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Seshadri S, Contento A, Sugiura K, Abendroth M, Macchi Z, Kluger BM. Parkinson's Disease Carepartners' Perceptions of the Challenges and Rewards of Caregiving. Am J Hosp Palliat Care 2024; 41:1442-1450. [PMID: 38264847 DOI: 10.1177/10499091231223739] [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: 01/25/2024] Open
Abstract
BACKGROUND Multiple debilitating symptoms and the progressive nature of Parkinson's disease (PD) affect carepartners' quality of life. Although, there is abundant knowledge on caregiver burden there is limited knowledge on PD carepartners' perceptions of caregiving. AIM To understand family members' perception of their role, and of the challenges and rewards of PD caregiving. METHOD Using a qualitative descriptive research design, we conducted semi-structured interviews with current and former PD carepartners (n = 16). Interviews were audio-recorded, de-identified, and transcribed verbatim. Data were coded and analyzed to identify themes. RESULTS We identified 5 themes: (a) Unpredictability is the hardest part of caregiving. It was hard to cope with the unpredictable daily and longer-term fluctuations in PD symptoms; (b) Disease progression and multiple symptoms contribute to carepartners' emotional distress. Carepartners felt unprepared and were saddened by the patient's and their own losses; (c) Caring for a family member is not a "burden." Though stressful, carepartners resisted associating caregiving with the term "burden"; (d) Caregiving is a partnership. Carepartners saw their role as being less of "givers" and more of partners in disease management; and (e) Caregiving is an opportunity for personal satisfaction, joy, and growth. Caregiving was seen as a "gift" that enabled carepartners to express love and experience personal growth. CONCLUSIONS Despite challenges PD carepartners view their role as "partners" in the management of the disease and find meaning and strength in caregiving. A palliative care approach emphasizing the positives and challenges of caregiving may provide carepartners with better support.
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Affiliation(s)
- Sandhya Seshadri
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | | | - Kei Sugiura
- Department of Neurology, University of Rochester, Rochester, NY, USA
| | | | | | - Benzi M Kluger
- Department of Neurology, University of Rochester, Rochester, NY, USA
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Becker L, Graessel E, Pendergrass A. Predictors of the quality of the relationship between informal caregiver and care recipient in informal caregiving of older people: presentation and evaluation of a new item. BMC Psychol 2024; 12:342. [PMID: 38858769 PMCID: PMC11165870 DOI: 10.1186/s40359-024-01840-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND An important factor that has not been directly addressed very often in caregiver (CG) counseling to date is the quality of the relationship between the CG and the care recipient (CR). One reason is the lack of availability of a suitable assessment tool that is not strongly influenced by social desirability. Here, we present and evaluate a new item for the assessment of relationship quality (RQ) in the context of informal caregiving of older people. METHODS N = 962 informal caregivers of older people participated. Our item assessed RQ by providing three answer categories (positive, neutral, and negative) that were presented through the use of smiley faces. For evaluation, and to avoid bias due to social desirability, the neutral and negative categories were combined. We calculated a stepwise binary logistic regression. RESULTS Expected associations with the variables care burden, perceived positive aspects, and care motivation were found (all p values < 0.01). An exploratory analysis revealed that additional predictors of RQ consisted of the CR's age as well as whether the CR's diagnosis was dementia, CG's amount of dysfunctional coping, and whether the CG was caring for more than one CR. CONCLUSIONS We conclude that our item is well-suited for the assessment of RQ in the context of informal caregiving of older people. Because it uses language-free answer categories by means of smiley faces, our item can be applied easily. Bias due to social desirability can be minimized by dichotomization (i.e., combining the negative and neural answer categories). In future research, our tool should be evaluated in other contexts.
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Affiliation(s)
- Linda Becker
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nägelsbachstr. 49a, 91052, Erlangen, Germany.
- Humanwissenschaftliche Fakultät, Vinzenz Pallotti University gGmbH, Vallendar, Germany.
| | - Elmar Graessel
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anna Pendergrass
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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Wawrziczny E, Flinois B, Constant E, Brugallé E, Sokolowski C, Manceau C, Baille G, Defebvre L, Dujardin K, Antoine P. Dealing with the diagnosis of Parkinson's disease and its implications for couple functioning in the early stage: An interpretative phenomenological analysis. PLoS One 2024; 19:e0294240. [PMID: 38381728 PMCID: PMC10880977 DOI: 10.1371/journal.pone.0294240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/27/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND For couples facing Parkinson's disease, marital relationships are significantly impacted, even at the early stages of the disease. However, very few studies have explicitly explored the functioning of the couple and how both partners deal with Parkinson's disease. The aim of this study was to explore the experiences and strategies of couples facing Parkinson's disease in the early stage using dyadic interpretative phenomenological analysis. METHODS Fifteen couples agreed to participate in the study. Semistructured interviews were conducted with each partner separately regarding his or her individual experience with Parkinson's disease, the couple's history, the impact of the diagnosis on the functioning of the couple, and his or her projections for the future. RESULTS Three higher-order themes emerged from the analyses. The first theme, "Being tested by the diagnosis", highlights 4 dyadic configurations according to the individual's and the couple's capacity for adjustment following the diagnosis: "noncongruent", "collapsed", "relieved" and "avoidant". The second theme, "Talking about everything except the disease", underlines that communication about the disease is often avoided both within the couple and with relatives to protect the persons with Parkinson's disease or respect their wishes. The third theme, "Supporting each other", describes the different levels of harmony between the two partners in the management of daily life and symptoms and their relational impacts. CONCLUSION These results allow us to better understand the experiences of both partners and to highlight the importance of promoting better acceptance of the diagnosis by persons with Parkinson's disease to allow better communication between partners and with relatives. Such support prevents disease-specific distress and facilitates better adjustment in the later stages of the disease.
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Affiliation(s)
- Emilie Wawrziczny
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Emilie Constant
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Elodie Brugallé
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Luc Defebvre
- Regional and University Hospital Centre of Lille, Lille, France
| | - Kathy Dujardin
- Regional and University Hospital Centre of Lille, Lille, France
| | - Pascal Antoine
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Glover L, Dixon C, Kobylecki C, Eccles FJR. Parkinson's and the couple relationship: a qualitative meta-synthesis. Aging Ment Health 2023; 27:2420-2429. [PMID: 37354064 DOI: 10.1080/13607863.2023.2227119] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 06/08/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVE The aim was to synthesise the current qualitative literature on the impact of Parkinson's on the couple relationship, including individual and dyad studies. METHODS Noblit and Hare's meta-ethnography approach was applied; 19 studies were included in the review following a systematic search of four electronic databases. The studies included experiences of 137 People with Parkinson's and 191 partners. FINDINGS Analysis produced three themes: (1) Disruption of roles and responsibilities; (2) Challenges to communication and closeness; and (3) Grief, burden, and isolation. The themes are discussed with supporting extracts from the 19 included studies. CONCLUSION The findings highlight the challenges that couples experience and the individual and relational resources that support coping. Support should be individually tailored to each couple as the impact on the couple may change in response to individual and contextual factors. This review adds further evidence to the case for relationally focused multidisciplinary team input at all stages of Parkinson's disease.
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Affiliation(s)
- Louise Glover
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Clare Dixon
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
| | - Christopher Kobylecki
- Manchester Centre for Clinical Neurosciences, Northern Care Alliance NHS Foundation Trust, Stott Lane, Salford, UK
- Division of Neuroscience and Experimental Psychology, University of Manchester, Manchester, UK
| | - Fiona J R Eccles
- Lancaster University, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster, UK
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Pendergrass A, Weiß S, Rohleder N, Graessel E. Validation of the Benefits of Being a Caregiver Scale (BBCS) - further development of an independent characteristic of informal caregiving. BMC Geriatr 2023; 23:26. [PMID: 36641428 PMCID: PMC9840821 DOI: 10.1186/s12877-022-03650-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 11/24/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Although larger amounts of scientific attention have been directed toward the concept of positive aspects of caregiving (PAC) in recent years, a globally uniform definition and a suitable, scientifically valid questionnaire for all informal caregivers have yet to be developed. On the basis of the questionnaires that already exist for measuring PAC, the authors aimed to (a) concretize the concept and (b) develop a new scale by focusing only on items that show that family caregivers experience a benefit for themselves and that the benefit they experience is the result of their caregiving activities. METHODS The Benefits of Being a Caregiver Scale (BBCS) was validated on data from 961 informal caregivers. Cronbach's alpha was calculated to assess the internal consistency of the items, and a factor analysis was conducted to determine the structure of the BBCS. The discriminatory power and item difficulties were examined. Construct validity was established by testing four hypotheses. RESULTS The factor analysis confirmed the single-factor structure of the BBCS. Cronbach's alpha for the total scale was 0.922. One of the 15 items did not show good to very good discriminatory power and was excluded from the final version of the scale. A higher BBCS score was observed if the caregiver experienced more positive aspects of caregiving and tended to have better general coping skills and a positive relationship with the care-receiver. The BBCS score was not associated with the subjective burden of the caregiver. Results confirmed the validity of the BBCS. CONCLUSION The BBCS is a valid assessment instrument for measuring the benefits that caregivers experience from their caregiving work and can easily be used in research and practice. The BBCS is available free of charge in English and German ( http://www.caregiver-benefits.de ).
