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Duodu PA, Okyere J, Simkhada B, Akrong R, Barker C, Gillibrand W, Simkhada P. Exploration of family caregivers' experiences on coping in dementia care in Ghana: a phenomenological study. BMC Psychol 2024; 12:361. [PMID: 38902797 PMCID: PMC11191216 DOI: 10.1186/s40359-024-01862-y] [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: 11/21/2023] [Accepted: 06/18/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Dementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers' experiences on coping in dementia care in Ghana. METHODS Adopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun's framework analysis. RESULTS Six themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving. CONCLUSION We conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer's Ghana must raise awareness about the dangers of caregivers' violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.
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Grants
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Bibha Simkhada
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Ransford Akrong
- Educational Assessment and Research Center, Osu, Accra, Ghana
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Caroline Barker
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Warren Gillibrand
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Padam Simkhada
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
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Matus A, Quinn R, Stawnychy MA, Thomas G, Goba M, Garo J, Gordon D, Riegel B. Social Determinants of Health are Associated with Coping of Informal Caregivers of Adults with Heart Failure. Clin Nurs Res 2024; 33:334-343. [PMID: 38288601 PMCID: PMC11188556 DOI: 10.1177/10547738231223790] [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] [Indexed: 06/20/2024]
Abstract
We explored the influence of social determinants of health (SDH) risk on stress and coping style in heart failure (HF) caregivers. In this cross-sectional study, data from 250 caregivers were analyzed. Multivariable linear regression analyses were performed to determine the extent to which SDH risk (measured using a modified PRAPARE tool (National Association of Community Health Centers), range 0-22) predicted stress (Perceived Stress Scale, 0-56) and coping style (active (0-45), avoidance (0-30), and minimization (0-30)) while accounting for caregiver burden (HF Caregiver Questionnaire (HF-CQ) 0-100). Multivariable regression analysis with backwards elimination variable selection approach was used to identify which SDH risk factors best predicted coping styles. SDH risk was significantly associated with avoidance and minimization coping styles. Each unit increase in SDH risk was associated with an increase of 0.6 ± 0.2 units (p = .0008) in avoidance and 0.7 ± 0.2 units (p < .0001) in minimization coping style. Race and "supporting others" significantly predicted avoidance coping style; scores were 3.3 ± 0.8 units greater for caregivers who were not White (p < .0001) and 1.4 ± 0.5 units greater (p < .01) for each additional person whom they supported. Race significantly predicted minimization coping style; scores were 4.4 ± 0.7 units greater for caregivers who were not White (p < .0001). Caregivers with higher SDH risk may avoid and minimize to cope with caregiving challenges.
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Affiliation(s)
- Austin Matus
- Institute for Diabetes, Obesity and Metabolism, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Ryan Quinn
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | | | - Gladys Thomas
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Miatta Goba
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Jenna Garo
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Deborah Gordon
- Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
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Bechthold AC, McIlvennan CK, Matlock DD, Ejem DB, Wells RD, LeJeune J, Bakitas MA, Odom JN. "When I do have some time, rather than spend it polishing silver, I want to spend it with my grandkids": a qualitative exploration of patient values following left ventricular assist device implantation. BMC Palliat Care 2024; 23:128. [PMID: 38778297 PMCID: PMC11110360 DOI: 10.1186/s12904-024-01454-y] [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: 02/13/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Values are broadly understood to have implications for how individuals make decisions and cope with serious illness stressors, yet it remains uncertain how patients and their family and friend caregivers discuss, reflect upon, and act on their values in the post-left ventricular assist device (LVAD) implantation context. This study aimed to explore the values elicitation experiences of patients with an LVAD in the post-implantation period. METHODS Qualitative descriptive study of LVAD recipients. Socio-demographics and patient resource use were analyzed using descriptive statistics and semi-structured interview data using thematic analysis. Adult (> 18 years) patients with an LVAD receiving care at an outpatient clinic in the Southeastern United States. RESULTS Interviewed patients (n = 27) were 30-76 years, 59% male, 67% non-Hispanic Black, 70% married/living with a partner, and 70% urban-dwelling. Three broad themes of patient values elicitation experiences emerged: 1) LVAD implantation prompts deep reflection about life and what is important, 2) patient values are communicated in various circumstances to convey personal goals and priorities to caregivers and clinicians, and 3) patients leverage their values for strength and guidance in navigating life post-LVAD implantation. LVAD implantation was an impactful experience often leading to reevaluation of patients' values; these values became instrumental to making health decisions and coping with stressors during the post-LVAD implantation period. Patient values arose within broad, informal exchanges and focused, decision-making conversations with their caregiver and the healthcare team. CONCLUSIONS Clinicians should consider assessing the values of patients post-implantation to facilitate shared understanding of their goals/priorities and identify potential changes in their coping.
