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Kayadjanian N, Hsu EA, Wood AM, Carson DS. Caregiver Burden and Its Relationship to Health-Related Quality of Life in Craniopharyngioma Survivors. J Clin Endocrinol Metab 2023; 109:e76-e87. [PMID: 37597173 PMCID: PMC10735386 DOI: 10.1210/clinem/dgad488] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 07/28/2023] [Accepted: 08/17/2023] [Indexed: 08/21/2023]
Abstract
CONTEXT Craniopharyngioma (CP) is a rare brain tumor associated with severe comorbidities that reduce survivor health-related quality of life (HRQOL). However, CP impact on caregivers is unknown. OBJECTIVE To measure caregiver burden and examine its relationship to survivor HRQOL and other determinants in CP. METHODS Eighty-two participants who self-identified as caregivers of CP survivors responded to an online survey including caregiver-reported Pediatric Quality of Life Inventory (PedsQL), and the Zarit Burden Interview (ZBI). RESULTS Caregivers reported an average of 13 out of 29 health conditions in survivors following tumor treatment, including excess weight, hypopituitarism, fatigue, mood, cognition, social issues, temperature dysregulation, visual impairment, and sleep problems. Strikingly, 70% of survivors who experienced obesity also experienced hyperphagia. ZBI scores were moderate with a median of 37. PedsQL total scores were poor with a median of 46.2. ZBI scores were independent of caregiver level of education and care duration. Both scores were independent of income, survivor age, gender, age at diagnosis, or tumor recurrence. In contrast, both scores depended on the number (P < .001) and the type of survivor health problems, with significantly worse scores for caregivers or survivors with symptoms of hypothalamic dysfunction (P < .001) including hyperphagia but not obesity. PedsQL total scores significantly predicted ZBI scores (P < .001). CONCLUSION Survivor poly-symptomatology predicted and incurred significant caregiver burden. Our study separated hyperphagia and obesity and identified hyperphagia and other hypothalamic dysfunction symptoms as understudied issues. Altogether, these findings draw particular attention to the unmet needs of CP survivors and their caregivers.
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Affiliation(s)
| | - Eugenie A Hsu
- Raymond A. Wood Foundation, Ocean City, MD 21842, USA
| | - Amy M Wood
- Raymond A. Wood Foundation, Ocean City, MD 21842, USA
| | - Dean S Carson
- Raymond A. Wood Foundation, Ocean City, MD 21842, USA
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2
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Chien SC, Chang YH, Yen CM, Onthoni DD, Wu IC, Hsu CC, Chiou HY, Chung RH. Exploring concepts and trends in informal caregiver burden: systematic review using citation network and content analysis. Aging Clin Exp Res 2023; 35:2873-2885. [PMID: 37907665 DOI: 10.1007/s40520-023-02582-w] [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: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. OBJECTIVE This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. METHODS We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. RESULTS Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). CONCLUSION For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients.
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Affiliation(s)
- Shuo-Chen Chien
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Yu-Hung Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chia-Ming Yen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Djeane Debora Onthoni
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ren-Hua Chung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan.
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Özönder Ünal I, Ordu C. Decoding Caregiver Burden in Cancer: Role of Emotional Health, Rumination, and Coping Mechanisms. Healthcare (Basel) 2023; 11:2700. [PMID: 37830736 PMCID: PMC10573024 DOI: 10.3390/healthcare11192700] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 10/02/2023] [Accepted: 10/06/2023] [Indexed: 10/14/2023] Open
Abstract
This study aimed to elucidate the role of psychological factors in caregiver burden among caregivers of stage 4 cancer patients. Data were collected from 328 caregivers of cancer patients, employing the Zarit Care Burden Scale, Depression-Anxiety-Stress Scale (DASS-42), Dysfunctional Attitudes Scale (DAS-A), Ruminative Thought Style Questionnaire (RTSQ), and Coping Orientation to Problems Experienced Inventory (Brief COPE). Males, spouses, and caregivers of patients with a PEG or tracheostomy, or those diagnosed with pancreatic biliary cancer were found to have a significantly higher risk of caregiver burden. Age, sex, caregiver-patient relationship, caregiving duration, patient's catheter status, cancer types, depression and stress severity, rumination, dysfunctional attitudes, and dysfunctional coping strategies explained 69.7% of the variance in Zarit Care Burden Scale scores (F(14,313) = 51.457, p < 0.001), illustrating their significant predictive relationship with caregiver burden. Moderation analysis revealed significant interactions of emotional coping with depression (b = -0.0524, p = 0.0076) and dysfunctional coping with stress on caregiver burden (b = 0.014, p = 0.006). Furthermore, rumination mediated the relationships between caregiver burden, stress, and depression (p < 0.01). Overall, the results highlight the intricate relationships among caregiver burden, mental health, and coping strategies, suggesting tailored interventions to support caregiver health and quality of care.
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Affiliation(s)
- Ipek Özönder Ünal
- Department of Psychiatry, Tuzla State Hospital, Içmeler Mahallesi, Piri Reis Caddesi, No: 74 Tuzla, Istanbul 34947, Turkey
| | - Cetin Ordu
- Division of Medical Oncology, Department of Internal Medicine, Gayrettepe Florence Nightingale Hospital, Cemil Aslan Güder Sk. No: 8, Beşiktaş, Istanbul 34349, Turkey;
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Demirbas M, Hahn-Pedersen JH, Jørgensen HL. Comparison Between Burden of Care Partners of Individuals with Alzheimer's Disease Versus Individuals with Other Chronic Diseases. Neurol Ther 2023; 12:1051-1068. [PMID: 37222859 PMCID: PMC10310688 DOI: 10.1007/s40120-023-00493-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 05/05/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Caregiving in Alzheimer's disease (AD) is often provided by informal care partners, who spend more hours per week on average than care partners of individuals with conditions other than AD. However, the burden of care in partners of individuals with AD has not been systematically compared to that of other chronic diseases. OBJECTIVE The current study therefore aims to compare the care partner burden of AD to that of other chronic diseases through a systematic literature review. METHODS Data was collected from journal articles published in the last 10 years, using two unique search strings in PubMed and analysed using pre-defined patient-reported outcome measures (PROMs) including the EQ-5D-5L, GAD-7, GHQ-12, PHQ-9, WPAI and the ZBI. The data was grouped according to the included PROMs and the diseases studied. The number of participants in the studies reporting burden of caregiving in AD was adjusted to reflect the number of participants in studies reporting care partner burden in other chronic diseases. RESULTS All results in this study are reported as a mean value and standard deviation (SD). The ZBI measurement was the most frequently used PROM to collect care partner burden (15 studies) and showed a moderate burden (mean 36.80, SD 18.35) on care partners of individuals with AD, higher than most of the other included diseases except for those characterized by psychiatric symptoms (mean scores 55.92 and 59.11). Other PROMs such as PHQ-9 (six studies) and GHQ-12 (four studies) showed a greater burden on care partners of individuals with other chronic diseases such as heart failure, haematopoietic cell transplantations, cancer and depression compared to AD. Likewise, GAD-7 and EQ-5D-5L measurements showed a lesser burden on care partners of individuals with AD compared to care partners of individuals with anxiety, cancer, asthma and chronic obstructive pulmonary disease. The current study suggests that care partners of individuals with AD experience a moderate burden, but with some variations depending on the PROMs used. CONCLUSION The results of this study were mixed with some PROMs indicating a greater burden for care partners of individuals with AD versus other chronic diseases, and other PROMs showing a greater burden for care partners of individuals with other chronic diseases. Psychiatric disorders imposed a greater burden on care partners compared to AD, while somatic diseases in the musculoskeletal system resulted in a significantly smaller burden on care partners compared to AD.
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Affiliation(s)
- Murat Demirbas
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | | | - Henrik L Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Witten JA, Coetzer R, Rowlands L, Turnbull OH. "Talk and Chalk": An emotion regulation intervention for anger after acquired brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-16. [PMID: 37339498 DOI: 10.1080/23279095.2023.2224481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Uncontrollable anger is a debilitating consequence of acquired brain injury (ABI). This proof-of-concept study investigated the preliminary efficacy of an emotion regulation intervention for managing post-ABI anger. A secondary objective was to determine which participant characteristics were related to intervention gains. With a pre-post intervention design and three-month follow-up, there were five individually administered meetings on Zoom, over a four-month period. 24 adults who had sustained an ABI were enrolled. Participants were mostly males, from 24 to 85 years old. A series of one-way repeated-measures ANOVAs were conducted to determine the intervention's efficacy, and Spearman's rho bivariate correlations for the association between participant characteristics and intervention gains. Significant differences were observed in external anger from baseline to post-treatment; there were no further changes from post-treatment to follow-up. Of the participant characteristics, only readiness to change and anxiety were correlated. The proposed intervention presents a brief, feasible, and preliminary efficacious alternative for regulating post-ABI anger. Intervention gains are associated with readiness to change and anxiety, which has important implications for clinical delivery.
