Contextual or general stress outcomes: making choices through caregiving appraisals.

This study contributes to the debate on general versus contextual measures of caregiver well-being through examining the differential relationships of caregiving appraisals to outcomes. Six dimensions of caregiving appraisal were examined as predictors of minor psychiatric symptoms, affect balance, and burden. Burden was high, symptoms were high, and affect was poor when caregivers held appraisals that reflected (a) low personal resiliency and (b) a conflict-ridden and dysfunctional relationship with the care receiver. When caregivers reported expending (c) considerable energy in maintaining their social networks, burden was also high, with some risk of symptoms, but affect was positive. The fourth appraisal, (d) a close loving caregiver-care receiver relationship, was positively correlated with general well-being, but was not related to burden. The fifth appraisal, (e) dealing with a heavy workload in providing care, was linked with poor affect, but neither symptoms nor burden. Finally, (f) caring at a distance was related to burden, but not to the general outcome measures. These findings suggest that the foci of research questions might be usefully located within an appraisal framework, and that this framework might then provide guidance for the choice of appropriate outcome variables. In many cases, however, a deeper understanding ensues from assessing both contextual and general well-being.