Protective Factors for the Well-Being in Caregivers of Patients with Alzheimer’s: The Role of Relational Quality


The work highlights one of the direct stakeholders of RSA organization, the caregivers of patients with Alzheimer. It studies if and in which measure the caregivers’ level of health are strongly influenced by their perceived Relational Quality of the retirement homes in which their loved ones are hospitalized. Participants were 111 caregivers of patients with a diagnosis of dementia and recovered in RSA since at least 6 months. The study measures if the relational quality perceived by caregivers has a positive and direct influence on two mood states of caregivers: depression-dejection, anger-hostility. It also investigates if the protective function of relational quality remains significant also in presence of moderator variable such as social support and burden. The analysis confirms that increasing perceived relational quality corresponds to a decreased perception of caregivers’ discomfort humoral. The social support factor does not act as moderator, but it is confirmed the moderator role of burden. The research work provided some important empirical about the important role of caregivers retirement homes. They represent an emotional and relational link that connects the guest on one hand with the familiar net and on the other hand with the service operators. Therefore caregiver is a central resource, who needs protection and valorisation.

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Gozzoli, C. , Giorgi, A. & D’Angelo, C. (2013). Protective Factors for the Well-Being in Caregivers of Patients with Alzheimer’s: The Role of Relational Quality. Psychology, 4, 57-66. doi: 10.4236/psych.2013.46A1009.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Anderson, E. W., Fornell, C., & Lehmann, D. R. (1994). Customer satisfaction, market share, and profitability: Finding from Sweden. Journal of Marketing, 58, 53-66. doi:10.2307/1252310
[2] Balardy, L., Voisin, T., Cantet, C., & Vellas, B. (2005). Predictive factors of emergency hospitalization in Alzheimer’s patients: Results of one-year follow-up in the REAL. Fr Cohort. The Journal of Nutrition, Health & Aging, 9, 112-116.
[3] Bell, C. M., Araki., S. S., & Neumann, P. J. (2001). The association between caregiver burden and caregiver health-related quality of life in Alzheimer disease. Alzheimer Disease & Associated Disorders, 15, 129-136. doi:10.1097/00002093-200107000-00004
[4] Bolgerand, N., & Amarel, D. (2007). Effects of social support visibility on adjustment to stress: Experimental evidence. Journal of Personality and Social Psychology, 92, 458-475. doi:10.1037/0022-3514.92.3.458
[5] Caplan, G. (1974). Support system and community mental health. New York: Behavioral.
[6] Cigoli, V. (2006). L’albero della discendenza. Milano: Franco Angeli.
[7] Cigoli, V., Farina, M., & Gennari, M. (2008). Dalla valutazione della qualità relazionale all’assessment familiare nelle Residenze Sanitarie Assistenziali: Un programma di ricerca intervento. Giornale di Psicologia, 2, 19-30.
[8] Clipp, E. C., & Geroge, L. K. (1993). Dementia and cancer: A comparison of spouse caregiver. Gerontologist, 33, 534-541. doi:10.1093/geront/33.4.534
[9] Clyburn, L., Stones, M., Hadjistavropoulos, T., & Tuokko, H. (2000). Predicting caregiver burden and depression in Alzheimer’s disease. Journal of Gerontology: Social Sciences, 55B, S2-S13.
[10] Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences. Hillsdale, NJ: Erlbaum.
[11] Cohen J., & Cohen P. (1983). Applied multiple regression/correlation analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
[12] Cohen, S., & McKay, G. (1984). Social support, stress and the buffering hypothesis. A theoretical analysis. In A. Baum, J. E. Singer, & S. E. Taylor (Eds.), Handbook of psychology and health (pp. 253-267). Hillsdale, NJ: Erlbaum.