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Affiliation(s)
| | - Rudi Coetzer
- Department of Psychology, Bangor University, Bangor, United Kingdom
- The Disabilities Trust, Wakefield, United Kingdom
- Faculty of Medical, Life and Health Science, Swansea University, Swansea, United Kingdom
| | - Leanne Rowlands
- School of Psychology, Arden University, Coventry, United Kingdom
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Moore A, Bennett B, Taylor-Stokes G, Daumont MJ. Caregivers of patients with malignant pleural mesothelioma: who provides care, what care do they provide and what burden do they experience? Qual Life Res 2023:10.1007/s11136-023-03410-4. [PMID: 37097405 PMCID: PMC10393857 DOI: 10.1007/s11136-023-03410-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/21/2023] [Indexed: 04/26/2023]
Abstract
PURPOSE There are limited data on the impact of caregiving for patients with malignant pleural mesothelioma (MPM) on the caregiver. We aimed to identify the demographic characteristics of these caregivers, the caregiving activities they perform and how caregiving burden impacts their work productivity and overall activity. METHODS This cross-sectional study collected data from caregivers of patients with MPM across France, Italy, Spain and the United Kingdom January-June 2019. Caregiver demographics, daily caregiving tasks and the impact of caregiving on physical health was collected via questionnaire. The Zarit Burden Interview (ZBI) was used to assess caregiver burden and the Work Productivity and Activity Impairment questionnaire (WPAI) assessed impairment at work and during daily activities. Analyses were descriptive. RESULTS Overall, 291 caregivers provided data. Caregivers were mostly female (83%), living with the patient (82%) and their partner/spouse (71%). Caregivers provided over five hours of daily emotional/physical support to patients. ZBI scores indicated 74% of caregivers were at risk of developing depression. Employed caregivers had missed 12% of work in the past seven days, with considerable presenteeism (25%) and overall work impairment (33%) observed. Overall, the mean activity impairment was 40%. CONCLUSION Caregivers provide essential care for those with MPM. We show caregiving for patients with MPM involves a range of burdensome tasks that impact caregivers' emotional health and work reflected in ZBI and WPAI scores. Innovations in the management of MPM must account for how caregivers may be impacted and can be supported to carry out this important role.
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Investigation of Caring Behavior and Caring Burden and Their Associated Factors among Nurses Who Cared for Patients with COVID-19 in East Guilan, the North of Iran. Nurs Res Pract 2023; 2023:8567870. [PMID: 36891224 PMCID: PMC9988378 DOI: 10.1155/2023/8567870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/13/2023] [Accepted: 02/18/2023] [Indexed: 03/03/2023] Open
Abstract
Background Nurses experience caring burdens, which can affect their caring behaviors. Caring for highly infectious patients, in particular COVID-19, is a new phenomenon and little is known about it. Considering that caring behaviors can be influenced by various factors and cultural differences of the society, it is necessary to conduct studies about caring behaviors and caring burdens. Thus, this study aimed to determine caring behavior and caring burden and their relationship with some associated factors among nurses who cared for patients with COVID-19. Materials and Methods This cross-sectional, descriptive design study was conducted by census sampling on 134 nurses working in public health centers in East Guilan, the north of Iran, in 2021. The research instruments included the Caring Behavior Inventory (CBI-24) and the Caregiver Burden Inventory (CBI). Descriptive and inferential statistics were used to analyze the data using SPSS software version 20 with a significant level of 0.05. Results The mean score of caring behavior and caring burden in nurses was 126.50 (SD = 13.63) and 43.65 (SD = 25.16), respectively. There was a significant relationship between caring behavior and some demographic characteristics (education, place of living, and history of COVID-19) and between caring burden and some demographic characteristics (housing status, job satisfaction, intention to change job, and history of COVID-19) (p < 0.05). Conclusions Findings showed that despite the new emergence of COVID-19, the caring burden on nurses was moderate and they had good caring behavior. Despite these results, it is necessary for the relevant managers to pay special attention to protecting health workers during a national crisis such as COVID-19 so that they experience less caring burden and improve caring behavior.
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Bastoni S, van Gemert-Pijnen L, Sanderman R, van Dongen A. Implementation of eMental health technologies for informal caregivers: A multiple case study. Front Digit Health 2023; 5:1130866. [PMID: 37035479 PMCID: PMC10081674 DOI: 10.3389/fdgth.2023.1130866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
Introduction Informal caregivers offer continuous unpaid support to loved ones who are unable to live independently. Providing care can be a very burdensome commitment, that heavily impacts informal caregivers' mental health. eMental health is a possible, yet challenging, solution to improve caregivers' mental health and their overall experience of caregiving. In fact, eMental health technologies often face challenges of implementation. The present work gathers knowledge on how to best deal with these challenges by collecting testimonies of implementation experts of eight eMental health technologies for informal caregivers with the aim of comparing them and extracting lessons learned. Methods For this multiple case study, technologies were selected (through informal suggestions and independent search) according to the following inclusion criteria: they were intended for informal caregivers as main user group, were aimed at improving informal caregivers' mental wellbeing and caregiving experience and were available and running in real life settings in Europe. Ten interviews were conducted (two pilots and eight included cases). The interviewees were asked to provide a description of the technology and its aims and their implementation approach, method and frameworks used. Finally, determinants of implementation, the influence of the Covid-19 pandemic on implementation processes and lessons learned were investigated. Results The results highlight key differences between technologies developed within academia and the industry regarding efficacy testing and use and use and choice of frameworks. Also, similarities in terms of recognized barriers such as financing are illustrated. Discussion Possible ways to overcome main barriers and examples of best practices, such as structuring a business model and discussing tool maintenance and long-term hosting in advance, are discussed.
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Affiliation(s)
- Sofia Bastoni
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Correspondence: Sofia Bastoni
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
- Department of Health Psychology, University Medical Center Groningen, Groningen, Netherlands
| | - Anne van Dongen
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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Chong E, Crowe L, Mentor K, Pandanaboyana S, Sharp L. Systematic review of caregiver burden, unmet needs and quality-of-life among informal caregivers of patients with pancreatic cancer. Support Care Cancer 2023; 31:74. [PMID: 36544073 PMCID: PMC9771849 DOI: 10.1007/s00520-022-07468-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 11/07/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE Informal caregivers play an important supportive care role for patients with cancer. This may be especially true for pancreatic cancer which is often diagnosed late, has a poor prognosis and is associated with a significant symptom burden. We systematically reviewed the evidence on caregiver burden, unmet needs and quality-of-life of informal caregivers to patients with pancreatic cancer. METHOD PubMed, Medline, CINAHL and Embase databases were systematically searched on 31 August 2021. Qualitative and quantitative data on informal caregivers' experiences were extracted and coded into themes of burden, unmet needs or quality-of-life with narrative synthesis of the data undertaken. RESULTS Nine studies (five qualitative, four quantitative), including 6023 informal caregivers, were included in the review. We categorised data into three key themes: caregiver burden, unmet needs and quality-of-life. Data on caregiver burden was organised into a single subtheme relating to symptom management as a source of burden. Data on unmet needs was organised into three subthemes need for: better clinical communication; support and briefings for caregivers; and help with navigating the health care system. Data on quality-of-life indicate large proportions of informal caregivers experience clinical levels of anxiety (33%) or depression (12%-32%). All five qualitative studies were graded as good quality; three quantitative studies were poor quality, and one was fair quality. CONCLUSION High-quality pancreatic cancer care should consider the impacts of informal caregiving. Prospective longitudinal studies examining multiple dimensions of caregiver burden, needs, and quality-of-life would be valuable at informing supportive care cancer delivery to pancreatic cancer informal caregivers.
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Affiliation(s)
- Eric Chong
- Surgical and Translational Research Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Lisa Crowe
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
| | - Keno Mentor
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Sanjay Pandanaboyana
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK ,Department of Hepatobiliary, Pancreatic and Transplant Surgery, Freeman Hospital, Tyne and Wear, Newcastle Upon Tyne, UK
| | - Linda Sharp
- Population Health Sciences Institute, Newcastle University Centre for Cancer, Newcastle University, Newcastle, UK
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Hellis E, Mukaetova-Ladinska EB. Informal Caregiving and Alzheimer's Disease: The Psychological Effect. Medicina (B Aires) 2022; 59:medicina59010048. [PMID: 36676672 PMCID: PMC9863258 DOI: 10.3390/medicina59010048] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
Background and Objectives: People with Alzheimer's disease and dementia in general benefit from home-based care as demonstrated via their better quality of life, increased lifespan, and delayed disease progression. Since currently nearly half of the dementia care is being provided by informal and unpaid caregiving, the health, wellbeing and quality of life of informal dementia caregivers is extremely important. Materials and Methods: We used a systematic review process with searches based upon the six elements from the "Quality of Life Scale for Informal Carers of Older Adults" with additional items on traditional and non-traditional caregiving ideologies, as well as caregivers' experiences. Results: We identified 19 studies with primary data. Informal caregivers of older adults with Alzheimer's Disease experience significant emotional strain, documented through increased levels of anxiety and depression, as well as increased caregiver burden and poorer quality of life, primarily due to caregiving ideologies, financial strain and a lack of support. Conclusions: Our findings suggest that caregiving should be a normative component of adult education to better prepare individuals with the mental and physical skills required for undertaking informal caregiving. They should also help inform policy makers to develop novel programs and services to both assist and reduce informal caregivers' strain, whilst considering their different social and cultural contexts.
