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A'Azman S, Sung P, Malhotra R. Engagement in Physical Activity and Quality of Life Among Informal Caregivers of Older Adults. J Aging Health 2023:8982643231209086. [PMID: 37936406 DOI: 10.1177/08982643231209086] [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: 11/09/2023]
Abstract
OBJECTIVES This study examined (1) the association of caregiver engagement in physical activity (PA) with their quality of life (QoL) and (2) the moderating effect of caregiver engagement in PA on the relationship between several caregiving stressors and their QoL, among informal caregivers of older adults. METHODS Multivariable regression was applied to data from 278 adult caregivers, aged 23-90 years, in Singapore. RESULTS Engagement in PA by caregivers was positively associated with psychological, social relationships, and environment domains of their QoL. Caregiver engagement in PA also mitigated the negative association between care-recipient mood impairment and QoL of caregivers in the physical health and social relationships domains. DISCUSSION QoL of caregivers may be improved or protected by their regular engagement in PA, especially when their care-recipients have mood impairment. Policymakers and practitioners should encourage caregivers to engage in PA and provide them with the necessary support to do so.
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Affiliation(s)
| | - Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Jang Y, Hepburn K, Park J, Haley WE, Kim MT. Changes in Depressive Symptoms of Korean American Dementia Caregivers After Attending the Savvy Caregiver Program: Preliminary Findings with a Pilot Sample. Clin Gerontol 2023:1-8. [PMID: 37724817 PMCID: PMC10948376 DOI: 10.1080/07317115.2023.2260815] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
OBJECTIVES Language accommodation is indispensable in making evidence-based interventions available and accessible to ethnic minorities with limited English proficiency. As part of the larger effort to culturally adapt the Savvy Caregiver Program for Korean American dementia caregivers, we first conducted linguistic adaptation, and the present study reports the preliminary findings on participants' changes in depressive Symptoms. METHODS The linguistically adapted program was delivered to two small groups of Korean American dementia caregivers (total n = 13) by two Savvy-certified Korean-speaking trainers. Participants' depressive symptoms were assessed at three time points (pre-intervention, immediate post-intervention, and 6-month follow-up). RESULTS Following the intervention, participants exhibited lowered depressive symptoms (t = 8.64, p < .001, Cohen's d = .89). This benefit was sustained at 6-month follow-up. CONCLUSIONS Findings suggest that the therapeutic benefit of the Savvy Caregiver Program could potentially be shared with linguistic minorities when delivered in their native language. CLINICAL IMPLICATIONS Although limited in its scope and nature, the pilot study with linguistic adaptation sheds light on efforts to close the gap in the evidence-based intervention delivery.
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Affiliation(s)
- Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
- Department of Social Welfare, Ewha Womans University, Republic of Korea
| | - Kenneth Hepburn
- Nell Hodgson Woodruff School of Nursing, Emory University, USA
| | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, USA
| | | | - Miyong T. Kim
- School of Nursing, University of Texas at Austin, USA
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Rodríguez-González AM, Rodríguez-Míguez E, Claveria A. Determinants of caregiving burden among informal caregivers of adult care recipients with chronic illness. J Clin Nurs 2021; 30:1335-1346. [PMID: 33528913 DOI: 10.1111/jocn.15683] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/26/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic disease. The effect of task type and patient-caregiver interaction is also analysed. BACKGROUND Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient-caregiver interaction. DESIGN Correlational study. METHODS One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index-6 Dimensions (DEP-6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies. RESULTS Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP-6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels. CONCLUSIONS These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction. RELEVANCE TO CLINICAL PRACTICE The findings indicate that the socio-sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.