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Affiliation(s)
- Anna Pendergrass
- grid.5330.50000 0001 2107 3311Department of Psychiatry and Psychotherapy, Centre of Health Services Research in Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
| | - Saskia Weiß
- grid.489512.30000 0000 8508 4813German Alzheimer Society, Berlin, Germany
| | - Nicolas Rohleder
- grid.5330.50000 0001 2107 3311Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Elmar Graessel
- grid.5330.50000 0001 2107 3311Department of Psychiatry and Psychotherapy, Centre of Health Services Research in Medicine, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054 Erlangen, Germany
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6
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Perepezko K, Hinkle JT, Forbes EJ, Pontone GM, Mills KA, Gallo JJ. The impact of caregiving on quality of life in Parkinson's disease: A systematic review. Int J Geriatr Psychiatry 2023; 38:e5870. [PMID: 36703272 PMCID: PMC10214089 DOI: 10.1002/gps.5870] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/09/2023] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Parkinson's disease (PD) is a progressive neurodegenerative disease that can reduce quality of life (QOL). Previous research has explored patient specific factors that influence QOL; but understanding external factors that may also affect patient QOL, such as caregiver characteristics, can provide additional intervention targets that may improve QOL for both the person with PD and their caregiver. METHODS We conducted a systematic review of existing literature on caregiver factors that are related to QOL for the person with PD. We developed a tailored search strategy in six databases and performed a screening procedure according to PRISMA guidelines. We synthesized findings from articles that met inclusion criteria using a narrative approach and identified themes categorizing caregiver factors associated with PD QOL. RESULTS We found 32 full-text articles that fulfilled the inclusion criteria and passed the quality appraisal. Seven themes were identified, including: (1) burden, (2) strain, (3) QOL and satisfaction, (4) demographic factors, (5) psychological factors, (6) relationship factors, and (7) caregiver input. CONCLUSIONS Our review presents critical insights into the role of the caregiver in the QOL of a person with PD. Findings reveal several targets for intervention to improve QOL in this population.
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Affiliation(s)
- Kate Perepezko
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | | | | | - Kelly A. Mills
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Joseph J. Gallo
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Manceau C, Constant E, Brugallé E, Wawrziczny E, Sokolowski C, Flinois B, Baille G, Defebvre L, Dujardin K, Antoine P. Couples facing the “honeymoon period” of Parkinson's disease: A qualitative study of dyadic functioning. Br J Health Psychol 2022; 28:366-382. [PMID: 36301684 DOI: 10.1111/bjhp.12629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 10/09/2022] [Accepted: 10/12/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION The public health issue of the Parkinson's disease (PD) has led to a great deal of research that has highlighted the individual challenges faced by the person with the Parkinson's disease (PwPD) and the caregiving spouse. Few studies, however, have sought to understand the functioning of couples facing PD, by differentiating each stage, each of which has its own issues. In particular, the "honeymoon period", characterized by a symptomatic respite allowed by the effectiveness of treatments for motor symptoms, has been poorly documented, especially at the dyadic level. DESIGN AND METHOD This qualitative study, based on Interpretative Phenomenological Analysis, aimed to understand the experience of couples and their functioning at this stage. Fifteen couples participated in separate semi-structured interviews for each partner. The analyses highlighted four dyadic dynamics, which call into question the relevance of the term "honeymoon" to describe the experience of couples. RESULTS While some couples appear to adjust by means of flexible functioning and a positive reinterpretation of this experience, other dyads oscillate between rigid hyperprotection in the face of perceived distress or a vicious circle of control/avoidance and, in some cases, gradually slipping towards the erosion of the relationship. DISCUSSION These results show that the relational difficulties suffered by partners at this stage should be taken into account as soon as possible after the diagnosis. Strengthening the communication and the togetherness between partners, as well as working on dyadic emotional regulation, are particularly relevant options for these couples.
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Affiliation(s)
- Charlotte Manceau
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Emilie Constant
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Elodie Brugallé
- Neurology and Movement Disorders Department CHU‐Lille Lille France
| | - Emilie Wawrziczny
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | - Céline Sokolowski
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
| | | | - Guillaume Baille
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Luc Defebvre
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Kathy Dujardin
- Neurology and Movement Disorders Department Univ. Lille, Inserm, Lille Neurosciences and Cognition, CHU‐Lille Lille France
| | - Pascal Antoine
- Univ. Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives Villeneuve d'Ascq France
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Interian A, Mann SL, Mavandadi S, St Hill LM, Kashan R, Rodriguez KM, Dobkin RD. Criticism in the Parkinson's Caregiving Relationship: A Key Target for Intervention. J Geriatr Psychiatry Neurol 2022; 35:671-679. [PMID: 34607483 PMCID: PMC11070948 DOI: 10.1177/08919887211049119] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Caregiver distress is prevalent in Parkinson's disease (PD) and predictive of negative health outcomes for both people with PD and caregivers. To identify future intervention targets, it is important to better elucidate the specific processes, such as criticism, that perpetuate burden. OBJECTIVE Evaluate the frequency and impact of criticism and reactivity to criticism in PD caregiving dyads. METHODS Eighty-three people with PD and their caregivers independently completed measures of criticism and physical and emotional health. RESULTS Criticism in the caregiving relationship was reported by 71.1% (n = 59) of people with PD and 80.7% (n = 67) of caregivers. Both perceived criticism and emotional reactivity to criticism were significant predictors of caregiver distress, adjusting for PD motor and non-motor symptom severity. In contrast, criticism was not related to PD depression. CONCLUSION Criticism in the PD caregiving relationship is a clear target for psychotherapeutic intervention and may improve caregiver health and quality of life.
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Affiliation(s)
| | | | | | | | - Rachel Kashan
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
| | | | - Roseanne D Dobkin
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ, USA. Mann is now with Bellevue Hospital, New York, NY, USA
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Lilleheie I, Debesay J, Bye A, Bergland A. The tension between carrying a burden and feeling like a burden: a qualitative study of informal caregivers' and care recipients' experiences after patient discharge from hospital. Int J Qual Stud Health Well-being 2021; 16:1855751. [PMID: 33345749 PMCID: PMC7758041 DOI: 10.1080/17482631.2020.1855751] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Purpose: The number of people aged 80 and above is projected to triple over the next 30 years. Expanding public expenditure on long-term care servicesHas made policies encouraged informal caregiving. Burden of care describes challenges connected to informal caregiving. Dependent patients report feelings of being a burden. Few studies have focused on both the experience of caregiver burden and recipients' feelings of burden. This study explore the experiences of old patients and informal caregivers in the first 30 days after the patient's discharge. Method: Aphenomenological approach was used to explore the subjective experiences of the participants . Semi-structured individual interviews were analysed thematically. Results: The reults reflect imbalance regarding care needs relative to time, social roles, physical and emotional states, and formal care resources. Four themes emerged from the interviews: 1) Bridging the gap, 2) Family is family, 3) Never enough, and 4) Stress and distress. Conclusions: The participants face strains within their roles. The care situation has potential to be burdensome. To secure healthcare quality for old patients, the informal carer's role needs to be recognized. Informal care based on altruism and reciprocity seems to be positive, whereas informal care based on family norms might have a negative impact.
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Affiliation(s)
- Ingvild Lilleheie
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University , Oslo, Norway
| | - Jonas Debesay
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University , Oslo, Norway
| | - Asta Bye
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway, and European Palliative Care Research Centre (PRC), Department of Oncology, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo , Oslo, Norway
| | - Astrid Bergland
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University , Oslo, Norway
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Psychological Impact of Parkinson Disease Delusions on Spouse Caregivers: A Qualitative Study. Brain Sci 2021; 11:brainsci11070871. [PMID: 34210042 PMCID: PMC8301855 DOI: 10.3390/brainsci11070871] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 12/15/2022] Open
Abstract
There is growing research on carers of people with Parkinson's disease (PD) experiences. However, the impact on carers by PD delusions is not specifically examined. We conducted a qualitative study using semi-structured interviews of spouse carers of PD patients with delusions. Thematic analysis was employed using MAXQDA 2018. Twelve spouse participants (SPs) were interviewed. Four themes emerged: Managing incredulity: trying to make sense of delusion content; Hypervigilance: constant alertness to bizarre and threatening discourse and behavior; Defensive strategizing: anticipating delusions and potential consequences; Concealing and exposing: ambivalence about disclosing the effect of delusions yet wanting support. SPs reported effects on their emotional well-being and marital relationship and challenges to an orderly, predictable life. SPs were reluctant to share their experiences due to delusion content (often infidelity and sexual in nature) and a desire to protect their spouses' image. SPs' awareness of the potential for delusional thought was low prior to their occurrence. Conclusions: education surrounding potential neurobehavioral changes should occur for patients and carers. Clinicians should be aware that the impact of delusions on carers is often greater than disclosed in clinical interviews. Interdisciplinary teams speaking separately to spousal carers may improve disclosure and delivery of appropriate psychological support.
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11
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Scharfenort M, Timpka J, Sahlström T, Henriksen T, Nyholm D, Odin P. Close relationships in Parkinson´s disease patients with device-aided therapy. Brain Behav 2021; 11:e02102. [PMID: 33949144 PMCID: PMC8213651 DOI: 10.1002/brb3.2102] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 01/31/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES Deep brain stimulation, continuous subcutaneous apomorphine infusion, and levodopa-carbidopa intestinal gel infusion, together called device-aided therapies (DAT), are introduced when oral and transdermal pharmacotherapy are not enough for a satisfactory control of Parkinson's disease (PD) symptoms. Solid relationships are central to an individual's well-being, but the impact of close relationships in advanced PD remains underexplored. The aim of this study was to investigate the development of close relationships between PD patients and their partners following the initiation of DAT and to examine the relationship structures in these relationships. MATERIALS AND METHODS This was a retrospective quantitative multicenter pilot study wherein 41 couples, patients with advanced PD and their partners, retrospectively rated their relationship satisfaction before the start of DAT, after one year of DAT and at the time of the interview. The couples also answered the Experiences in Close Relationships-Questionnaire of Relational Structures (ECR-RS). RESULTS Partners more often report changes in relationship satisfaction than patients between baseline and both 1 year after start of DAT (p = .049) and last evaluation (p = .041). The ECR-RS data reported significantly higher avoidance score for partners (p = .005) and significantly higher anxiety score for patients (p = .024). CONCLUSIONS The close relationship wherein one part has PD and receives DAT has a high risk of being unequal. Prospective studies are needed for further clarification of the interplay between advanced PD, DAT, and close relationships, this in order to improve pre- and postinterventional support for PD patients receiving DAT, as well as their partners.
