ORIGINAL RESEARCH: EMPIRICAL RESEARCH – QUANTITATIVE The association between positive–negative reactions of informal caregivers of people with dementia and health outcomes in eight European countries: a cross-sectional study M. Carme Alvira*, Ester Risco*, Esther Cabrera, Marta Farr e, Ingalill Rahm Hallberg, Michael H.C. Bleijlevens, Gabriele Meyer, Jaana Koskenniemi, Maria E. Soto & Adelaida Zabalegui on behalf of the RightTimePlaceCare Consortium † Accepted for publication 23 August 2014 Correspondence to A. Zabalegui: e-mail: azabaleg@clinic.ub.es *Equal contribution to this work. † The RightTimePlaceCare Consortium is disclosed in Appendix 1. M. Carme Alvira MScN RN Registered Nurse CAP Comte Borrell, Barcelona, Spain Ester Risco MSc RN Nurse Research Support Hospital Clinic de Barcelona, Spain Esther Cabrera PhD RN School of Health Sciences Director, University Pompeu Fabra, School TecnoCampus Matar o, Spain Marta Farr e MSc RN Registered Nurse Department of Internal Medicine, Hospital Cl  ınic de Barcelona, Spain Ingalill Rahm Hallberg PhD RN Senior Professor Department of Health Sciences, Lund University, Sweden ALVIRA M.C., RISCO E., CABRERA E., FARR  E M., HALLBERG I.R., BLEIJLE- VENS M.H.C., MEYER G., KOSKENNIEMI J., SOTO M. & ZABALEGUI A., ON BEHALF OF THE RIGHTTIMEPLACECARE CONSORTIUM (2014) The associa- tion between positive–negative reactions of informal caregivers of people with dementia and health outcomes in eight European countries: a cross-sectional study. Journal of Advanced Nursing 00(0), 000–000. doi: 10.1111/jan.12528 Abstract Aim. To describe the associations between positive and negative reactions of informal caregivers of people with dementia and health outcomes across eight European Countries. Background. Caring for someone with dementia may have implications for the caregiver’s own health and for the care recipient. These consequences could be associated with caregivers’ reactions to the process of care. Design. Association study based on cross-sectional data. Methods. Participants were people with dementia and their informal caregivers living at home or in long-term care institutions. Data were collected between November 2010–April 2012 using the Caregiver Reaction Assessment (with dimensions of self-esteem, lack of family support, financial problems, disrupted schedule and health problems) and associations were sought with informal caregiver burden, quality of life and psychological well-being and with dementia sufferers’ neuropsychiatric symptoms, comorbidity and dependency in activities of daily living using correlation coefficients. Results. Data from 2014 participants were used. Variability across countries was noted, as well as differences between care at home and in long-term care institutions. In general, self-esteem and lack of family support correlated with caregiver burden and psychological well-being. Associations were also found between disrupted schedule and caregiver burden, psychological well-being and quality of life. Health problems were clearly associated with caregiver burden, psychological well-being and quality of life. © 2014 John Wiley & Sons Ltd 1 continued on page 2