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Purpose: Few empirical studies have compared the efficacy between psychoeducational (skill-building) approaches for reducing caregivers' psychological distress and interventions modeled after typical community-based support groups. We compare the impact of two distinct interventions on Anglo and Latino caregivers of elderly relatives with dementia. Design and Methods: The change from preassessment to postassessment (baseline to 3 months) for 213 female caregivers (122 Anglo and 91 Latino) is presented. They were seen weekly for 10 weeks in either the Coping With Caregiving psychoeducational program (instruction and practice in small groups to learn specific cognitive and behavioral skills) or in the Enhanced Support Group condition (guided discussion and empathic listening to develop reciprocal support within the group). Both programs were tailored to be sensitive to the cultural concerns of Anglo and Latino caregivers, and they were delivered in either English or Spanish by trained interventionists. Results: Overall, participants in the Coping With Caregiving condition reported a significant reduction in depressive symptoms, increased use of adaptive coping strategies, and a trend toward decreased use of negative coping strategies when compared with those in the Enhanced Support Group condition. Results were similar for both ethnic groups: there were no main effects for ethnicity, and no significant ethnicity by treatment interaction effects. Implications: This study provides empirical support that female caregivers benefit more from a skill-building approach to managing their distress than from support group membership alone. We find it very encouraging that the Latino caregivers responded well on key outcome variables, suggesting that Latinos will participate in clinical research and will benefit from their involvement when services are provided to meet their specific needs.

Ethnographic descriptions suggest that cultures differ in the extent to which they value physical touch and its acceptability in different kinds of social relationships. For example, compared to European American (EA) culture, Mexican culture is described as placing greater emphasis on warm interpersonal interactions, in which touch may play an important part. We tested this notion empirically by assessing attitudes about touch among 271 Mexican American (MA; 208 female) and 578 EA (434 female) college students. Specifically, we examined potential ethnic group differences in (1) participants' perception of the acceptability of affectionate touch (AT) within their cultures, depending on the relationship (close others vs. acquaintances) and setting (private vs. public) in which the touch occurs; and (2) participants' own personal comfort with AT. Among MAs, we examined associations between touch attitudes and acculturation. As predicted, MAs reported greater cultural acceptability of AT with acquaintances (but not close others) and in public (but not private) settings than did EAs. Participants' own comfort with AT was greater for both MA men and EA women than for EA men. Further, higher perceived cultural acceptability of AT predicted greater personal comfort with AT in both ethnic groups. Finally, among MAs, greater acculturation predicted less comfort with AT. Together, these results lend support to the notion that MA ethnocultural norms encourage AT in nonintimate contexts to a greater degree than EA norms, particularly for men, and that personal attitudes about AT are largely congruent with these norms. They also call attention to cross-cultural similarities in attitudes about touch in more intimate contexts. [ABSTRACT FROM AUTHOR]

Purpose: Specific stressors associated with caregiving in Mexican American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. This article describes these understudied families who are poorly served by contemporary health systems because their characteristics are unknown. Design: Descriptive, multisite, longitudinal mixed-methods study of MA caregiving families. Findings: We identified three types of collective caregivers: those providing care for multiple family members simultaneously, those providing care successively to several family members, and/or those needing care themselves during their caregiving of others. Discussion and Conclusions: Collective caregiving of MA elders warrants further investigation. Implications for Practice: Exploration of collective caregiving may provide a foundation for tailored family interventions. [ABSTRACT FROM AUTHOR]

Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the “point of reckoning” in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a “reckoning point” that initiated the caregiving trajectory, while eight cited “gradual decline” into caregiving for elders in their homes. This “reckoning point,” which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families. [ABSTRACT FROM AUTHOR]

This report extends knowledge about the informal caregiving trajectory in Mexican American (MA) families, constituting the second known empirical study of the emerging phenomenon of personal care by (MA) sons for their aging mothers, previously reported by our research team. It uses life course perspective (LCP) to compare caregiving patterns over time through case-based comparative-historical methods. “Historical” within-case analysis searches for themes, while “comparative” cross-case analysis allows exploration of themes across multiple cases, enabling examination of eight cases of caregiving MA sons who were currently providing personal care or confronting the imminent need to do so. We used the comparative-historical technique of pattern matching to determine the worth of LCP for exploration of MA family caregiving, test data-derived theoretical propositions, and function as a template for combining multiple methods. Qualitative findings were buttressed in this sub-analysis of a parent study by results from a battery of variable-oriented scales. [ABSTRACT FROM AUTHOR]

This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry. [ABSTRACT FROM AUTHOR]