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Affiliation(s)
- Monica Scharfenort
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | - Jonathan Timpka
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
| | | | - Tove Henriksen
- Department of Neurology, University Hospital of Bispebjerg, Copenhagen, Denmark
| | - Dag Nyholm
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Per Odin
- Division of Neurology, Lund University, Lund, Sweden.,Department of Neurology, Skåne University Hospital, Lund, Sweden
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12
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Rastgardani T, Armstrong MJ, Gagliardi AR, Grabovsky A, Marras C. Experience and Impact of OFF Periods in Parkinson's Disease: A Survey of Physicians, Patients, and Carepartners. JOURNAL OF PARKINSONS DISEASE 2021; 10:315-324. [PMID: 31815702 DOI: 10.3233/jpd-191785] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND OFF periods impair quality of life in Parkinson's disease but the nature and degree of this impact is largely unquantified. Optimal treatment relies on assessing the experience and impact of these periods on patients and their carepartners. OBJECTIVES To understand the experience and impact of OFF periods on their lives. METHODS Informed by qualitative interviews we designed questionnaires and surveyed neurologists, people with Parkinson's disease and carepartners. RESULTS 50 general neurologists, 50 movement disorder neurologists, 442 patients (median disease duration 5 years) and 97 carepartners were included. The most common OFF symptoms reported by patients and carepartners were stiffness, slowness of movement and changes in gait. Non-motor symptoms were less common. A higher proportion of carepartners reported each symptom. A minority of neurologists recognized pain, sweating and anxiety as possible symptoms of OFF periods. The three OFF symptoms most frequently designated as having great impact by people with Parkinson's disease were changes in gait, slowness and stiffness. In contrast, cognitive impairment was most frequently rated as having great impact on carepartners. OFF periods were reported to impact many aspects of the lives of both patients and carepartners. CONCLUSIONS In people with Parkinson's disease of under 10 years duration, motor symptoms of OFF periods predominate in impact, however cognitive impairment has great impact on carepartners. Education is needed for neurologists regarding the non-motor aspects of OFF. The importance of involving carepartners in the assessment regarding OFF periods is supported by the higher frequency of symptom reporting by carepartners, and the significant impact on their lives.
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Affiliation(s)
- Tara Rastgardani
- The Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, Toronto, ON, Canada
| | - Melissa J Armstrong
- Department of Neurology, University of Florida College of Medicine, Gainesville, FL, USA
| | - Anna R Gagliardi
- Toronto General Hospital Research Institute, University Health Network, Toronto, ON, Canada
| | | | - Connie Marras
- The Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's Research, Toronto Western Hospital, Toronto, ON, Canada
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Wade R, Pachana NA, Dissanayaka N. Management of Sleep Disturbances in Parkinson's Disease Patients, Carers and the Patient and Carer Dyadic Relationship: A Scoping Review. Clin Gerontol 2020; 43:499-507. [PMID: 30422081 DOI: 10.1080/07317115.2018.1539424] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Sleep disturbances are a debilitating non-motor symptom in Parkinson's disease (PD) and negatively impact patients, their carers and the patient-carer dyadic relationship. This review outlines the phenomenology, as well as factors associated with and treatment of sleep disturbances, in PD patients and their informal carers. METHODS The following terms were used in four databases: Parkinson*, sleep* disturbance*, carer*, dyad*, intervention* and treatment*. RESULTS Across the articles reviewed, the frequency of reported sleep disturbances in PD ranged between 60% and 98%. Common sleep problems in PD included insomnia, excessive day time sleepiness, REM sleep behavior disorder (RBD), sleep apnoea, periodic limb movements and sleep attacks. Within dyads, significant correlations were found with depression, anxiety and carer burden relating to night time care in particular. Despite the negative impact of sleep disturbance in PD, the evidence-base for treatment remains limited. CONCLUSIONS While addressing individual factors associated with sleep disturbances, it is also important to emphasize the needs arising from the patient-carer dyadic relationship. While a number of non-pharmacological interventions were suggested in the literature, further well-controlled trials are still required. CLINICAL IMPLICATIONS Multiple approaches are required to reduce sleep disturbances and associated burden in PD.
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Affiliation(s)
- Rachael Wade
- School of Psychology, The University of Queensland , Brisbane, Australia.,UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland , Brisbane, Australia
| | - Nancy A Pachana
- School of Psychology, The University of Queensland , Brisbane, Australia
| | - Nadeeka Dissanayaka
- School of Psychology, The University of Queensland , Brisbane, Australia.,UQ Centre for Clinical Research, Faculty of Medicine, The University of Queensland , Brisbane, Australia.,Department of Neurology, Royal Brisbane & Women's Hospital , Brisbane, Australia
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14
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The Association Between Mutuality, Anxiety, and Depression in Heart Failure Patient-Caregiver Dyads: An Actor-Partner Interdependence Model Analysis. J Cardiovasc Nurs 2020; 34:465-473. [PMID: 31365444 DOI: 10.1097/jcn.0000000000000599] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Heart failure (HF) patient-caregiver dyads experience severe psychological problems, such as anxiety and depression. A variable that has been found to be associated with anxiety and depression in patients and caregivers in severe chronic conditions is mutuality. However, this association has not been explored in HF patient-caregiver dyads to date. OBJECTIVE The aim of this study was to evaluate the associations among mutuality, anxiety, and depression in HF patient-caregiver dyads. METHODS This was a cross-sectional study. Mutuality, anxiety, and depression in HF patient-caregiver dyads were assessed using the Mutuality Scale (MS) total and 4 dimension scores and the Hospital Anxiety and Depression Scale, respectively. Data were analyzed using the actor-partner interdependence model to examine how mutuality of patients and caregivers was associated with both the patients' own (actor effect) and their partners' anxiety and depression (partner effect). RESULTS A sample of 366 dyads of patients with HF (mean age, 72 years; 56% male) and caregivers (mean age, 54 years; 73.3% female) was enrolled. Regarding patient anxiety, we observed only an actor effect between the MS dimension scores of "love and affection" and "reciprocity" and anxiety in patients (B = -1.108, P = .004 and B = -0.826, P = .029, respectively). No actor and partner effects were observed concerning caregiver anxiety. Regarding depression, we observed that only the MS dimension of "love and affection" in patients had both an actor (patient: B = -0.717, P = .032) and a partner (caregiver: B = 0.710, P = .040) effect on depression. CONCLUSIONS The assessment of MS in HF patient-caregiver dyads is important to formulate interventions aimed at improving anxiety and depression in patients and caregivers.
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Karlstedt M, Fereshtehnejad SM, Aarsland D, Lökk J. Mediating effect of mutuality on caregiver burden in Parkinson's disease partners. Aging Ment Health 2020; 24:1421-1428. [PMID: 31140294 DOI: 10.1080/13607863.2019.1619165] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Objectives: Parkinson's disease (PD) is a complex neurodegenerative disorder with a broad list of motor and non-motor symptoms (NMS) that has been shown to affect the relationship quality (mutuality) and caregiver burden. However, little is known if the effect of motor and NMS on caregiver burden is mediated by mutuality. Therefore, the aim of this study was to explore if perceived mutuality by patients and partners mediates the effect of motor and NMS on caregiver burden.Methods: Data were collected from 51 dyads with one PD patient, including measures of motor signs, NMS, impaired cognition, patients' and partners' perceived mutuality, caregiver burden and dependency in activities in daily life (ADL). Structural equation model with manifest variables were applied to explore if patients' and partners' mutuality score mediated the effect of motor signs, NMS, ADL or impaired cognition on caregiver burden.Result: Our results suggest that having a partner with PD who is dependent in ADL or has impaired cognition decreases partners' mutuality which leads to elevated burden. Motor symptoms or other NMS were not associated with partners' mutuality or caregiver burden. Instead, increasing severity of motor symptoms decrease patients' mutuality in turn leading to lower level of partners' mutuality.Conclusion: Our findings enhance the understanding of the complexity of living with PD for the partner and suggest that clinical assessment should include evaluation of how PD symptoms influence the quality of the relationship between partners and patients.
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Affiliation(s)
- Michaela Karlstedt
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Dag Aarsland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Johan Lökk
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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16
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Zanini C, Fiordelli M, Amann J, Brach M, Gemperli A, Rubinelli S. Coping strategies of family caregivers in spinal cord injury: a qualitative study. Disabil Rehabil 2020; 44:243-252. [PMID: 32449426 DOI: 10.1080/09638288.2020.1764638] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: To identify the coping strategies used by family caregivers of persons with spinal cord injury (SCI) in Switzerland in order to develop tailored support programs.Materials and methods: Purposive sample of >18 years participants, speaking an official Swiss language fluently, being family caregivers of persons with SCI for at least 4 years, and perceiving either a high or low burden in relation to caregiving. Data were collected through face-to-face semi-structured interviews (N = 22). Thematic analysis was performed.Results: Four main coping strategies were identified: reappraisal, active acceptance, setting limits to the caregiver role, and seeking support. These strategies can be used one at a time or combined, and at different times of a caregiver pathway. Our analysis highlighted that caregivers need skills to implement these strategies (e.g., self-evaluation skills).Conclusions: Caregivers of persons with SCI develop cognitive coping strategies to make sense of the situation and establish a "new normal" and problem-focused coping strategies to deal with their new tasks and role. These strategies do not seem to be typical only of SCI caregivers. Hence, interventions that worked for caregivers in other fields could be adapted. Rehabilitation centers should systematically integrate programs targeted to caregivers into their offerings.IMPLICATIONS FOR REHABILITATIONHealthcare systems need to develop educational and support measures for both persons with a health condition and their caregivers.Caregivers should become long-term partners in rehabilitation and a regular and structured needs assessment should be offered.Interventions that worked for caregivers in other fields can be adapted to support also caregivers in SCI.Educational and support programs dedicated to caregivers should teach not only how to perform caregiving tasks but also how to balance between responding to the care recipient's needs and their own needs.