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Affiliation(s)
- Ana-María Rodríguez-González
- University of Vigo, Vigo, Spain.,Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Cantabrian Health Service, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Department of Applied Economics, University of Vigo, Vigo, Spain.,Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
| | - Ana Claveria
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Quality and Research Unit, EOXI Vigo, Galician Health Service, Vigo, Spain
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Lee EE, Lee SY. Caregiving experiences of Korean family caregivers of cancer patients: An integrative literature review. Psychooncology 2020; 29:1486-1503. [PMID: 32720400 DOI: 10.1002/pon.5498] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 07/09/2020] [Accepted: 07/22/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the experiences of Korean family caregivers of patients with cancer by reviewing recent literature. METHODS Five electronic databases were searched-MEDLINE, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and PubMed for English literature, and Korean Information Service System (KISS), and Research Information Sharing Service (RISS) for Korean literature for articles published from January 2010 to March 2020 using the key words cancer, caregiver, and Korean. Twenty-six articles met the inclusion criteria and remained in the final review. RESULTS No intervention study was found and most of studies were quantitative without theoretical/conceptual framework. All the studies were conducted with Koreans living in Korea. No previous study has been conducted with Koreans living in the U.S. or other countries. Most studies focused on caregivers' quality of life, burden, unmet needs, and resilience/adaptation/post-traumatic growth. CONCLUSIONS Comprehensive intervention studies focused on improving quality of life, burden, and adaptation to their complex roles as caregivers in the context of Korean culture would be helpful. Further research is needed in examining the caregiver-patient dyad interactions longitudinally to understand the dynamic complicated processes of caregiving.
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Affiliation(s)
- Eunice E Lee
- School of Nursing, University of California, Los Angeles, California, USA
| | - Shin-Young Lee
- Department of Nursing, Chosun University, Gwangju, Republic of Korea
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Rodríguez-González AM, Rodríguez-Míguez E. A meta-analysis of the association between caregiver burden and the dependent’s illness. J Women Aging 2019; 32:220-235. [DOI: 10.1080/08952841.2019.1700728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Ana-María Rodríguez-González
- Department of Psychosocioeducational analysis and intervention, University of Vigo, Vigo, Spain
- Fundación Biomédica Galicia Sur, Vigo, Spain
- Department of Social work, Cantabrian Service Health, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Fundación Biomédica Galicia Sur, Vigo, Spain
- Department of Applied Economics, University of Vigo, Vigo, Spain
- Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
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Or R, Kartal A. Influence of caregiver burden on well-being of family member caregivers of older adults. Psychogeriatrics 2019; 19:482-490. [PMID: 30854774 DOI: 10.1111/psyg.12421] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/24/2018] [Accepted: 01/09/2019] [Indexed: 01/02/2023]
Abstract
BACKGROUND Caregiving to older adults is one of the most important social issues associated with aging. While caregiving provides a suitable care and supportive environment for older adults, changes in the lives of caregiving family members also affect their health. The aim of this study was to examine the effect of care burden on the well-being of family members providing care for older adults. METHODS The study used a cross-sectional design. The study sample included 363 family caregivers of older adults. Socio-demographic questionnaire form, Burden Interview and Caregiver Well-Being Scale were used as data collection tools. Multiple linear regression analysis was performed to explore the predictors of well-being in the family caregivers of older adults. RESULTS The caregiver burden mean score was 32.63 ± 15.72 and Caregiver Well-Being Mean score was 159.38 ± 24.55. Caregiver burden, perceived health status of the older adults, marital status, perceived health status of caregiver and social support of caregiver were found to be statistically significant predictors of well-being in family member caregivers of older adults. Caregiver burden level was found to be the strongest predictor of well-being in the family caregivers of older adults. CONCLUSION Results showed that caregiver burden had an important effect on well-being of the caregiver. For this reason caregiver burden should be considered during interventions for improving well-being in family caregivers of older adults. Findings of our study revealed the necessity of showing special attention to caregivers by healthcare professionals and the importance of conducting interventional studies that aim to reduce caregiver burden in order to promote well-being.
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Affiliation(s)
- Recep Or
- Directorate of Public Health, Pamukkale University Health Sciences Institute, Denizli, Turkey
| | - Asiye Kartal
- Public Health Nursing Department, Pamukkale University Faculty of Health Sciences, Denizli, Turkey
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Blanco V, Guisande MA, Sánchez MT, Otero P, López L, Vázquez FL. [Caregiver burden and associated factors in family caregivers in the Community of Galicia, Spain]. Rev Esp Geriatr Gerontol 2019; 54:19-26. [PMID: 30646994 DOI: 10.1016/j.regg.2018.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/12/2018] [Accepted: 03/09/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Most of existing work on burden among family caregivers has methodological sample constraints. Moreover, there is contradictory information regarding sociodemographic variables, especially those related to care, clinical variables, and burden. Few studies have analysed the self-esteem and personality characteristics as correlates of burden. In this study, an analysis is performed on the prevalence of burden among family caregivers and the relationship with their sociodemographic, care-related, and clinical characteristics. MATERIALS AND METHODS The study consisted of a randomly selected sample of 294 family caregivers (mean age 55.3years, 89.8% women) from the Autonomous Region of Galicia, Spain. Trained psychologists assessed the presence of burden via the Zarit Caregiver Burden Interview (CBI). Information was also collected on sociodemographic, care-related variables, social support, personality characteristics, and self-esteem. RESULTS More than half (55.4%) of the surveyed caregivers exhibited burden (CBI>24), with mean score of 27.3 (SD=13.3). Not being employed outside the home and having higher scores in neuroticism were associated with a greater probability of presenting with burden, while being older and having higher social support were associated with a lower risk. CONCLUSIONS A significant number of caregivers suffered from burden in the current study. Psychotherapeutic interventions need to be developed for those who are already suffering from burden, as well as prevention strategies for those who have not yet developed it.
