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Brewster G, Yang I, Pelkmans J, Higgins M, Waldrop D, Dunbar SB, Yeager KA. Factors related to cognitive performance among black caregivers of persons living with a chronic illness: An exploratory study. Geriatr Nurs 2024; 59:159-169. [PMID: 39013234 DOI: 10.1016/j.gerinurse.2024.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 06/05/2024] [Accepted: 06/27/2024] [Indexed: 07/18/2024]
Abstract
This study investigated factors associated with cognitive performance among Black caregivers of persons living with two chronic conditions: dementia or cancer. Fifty-six Black caregivers of people living with dementia or cancer were recruited from clinic and community sources. Variables measured included: depression, anxiety, stress, sleep, fatigue, and caregiver burden. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Descriptive statistics and non-parametric analyses were conducted to identify factors related to MoCA scores. Caregivers were 58.3 years of age and predominantly female. The average MoCA score was 25.23. Gender and education, along with positive appraisal of caregiving were significantly associated with cognitive performance. Several other factors approached significance including cohabitation with the care recipient, fatigue, and stress due to perceived individual and institutional racism. Our findings suggest several factors that warrant further investigation for understanding the relationship between caregiving and cognitive performance in Black caregivers of people living with cancer or dementia.
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Affiliation(s)
- Glenna Brewster
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Irene Yang
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA.
| | - Jordan Pelkmans
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Melinda Higgins
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Drenna Waldrop
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Sandra B Dunbar
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
| | - Katherine A Yeager
- Emory University, Nell Hodgson Woodruff School of Nursing, 1520 Clifton Road NE, Atlanta, GA 30322, USA
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Chen S, Lou VWQ, Leung R, Yu DSF. Meaning-making of dementia caregiving: A systematic review of qualitative studies. Int J Nurs Stud 2024; 158:104848. [PMID: 39043114 DOI: 10.1016/j.ijnurstu.2024.104848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 06/13/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Being the backbone of informal care for people living with dementia, caregivers suffer overwhelming physical and psychological challenges in their daily caregiving experience. Proactive coping strategies to alleviate the caregiving burden are of utmost importance. Meaning-making emerges as an effective coping approach to benefit caregivers and mitigate their care burden. However, the conceptualisation of meaning-making on its dimensions and process has been ambiguously identified. OBJECTIVES To synthesise the qualitative research evidence on meaning-making in a dementia context to identify: (1) the situational dimension in making sense of caregiving scenarios, and (2) how the meaning-making process evolves during dementia caregiving. METHODS This systematic review identified 62 qualitative studies published between 1969 and 2022 from the major databases. Eligible studies met the following inclusion criteria: (1) having informal caregivers of people living with dementia; (2) involving meaning-making of care experience; (3) adopting qualitative design; and (4) full-text of research articles. The risk of bias was evaluated using the Clinical Appraisal Skills Programme checklist. By using Qualitative Evidence Synthesis, themes relevant to critical dimensions and phases of meaning-making were generated from the extracted data. RESULTS Sixty-two studies involving 2487 subjects were synthesised investigating the critical dimensions and process of meaning-making of dementia care experience. Results indicated that the dementia care experience can be made sense of in several folds: (1) it involved complicated demands from people living with dementia and requires customised care; (2) the dynamics of dyadic interactions with dilemma and ambivalence; and (3) adaptive coping encapsulating perceptions of loss and growth, complied and integrated values, balanced expectations of care and self, and improvement in self-efficacy. The meaning-making process underwent phases of meaning creation (meaning created in initial encounter with dementia symptoms), meaning appraisal (assimilation and accommodation pathways for appraisal), and meaning adherence (integration of the appraised meanings). CONCLUSION Findings suggest meaning-making of dementia caregiving is a multi-faceted and multi-phased recursive process. Future implications give directions on the facilitation of meaning-oriented interventions to enhance the awareness of caregiving role and the knowledge of dementia care, learn techniques of reframing and restructuring, and seek meaningful perspectives; and to adopt strategies to overcome the barriers for meaning-making by empowering self-identity, roles and expectations, and the dyadic relationship. In addition, our findings inform future advancement in the conceptualisation and measurement of meaning-making in the context of family caregiving. Optimisation of the meaning-making process inspires professional assistance to enhance caregivers' coping for dementia care experience.
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Affiliation(s)
- Shuangzhou Chen
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Reynold Leung
- Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong; Department of Social Work and Social Administration, Sau Po Center on Ageing, The University of Hong Kong, Hong Kong.
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Domeisen Benedetti F, Hechinger M, Fringer A. Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review. Healthcare (Basel) 2024; 12:1016. [PMID: 38786426 PMCID: PMC11120749 DOI: 10.3390/healthcare12101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/21/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.
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Affiliation(s)
- Franzisca Domeisen Benedetti
- School of Health Professions, Institute of Nursing, ZHAW—Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401 Winterthur, Switzerland (A.F.)
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Pendergrass A, Weiß S, Rohleder N, Graessel E. Validation of the Benefits of Being a Caregiver Scale (BBCS) - further development of an independent characteristic of informal caregiving. BMC Geriatr 2023; 23:26. [PMID: 36641428 PMCID: PMC9840821 DOI: 10.1186/s12877-022-03650-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/24/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Although larger amounts of scientific attention have been directed toward the concept of positive aspects of caregiving (PAC) in recent years, a globally uniform definition and a suitable, scientifically valid questionnaire for all informal caregivers have yet to be developed. On the basis of the questionnaires that already exist for measuring PAC, the authors aimed to (a) concretize the concept and (b) develop a new scale by focusing only on items that show that family caregivers experience a benefit for themselves and that the benefit they experience is the result of their caregiving activities. METHODS The Benefits of Being a Caregiver Scale (BBCS) was validated on data from 961 informal caregivers. Cronbach's alpha was calculated to assess the internal consistency of the items, and a factor analysis was conducted to determine the structure of the BBCS. The discriminatory power and item difficulties were examined. Construct validity was established by testing four hypotheses. RESULTS The factor analysis confirmed the single-factor structure of the BBCS. Cronbach's alpha for the total scale was 0.922. One of the 15 items did not show good to very good discriminatory power and was excluded from the final version of the scale. A higher BBCS score was observed if the caregiver experienced more positive aspects of caregiving and tended to have better general coping skills and a positive relationship with the care-receiver. The BBCS score was not associated with the subjective burden of the caregiver. Results confirmed the validity of the BBCS. CONCLUSION The BBCS is a valid assessment instrument for measuring the benefits that caregivers experience from their caregiving work and can easily be used in research and practice. The BBCS is available free of charge in English and German ( http://www.caregiver-benefits.de ).