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Affiliation(s)
- Claudia Zanini
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Maddalena Fiordelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Institute of Communication and Health, Università della Svizzera italiana, Lugano, Switzerland
| | - Julia Amann
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Technology, Health Ethics and Policy Lab, ETH, Zurich, Switzerland
| | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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17
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Dlay JK, Duncan GW, Khoo TK, Williams-Gray CH, Breen DP, Barker RA, Burn DJ, Lawson RA, Yarnall AJ. Progression of Neuropsychiatric Symptoms over Time in an Incident Parkinson's Disease Cohort (ICICLE-PD). Brain Sci 2020; 10:E78. [PMID: 32024222 PMCID: PMC7071603 DOI: 10.3390/brainsci10020078] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 01/25/2020] [Accepted: 01/31/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cross-sectional studies have identified that the prevalence of neuropsychiatric symptoms (NPS) in Parkinson's disease (PD) ranges from 70-89%. However, there are few longitudinal studies determining the impact of NPS on quality of life (QoL) in PD patients and their caregivers. We seek to determine the progression of NPS in early PD. METHODS Newly diagnosed idiopathic PD cases (n = 212) and age-matched controls (n = 99) were recruited into a longitudinal study. NPS were assessed using the Neuropsychiatric Inventory with Caregiver Distress scale (NPI-D). Further neuropsychological and clinical assessments were completed by participants, with reassessment at 18 and 36 months. Linear mixed-effects modelling determined factors associated with NPI-D and QoL over 36 months. RESULTS Depression, anxiety, apathy and hallucinations were more frequent in PD than controls at all time points (p < 0.05). Higher motor severity at baseline was associated with worsening NPI-D scores over time (β = 0.1, p < 0.05), but not cognition. A higher NPI total score was associated with poorer QoL at any time point (β = 0.3, p < 0.001), but not changed in QoL scores. CONCLUSION NPS are significantly associated with poorer QoL, even in early PD. Screening for NPS from diagnosis may allow efficient delivery of better support and treatment to patients and their families.
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Affiliation(s)
- J. K. Dlay
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - G. W. Duncan
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - T. K. Khoo
- School of Medicine and Menzies Health Institute Queensland, Griffith University, Gold Coast 4222, Australia;
- School of Medicine, University of Wollongong, New South Wales 2522, Australia
| | - C. H. Williams-Gray
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. P. Breen
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
- Anne Rowling Regenerative Neurology Clinic, University of Edinburgh, Edinburgh EH16 4SB, UK
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh EH16 4UX, UK
| | - R. A. Barker
- John van Geest Centre for Brain Repair, University of Cambridge, Cambridge CB2 0PY, UK; (C.H.W.-G.); (R.A.B.)
| | - D. J. Burn
- Faculty of Medical Sciences, Newcastle University & Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE2 4HH, UK;
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
| | - R. A. Lawson
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
| | - A. J. Yarnall
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne NE4 5PL, UK; (J.K.D.); (G.W.D.); (R.A.L.)
- Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE7 7DN, UK
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18
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Habermann B, Shin JY, Shearer G. Dyadic Decision-Making in Advanced Parkinson’s Disease: A Mixed Methods Study. West J Nurs Res 2019; 42:348-355. [DOI: 10.1177/0193945919864429] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
People with advanced Parkinson’s disease (PD) are living at home being cared for by a family member. Decisions about health care and living preferences are made in a family context. The aims of the study were to (a) examine the types and timing of the decisions being made by dyads (person with Parkinson’s [PWP] and caregiver) in advanced PD; and (b) explore perceived decision quality relative to specific decisions made. A mixed methods design of semi-structured dyad interviews followed by individual completion of decision measures twice at six months apart was utilized. Decisions involved obtaining more services in the home, moving into assisted living communities, maintaining as is, and initiating hospice. There was high decision quality as reflected by low decisional conflict and regret without statistical differences within the dyad. The findings provide insight into the nature of decisions dyads face and suggest ways that health care providers can support decision-making.
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Affiliation(s)
- Barbara Habermann
- School of Nursing, College of Health Sciences, University of Delaware, Newark, USA
| | - Ju Young Shin
- School of Nursing, College of Health Sciences, University of Delaware, Newark, USA
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19
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Vaughan CP, Burgio KL, Goode PS, Juncos JL, McGwin G, Muirhead L, Markland AD, Johnson TM. Behavioral therapy for urinary symptoms in Parkinson's disease: A randomized clinical trial. Neurourol Urodyn 2019; 38:1737-1744. [PMID: 31187552 DOI: 10.1002/nau.24052] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/05/2019] [Accepted: 05/13/2019] [Indexed: 01/03/2023]
Abstract
AIM Determine the efficacy of behavioral therapy for urinary symptoms in Parkinson's disease. METHODS Randomized trial of behavioral therapy compared with control condition among adults (aged 54-85 years, 74% male, 10% Black/ 83% White) with Parkinson's and greater than or equal to 4 incontinence episodes weekly. Behavioral therapy included pelvic floor muscle exercises, bladder training, fluid and constipation management. Both groups completed bladder diary self-monitoring. Outcomes included diary-derived incontinence and ICIQ-overactive bladder (OAB) score (range, 0-16) with bother and quality of life questionnaires (higher scores = worse outcomes). RESULTS Fifty-three participants randomized and 47 reported 8-week outcomes including 26 behavioral therapy and 21 control. Behavioral vs control participants were similar with respect to age (71.0 ± 6.1 vs 69.7 ± 8.2 years), sex (70% vs 78% male), motor score, cognition, mean weekly incontinence episodes (13.9 ± 9.6 vs 15.1 ± 11.1) and OAB symptoms (8.9 ± 2.4 vs 8.3 ± 2.2). Weekly incontinence reduction was similar between behavioral (-6.2 ± 8.7) and control participants (-6.5 ± 13.8) (P = 0.89). After multiple imputation analysis, behavioral therapy participants reported statistically similar reduction in OAB symptoms compared to control (-3.1 ± 2.8 vs -1.9 ± 2.2, P = 0.19); however quality of life (-22.6 ± 19.1 vs -7.0 ± 18.4, P = 0.048) and bother (-12.6 ± 17.2 vs - 6.7 ± 8.8, P = 0.037) improved significantly more with behavioral therapy. CONCLUSION Self-monitoring resulted in fewer urinary symptoms; however, only multicomponent behavioral therapy was associated with reduced bother and improved quality of life. Providers should consider behavioral therapy as initial treatment for urinary symptoms in Parkinson's disease.
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Affiliation(s)
- Camille P Vaughan
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta VA Health System, Atlanta, Georgia.,Division of General Medicine & Geriatrics, Department of Medicine, Emory University, Decatur, Georgia
| | - Kathryn L Burgio
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Birmingham VA Health System, Birmingham, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Patricia S Goode
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Birmingham VA Health System, Birmingham, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jorge L Juncos
- Department of Neurology, Emory University, Atlanta, Georgia
| | - Gerald McGwin
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Birmingham VA Health System, Birmingham, Alabama.,Department of Epidemiology, University of Alabama at Birmingham, Birmingham, Alabama
| | - Lisa Muirhead
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta VA Health System, Atlanta, Georgia.,Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Alayne D Markland
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Birmingham VA Health System, Birmingham, Alabama.,Division of Gerontology, Geriatrics, and Palliative Care, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Theodore M Johnson
- Birmingham/Atlanta VA Geriatric Research, Education, and Clinical Center, Atlanta VA Health System, Atlanta, Georgia.,Division of General Medicine & Geriatrics, Department of Medicine, Emory University, Decatur, Georgia
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20
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Vaughan CP, Fitzgerald CM, Markland AD. Management of Urinary Incontinence in Older Adults in Rehabilitation Care Settings. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2019. [DOI: 10.1007/s40141-019-00221-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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21
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Kayser K, Acquati C. The influence of relational mutuality on dyadic coping among couples facing breast cancer. J Psychosoc Oncol 2019; 37:194-212. [PMID: 30822220 DOI: 10.1080/07347332.2019.1566809] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The study examined how a couple's capacity for mutuality as conceptualized by the Relational-Cultural Theory plays a role in their managing the stresses accompanying breast cancer. METHODS Eighty-six women treated for a primary, non-metastatic breast cancer and their partners completed measures of quality of life, relational mutuality, and dyadic coping. Demographic and clinical factors were self-reported. The relationship between mutuality and dyadic coping was evaluated using the Actor-Partner Interdependence Model (APIM). RESULTS Relational mutuality was positively associated with both the patients' and the caregivers' scores on common and positive dyadic coping. Similarly, relational mutuality was associated with both patients' and caregivers' reduced scores on avoidance of dyadic coping. CONCLUSIONS Relational mutuality emerges as a significant factor in our understanding about dyadic coping in the context of cancer and this study highlights the role it plays in dyadic coping behaviors. IMPLICATIONS The promotion of relational mutuality in couples coping with cancer-related stress should be a major focus in couple-based interventions.
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Affiliation(s)
- Karen Kayser
- a Kent School of Social Work , University of Louisville , Louisville , Kentucky , USA
| | - Chiara Acquati
- b Graduate College of Social Work , University of Houston , Houston , Texas , USA
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22
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Rastgardani T, Armstrong MJ, Gagliardi AR, Marras C. Understanding, Impact, and Communication of "Off" Periods in Parkinson's Disease: A Scoping Review. Mov Disord Clin Pract 2018; 5:461-470. [PMID: 30515435 PMCID: PMC6207105 DOI: 10.1002/mdc3.12672] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/19/2018] [Accepted: 07/31/2018] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Off periods are a common and disabling symptom of Parkinson's disease. We reviewed published research on understanding, impact, and communication regarding off periods to identify issues warranting further research. METHODS We performed a scoping review, searching MEDLINE, EMBASE, Cochrane Library, CINAHL, and PsycINFO from 2006 to January 2018 for studies examining the impact of, understanding of, or communication about off periods. RESULTS Twenty-six papers met eligibility criteria. Twenty-three studies evaluated the impact or experience of off periods in patients, three evaluated the impact upon carepartners, two papers addressed understanding of off periods, one study evaluated communication about off periods, and three studies evaluated a facilitator of communication about off periods. The findings indicate that (1) off periods are among the most troublesome symptoms to patients and that their impact on activities is broad; (2) the understanding of off periods by patients, carepartners, and nurses may be suboptimal; and (3) questionnaires hold promise as a mechanism for facilitating communication given the findings that they may enhance the detection of off periods and are rated as useful by physicians. No studies evaluated interventions to promote knowledge about off periods, and no studies identified barriers of communication about off periods. CONCLUSIONS There is a paucity of knowledge regarding the lived experiences of off periods, particularly for carepartners. Additionally, little knowledge exists in the literature regarding understanding of and communication about off periods between patients or carepartners and treating physicians. Further research is required to explore these issues to ultimately improve the treatment of off periods.
