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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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King JJ, Badger TA, Segrin C, Thomson CA. Loneliness, Spirituality, and Health-Related Quality of Life in Hispanic English-Speaking Cancer Caregivers: A Qualitative Approach. JOURNAL OF RELIGION AND HEALTH 2024; 63:1433-1456. [PMID: 37665415 DOI: 10.1007/s10943-023-01880-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/25/2023] [Indexed: 09/05/2023]
Abstract
Hispanic caregivers experiencing higher caregiving burden than their non-Hispanic cohorts, due in part to contextual factors, such as barriers to accessing health care, challenging employment environments, low education and income, immigration issues, and minority stress. Spirituality may serve as a coping strategy for Hispanic caregivers that influences health-related quality of life (HRQoL), possibly by modifying loneliness associated with caregiving. We explored these concepts using semi-structured interviews (N = 10 Hispanic caregivers). Participants shared perceptions of loneliness, spirituality, and how these factors related to HRQoL. Five themes emerged: caregiver experience, coping strategies, loneliness, religion and spirituality to gain strength. Findings suggested that spirituality and religion improved HRQoL partially by reducing loneliness. Future programs to improve HRQoL in Hispanic English-speaking cancer caregivers should address spirituality.
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Affiliation(s)
- Jennifer J King
- University of Arizona Cancer Center, University of Arizona, 1295 N. Martin Ave., Drachman Hall, A260, PO Box 245209, Tucson, AZ, 85719, USA.
| | - Terry A Badger
- College of Nursing, University of Arizona, Tucson, AZ, USA
| | - Chris Segrin
- College of Social and Behavioral Sciences, University of Arizona, Tucson, AZ, USA
| | - Cynthia A Thomson
- Department of Health Promotion Sciences, The University of Arizona Cancer Center, University of Arizona, Tucson, AZ, USA
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Ruyant Belabbas E, Manceau C, Wawrziczny E. The relationship at the heart of the experience of daughter caregivers of a parent with dementia: An interpretative phenomenological analysis. DEMENTIA 2024; 23:175-190. [PMID: 38078431 DOI: 10.1177/14713012231220223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Parents with dementia require emotional, physical, psychological and financial support from their child caregivers to continue living at home. Daughter caregivers have been shown to be more involved in self-care and household tasks and to experience higher levels of distress than son caregivers. OBJECTIVE The aim of this study was to investigate the experience of daughter caregivers who provide informal care for a parent with dementia living in their own home. METHOD Semi-structured interviews were conducted with 11 daughter caregivers of a parent with Alzheimer's disease. Interviews were analysed using Interpretative Phenomenological Analysis. RESULTS Three axes emerged from the analyses: [1] the before conditions the after: the quality of the previous relationship with the parent with Alzheimer's disease is a determining factor and allows the identification of three profiles of daughter caregivers: 'the grateful', 'the resentful' and 'the ambivalent', [2] when the relationship protects against the sense of burden: the feeling of being invaded by the caregiving situation is influenced by the quality of the relationship with the parent with Alzheimer's disease, and [3] alone or almost: the support network is desired when it is absent but kept at arm's length when it is present. DISCUSSION The results underline the importance of assessing the quality of attachment and supporting the relationship with the parent (especially when the relationship prior to the disease was difficult). Daughter caregivers should also be encouraged to delegate tasks and refocus their actions related to their values. Family mediation sessions may be planned to improve the organisation of care and set up an efficient collaboration.
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Affiliation(s)
| | - Charlotte Manceau
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
| | - Emilie Wawrziczny
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
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Interactions, relationships and belonging: comparing social connectedness and perceived isolation among older women living alone in private homes and in assisted living. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22000812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Age-related changes shape social connectedness, isolation and loneliness among older adults. Ageing often accompanies decisions about ageing in place or moving (i.e. senior living facility). Scant research compares these two living arrangements and even sparser research focuses on older women. This study, thus, poses the following questions: How do older women (aged 75+ years) experience social connectedness and perceived isolation? How does this experience vary between older women living alone in private homes and those living in assisted living facilities? Data include semi-structured interviews with women aged 75+ years who live alone in a private home or in an assisted living facility (N = 16). Findings revealed differences in three aspects of social connectedness: interactions, relationships and belonging. Private home participants' interactions underscored intentionality, with minimal investment in forging new or deeper relationships and an emphasis on belonging to the world through awareness, contribution and cognitive ability. The experiences of participants living in assisted living were characterised by availability of interactions and casual relationships. They emphasised belonging to the facility community, while positioning themselves between the status of resident and staff. Surprisingly, most participants in both groups did not express feelings of perceived isolation. Both had adapted their social connectedness expectations to reflect their current situation.
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Kokorelias KM, Naglie G, Gignac MA, Rittenberg N, Cameron JI. A qualitative exploration of how gender and relationship shape family caregivers' experiences across the Alzheimer's disease trajectory. DEMENTIA 2021; 20:2851-2866. [PMID: 33998323 PMCID: PMC8678646 DOI: 10.1177/14713012211019502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Caregiving experiences are not static. They change across the disease trajectory and care continuum. However, it is not clear how caregiver gender or relationship type is related to evolving caregiver experiences over time. This qualitative study informed by constructivist grounded theory and framework analysis explored the experiences over time of men and women who were adult children and spousal caregivers to persons with Alzheimer's disease. Forty spousal (10 husbands and 10 wives) and adult children (10 sons and 10 daughters) caregivers to persons with Alzheimer's disease were interviewed using a semi-structured interview guide. Our findings suggest the experiences of caregiving, examined through a gender and relationship type lens, are complex and variable. The caregiving experience was not related to gender or relationship type alone, but often to a combination of the two. For instance, spousal caregivers did not immediately accept the diagnosis, with wives being more optimistic than husbands about a slow progression of the disease. Adult children caregivers were concerned about the ways the caregiving role would impact their personal and career obligations and sought ways to mitigate the changes to their daily lives. Sons and husband caregivers largely utilized home and community health services to assist with personal care tasks, whereas daughters and wives utilized the same services to allow them to complete other caregiving tasks (e.g., housekeeping). Recognition of the complex inter-relationships among gender and relationship type on caregiving experiences supports the need for family-centered interventions. This article also extends sex and gender research as it highlights that an in-depth understanding of the caregiving experience cannot be understood by gender alone and relationship type must also be considered.
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Affiliation(s)
| | - Gary Naglie
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, Rotman Research Institute, 7942Baycrest Health Sciences, Toronto, ON, Canada
| | - Monique Am Gignac
- Dalla Lana School of Public Health, 274071University of Toronto, Toronto, ON, Canada; 7966Institute for Work and Health, Toronto, ON, Canada
| | - Nira Rittenberg
- Department of Occupational Therapy and Occupational Sciences, 7938The Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, The Temerty Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, 12366University of Toronto, Toronto, ON, Canada
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Mendez-Luck CA, Anthony KP, Guerrero LR. Burden and Bad Days Among Mexican-Origin Women Caregivers. J Gerontol B Psychol Sci Soc Sci 2020; 75:1719-1730. [PMID: 31420678 DOI: 10.1093/geronb/gbz102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES This article examines the construct of burden and the use of coping strategies among Mexican-origin caregivers of older adults. METHODS In-depth semistructured interviews were conducted with 44 Mexican-origin women caregivers living in the East Los Angeles area. Audio files were transcribed and analyzed in Atlas.ti V7.1.8. Data were analyzed using a grounded theory approach. RESULTS Caregivers did not typically talk about caregiving as a burden per se; they used other terms for burden that resonated with their experiences. Caregivers viewed caregiving difficulty in physical and emotional terms as it related to specific caregiving circumstances and situations. Caregivers used a variety of coping strategies to get through bad days, including reframing stressful situations to make sense of their circumstances. DISCUSSION Findings shed light on the mixed results found in the literature on Latino caregiving burden. Results suggest that Mexican-origin women caregivers have a more nuanced experience of caregiving burden than has been found in prior literature. Results also suggest research using traditional measures of burden may not fully capture situational and cultural distinctions to the extent Mexican-origin caregivers ascribe other language to represent difficult caregiving experiences.