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Affiliation(s)
- Vanessa Blanco
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
| | - María Adelina Guisande
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - María Teresa Sánchez
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Patricia Otero
- Departamento de Psicología, Universidad de A Coruña, A Coruña, España
| | - Lara López
- Departamento de Psicología Clínica y Psicobiología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Fernando Lino Vázquez
- Departamento de Psicología Clínica y Psicobiología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
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Prevalence and predictors of major depressive disorder in bereaved caregivers at 6 and 13 months. Palliat Support Care 2018; 17:300-305. [PMID: 29806573 DOI: 10.1017/s1478951518000366] [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: 11/06/2022]
Abstract
OBJECTIVE Depressive symptoms are common in bereaved caregivers; however, there have been few prospective studies using a structured interview. This study investigated the prevalence and preloss predictors of major depressive disorder (MDD) in bereaved caregivers of patients in a palliative care unit. METHOD This prospective cohort study collected caregiver sociodemographic and psychological data before the death of a palliative care unit patient, including MDD, care-burden, coping style, and hopeful attitude. Postloss MDD was assessed 6 and 13 months after death, and a multivariate logistic regression analysis was conducted to identify its predictors.ResultOf 305 caregivers contacted, 92 participated in this study. The prevalence of preloss MDD was 21.8%; the prevalences of postloss MDD were 34.8% and 24.7% at 6 and 13 months, respectively. Preloss MDD predicted postloss MDD at 6 months (odds ratio [OR] = 5.38, 95% confidence interval [CI95%] = 1.29, 22.43); preloss nonhopeful attitude and unemployment status of caregivers predicted postloss MDD at 13 months (OR = 8.77, CI95% = 1.87, 41.13 and OR = 7.10, CI95% = 1.28, 39.36, respectively).Significance of resultsApproximately 35% of caregivers suffered from MDD at 6 months postloss, but the prevalence of MDD decreased to about 25% at 13 months. Preloss MDD significantly predicted postloss MDD at 6 months, whereas hopeful attitude and unemployment at baseline were significantly associated with postloss MDD at 13 months.
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Bień-Barkowska K, Doroszkiewicz H, Bień B. Silent strain of caregiving: exploring the best predictors of distress in family carers of geriatric patients. Clin Interv Aging 2017; 12:263-274. [PMID: 28203067 PMCID: PMC5295808 DOI: 10.2147/cia.s125664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objectives The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. Methods A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. Results The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. Conclusion Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs.
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Affiliation(s)
| | | | - Barbara Bień
- Department of Geriatrics, Medical University of Białystok, Białystok, Poland
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Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD). Int Psychogeriatr 2016; 28:1363-74. [PMID: 27019317 DOI: 10.1017/s1041610216000508] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Transcultural studies regarding the comparison of levels of burden in caregivers of patients with Alzheimer's disease (AD) from Europe and Latin America are rare. We designed this study to investigate the differentiating factors associated with burden in Brazilian and Spanish caregivers of patients with AD. METHODS This is a cross-sectional study composed by samples of outpatients with AD and their caregivers from Brazil (n = 128) and Spain (n = 146). Caregivers answered the Zarit Burden Interview (ZBI) and a Sociodemographic Questionnaire. Patients were assessed with the Mini-Mental State Examination (MMSE), Functional Activities Questionnaire (FAQ), Disability Assessment for Dementia (DAD), Neuropsychiatric Inventory (NPI), and Clinical Dementia Rating (CDR) Scale. RESULTS In the multivariate regression analysis, high burden levels were reported in Brazil, when caregivers were female (p = 0.025) and when patients did not attend Day Care Center (p = 0.025). In Spain, high burden levels were associated with living with the patient (p = 0.014), younger caregivers (p = 0.003), and participation of patients at Day Care Center (p = 0.046). Also, different neuropsychiatric symptoms explained high burden levels: in Brazil, depression (p < 0.001) and anxiety (p = 0.024) and, in Spain, apathy/indifference (p < 0.001), agitation/aggression (p = 0.019) and irritability/lability (p = 0.027). CONCLUSIONS Caregivers' gender, patients who attended Day Care Center and neuropsychiatric symptoms were differentiating factors in the burden of Brazilian and Spanish caregivers.