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Affiliation(s)
- Tara Rastgardani
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's ResearchToronto Western HospitalTorontoONCanada
| | - Melissa J. Armstrong
- Department of NeurologyUniversity of Florida College of MedicineGainesvilleFloridaUSA
| | - Anna R. Gagliardi
- Toronto General Hospital Research InstituteUniversity Health NetworkTorontoONCanada
| | - Connie Marras
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J Safra Program in Parkinson's ResearchToronto Western HospitalTorontoONCanada
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Hellqvist C, Dizdar N, Hagell P, Berterö C, Sund-Levander M. Improving self-management for persons with Parkinson's disease through education focusing on management of daily life: Patients’ and relatives’ experience of the Swedish National Parkinson School. J Clin Nurs 2018; 27:3719-3728. [DOI: 10.1111/jocn.14522] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Revised: 03/12/2018] [Accepted: 05/08/2018] [Indexed: 11/30/2022]
Affiliation(s)
- Carina Hellqvist
- Department of Medical and Health Science; Linköping University; Linköping Sweden
| | - Nil Dizdar
- Division of Neuro and Inflammation Sciences; Department of Clinical and Experimental Medicine; Linköping University; Linköping Sweden
| | - Peter Hagell
- The PRO-CARE Group; School of Health and Society; Kristianstad University; Kristianstad Sweden
| | - Carina Berterö
- Department of Medical and Health Science; Linköping University; Linköping Sweden
| | - Märta Sund-Levander
- Department of Medical and Health Science; Linköping University; Linköping Sweden
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24
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Coping with Cognitive Impairment in People with Parkinson's Disease and Their Carers: A Qualitative Study. PARKINSONS DISEASE 2018; 2018:1362053. [PMID: 29850013 PMCID: PMC5911314 DOI: 10.1155/2018/1362053] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 01/22/2018] [Indexed: 11/17/2022]
Abstract
Cognitive impairment is common in Parkinson's disease (PD). However, the psychosocial impact of living and coping with PD and cognitive impairment in people with PD and their carers have not been explored. This paper draws on a qualitative study that explores the subjective impact of cognitive impairment on people with PD and their carers. Thirty-six one-to-one interviews were completed; people with PD were from three groups: normal cognition, mild cognitive impairment, and dementia. Data collection and analysis were iterative, and verbatim transcripts were analysed using thematic analysis. Themes were interpreted in consultation with coping and adaptation theory. The analysis revealed four main themes: threats to identity and role, predeath grief and feelings of loss in carers, success and challenges to coping in people with PD, and problem-focused coping and finding meaning in caring. Our data highlight how cognitive impairment can threaten an individual's self-perception; the ostensible effects of cognitive impairment depended on the impact individual's perceived cognitive impairment had on their daily lives. For carers, cognitive impairment had a greater emotional impact than the physical symptoms of PD. The discussion that developed around protective factors provides possible opportunities for future interventions, such as psychological therapies to improve successful adjustment.
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25
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van Driel TJW, Hilderink PH, Hanssen DJC, de Boer P, Rosmalen JGM, Oude Voshaar RC. Assessment of Somatization and Medically Unexplained Symptoms in Later Life. Assessment 2018; 25:374-393. [PMID: 28745072 PMCID: PMC5865474 DOI: 10.1177/1073191117721740] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The assessment of medically unexplained symptoms and "somatic symptom disorders" in older adults is challenging due to somatic multimorbidity, which threatens the validity of somatization questionnaires. In a systematic review study, the Patient Health Questionnaire-15 (PHQ-15) and the somatization subscale of the Symptom Checklist 90-item version (SCL-90 SOM) are recommended out of 40 questionnaires for usage in large-scale studies. While both scales measure physical symptoms which in younger persons often refer to unexplained symptoms, in older persons, these symptoms may originate from somatic diseases. Using empirical data, we show that PHQ-15 and SCL-90 SOM among older patients correlate with proxies of somatization as with somatic disease burden. Updating the previous systematic review, revealed six additional questionnaires. Cross-validation studies are needed as none of 46 identified scales met the criteria of suitability for an older population. Nonetheless, specific recommendations can be made for studying older persons, namely the SCL-90 SOM and PHQ-15 for population-based studies, the Freiburg Complaint List and somatization subscale of the Brief Symptom Inventory 53-item version for studies in primary care, and finally the Schedule for Evaluating Persistent Symptoms and Somatic Symptom Experiences Questionnaire for monitoring treatment studies.
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26
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Mosley PE, Moodie R, Dissanayaka N. Caregiver Burden in Parkinson Disease: A Critical Review of Recent Literature. J Geriatr Psychiatry Neurol 2017; 30:235-252. [PMID: 28743212 DOI: 10.1177/0891988717720302] [Citation(s) in RCA: 168] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Burden is a negative psychological state induced in caregivers by the demands of providing care to a person with an illness or a disability. Managing caregiver burden in Parkinson disease (PD) is significant because informal caregivers make a substantial contribution to the well-being of persons with PD, incurring financial, social, and personal losses. Failure to recognize and manage caregiver burden may lead to burnout and premature institutionalization of the person with PD. We conducted a comprehensive literature review to identify and summarize factors that may amplify burden, including motor and nonmotor symptoms of PD, caregiver psychiatric symptoms, and caregiver coping style. We review instruments designed to sample the construct of burden among caregivers and evaluate interventions that may reduce burden, either by directly targeting caregivers or by treating PD symptoms associated with burden. We aim to provide a concise synopsis of these issues for the clinician or researcher working with this population in order to facilitate recognition of caregiver burden, provide accurate assessment, administer appropriate interventions, and stimulate further research in this area.
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Affiliation(s)
- Philip E Mosley
- 1 Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.,2 Neurosciences Queensland, St Andrew's War Memorial Hospital, Spring Hill, Queensland, Australia.,3 Queensland Brain Institute, University of Queensland, St Lucia, Queensland, Australia.,4 School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Rebecca Moodie
- 1 Systems Neuroscience Group, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia
| | - Nadeeka Dissanayaka
- 5 UQ Centre for Clinical Research, University of Queensland, Herston, Queensland, Australia.,6 School of Psychology, University of Queensland, St Lucia, Queensland, Australia.,7 Department of Neurology, Royal Brisbane & Woman's Hospital, Herston, Queensland, Australia
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Pan Y, Jones PS, Pothier P. The Relationship Between Mutuality and Health-Related Quality of Life in Adult Child Caregivers in China. JOURNAL OF FAMILY NURSING 2017; 23:366-391. [PMID: 28795855 DOI: 10.1177/1074840717718540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The strain inherent in caregiving relationships between adult children and aging parents is a prominent issue in contemporary China due to a combination of demographic and socioeconomic changes. The purpose of this study was to explore how mutuality, a positive quality of caregiving relationships, contributes to the physical health and mental health (health-related quality of life [HRQoL]) of adult child caregivers [ACCs] of parent stroke survivors. A cross-sectional correlational study was conducted on a nonproportional quota sample of 126 ACCs, using questionnaires of demographics, the 15-item Mutuality Scale, and the Second Version of the Standard 12-Item Health Survey (SF-12v2). Higher mutuality was found to be correlated with better caregiver physical health and mental health. However, after adjusting for the covariates, mutuality significantly explained 4.6% of the variance of caregiver physical health (β = .22, ΔR2 = .046, p < .01) but it did not significantly explain the variance of caregiver mental health. Although multiple factors correlate with Chinese family caregivers' HRQoL, this was the first study exploring the impact of caregiver-care receiver dyadic relationships on caregiver HRQoL in mainland China by using a mutuality scale with SF-12v2. Despite the fact that the Chinese tradition of filial piety can facilitate mutuality, socioeconomic changes and legislation that require adult children to care for aging parents appear to create high stress among family caregivers. Higher levels of mutuality contribute to better physical health in Chinese family caregivers. Therefore, culturally appropriate family nursing strategies and social policies in China could enhance caregiver mutuality and potentially promote their HRQoL, in particular physical health.
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Affiliation(s)
- Yuqin Pan
- 1 Jinhua Polytechnic, Zhejiang Province, China
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Karlstedt M, Fereshtehnejad SM, Winnberg E, Aarsland D, Lökk J. Psychometric properties of the mutuality scale in Swedish dyads with Parkinson's disease. Acta Neurol Scand 2017; 136:122-128. [PMID: 27781261 DOI: 10.1111/ane.12706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The 15-item mutuality scale (MS) has been used in several neurological conditions assessing the quality of relationship associations with negative effects of the caregiving situation. The aim of this study was to translate the original MS into Swedish and assess its psychometric properties in Parkinson's disease (PD). MATERIALS AND METHODS Following the forward-backward translation method, the scale was evaluated regarding linguistic correctness at a conceptual level and user-friendliness. The scale was filled out by a sample of 50 care dyads where one was having PD. Scale assumptions and scale structure were evaluated using floor/ceiling effect and principal component analyses (PCA) with promax rotation. Internal consistency was evaluated using Cronbach's alpha and mean inter-item correlation coefficients. RESULTS The Swedish MS was evaluated as user-friendly and relevant by the participants. The scale demonstrated no floor/ceiling effect and showed high internal consistency (α≥0.93) with a mean inter-item correlation coefficient of ≥0.5. Through the PCA, a two factor solution emerged, which accounted for 67% and 64% of the variance of the MS score by PD-partners and PD-patients, respectively. However, some variables were complex and discarded in the final solution. CONCLUSION Our findings provide initial support of the Swedish MS as a user-friendly and useful instrument with acceptable psychometric properties even though more research is needed to evaluate the existence of subscales.