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Ilik F, Büyükgöl H, Kayhan F, Ertem DH, Ekiz T. Effects of Inappropriate Sexual Behaviors and Neuropsychiatric Symptoms of Patients With Alzheimer Disease and Caregivers' Depression on Caregiver Burden. J Geriatr Psychiatry Neurol 2020; 33:243-249. [PMID: 31526077 DOI: 10.1177/0891988719874123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
OBJECTIVE We investigated the effects of inappropriate sexual behaviors (ISBs) and neuropsychiatric symptoms (NPSs) of patients with Alzheimer disease (AD), and of caregivers' depression, on the caregiver burden. METHOD One hundred forty three patients with AD and their caregivers were included in the study. Sixty-five patients without AD who needed care due to their disability and their caregivers were enrolled for the comparison. Depression in caregivers was diagnosed using The Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (SCID-I). The Mini-Mental State Examination (MMSE) and Clinical Dementia Rating Scale were used to evaluate the severity of AD. The Neuropsychiatric Inventory (NPI) was used to assess the NPSs of patients. Caregiver burden was evaluated using the Zarit Burden Interview (ZBI). RESULTS Inappropriate sexual behaviors were found in 13 (9.1%) of the AD group. Inappropriate sexual behaviors were more common in moderate or severe AD (P = .009, χ2 = 9.396). The prevalence of depression (n = 38, 26.6%) was higher in caregivers of AD group with ISBs (P = .000, χ2 = 24.69). The ZBI scores of caregivers of patients with AD were higher than the comparison group. In addition, the ZBI scores of caregivers of patients with AD were significantly higher in the AD group with ISB, a high total score of NPI, and a low score of MMSE. The caregivers of AD group with depression had higher ZBI scores (P < .05). CONCLUSIONS The severity of AD, the presence of NPSs in patients, and major depression in caregivers were risk factors for an increased caregiver burden.
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Affiliation(s)
- Faik Ilik
- Department of Neurology, KTO University Medical Faculty affiliated Konya Medicana Hospital, Konya, Turkey
| | - Hüseyin Büyükgöl
- Department of Neurology, KTO University Medical Faculty affiliated Konya Medicana Hospital, Konya, Turkey
| | - Fatih Kayhan
- Department of Psychiatry, Private Institution, Konya, Turkey
| | - Devrimsel Harika Ertem
- University of Health Sciences, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, Turkey
| | - Timur Ekiz
- İstanbul Gedik University, Faculty of Health Sciences, Department of Physical Therapy and Rehabilitation, İstanbul, Turkey
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Guerrero LR, Mendez-Luck CA. Overcoming a Bad Day: a Qualitative Look into the Dementia Caregiving Experiences of Mexican-Origin Women in East Los Angeles. J Cross Cult Gerontol 2020; 34:373-384. [PMID: 31134464 DOI: 10.1007/s10823-019-09373-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
The number of Latinos with Alzheimer's disease (AD) is projected to more than double by 2030. Yet, the current literature is lagging on Alzheimer's caregiving among Latinos. This study explores how Mexican origin women experience dementia caregiving, and the coping strategies they use to manage their caregiving situations. Nine women were identified as caregivers of a family member with AD or dementia from a larger study on caregiving. Interviews with them were collected and subsequently analyzed using a modified grounded theory approach to reduce the data to identify thematic content. All but one participant described caregiving as "tiring," "wearing," or "hard." They reported suffering from stress, insomnia, nervousness, migraines, and/or depression because of their caregiving experiences. Participants engaged in various coping strategies to help combat the perceived negative consequences of their caregiving experiences. The most commonly reported strategies were various forms of distraction, and meditation or prayer. The Mexican origin women in this study experience faced two types of interpersonal challenges related to dementia caregiving: changes in the care receiver's personality and behaviors, and physical care needs. They engaged in various coping to strategies to address the difficulties of their situation. This study provides formative research for identifying research questions and topics of examination in the future.
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Affiliation(s)
- Lourdes R Guerrero
- David Geffen School of Medicine at UCLA Medicine, Geriatrics, BOX 951687, 2339 PVUB, Los Angeles, CA, 90095-1687, USA.
| | - Carolyn A Mendez-Luck
- College of Public Health & Human Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, 97331, USA
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Phetsitong R, Vapattanawong P, Sunpuwan M, Völker M. State of household need for caregivers and determinants of psychological burden among caregivers of older people in Thailand: An analysis from national surveys on older persons. PLoS One 2019; 14:e0226330. [PMID: 31826014 PMCID: PMC6905555 DOI: 10.1371/journal.pone.0226330] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 11/25/2019] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES To explore the levels and trends of household need for caregivers of older people and to explore the impact of potential determinants of psychological burden among caregivers of older people in Thailand. METHODS The secondary data analysis was performed using the Survey of Older Persons in Thailand 2007, 2011, and 2014 datasets which conducted by the National Statistical Office of Thailand. The household need for caregivers of older persons refers to having at least one older person in the household who needs a caregiver for assistance with activities of daily living. Caregiver mental health, which is confined to the available 2011 data, is defined as a state of psychological burden. Ordinal logistic regression models were used to explore the impact of potential determinants of psychological caregiver burden. RESULTS The household need for caregivers in Thailand tends to be increasing, from 5.0% in 2007 to 6.6% in 2014. The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households. In terms of psychological caregiver burden, the Thai Mental Health Indicators in 2011 produced, on average, a fair level of mental health, but one-fourth of caregivers had poor mental health. Duration of care for older people, household wealth, and functional dependency significantly predict total caregiver burden. Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high (odds ratio = 2.34; 95% confidence interval = 1.47-3.73). CONCLUSION The increasing need for caregiving in households with an older person can lead to a higher caregiver burden, particularly among those caregivers who care for dependent older people in poor households. Longer duration of caregiving is a factor that mitigates this burden.
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Affiliation(s)
- Ruttana Phetsitong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Patama Vapattanawong
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
- * E-mail:
| | - Malee Sunpuwan
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
| | - Marc Völker
- Institute for Population and Social Research, Mahidol University, Nakhon Pathom, Thailand
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Abstract
OBJECTIVES Providing care for a person with dementia or other chronic illness at home often places stress on the primary caregiver. In an Irish population, ~67% of carers reported experiencing extreme physical or mental tiredness. This study aimed to identify factors that influence carer burden and identify the sub-populations of carers who are most susceptible to burden. METHODS Consecutive carers referred to a local carers' support organisation completed the following measurements: the Neuropsychiatric Inventory, Zarit Burden Interview, Social Network Index, General Health Questionnaire, Short Form Survey, Hamilton Depression Rating Scale, Brown's Locus of Control scale and provided demographic data on themselves and their patient. RESULTS The sample consisted 53 carers, mean age: 64.5±11.7, of whom 43 (81.1%) were females. A linear regression model found significant independent (p<0.05) factors for carer burden were: increased behavioural problems of the patient, carer characteristics including female gender, younger age, high number of contacts, lower physical functioning and emotional problems, while protective factors were marriage and higher number of embedded networks. CONCLUSIONS The ability to predict which carers are more susceptible to burden allows service providers to more quickly and accurately identify 'higher risk' carers, facilitating routine check-ups by physicians and carer support services.
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Childers KM. Sense of Coherence and Caregivers of Persons with Dementia. Behav Sci (Basel) 2019; 9:E14. [PMID: 30696071 PMCID: PMC6406261 DOI: 10.3390/bs9020014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/19/2019] [Accepted: 01/22/2019] [Indexed: 01/07/2023] Open
Abstract
Unpaid caregivers (CG) provide most of the assistance to persons with dementias (PWD) living in the community. This study explores the current state of knowledge regarding the concept of sense of coherence (SOC) and CG of PWD via a concept analysis. The identified defining attributes were health, health-related quality of life (HRQoL), CG burden, CG stress, coping as a strength, gender, and decreasing sense of CG coherence over the progression of the disease (dementia). Further study by health care professionals using clinical observations, large samples of respondents, a consistent theory, valid and reliable instruments used to measure defining attributes consistently, and critical reviews of the literature are needed.
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Affiliation(s)
- Kristina M Childers
- School of Nursing Student in Ph. D Nursing Program, West Virginia University Morgantown, WV 26506-9600, USA.
