Middle Eastern Journal of Disability Studies

Abstract
Background & Objectives: Dementia or Alzheimer, a major neuro–cognitive disorder, is characterized by significant cognitive decline. Caring for Alzheimer patients is one of the most challenging types of care and leads to a decrease in the "mental health" of caregivers. Many caregivers of patients sometimes experience anxiety related to their health. Mental health is affected by different factors, such as ambiguity intolerance, a tendency arising from negative beliefs about ambiguity or uncertainty and its consequences and implications, which is an essential predictor of anxiety and mental health. Caregivers of Alzheimer patients may experience varying degrees of ambiguity due to their patient's physical condition, which makes them prone to physical and mental problems. The present study aimed to explain the structural pattern of the relationship between ambiguity intolerance and mental health symptoms with the mediation role of health anxiety in female caregivers of Alzheimer patients.
Methods: The research method was analytical correlational. The statistical population of this research included all the female caregivers of Alzheimer patients referred to the Alzheimer Association in Tehran City, Iran, in 2019. Of them, 320 people were selected voluntarily. The inclusion criteria were female gender, age over 25 years, history of caring for a patient with Alzheimer disease for more than one year, no simultaneous use of psychiatric drugs and psychotherapy, and no chronic physical diseases and hospitalization. By contacting the researcher after being fully informed about the research objectives, volunteers in the study sent their details and a manuscript to review the inclusion criteria and declare informed consent. Symptom Check List–90–Revised (Derogatis et al., 1976), Ambiguity Tolerance Scale–II (McLain, 2009), and Health Anxiety Questionnaire (Salkovskis et al. 2002) were used to collect data. Structural equation model and SPSS–24 and AMOS–24 software, and a significance level equal to 0.05 were used for data analysis.
Results: The present study showed that the hypothesized model had fitness with the collected data (χ²=70.63, χ²/df=1.91, CFI=0.975, GFI=0.943, AGFI=0.898, and RMSEA=0.067). In the present study, the direct path coefficient between ambiguity intolerance and mental health (p=0.001, β=0.250), the direct path coefficient between health anxiety and mental health (p=0.019, β=0.136), and the direct path coefficient between ambiguity intolerance and health anxiety (p=0.001, β=0.241) was positive and significant. In the present study, the indirect path coefficient between ambiguity intolerance and mental health was positive and significant (p=0.043, β=0.032).
Conclusion: Based on the findings of this research, health anxiety mediates the relationship between ambiguity intolerance and mental health in caregivers of Alzheimer patients. It is suggested that to increase the mental health caused by caring for Alzheimer patients, training courses should be held to focus on health anxiety and ambiguity intolerance in them.