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Affiliation(s)
- M. Karlstedt
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - S. M. Fereshtehnejad
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - E. Winnberg
- Department of Health Care Sciences; Ersta Sköndal University College; Stockholm Sweden
| | - D. Aarsland
- Division of Neurogeriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - J. Lökk
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
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Abstract
ABSTRACTIn health and chronic illness, satisfying marriages promote wellbeing and life satisfaction, yet stroke research has focused on either the stroke survivor as the patient or the spouse as a care-giver. Using Pope, Mays and Popay's framework for synthesising qualitative and quantitative methods, we conducted a systematic review and synthesis of 39 peer-reviewed studies to determine what happens to marital relationships after one partner has suffered a stroke. All the articles examined the impact of stroke. Three overarching themes characterise the evolution of marriage after stroke: chaos in the marriage, work to re-establish the marriage and evolution of the marriages. While both the stroke condition itself and the survivors’ need for care undermined the emotional qualities of the relationship for some couples, about two-thirds were able to retain or regain the relationship closeness. As in other chronic illnesses, the relationship closeness and a couple's ability to collaborate contributed to the survivor's recovery and to the satisfaction with life of the stroke survivor and the spouse. Our results underscore the need to consider the quality of, and the qualities of, the relationship between stroke survivors and their spouses. Future research could include a greater focus on qualitative or mixed-methods approaches to explore the interactions between stroke survivors and spouses that impact the wellbeing of both partners.
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Determinants of Dyadic Relationship and Its Psychosocial Impact in Patients with Parkinson's Disease and Their Spouses. PARKINSONS DISEASE 2017; 2017:4697052. [PMID: 28286689 PMCID: PMC5329678 DOI: 10.1155/2017/4697052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/08/2017] [Accepted: 01/17/2017] [Indexed: 11/17/2022]
Abstract
The caregiver-care receiver relationship (mutuality) in Parkinson's disease (PD) and its association with motor and non-motors symptoms, health-related quality of life (HRQoL), and caregiver burden have not fully been investigated. The aim of our study was to explore if (1) the level of mutuality perceived by PD-patients and PD-partners differs, (2) different factors are associated with perceived mutuality by PD-patients and PD-partners, and (3) mutuality is associated with PD-patients health-related quality of life (HRQoL) and caregiver burden. We collected data on motor signs (UPDRS III), non-motor manifestations (NMSQuest), PD-patients' cognition (IQCODE), mutuality scale (MS), PD-patients' HRQoL (PDQ8), and caregiver burden (CB) from 51 PD dyads. Predictors were identified using multivariate regression analyses. Overall, the dyads rated their own mutuality as high with no significant difference between the dyads except for the dimension of reciprocity. PD-patients' MS score (p = .001) and NMSQuest (p ≤ .001) were significant predictors of PDQ8. Strongest predictor of CB was PD-partners' MS score (<.001) and IQCODE (p = .050). In general, it seems that non-motor symptoms contribute to a larger extent to the mutual relationship in PD-affected dyads than motor disabilities.
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Fereshtehnejad SM. Strategies to maintain quality of life among people with Parkinson's disease: what works? Neurodegener Dis Manag 2016; 6:399-415. [PMID: 27600287 DOI: 10.2217/nmt-2016-0020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Among chronic neurodegenerative disorders, Parkinson's disease (PD) is one of the most difficult and challenging to tackle as several motor and nonmotor features influence the patients' quality of life (QoL) and daily activities. Assessing patients QoL with valid instruments and gathering knowledge about the determinants that affect QoL in individuals with PD are the basis of an efficient caring strategy. In addition to the known motor symptoms, nonmotor disorders must also be comprehensively tracked and targeted for treatment to enhance QoL. A holistic strategy to maintain QoL in people with PD should consist of a multidisciplinary, personalized and patient-centered approach with timely administration of palliative care and efficient involvement of caregivers and family members.
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Affiliation(s)
- Seyed-Mohammad Fereshtehnejad
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences & Society (NVS), Karolinska Institutet, Stockholm, Sweden.,Department of Neurology & Neurosurgery, Faculty of Medicine, McGill University, Montreal General Hospital, Montreal, Québec, Canada
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[Psychosocial strategies to strengthen the coping with Parkinson's disease: Perspectives from patients, family carers and healthcare professionals]. Aten Primaria 2016; 49:214-223. [PMID: 27566906 PMCID: PMC6876005 DOI: 10.1016/j.aprim.2016.06.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 06/06/2016] [Accepted: 06/07/2016] [Indexed: 11/20/2022] Open
Abstract
Objetivo Explorar los principales aspectos psicosociales que influyen en el afrontamiento de la enfermedad de los pacientes con enfermedad de Parkinson (EP) y sus familiares cuidadores. Diseño Estudio cualitativo exploratorio que constituye la segunda fase de un proyecto de metodología combinada. Emplazamiento Estudio multicéntrico realizado en la Comunidad Autónoma de Navarra en 2014 con la colaboración de Atención Primaria del Servicio Navarro de Salud-Osasunbidea, la Clínica Universidad de Navarra y la Asociación Navarra de Parkinson. Participantes Un total de 21 participantes: 9 personas con EP, 7 familiares cuidadores y 5 profesionales sociosanitarios. Método Los participantes fueron seleccionados mediante muestreo opinático. Se realizaron grupos focales hasta que se consideró adecuada la saturación de los datos. Las transcripciones fueron analizadas por 2 investigadores a través de un análisis de contenido. Resultados Se identificaron 3 aspectos que influían en cómo pacientes y familiares afrontaban la EP: funcionalidad de la atención sanitaria; entorno familiar, y aceptación de la enfermedad. Considerando estos resultados, se proponen estrategias que podrían promover estos aspectos desde atención primaria, para así mejorar la adaptación a esta enfermedad en pacientes y en sus familiares cuidadores. Conclusiones La atención sociosanitaria de las personas con EP debería adoptar un enfoque integral que aborde el control de los síntomas del paciente y que responda también a los aspectos psicosociales que influyen en el afrontamiento de la enfermedad, tanto en los pacientes como en sus familiares cuidadores.
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Pucciarelli G, Buck HG, Barbaranelli C, Savini S, Simeone S, Juarez-Vela R, Alvaro R, Vellone E. Psychometric Characteristics of the Mutuality Scale in Stroke Patients and Caregivers. THE GERONTOLOGIST 2016; 56:e89-98. [DOI: 10.1093/geront/gnw083] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2015] [Accepted: 03/30/2016] [Indexed: 11/14/2022] Open
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Rana AQ, Qureshi ARM, Mumtaz A, Abdullah I, Jesudasan A, Hafez KK, Rana MA. Associations of pain and depression with marital status in patients diagnosed with Parkinson's disease. Acta Neurol Scand 2016; 133:276-80. [PMID: 26147247 DOI: 10.1111/ane.12454] [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: 06/05/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND Depression and pain are significant clinical problems that are comorbid with Parkinson's disease (PD). However, the relationship of these variables with the marital status of patients with PD has not been explored in previous studies. Therefore, the goal of this study was to assess the possible relationship between depression prevalence, depression severity, and pain interference with the marital status of the sufferers of PD. METHODS This study included 40 patients and 40 healthy control participants who were assessed for depression prevalence and severity using The Hospital Anxiety and Depression Scale (HADS). The same individuals were also assessed for pain interference using the Brief Pain Inventory (BPI). RESULTS When compared to the control groups, the PD (Single) group was found to have the highest prevalence of depression, followed by the PD (Married) group whereas the Control (Single) group was found to have a higher prevalence than the Control (Married) group (P < 0.0001). A main effect was found on depression severity (P < 0.0001), but no significant differences were observed between the PD groups. Lastly, PD (Single) patients had significantly greater pain interference scores than the PD (Married) patients (P < 0.05) with no other significant case-control or control-control group differences. CONCLUSION Patient-spouse relationship, which indicates physical and emotional support may have a mitigating effect on patient outcomes of depression prevalence and pain interference.
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Affiliation(s)
- A. Q. Rana
- Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre; Toronto ON Canada
| | | | - A. Mumtaz
- University of Toronto at Scarborough; Toronto ON Canada
| | - I. Abdullah
- Parkinson's Clinic of Eastern Toronto & Movement Disorders Centre; Toronto ON Canada
- University of Toronto at Scarborough; Toronto ON Canada
| | - A. Jesudasan
- Faculty of Medicine; University of Ottawa; Ottawa ON Canada
| | - K. K. Hafez
- Department of Family Medicine; University of Calgary; Calgary AB Canada
| | - M. A. Rana
- Faculty of Medicine and Dentistry; James Cook University; Townsville Qld Australia
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Solomon DN, Hansen L, Baggs JG, Lyons KS. Relationship Quality in Non-Cognitively Impaired Mother-Daughter Care Dyads: A Systematic Review. JOURNAL OF FAMILY NURSING 2015; 21:551-578. [PMID: 26307098 DOI: 10.1177/1074840715601252] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
More than 60 million Americans provide care to a family member; roughly two thirds are women providing care to aging mothers. Despite the protective nature of relationship quality, little attention has been given to its role in mother-daughter care dyads, particularly in mothers without cognitive impairment. A systematic appraisal of peer-reviewed, English language research was conducted. Nineteen articles met criteria. When relationship quality is positive, mother-daughter dyads enjoy rewards and mutuality, even when conflict occurs. Daughters grow more emotionally committed to mothers' over the care trajectory, despite increasing demands. Daughters' commitment deepens as mothers physically decline, and mothers remain engaged, emotional partners. When relationship quality is ambivalent or negative, burden, conflict, and blame conspire, creating a destructive cycle. Avenues for continuing study, including utilizing the dyad as the unit of analysis, troubled dyads, longitudinal assessment, and end of life context, are needed before interventions to improve mother-daughter relationship quality may be successfully implemented.