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12
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Theurer C, Burgsmüller L, Wilz G. [Care of parents with dementia: comparison of caregiving sons and daughters]. Z Gerontol Geriatr 2018; 52:648-653. [PMID: 30519768 DOI: 10.1007/s00391-018-01483-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/22/2018] [Accepted: 11/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND In view of the demographic changes and the associated increasing need for care, the role of caregiving sons will also become more important; however, little is known about the caregiving experiences of sons. OBJECTIVE Potential differences between caregiving sons and daughters were investigated with respect to the style of caregiving, the feeling of stress and burden and the utilization of support offers. MATERIAL AND METHODS Baseline survey data from the interventional study Tele.TAnDem conducted from September 2012 to January 2014 were analyzed. From the total sample of 322 caregiving relatives of people suffering from dementia the participating sons (n = 17) were selected. For comparison 17 participants from the subsample of daughters (n = 111) were selected by propensity score matching. The analyses were conducted using t‑tests, Mann-Whitney tests and χ2-tests. RESULTS The analyses regarding the style of caregiving, the feeling of stress and burden and the utilization of professional and informal assistance did not reach statistical significance. Daughters scored on average higher than sons only with respect to the acceptance of the caregiving situation (p < 0.05). CONCLUSION Overall caregiving daughters and sons did not differ with respect to caregiving experiences as strongly as previously assumed. Perhaps earlier studies found more gender differences because caregiving sons compared to daughters already have different initial situations, which however remained uncontrolled.
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Affiliation(s)
- Christina Theurer
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland.
| | - Lena Burgsmüller
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland
| | - Gabriele Wilz
- Abteilung Klinisch-Psychologische Intervention, Institut der Psychologie, Friedrich-Schiller-Universität Jena, Semmelweißstraße 12, 07743, Jena, Deutschland
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Cho Y, Jeon Y, Jang SI, Park EC. Family Members of Cancer Patients in Korea Are at an Increased Risk of Medically Diagnosed Depression. J Prev Med Public Health 2018; 51:100-108. [PMID: 29631349 PMCID: PMC5897230 DOI: 10.3961/jpmph.17.166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 01/31/2018] [Indexed: 12/21/2022] Open
Abstract
Objectives Family members are often cancer patients’ primary source of social and emotional support and make a major contribution to how well patients manage their illness. We compared the prevalence of depression in the family members of cancer patients and the general population. Methods This study used the data from the fourth, fifth, and sixth rounds of the Korea National Health and Nutrition Examination Survey. The variable of interest was the presence of a cohabitating cancer patient in the family and the dependent variable was the presence of diagnosed depression. Results The odds of having medically diagnosed depression in those with a cohabitating cancer patient in the family were significantly higher than among those who did not have cancer patients in their families (odds ratio [OR], 1.56; 95% confidence interval [CI], 1.12 to 2.17; p=0.009). The OR for females was 1.59, and this increase was statistically significant (95% CI, 1.09 to 2.31; p=0.02). Conclusions We need to invest more effort into diagnosing and managing depression in the family members of cancer patients. This will have an impact both on their quality of life and on the well-being of patients, as supporters and caregivers play an instrumental role in helping patients manage their illness.
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Affiliation(s)
- Youngdae Cho
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yongwoo Jeon
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sung-In Jang
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Eun-Cheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Namkung EH, Greenberg JS, Mailick MR. Well-being of Sibling Caregivers: Effects of Kinship Relationship and Race. THE GERONTOLOGIST 2018; 57:626-636. [PMID: 26884066 DOI: 10.1093/geront/gnw008] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 11/09/2015] [Indexed: 11/13/2022] Open
Abstract
Purpose of the Study This study examined whether caregiving has a differential effect on the well-being of sibling caregivers relative to other caregiving groups and whether race moderates this effect. Design and Methods Using the National Survey of Midlife Development in the United States, 631 family caregivers (including 61 sibling caregivers) and 4,944 noncaregivers were identified. Hierarchical regression analyses were conducted to estimate the effect of the caregiver-care recipient relationship and its interaction with race on caregivers' well-being (i.e., depressive symptoms, self-rated health, life satisfaction, and perceived control over life). Results Caregivers in general reported poorer well-being than noncaregivers, but sibling caregivers were less affected by caregiving than parent or spouse caregivers. Among sibling caregivers, caregiving took a significantly greater toll on non-Hispanic White caregivers than those from minority groups with respect to depressive symptoms and life satisfaction. Implication The findings suggest that the experience of sibling caregivers is significantly shaped by their cultural background.
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Affiliation(s)
| | - Jan S Greenberg
- School of Social Work.,Waisman Center, University of Wisconsin-Madison
| | - Marsha R Mailick
- School of Social Work.,Waisman Center, University of Wisconsin-Madison
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Torrisi M, De Cola MC, Marra A, De Luca R, Bramanti P, Calabrò RS. Neuropsychiatric symptoms in dementia may predict caregiver burden: a Sicilian exploratory study. Psychogeriatrics 2017; 17:103-107. [PMID: 27411501 DOI: 10.1111/psyg.12197] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2015] [Revised: 12/30/2015] [Accepted: 01/29/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Behavioural and psychological symptoms of dementia are very common. They represent a main cause of burden and distress in caregivers and can lead to early institutionalization of patients. We aimed to find the most specific behavioural and psychological symptoms of dementia that can strongly affect the caregivers' burden. METHODS Twenty-seven patients and their caregivers were enrolled in this study. All of the patients were affected by Alzheimer's, vascular, or frontotemporal dementia and were evaluated with the Neuropsychiatric Inventory and Mini-Mental State Examination. Caregivers were administered the Caregiver Burden Inventory. RESULTS Apathy, depression, anxiety, and agitation were the most common symptoms and were found in up to 90% of the patients. We detected strong correlations between patient neuropsychiatric symptoms, (i.e. irritability, hallucinations, aberrant motor behavioural, depression, and agitation) and Caregiver Burden Inventory scores. Multiple regression analysis found hallucinations, irritability, and depression to be significant predictors of caregiver burden. Moreover, the Neuropsychiatric Inventory score was more closely related to caregiver burden than the Mini-Mental State Examination score. CONCLUSION Our results revealed that demented patients' behavioural problems are related to the level of caregiver burden and distress. Further investigations are needed to differentiate the present findings among dementia subtypes and to better evaluate the effect of caregivers' personal characteristics on their own burden.
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Affiliation(s)
- Michele Torrisi
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
| | - Maria C De Cola
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
| | - Angela Marra
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
| | - Rosaria De Luca
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
| | - Placido Bramanti
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
| | - Rocco S Calabrò
- Behavior and Robotic Neurorehabilitation Laboratory, Istituto di Ricerca e Cura a Carattere Scientifico, Centro Neurolesi 'Bonino-Pulejo', Messina, Italy
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Choi NG, Burr JA, Mutchler JE, Caro FG. Formal and Informal Volunteer Activity and Spousal Caregiving Among Older Adults. Res Aging 2016. [DOI: 10.1177/0164027506296759] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
On the basis of data from the 1998 and 2000 waves of the Health and Retirement Study, this study tested two alternative hypotheses, role overload and role extension, about the relationship between volunteering and spousal caregiving among older married persons. Spousal caregiving was not significantly associated with the likelihood of formal or informal volunteering for men; however, female caregivers were found to be less likely than noncaregivers to have engaged in formal or informal volunteering to a certain extent, thus lending partial support to the role overload hypothesis. Functional health status and other human and cultural capital resources were significant predictors of both formal and informal volunteering for both men and women. Future studies need to examine in more depth the effect of spousal caregiving on volunteering, taking caregiving burden and stress into consideration, to more fully understand these two types of productive activity in later life.
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Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family - caregivers of people with mental illnesses. World J Psychiatry 2016; 6:7-17. [PMID: 27014594 PMCID: PMC4804270 DOI: 10.5498/wjp.v6.i1.7] [Citation(s) in RCA: 356] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/15/2015] [Accepted: 12/13/2015] [Indexed: 02/05/2023] Open
Abstract
All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly assuming roles as caregivers. However, the experience of men while providing care has not been explored adequately. The impact of gender on caregiving outcomes may be mediated by several other variables including patient-related factors, socio-demographic variables, and effects of kinship status, culture and ethnicity, but these have seldom been considered in the research on gender differences. Finally, it is apparent that methodological variations in samples, designs and assessments between studies contribute a great deal to the observed gender differences. This review highlights all these issues and concludes that there is much need for further research in this area if the true nature of gender differences in family-caregiving of mental illnesses is to be discerned.