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Affiliation(s)
- Anna Pendergrass
- grid.5330.50000 0001 2107 3311Department of Psychiatry and Psychotherapy, Centre of Health Services Research in Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Saskia Weiß
- grid.489512.30000 0000 8508 4813German Alzheimer Society, Berlin, Germany
| | - Nicolas Rohleder
- grid.5330.50000 0001 2107 3311Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Elmar Graessel
- grid.5330.50000 0001 2107 3311Department of Psychiatry and Psychotherapy, Centre of Health Services Research in Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
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Mitchell HR, Applebaum AJ, Lynch KA, Reiner AS, Atkinson TM, Buthorn JJ, Sigler AS, Bossert D, Brewer K, Corkran J, Fournier D, Panageas KS, Diamond EL. Challenges and positive impact of rare cancer caregiving: A mixed-methods study of caregivers of patients with Erdheim-Chester disease and other histiocytic neoplasms. EClinicalMedicine 2022; 54:101670. [PMID: 36188434 PMCID: PMC9519468 DOI: 10.1016/j.eclinm.2022.101670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The importance of deriving benefit and meaning has been identified among cancer caregivers, but this has yet to be examined in the context of rare cancers. We sought to characterize unmet needs and experiences of caregivers of patients with Erdheim-Chester disease (ECD) and other histiocytic neoplasms (HN) and to identify factors associated with finding benefit and meaning-making in providing care for patients with rare cancers. METHODS Caregivers of patients with ECD and other HN completed quantitative surveys. Linear univariable regression modeling examined associations between unmet needs, social and family support, and intolerance of uncertainty with benefit finding and meaning-making. A subset participated in qualitative interviews assessing experiences of rare cancer caregiving that were analyzed with applied thematic analysis (NCT039900428). FINDINGS Of caregivers (N = 92, M = 54 years old, 68% female) of patients with ECD (75%) and other HN (25%), 78% reported moderately or severely unmet support needs, most frequently informational (58%) and psychological/emotional (66%) needs. Caregivers with unmet informational, psychological/emotional, and social support needs, difficulty tolerating uncertainty, a longer duration of the patient's illness, lower social support, more family conflict, and higher anxiety and depression symptoms demonstrated less benefit finding and meaning-making (ps <.05). Qualitative interviews (N = 19) underscored information and support needs and the capacity to derive meaning from caregiving. INTERPRETATION Rare cancer caregivers report numerous unmet information and support needs, needs that arise from disease rarity itself and which are associated with diminished capacity for deriving benefit and meaning from caregiving. Findings highlight targets for interventions to improve support for caregivers with HN and other rare cancers. FUNDING NIH P30 CA008748 (PI: Craig Thompson, MD), NIH T32 CA009461 (H.M.; PI: Jamie Ostroff, PhD), Frame Family Fund (E.L.D.), Applebaum Foundation (E.L.D.).
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Affiliation(s)
- Hannah-Rose Mitchell
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison J. Applebaum
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen A. Lynch
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Anne S. Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Thomas M. Atkinson
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Justin J. Buthorn
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Allison S. Sigler
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Dana Bossert
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Kathleen Brewer
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | - Jessica Corkran
- Erdheim-Chester Disease Global Alliance, DeRidder, LA, United States
| | | | - Katherine S. Panageas
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Eli L. Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, United States
- Corresponding author at: Department of Neurology, Memorial Sloan Kettering Cancer Center 160 East 53rd St. Second Floor Neurology, New York, NY 10022 United States.
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Lou VW, Cheng CYM, Yu DSF, Wong DFK, Lai DWL, Chong AML, Chen S, Chou KL. Meaning Making as a Lifebuoy in Dementia Caregiving: Predicting Depression from a Generation Perspective Using a Fuzzy-Set Qualitative Comparative Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15711. [PMID: 36497785 PMCID: PMC9736359 DOI: 10.3390/ijerph192315711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Depressive symptomatology is associated with caregiver burden and poor health outcomes among dementia caregivers. Scholars called for a paradigm shift to focus on positive aspects of caregiving, in particular, meaning making during the caregiving journey. This study draws on the meaning making model and a generation perspective to predict depression among dementia caregivers from two generations, including Baby Boomers who were born between 1946 and 1964 and Generation X who were born between 1965 and 1980, using a configuration approach. Data was collected in a two-wave longitudinal design, from December 2019 to March 2021 in Hong Kong. A fuzzy-set qualitative comparative analysis resulted in six configurations with an overall solution consistency and overall solution coverage of 0.867 and 0.488, respectively. These configurations consist of a different combination of conditions that predict high depressive symptomatology among dementia caregivers in two generations. Specifically, generation is related to five out of six configurations. This study is the first to predict depression among dementia caregivers using a meaning making model from a generation perspective. It advances the understanding of factors contributing to high depressive symptomatology among dementia caregivers from two generations, thus contributing to the future development of generation-responsive assessments, interventions, and policies.
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Affiliation(s)
- Vivian Weiqun Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
| | - Clio Yuen Man Cheng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
| | - Doris Sau Fung Yu
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
| | - Daniel Fu Keung Wong
- Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Kowloon, Hong Kong, China
| | - Daniel W. L. Lai
- Faculty of Social Sciences, Hong Kong Baptist University, Kowloon Tong, Kowloon, Hong Kong, China
| | - Alice Ming Lin Chong
- Felizberta Lo Padilla Tong School of Social Sciences, Caritas Institute of Higher Education, Tseung Kwan O, New Territories, Hong Kong, China
| | - Shuangzhou Chen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
- Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam, Hong Kong Island, Hong Kong, China
| | - Kee Lee Chou
- Department of Asian and Policy Studies, The Education University of Hong Kong, Tai Po, New Territories, Hong Kong, China
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Faw MH, Matter MM, Luzinski CH. Preliminary evaluation and implications of the SPECAL method as an intervention for informal dementia care partners. Aging Ment Health 2022; 26:1971-1978. [PMID: 35138225 DOI: 10.1080/13607863.2022.2032598] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Objective: The degenerative nature of Alzheimer's disease and related dementias (ADRD) means that people diagnosed with ADRD often rely on friends and family to provide care as their cognitive and physical abilities decline. Caring for a person with dementia is complicated, in part because ADRD changes a person's ability to communicate and create memories. Practitioners have increasingly identified communication-centered interventions as one way to address care partner needs while also improving well-being for the person with dementia. In this study, we evaluated one program, the SPECAL® method.Method: Using mixed-methods research, we assessed the effectiveness of a seven-week SPECAL course at facilitating positive outcomes for informal care partners. Participants completed pre- and post-program surveys (n = 17) as well as post-program interviews (n = 20).Results: Results showed several positive changes from pre- to post-program. Participants also reported several key themes in their experiences and implementation of SPECAL, including many beneficial and some challenging outcomes.Conclusion: Results from this study underscore the importance of communication as an intervention target for dementia care partners, identifying opportunities and challenges in working to help care partners communicate with people with ADRD in ways that sustain their relationship and foster mutual well-being.
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Affiliation(s)
- Meara H Faw
- Communication Studies Department, Colorado State University, Fort Collins, CO, USA
| | - Michelle M Matter
- Communication Studies Department, Colorado State University, Fort Collins, CO, USA
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Wang J, Li X, Liu W, Yang B, Zhao Q, Lü Y, Xiao M. The positive aspects of caregiving in dementia: A scoping review and bibliometric analysis. Front Public Health 2022; 10:985391. [PMID: 36187613 PMCID: PMC9515975 DOI: 10.3389/fpubh.2022.985391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose The increasing incidence of dementia and home-based care exposes family caregivers to a variety of challenges as they endure strong stressors underlying the caregiver role. Despite growing publications on positive aspects of caregiving in dementia, few studies have identified the extent, nature, and gaps in the existing literature based on a holistic view. The aim was to identify key issues and a holistic view of literature regarding positive aspects of caregiving in dementia. Methods A scoping review was conducted underlying a five-stage framework by Arksey and O'Malley. Five databases, including PubMed, CINAHL, PsycINFO, Embase, and Web of Science, were searched, and references were listed accordingly. Data were extracted by two researchers, comprising article characteristics, forms of positive aspects of caregiving and measurements, theories, forms of dementia and family caregiver, and keywords. Descriptive statistics and narrative synthesis were performed to analyze data. Network analysis of keywords and authors was conducted using VOSviewer software. Word cloud analysis of titles was examined by NVivo. Results The review included 230 articles, most of which have been published in the last decade (62.61%). Most articles (40.00%) were contributed by the United States. Cross-sectional studies (41.30%) ranked first, followed by qualitative studies (13.48%). Over a quarter of the literature (28.26%) focused on Alzheimer's care, and nearly 90% included all forms of family caregivers. The Positive Aspects of Caregiving Scale and stress coping theory were most frequently cited. Four clusters dominated by Casey D, Quinn C, Joling KJ, and Teahan A were identified in the network of co-authorship. Six themes were identified: current situations of caregiver experiences, antecedents, consequences, measurement development, effects of interventions, and the concept of positive aspects of caregiving. These were in line with network analysis of keywords and word cloud analysis of titles. Conclusions Positive aspects of caregiving in dementia have been widely concerned, but most of them are based on the theory of the negative stress process and are limited to current situations and influencing factors. Building theories focus on the positive aspects of caregiving, subsequently developing a comprehensive measurement and effective interventions, should be further studied.