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Affiliation(s)
- Diane N Solomon
- Oregon Health & Science University, Portland, USA Private Psychiatry Practice, Portland, OR, USA
| | - Lissi Hansen
- Oregon Health & Science University, Portland, USA
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Greenwell K, Gray WK, van Wersch A, van Schaik P, Walker R. Predictors of the psychosocial impact of being a carer of people living with Parkinson's disease: a systematic review. Parkinsonism Relat Disord 2014; 21:1-11. [PMID: 25457815 DOI: 10.1016/j.parkreldis.2014.10.013] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/10/2014] [Accepted: 10/10/2014] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Caring for a person with Parkinson's disease (PwP) can have a variety of negative consequences that may challenge their ability to continue their caring role. It is still unknown why some individuals adapt better than others in response to such burdens. This review is the first to synthesize and evaluate the evidence on the predictive factors of psychosocial outcomes in PwP carers. METHODS Studies which identified predictors of psychosocial outcomes for unpaid carers were included. PsychINFO, EMBASE, AMED, BNI and CINAHL databases were searched, supplemented by scanning of references lists of included studies and relevant journals from 2008 onwards. Quality was assessed using the NICE methodology checklist for prognostic studies. RESULTS Twenty-nine studies were included in the review, providing a low-level of evidence. Carer burden was investigated in 18 studies and mental health and quality of life (QoL) in seven studies each. PwP non-motor symptoms and QoL and carer depression were consistently identified as predictors for at least one psychosocial outcome. Demographics and disease factors were consistently found not to be predictors. Carer involvement and protective factors (e.g. social support, personality) demonstrated promising findings but studies were too few or factors measured inconsistently. CONCLUSION Confident conclusions could not be drawn regarding the most important predictors that should be targeted in psychosocial interventions due to methodological weaknesses and lack of theoretical testing across the current literature. Future research should build upon psychological theory to gain a better understanding of the mechanisms that explain how carers adapt to caregiving.
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Affiliation(s)
- Kate Greenwell
- Northumbria Healthcare NHS Foundation Trust, Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, UK.
| | - William K Gray
- Northumbria Healthcare NHS Foundation Trust, Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, UK
| | - Anna van Wersch
- School of Social Sciences and Law, Teesside University, Middlesbrough, UK
| | - Paul van Schaik
- School of Social Sciences and Law, Teesside University, Middlesbrough, UK
| | - Richard Walker
- Northumbria Healthcare NHS Foundation Trust, Department of Medicine, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear, UK; Institute of Health and Society, Newcastle University, Newcastle-upon-Tyne, UK
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Savini S, Buck HG, Dickson VV, Simeone S, Pucciarelli G, Fida R, Matarese M, Alvaro R, Vellone E. Quality of life in stroke survivor-caregiver dyads: a new conceptual framework and longitudinal study protocol. J Adv Nurs 2014; 71:676-87. [PMID: 25186274 DOI: 10.1111/jan.12524] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2014] [Indexed: 11/30/2022]
Abstract
AIM To describe a new conceptual framework and the research protocol of a study designed to examine the quality of life in stroke survivor-caregiver dyads. BACKGROUND Stroke has a significant impact on the patient-caregiver dyad. Few studies have been guided by a specific conceptual framework which considers the interactions among pre-existing situations prior to stroke, the new situation caused by the stroke and the moderating effects of environmental and caregiver-related variables. DESIGN Longitudinal study. METHODS A sample of stroke survivor-caregiver dyads will be enrolled at patient discharge from rehabilitation hospitals and will be surveyed every 3 months for 1-year. Hypotheses generated from the conceptual framework will test predictors, mediators and moderators of stroke survivor and caregiver quality of life from the pre-existing situation prior to the stroke, the new situation mediation poststroke and situation moderators. The study is supported by a grant from the Centre of Excellence for Nursing Scholarship, Rome, December 2013. DISCUSSION This study seeks to identify variables in the pre-existing situation prior to the stroke (e.g. living condition), the new situation mediation poststroke (e.g. type of stroke and caregiver burden) as well as situation moderators (e.g. social support) that influence stroke survivor-caregiver dyad's quality of life across the stroke trajectory. Also, the study will inform clinical practice and research by identifying variables that are potentially modifiable and therefore amenable to intervention. The proposed framework will also be helpful for future research focused on stroke survivor-caregiver dyads.
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Lum HD, Lo D, Hooker S, Bekelman DB. Caregiving in heart failure: relationship quality is associated with caregiver benefit finding and caregiver burden. Heart Lung 2014; 43:306-10. [PMID: 24992881 DOI: 10.1016/j.hrtlng.2014.05.002] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Revised: 05/01/2014] [Accepted: 05/02/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether relationship quality is associated with caregiver benefit or burden and how depression influences these associations. BACKGROUND Caregivers influence outcomes of patients with heart failure (HF). Relationship quality, caregiver benefit and burden are key factors in the caregiving experience. METHODS Nineteen caregivers of HF outpatients completed measures of relationship quality, caregiver benefit, burden and depression. Associations were assessed using Pearson's correlations. RESULTS Relationship quality was positively associated with caregiver benefit (r = 0.45, P = 0.05) and negatively associated with burden (r = -0.80, P < 0.0001) and depression (r = -0.77, P = 0.0001). Relationship quality and burden remained associated after controlling for depression. CONCLUSIONS In this exploratory study, relationship quality was positively associated with caregiver benefit and negatively associated with burden. Future studies are needed to further understand these key caregiving factors, which may lead to opportunities to help caregivers see benefits and reduce burden.
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Affiliation(s)
- Hillary D Lum
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA; VA Eastern Colorado Health Care System, Denver, CO, USA.
| | - Daphne Lo
- Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Stephanie Hooker
- Department of Psychology, University of Colorado Denver, Denver, CO, USA
| | - David B Bekelman
- Division of General Internal Medicine, University of Colorado School of Medicine and College of Nursing, Anschutz Medical Campus, Aurora, CO, USA; Colorado Cardiovascular Outcomes Research (CCOR), Denver, CO, USA
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Does spouse participation influence quality of life reporting in patients with Parkinson’s disease? Qual Life Res 2014; 24:245-9. [DOI: 10.1007/s11136-014-0744-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2014] [Indexed: 10/25/2022]
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Tickle-Degnen L, Saint-Hilaire M, Thomas CA, Habermann B, Martinez LSS, Terrin N, Noubary F, Naumova EN. Emergence and evolution of social self-management of Parkinson's disease: study protocol for a 3-year prospective cohort study. BMC Neurol 2014; 14:95. [PMID: 24885181 PMCID: PMC4016672 DOI: 10.1186/1471-2377-14-95] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 04/23/2014] [Indexed: 11/16/2022] Open
Abstract
Background Parkinson’s disease affects facial, vocal and trunk muscles. As symptoms progress, facial expression becomes masked, limiting the person’s ability to communicate emotions and intentions to others. As people with the disease live and reside in their homes longer, the burden of caregiving is unmitigated by social and emotional rewards provided by an expressive individual. Little is known about how adults living with Parkinson’s disease manage their social lives and how an inability to be emotionally expressive can affect social connections and health. Because social networks have been shown to be crucial to the overall well-being of people living with chronic diseases, research is needed on how expressive capacity affects life trajectories and health. Methods/Design The overall objective is to understand the emergence and evolution of the trajectories of the self-management of the social lives of people living with Parkinson’s disease. The central hypothesis is that expressive capacity predicts systematic change in the pattern of social self-management and quality of life outcomes. The specific aims of this 3-year longitudinal study of 120 people with the disease and a maximum of 120 care partners are: 1) characterize social self-management trajectories over a 3-year period; 2) estimate the degree to which expressive nonverbal capacity predicts the trajectory; and 3) determine the moderating effect of gender on the association between expressive capacity and change in social self-management. Each participant will be assessed 14 times to detect rapid and non-linear changes in social participation and management of social activities; social network; and social comfort, general health and well-being. Discussion This project will provide evidence to guide the development of interventions for supporting social integration of those living with Parkinson’s disease, thus leading to improved overall health. It focuses on the novel construct of social self-management and known factors—expressive capacity and gender—that contribute to stigmatization. The repeated measures design detects triggers of rapid changes in social and health outcomes.
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Affiliation(s)
- Linda Tickle-Degnen
- Department of Occupational Therapy, School of Arts & Sciences, Tufts University, Medford, MA, USA.
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Lawn S, McMahon J. The importance of relationship in understanding the experiences of spouse mental health carers. QUALITATIVE HEALTH RESEARCH 2014; 24:254-266. [PMID: 24482422 DOI: 10.1177/1049732313520078] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The burden of caring for family members with mental illness has been researched extensively; however, knowledge of spouse carers' experiences is limited. In this article, we explore this from a carers' perspective, with 28 spouse carers, using qualitative open-ended semistructured interviews and a grounded theory approach informed by the social interactionism tradition to collect and analyze the data. We present six interrelated themes around the central theme of this being "a real and genuine relationship." The findings indicate that caring for a spouse with severe mental illness is a unique role compared with other caring roles. First and foremost, spouse carers strive for the relationship with their partner and accommodate mental illness into their lives to protect the relationship. Because of this, they often lead surreal lives marked by significant emotional pressure and isolation. This has implications for how mental health service providers work with and support spouse carers.
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Affiliation(s)
- Sharon Lawn
- 1Flinders University, Adelaide, South Australia, Australia
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Godwin KM, Ostwald SK, Cron SG, Wasserman J. Long-term health-related quality of life of stroke survivors and their spousal caregivers. J Neurosci Nurs 2013; 45:147-54. [PMID: 23558977 PMCID: PMC3646534 DOI: 10.1097/jnn.0b013e31828a410b] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Because treatment for stroke has improved, individuals are living longer with the effects of a stroke. The resulting long-term impairment can affect both stroke survivors' and their caregivers' health-related quality of life (HRQOL). Few studies have examined the HRQOL of stroke survivors and their caregivers greater than 2 years poststroke. The stroke survivors and their spousal caregivers (n = 30 dyads) who had previously completed a 12-month study after discharge from inpatient rehabilitation were assessed at 3-5 years poststroke. The HRQOL and related outcomes were measured for stroke survivors and caregivers. Data from baseline to 12 months were used in conjunction with data from this study. Linear mixed models were used to analyze the change in repeated measures over time. Multiple linear regression was used to analyze the relationship of generic HRQOL to related psychosocial outcomes. The stroke survivors were an average of 4.68 years poststroke. The mean age for stroke survivors and caregivers was 70.8 and 64.9 years, respectively. Most stroke survivors were men (80%) and non-Hispanic White (70%). Among stroke survivors, depression decreased from baseline to 12 months (p = .04) but increased from 12 months to the end of follow-up (p = .003). The caregivers' depression decreased from baseline to all time points (p = .015). Stroke-specific HRQOL showed statistically significant (p < .03) decreases between 12 months and end of follow-up. Increased number of illnesses and older age were associated with caregivers' lower physical HRQOL score (p = .004). Higher depression was associated with lower mental HRQOL score for both caregivers and stroke survivors (p = .003 and p = .011, respectively). Both stroke survivors and caregivers continue to experience negative stroke-related health outcomes for many years after the initial stroke; some of these outcomes even worsen over time. These findings illustrate the need for ongoing psychological and medical evaluation for both long-term stroke survivors and caregivers. Development and testing of targeted behavioral interventions are also warranted.