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Kim EY, Yeom HE. Influence of home care services on caregivers' burden and satisfaction. J Clin Nurs 2016; 25:1683-92. [PMID: 26898819 DOI: 10.1111/jocn.13188] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2015] [Indexed: 12/23/2022]
Abstract
AIMS AND OBJECTIVES To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. BACKGROUND Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. DESIGN A cross-sectional study. METHODS A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. RESULTS There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. CONCLUSIONS Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. RELEVANCE TO CLINICAL PRACTICE Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning.
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Affiliation(s)
- Eun-Young Kim
- Department of Nursing, Dong-A University, Busan, Korea
| | - Hyun-E Yeom
- Department of Nursing, Dongguk University, Gyeongju, Korea
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Abstract
BACKGROUND Few studies have estimated care burden in large, representative, multi-ethnic Asian population-based informal caregivers of older adults with care needs. This study describes informal caregivers' care participation for a population-based sample of older adults with care needs in Singapore, investigates differences by dementia status, and examines correlates of caregivers' burden. METHODS Data collected from 693 pairs of older adults, aged 60 to 100 years, having any care needs, and their informal caregivers, who were aged 21 to 88 years, closely involved in their care and "knew the older resident best," and were interviewed during a cross-sectional national survey, were used. Clinical characteristics of older adults, including behavioral and psychological symptoms of dementia (BPSD) and dementia diagnosis, care needs, and socio-demographic characteristics of participants were obtained. Care burden was assessed with the Zarit Burden Interview. RESULTS Informal caregivers' participation was highest in activities related to communication (35.1%), feeding (32%), and bathing (21.1%). Among the older adults with any care need, 356 (51.4%) had dementia. Care burden was significantly associated with married caregivers (odds ratio (OR) 2.4 vs. never married), when their relative belonged to a younger cohort (OR 2.5 vs. >84 years), needed care much of the time (OR 2.5 vs. no care needed), exhibited BPSD (OR 3.5 vs. no BPSD), and had dementia (OR 2.52 vs. no dementia). CONCLUSIONS Factors related to older adults--more care needs, presence of BPSD, and dementia--were significant contributors to informal caregivers' burden, and these should be considered while planning interventions to alleviate care burden.
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Lo Sterzo E, Orgeta V. Illness representation and sense of coherence in dementia caregiving. J Health Psychol 2015; 22:722-732. [DOI: 10.1177/1359105315613132] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The objectives of this study were to describe illness representations in dementia caregiving and examine the relationship between illness perceptions and carers’ sense of coherence. Illness perceptions were assessed by the Brief Illness Perception Questionnaire. We measured sense of coherence, symptoms of anxiety and depression and carer burden. Regression analyses indicated that after controlling for demographic factors, burden and psychological distress in carers, illness coherence and emotional responses to the disease independently contributed towards explaining variance in carers’ sense of coherence. Results provide support for the usefulness of the self-regulation model in understanding dementia caregiving.
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Affiliation(s)
- Elena Lo Sterzo
- Studi Cognitivi, Cognitive Psychotherapy School, Modena, Italy
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Arai Y, Kumamoto K, Mizuno Y, Washio M. Depression among family caregivers of community-dwelling older people who used services under the Long Term Care Insurance program: a large-scale population-based study in Japan. Aging Ment Health 2015; 18:81-91. [PMID: 23631721 DOI: 10.1080/13607863.2013.787045] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To identify predictors for depression among family caregivers of community-dwelling older people under the Long Term Care Insurance (LTCI) program in Japan through a large-scale population-based survey. METHOD All 5938 older people with disabilities, using domiciliary services under the LTCI in the city of Toyama, and their family caregivers participated in this study. Caregiver depression was defined as scores of ≥16 on the Center for Epidemiological Studies Depression Scale (CES-D). Other caregiver measures included age, sex, hours spent caregiving, relationship to the care recipient, income adequacy, living arrangement, self-rated health, and work status. Care recipient measures included age, sex, level of functional disability, and severity of dementia. The data from 4128 pairs of the care recipients and their family caregivers were eligible for further analyses. A multiple logistic regression analysis was used to examine the predictors associated with being at risk of clinical depression (CES-D of ≥16). RESULTS Overall, 34.2% of caregivers scored ≥16 on the CES-D. The independent predictors for depression by logistic regression analysis were six caregiver characteristics (female, income inadequacy, longer hours spent caregiving, worse subjective health, and co-residence with the care recipient) and one care-recipient characteristic (moderate dementia). CONCLUSION This is one of the first population-based examinations of caregivers of older people who are enrolled in a national service system that provides affordable access to services. The results highlighted the importance of monitoring caregivers who manifest the identified predictors to attenuate caregiver depression at the population level under the LTCI.
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Affiliation(s)
- Yumiko Arai
- a Department of Gerontological Policy, National Center for Geriatrics and Gerontology (NCGG) , Aichi , Japan
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22
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Sutter M, Perrin PB, Peralta SV, Stolfi ME, Morelli E, Peña Obeso LA, Arango-Lasprilla JC. Beyond Strain: Personal Strengths and Mental Health of Mexican and Argentinean Dementia Caregivers. J Transcult Nurs 2015; 27:376-84. [PMID: 25712148 DOI: 10.1177/1043659615573081] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Life expectancy is increasing in Latin America resulting in the need for more family caregivers for older adults with dementia. The purpose of the current study was to examine the relationships between personal strengths (optimism, sense of coherence [SOC], and resilience) and the mental health of dementia caregivers from Latin America. METHOD Primary family dementia caregivers (n = 127) were identified via convenience sampling at the Instituto de Neurociencias de San Lucas, Argentina, and CETYS University, in Baja California, Mexico and completed measures of these constructs. FINDINGS Personal strengths explained between 32% and 50% of the variance in caregiver mental health. In a series of hierarchical multiple regressions, more manageability (β = -.38, p = .001), general resilience (β = -.24, p = .012), and social competence (β = -.21, p = .034) were uniquely associated with lower depression. Greater comprehensibility (β = -.28, p = .008) was uniquely associated with decreased burden, and manageability was marginally related (β = -.21, p< .10). Greater optimism (β = .37, p< .001) and manageability (β = .27, p = .004) were uniquely associated with increased life satisfaction. DISCUSSION The personal strengths of caregivers in Latin America may be particularly important for their mental health because of the culturally imbedded sense of duty toward older family members. IMPLICATIONS Incorporating strengths-based approaches into research on caregiver interventions in regions where caregiving is a highly culturally valued role such as Latin America may have the potential to improve the mental health of dementia caregivers.
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Affiliation(s)
- Megan Sutter
- Virginia Commonwealth University, Richmond, VA, USA
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Tzeng NS, Chang CW, Hsu JY, Chou YC, Chang HA, Kao YC. Caregiver Burden for Patients with Dementia with or Without Hiring Foreign Health Aides: A Cross-Sectional Study in a Northern Taiwan Memory Clinic. JOURNAL OF MEDICAL SCIENCES 2015. [DOI: 10.4103/1011-4564.172999] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ng S, Morgan RO, Walder A, Biswas J, Bass DM, Judge KS, Snow AL, Wilson N, Kunik ME. Functional Decline Predicts Emergency Department Use in Veterans With Dementia. Am J Alzheimers Dis Other Demen 2014; 29:362-71. [PMID: 24413540 PMCID: PMC10852555 DOI: 10.1177/1533317513518655] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND We examined emergency room (ER) utilization by persons with dementia (PWDs) using caregiver and patient characteristics as predictors. METHODS A secondary analysis of 296 veteran-caregiver dyads. Caregivers recorded PWD baseline characteristics and noted ER visits over the next year. Two sets of regression models analyzed categorical ER use and repeat ER use. RESULTS In the univariate analysis, categorical use of the ER was predicted by patients' functional status (P ≤ .008) and Veterans Affairs priority grouping (P ≤ .02). Repeat ER admissions were predicted by functional status (P ≤ .04), number of chronic conditions (P ≤ .01), and caregiver-reported relationship strain (P ≤ .04). In multivariate analysis, categorical ER use was predicted by functional status (P ≤ .02), priority grouping (P ≤ .03), and number of chronic conditions (P ≤ .06). CONCLUSIONS Functional status most strongly predicted ER use, highlighting the promise of home-based interventions to improve activities of daily living. Number of chronic conditions and caregiver-reported relationship strain are potential targets of intervention during discharge process.