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Affiliation(s)
- Jun Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuelian Li
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weichu Liu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mingzhao Xiao
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Applebaum AJ, Baser RE, Roberts KE, Lynch K, Gebert R, Breitbart WS, Diamond EL. Meaning-Centered Psychotherapy for Cancer Caregivers: A pilot trial among caregivers of patients with glioblastoma multiforme. Transl Behav Med 2022; 12:841-852. [PMID: 35852487 PMCID: PMC9385123 DOI: 10.1093/tbm/ibac043] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/21/2023] Open
Abstract
Caregivers of patients with glioblastoma multiforme (GBM) are at significant risk for existential distress. Such distress negatively impacts caregivers' quality of life and capacity to serve in their role as healthcare proxies, and ultimately, contributes to poor bereavement outcomes. Our team developed Meaning-Centered Psychotherapy for Cancer Caregivers (MCP-C), the first targeted psychosocial intervention that directly addresses existential distress in caregivers. The purpose of this study was to evaluate the feasibility, acceptability, and preliminary effects of MCP-C among caregivers of patients with GBM via a mixed-method pilot trial. Caregivers were randomized to seven sessions of MCP-C or Enhanced Usual Care (EUC), which included distress screening and the provision of targeted referrals and completed quantitative assessments at baseline (T1), after completion of MCP-C (T2), and at 2-month follow-up (T3). A subset of participants engaged in semistructured interviews at T2. Of 60 caregivers randomized, 55 were evaluable for preliminary efficacy analysis. Constrained linear mixed models indicated the MCP-C arm had statistically significant improvement relative to the EUC arm in the primary outcome of personal meaning and multiple secondary outcomes, including benefit finding, depressive symptomatology, and spiritual wellbeing. MCP-C demonstrated preliminary efficacy in facilitating caregivers' capacity to experience a sense of meaning and purpose despite the challenges and suffering associated with providing care to patients with GBM. Future studies are needed among more diverse samples of caregivers and should include the opportunity for concurrent patient enrollment to allow for a reciprocal and augmented experience of meaning among patient-caregiver dyads.
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Affiliation(s)
| | - Raymond E Baser
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Kailey E Roberts
- Clinical Psychology PsyD Program, Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Kathleen Lynch
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rebecca Gebert
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William S Breitbart
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Eli L Diamond
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Marziliano A, Applebaum A, Siess S, Moyer A. A mixed‐methods evaluation of the experience of emerging young adult care partners. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Allison Marziliano
- Institute for Health System Science, The Feinstein Institutes for Medical Research Northwell Health Manhasset New York USA
| | - Allison Applebaum
- Department of Psychiatry and Behavioral Sciences Memorial Sloan Kettering Cancer Center New York New York USA
| | - Samantha Siess
- College of Veterinary Medicine Cornell University Ithaca New York USA
| | - Anne Moyer
- Department of Psychology Stony Brook University Stony Brook New York USA
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11
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Positive experiences in dementia care-giving: findings from the IDEAL programme. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
There is a growing evidence base that identifying positive experiences in providing care can have a beneficial influence on carer wellbeing. However, there is a need to better understand what carers identify as the positive aspects of care-giving. The aim of this study is to explore the satisfying aspects of providing care to people with dementia. This study utilised Time 1 data from 1,277 carers of people in the mild-to-moderate stages of dementia taking part in the IDEAL (Improving the experience of Dementia and Enhancing Active Life) cohort study. Responses from 900 carers who answered the open-ended question ‘What is your greatest satisfaction in caring for your relative/friend?’ were analysed using thematic analysis. From the responses, 839 carers detailed satisfactions. Eight themes were identified, pertaining to three groups of beneficiaries: carers, people with dementia and the dyad. Perceived benefits for carers included identifying aspects of personal growth, seeing glimpses of the person, feeling they were making a difference and doing their duty. For the person with dementia, these included retaining independence, receiving good quality care and being happy. Dyadic benefits concerned the continuation of the relationship between carer and person with dementia. The findings highlight the need to take a dyadic approach when conceptualising positive experiences in providing care. Further research is needed to understand the role these positive experiences play and to develop interventions. Professionals working with carers should identify and validate these experiences.
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Zulueta Egea M, Prieto-Ursúa M, Bermejo Toro L, Jodar Anchía R. Quality of palliative nursing care: Meaning, death anxiety, and the mediating role of well-being. Palliat Support Care 2022; 21:1-9. [PMID: 35139982 DOI: 10.1017/s1478951521001954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND There is increasing concern regarding the quality of palliative nursing care. However, despite the growing number of studies identifying related variables, there is still a paucity of studies analyzing models of how these variables interrelate. OBJECTIVE The study aimed to identify the role played in the quality of palliative care of nursing professionals by the variables meaning and death anxiety and to investigate the mediating role of psychological well-being and engagement. METHOD 176 palliative nursing professionals participated, selected by non-probabilistic convenience sampling using the snowball method. A simple mediation analysis and a multiple mediator model were performed in parallel, and data were collected using a paper and online questionnaire between January and May 2018. RESULTS Well-being mediated the impact of meaning (indirect effect = 0.096, SE = 0.044, 95% confidence interval (CI): 0.028, 0.213) and death anxiety (indirect effect = -0.032, SE = 0.013, 95% CI: -0.064, -0.010) on the quality of care. Engagement, on the other hand, only mediated the impact of meaning (indirect effect = 0.185, SE = 0.085, 95% CI: 0.035, 0.372), while the indirect effect of death anxiety with the quality of care through engagement was not statistically significant (indirect effect = 0.008, SE = 0.009, 95% CI: -0.004, 0.032). SIGNIFICANCE OF RESULTS Death anxiety is not directly related to the quality of care, but rather has an effect through psychological well-being, a variable acting as a mediator between the two. The effect of meaning on the quality of care is explained by the mediation of both engagement and psychological well-being, and its impact on the quality of care is thereby mediated by more variables than death anxiety.
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Affiliation(s)
- Mar Zulueta Egea
- Nursing, Centro Universitario de Ciencias de la Salud San Rafael-Nebrija, Madrid, Spain
| | - María Prieto-Ursúa
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Laura Bermejo Toro
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
| | - Rafa Jodar Anchía
- Psychology Department and Clinical Unit of Psychology (UNINPSI), Comillas Pontifical University - Cantoblanco Campus, Comunidad de Madrid, Spain
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Lee Y, Li L. Evaluating the Positive Experience of Caregiving: A Systematic Review of the Positive Aspects of Caregiving Scale. THE GERONTOLOGIST 2021; 62:e493-e507. [PMID: 34216215 DOI: 10.1093/geront/gnab092] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES As attention to positive caregiving experience increases, there is growing evidence concerning how the identification of the positive aspects of caregiving can be beneficial in supporting caregivers. The purpose of the current study is to review the literature where the Positive Aspects of Caregiving Scale (PACS) was used, identify the ways studies have used the PACS, and summarize the relationship between PACS and the contextual factors as well as outcomes of caregiving. RESEARCH DESIGN AND METHODS A systematic literature review was conducted. Electronic databases were searched, and empirical research studies written in English that were published in a peer-reviewed journal after 2004 were identified. After a careful review of the 194 abstracts yielded from the databases and the reference lists of the associated articles, 52 eligible studies were identified, and relevant findings were extracted. RESULTS Some commonality in terms of how studies have used the PACS emerged. The literature reviewed was further grouped into three categories depending on whether the study tested the PACS as a valid and reliable measurement, examined the PACS as outcomes of caregiving, or as a predictor of certain outcomes. DISCUSSION AND IMPLICATIONS This review suggests that PACS is utilized for multiple purposes and yields considerable evidence supporting the importance of understanding the positive experience of caregiving. However, there is limited adaptation of the PACS in a large survey, and studies were heavily focused in the U.S. with little evidence from other countries. Further studies to address these limitations will be needed.
