Date of Award
Doctor of Philosophy (PhD)
Purpose and Objectives: The purpose of this study was to explore dementia family caregivers' appraisals of communication behaviors and strategies, and their relationships to caregiver burden. Study objectives were to investigate: 1) the relationship between frequency of dementia-related communication behaviors and caregivers' appraisals of frustration; 2) the relationship between caregivers' use of communication strategies and appraisals of helpfulness; 3) the structural relationships between communication behavior appraisal, communication strategy appraisal, problem behaviors, and caregiver burden; and 4) caregiver education level as a moderating variable of the final structural model. Methods: A written, mailed questionnaire was developed to capture dementia family caregivers' perceptions of communication behaviors, communication strategies, problem behaviors, and caregiver burden (N = 239). Results: Frequency and appraised frustration of the relatives' communication behaviors were significantly correlated (rs = 0.631, p < 0.001). Pairwise comparisons of frequency and appraisal revealed significant differences for 18 of 32 communication behaviors. The two behaviors rated highest for both frequency and frustration were: failure to retain instructions and repeated questions/comments. Frequency of use and appraised helpfulness of the caregivers' communication strategies were also significantly correlated (rs = 0.631, p < 0.001). Pairwise comparison of use and appraisal revealed strategy use was significantly greater than appraised helpfulness for 18 of 19 strategies. The two strategies rated highest for both use and helpfulness were: pay attention/actively listen and ask one question/give one instruction at a time. Results of structural equation modeling indicated that problem behaviors partially mediated the relationship between communication behavior appraisal and caregiver burden (z = 2.98, SE = 0.065, p < 0.003). Caregivers' education level did not moderate the mediated relationship. Caregivers' appraisals of communication strategies did not predict problem behaviors or caregiver burden. Conclusions: Findings underscore the importance of understanding communication in the context of dementia family caregiving and dementia family caregivers' perceptions of it. This study expands upon previous empirical investigations of the relationships between communication, problem behaviors, and caregiver burden.