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Influence of caregiver personality on the burden of family caregivers of terminally ill cancer patients. Palliat Support Care 2015; 14:5-12. [DOI: 10.1017/s1478951515000073] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AbstractObjective:To determine the influence of caregiver personality and other factors on the burden of family caregivers of terminally ill cancer patients.Method:We investigated a wide range of factors related to the patient–family caregiver dyad in a palliative care setting using a cross-sectional design. Caregiver burden was assessed using the seven-item short version of the Zarit Burden Interview (ZBI–7). Caregiver personality was assessed using the 10-item short version of the Big Five Inventory (BFI–10), which measures the following five personality dimensions: extroversion, agreeableness, conscientiousness, neuroticism, and openness. Patient- and caregiver-related sociodemographic and psychological factors were included in the analysis because of their potential association with caregiver burden. Clinical patient data were obtained from medical charts or by using other measures. Multivariate linear regression analysis was performed to identify the independent factors associated with caregiver burden.Results:We analyzed 227 patient–family caregiver dyads. The multivariate analysis revealed that caregiver extroversion was protective against caregiver burden, whereas depressive symptoms in caregivers were related to increased burden. Neuroticism was positively correlated with caregiver burden, but this relationship was nonsignificant following adjustment for depressive symptoms. Patient-related factors were not significantly associated with caregiver burden.Significance of Results:Evaluating caregiver personality traits could facilitate identification of individuals at greater risk of high burden. Furthermore, depression screening and treatment programs for caregivers in palliative care settings are required to decrease caregiver burden.
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Determinants of a hopeful attitude among family caregivers in a palliative care setting. Gen Hosp Psychiatry 2014; 36:165-71. [PMID: 24342114 DOI: 10.1016/j.genhosppsych.2013.10.020] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 10/29/2013] [Accepted: 10/29/2013] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study investigated the determinants of a hopeful attitude among family caregivers involved with palliative care. METHOD We investigated a broad range of factors for the patient-family dyad in a palliative care setting using a cross-sectional design. The patients' sociodemographic, clinical and psychological factors were evaluated, as well as caregiver-related sociodemographic and psychological factors, including depressive symptoms, burden, coping style and religiosity. Caregivers were divided into two groups based on a hopeful or nonhopeful attitude and assessed using the abbreviated version of the seven-item Beck Hopelessness Scale (BHS-7). RESULTS Of 304 analyzed dyads, 210 (69.1%) caregivers showed a hopeful attitude, with a BHS-7 score of 0. The adjusted logistic regression analyses showed that caregivers' hopeful attitude was determined by only their psychological status: less depressive symptoms [odds ratio (OR), 0.86; 95% confidence interval (CI), 0.83-0.90], active coping strategy (OR, 1.12; 95% CI, 1.07-1.18) and lower burden (OR, 0.93; 95% CI, 0.88-0.99). In a subpopulation analysis (n=200), higher religiosity was a significantly associated factor. CONCLUSION Healthcare providers need to pay attention to the psychological vulnerability of caregivers to encourage a hopeful attitude. Additional studies of longitudinal design for hopeful attitude throughout the trajectory of palliative care are necessary.
