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Abstract: African American daughters provide more care to debilitated family members and suffer more from hypertension, diabetes, and heart disease than their Caucasian counterparts, placing them at greater risk for poorer health outcomes from caregiving stress. This Neuman system model and stress process theory-based secondary data analysis was designed to investigate the direct and indirect effects of stressors and the direct effect of emotional support and coping on psychological and physical health outcomes in 106 African-American daughters who have functioned as caregivers for aging parents. Caregivers who reported greater role overload and higher care giving demands experienced more psychological symptoms. Those who reported self-mastery experienced fewer psychological symptoms and better physical health. These findings demonstrate daughters' vulnerability to the deleterious effects of stressors on psychological and physical health as caregiving demands increased.
Key Words: Informal Caregiver, Stress Process Theory, Caregiving, African-Americans, Neuman System Model (NSM)
INTRODUCTION
Caregiving is a compelling problem in several developed countries (e.g., Europe, Japan, and South Korea) as rapid growth in the aging population occurs. For example, between 2005 and 2015, age 60 and over population increased 34%, from 49.8 million to 66.8 million worldwide (Administration for Community Living (ACL), 2016). The U.S. and global populations share of people 65 and older is expected to double, from 7.7% in 2010 to 15.6% in 2050 (Kochhar, 2014). The consequences of the 'sandwich generation' and stressors involved with taking care of an aging parent, primarily by daughters, are not unique to any one country (Graham, 2012). Daughters may be juggling parent care, employment and care for their own children and other family members (Amankwaa, 2017; Greenberg, 2002).
African-American caregivers are more likely than Caucasians Americans to cope with the added responsibility for care recipients who have dementia and stroke (American Heart Association News, 2017). As a result, a higher proportion of African-American caregivers report suffering physical and mental problems and therefore describe their own physical health as fair to poor (Family Caregiving Alliance (FCA), 2015; Pinquart & Sorenson, 2005).
Although some researchers underemphasize the magnitude of negative outcomes of caregiving in AfricanAmericans because of cultural and traditional values that make this group more resilient to the negative effects of caregiving (Dilworth-Anderson, Goodwin, & William, 2004; Lindauer, Harvath, Berry, & Wros, 2016), the...