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Affiliation(s)
- Kyler M Godwin
- Baylor College of Medicine, Houston VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Godwin KM, Swank PR, Vaeth P, Ostwald SK. The longitudinal and dyadic effects of mutuality on perceived stress for stroke survivors and their spousal caregivers. Aging Ment Health 2013; 17:423-31. [PMID: 23323629 PMCID: PMC3646563 DOI: 10.1080/13607863.2012.756457] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE Functional impairment resulting from a stroke frequently requires the care of a family caregiver, often the spouse. This change in the relationship can be stressful for the couple. Thus, this study examined the longitudinal, dyadic relationship between caregivers' and stroke survivors' mutuality and caregivers' and stroke survivors' perceived stress. METHOD This secondary data analysis of 159 stroke survivors and their spousal caregivers utilized a cross-lagged, mixed models analysis with the actor-partner interdependence model to examine the dyadic relationship between mutuality and perceived stress over the first year post-discharge from inpatient rehabilitation. RESULTS Caregivers' mutuality showed an actor effect (β = -3.82, p < 0.0001) but not a partner effect. Thus, caregivers' mutuality influenced one's own perceived stress but not the stroke survivors' perceived stress. Stroke survivors' perceived stress showed a partner effect and affected caregivers' perceived stress (β = 0.13, p = 0.047). Caregivers' perceived stress did not show a partner effect and did not significantly affect stroke survivors' perceived stress. CONCLUSION These findings highlight the interpersonal nature of stress in the context of caregiving for a spouse. Caregivers are especially influenced by perceived stress in the spousal relationship. Couples should be encouraged to focus on positive aspects of the caregiving relationship to mitigate stress.
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Affiliation(s)
- Kyler M. Godwin
- Baylor College of Medicine, Department of Family and Community Health
| | - Paul R. Swank
- The University of Texas Health Science Center at Houston, Medical School
| | - Patrice Vaeth
- The University of Texas Health Science Center at Houston, School of Public Health, Dallas Regional Campus
| | - Sharon K. Ostwald
- The University of Texas Health Science Center at Houston, School of Nursing, Center on Aging
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Park EO, Schumacher KL. The state of the science of family caregiver-care receiver mutuality: a systematic review. Nurs Inq 2013; 21:140-52. [PMID: 23617406 DOI: 10.1111/nin.12032] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2013] [Indexed: 10/26/2022]
Abstract
This review critically examines the current state of the science on the concept of family caregiver-care receiver mutuality, summarizes accomplishments and gaps and identifies directions for future theory development and research. Mutuality between family caregivers and care receivers is of increasing interest to researchers. However, no analysis of the current state of the science of this important concept has been published. Our literature search revealed 34 research articles that met inclusion criteria. The studies were assessed in terms of conceptualization of mutuality, instrument development, populations studied, research designs and methods and findings. Significant scientific progress during the past 30 years includes the development of clear definitions and new instruments, expansion of research beyond the clinical populations in which mutuality was first studied, the use of a variety of research designs, and increasingly sophisticated methods of data analysis. Growing evidence suggests that mutuality is associated with caregiver emotional health outcomes and may decrease over time in the context of chronic illness. Directions for future research include development of new theoretical frameworks grounded in relational theory, development of theory on the dynamics of mutuality over time, exploration of mutuality in diverse cultures and populations, and intervention studies aimed at enhancing mutuality.
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Affiliation(s)
- Esther O Park
- Nursing Department, New Jersey City University, Jersey City, NJ, USA
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Tanji H, Koyama S, Wada M, Kawanami T, Kurita K, Tamiya G, Saito N, Suzuki K, Kato T, Anderson KE, Gruber-Baldini AL, Fishman PS, Reich SG, Weiner WJ, Shulman LM. Comparison of caregiver strain in Parkinson's disease between Yamagata, Japan, and Maryland, The United States. Parkinsonism Relat Disord 2013; 19:628-33. [PMID: 23514630 DOI: 10.1016/j.parkreldis.2013.02.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2012] [Revised: 01/10/2013] [Accepted: 02/23/2013] [Indexed: 11/27/2022]
Abstract
BACKGROUND Japan and the United States (US) have different cultures of caregiving including differences in family structure and social programs that may influence caregiver strain. Differences in caregiver strain between regions in Japan and in the US have not been investigated in patient-spouse dyads in PD. OBJECTIVES To compare caregiver strain in spouses of PD patients between Yamagata, Japan and Maryland, US. Correlations between caregiver strain and patient/spousal variables are also examined. METHODS In Yamagata and Maryland, spouses of patients with PD completed questionnaires assessing caregiver strain. Patients and spouses completed scales assessing mental health, and medical co-morbidity. PD severity and disability were assessed with the Unified Parkinson's Disease Rating Scale and the Schwab and England Activities of Daily Living Scale. Results in the two regions were compared with Chi-square and Student's t-tests. Relationships between caregiver strain and patient/spousal variables were analyzed with univariate correlations and multivariate regression. RESULTS 178 Spouse-patient pairs were assessed. The level of caregiver strain in PD did not differ between Yamagata, Japan and Maryland, US despite differences in demographics and social support programs in the two regions. Yamagata spouses reported physical, time and financial constraints, while Maryland spouses reported more emotional distress. In both regions, spousal depression was a significant contributor to caregiver strain. CONCLUSION Different approaches to reduce caregiver strain will likely be necessary in Yamagata and Maryland since the contributing factors to caregiver strain are influenced by differences in culture and social supports in each country.
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Affiliation(s)
- Haruko Tanji
- Department of Neurology, Hematology, Metabolism, Endocrinology and Diabetology, Yamagata University School of Medicine, 2-2-2 Iida-Nishi, Yamagata, Japan.
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Martinez-Martin P, Rodriguez-Blazquez C, Forjaz MJ. Quality of life and burden in caregivers for patients with Parkinson's disease: concepts, assessment and related factors. Expert Rev Pharmacoecon Outcomes Res 2012; 12:221-30. [PMID: 22458623 DOI: 10.1586/erp.11.106] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Caregivers of Parkinson's disease patients face responsibilities stemming from providing assistance to a person, usually a family member, who suffers a progressively disabling disease characterized by both motor and nonmotor symptoms. These circumstances impact on the physical, emotional and psychosocial aspects of the caregivers' lives and, therefore, on their quality of life (QoL). Studies have identified factors related to caregivers' global QoL and health-related QoL, causing caregivers distress and affecting their QoL. These factors are related to patients' and caregivers' characteristics and may be classified as sociodemographic, psychological and disease related. Caregiver's burden refers to the multiplicity of difficulties ensuing as a consequence of caring, including, for example, health problems, modification of habits, economic loss and QoL deterioration. Therefore, burden-related factors are also briefly reviewed. The implementation of effective interventions to preserve the caregiver's wellbeing and allow the patients to remain at home and be properly assisted is a pragmatic consequence of this knowledge.
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Affiliation(s)
- Pablo Martinez-Martin
- Alzheimer Disease Research Unit, CIEN Foundation-Reina Sofia Foundation, Carlos III Institute of Health, Alzheimer Center Reina Sofia Foundation, Cl. Valderrebollo, 5, 28031 Madrid, Spain.
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Kelly DH, McGinley JL, Huxham FE, Menz HB, Watts JJ, Iansek R, Murphy AT, Danoudis M, Adair B, Morris ME. Health-related quality of life and strain in caregivers of Australians with Parkinson's disease: an observational study. BMC Neurol 2012; 12:57. [PMID: 22804846 PMCID: PMC3434109 DOI: 10.1186/1471-2377-12-57] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2011] [Accepted: 06/19/2012] [Indexed: 11/15/2022] Open
Abstract
Background The relationship between health-related quality of life (HRQoL) in people with Parkinson’s disease and their caregivers is little understood and any effects on caregiver strain remain unclear. This paper examines these relationships in an Australian sample. Methods Using the generic EuroQol (EQ-5D) and disease-specific Parkinson’s Disease Questionnaire-39 Item (PDQ-39), HRQoL was evaluated in a sample of 97 people with PD and their caregivers. Caregiver strain was assessed using the Modified Caregiver Strain Index. Associations were evaluated between: (i) caregiver and care-recipient HRQoL; (ii) caregiver HRQoL and caregiver strain, and; (iii) between caregiver strain and care-recipient HRQoL. Results No statistically significant relationships were found between caregiver and care-recipient HRQoL, or between caregiver HRQoL and caregiver strain. Although this Australian sample of caregivers experienced relatively good HRQoL and moderately low strain, a significant correlation was found between HRQoL of people with PD and caregiver strain (rho 0.43, p < .001). Conclusion Poor HRQoL in people with PD is associated with higher strain in caregivers. Therapy interventions may target problems reported as most troublesome by people with PD, with potential to reduce strain on the caregiver.
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Affiliation(s)
- David H Kelly
- Physiotherapy, Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC, Australia 3010
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Hsiao CY, Hsieh MH, Tseng CJ, Chien SH, Chang CC. Quality of life of individuals with schizophrenia living in the community: relationship to socio-demographic, clinical and psychosocial characteristics. J Clin Nurs 2012; 21:2367-76. [DOI: 10.1111/j.1365-2702.2012.04067.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Haahr A, Kirkevold M, Hall EO, Østergaard K. ‘Being in it together’: living with a partner receiving deep brain stimulation for advanced Parkinson’s disease - a hermeneutic phenomenological study. J Adv Nurs 2012; 69:338-47. [DOI: 10.1111/j.1365-2648.2012.06012.x] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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