Sense of coherence, coping and caregiver role overload.

The focus of the present study is to examine the relationship between Antonovsky's Sense of Coherence (SOC), the nature of patient pathology, situational coping responses, and role overload in Belgian primary caregivers to dementing and nondementing chronically ill family members (n = 126). The hypotheses that caregivers with a strong SOC are likely to cope in situationally-appropriate ways were confirmed. Sense of Coherence appears to have a protective effect, in the sense of being related to management of the meaning of the situation, the selection of realistic coping strategies, and the avoidance of potentially maladaptive or unhealthy behaviors. Multi-variate analyses revealed that SOC alone predicted 29% of the variance in role overload for caregivers to dementing patients, while strategies to manage the situation and symptoms of distress were the only significant, yet maladaptive, coping responses for caregivers to nondementing patients. It is arguable that these findings indicate a threshold effect of the nature of patient disability on the protective effects of the sense of coherence. The multi-dimensional impact of caring for a patient with a dementing disorder exerts a unique and particular strain, one that requires caregivers to be able to cope by redefining the meaning of their relationship with their dependent. The theoretical rationale for the hypothesized threshold effect is explored.