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Affiliation(s)
- Yeonjung Lee
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Lun Li
- Gerontology Research Centre, Simon Fraser University, Vancouver, British Columbia, Canada
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Shiraishi N, Reilly J. Content analysis of the emotions affecting caregivers of relatives with schizophrenia. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01185-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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15
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Quinn C, Toms G. Influence of Positive Aspects of Dementia Caregiving on Caregivers' Well-Being: A Systematic Review. THE GERONTOLOGIST 2020; 59:e584-e596. [PMID: 30597058 DOI: 10.1093/geront/gny168] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a growing evidence base that informal caregivers can identify positive aspects of providing care and that this may have a beneficial influence on their well-being. The aim of this systematic review was to explore how positive aspects of caregiving (PAC) affects the well-being of caregivers of people with dementia. RESEARCH DESIGN AND METHODS We searched electronic databases for quantitative studies exploring the association between PAC and caregiver well-being. Studies were included if they involved informal (unpaid) caregivers of people with dementia, at least 75% of whom had to be residing in the community. A narrative synthesis was used to explore patterns within the data. RESULTS Fifty-three studies were included in the narrative synthesis. Most studies utilized a cross-sectional design. The majority of samples consisted primarily of spouses and female caregivers. Twenty different PAC measures were employed and studies referred to a variety of constructs, such as satisfactions, gains, meaning, and rewards. PAC was associated with lower depressive symptoms and burden. Conversely, PAC was associated with better mental health, quality of life, satisfaction with life, and competence/self-efficacy. PAC was not associated with self-rated health or personal strain/stress. DISCUSSION AND IMPLICATIONS The findings suggest that identifying PAC is associated with better caregiver well-being, although further longitudinal studies are required to explore how this relationship changes over time. Interventions that enable caregivers to gain a more positive experience of caregiving could be beneficial for their well-being.
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Affiliation(s)
- Catherine Quinn
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, UK.,Centre of Applied Dementia Studies, University of Bradford, Faculty of Health Studies, West Yorkshire, UK
| | - Gill Toms
- Wales School for Social Care Research: School of Health Sciences, Bangor University, Gwynedd, UK
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16
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Yoon HK, Kim GS. An empowerment program for family caregivers of people with dementia. Public Health Nurs 2019; 37:222-233. [PMID: 31797446 DOI: 10.1111/phn.12690] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 11/05/2019] [Accepted: 11/07/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Family caregivers of people with dementia (PWD) often feel powerless and experience decreased well-being. Our aim was to develop an intervention program based on the caregiver empowerment model (CEM) and apply it with the Korean caregivers to evaluate its effects. DESIGN AND SAMPLE The study population comprised 115 family caregivers (experimental group, n = 35, control group 1, n = 40, control group 2, n = 40). METHODS Using an experimental design with two control groups. The experimental group received a 12-week program including intensive counseling, education, and telephone calls. The control group 1 (CG1) received usual service. The control group 2 (CG2) was provided with a handbook during the first week. A mixed-effects model was used to clarify longitudinal changes in participants' outcomes. RESULTS The experimental group showed significantly increased caregiving appraisal (effect size in CG1 = -7.25; CG2 = -5.63), caregiving attitude (CG1 = -21.47; CG2 = -17.79), self-efficacy (CG1 = -12.42; CG2 = -10.12), and well-being (CG1 = -4.33; CG2 = -2.35) after the program. CONCLUSIONS The empowerment program can be used to promote family caregivers' positive adaptation and to help caregivers who care for PWD to effectively cope with their problems.
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Affiliation(s)
- Heun Keung Yoon
- Department of Nursing, Wonju College of Medicine, Yonsei University, Gangwon-do, Korea.,Department of Nursing, Graduate School of Yonsei University, Seoul, Korea
| | - Gwang Suk Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, Korea
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18
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Applebaum AJ, Buda KL, Schofield E, Farberov M, Teitelbaum ND, Evans K, Cowens-Alvarado R, Cannady RS. Exploring the cancer caregiver's journey through web-based Meaning-Centered Psychotherapy. Psychooncology 2017; 27:847-856. [PMID: 29136682 DOI: 10.1002/pon.4583] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/23/2017] [Accepted: 10/27/2017] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Psychosocial interventions are historically underutilized by cancer caregivers, but support programs delivered flexibly over the Internet address multiple barriers to care. We adapted Meaning-Centered Psychotherapy for cancer caregivers, an in-person psychotherapeutic intervention intended to augment caregivers' sense of meaning and purpose and ameliorate burden, for delivery in a self-administered web-based program, the Care for the Cancer Caregiver (CCC) Workshop. The present study evaluated the feasibility, acceptability, and preliminary effects of this program. METHODS Eighty-four caregivers were randomized to the CCC Workshop or waitlist control arm. Quantitative assessments of meaning, burden, anxiety, depression, benefit finding, and spiritual well-being were conducted preintervention (T1), within 2-weeks postintervention (T2), and 2- to 3-month follow-up (T3). In-depth semistructured interviews were conducted with a subset of participants. RESULTS Forty-two caregivers were randomized to the CCC Workshop. Attrition was moderate at T2 and T3, with caregiver burden and bereavement as key causes of drop-out. At T2 and T3, some observed mean change scores and effect sizes were consistent with hypothesized trends (eg, meaning in caregiving, benefit finding, and depressive symptomatology), though no pre-post significant differences emerged between groups. However, a longitudinal mixed-effects model found significant differential increases in benefit finding in favor of the CCC arm. CONCLUSIONS The CCC Workshop was feasible and acceptable. Based on effect sizes reported here, a larger study will likely establish the efficacy of the CCC Workshop, which has the potential to address unmet needs of caregivers who underutilize in-person supportive care services.
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Affiliation(s)
- A J Applebaum
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K L Buda
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - E Schofield
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - M Farberov
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - N D Teitelbaum
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - K Evans
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Burke SL, Burgess A, Cadet T. Utilizing evidence-based assessment instruments to detect well-being and distress in English- and Spanish-speaking caregivers of individuals affected by dementia. DEMENTIA 2017; 18:2062-2084. [PMID: 29141448 DOI: 10.1177/1471301217739095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective The purpose of this study was to examine the most effective and available English and Spanish language caregiver assessments for providers and caregivers. Methods Assessments were included if they screened for caregiving-related concerns, including stress, depression, and caregiving burden and could be administered directly to caregivers in person or online. Results Eighteen assessments are designed to assess caregiver burden, distress, depression, and grief. Six did not have psychometric data to support efficacy but are widely used in clinical and research settings. Six were validated in Spanish, and one other is available in Spanish but not validated. Conclusion As many as 80% of care recipients are cared for in the home by family members who act as informal caregivers. Caregivers of persons with dementia may experience depression symptoms, high caregiver burden, and feelings of being constrained. Due to the lack of psychometric evidence available, the validity of some assessments is questionable.
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Affiliation(s)
| | | | - Tamara Cadet
- Simmons College School of Social Work, Simmons College, USA; Harvard School of Dental Medicine, USA
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20
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Positive psychology outcome measures for family caregivers of people living with dementia: a systematic review. Int Psychogeriatr 2017; 29:1281-1296. [PMID: 28511738 DOI: 10.1017/s1041610217000655] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Family caregivers of people living with dementia can have both positive and negative experiences of caregiving. Despite this, existing outcome measures predominately focus on negative aspects of caregiving such as burden and depression. This review aimed to evaluate the development and psychometric properties of existing positive psychology measures for family caregivers of people living with dementia to determine their potential utility in research and practice. METHOD A systematic review of positive psychology outcome measures for family caregivers of people with dementia was conducted. The databases searched were as follows: PsychINFO, CINAHL, MEDLINE, EMBASE, and PubMed. Scale development papers were subject to a quality assessment to appraise psychometric properties. RESULTS Twelve positive outcome measures and six validation papers of these scales were identified. The emerging constructs of self-efficacy, spirituality, resilience, rewards, gain, and meaning are in line with positive psychology theory. CONCLUSIONS There are some robust positive measures in existence for family caregivers of people living with dementia. However, lack of reporting of the psychometric properties hindered the quality assessment of some outcome measures identified in this review. Future research should aim to include positive outcome measures in interventional research to facilitate a greater understanding of the positive aspects of caregiving and how these contribute to well-being.