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Predictive factors for the objective burden of informal care in people with dementia: a systematic review. Alzheimer Dis Assoc Disord 2013; 26:197-204. [PMID: 22075941 DOI: 10.1097/wad.0b013e31823a6108] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Informal care plays a substantial role in the provision of total care in dementia. Several reviews have been published on the predictive factors of subjective burden; however, such a review lacks information on objective burden, which refers to the amount and/or costs of informal care. OBJECTIVES The objectives of this study were to (1) give an overview of the predictive factors that are associated with the objective burden of informal care; (2) discuss whether these factors are similar to the predictive factors of subjective burden; and (3) examine whether they are modifiable. DESIGN The literature in a number of international databases was systematically searched. Methodological quality and level of certainty were assessed. RESULTS Ten studies were identified as relevant for the purpose of this review, describing a total of 39 predictive factors. Three factors (behavioral problems and impairments regarding daily functioning and cognition) were considered to be predictors of objective burden. Three factors were not related; 12 were potential predictors; and the results of the remaining 22 factors were inconclusive. CONCLUSIONS Many factors were found to be (potential) predictors of objective burden, reflecting its complex nature. Objective and subjective burdens are 2 different relevant aspects of informal care. Interventions aimed at countering behavioral problems and impairments regarding daily functioning could reduce objective burden.
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Yiengprugsawan V, Harley D, Seubsman SA, Sleigh AC. Physical and mental health among caregivers: findings from a cross-sectional study of Open University students in Thailand. BMC Public Health 2012; 12:1111. [PMID: 23267664 PMCID: PMC3543164 DOI: 10.1186/1471-2458-12-1111] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 12/22/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caregivers constitute an important informal workforce, often undervalued, facing challenges to maintain their caring role, health and wellbeing. Little is known about caregivers in middle-income countries like Thailand. This study investigates the physical and mental health of Thai adult caregivers. METHODS This report derives from distance-learning students working and residing throughout Thailand and recruited for a health-risk transition study in 2005 (N=87,134) from Sukhothai Thammathirat Open University. The cohort follow-up questionnaire in 2009 (N = 60,569) includes questions on caregiver status which were not available in 2005; accordingly, this study is confined to analysis of the 2009 data. We report cross-sectional associations between caregiver status and health. RESULTS Among the study participants in 2009, 27.5% reported being part-time caregivers and 6.6% reported being full-time caregivers. Compared to male non-caregivers, being a part-time or full-time male caregiver was associated with lower back pain (covariate-Adjusted Odds Ratios, AOR 1.36 and 1.67), with poor psychological health (AOR 1.16 and 1.68), but not with poor self-assessed health. Compared to female non-caregivers, being a part- or full-time female caregiver was associated with lower back pain (AOR 1.47 and 1.84), psychological distress (AOR 1.32 and 1.52), and poor self-assessed health (AOR 1.21 and 1.34). CONCLUSIONS Adult caregivers in Thailand experienced a consistent adverse physical and mental health burden. A dose-response effect was evident, with odds ratios higher for full-time caregivers than for part-time, and non-caregivers. Our findings should raise awareness of caregivers, their unmet needs, and support required in Thailand and other similar middle-income countries.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, The Australian National University, Building 62, Mills Rd, Acton 2601, Canberra, ACT, Australia
| | - David Harley
- National Centre for Epidemiology and Population Health, The Australian National University, Building 62, Mills Rd, Acton 2601, Canberra, ACT, Australia
| | - Sam-ang Seubsman
- School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health, The Australian National University, Building 62, Mills Rd, Acton 2601, Canberra, ACT, Australia
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Prince M, Brodaty H, Uwakwe R, Acosta D, Ferri CP, Guerra M, Huang Y, Jacob KS, Llibre Rodriguez JJ, Salas A, Sosa AL, Williams JD, Jotheeswaran AT, Liu Z. Strain and its correlates among carers of people with dementia in low-income and middle-income countries. A 10/66 Dementia Research Group population-based survey. Int J Geriatr Psychiatry 2012; 27:670-82. [PMID: 22460403 PMCID: PMC3504977 DOI: 10.1002/gps.2727] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Accepted: 03/08/2011] [Indexed: 12/01/2022]
Abstract
OBJECTIVES In a multi-site population-based study in several middle-income countries, we aimed to investigate relative contributions of care arrangements and characteristics of carers and care recipients to strain among carers of people with dementia. Based on previous research, hypotheses focused on carer sex, care inputs, behavioural and psychological symptoms (BPSD) and socioeconomic status, together with potential buffering effects of informal support and employing paid carers. METHODS In population-based catchment area surveys in 11 sites in Latin America, India and China, we analysed data collected from people with dementia and care needs, and their carers. Carer strain was assessed with the Zarit Burden Interview. RESULTS With 673 care recipient/carer dyads interviewed (99% of those eligible), mean Zarit Burden Interview scores ranged between 17.1 and 27.9 by site. Women carers reported more strain than men. The most substantial correlates of carer strain were primary stressors BPSD, dementia severity, needs for care and time spent caring. Socioeconomic status was not associated with carer strain. Those cutting back on work experienced higher strain. There was tentative evidence for a protective effect of having additional informal or paid support. CONCLUSIONS Our findings underline the global impact of caring for a person with dementia and support the need for scaling up carer support, education and training. That giving up work to care was prevalent and associated with substantial increased strain emphasizes the economic impact of caring on the household. Carer benefits, disability benefits for people with dementia and respite care should all be considered.