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Affiliation(s)
- Stephanie Ng
- Baylor College of Medicine, Houston, TX, USA Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA
| | - Robert O Morgan
- Management, Policy and Community Health, The University of Texas School of Public Health, Houston, TX, USA
| | - Annette Walder
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA Baylor College of Medicine, Houston, TX, USA
| | - Jonmenjoy Biswas
- Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA Baylor College of Medicine, Houston, TX, USA
| | - David M Bass
- Margaret Blenkner Research Institute, Benjamin Rose Institute, Cleveland, OH, USA
| | - Katherine S Judge
- Department of Psychology, Cleveland State University, Cleveland, OH, USA
| | - A Lynn Snow
- Center for Mental Health and Aging, University of Alabama, Tuscaloosa Veterans Affairs Medical Center, Tuscaloosa, AL, USA
| | - Nancy Wilson
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA Baylor College of Medicine, Houston, TX, USA
| | - Mark E Kunik
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA Baylor College of Medicine, Houston, TX, USA Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA VA South Central Mental Illness Research, Education and Clinical Center, USA
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Viana MC, Gruber MJ, Shahly V, Alhamzawi A, Alonso J, Andrade LH, Angermeyer MC, Benjet C, Bruffaerts R, Caldas-de-Almeida JM, Girolamo GD, Jonge PD, Ferry F, Florescu S, Gureje O, Haro JM, Hinkov H, Hu C, Karam EG, Lépine JP, Levinson D, Posada-Villa J, Sampson NA, Kessler RC. Family burden related to mental and physical disorders in the world: results from the WHO World Mental Health (WMH) surveys. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 35:115-25. [PMID: 23904015 DOI: 10.1590/1516-4446-2012-0919] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 08/08/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To assess prevalence and correlates of family caregiver burdens associated with mental and physical conditions worldwide. METHODS Cross-sectional community surveys asked 43,732 adults residing in 19 countries of the WHO World Mental Health (WMH) Surveys about chronic physical and mental health conditions of first-degree relatives and associated objective (time, financial) and subjective (distress, embarrassment) burdens. Magnitudes and associations of burden are examined by kinship status and family health problem; population-level estimates are provided. RESULTS Among the 18.9-40.3% of respondents in high, upper-middle, and low/lower-middle income countries with first-degree relatives having serious health problems, 39.0-39.6% reported burden. Among those, 22.9-31.1% devoted time, 10.6-18.8% had financial burden, 23.3-27.1% reported psychological distress, and 6.0-17.2% embarrassment. Mean caregiving hours/week was 12.9-16.5 (83.7-147.9 hours/week/100 people aged 18+). Mean financial burden was 15.1% of median family income in high, 32.2% in upper-middle, and 44.1% in low/lower-middle income countries. A higher burden was reported by women than men, and for care of parents, spouses, and children than siblings. CONCLUSIONS The uncompensated labor of family caregivers is associated with substantial objective and subjective burden worldwide. Given the growing public health importance of the family caregiving system, it is vital to develop effective interventions that support family caregivers.
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Affiliation(s)
- Maria Carmen Viana
- Department of Social Medicine, Universidade Federal do Espírito Santo (UFES), Vitória, ES, Brazil.
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Clinical Characterization and the Caregiver Burden of Dementia in China. Value Health Reg Issues 2013; 2:118-126. [DOI: 10.1016/j.vhri.2013.02.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Abstract
This study explored the experiences of sons caring for a parent with dementia. Individual, semi-structured interviews were conducted with a purposeful sample of sons ( n = 13) in a rural part of Ireland. Interviews were audiotaped, transcribed verbatim and analysed for common themes. The key themes that emerged were ‘the parental bond’, ‘a binding role’, ‘coordinating care and support’ and a ‘getting on with it’ approach to care. The study highlighted the commitment of sons to their caregiving role and the strong sense of duty that motivated them to provide care. The findings suggested that while many aspects of the caregiving experience such as lack of information and support are gender neutral, there are differences in the caregiving experiences of men and women in how they view their relationship with their parent and in the management of their caregiving role that merit further investigation.
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Shahly V, Chatterji S, Gruber MJ, Al-Hamzawi A, Alonso J, Andrade LH, Angermeyer MC, Bruffaerts R, Bunting B, Caldas-de-Almeida JM, de Girolamo G, de Jonge P, Florescu S, Gureje O, Haro JM, Hinkov HR, Hu C, Karam EG, Lépine JP, Levinson D, Medina-Mora ME, Posada-Villa J, Sampson NA, Trivedi J, Viana MC, Kessler RC. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the World Health Organization World Mental Health (WMH) Surveys. Psychol Med 2013; 43:865-879. [PMID: 22877824 PMCID: PMC4045502 DOI: 10.1017/s0033291712001468] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiological research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Method Cross-sectional community surveys in 20 countries asked 13 892 respondents aged 50+ years about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status and type of condition. RESULTS Among the 26.9-42.5% respondents in high-, upper-middle-, and low-/lower-middle-income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours per week in those giving any time were 16.6-23.6 (169.9-205.8 h/week per 100 people aged 50+ years). Burden in low-/lower-middle-income countries was 2- to 3-fold higher than in higher-income countries, with any financial burden averaging 14.3% of median family income in high-, 17.7% in upper-middle-, and 39.8% in low-/lower-middle-income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. CONCLUSIONS Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low-/lower-middle-income countries.
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Affiliation(s)
- V. Shahly
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | | | - M. J. Gruber
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - A. Al-Hamzawi
- Al-Qadisia University College of Medicine, Diwania Teaching Hospital, Diwania, Iraq
| | - J. Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Research Institute), and CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - L. H. Andrade
- Section of Psychiatric Epidemiology, Sãu Paulo, Brazil
| | | | - R. Bruffaerts
- Universitair Psychiatrisch Centrum – Katholieke Universiteit Leuven (UPC-KUL), Leuven, Belgium
| | - B. Bunting
- University of Ulster, Londonderry, Northern Ireland, United Kingdom
| | - J. M. Caldas-de-Almeida
- Chronic Diseases Research Center (CEDOC) and Department of Mental Health, Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Lisbon, Portugal
| | - G. de Girolamo
- IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - P. de Jonge
- University Medical Center Groningen, Groningen, Netherlands
| | - S. Florescu
- National School of Public Health Management and Professional Development, Bucharest, Romania
| | - O. Gureje
- Department of Psychiatry, University of Ibadan, College of Medicine, Ibadan, Nigeria
| | - J. M. Haro
- Parc Sanitari Sant Joan de Déu, CIBERSAM, Sant Boi de Llobregat, Barcelona, Spain
| | - H. R. Hinkov
- National Center for Public Health Protection, Sofia, Bulgaria
| | - C. Hu
- Shenzhen Institute of Mental Health & Shenzhen Kangning Hospital, Shenzhen, People’s Republic of China
| | - E. G. Karam
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), St. George Hospital University Medical Center, Beirut, Lebanon
| | - J.-P. Lépine
- Hôpital Lariboisiére Fernand Widal, Paris, France
| | - D. Levinson
- Research and Planning, Mental Health Services, Ministry of Health, Jerusalem, Israel
| | - M. E. Medina-Mora
- Instituto Nacional de Psiquiatria Ramon de La Fuente Muñiz, Mexico City, Mexico
| | | | - N. A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
| | - J.K. Trivedi
- Department of Psychiatry, C.S.M. Medical University, Lucknow, India
| | - M. C. Viana
- Department of Social Medicine, Center for Health Sciences, Vitória, Spain
| | - R. C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts, USA
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Solum Myren GE, Enmarker I, Saur E, Hellzen O. Relatives’ experiences of everyday life when receiving day care services for persons with dementia living at home. Health (London) 2013. [DOI: 10.4236/health.2013.58166] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Caregiving burden and out-of-home mobility of cognitively impaired care-recipients based on GPS tracking. Int Psychogeriatr 2012; 24:1836-45. [PMID: 22874772 DOI: 10.1017/s1041610212001135] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Out-of-home mobility refers to the realization of trips outside the home, by foot or by other means of transportation. Although out-of-home mobility is important for the well-being of older people with cognitive impairment, its importance for their caregivers is not clear. This study aims to clarify the relationship between caregiving burden and out-of-home mobility of care-recipients using Global Positioning Systems (GPS) technology. METHODS Seventy-six dyads (care-recipients and caregivers) were recruited from a psychogeriatric center, where they underwent cognitive assessment, followed by psychosocial interviews at home. Care-recipients received GPS tracking kits to carry for a period of four weeks, whenever they left home. Mobility data and diagnostic and psychosocial data were examined in relation to caregiver burden. RESULTS The strongest predictors of burden were care-recipients' lower cognitive status and more time spent walking out-of-home. An interaction was found between cognitive status and time spent walking in relation to caregiver burden. The relationship between walking and burden was stronger among caregivers of care-recipients with dementia than caregivers of care-recipients with no cognitive impairment or mild cognitive impairment. Care-recipients' behavioral and emotional states were also positively related to caregiver burden. CONCLUSIONS The findings stress the importance of maintaining older persons' out-of-home mobility during cognitive decline.