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Affiliation(s)
- Emily Hellis
- School of Psychology and Visual Science, University of Leicester, Leicester LE1 7RH, UK
| | - Elizabeta B. Mukaetova-Ladinska
- School of Psychology and Visual Science, University of Leicester, Leicester LE1 7RH, UK
- The Evington Centre, Leicester General Hospital, Gwendoline Road, Leicester LE5 4QF, UK
- Correspondence:
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Bayen E, de Langavant LC, Youssov K, Bachoud-Lévi AC. Informal care in Huntington's disease: Assessment of objective-subjective burden and its associated risk and protective factors. Ann Phys Rehabil Med 2022; 66:101703. [PMID: 36055643 DOI: 10.1016/j.rehab.2022.101703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 08/09/2022] [Accepted: 08/09/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Because of the genetic transmission of Huntington's disease (HD), informal caregivers (ICs, i.e., non-professional caregivers) might experience consecutive and/or concurrent caregiving roles to support several symptomatic relatives with HD over their life. Additionally, some ICs might be HD carriers. However, whether family burden of care is associated with specific factors in HD remains poorly studied. OBJECTIVE To provide a quantitative view of the IC burden and identify associated factors. METHODS This was a cross-sectional assessment of home-dwelling symptomatic HD individuals (from REGISTRY and Bio-HD studies) and their primary adult ICs, including the HD individual's motor, cognitive, behavioral, functional Unified Huntington's Disease Rating Scale score; IC objective burden (quantification of IC time in activities of daily living, instrumental activities of daily living and supervision, using the Resource Utilization in Dementia instrument), IC subjective burden (Zarit Burden Inventory), and ICs' social economic functioning and use of professional home care. RESULTS We included 80 ICs (mean [SD] age 57 [12.9] years, 60% women) in charge of 80 individuals with early to advanced stage HD (mean age 56 [12.6] years, 51% men). The mean hours of informal care time was high: 7.3 (7.9) h/day (range 0-24); the mean professional home care was 2.8 (2.8) h/day (range 0.1-12.3). This objective burden increased with higher functional loss of the HD individual and with more severe cognitive-behavioral disorders. The mean subjective burden (35.4 [17.8], range 4-73) showed a high level since the earliest stage of HD; it was associated with HD duration (mean 9.2 [4.7] years) and with aggressive symptoms in individuals (44% of cases). The burden was partially related to the multiplex caregiving status (19%). Protective factors lowering the IC burden included the absence of financial hardship (57%), a strong social network (16%) and keeping active on the job market outside home (46%). CONCLUSIONS The objective-subjective burden of ICs related to changing patterns of neuro-psychiatric symptoms and mitigating environmental characteristics around the HD individual-caregiver dyads.
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Affiliation(s)
- Eléonore Bayen
- Service de Médecine Physique et de Réadaptation, hôpital Pitié-Salpêtrière, APHP, Paris, France et Faculté de Médecine, Sorbonne Université, Paris, France; Laboratoire d'Imagerie Biomédicale (LIB), Sorbonne Université, Paris, France; Global Brain Health Institute, University of California San Francisco, San Francisco, USA.
| | - Laurent Cleret de Langavant
- Global Brain Health Institute, University of California San Francisco, San Francisco, USA; National Reference Center for Huntington's Disease, Département de Neurologie, hôpital Henri Mondor-Albert Chenevier, APHP, Créteil, France; Equipe Neuropsychologie Interventionnelle, Département d'Etudes Cognitives, Ecole normale supérieure, PSL Research University, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, INSERM U955 E01, Paris et Créteil, France; Faculté de Médecine, Université Paris-Est Créteil, Créteil, France
| | - Katia Youssov
- National Reference Center for Huntington's Disease, Département de Neurologie, hôpital Henri Mondor-Albert Chenevier, APHP, Créteil, France; Equipe Neuropsychologie Interventionnelle, Département d'Etudes Cognitives, Ecole normale supérieure, PSL Research University, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, INSERM U955 E01, Paris et Créteil, France
| | - Anne-Catherine Bachoud-Lévi
- National Reference Center for Huntington's Disease, Département de Neurologie, hôpital Henri Mondor-Albert Chenevier, APHP, Créteil, France; Equipe Neuropsychologie Interventionnelle, Département d'Etudes Cognitives, Ecole normale supérieure, PSL Research University, Institut Mondor de Recherche Biomédicale, Université Paris-Est Créteil, INSERM U955 E01, Paris et Créteil, France; Faculté de Médecine, Université Paris-Est Créteil, Créteil, France
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R. R, Shetty S, Bhandary R, Kulkarni V. Assessment of psychological stress among family care takers of cancer subjects in India- A cross-sectional study. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i5.2157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction and Aim: A rapid increase in cancer rate is one of major concerns in India. It is a well-known fact that family caretakers play an essential part in aiding cancer subjects who are in critical stage. But the psychological strain and economic impact on caretakers are not widely known. The present cross-sectional study assesses the relationship between various factors and higher burden among family caretakers of cancer subjects.
Materials and Methods: One hundred and ninety family caretakers of cancer patients who met inclusion criteria were recruited for study. A proforma was collected regarding the age, gender, social and economic status according to Modified Kuppuswamy Scale 2019, the type of family or the caregiver and their relation to the patient.
Results: Monthly income had an inter quartile range of Rs.10,000-25,000 with the median being Rs.14,000. Higher number of males participated (58.4%) as compared to the females (41.6%). Moderate to severe stress (53.3%), and severe stress (6.7%) was maximum in class 5 of the socio-economic classification. Lower income was found to be related to higher burden scores.
Conclusion: Present study showed that the burden was more among class 5 of the Kuppuswamy Socioeconomic classification. The findings suggest that education levels, occupation and monthly income are the major contribution for the burden among the caregivers.
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Pinar Boluktas R. Caregiving burden of family caregivers of substance-addicted people in Turkey. Perspect Psychiatr Care 2022; 58:1657-1664. [PMID: 34846069 DOI: 10.1111/ppc.12974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 10/30/2021] [Accepted: 11/07/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this exploratory study was to examine the caregiving burden (CB) and the determinants of burden among family members of substance-addicted people. DESIGN AND METHODS The sample of this cross-sectional research was 128 informal family caregivers of substance-addicted people. We collected data by using the Zarit Burden Interview (ZBI) assessing subjective burden. FINDINGS Mean ZBI score was 52.2. The regression analysis showed that ZBI mean score was higher in female caregivers and caregivers with lower education, poor economic status, and longer caregiving duration. There was an inverse relationship between the addict's age and the CB. PRACTICE IMPLICATIONS The predictors of CB may assist in setting caregivers at greater risk of CB as targets for the intervention.
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Affiliation(s)
- Rukiye Pinar Boluktas
- Department of Nursing, Faculty of Health Sciences, Istanbul Sabahattin Zaim University, Istanbul, Turkey
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Papageorgiou N, Zygogianni A, Parpa E, Tsilika E, Mystakidou K. Comparative Analysis of Quality of Life and Attachment Style among Cancer and Dementia Informal Caregivers. ADVANCES IN GERONTOLOGY 2022. [DOI: 10.1134/s2079057022020151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Secinti E, Wu W, Kent EE, Demark-Wahnefried W, Lewson AB, Mosher CE. Examining Health Behaviors of Chronic Disease Caregivers in the U.S. Am J Prev Med 2022; 62:e145-e158. [PMID: 34579984 DOI: 10.1016/j.amepre.2021.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 06/13/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Many informal caregivers experience a significant caregiving burden, which may interfere with their health behaviors. Caregiver health behaviors may vary by disease context, but this has rarely been studied. This study compares the health behaviors of prevalent groups of chronic illness caregivers (i.e., dementia, cancer, chronic obstructive pulmonary disease/emphysema, diabetes) with those of noncaregivers and examines whether caregiving intensity is associated with these behaviors. METHODS In 2021, using pooled cross-sectional 2015-2019 Behavioral Risk Factor Surveillance System data, health behaviors (i.e., physical activity, diet, alcohol use, smoking, sleep, and influenza immunization) of caregivers of patients with dementia (n=5,525), cancer (n=4,246), chronic obstructive pulmonary disease/emphysema (n=1,959), and diabetes (n=2,853) and noncaregivers (n=203,848) were compared. Relationships between caregiving intensity (e.g., hours, type of tasks) and caregiver health behaviors were examined. Regression analyses were used to compare groups. RESULTS Compared with noncaregivers, caregiver groups were more likely to report engaging in both risky (i.e., smoking, shorter sleep duration) and health-promoting (i.e., physical activity, vegetable consumption, abstaining from heavy drinking) behaviors, whereas nonsignificant differences were observed for influenza immunization. Longer caregiving hours and providing help with personal care were associated with poorer health behaviors (e.g., shorter sleep duration). Few differences in health behaviors were observed between caregivers of patients with dementia and other caregiver groups. CONCLUSIONS Results suggest that caregivers are more likely to engage in both risky and health-promoting behaviors than noncaregivers. Furthermore, findings suggest that greater caregiving responsibilities are associated with certain risky health behaviors. Findings support the development and implementation of strategies to improve caregivers' health behaviors across disease contexts.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana.