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Abstract
OBJECTIVE Reliable and valid measures of caregiver experience are critical components of researching the caregiver experience and providing effective care to family caregivers. Assessments should be comprehensive, including positive aspects of caregiving as well as multiple dimensions of stress and burden (Family Caregiver Alliance, 2006). One such measure is the Caregiver Reaction Scale (CRS), a clinical tool adapted from research protocols in 1990. METHODS This study is a preliminary examination of the psychometric properties of the CRS using a sample of family caregivers (N = 502) seeking services at a community based mental health and aging family service agency. RESULTS The eight subscales of the CRS exhibited very good internal reliability α ≥ .81. Test-retest reliability was r ≥ .62, and convergent validity evidence is positive. Means and standard deviations are reported. CONCLUSIONS Initial psychometrics suggest the CRS offers a reliable and valid assessment of multiple dimensions of the caregiving experience and warrants further research.
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Affiliation(s)
- Kelly A O'Malley
- a University of Colorado Colorado Springs , Colorado Springs , Colorado , USA
| | - Sara H Qualls
- a University of Colorado Colorado Springs , Colorado Springs , Colorado , USA
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22
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Meaning in stroke family caregiving: A literature review. Geriatr Nurs 2017; 38:48-56. [DOI: 10.1016/j.gerinurse.2016.07.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Revised: 07/10/2016] [Accepted: 07/18/2016] [Indexed: 01/31/2023]
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23
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‘In this together’ or ‘Going it alone’: Spousal dyad approaches to Alzheimer's. J Aging Stud 2017; 40:57-63. [DOI: 10.1016/j.jaging.2017.01.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 01/11/2017] [Accepted: 01/19/2017] [Indexed: 11/19/2022]
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Development of a measure to evaluate gains among spanish dementia caregivers: The gains associated with caregiving (GAC) scale. Arch Gerontol Geriatr 2017; 68:76-83. [DOI: 10.1016/j.archger.2016.09.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 08/02/2016] [Accepted: 09/12/2016] [Indexed: 12/26/2022]
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25
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Butcher HK, Gordon JK, Ko JW, Perkhounkova Y, Cho JY, Rinner A, Lutgendorf S. Finding Meaning in Written Emotional Expression by Family Caregivers of Persons With Dementia. Am J Alzheimers Dis Other Demen 2016; 31:631-642. [PMID: 27574336 PMCID: PMC7241250 DOI: 10.1177/1533317516660611] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study tested the effect of written emotional expression on the ability to find meaning in caregiving and the effects of finding meaning on emotional state and psychological burden in 91 dementia family caregivers. In a pretest-posttest design, participants were randomly assigned to either an experimental or a comparison group. Experimental caregivers (n = 57) wrote about their deepest thoughts and feelings about caring for a family member with dementia, whereas those in the comparison group (n = 34) wrote about nonemotional topics. Results showed enhanced meaning-making abilities in experimental participants relative to comparison participants, particularly for those who used more positive emotion words. Improved meaning-making ability was in turn associated with psychological benefits at posttest, but experimental participants did not show significantly more benefit than comparison participants. We explore the mediating roles of the meaning-making process as well as some of the background characteristics of the individual caregivers and their caregiving environments.
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Affiliation(s)
| | - Jean K Gordon
- Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | - Ji Woon Ko
- Department of Nursing Science, Sun Moon University, Asan, Chungcheongnam-do, South Korea
| | - Yelena Perkhounkova
- Office for Nursing Research and Scholarship, The University of Iowa College of Nursing, Iowa City, IA, USA
| | - Jun Young Cho
- Communication Sciences & Disorders, University of Iowa, Iowa City, IA, USA
| | - Andrew Rinner
- Information Technology Services, University of Iowa, Iowa City, IA, USA
| | - Susan Lutgendorf
- Department of Psychology, University of Iowa, Iowa City, IA, USA
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Salmon JR, Kwak J, Acquaviva KD, Egan KA, Brandt K. Validation of the Caregiving at Life’s End questionnaire. Am J Hosp Palliat Care 2016; 22:188-94. [PMID: 15909781 DOI: 10.1177/104990910502200307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The researchers in this study developed and validated a questionnaire to measure the needs of end-of-life (EOL) caregivers. The model is used to facilitate meaningful and supportive experiences for both the patient and caregiver. The questionnaire was developed using existing scales of meaning, self-acceptance, burden, and gain as well as new scales of caregiver comfort, importance of caregiving tasks, and caregiver closure. The sample included 34 current and 17 bereaved caregivers affiliated with The Hospice Institute of the Florida Suncoast. The scales performed well in terms of concurrent validity, internal consistency, and reliability.
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Affiliation(s)
- Jennifer R Salmon
- School of Aging Studies, Florida Policy Exchange Center on Aging, University of South Florida, Tampa, Florida, USA
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27
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Tarlow BJ, Wisniewski SR, Belle SH, Rubert M, Ory MG, Gallagher-Thompson D. Positive Aspects of Caregiving. Res Aging 2016. [DOI: 10.1177/0164027504264493] [Citation(s) in RCA: 314] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of this study was to assess a newly developed measure for the positive aspects of caregiving using a sample of dementia caregivers. The measure was developed and administered to 1,229 participants in a national collaborative Alzheimer’s disease caregiver study and evaluated for validity and reliability using standard psychometric analyses. Factor analysis identified two components in this nine-item measure: Self-Affirmation and Outlook on Life. Cronbach’s alphas for the components were .86 and .80, respectively. For the entire scale, Cronbach’s alpha was .89. The Positive Aspects of Caregiving measure, tested with a large, diverse, and well-characterized sample shows promise as a valid and reliable instrument. With additional implementation and testing, the measure has the potential to substantially increase our understanding of basic caregiving research and the outcomes of intervention efforts.
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Boström K, Ahlström G, Sunvisson H. Being the Next of Kin of an Adult Person With Muscular Dystrophy. Clin Nurs Res 2016; 15:86-104; discussion 105-6. [PMID: 16638828 DOI: 10.1177/1054773805285706] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A chronic disorder affects all members of the family in various ways. The aim of this study is to elucidate the next of kin's ( N= 36) experiences when an adult family member has muscular dystrophy. The relationships were partner (36%, n= 14), parent (18%, n= 7), child (21%, n= 8), sibling (15%, n= 6), and other relative (3%, n= 1). Latent content analysis is employed and involves an interpretation of the interviewtext. The results showthe meaning of being close to a person with muscular dystrophy through the themes that emerged: exposure of the family; the span between obligation and love; being vigilant, protective, and supportive; and striving for an ordinary life. This study reveals a need for healthcare staff to understand the next of kin's narrated meaning of changes when a family member has a progressive disease.