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Zielińska-Więczkowska H, Ciemnoczołowski W, Kędziora-Kornatowska K, Muszalik M. The sense of coherence (SOC) as an important determinant of life satisfaction, based on own research, and exemplified by the students of University of the Third Age (U3A). Arch Gerontol Geriatr 2012; 54:238-41. [DOI: 10.1016/j.archger.2011.03.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Revised: 03/03/2011] [Accepted: 03/04/2011] [Indexed: 11/24/2022]
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Abstract
In this paper we present a review of the literature on men caring for a relative with dementia. While there is an abundance of literature on caregiving in general, there is a dearth of information on male caregiving and in particular on the role of sons as carers. Keywords used were dementia, Alzheimer's disease, caregiver, caregiver burden, caregiver support, sons, spouses, husbands, men, fathers, male, widowers, help seeking behaviour, parent child relations, gender identity and combinations of these. The inclusion criteria stipulated that papers had to be research based, written in English, published between the years 1999 and 2010 and related to men caring for a person with dementia. The categories that emerged from the literature included men in a caregiving role, gender differences in caregiver burden, support services and sons as carers. Further research is needed to highlight the needs and experiences of men in a caregiving role.
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García-Alberca JM, Lara JP, Berthier ML. Anxiety and depression in caregivers are associated with patient and caregiver characteristics in Alzheimer's disease. Int J Psychiatry Med 2011; 41:57-69. [PMID: 21495522 DOI: 10.2190/pm.41.1.f] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE The aim of this study is to know the prevalence of anxiety and depression in caregivers of patients with Alzheimer's disease (AD) and assess the association of caregiver burden (CB) with characteristics of both patients and caregivers. METHOD Sociodemographic and clinical variables have been obtained (patients: age, gender, marital status, years of education, duration and severity of dementia, psychiatric disorders, previous history, and use of psychoactive and antidementia drugs; caregivers: age, gender, relationship with patient, and marital status). Cognition was assessed with Mini Mental State Examination (MMSE); severity of dementia was assessed with Global Deterioration Scale (GDS); caregiver burden was assessed with Hamilton Depression Rating Scale (HDRS), State-Trait Anxiety Inventory (STAI), and the number of hours of attention to the basic activities of daily-living (H-BADL). RESULTS More than 50% of caregivers have shown high anxiety and depression scores. Patients with longer duration of dementia, greater severity of dementia, and lower education levels significantly differ in anxiety and depression mean scores. CONCLUSION The presence of CB in AD patients is strongly associated with the duration and severity of dementia and the educational level of patients. The results of this study should encourage researchers and clinicians working with elderly persons to consider these modifiable psychological states.
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Pinquart M, Sörensen S. Spouses, adult children, and children-in-law as caregivers of older adults: a meta-analytic comparison. Psychol Aging 2011; 26:1-14. [PMID: 21417538 PMCID: PMC4449135 DOI: 10.1037/a0021863] [Citation(s) in RCA: 515] [Impact Index Per Article: 39.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The present meta-analysis integrates the results from 168 empirical studies on differences between caregiving spouses, adult children, and children-in-law. Spouses differ from children and children-in-law significantly with regard to sociodemographic variables; also, they provide more support but report fewer care recipient behavior problems. Spouse caregivers report more depression symptoms, greater financial and physical burden, and lower levels of psychological well-being. Higher levels of psychological distress among spouses are explained mostly--but not completely--by higher levels of care provision. Few differences emerge between children and children-in-law, but children-in-law perceive the relationship with the care recipient as less positive and they report fewer uplifts of caregiving.
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Affiliation(s)
- Martin Pinquart
- Department of Psychology, Philipps University, Marburg, Germany.
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Abstract
RÉSUMÉMalgré l'accent mis, lors de la recherche en gérontologie, sur les obligations en matière de prestation de soins, des études ont démontré que peu de dispensateurs de soins sont soumis à un trop lourd fardeau. Le présent article compare les prévisions des obligations particulières aux rôles et deux mesures de la qualité de vie chez les dispensateurs de soins soumis à des exigences importantes en matière de soins de santé afin d’évaluer les effets du rôle de chacun. l'étude a porté sur 92 dispensateurs communautaires de soins dans l'île de Vancouver, en Colombie-Britannique. Les prédicteurs comprenaient des facteurs primaires de stress, des ressources personnelles, et des facteurs socio-démographiques. Les exigences en matière de prestation de soins ont été la corrélation la plus significative des obligations particulières aux rôles, et elles avaient une importance indirecte en raison des obligations liées au bien-être général. La résilience avait un rapport important avec les trois résultats. Au cours de l'année de l'étude, les dispensateurs de soins se sont améliorés dans les trois résultats, mais ils n’ont pas réussi à prévoir ce changement. Les résultats suggèrent que les dispensateurs de soins peuvent être à la fois accablés et faire simultanément l'expérience d’un bien-être appréciable ou élevé, ce qui exige de ne pas généraliser à partir d’études limitées uniquement aux obligations des dispensateurs de soins lorsqu’il s’agit de présenter des recommandations sur l'ensemble de la vie de chacune de ces personnes.
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Bradley SE, Sherwood PR, Kuo J, Kammerer CM, Gettig EA, Ren D, Rohrer WM, Donovan HS, Hricik A, Newberry A, Given B. Perceptions of economic hardship and emotional health in a pilot sample of family caregivers. J Neurooncol 2009; 93:333-42. [PMID: 19159080 PMCID: PMC2735729 DOI: 10.1007/s11060-008-9778-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2008] [Accepted: 12/30/2008] [Indexed: 11/30/2022]
Abstract
Although several studies have quantified costs of cancer care; none to date have examined how cancer costs impact family caregivers' emotional health. This study was designed to evaluate how perceptions of economic hardship influence burden, depressive symptoms, and anxiety in family caregivers of persons with a primary malignant brain tumor. Caregiver (CG)/patient dyads (n = 33) were recruited at the time of diagnosis; data were collected at diagnosis and 4 months, and linear regression determined the impact of economic hardship on caregivers' emotional health. Economic hardship did not predict CG burden-schedule at diagnosis or 4 months. Economic hardship predicted burden-abandonment at diagnosis (P < 0.01), but not 4 months. There was a trend for economic hardship to predict CG depressive symptoms at 4 months (P = 0.09), but not at diagnosis. Economic hardship predicted CG anxiety at 4 months (P = 0.06), but not diagnosis. Results suggest caregivers' economic hardship is an important and dynamic aspect of the emotional health of neuro-oncology family caregivers.
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Affiliation(s)
- Sarah E. Bradley
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
| | - Paula R. Sherwood
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA,
- Department of Neurosurgery, School of Medicine, University of Pittsburgh, Pittsburgh, USA
| | - Jean Kuo
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | | | | | - Dianxu Ren
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | - Wesley M. Rohrer
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, USA
- School of Health & Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, USA
| | - Heidi S. Donovan
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | - Allison Hricik
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | - Alyssa Newberry
- School of Nursing, University of Pittsburgh, 336 Victoria Building, 3500 Victoria Street, Pittsburgh, PA 15261, USA
| | - Barbara Given
- College of Nursing, Michigan State University, East Lansing, USA
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Spillers RL, Wellisch DK, Kim Y, Matthews BA, Baker F. Family caregivers and guilt in the context of cancer care. PSYCHOSOMATICS 2009; 49:511-9. [PMID: 19122128 DOI: 10.1176/appi.psy.49.6.511] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Guilt as a key emotional phenomenon in the cancer-caregiving experience is an understudied issue. OBJECTIVE The purpose of this study is to identify demographic characteristics of cancer caregivers and care-related stress factors that are associated with their feelings of caregiver guilt, as well as to explore the effect of caregiver guilt on their adjustment outcomes. METHOD A total of 739 caregivers of cancer survivors completed a survey (66.7% response rate), of which 635 provided complete data for the measures in this study. RESULTS Hierarchical regression analyses revealed that certain caregiver demographics (i.e., younger age, adult offspring, employed) and care-related stress factors (i.e., greater impact on schedule, less perceived caregiving competence, poorer overall health of the care-recipient) were significantly related to caregiver guilt. Higher levels of psychological distress and poorer mental, social, and physical functioning were significantly associated with caregiver guilt, above and beyond the variance accounted for by the covariates. CONCLUSION Results suggest that caregiver guilt compromises the psychosocial and somatic adjustment of cancer caregivers. Guilt may be a cardinal feature of the caregiving experience, and to fully understand the implications of this complex phenomenon, more research is needed.