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Affiliation(s)
- Avery C Bechthold
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South NB 350, Birmingham, AL, 35294, USA.
| | - Colleen K McIlvennan
- Division of Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Daniel D Matlock
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Deborah B Ejem
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South NB 350, Birmingham, AL, 35294, USA
| | - Rachel D Wells
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South NB 350, Birmingham, AL, 35294, USA
| | - Jesse LeJeune
- Cardiology Clinic, UAB Hospital, Birmingham, AL, USA
| | - Marie A Bakitas
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South NB 350, Birmingham, AL, 35294, USA
| | - J Nicholas Odom
- School of Nursing, University of Alabama at Birmingham, 1720 2nd Avenue South NB 350, Birmingham, AL, 35294, USA
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Zhao C, Lu X, Li Y, Li J, Gao Y. Predictors of quality of life in primary caregivers of patients with heart failure: A model of health literacy and caregiving burden. Heart Lung 2024; 65:78-83. [PMID: 38442526 DOI: 10.1016/j.hrtlng.2024.02.006] [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] [Received: 10/31/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Heart Failure (HF) is a chronic disease that impairs patients' ability to care for themselves. The accumulation of caregiving activities by caregivers to patients creates stress. OBJECTIVES This study intends to investigate the mediating role of caregiving burden in the relationship between health literacy and quality of life of caregivers. METHODS This study is a cross-sectional research conducted through a questionnaire survey. A convenience sampling method was employed to select 410 primary caregivers for the study. RESULTS The overall mean score for quality of life for caregivers of patients with HF was (49.30±9.64). The results showed that the caregiving burden mediated the relationship between health literacy and quality of life, with the mediating effect accounting for 39.04 % (P < 0.05) of the total effect. CONCLUSION Caregiving burden is a mediating variable in the relationship between health literacy and quality of life. Therefore, we offer some recommendations for healthcare professionals: ①We suggest that healthcare professionals provide relevant education and training to caregivers, as this can enhance their knowledge and skills in effectively managing the health condition of patients;②Healthcare professionals can also proactively assess the caregiver's burden level and design personalized support plans based on the assessment results.
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Affiliation(s)
- Chunli Zhao
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Xiuying Lu
- University of Electronic Science and Technology, Chengdu, Sichuan Province 610042, China.
| | - Yunying Li
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Juan Li
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Yuling Gao
- The First People's Central Hospital, Guang yuan, Sichuan Province, China
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Buck HG, Howland C, Stawnychy MA, Aldossary H, Cortés YI, DeBerg J, Durante A, Graven LJ, Irani E, Jaboob S, Massouh A, Oberfrank NDCF, Saylor MA, Wion RK, Bidwell JT. Caregivers' Contributions to Heart Failure Self-care: An Updated Systematic Review. J Cardiovasc Nurs 2024:00005082-990000000-00168. [PMID: 38306302 DOI: 10.1097/jcn.0000000000001060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
BACKGROUND A previous systematic review reporting the contributions of informal, unpaid caregivers to patient heart failure (HF) self-care requires updating to better inform research, practice, and policy. OBJECTIVE The aim of this study was to provide an updated review answering the questions: (1) What specific activities do informal caregivers of adults with HF take part in related to HF self-care? (2) Have the activities that informal caregivers of adults with HF take part in related to HF self-care changed over time? (3) What are the gaps in the science? METHODS This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PubMed, CINAHL, EMBASE, and Cochrane CENTRAL databases were searched. Eligible studies involved an informal, unpaid caregiver of an adult with HF as a study variable or participant. Caregiving activities were benchmarked using the theory of self-care in chronic illness. RESULTS Two thousand one hundred fifty-four research reports were identified, of which 64 met criteria. Caregivers' contributions occurred in self-care maintenance (91%), monitoring (54%), and management (46%). Activities performed directly on or to the patient were reported more frequently than activities performed for the patient. Change over time involved the 3 domains differentially. Gaps include ambiguous self-care activity descriptions, inadequate caregiving time quantification, and underrepresented self-care monitoring, supportive, and communication activities. CONCLUSIONS Newly identified caregiver-reported activities support updating the theory of self-care in chronic illness to include activities currently considered ancillary to HF self-care. Identified gaps highlight the need to define specific caregiving activities, determine task difficulty and burden, and identify caregiver self-care strategy and education needs. Exposing the hidden work of caregiving is essential to inform policy and practice.
