Understanding the Multidimensionality of Caregiving Appraisal: A Concept Analysis

Caregiving appraisal refers to how caregivers evaluate their caregiving situation. However, this concept, first introduced by Lawton et al. in 1989, has been inconsistently defined (e.g., often inaccurately interchanged with caregiving burden) over the past three decades. As the landscape of healthcare advances and caregiver roles evolve, it is crucial to re-evaluate the concept of caregiving appraisal. This concept analysis aimed to achieve conceptual clarity and to understand the multidimensionality of caregiving appraisal. Using Rodgers’ evolutionary model, our analysis systematically searched six databases, identifying 86 relevant studies that revealed various definitions and dimensions of caregiving appraisal. The concept analysis clarifies that caregiving appraisal involves subjective cognitive evaluations and assessments by caregivers, encompassing cognitive and affective responses, and the re-evaluation of potential stressors and one’s coping ability. Caregiving appraisal is a multidimensional construct that can be neutral, positive, or negative. Different dimensions of caregiving appraisal can occur simultaneously. Additionally, caregiving appraisal acts as a mediator between caregivers’ objective stress and their reactions to that stress. In this analysis, we defined the action of appraising unspecified stress in a caregiving situation as the general (or broad) definition of caregiving appraisal and the action of appraising specified stress as the specific (or narrow) definition (e.g., illness severity caregiving appraisal and social support caregiving appraisal). Caregiving appraisal encompasses four key categories: caregivers appraising their own situation, caregivers assessing the care recipient’s situation, caregivers evaluating personal capabilities, and caregivers evaluating the caregiver–care receiver relationship. This conceptual analysis underscores the imperative need to reassess Lawton’s caregiving appraisal model and refine measurement tools in line with evolving healthcare practices. Future studies must clearly define caregiving appraisal, avoid using a single dimension to reflect holistic caregiving appraisal, and provide a valid reason for only focusing on one (or several) domain when using caregiving appraisal as the concept of interest.

Duke Scholars

Author Cristina Cu Hendrix School of Nursing

Author Michael Paul Cary School of Nursing

Author Sharron Rushton School of Nursing