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Affiliation(s)
- Rachel L Spillers
- Behavioral Research Center, American Cancer Society, 250 Williams St. NW, Atlanta, GA 30303-1002, USA.
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Papastavrou E, Charalambous A, Tsangari H. Exploring the other side of cancer care: the informal caregiver. Eur J Oncol Nurs 2009; 13:128-36. [PMID: 19297245 DOI: 10.1016/j.ejon.2009.02.003] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 02/04/2009] [Accepted: 02/07/2009] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To identify the caregiver outcomes among relatives caring for patients with cancer and to examine the patient and family caregiver variables that predicted for caregiver burden and depression. METHODS One hundred and thirty caregivers completed the Greek versions of the Burden Interview (BI), the Center of Epidemiology--Depression Scale (CES-D) and the Ways of Coping Questionnaire. Principal component analysis was performed to examine the underlying dimensions of caregiver outcome measures. One-way ANOVA and independent sample t-tests were used to test for differences in burden and depression in relation to demographic variables of interest. One-way ANOVA was used for examining differences in coping strategies. FINDINGS One-way ANOVA showed that there are significant differences among the various educational levels (p<0.001) and the income (p<0.005) of the caregiver in terms of overall burden. 66.4% of caregivers had a depression above the usual cutoff point for depression. An independent samples t-test for possible gender differences, showed that there is a significant difference between males and females (p=0.29). In regression analysis it was found that only caregiver's income and patient's age are statistically significant in predicting burden and depression. When considering high-burdened caregivers results showed that there are significant differences in the use of coping strategies (p<0.001). CONCLUSIONS Caregivers reported high levels of burden and depression. These outcomes of caregiving are related to several variables, but the caregiver's income and patient's age are predictive. Intervention strategies are needed to the vulnerable caregivers to help reduce burden and depression associated with caregiving.
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Affiliation(s)
- Evridiki Papastavrou
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, 215 Dromos Lemesou, 2252 Latsia, Nicosia, Nicosia 2252, Cyprus.
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Wilkins VM, Bruce ML, Sirey JA. Caregiving tasks and training interest of family caregivers of medically ill homebound older adults. J Aging Health 2009; 21:528-42. [PMID: 19252141 DOI: 10.1177/0898264309332838] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study assessed the caregiving activities and training interests of family caregivers of medically ill older adults without dementia who receive home health care. METHODS Participants were 101 family caregivers of patients from the Training in the Assessment of Depression (TRIAD) study. Caregivers were assessed using a sociodemographic questionnaire and measures of caregiver tasks and training interest. RESULTS Family caregivers provided a variety of caregiving tasks and their interest in training was independent of current provision of tasks. Black caregivers expressed greater overall interest in receiving training than did White caregivers, as did younger caregivers compared to same-generation caregivers. DISCUSSION Family caregivers in this study evidenced both a range of care provision and clear interest in improving caregiving skills through training. Research efforts should focus on meeting the specific training needs of family caregivers and determining the impact training can have on patient health outcomes.
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Affiliation(s)
- Victoria M Wilkins
- Department of Psychiatry, Weill Medical College of Cornell University, 21 Bloomingdale Road, White Plains, NY 10605, USA.
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Kim Y, Wellisch DK, Spillers RL. Effects of psychological distress on quality of life of adult daughters and their mothers with cancer. Psychooncology 2009; 17:1129-36. [PMID: 18318454 DOI: 10.1002/pon.1328] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION As the population continues to age, adult daughters are more likely to be involved in caregiving. Given the fact that sharing emotional experiences is common in female relationships, (dis)similarity between mothers with cancer and their adult caregiving daughters is expected. However, the extent to which the (dis)similarity in psychological distress influences the quality of life of each person remains unknown. METHOD This study aims at addressing this concern, using a total of 98 mother-daughter dyads participating in the American Cancer Society's Study of Cancer Survivors-I and Quality of Life Survey for Caregivers. RESULTS Using the Actor Partner Interdependence Model, the results showed that although each person's psychological distress is the strongest predictor of their own quality of life, a mother's distress also plays a significant role in the daughter's quality of life. Specifically, when mothers experienced greater levels of psychological distress, the daughters reported better mental health but poorer physical health. CONCLUSIONS Our findings on the disproportionately strong association between psychological distress of mothers with cancer and their adult caregiving daughters' quality of life suggest that caregiving daughters may benefit from programs designed to assist them to cope better with their mothers' psychological distress when both are living with cancer.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, 250 Williams St., NW, Atlanta, GA 30303, USA.
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Etters L, Goodall D, Harrison BE. Caregiver burden among dementia patient caregivers: a review of the literature. ACTA ACUST UNITED AC 2009; 20:423-8. [PMID: 18786017 DOI: 10.1111/j.1745-7599.2008.00342.x] [Citation(s) in RCA: 668] [Impact Index Per Article: 44.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE To identify current evidence of factors influencing dementia-related caregiver burden (CB), describe patient and caregiver characteristics associated with CB, and describe evidence-based interventions designed to lessen the burden of caregiving. DATA SOURCES Comprehensive literature review of Cumulative Index of Nursing and Allied Health Literature, MEDLINE, and Psych Info was performed for the years 1996-2006 of peer-reviewed journals using keywords CB and dementia. CONCLUSION Dementia caregiving has been associated with negative effects on caregiver health and early nursing home placement for dementia patients. Many factors influence the impact of the caregiving experience such as gender, relationship to the patient, culture, and personal characteristics. Although various interventions have been developed with the goal of alleviating CB, evidence suggests that individually developed multicomponent interventions including a diversity of services will decrease burden, improve quality of life, and enable caregivers to provide at-home care for longer periods prior to institutionalization. IMPLICATIONS FOR PRACTICE The ability to properly assess the dementia patient-caregiver dyad related to CB is critical to decreasing its negative physical and psychological health outcomes. Appropriately tailored interventions can improve the health and well-being of both caregiver and patient.
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Affiliation(s)
- Lynn Etters
- Detroit Medical Center Huron Valley-Sinai Hospital, Krieger Geriatric Center, Commerce, Twp Michigan, USA
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Kong EH. Family Caregivers of Older People in Nursing Homes. Asian Nurs Res (Korean Soc Nurs Sci) 2008; 2:195-207. [PMID: 25029957 DOI: 10.1016/s1976-1317(09)60001-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2008] [Revised: 09/30/2008] [Accepted: 10/18/2008] [Indexed: 11/30/2022] Open
Affiliation(s)
- Eun-Hi Kong
- Assistant Professor, Department of Nursing, Kyungwon University, Seongnam, Korea
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Van Puymbroeck M, Hinojosa MS, Rittman MR. Influence of sense of coherence on caregiver burden and depressive symptoms at 12 months poststroke. Top Stroke Rehabil 2008; 15:272-82. [PMID: 18647731 DOI: 10.1310/tsr1503-272] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE The purpose of this study was to examine the relationship of sense of coherence for informal stroke caregivers with sociodemographic variables and caregiving outcomes of depressive symptoms and burden. METHOD Using path analysis, data 1 month after the stroke (stroke survivor and caregiver characteristics) from 87 dyads (stroke survivors and their caregivers) were used to predict caregiver outcomes of burden and depressive symptoms at 12 months poststroke. RESULTS Sense of coherence, although not predicted by sociodemographic variables, had a significant inverse relationship with caregiver burden and depressive symptoms, indicating that caregivers with a higher sense of coherence at 1 month experience less burden and depressive symptoms at 12 months. Caregiver burden was also predicted by stroke survivor comorbidities, caregiver gender, and time spent per day providing care. Caregiver depressive symptoms were predicted by race, gender, and hours spent providing care per day. CONCLUSION Caregivers who have high sense of coherence experience less burden and depressive symptoms at 12 months poststroke. Suggestions for improving caregiver sense of coherence are discussed.
