Objective: The purpose of this study was to compare the emotional and immunological effects of relaxation therapy (RT) for male and female caregivers of patients with Alzheimer’s disease using bioinstrumentation monitoring, quality of life measurements, and immune function in caregivers of Alzheimer’s patients.
Sample: Family spousal caregivers (females=23 with average age 69.5; males=11 with average age 71.4) were enrolled in the study.
Design: Caregivers were taught to practice relaxation at home using a 30-minute relaxation tape for 8 weeks. Testing was done at weeks 0, 4, and 8 after beginning RT. Two months after the RT intervention was completed, subjects were tested again. Exit interviews were conducted.
Methods: Caregivers completed questionnaires that assessed psychosocial variables. During each testing session blood was drawn and natural killer (NK) cell number and cytotoxicity (NKC) were determined using flow cytometry. The degree of relaxation was determined using bioinstrumentation to measure muscle tension (EMG) in the frontalis and trapezius muscles, electrodermal response (EDG), and skin temperature.
Intervention and Outcome Variables: RT was the intervention. Outcome variables were NK cell number and NKC, stress, depression, anger/hostility, anxiety, caregiver burden, and bioinstrumentation parameters.
Results: At the beginning of the study males (as compared to the females) had significantly lower levels of stress, depression, caregiver burden, anxiety, anger-hostility, mental health scores, and somatic symptoms and higher levels of sense of coherence and social and physical functioning. There were no statistically significant differences between the 2 groups in coping resources or T, T helper, T suppressor, or activated T cells, or NK cell number or function.
Repeated measures analysis indicated that over the course of the study both groups had decreases in stress, caregiver burden, anxiety, anger-hostility, and increases in mental health scores. However, at the end of the study the scores on these measurements for females were higher than that for males indicating greater emotional distress for females. Although male caregivers showed significant decreases in depression, there were no significant changes in depression for females. Interestingly, the females showed greater improvement than males in NK cell number and function. The bioinstrumentation parameters showed the both male and female spousal caregivers improved their ability to relax as indicated by EMG, skin temperature, and EDG measurements. Exit interviews indicated that male spousal caregivers found more time to take care of themselves than the female spousal caregivers.
Conclusion: The results of this study indicate that RT is an effective intervention in enhancing quality of life, improving immune function, and promoting the relaxation response. Overall the RT intervention was an effective intervention for improving emotional distress for both male and female caregivers with the males having greater improvement in emotional distress and females more improvement in NK function. Both groups perceived RT to be an effective technique in reducing stress. They consistently described an increased sense of self-control. Caregivers learned their well being is essential to being an effective caregiver.
Implications: Strategies need to be developed and implemented to assist the increasing number of caregivers as our society ages. Caregivers experience a great deal of stress that can adversely affect their emotional and physical well being. RT is an effective self-management technique that can empower both male and female caregivers to gain control of their lives.
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