[13] Cotelli, M., Manenti, R, Cappa, S. F., Zanetti, O., & Miniussi, C. (2008). Transcranial magnetic stimulation improves naming in Alzheimer disease patients at different stages of cognitive decline. European Journal of Neurology, 15, 1286-1292. doi:10.1111/j.1468-1331.2008.02202.x
[14] Crespo, M, Lüpez, J., & Zarit, S. H. (2005). Depression and anxiety in primary caregivers: A comparative study of caregivers of demented and nondemented older persons. International Journal of Geriatric Psychiatry, 20, 591-92. doi:10.1002/gps.1321
[15] Dunkin, J. J., & Anderson-Hanley, C. (1998). Dementia caregiver burden: A review of the literature and guidelines for assessment and intervention. Neurology, 51, S53-S60. doi:10.1212/WNL.51.1_Suppl_1.S53
[16] Farnè, M., & Sebellico, A. (1986). Emotional reactions in stress conditions: The effect of boredom and mental overload. Bollettino della Società Italiana di Biologia Sperimentale, 62, 553-559.
[17] Farnè, M., Sebellico, A., Gnugnoli, D., & Corallo, A. (1991). POMS. Profile of Mood States: Adattamento italiano. Firenze: Organizzazioni Speciali.
[18] Ferrell, B. A., Ferrell, B. R., & Osterweil, D. (1990). Pain in the nursing home. Journal of the American Geriatric Society, 38, 409-414.
[19] Frazier, P. A., Tix, A. P., & Barron, K. E. (2004). Testing moderator and mediator effects in counseling psychology research. Journal of Counseling Psychology, 51, 115-134. doi:10.1037/0022-0167.51.1.115
[20] Gallicchio, L., Siddiqi, N., Langenberg, P., & Baumgarden, M. (2002). Gender differences in burden and depression among informal caregivers of demented elders in the community. International Journal of Geriatric Psychiatry, 17, 154-163. doi:10.1002/gps.538
[21] Gill, P., Kaur, J., Rummans, T., Novotny, P., & Sloan, J. (2003). The hospice patient’s primary caregivers. What is the quality of life? Journal of Psychosomatic Research, 55, 445-451. doi:10.1016/S0022-3999(03)00513-0
[22] Given, C. W., Given, B. A., Stommel, V., & Azzouz, F. (1999). The impact of new demands for assistance on caregiver depression: Tests using an inception cohort. Gerontologist, 39, 76-85. doi:10.1093/geront/39.1.76
[23] Gozzoli, C., & Frascaroli, D. (2012). Managing participatory action research in a health-care service experiencing conflicts. Qualitative Research in Organizations and Management: An International Journal, 7, 275-289. doi:10.1108/17465641211279752
[24] Grimes, D. A., & Schulz, K. F. (2002). An overview of clinical research: The lay of the land. Lancet, 359, 57-61. doi:10.1016/S0140-6736(02)07283-5
[25] Grossberg, G. T. (2003). Diagnosis and treatment of Alzheimer’s disease. The Journal of Clinical Psychiatry, 64, 3-6.
[26] Grunig, J. E. (1984). Managing public relations. New York: Harcourt, Brace, Jovanovich.
[27] Hennekens, C. H., & Buring, J. E. (1987). Epidemiology in medicine. Boston-Toronto: Little Brown and Company.
[28] Ishikawa, K. (1985). What is total quality control? The Japanese way. Englewood Cliffs, NJ: Prentice-Hall.
[29] Kahana, E., Young, R. F., Kerchir, K., & Kaczynski, R. (1993). Testing a symmetrical model of caregiving outcomes during recovery from heart attacks. Research on Aging, 15, 371-398. doi:10.1177/0164027593154001
[30] Kettinger, W. J., & Lee, C. C. (2005). Zones of tolerance: Alternative scales for measuring information systems service quality. MIS Quarterly, 29, 607-621.
[31] Marvardi, M., Mattioli, P., Spazzafumo, L., Mastriforti. R., Rinaldi, P., Polidori, M. C., & Mecocci, P. (2005). The caregiver burden inventtory in evaluating the burden of caregivers of elderly demented patients: Results from a multicenter study. Aging Clinical and Experimental Research, 17, 46-53.
[32] McBurney, D., & White, T. L. (2009). Research methods. Belmont, CA: Wadsworth Cengage Learning.
[33] McNair, D. M., Lorr, M., & Droppleman, L. F. (1981). Manual for the profile of the mood state. San Diego: Educational Testing Service.