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Durante A, Younas A, Cuoco A, Boyne J, Rice BM, Juarez-Vela R, Zeffiro V, Vellone E. Burden among informal caregivers of individuals with heart failure: A mixed methods study. PLoS One 2023; 18:e0292948. [PMID: 37976279 PMCID: PMC10656022 DOI: 10.1371/journal.pone.0292948] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/02/2023] [Indexed: 11/19/2023] Open
Abstract
AIMS To develop a comprehensive understanding of caregiver burden and its predictors from a dyadic perspective. METHOD A convergent mixed methods design was used. This study was conducted in three European countries, Italy, Spain, and the Netherlands. A sample of 229 HF patients and caregivers was enrolled between February 2017 and December 2018 from the internal medicine ward, outpatient clinic, and private cardiologist medical office. In total, 184 dyads completed validated scales to measure burden, and 50 caregivers participated in semi-structured interviews to better understand the caregiver experience. The Care Dependency Scale, Montreal Cognitive Assessment, and SF-8 Health Survey were used for data collection. Multiple regression analysis was conducted to identify the predictors and qualitative content analysis was performed on qualitative data. The results were merged using joint displays. RESULTS Caregiver burden was predicted by the patient's worse cognitive impairment, lower physical quality of life, and a higher care dependency perceived by the caregivers. The qualitative and mixed analysis demonstrated that caregiver burden has a physical, emotional, and social nature. CONCLUSIONS Caregiver burden can affect the capability of informal caregivers to support and care for their relatives with heart failure. Developing and evaluating individual and community-based strategies to address caregiver burden and enhance their quality of life are warranted.
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Affiliation(s)
- Angela Durante
- Pre-department Unit of Nursing, GRUPAC, University of La Rioja, Logroño, Spain
- University of Eastern Piedmont, Novara, Italy
| | - Ahtisham Younas
- Faculty of Nursing, Memorial University of Newfoundland, St. John’s, Canada
| | - Angela Cuoco
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Josiane Boyne
- Department of Cardiology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bridgette M. Rice
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Philadelphia, United States of America
| | - Raul Juarez-Vela
- Pre-department Unit of Nursing, GRUPAC, University of La Rioja, Logroño, Spain
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome “Tor Vergata”, Rome, Italy
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Baik D, Reeder B, Coats H, Baker C, Jankowski C. Perceptions and Attitudes toward a Proposed Digital Health Physical Activity Program among Older Family Caregivers of Persons with Heart Failure: A Qualitative Study. Inform Health Soc Care 2023; 48:239-251. [PMID: 37417465 PMCID: PMC10990475 DOI: 10.1080/17538157.2023.2227704] [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] [Indexed: 07/08/2023]
Abstract
Tailored physical activity (PA) programs using digital health technologies in the home can promote family caregivers' (FCGs) physical function and psychological wellbeing. However, there is a gap in research for digital health PA interventions targeting older FCGs of persons with HF (HF-FCGs). The burden of caregiving for persons with HF may displace the FCG's self-care, including PA. Therefore, we examined older HF-FCGs' perceptions and attitudes toward three technology components (video-conferencing, fitness tracker, text messaging) that would be most useful in delivering a digital health PA program. Interviews were conducted with 13 HF-FCGs (≥65 years old) between January and April 2021. Directed content analysis was used and the analysis was guided by the adapted unified theory of acceptance and use of technology (UTAUT) model. In addition to HF-FCGs' perceptions and attitudes toward each technology component in each construct of the adapted UTAUT model (ease of use, usefulness, facilitating conditions), three additional factors were associated with intention to use technology. These were: (1) HF patients' positive experience, (2) digital skills, and (3) quality of internet connectivity. The findings provide digital health requirements for design and modification of a technology-supported PA program that engages older FCGs who care for persons with HF.
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Affiliation(s)
- Dawon Baik
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Blaine Reeder
- Sinclair School of Nursing, MU Institute for Data Science and Informatics, University of Missouri, Columbia, Missouri, USA
| | - Heather Coats
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Christina Baker
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
| | - Catherine Jankowski
- College of Nursing, University of Colorado College of Nursing, Aurora, Colorado, USA
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