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Affiliation(s)
- Katrin Boström
- Swedish Institute for Disability Research, Orebro University, Center for Rehabilitation Research, Orebro County Council
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Crellin NE, Orrell M, McDermott O, Charlesworth G. Self-efficacy and health-related quality of life in family carers of people with dementia: a systematic review. Aging Ment Health 2014; 18:954-69. [PMID: 24943873 PMCID: PMC4192898 DOI: 10.1080/13607863.2014.915921] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES This review aims to explore the role of self-efficacy (SE) in the health-related quality of life (QoL) of family carers of people with dementia. METHODS A systematic review of literature identified a range of qualitative and quantitative studies. Search terms related to caring, SE, and dementia. Narrative synthesis was adopted to synthesise the findings. RESULTS Twenty-two studies met the full inclusion criteria, these included 17 quantitative, four qualitative, and one mixed-method study. A model describing the role of task/domain-specific SE beliefs in family carer health-related QoL was constructed. This model was informed by review findings and discussed in the context of existing conceptual models of carer adaptation and empirical research. Review findings offer support for the application of the SE theory to caring and for the two-factor view of carer appraisals and well-being. Findings do not support the independence of the negative and positive pathways. The review was valuable in highlighting methodological challenges confronting this area of research, particularly the conceptualisation and measurement issues surrounding both SE and health-related QoL. CONCLUSIONS The model might have theoretical implications in guiding future research and advancing theoretical models of caring. It might also have clinical implications in facilitating the development of carer support services aimed at improving SE. The review highlights the need for future research, particularly longitudinal research, and further exploration of domain/task-specific SE beliefs, the influence of carer characteristics, and other mediating/moderating variables.
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Affiliation(s)
- Nadia E. Crellin
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK,Research and Development Department, North East London NHS Foundation Trust, London, UK,Corresponding author.
| | - Martin Orrell
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK,Research and Development Department, North East London NHS Foundation Trust, London, UK
| | - Orii McDermott
- Division of Psychiatry, Faculty of Brain Sciences, University College London, London, UK,Doctoral Programme in Music Therapy, Aalborg University, Aalborg, Denmark
| | - Georgina Charlesworth
- Research and Development Department, North East London NHS Foundation Trust, London, UK,Research Department of Clinical, Educational & Health Psychology, University College London, London, UK
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Gonzalez EW, Polansky M, Lippa CF, Gitlin LN, Zauszniewski JA. Enhancing resourcefulness to improve outcomes in family caregivers and persons with Alzheimer's disease: a pilot randomized trial. Int J Alzheimers Dis 2014; 2014:323478. [PMID: 25328754 PMCID: PMC4195254 DOI: 10.1155/2014/323478] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/11/2014] [Accepted: 09/14/2014] [Indexed: 11/17/2022] Open
Abstract
This pilot randomized trial tested an intervention aimed at enhancing resourcefulness in family caregivers of persons with dementia, postulating that caregivers' emotional outcomes (anxiety and depression) and role outcomes (reward, strain, mutuality, and preparedness) would be improved, and problem behaviors in the care recipients (persons with dementia) would be reduced as a result of the intervention. Subjects were stratified by race (white or African American) and by baseline resourcefulness (high or low). Family caregivers were randomly assigned to an intervention group in which subjects attended six resourcefulness training sessions, meeting for 2 hours weekly over 6 weeks, or to a control group that received no treatment. Small to medium effects were shown for the intervention program on resourcefulness, anxiety, and preparedness of the caregivers and on frequency of behavior problems in the care recipients. Caregivers in the intervention group reported significantly more resourcefulness skills, with a medium effect at week 6 and a small effect 12 weeks later, compared with the control group. Persons with dementia had fewer behavior problems in the intervention group compared with control, although the difference was not significant. Caregivers' anxiety was reduced in the intervention group at 12 weeks.
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Affiliation(s)
- Elizabeth W. Gonzalez
- Doctoral Nursing Program, Division of Graduate Nursing, College of Nursing and Health Professions, Drexel University, 245 N. 15th Street, MS 1030, Philadelphia, PA 19102-1192, USA
| | - Marcia Polansky
- Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA 19104, USA
| | - Carol F. Lippa
- Memory Disorder Clinic, Department of Neurology, Drexel University College of Medicine, Philadelphia, PA 19102-1192, USA
| | - Laura N. Gitlin
- Center for Innovative Care in Aging, Department of Community-Public Health, Johns Hopkins School of Nursing, Baltimore, MD 21205, USA
| | - Jaclene A. Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106-7123, USA
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31
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Chan WCH. Factor structure of the Chinese version of the Meaning in Life Questionnaire among Hong Kong Chinese caregivers. HEALTH & SOCIAL WORK 2014; 39:135-143. [PMID: 25095626 DOI: 10.1093/hsw/hlu025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examines the factor structure of the Chinese version of the Meaning in Life Questionnaire (C-MLQ) in a sample of Hong Kong Chinese caregivers of patients with chronic illness (N = 223). Confirmatory factor analysis was performed to examine the factor structure. Findings confirm that, identical to the original version, C-MLQ showed the same two-factor structure: Presence and Search. Correlation between Presence and Search was found to be positive and moderate (r = .47). This study establishes empirically the same factor structure as the original version of MLQ among caregivers in Hong Kong. The relationship between Presence and Meaning is discussed in the contexts of Chinese culture and caregiving. Results suggest caregivers' continuing need for meaning in life. Medical social workers may help caregivers to integrate their caregiving experience with their sense of meaning in life and search for meaning in life to sustain their caregiving role.
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Abstract
Caregiving in a rural context is unique, but the experience of rural caregivers is understudied. This paper describes how rural caregivers cope with caring for a loved one diagnosed with mild cognitive impairment or dementia using qualitative description to generate a low-inference summary of a response to an open-ended question. This approach allowed these rural caregivers to describe their positive experiences in addition to the more commonly explored caregiver experiences related to stress. Analyses of coping revealed use of social support, engaging in relaxing and physical activity, and cognitive reframing. In addition, caregivers reported strong faith and religiosity, and to a lesser frequency behavioral changes, checking in with the person with dementia via telephone, and joint activity. Predominantly, these methods reflect approach-based strategies. The current data suggest that these caregivers manage well and adopt adaptive coping strategies to meet the demands of the caregiving role.
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Gelkopf M, Roe D. Evaluating outcome domains assessing caregivers of individuals with mental illness: a review. FAMILY PROCESS 2014; 53:150-174. [PMID: 24372325 DOI: 10.1111/famp.12056] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this article, we describe the properties and consider the outcome dimensions of a collection of self-administered questionnaires that assess caregivers of offspring with mental illness. To this end, we searched the MEDLINE, Web of Science, and PsycINFO databases, as well as reference lists of studies published between 1980 and 2012. We reviewed 43 instruments, and found multiple outcome domains, associated with either objective burden or subjective burden, or both. A number of tools captured additional negative aspects of caregiving (e.g., strain, stress, and worrying) as well as positive aspects (e.g., personal growth, strength, support, rewards, and satisfaction), supplemented by measures assessing caregivers' perceptions and attitudes toward their offspring with SMI (e.g., insight, stigma, and efficacy). This current review of existing measures and their specific domains contributes to a more comprehensive understanding of the caregiving experience and allows both clinicians and researchers to select the most appropriate measurement tools for their purposes.
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Affiliation(s)
- Marc Gelkopf
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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Experience of meaning in life in bereaved informal caregivers of palliative care patients. Support Care Cancer 2014; 22:1391-9. [DOI: 10.1007/s00520-013-2099-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 12/05/2013] [Indexed: 12/12/2022]
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Kate N, Grover S, Kulhara P, Nehra R. Caregiving appraisal in schizophrenia: A study from India. Soc Sci Med 2013; 98:135-40. [DOI: 10.1016/j.socscimed.2013.09.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 06/27/2013] [Accepted: 09/03/2013] [Indexed: 11/28/2022]
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Attachment style, social support and finding meaning among spouses of colorectal cancer patients: gender differences. Palliat Support Care 2013; 13:527-35. [PMID: 23928072 DOI: 10.1017/s1478951513000242] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES The current study explores the relationship between attachment styles, social support, gender and finding meaning in caregiving among spousal caregivers of colorectal cancer patients. METHODS Sixty caregivers (30 men and 30 women) were administered questionnaires assessing attachment styles, social support and finding meaning in caregiving, using a cross-sectional design. RESULTS For male caregivers avoidance attachment is associated with their finding meaning, whereas for female caregivers social support is associated with their finding meaning. SIGNIFICANCE OF RESULTS Psychological interventions for caregivers should take into consideration gender differences and might benefit from addressing the process of finding meaning in caregiving.
