A Mixed-Method Approach on Secure Attachment and its Effects on Caregivers of Older Adults Living at Home

A secure attachment style of informal caregivers is important for the care of older adults at home. Informal caregivers who have secure attachment style to care for older adults, can effectively provide care for older adults.

A sequential explanatory mixed-method design was introduced to study the factors predicting secure attachment and explain informal caregivers’ perceptions.

140 informal caregivers were selected from sub-district health-promoting hospitals from provinces in the northeastern Thailand by using the multi-stage random sampling method. The parameters included were caregivers’ personal information, satisfaction, empathy, health status, and caregivers’ attachment. Five experts in the field considered the content validity of all the measurements. The reliability of the four measurements was verified by applying Cronbach’s alpha coefficient, yielding 0.83, 0.70, 0.82 and 0.74. The researchers analyzed the data obtained from descriptive statistics and hierarchical regression analysis. A qualitative descriptive study was performed using semi-structured interviews, and data were analyzed using thematic analysis.

The results of quantitative data (a cross-sectional design) revealed that caregivers’ health status was considered the strongest predictor (β = .362, t = 5.208, p <.001) of secure attachment, followed by satisfaction, gender (female) and empathy. The qualitative data results revealed that four factors, i.e., caregivers’ healthy status, caregivers’ satisfaction, caregivers’ empathy, and female gender, could help the caregivers provide better care.

Informal caregivers with good health status exhibited secure attachment. Healthcare teams and nurses should implement a program promoting good health status for informal caregivers who care for older adults at home.