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Affiliation(s)
- Martin Prince
- King's College London, (Institute of Psychiatry, Centre for Global Mental Health, Health Service and Population Research Department), London, UK.
| | - Henry Brodaty
- Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, The University of New South WalesSydney, NSW, Australia
| | - Richard Uwakwe
- Nnamdi Azikiwe University Teaching HospitalNnewi, Anambra State, Nigeria
| | - Daisy Acosta
- Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine DepartmentGeriatric Section, Santo Domingo, Dominican Republic
| | - Cleusa P Ferri
- King's College London, (Institute of Psychiatry, Centre for Global Mental Health, Health Service and Population Research Department)London, UK
| | - Mariella Guerra
- Universidad Peruana Cayetano Heredia and Instituto de la Memoria y Desordenes RelacionadosLima, Perú
| | - Yueqin Huang
- Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University)Beijing, China
| | - KS Jacob
- Christian Medical CollegeVellore, India
| | | | - Aquiles Salas
- Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de VenezuelaCaracas, Venezuela
| | - Ana Luisa Sosa
- The Cognition and Behavior Unit, National Institute of Neurology and Neurosurgery of Mexico, Autonomous National University of MexicoDelegacion Tlalpan, Mexico City, Mexico
| | | | | | - Zhaorui Liu
- Peking University Institute of Mental Health, Key Laboratory of Mental Health, Ministry of Health (Peking University)Beijing, China
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Wakefield BJ, Hayes J, Boren SA, Pak Y, Davis JW. Strain and satisfaction in caregivers of veterans with chronic illness. Res Nurs Health 2011; 35:55-69. [DOI: 10.1002/nur.21456] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/01/2011] [Indexed: 11/08/2022]
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17
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Kang Y, Moyle W, Venturato L. Korean nurses’ attitudes towards older people with dementia in acute care settings. Int J Older People Nurs 2010; 6:143-52. [DOI: 10.1111/j.1748-3743.2010.00254.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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18
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Urban-rural comparisons of outcomes for informal carers of elderly people in the community: a systematic review. Maturitas 2010; 67:139-43. [PMID: 20598817 DOI: 10.1016/j.maturitas.2010.06.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2010] [Revised: 06/02/2010] [Accepted: 06/02/2010] [Indexed: 01/10/2023]
Abstract
As the age of the general population increases, the number of elderly people who need care is increasing. It has been suggested that rural carers may be disadvantaged compared to urban carers, but it is not clear what affect geographic location has on carers. This paper presents a systematic review of the literature on urban-rural comparisons on various outcomes for informal carers who provide care for elderly people in the community. Of 150 articles that were reviewed, eight articles were included with three themes in the outcomes for carers: service use, health promotion behaviors and psychological health (such as carer stress, burden or depressive symptoms). Overall, there were few consistent or statistically significant differences between urban and rural carers. Many of the differences observed were explained by other factors, such as carer or care recipient characteristics. The literature search was limited to papers in the English language, involving quantitative methods and published in peer-reviewed journals. There were not enough studies found to examine other outcomes or to pool data across studies. There is too little evidence comparing urban and rural carers to inform clinicians and policy makers. More good-quality research is urgently needed.