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Carrillo-González GM, Sánchez-Herrera B, Barrera-Ortiz L, Chaparro-Díaz OL. The Burden of Care in Instances of Chronic Non-communicable Disease. AQUICHAN 2013. [DOI: 10.5294/aqui.2013.13.2.10] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objetivo: analizar los diferentes enfoques para abordar la carga del cuidado en la enfermedad crónica no transmisible (ECNT). Materiales y métodos: con base en una revisión de literatura en las bases de datos: CINAHL, Ovid, Scielo, Medline y Psychoinfo, bajo los descriptores carga, impacto, costos, en combinación con enfermedad crónica y cuidado, con su respectiva traducción al inglés, se identificaron y analizaron los elementos estudiados como carga del cuidado de la ECNT. Resultados: la carga del cuidado en la ECNT es un constructo multidimensional que incluye la perspectiva epidemiológica (relación con la frecuencia y valoración de consecuencias en años de vida y pérdidas funcionales), la económica (impacto sobre consumo, ahorro, oferta de mano de obra, productividad y acumulación de capital humano) y la social (factores de desgaste, estrés, impacto familiar, limitación social y aspectos positivos de la experiencia), con múltiples interrelaciones entre sí. Conclusión: se requiere una mirada integral para examinar la carga del cuidado en la ECNT que incluya los actores sociales afectados: pacientes, cuidadores familiares, familias, profesionales e instituciones de salud.
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Reizer A, Dahan D, Shaver PR. The Contributions of Attachment and Caregiving Orientations to Living a Meaningful Life. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/psych.2013.412151] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
BACKGROUND Research indicates that spirituality and self-efficacy have been associated with higher levels of caregivers' well-being. However, these two concepts have rarely been examined simultaneously. The aim of this study was to analyze the combined effect of spirituality and self-efficacy on the caregiving stress process. METHODS The study design was cross-sectional. Dementia family caregivers (n = 122) were assessed in relation to the following variables: stressors (time since caregiving began, daily hours caring, frequency of behavioral problems, patient's functional status); appraisal (caregiver's appraisal of behavioral problems), caregiver's personal resources (self-efficacy, spiritual meaning, social support), and outcomes (depression and anxiety). RESULTS Participants were divided into four groups corresponding to four profiles defined by their scores on spiritual meaning and self-efficacy: LELS = Low self-efficacy and low spirituality; HELS = High self-efficacy and low spirituality; LEHS = Low self-efficacy and high spirituality; and HEHS = High self-efficacy and high spirituality. No differences were found between groups in stressors, appraisal, or personal resources. Caregivers in the HEHS group had significantly less depression compared to the LEHS group. Regression analysis showed that being a HEHS caregiver, low appraisal of behavioral problems and high social support were associated with low caregiver depression. Only high appraisal of behavioral problems was associated with high levels of anxiety. CONCLUSION The results of this study suggest that spirituality and self-efficacy had an additive effect on caregivers' well-being. A high sense of spiritual meaning and a high self-efficacy, in combination, was associated with lower levels of depression in caregivers.
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Wennerberg MMT, Lundgren SM, Danielson E. Using the salutogenic approach to unravel informal caregivers' resources to health: theory and methodology. Aging Ment Health 2012; 16:391-402. [PMID: 22292489 DOI: 10.1080/13607863.2011.628974] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
OBJECTIVES This article describes the theoretical foundation and methodology used in a study intended to increase knowledge concerning informal caregivers' resources to health (in salutogenesis; General Resistance Resources, GRRs). A detailed description of how the approach derived from salutogenic theory was used and how it permeated the entire study, from design to findings, is provided. How participation in the study was experienced is discussed and methodological improvements and implications suggested. METHOD Using an explorative, mixed method design, data was collected through salutogenically guided interviews with 32 Swedish caregivers to older adults. A constant comparative method of analysis was used to identify caregiver-GRRs, content analysis was further used to describe how participation was experienced. FINDINGS The methodology unraveled GRRs caregivers used to obtain positive experiences of caregiving, but also hindrances for such usage contributing to negative experiences. Mixed data made it possible to venture beyond actual findings to derive a synthesis describing the experienced, communal context of the population reliant on these GRRs; Caregivinghood. Participating in the salutogenic data-collection was found to be a reflective, mainly positive, empowering and enlightening experience. CONCLUSION The methodology was advantageous, even if time-consuming, as it in one study unravelled caregiver-GRRs and hindrances for their usage on individual, communal and contextual levels. It is suggested that the ability to describe Caregivinghood may be essential when developing health-promoting strategies for caregivers at individual, municipal and national levels. The methodology makes such a description possible and suggested methodological improvements may enhance its usability and adaptability to other populations.
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Affiliation(s)
- Mia M T Wennerberg
- Institute of Health and Care Sciences, Sahlgrenska Academy, Gothenburg, Sweden.
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Kulhara P, Kate N, Grover S, Nehra R. Positive aspects of caregiving in schizophrenia: A review. World J Psychiatry 2012; 2:43-8. [PMID: 24175167 PMCID: PMC3782175 DOI: 10.5498/wjp.v2.i3.43] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2011] [Revised: 06/19/2012] [Accepted: 06/20/2012] [Indexed: 02/05/2023] Open
Abstract
Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains (in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.
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Affiliation(s)
- Parmanand Kulhara
- Parmanand Kulhara, Natasha Kate, Sandeep Grover, Ritu Nehra, Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Lee Y, Choi S. Korean American Dementia Caregivers’ Attitudes Toward Caregiving. J Appl Gerontol 2012; 32:422-42. [DOI: 10.1177/0733464811431163] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore how Korean American family caregivers view the services they offer to patients with dementia. It also investigated the roles of social networks and satisfaction with social support on attitudes toward caregiving. Social network, satisfaction with social support, demographic characteristics, caregiving-related stress factors, and cultural factors were examined. We used a convenience sample of 85 Korean American dementia caregivers. The results from hierarchical multiple regression models show that the level of satisfaction with social support significantly contributed to Korean American caregivers’ attitudes toward working with patients with dementia, while no statistically significant associate was found for social network. Higher levels of satisfaction with social support were associated with greater positive attitudes toward caregiving among Korean American caregivers ( b = 0.26, p = .024). The implications for mental health professionals and policy makers are discussed.
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Márquez-González M, López J, Romero-Moreno R, Losada A. Anger, spiritual meaning and support from the religious community in dementia caregiving. JOURNAL OF RELIGION AND HEALTH 2012; 51:179-186. [PMID: 20467814 DOI: 10.1007/s10943-010-9362-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
This study explores the relationships between spiritual meaning and social support from the religious community and problem behaviors, anger and depression in 128 dementia caregivers. The results suggest a mediating role of anger in the relationship between the appraisal of problem behaviors and depression. Support from the religious community is directly and negatively associated with anger, but the relationship between spiritual meaning and anger is mediated by caregivers' appraisals of problem behaviors, suggesting that spiritual beliefs might help caregivers to find meaning in caregiving experiences and thus appraise care recipients' behavioral problems as less stressful.
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Affiliation(s)
- María Márquez-González
- Facultad de Psicología, Departamento de Psicología Clínica y de la Salud, Universidad Autónoma de Madrid, Campus de Cantoblanco, Madrid, Spain.