[34] Miller, E. A., Allen, S. M., & Mor, V. (2009). Commentary: Navigating the labyrinth of long-term care: shoring up informal caregiving in a home and community-based world. Journal of Aging & Social Policy, 21, 1-16. doi:10.1080/08959420802473474
[35] Miller, E. A., Schneider, L. S., & Rosenheck, R. A. (2009b). Assessing the relationship between health utilities, quality of life, and health services use in Alzheimer’s disease. International Journal of Geriatric Psychiatry, 24, 96-105. doi:10.1002/gps.2160
[36] Nijoboer, C., Tempelaar, R., & Sanderman, R. (1998). Cancer and caregiving: The impact on the caregivers health. Psychooncology, 7, 3-13. doi:10.1002/(SICI)1099-1611(199801/02)7:1<3::AID-PON320>3.0.CO;2-5
[37] Novak, M., & Guest, C. (1989). Caregiver response to Alzheimer’s disease. The International Journal of Aging and Human Development, 28, 67-79. doi:10.2190/4W02-HLMK-HAMJ-UTQP
[38] Parasuraman A., Zeithaml, V. A., & Berry, L. L. (1994). Reassessment of expectations as a comparison standard in measuring service quality: Implications for further research. Journal of Marketing, 58, 111-124. doi:10.2307/1252255
[39] Parasuraman, A., Zeithaml, V. A., & Berry, L. L. (1988). SERVQUAL: A multiple item scale for measuring consumer perceptions of service quality. Journal of Retailing, 64, 12-40.
[40] Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. Gerontologist, 3, 583-594. doi:10.1093/geront/30.5.583
[41] Prezza, M., & Principato, M. C. (2002). La rete e il sostegno sociale. In M. Prezza, & M. santinello (Eds.), Conoscere la comunità (pp. 193-233). Bologna: Il Mulino.
[42] Sube, B., Rosalind, W., Nori, G., & Barry, J. G. (2010). The Stroud/ ADI Dementia Quality Framework: A cross-national population-level framework for assessing the quality of life impacts of services and policies for people with dementia and their family carers. International Journal of Geriatric Psychiatry, 25, 249-257. doi:10.1002/gps.2330
[43] Tamanza, G. (1998). La malattia del riconoscimento: L’Alzheimer, le relazioni familiari, il processo di cura. Milano: Unicopli.
[44] Tamanza, G. (2001). Anziani. Milano: Franco Angeli.
[45] Tanese, A., Negro, G., & Gramigna, A. (2003). La customer satisfaction nelle amministrazioni pubbliche. Valutare la qualità percepita dai cittadini. Cantieri-Analisi e strumenti per l’innovazione, I Manuali. Roma: Rubbettino.
[46] Taylor, S. E., Lichtman R. R, Wood, J. V., Bluming, A. Z., Dosik, G. M., & Leibowitz R. L. (1985). Illness related and treatment related factors in psychological adjustment to breast cancer. Cancer, 55, 2506-2513. doi:10.1002/1097-0142(19850515)55:10<2506::AID-CNCR2820551033>3.0.CO;2-0
[47] Zanella, A., & Cerri, M. (2000). La misura di customer satisfaction: Qualche riflessione sulla scelta delle scale di punteggio. In AA.VV. Valutazione della qualità e customer satisfaction: Il ruolo della statistica. Milano: Vita e Pensiero.
[48] Zanetti, O., Frisoni, G. B., Bianchetti, G., Tamanza, G., Cigoli, V. & Trabucchi, M. (1998). Depressive symptoms of Alzheimer caregivers are mainly due to personal rather than patient factors. International Journal of Geriatric Psychiatry, 13, 358-367. doi:10.1002/(SICI)1099-1166(199806)13:6<358::AID-GPS772>3.0.CO;2-J
[49] Zarit, S. H., & Toseland, R. W. (1989). Current and future direction in family caregiving research. Gerontologist, 29, 481-483. doi:10.1093/geront/29.4.481
[50] Zimet, G., Dahlem, N., Zimet, S., & Farley, G. (1988). The multidimensional scale of perceived social support. Journal of Personality Assessment, 52, 30-41. doi:10.1207/s15327752jpa5201_2

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