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Erin E Kent
- Department of Health Policy and Management, UNC Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Wendy Demark-Wahnefried
- Department of Nutrition Sciences, School of Health Professions, The University of Alabama at Birmingham, Birmingham, Alabama
| | - Ashley B Lewson
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, Indiana
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16
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Pop RS, Payne S, Tint D, Pop CP, Mosoiu D. Instruments to assess the burden of care for family caregivers of adult palliative care patients. Int J Palliat Nurs 2022; 28:80-99. [PMID: 35446673 DOI: 10.12968/ijpn.2022.28.2.80] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND A primary caregiver shares the illness experience of the patient and undertakes vital care work, alongside managing the patient's emotions, and is actively involved in care process without being paid. When faced with the palliative care patient's needs, caregivers are affected on multiple levels (physical, psychological and socio-economic), thereby experiencing a moderate or severe burden of care. AIM To identify assessment instruments for the burden of care for family caregivers that are suitable to be used in clinical practice. METHOD A narrative review was conducted using an electronic search in Pubmed, PsychINFO, CINAHL of articles published in English between 2009-2019, using the search terms: 'caregiver/family, caregiver/carer and burden and palliative care/hospice/end of life'. An assessment grid was developed to appraise the clinical use of identified instruments. RESULTS Of the 568 articles identified, 40 quantitative studies were selected using 31 instruments to measure the caregiver burden of cancer, noncancer and terminally ill patients. Most instruments 23 (74.11%) evaluate the psycho-emotional and, 22 (70.96%) the social domain, 12 instruments (38.7%) focused on the physical domain, three (9.67%) on the spiritual field and six instruments (19.35%) on economic aspects. For the multidimensional instruments, the assessment grid scored highest for the Burden Scale for Family Caregiver (BSFC). CONCLUSION The BSFC is the tool that seems to meet the most requirements, being potentially the most useful tool in clinical practice.
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Affiliation(s)
- Rodica Sorina Pop
- Assistant Professor, Department of Family Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Faculty of Medicine, Cluj-Napoca, Romania
| | - Sheila Payne
- Professor, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Diana Tint
- Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
| | | | - Daniela Mosoiu
- Associate Professor, Transilvania University, Faculty of Medicine, Brasov, Romania
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17
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de Goumoëns V, Ayigah K, Joye D, Ryvlin P, Ramelet AS. The Development of an Early Intervention for Supporting Families of Persons With Acquired Brain Injuries: The SAFIR © Intervention. JOURNAL OF FAMILY NURSING 2022; 28:6-16. [PMID: 34617490 PMCID: PMC8814967 DOI: 10.1177/10748407211048217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Families of persons with acquired brain injuries need to be supported from the early phase of hospitalization. To date, no known early family intervention is available for this population. Using the Medical Research Council Framework, we developed a new intervention based on the Calgary Assessment and Intervention Models that includes the family preferences, clinician's expertise, and the contextual resources. This paper aims to describe the complete development process including a scoping review, an assessment of families and clinicians' needs, an evaluation of the contextual resources, and an adaptation of the theoretical framework. Using a systemic perspective, we tailored the new intervention to involve the stakeholder's preferences. The result is an early family intervention named SAFIR©, led by a clinical nurse specialist, including five core components and structured around three phases and a follow-up. The next steps will be focused on assessment of the clinical feasibility of this new intervention.
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Affiliation(s)
- Véronique de Goumoëns
- La Source School of Nursing, HES-SO University of Applied Sciences and Arts Western Switzerland, Av. Vinet 30, Lausanne
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Lausanne University Hospital, (CHUV), Lausanne, Switzerland
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland
| | - Koffi Ayigah
- HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland
| | - Daniel Joye
- Lausanne University Hospital, (CHUV), Lausanne, Switzerland
| | | | - Anne-Sylvie Ramelet
- University Institute of Higher Education and Research in Healthcare, Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
- Lausanne University Hospital, (CHUV), Lausanne, Switzerland
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18
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Biliunaite I, Kazlauskas E, Sanderman R, Andersson G. Informal caregiver support needs and burden: a survey in Lithuania. BMJ Open 2022; 12:e054607. [PMID: 34983768 PMCID: PMC8728458 DOI: 10.1136/bmjopen-2021-054607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION A demand for informal care exists worldwide. Lithuania presents an interesting case example where the need for the informal care is increasing, but relatively little research has been conducted documenting caregivers' experiences and needs. OBJECTIVES The main objective of this study was to investigate Lithuanian informal caregiver characteristics, support needs and burden. In addition, the impact of the COVID-19 on the caregiver's and care receiver's well-being was investigated. METHODS The study was conducted online between May and September 2020. Informal caregivers and individuals with informal caregiving experiences were invited to participate in the survey. The survey questionnaire comprised 38 multiple-choice items including participant demographic characteristics, availability of the support, support needs, well-being and the impact of the COVID-19 pandemic. In addition, caregiver burden was assessed with the 24-item Caregiver Burden Inventory (CBI). RESULTS A total of 226 individuals completed the survey. Most of the participants were women (87.6%). Almost half of the participants (48.7%) were not receiving any support, and a total of 73.9% expressed a need to receive more professional support. Participants were found to experience high burden on the CBI (M=50.21, SD=15.63). Women were found to be significantly more burdened than men (p=0.011). Even though many participants experienced psychological problems (55.8%), only 2.2% were receiving any psychological support. Finally, majority of the participants did not experience any changes in their own (63.7%) or the well-being of their care receiver (68.1%) due to the COVID-19 pandemic. CONCLUSION Most of the participants were identified as intensive caregivers experiencing a high burden. A majority did not experience changes in their well-being due to COVID-19. We propose several recommendations for increasing accessibility and availability of support for informal caregivers in Lithuania based on the study findings.
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Affiliation(s)
- Ieva Biliunaite
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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19
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Spatuzzi R, Vespa A, Fabbietti P, Ricciuti M, Rosati G, Guariniello L, Verrastro MAF, Attademo L, Giulietti MV. Elderly Helping Other Elderly: A Comparative Study of Family Caregiver Burden Between Patients With Dementia or Cancer at the End of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2022; 18:96-108. [PMID: 35245165 DOI: 10.1080/15524256.2022.2042459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A new reality is being observed around the world as the population ages: family caregivers, who are themselves older adults helping their ill older relatives. The aim of this study is to assess the burden of the older family caregiver assisting older patients in his or her end-of-life who are suffering from dementia or cancer. In this context, the elderly person is involved in the dual role of patient and caregiver. In this comparative study, a total of 87 older family caregivers (age ≥ 65 years) completed the Caregiver Burden Inventory (CBI) measurement. The sample was divided into 2 subgroups based on the individuals' advanced disease: Alzheimer's disease (AD) or cancer. Compared to cancer caregivers, the AD subgroup reported significantly higher scores in the CBI-emotional subscale (P = 0.006), confirmed by the evaluation of the generalized linear model (multivariate). There were no significant differences in the other CBI subscales and overall scores. According to the findings of this study, elderly who help elderly with AD are at a higher risk of experiencing an emotional burden than cancer caregivers. This data could be considered in designing interventions to reduce the caregiver burden of older family caregivers as they provide informal end-of-life care.