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19
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Yamamoto Y, Hayashino Y, Yamazaki S, Takegami M, Fukuhara S. Violent patient behavior is associated with bodily pain and a high burden on informal caregivers. J Gen Intern Med 2009; 24:1085-8. [PMID: 19579047 PMCID: PMC2762500 DOI: 10.1007/s11606-009-1060-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2008] [Revised: 03/04/2009] [Accepted: 06/09/2009] [Indexed: 11/25/2022]
Abstract
BACKGROUND There have been no studies of the relationship between violent behavior by older patients and the physical and mental health of caregivers. OBJECTIVE To evaluate the influence of violent behavior in vulnerable elderly patients on bodily pain and caregiver burden in their informal caregivers. DESIGN Cross-sectional study. SUBJECTS One hundred thirty-seven patients aged > or =40 years old with limited activity and mobility in ten facilities providing home-care services in Japan. MEASUREMENTS Degree of caregiver-perceived violent patient behavior and caregivers' bodily pain derived from a self-administered questionnaire, and caregiver burden assessed using scores from both the Burden Index of Caregivers and the Zarit Burden Interview. RESULTS The mean age of the 137 patients enrolled in this study was 80.9 years. Of these patients, 31.4% were men, and 34.3% had violent behavior. The mean caregiver age was 65.0 years, and 29.2% were men. Caregivers who looked after violent patients experienced significantly higher odds of having bodily pain [AOR = 3.51; 95% confidence interval (CI): 1.81 to 6.85]. Caregivers of violent patients also reported significant caregiver burden as assessed by the Burden Index of Caregivers (beta-coefficient = 4.92; 95% CI: 1.95 to 7.88) and the Zarit Burden Interview (beta-coefficient = 5.81; 95% CI: 2.92 to 8.70). CONCLUSIONS Violent behavior among older patients is associated with significant increases in both physical and psychological burden in their informal caregivers.
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Affiliation(s)
- Yosuke Yamamoto
- Department of Epidemiology and Healthcare Research, Graduate School of Medicine, Kyoto University, Yoshida Konoe-cho, Sakyo-ku, Kyoto, Japan.
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Abstract
Caregiving is a women's health issue globally, as many more women than men are informal caregivers. Caregiving related to gender role socialization, burden, and economic and health consequences has been discussed in the literature. Together this body of work demonstrates some positive but mainly negative consequences to the health and economic circumstances of women. Overall achievement of the United Nations' Millennium Development Goals has important implications for informal caregivers globally, because achievement of these goals is essential to reducing the undue burden, the lost opportunities, and the injustice of health care systems that take advantage of women's volunteer caregiving.
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Affiliation(s)
- Judith A Berg
- University of Arizona College of Nursing, Tucson, AZ 85739, USA.
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Hong GRS, Kim H. Family caregiver burden by relationship to care recipient with dementia in Korea. Geriatr Nurs 2008; 29:267-74. [PMID: 18694702 DOI: 10.1016/j.gerinurse.2007.09.004] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2006] [Revised: 09/14/2007] [Accepted: 09/15/2007] [Indexed: 10/21/2022]
Abstract
The purpose of this study is to compare demographic and clinical characteristics of caregivers and care recipients by caregiver type (i.e., daughter, son, daughter-in-law, and spouse) and to compare the caregiver burden among each type of caregiver. A cross-sectional survey design was used involving 157 primary family caregivers and their care recipients who were diagnosed with dementia. Participants were from the Korean capital and the surrounding suburbs. Spouse caregivers rated themselves as having poorer health and less social support than adult child caregivers did. Those cared for by daughters-in-law were older and demonstrated more memory and behavioral problems than those by spouses, sons, or daughters. Spouses perceived the highest burden among caregivers. Nursing interventions could be developed on the basis of the specific type of burden that various caregivers experience. For future studies, exploring the earlier marital relationship between spouse caregiver and care recipient would be useful for understanding the burden of spouse caregivers.
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Affiliation(s)
- Gwi-Ryung Son Hong
- Department of Nursing, College of Medicine, Hanyang University, Seoul, Korea
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Lai DWL, Surood S. Service Barriers of Chinese Family Caregivers in Canada. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2008; 51:315-336. [PMID: 19042654 DOI: 10.1080/01634370802039650] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
<p>Family caregiving is a stressful process, especially when the complexity of being an immigrant or ethnic minority is added. This paper examined service barriers experienced by Chinese immigrant family caregivers in Canada and the predictors of different types of barriers. Principle component analysis was performed with the barriers reported loading onto cultural barriers, administrative problems, circumstantial challenges, perceived negative quality of services, and personal attitudes. Multiple regression analysis was used to identify the role of the culture-related factors in predicting service barriers, controlling for socio-demographic status of the caregivers'. The results show that financial factors significantly predicted the number and types of barriers reported by the caregivers. Culture-related factors were significant in predicting the total number of access barriers and the different types of barriers experienced by the family caregivers. The findings indicate the importance of culturally sensitive support for family caregivers in order to reduce the access barriers.</p>
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