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Van Durme T, Macq J, Jeanmart C, Gobert M. Tools for measuring the impact of informal caregiving of the elderly: a literature review. Int J Nurs Stud 2011; 49:490-504. [PMID: 22078211 DOI: 10.1016/j.ijnurstu.2011.10.011] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 10/09/2011] [Accepted: 10/17/2011] [Indexed: 10/15/2022]
Abstract
OBJECTIVES (1) Describe available tools to assess the impact of informal caregiving of home-dwelling elderly, (2) identify an acceptable and appropriate tool for a study aiming at the evaluation of the impact of innovative projects for care and support of care for elderly at home, on their main informal caregiver and (3) find a definition of 'main informal caregiver'. STUDY DESIGN Literature review by searches of the following electronic databases: MEDLINE, CINAHL, EMBASE, using firstly keywords and exclusion criteria, then citations and reference search. RESULTS This review has identified 105 scales assessing the impact of informal caregiving of the elderly. Those scales were described in terms of characteristics of the care receiver population, content and psychometric properties. Most retrieved scales are intended to measure the impact of caregiving on caregivers' health of elderly with dementia (n=49), overall elderly (n=21), cancer patients (n=7), chronically ill patients (n=7), psychiatric patients (n=7) and stroke patients (n=3). Dimensions of the impact of caregiving were classified into its positive (n=34), negative (n=55) or neither positive nor negative (n=16) consequences on the informal caregiver's health. Internal consistency varied from 0.48 to 0.99 and in half of the cases (n=52), construct validity was reported. Scales comprised 1-200 questions. The Zarit Burden Interview (ZBI-12) was selected for the study and an operational definition of the concept of "main informal caregiver" was constructed. CONCLUSION This review identified a large number of scales that can be used to assess the impact of caregiving, viewed through different dimensions. The Zarit Burden Interview can be a useful tool for researchers and clinicians due to its user-friendliness, extensively validation and international use, making comparisons between groups possible. Despite the fact that only the original version of each scale was selected, this inventory should be a useful tool for intervention studies and even clinicians work.
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Affiliation(s)
- Thérèse Van Durme
- Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium.
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McLennon SM, Habermann B, Rice M. Finding meaning as a mediator of burden on the health of caregivers of spouses with dementia. Aging Ment Health 2011; 15:522-30. [PMID: 21500019 DOI: 10.1080/13607863.2010.543656] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of this study was to examine the role of finding meaning in caregiving as a way of coping and potential mediator of the effect of caregiver burden on caregiver health, controlling for potentially influencing factors. METHOD This was a cross-sectional, descriptive study of 84 community-residing spouse caregivers for persons with dementia in which participants completed questionnaires during a face-to-face meeting. Variables included background and contextual variables, caregiver burden, finding meaning through caregiving (FMTCG), and caregiver physical and mental health. Measures included the Zarit Burden Interview, the FMTCG Scale, and the Medical Outcomes Short Form-36, v2. RESULTS Regression analyses revealed that FMTCG partially mediated the relationship between caregiver burden and caregiver mental health. Caregiver burden was not associated with caregiver physical health. CONCLUSION This study contributed new information by examining the role of finding meaning in caregiving, conceptualized from an existential perspective, as a mediator in the stress-coping process. Caregiver burden had an indirect effect on caregiver mental health that was partially mediated by finding meaning. Results underscore the importance of the positive aspects of caregiving such as finding meaning as potential buffers of the burden of caregiving.
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Jones PS, Winslow BW, Lee JW, Burns M, Zhang XE. Development of a caregiver empowerment model to promote positive outcomes. JOURNAL OF FAMILY NURSING 2011; 17:11-28. [PMID: 21343620 DOI: 10.1177/1074840710394854] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Family members caring for aging parents experience both negative and positive outcomes from providing care. Theoretical explanations for negative outcomes have been developed. There is need for models that explain and predict positive outcomes. This article describes the evolution of the Caregiver Empowerment Model (CEM) to explain and predict positive outcomes of family caregiving. Although empirical findings support positive outcomes of family caregiving, less attention has been given to theoretical rationale for positive effects. The CEM predicts that, in the presence of filial values and certain background variables, caregiving demands are appraised as challenges instead of stressors. Appraising caregiving demands as a challenge, finding meaning, and using certain types of coping strategies are posited to be associated with growth and well-being. The CEM extends our understanding of the complexity of the caregiving experience, and can serve as a framework to guide in developing and testing theory-based interventions to promote positive outcomes.
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Paulson D, Lichtenberg PA. Effect of Caregiver Family Status on Care Recipient Symptom Severity and Caregiver Stress at Nursing Home Intake. Clin Gerontol 2011; 34:132-143. [PMID: 21796229 PMCID: PMC3142942 DOI: 10.1080/07317115.2011.539518] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The present research investigates differences between primary informal caregivers who were in the care recipient's immediate family (adult children or spouses) versus those primary caregivers who were outside the immediate family. Measurement occurred at the time of admission of the care recipient to an urban nursing home. We hypothesized that immediate family caregivers would report greater behavioral disturbance among care recipients and increased caregiver depression and stress. Data were collected from 115 consecutive caregiver-elder dyads at nursing home intake. Non-immediate family caregivers comprised 43% of the sample. Consistent with our hypotheses, immediate family caregivers reported significantly greater caregiver depression and caregiver stress. Immediate family care recipients demonstrated greater behavioral disturbance. Implications for policy and caregiver interventions are discussed.
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Villareal-Reyna MDLÁ, Salazar-González BC, Cruz-Quevedo JE, Carrillo-Cervantes AL, Champion JD. Outcomes of Interventions for Alzheimer’s Family Caregivers in Mexico. West J Nurs Res 2010; 34:973-90. [DOI: 10.1177/0193945910387283] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study examines which of three interventions of cognitive conduct, laughter, or a mixed intervention including both cognitive conduct and laughter components, is more effective for improvement of attitudes toward care and reduction of anxiety among female Mexican caregivers of family members with Alzheimer’s disease. A repeated measures quasi-experimental design with four groups, three experimental and a control group, was used. All intervention groups received cognitive conduct, laughter, or a mixed intervention weekly for 8 weeks. The control group received information about home accident prevention. Outcome measurements were performed at baseline, Week 4, end of the intervention (Week 8), and 4 weeks following the intervention completion. A repeated measures ANOVA was used for each outcome variable and the Tukey’s post hoc analysis to determine group differences. Results suggest that the cognitive conduct component significantly improved positive attitudes toward care and reduced anxiety both at the end of the intervention and at follow-up.
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Hui SKA, Elliott TR, Martin R, Uswatte G. Family caregivers’ attributions about care-recipient behaviour: Does caregiver relationship satisfaction mediate the attribution-distress relationship? Br J Health Psychol 2010; 16:642-59. [DOI: 10.1348/2044-8287.002003] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Video-based coping skills to reduce health risk and improve psychological and physical well-being in Alzheimer's disease family caregivers. Psychosom Med 2010; 72:897-904. [PMID: 20978227 PMCID: PMC3005287 DOI: 10.1097/psy.0b013e3181fc2d09] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine whether video-based coping skills (VCS) training with telephone coaching reduces psychosocial and biological markers of distress in primary caregivers of a relative with Alzheimer's disease or related dementia (ADRD). METHODS A controlled clinical trial was conducted with 116 ADRD caregivers who were assigned, alternately as they qualified for the study, to a Wait List control condition or the VCS training arm in which they viewed two modules/week of a version of the Williams LifeSkills Video adapted for ADRD family care contexts, did the exercises and homework for each module presented in an accompanying Workbook, and received one telephone coaching call per week for 5 weeks on each week's two modules. Questionnaire-assessed depressive symptoms, state and trait anger and anxiety, perceived stress, hostility, caregiver self-efficacy, salivary cortisol across the day and before and after a stress protocol, and blood pressure and heart rate during a stress protocol were assessed before VCS training, 7 weeks after training was completed, and at 3 months' and 6 months' follow-up. RESULTS Compared with controls, participants who received VCS training plus telephone coaching showed significantly greater improvements in depressive symptoms, trait anxiety, perceived stress, and average systolic and diastolic blood pressures that were maintained over the 6-month follow-up period. CONCLUSIONS VCS training augmented by telephone coaching reduced psychosocial and biological indicators of distress in ADRD caregivers. Future studies should determine the long-term benefits to mental and physical health from this intervention. TRIAL REGISTRATION http://www.clinicaltrials.gov; #NCT00396825.
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