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Affiliation(s)
- Roberta Spatuzzi
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | - Anna Vespa
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | - Paolo Fabbietti
- Biostatistical Center, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | | | - Gerardo Rosati
- Medical Oncology Unit, "San Carlo" Hospital, Potenza, Italy
| | - Lorella Guariniello
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | | | - Luigi Attademo
- Department of Mental Health, Hospital Psychiatric Service of Diagnosis and Care at "San Carlo" Hospital, ASP Basilicata, Italian NHS, Italy
| | - Maria Velia Giulietti
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
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20
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Pattison A, Torres E, Wieters L, Waldschmidt JG. A comparison of caregiver burden between long-term care and developmental disability family caregivers. J Res Nurs 2021; 26:781-793. [DOI: 10.1177/17449871211024325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background As the United States’ population ages and health concerns rise, the family caregiver occupation will continue to be an integral part of the health care system. Aims It is important to examine the burden that family caregivers experience so they can seek out additional training and services to maintain their own well-being. The researchers examined caregiver burden from a perspective of developmentally disabled and long-term care. Methods The researchers examined difference in Zarit scores, guilt, burden and personal strain for 72 caregivers of people with developmental disability (DD) or people with long-term care (LTC) needs. The researchers also examined differences in these based on whether the individual was caregiving for family or “others”. Results For DD, there were significant differences in Zarit, role strain and personal strain; caring for others has significantly lower scores on these. Role strain was significantly higher than personal strain, which was significantly higher than guilt for both LTC and DD groups. Conclusions Given these findings, it is important to support family caregivers first and foremost with role strain, especially for those caring for family members with DD. This support could be given through personal counselling, caregiver training, non-profit social service resources, and support groups for family caregivers.
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Affiliation(s)
- Alison Pattison
- Associate Adjunct Professor and Senior Doctoral Adjunct Chair, The College of Doctoral Studies, Grand Canyon University, USA
- Founder and CEO, Arizona Provider Training, USA
| | | | - Lori Wieters
- Industrial/Organisational Psychologist, Grand Canyon University, USA
- Owner of the Wi2 Co-Lab, Arizona Provider Training, USA
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Secinti E, Lewson AB, Wu W, Kent EE, Mosher CE. Health-Related Quality of Life: A Comparative Analysis of Caregivers of People With Dementia, Cancer, COPD/Emphysema, and Diabetes and Noncaregivers, 2015-2018 BRFSS. Ann Behav Med 2021; 55:1130-1143. [PMID: 33761526 DOI: 10.1093/abm/kaab007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many informal caregivers experience significant caregiving burden and report worsening health-related quality of life (HRQoL). Caregiver HRQoL may vary by disease context, but this has rarely been studied. PURPOSE Informed by the Model of Carer Stress and Burden, we compared HRQoL outcomes of prevalent groups of caregivers of people with chronic illness (i.e., dementia, cancer, chronic obstructive pulmonary disease [COPD]/emphysema, and diabetes) and noncaregivers and examined whether caregiving intensity (e.g., duration and hours) was associated with caregiver HRQoL. METHODS Using 2015-2018 Behavioral Risk Factor Surveillance System data, we identified caregivers of people with dementia (n = 4,513), cancer (n = 3,701), COPD/emphysema (n = 1,718), and diabetes (n = 2,504) and noncaregivers (n = 176,749). Regression analyses were used to compare groups. RESULTS Caregiver groups showed small, nonsignificant differences in HRQoL outcomes. Consistent with theory, all caregiver groups reported more mentally unhealthy days than noncaregivers (RRs = 1.29-1.61, ps < .001). Caregivers of people with cancer and COPD/emphysema reported more physically unhealthy days than noncaregivers (RRs = 1.17-1.24, ps < .01), and caregivers of people with diabetes reported a similar pattern (RR = 1.24, p = .01). However, general health and days of interference of poor health did not differ between caregivers and noncaregivers. Across caregiver groups, most caregiving intensity variables were unrelated to HRQoL outcomes; only greater caregiving hours were associated with more mentally unhealthy days (RR = 1.13, p < .001). CONCLUSIONS Results suggest that HRQoL decrements associated with caregiving do not vary substantially across chronic illness contexts and are largely unrelated to the perceived intensity of the caregiving. Findings support the development and implementation of strategies to optimize caregiver health across illness contexts.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Ashley B Lewson
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
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22
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Alsirafy SA, Nagy R, Hassan AD, Fawzy R, Abdelhafeez AAM, Husein MO, Almashiakhi MA, Alabdullateef SH, Alghamdi SA, Elyamany AM. Caregiver burden among family caregivers of incurable cancer patients in two eastern Mediterranean countries. BMC Palliat Care 2021; 20:163. [PMID: 34663283 PMCID: PMC8522156 DOI: 10.1186/s12904-021-00857-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 09/28/2021] [Indexed: 11/17/2022] Open
Abstract
Background Although family caregivers (FCs) play an important role in the care provided to incurable cancer patients in our region, little is known about the burden they experience. This study was conducted to determine the prevalence of caregiver burden (CB) among FCs of incurable cancer patients in two Eastern Mediterranean countries and to identify factors that may be associated with significant CB. Methods The study included 218 FCs, 165 from Egypt and 53 from Saudi Arabia. The 22-item Zarit Burden Interview (ZBI-22) was used to assess caregiver burden CB. Significant CB was defined as a ZBI-22 score ≥ 21. The assistance with basic ADLs was classified into 3 levels according to FCs’ assistance with early/middle/late-loss basic ADLs. The relationship between CB and the assistance with ADLs and other factors was studied. Results The mean (SD) ZBI-22 score among FCs was 23.4 (9.3) and the majority (128/218, 59%) had significant CB. Eighty-nine percent of FCs assisted with at least one basic ADL. Assistance with late-loss basic ADLs, best supportive care treatment plan and poorer performance status were associated with higher CB (p < 0.0001, =0.018 and = 0.005). However, in logistic regression analysis, only assistance with late-loss ADLs was independently associated with significant CB (OR = 3.4 [95%CI:1.2–9.7], p = 0.024). Conclusion A substantial proportion of FCs of incurable cancer patients in our region experience significant CB. Family caregivers assisting with late-loss basic ADLs are at risk of significant CB and should be routinely screened for CB.
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Affiliation(s)
- Samy A Alsirafy
- Palliative Care Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia. .,Palliative Medicine Unit, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.
| | - Radfan Nagy
- Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Amneh D Hassan
- Palliative Care Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Radwa Fawzy
- Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt.,The Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton, UK
| | - Ahmad A M Abdelhafeez
- Oncology Department, Kasr Al-Ainy Center of Clinical Oncology and Nuclear Medicine, Kasr Al-Ainy School of Medicine, Cairo University, Cairo, Egypt
| | - Marahim O Husein
- Oncology Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia
| | | | - Saad H Alabdullateef
- Palliative Care Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Saeed A Alghamdi
- Oncology Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Ashraf M Elyamany
- Oncology Unit, Hemato-Oncology Department, King Saud Medical City, Riyadh, Saudi Arabia.,Medical Oncology Department, South Egypt Cancer Institute, Assiut University, Assiut, Egypt
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23
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Health-Related and Economic Burden Among Family Caregivers of Patients with Acute Myeloid Leukemia or Hematological Malignancies. Adv Ther 2021; 38:5002-5024. [PMID: 34499319 PMCID: PMC8478752 DOI: 10.1007/s12325-021-01872-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023]
Abstract
Introduction Acute myeloid leukemia (AML) is associated with lower survival and greater unmet need compared with some other hematologic malignancies (HMs). Despite differences in acuteness between AML and other HMs, the burden of family caregivers (FCs) of patients with these malignancies offer similar patient experiences. A targeted literature review was conducted to explore FC burden of patients with AML and HM with and without hematopoietic stem cell transplant (HSCT). Instruments to measure and interventions to address FC burden were identified. Methods Studies on economic burden and compromised health-related quality of life (HRQoL) associated with FC burden, family affairs, and childcare from 1 January 2010 to 30 June 2019 were identified through database and hand searches. Published English articles on randomized controlled trials or standardized qualitative or quantitative observational studies were included. FCs were those in close familial proximity to the patient (i.e., spouse, parents, children, relatives, other family members, significant others). Results Seventy-one publications were identified (AML, n = 3; HM, n = 29; HSCT, n = 39). Predominant burden categories included humanistic (n = 33), economic (n = 17), and interventions (n = 22); one study was classified as humanistic and economic. FCs lack sufficient resources to manage stressors and experience negative psychological, behavioral, and physiological effects. FCs of patients with HMs reported post-traumatic stress disorder, significant sleep problems, moderate-to-poor HRQoL, and negative impacts on family relationships. Instruments designed to measure caregiver burden were generic and symptom-specific. Educational, expressional, and self-adjustment interventions were used to improve FC burden. Conclusion Findings indicate a need for additional research, public health approaches to support FCs, and effective interventions to address FC burden. Minimizing FC burden and improving quality of life may reduce the overall healthcare service use and allow FCs to more effectively fulfill caregiver tasks. Support systems to alleviate caregiver burden may create reinforced integrators, thus positively affecting quality of life and possibly the outcomes of patients. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-021-01872-x.
