.1024/1662-9647/a00010... )
There was no significant relationship between social skills and emotional intelligence. However, caregivers reported feeling better prepared to manage the daily activities related to their older relative.	Maciá and López (2014Maciá, E. S., & López, B. B. (2014). Desarrollo de un programa psicoeducativo en inteligencia emocional para cuidadores principales de enfermos de Alzheimer [Development of a psychoeducational program in emotional intelligence for primary caregivers of Alzheimer’s patients]. European Journal of Investigation in Health, Psychology and Education, 4(3), 257-266. doi:10.1989/ejihpe.v4i3.73 https://doi.org/10.1989/ejihpe.v4i3.73... )
Caregivers who helped an older relative with dementia reported higher perceptions of burden, greater difficulty in accepting criticism, and greater problems with emotional self-control than caregivers who assisted a dependent older relative with no signs of dementia.	Pinto and Barham (2014aPinto, F. N. F. R., & Barham, E. J. (2014a). Bem-estar psicológico: Comparação entre cuidadores de idosos com e sem demência [Psychological wellbeing: A comparison between caregivers of older adults, with and without dementia]. Psicologia, Saúde & Doenças, 15(3), 635-655. doi:10.15309/14psd150307 https://doi.org/10.15309/14psd150307... )
Caregivers who said they used coping strategies and social skills more frequently reported fewer conflicts with the older adult who they were caring for.	Pinto and Barham (2014bPinto, F. N. F. R., & Barham, E. J. (2014b). Habilidades sociais e estratégias de enfrentamento de estresse: Relação com indicadores de bem-estar psicológico em cuidadores de idosos de alta dependência [Social skills and coping strategies: Their relationship with psychological wellbeing among caregivers of highly dependent elderly people]. Revista Brasileira de Geriatria e Gerontologia , 17(3), 525-539. doi:10.1590/1809-9823.2014.13043 https://doi.org/10.1590/1809-9823.2014.1... )
The main conflicts involved in the context of caring for an older adult were differences of opinions and financial issues. The social skills considered most important were: expressing positive feelings, controlling aggressiveness, and discussing problems.	Pinto et al. (2016Pinto, F. N. F. R., Barham, E. J., & Del Prette, Z. A. P. (2016). Interpersonal conflicts among family caregivers of the elderly: The importance of social skills. Paidéia (Ribeirão Preto), 26(64), 161-170. doi:10.1590/1982-43272664201605 https://doi.org/10.1590/1982-43272664201... )

[1] Corresponding address: Francine Náthalie Ferraresi Rodrigues Queluz. Universidade São Francisco. Psicologia. Campinas-SP, Brazil. E-mail: francine.queluz@gmail.com

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A Relação Entre as Habilidades Sociais de Cuidadores de Idosos e seu Ajustamento Psicossocial

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