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Affiliation(s)
- Marieke Van Puymbroeck
- Department of Recreation, Park, and Tourism Studies, Indiana University, Bloomington, IN, USA
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Guiding research in family care: a new approach to oncology caregiving. Psychooncology 2008; 17:986-96. [DOI: 10.1002/pon.1314] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lim YM, Son GR, Song JA, Beattie E. Factors affecting burden of family caregivers of community-dwelling ambulatory elders with dementia in Korea. Arch Psychiatr Nurs 2008; 22:226-34. [PMID: 18640542 DOI: 10.1016/j.apnu.2007.12.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2007] [Revised: 12/06/2007] [Accepted: 12/08/2007] [Indexed: 11/24/2022]
Abstract
The purpose of the study was to test a staged causal model as a theoretical base to explain the burden of family caregivers of community-dwelling self-ambulatory persons with dementia (PWDs) in Korea. The model contained three stages including antecedents (Stage 1), behavior (Stage 2), and outcome (Stage 3). The antecedents were variables of the PWDs (e.g., cognitive impairment and activities of daily living [ADL] dependency of the PWDs) and caregiver variables (e.g., age, gender of caregiver, and the relationship of caregiver to PWD). Stage 2 focused on wandering behavior. In Stage 3, the outcome variable was caregiver burden. A total of 83 noninstitutionalized, community-dwelling elders with dementia and their family caregivers participated. The instruments used in this study were the Korean version of Mini Mental State Examination, K-PADL (Korean-Physical Activities of Daily Living), Korean-Revised Algase Wandering Scale-Community Version, and K-CWOB (Caregiver Worry, Overload, and Role Captivity Scale-Korean) Korean versions of standardized Western instruments. Results indicate that cognitive impairment and ADL dependency had an indirect influence on caregiver burden through wandering behavior. In addition, caregiver age had a direct impact on caregiver burden. The findings of this study suggest that further refinement of the underlying model is warranted.
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Affiliation(s)
- Young Mi Lim
- Yonsei University Wonju College of Medicine Department of Nursing, Kangwon-Do, South Korea
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46
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Kim Y, Given BA. Quality of life of family caregivers of cancer survivors: across the trajectory of the illness. Cancer 2008; 112:2556-68. [PMID: 18428199 DOI: 10.1002/cncr.23449] [Citation(s) in RCA: 303] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cancer affects not only the quality of life (QOL) of individuals with the disease but also that of their family members and close friends. The impact on various aspects of the family caregivers' QOL is significant throughout the trajectory of the illness. The authors reviewed literature on the QOL of family caregivers at the acute and middle- to long-term survivorship phases as well as the bereavement phase. METHODS By using several databases, the authors searched the literature published in English from 1996 through July 2007. Keywords searched included cancer, carcinoma, family, family member, caregivers, and quality of life. Several criteria were used to guide the literature review: Articles had to be published in refereed journals and had to use rigorous methods, sample, and validated measures. RESULTS The findings suggested that the QOL of family caregivers of individuals with cancer varies along the illness trajectory. This highlights were importance of assessing the ongoing adjustment of the caregivers over time. However, there were few theory-driven studies, and significant gaps remain in the current understanding of the effects of family caregiving beyond the time of diagnosis and treatment. CONCLUSIONS Accumulating evidence has supported the concept that cancer affects not only the patients/survivors but also their family members. However, theoretically and methodologically rigorous research on various aspects of the family's QOL, including not only the psychological but also the physical, spiritual, and behavioral adjustment to cancer in the family, remains sparse. Family-based interventions across the trajectory of the illness also are needed.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303-1002, USA.
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Mendez-Luck CA, Kennedy DP, Wallace SP. Concepts of burden in giving care to older relatives: a study of female caregivers in a Mexico City neighborhood. J Cross Cult Gerontol 2008; 23:265-82. [PMID: 18324460 DOI: 10.1007/s10823-008-9058-6] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 01/28/2008] [Indexed: 10/22/2022]
Abstract
This study examined how women in a Mexico City suburb conceptualized the construct of burden within the context of giving care to older relatives. Data were collected on 41 women through semi-structured interviews regarding their caregiving experiences to elderly relatives. Phenomenological principles were used to analyze meanings and understandings of caregiving experiences. Burden was a multi-dimensional construct that referred to specific situations that made caregivers feel emotionally or physical "heavy." Burden also referred to "being a burden" by being in the way, making things difficult, or being a 'weight' on caregivers' shoulders. However, women in this study also viewed burden as a positive sacrifice that involved love, initiative, and good will. This study is an important first step in defining the ways in which caregiving is positively and negatively meaningful for Mexican caregivers and their families. Our findings offer an additional dimension of caregiver burden to broaden our understanding and measurement of the construct. The development of culturally appropriate instruments to measure caregiving burden in Mexico is necessary to provide an empirical foundation for policy recommendations that address the growing need for institutional support of caregivers. Moreover, our findings suggest that researchers studying caregiving in Mexico should think about how burden is measured on existing instruments before adapting them for widespread use.
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Affiliation(s)
- Carolyn A Mendez-Luck
- Department of Community Health Sciences, UCLA School of Public Health, Los Angeles, CA, 90095-1772, USA.
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Kim Y, Baker F, Spillers RL. Cancer caregivers' quality of life: effects of gender, relationship, and appraisal. J Pain Symptom Manage 2007; 34:294-304. [PMID: 17572056 DOI: 10.1016/j.jpainsymman.2006.11.012] [Citation(s) in RCA: 138] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2006] [Revised: 11/04/2006] [Accepted: 11/08/2006] [Indexed: 10/23/2022]
Abstract
The objective of this study was to examine caregivers' gender and relationship to the cancer survivor as plausible predictors of their appraisals of providing care, and to further examine the association of the caregivers' appraisal with their own quality of life. Of the 739 caregivers who participated in the American Cancer Society's Quality of Life Survey for Caregivers, 627 were either the spouse or the offspring of a cancer survivor. Of those, 448 who provided complete information on study variables were included in this study. Multivariate analyses revealed that male caregivers were more likely to appraise the caregiving experience as boosting their self-esteem (positive) than female caregivers, whereas adult daughters appraised the experience as stressful (negative), and sons appraised the experience as the least stressful. More importantly, caregivers' esteem and caregiving stress were strong predictors of the caregivers' quality of life. These effects were significant after controlling for potentially confounding variables. The findings suggest that cancer caregivers may benefit from programs designed to assist them in viewing their involvement in cancer care as meaningful and as a personal growth experience, as well as helping them to seek support to minimize their caregiving stress.
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Affiliation(s)
- Youngmee Kim
- Behavioral Research Center, American Cancer Society, Atlanta, Georgia 30303, USA.
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A Proposed Theoretical Framework Addressing the Effects of Informal Caregivers on Health-Related Outcomes of Elderly Recipients in Home Health Care. Asian Nurs Res (Korean Soc Nurs Sci) 2007; 1:23-34. [DOI: 10.1016/s1976-1317(08)60006-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Pinquart M, Sörensen S. Correlates of physical health of informal caregivers: a meta-analysis. J Gerontol B Psychol Sci Soc Sci 2007; 62:P126-37. [PMID: 17379673 DOI: 10.1093/geronb/62.2.p126] [Citation(s) in RCA: 656] [Impact Index Per Article: 38.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Effects of caregiving on physical health have received less theoretical and empirical attention than effects on psychological health. This meta-analysis integrates results from 176 studies on correlates of caregiver physical health. Caregiver depressive symptoms had stronger associations with physical health than did objective stressors. Higher levels of care recipient behavior problems were more consistently related to poor caregiver health than were care receiver impairment and intensity of caregiving. Higher age, lower socioeconomic status, and lower levels of informal support were related to poorer health. Predictors of physical health are not identical to predictors of psychological health. Associations of caregiving stressors with health were stronger among older samples, dementia caregivers, and men. In sum, negative effects of caregiving on physical health are most likely to be found in psychologically distressed caregivers facing dementia-related stressors.
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Affiliation(s)
- Martin Pinquart
- Department of Developmental Psychology, Friedrich Schiller University, Am Steiger 3 Haus 1, D-07743 Jena, Germany.
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