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24
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Carboni-Jiménez A, Rice DB, Levis B, Cañedo-Ayala M, Imran M, Chiovitti M, Benedetti A, Thombs BD. Intensity of care and perceived burden among informal caregivers to persons with chronic medical conditions: a systematic review and meta-analysis. Disabil Rehabil 2021; 44:6230-6246. [PMID: 34455877 DOI: 10.1080/09638288.2021.1966675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Informal caregivers provide ongoing assistance to a loved one with a health condition. No studies have compared caregiving intensity and perception of burden across chronic medical conditions. MATERIALS AND METHODS Databases were searched from inception through 11 September 2020 to identify studies that included the Level of Care Index or the Zarit Burden Inventory (ZBI) among caregivers for people with chronic diseases. Pooled mean ZBI scores and 95% confidence intervals by medical condition were calculated using a random effects model and heterogeneity with I2. RESULTS Ninety-seven included articles reported on 98 unique samples across 21 chronic diseases. No study used the Level of Care Index. Among 12 disease groups with more than one study, heterogeneity was too high (I2 range: 0-99.6%, ≥76.5% in 11 groups) to confidently estimate burden. The percent of studies rated high risk of bias ranged from 0% to 98%, but all external validity items were rated as high-risk in >50% of studies. CONCLUSIONS Findings highlight the need for studies on caregiver burden to improve sampling techniques; better report sampling procedures and caregiver and care recipient characteristics; and develop a standard set of outcomes, including a measure of caregiving intensity. Systematic Review Registration: CRD42017080962IMPLICATIONS FOR REHABILITATIONThe amount of burden reported by caregivers to loved ones is associated with reduced physical and mental health.We found considerable heterogeneity in perceived burden reported by informal caregivers across different studies within disease groups, which is likely related to methodological issues, including sampling techniques.Health care providers who use research on caregiver burden should assess how representative study samples may be and exercise caution in drawing conclusions.
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Affiliation(s)
- Andrea Carboni-Jiménez
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Danielle B Rice
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychology, McGill University, Montreal, Canada
| | - Brooke Levis
- Centre for Prognosis Research, School of Medicine, Keele University, Staffordshire, UK
| | - Mara Cañedo-Ayala
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Mahrukh Imran
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Matthew Chiovitti
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada
| | - Brett D Thombs
- Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada.,Department of Psychology, McGill University, Montreal, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Department of Medicine, McGill University, Montreal, Canada.,Department of Educational and Counselling Psychology, McGill University, Montreal, Canada.,Biomedical Ethics Unit, McGill University, Montreal, Canada
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Park J, Galvin JE. Pre-Loss Grief in Caregivers of Older Adults with Dementia with Lewy Bodies. J Alzheimers Dis 2021; 82:1847-1859. [PMID: 34219734 DOI: 10.3233/jad-210616] [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: 11/15/2022]
Abstract
BACKGROUND Pre-loss grief increases as dementia advances. Caregivers who experience pre-loss grief face risks to their own physical and psychological health. OBJECTIVE The study examined factors associated with pre-loss grief in caregivers of older adults with dementia with Lewy bodies (DLB) to determine whether overall caregiver experiences differ based on the stages of DLB in care recipients. The study also compared pre-loss grief in caregivers of DLB patients with that in caregivers of patients with Alzheimer's disease (AD) and other dementias. METHOD Using a cross-sectional design, 714 caregivers of older adults with dementia (488 DLB, 81 AD, 145 other dementias) completed an online survey on pre-loss grief. Multivariate linear regression identified risk factors associated with pre-loss grief and analysis of variance examined whether pre-loss grief in caregivers differed significantly based on type of dementia or stage of DLB. RESULTS Being the caregiver of a spouse, lower level of caregiver well-being, lower psychological well-being of the caregiver, and higher level of burden were associated (p < 0.005) with increased pre-loss grief in caregivers of older adults with DLB. There was no significant difference in caregiver burden, well-being, or depression according to the various stages of DLB (mild, moderate, severe, deceased) in the care recipients. There was no significant difference in pre-loss grief in caregivers of DLB care recipients compared to caregivers of patients with other dementias. CONCLUSION Assessment of DLB caregivers and appropriate interventions should be conducted to reduce their burden and emotional distress to decrease the incidence of pre-loss grief.
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Affiliation(s)
- Juyoung Park
- Phyllis and Harvey Sandler School of Social Work, The Florida Atlantic University, Boca Raton, FL, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
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Treml J, Schmidt V, Nagl M, Kersting A. Pre-loss grief and preparedness for death among caregivers of terminally ill cancer patients: A systematic review. Soc Sci Med 2021; 284:114240. [PMID: 34303292 DOI: 10.1016/j.socscimed.2021.114240] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND Cancer is one of the most common causes of death. The period of time between receiving a terminal diagnosis of cancer and the death of a loved one has been operationalized as pre-loss grief and, more recently, as preparedness for death. Originally, grief before loss was thought to have positive effects on the bereavement outcome, but some studies have revealed contradictory findings. This systematic review investigates definitions and measurement tools of pre-loss grief and preparedness for death, as well as the associations of both constructs with caregiver characteristics, pre-loss psychological aspects and post-loss adjustment among caregivers of people living with terminal cancer. METHODS PubMed/Medline, PsycINFO and Web of Science were searched for studies published up until October 2020. Quantitative empirical studies from peer reviewed journals were included if a measurement tool for pre-loss grief or preparedness for death was used and if they focused on adult caregivers of adult people with cancer in an end-of-life trajectory and were excluded when they were not written in English or were descriptive/qualitative studies. Quality assessment of all studies was performed. RESULTS Most studies used convenience samples and had a mean number of 725 participants. Overall, 16,326 participants in 35 articles were included and narratively synthesized. High levels of pre-loss grief, as well as low levels of perceived preparedness for death, were associated with poor post-loss adjustment (e.g., prolonged grief, depressive symptoms, etc.). CONCLUSIONS Caregivers with high levels of pre-loss grief and low levels of preparedness for the death of their loved one would benefit from targeted support for post-loss adjustment. Results are limited by an inconsistent operationalization of both constructs.
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Affiliation(s)
- Julia Treml
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Viktoria Schmidt
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Michaela Nagl
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
| | - Anette Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University of Leipzig, Semmelweisstraße 10, 04103, Leipzig, Germany.
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27
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van Roij J, Brom L, Sommeijer D, van de Poll-Franse L, Raijmakers N. Self-care, resilience, and caregiver burden in relatives of patients with advanced cancer: results from the eQuiPe study. Support Care Cancer 2021; 29:7975-7984. [PMID: 34215933 PMCID: PMC8549961 DOI: 10.1007/s00520-021-06365-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 06/13/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Relatives are often involved in caregiving for patients with advanced cancer and carry a heavy burden. Self-care and resilience might be beneficial to enhance their wellbeing and burden-bearing capacity. This study assessed the engagement in self-care and resilience in relatives of patients with advanced cancer and its association with their caregiver burden. METHODS This study analyzed baseline data of the eQuiPe study, a prospective longitudinal, multicenter, observational study on quality of care and life of patients with advanced cancer and their relatives in which self-care (Self-care Practices Scale), resilience (Connor-Davidson Resilience Scale), and caregiver burden (Zarit Burden Interview (ZBI)) of relatives were included. Their scores were compared with a gender- and age-matched normative population. Multivariable logistic regression analysis was performed to assess the association between self-care and resilience with caregiver burden. RESULTS Most of the 746 relatives were the patient's partner (78%) and 54% reported to be an informal caregiver of the patient. The median hours of caregiving a week for all relatives was 15 and 11% experienced high caregiver burden (ZBI > 20). Relatives who reported a high caregiver burden engaged less often in self-care (OR = .87) and were less resilient (OR = .76) compared to relatives with low/medium caregiver burden. Relatives with high caregiver burden were younger (OR = .96), highly educated (OR = 2.08), often reported to be an informal caregiver of the patient (OR = 2.24), and were less well informed about the importance of self-care (OR = .39). CONCLUSION A significant number of relatives of patients with advanced cancer experienced high caregiver burden. As more self-care and resilience were associated with lower experienced caregiver burden, creating awareness of the beneficial potential of self-care is important. Future studies should illuminate the causal relation. TRIAL REGISTRATION NUMBER NTR6584 (date of registration: 30 June 2017).
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Affiliation(s)
- Janneke van Roij
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.,Libra Rehabilitation and Audiology, Tilburg, The Netherlands
| | - Linda Brom
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands
| | - Dirkje Sommeijer
- Department of Medical Oncology, Amsterdam University Medical Center, Amsterdam, The Netherlands.,Department of Medical Oncology, Almere, The Netherlands
| | - Lonneke van de Poll-Franse
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands.,CoRPS-Center of Research On Psychology in Somatic Diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands.,Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Natasja Raijmakers
- Research & Development, Netherlands Comprehensive Cancer Organization (IKNL), PO box 19079, 3501 DB, Utrecht, The Netherlands. .,Netherlands Association for Palliative Care (PZNL), Utrecht, The Netherlands.
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Souesme G, Voyer M, Gagnon É, Terreau P, Fournier-St-Amand G, Lacroix N, Gravel K, Vaillant MC, Gagné MÈ, Ouellet MC. Barriers and facilitators linked to discharge destination following inpatient rehabilitation after traumatic brain injury in older adults: a qualitative study. Disabil Rehabil 2021; 44:4738-4749. [PMID: 34126821 DOI: 10.1080/09638288.2021.1919212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To identify facilitators and barriers associated with returning home for older adults having received inpatient rehabilitation after traumatic brain injury (TBI). METHODS A qualitative design was used. Five older patients with TBI and four family caregivers were interviewed and six healthcare professionals participated in a focus group. RESULTS Main facilitators to returning home highlighted by all participants were: (1) Patient's adequate health condition and functional status, (2) Access to health and other services at home, (3) Availability of help from a family caregiver. Conversely, if one of these factors was not met, it represented a barrier. Other facilitators identified were (4) Attachment to one's home, (5) Feeling of commitment toward a loved one, (6) Having the possibility of going through a transitional phase, (7) United front between the patient and the family caregiver towards a return home. Additional barriers to returning home included: (8) Incongruent perspectives, and (9) Unclear knowledge about available health and other services at home. CONCLUSION The results of this study could be translated into a practical tool to guide patients, families and professionals in the decision about returning home or exploring an alternative option after inpatient rehabilitation for TBI in older adults.IMPLICATIONS FOR REHABILITATIONWhen orienting an older patient home or to an alternative living environment after a traumatic brain injury (TBI), the perspective of rehabilitation professionals can differ from that of patients and caregivers.Professionals tend to emphasize security, whereas patients and caregivers' focus on the well-being associated with home and on the importance of being with their loved one.Integrating the views, values and wishes of older patients with TBI and their caregivers will support a shared decision-making approach for orientation after rehabilitation.
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Affiliation(s)
- Guillaume Souesme
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Manon Voyer
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Éric Gagnon
- Centre de Recherche sur les Soins et les Services de Première Ligne, Québec, Canada.,Sociology Department, Laval University, Québec, Canada
| | - Paule Terreau
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Geneviève Fournier-St-Amand
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Nadine Lacroix
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale- Site, Institut de réadaptation en déficience physique de Québec, Canada
| | - Kristina Gravel
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Claude Vaillant
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Ève Gagné
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
| | - Marie-Christine Ouellet
- Interdisciplinary Centre for Research in Rehabilitation and Social Integration, Québec, Canada.,School of Psychology, Laval University, Québec, Canada
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Abstract
OBJECTIVE Despite the policy relevance of carer burden, limited research focuses on family carers' experience of carer burden among different disease groups. This study aimed to examine differences in carer burden among family carers of people with and without dementia. DESIGN Secondary data analysis was conducted on a national cross-sectional dataset. Multivariable ordered logistic regression was used to analyze four levels of carer burden (low, mild, moderate, high). The main independent variable was dementia diagnosis, and controls included variables relating to the care recipient, family carer, and context of care. SETTING The original survey was funded by Irish Health Service Executive and undertaken by the National Centre for the Protection of Older People in Ireland. PARTICIPANTS The original dataset consisted of 2,311 family carers of older people in Ireland. Approximately, one-fifth of this sample had a diagnosis of dementia. MEASUREMENTS Carer burden was measured using the standardized 22-item Zarit Burden Interview. Care-recipient dependency was measured using the Activities for Daily Living Scale. Sociodemographic details and information about the context of caring were collected using self-report scales. RESULTS In our model, dementia diagnosis and dependency level were significantly associated with carer burden. Family carer and context of care variables including gender, marital status, education, residence, co-residence, and perceived support showed significant relationships with carer burden. Our results highlighted significant differences in carer burden distribution; in particular, family carers of people with dementia were less likely to report low or mild carer burden (-6.95 ppts and -3.64 ppts, respectively) and more likely to report moderate or high carer burden (8.46 ppts and 2.13 ppts, respectively). CONCLUSION Our findings suggest that family carers of people with dementia may experience additional challenges associated with caring. Therefore, family carers of people with dementia may require tailored social supports to maintain good health and well-being.
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Hanari K, Sugiyama T, Inoue M, Mayers T, Tamiya N. Caregiving Experience and Other Factors Associated With Having End-Of-Life Discussions: A Cross-Sectional Study of a General Japanese Population. J Pain Symptom Manage 2021; 61:522-530.e5. [PMID: 32827656 DOI: 10.1016/j.jpainsymman.2020.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/12/2020] [Accepted: 08/14/2020] [Indexed: 11/19/2022]
Abstract
CONTEXT The factors associated with end-of-life discussion (EOLD) are not well elucidated; an understanding of these factors may help facilitate EOLD. OBJECTIVES To investigate the associations between EOLD and experiences of the death of and/or care for a loved one and other factors. METHODS Data from a nationwide anonymous questionnaire survey of public attitudes toward end-of-life medical care, conducted in December 2017 in Japan, were used. Participants were randomly selected from the general population (age ≥ 20 years), and respondents who completed the questionnaire were analyzed (respondents: n = 836; effective response rate: 13.9%). Respondents were divided into two groups based on their experience of EOLD: those who had engaged in EOLD and those who had not. The main predictors were the experiences of the death of and care for a loved one. Multivariable logistic regression analyses were performed. RESULTS Of the 836 respondents (male: 55.6%, aged 65 and over: 43.5%), 43.7% reported their engagement in EOLD. In the analyses, "having experience of caring for a loved one" was associated with EOLD compared with never having experience (odds ratio 1.88, 95% confidence interval 1.35-2.64). However, having experience of the death of a loved one had no association. CONCLUSION For health-care providers, it may be worth recognizing that the care experience of their patient's caregiver might affect the caregiver's own EOLD in the future.
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Affiliation(s)
- Kyoko Hanari
- Doctoral Programs in Medical Sciences, Department of Health Services Research, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tsukuba, Ibaraki, Japan; Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Takehiro Sugiyama
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan; Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, Tokyo, Japan; Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Megumi Inoue
- Department of Social Work, George Mason University, Fairfax, Virginia, USA
| | - Thomas Mayers
- Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Medical English Communications Center, University of Tsukuba, Tsukuba, Ibaraki, Japan
| | - Nanako Tamiya
- Health Services Research & Development Center, University of Tsukuba, Tsukuba, Ibaraki, Japan; Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Ibaraki, Japan
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Mishra S, Gulia A, Satapathy S, Gogia A, Sharma A, Bhatnagar S. Caregiver Burden and Quality of Life among Family Caregivers of Cancer Patients on Chemotherapy: A Prospective Observational Study. Indian J Palliat Care 2021; 27:109-112. [PMID: 34035627 PMCID: PMC8121224 DOI: 10.4103/ijpc.ijpc_180_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 10/02/2020] [Indexed: 11/15/2022] Open
Abstract
Aim: Informal caregivers of cancer patients have extensive burdens. They are susceptible for deterioration of their quality of life (QOL). We aimed to assess caregiver burden and QOL of family caregivers of cancer patients receiving chemotherapy admitted in the ward/intensive care unit/high-dependency unit. Materials and Methods: This prospective observational study including 178 caregivers was carried out in a tertiary care hospital. The assessment of caregiving burden was done using the Zarit Burden Interview and its impact on QOL using the WHO BREF QOL questionnaire. Results: The mean age and mean Zarit Burden score of caregivers were 38.98 ± 10.53 and 30.697 ± 8.96, respectively. Of the total, 70.22% of caregivers reported mild-to-moderate burden and 21.38% reported moderate-to-severe burden. On assessment of QOL WHO BREF, the mean general score was 5.79 ± 1.84, physical health score was 49.65 ± 16.07, psychological health 51.85 ± 20.43, social relations 59.38 ± 21.43, and environmental 58.73 ± 17.51. The QOL scores were slightly better in mild-to-moderate burden compared to moderate-to-severe burden but not statistically significant except for social relations (P = 0.053). We did not find any difference in burden scores or QOL between male and female caregivers. Conclusion: Mild-to-moderate burden was seen in 70.22% of caregivers and 21.38% had moderate-to-severe burden.
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Affiliation(s)
- Seema Mishra
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. B. R. Ambedkar IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Abhity Gulia
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. B. R. Ambedkar IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sujata Satapathy
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Gogia
- Department of Medical Oncology, Dr. B. R. Ambedkar IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Sharma
- Department of Medical Oncology, Dr. B. R. Ambedkar IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Sushma Bhatnagar
- Department of Onco-Anaesthesia and Palliative Medicine, Dr. B. R. Ambedkar IRCH, All India Institute of Medical Sciences, New Delhi, India
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Singer J, Shrout MR, Papa A. Rates and prospective psychosocial correlates of pre-loss grief in cancer and dementia family members. J Health Psychol 2021; 27:1547-1555. [DOI: 10.1177/1359105321995945] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
This study examined changes in Pre-Loss Grief (PLG) among individuals whose family member has a life limiting illness and how baseline psychosocial factors predicted PLG. This two-wave study recruited family members of advanced cancer ( N = 100) and dementia ( N = 38) patients. A subsample completed 1-month follow-up (Cancer = 33; Dementia = 28). Higher caregiver burden and female participants predicted greater PLG at follow-up, accounting for baseline PLG. Family members of dementia patients (10.5%) were significantly more likely than family members of cancer patients (2.1%) to be in the “severe PLG” group. Findings demonstrate psychosocial factors related to PLG, informing interventions aimed at reducing PLG.
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Zarshenas S, Gagnon-Roy M, Couture M, Bier N, Giroux S, Nalder E, Pigot H, Dawson D, Poncet F, LeDorze G, Bottari C. Potential of using an assistive technology to address meal preparation difficulties following acquired brain injury: clients' and caregivers' perspectives. Disabil Rehabil Assist Technol 2021; 18:458-466. [PMID: 33533286 DOI: 10.1080/17483107.2020.1867244] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES This study explored difficulties in meal preparation experienced by adults with moderate to severe acquired brain injury (ABI) and available compensatory strategies from both ABI individuals' and caregivers' perspectives. Further, this study investigated their opinions on potential benefits, barriers and facilitators to the use of the Cognitive Orthosis for coOKing (COOK) in their living environment. METHODS Using a qualitative descriptive approach, semi-structured individual interviews and focus groups were carried out with adults with moderate to severe ABI (n = 20) and formal and informal caregivers (n = 13) in Ontario and Quebec, Canada. A qualitative analysis based on Miles et al.'s approach was used. RESULTS According to participants, cognitive, physical, psychosocial dysfunctions and lack of availability of supportive caregivers were the main difficulties that impede persons with ABI from engaging effectively in meal preparation tasks. Memory aids on smartphones, and caregivers' direct support were reported as the most commonly used compensatory strategies, though the latter do not provide adequate support. COOK was identified as a technology with great potential to improve independence and increase safety in meal preparation for these clients while decreasing caregiver burden. However, psychosocial issues and limited access to funding were considered as the main barriers to the use of COOK. Providing training and the availability of financial support were mentioned as the main facilitators to the use of this technology. CONCLUSIONS Findings of this study on difficulties of meal preparation following ABI and potential benefits and barriers of COOK will help improve this technology and customize it to the needs of clients with ABI and their caregivers.Implications for RehabilitationCurrent compensatory strategies are not tailored to the specific needs of clients with ABI and cannot provide sufficient support for caregivers.COOK shows a high potential for increasing independence and safety during meal preparation in a living environment for clients with ABI via a sensor-based autonomous safety system and a cognitive assistance application.COOK has the potential to decrease caregivers' burden by proving remote access to a stove/oven.
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Affiliation(s)
- Sareh Zarshenas
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Mireille Gagnon-Roy
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
| | - Melanie Couture
- Centre for Research and Expertise in Social Gerontology, Côte Saint-Luc, Canada
| | - Nathalie Bier
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montreal, Canada.,Centre de recherche de l'Institut universitaire de gériatrie de Montréal, Montreal, Canada
| | - Sylvain Giroux
- DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, Canada
| | - Emily Nalder
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada.,March of Dimes Canada, Toronto, Canada
| | - Hélène Pigot
- DOMUS Laboratory, Université de Sherbrooke, Sherbrooke, Canada
| | - Deirdre Dawson
- Occupational Science and Occupational Therapy Department, University of Toronto, Toronto, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada.,Rotman Research Institute, Baycrest Health Sciences, Toronto, Canada.,Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Frédérique Poncet
- Lethbridge-Layton-Mackay Rehabilitation Center, Montreal, Canada.,Optometry Department, Université de Montréal, Montreal, Canada
| | - Guylaine LeDorze
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada.,School of Speech-Language Pathology and Audiology, Université de Montréal, Montreal, Canada
| | - Carolina Bottari
- Occupational Therapy Program, School of Rehabilitation, Université de Montréal, Montreal, Canada.,Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Institut universitaire sur la réadaptation en déficience physique de Montréal du CIUSSS du Centre-Sud-de-l'Île-de-Montréal, Montreal, Canada
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Poor patient health is associated with higher caregiver burden for older adults with advanced cancer. J Geriatr Oncol 2021; 12:771-778. [PMID: 33478890 DOI: 10.1016/j.jgo.2021.01.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 10/12/2020] [Accepted: 01/05/2021] [Indexed: 01/01/2023]
Abstract
OBJECTIVES Family caregiver burden among older adults with advanced cancer remains poorly understood. We sought to (1) identify patient factors associated with caregiver burden and (2) examine how amount of time caregiving modifies these relationships. METHODS Cross-sectional analysis of baseline data from a cluster-randomized palliative care intervention trial including patients with advanced cancer and their family caregivers, recruited from 17 oncology practices in Pennsylvania. Caregiver burden was measured using Zarit Burden Interview (ZBI-12; range 0-48). Patient factors included functional status (Eastern Cooperative Oncology Group), symptom burden (Edmonton Symptom Assessment Scale), anxiety and depression (Hospital Anxiety and Depression Scale), and quality of life (Functional Assessment of Chronic Illness Therapy - Palliative Care). Using adjusted multivariable regression, we analyzed (1) independent associations between patient factors and caregiver burden and (2) how weekly caregiving hours modified these relationships. RESULTS Among 441 patient-caregiver dyads, mean patient age was 70 ± 10 and caregiver age was 62 ± 13 years. Most caregivers (59%) were patients' partners. Caregivers reported 44.5 ± 53.5 average hours spent caregiving weekly; mean ZBI-12 scores were 10.3 ± 7.3. Worse patient functional status (β = 4.20, p < 0.01), poorer quality of life (β = -0.07, p < 0.01), more anxiety (β = 0.33, p < 0.01) and depression (β = 0.33, p < 0.01) were associated with higher caregiver burden; caregiving hours did not affect these relationships. CONCLUSIONS In advanced cancer, poor patient physical and mental health is associated with higher caregiver burden regardless of hours caregiving; future studies should examine interventions tailored to alleviate caregiver burden for this group.
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Arias JJ. Deception in Dementia: Adding Caregivers to the Equation. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2021; 49:263-265. [PMID: 34924050 DOI: 10.1017/jme.2021.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Yoshino M, Tsukamoto K. Humanistic burden among caregivers of patients with Alzheimer's disease or dementia in Japan: a large-scale cross-sectional survey. J Med Econ 2021; 24:181-192. [PMID: 33467967 DOI: 10.1080/13696998.2021.1877149] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS As the population in Japan is rapidly aging, the prevalence of dementia, particularly Alzheimer's Disease (AD), is expected to increase, resulting in a growing need for caregivers. This study aims to quantify and compare the humanistic burden of caregivers of AD/dementia patients with caregivers of patients with other conditions in Japan. MATERIALS AND METHODS This cross-sectional study used data from the 2018 Japan National Health and Wellness Survey (NHWS). Outcome measures included the Short-Form 12-item Health Survey (SF-12) for health-related quality-of-life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, impact of health on productivity and activity, and evaluation of depression and anxiety. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects. RESULTS A total of 805 caregivers of AD/dementia patients, 1,099 other caregivers, and 27,137 non-caregivers were identified. Both AD/dementia caregivers and other caregivers had lower HRQoL and EQ-5D scores, higher total activity impairment, and more caregivers tended to experience anxiety than non-caregivers. There were no significant differences in the involvment in basic and instrumental activities of daily living (ADL) between AD/dementia caregivers and caregivers of other conditions. Notably, AD/dementia caregivers were more involved in making treatment decisions and finance management than other caregivers. Among AD/dementia caregivers caring for one patient, 395 patients lived in the community and 282 in an institution. AD/dementia caregivers whose patients lived in the community were more significantly involved in basic and instrumental ADL. Caregivers of patients with both AD/dementia and cancer had higher caregiving burden than caregivers of patients with either condition. CONCLUSIONS Caregivers of AD/dementia patients in Japan reportedly experienced significant humanistic burden which is associated with patients' living arrangements and the presence of an additional chronic condition. Therefore, provision of effective care/support is essential to relieve the burden experienced by the caregivers.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | | | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Durepos P, Ploeg J, Sussman T, Akhtar-Danesh N, Kaasalainen S. "A Crazy Roller Coaster at the End": A Qualitative Study of Death Preparedness With Caregivers of Persons With Dementia. SAGE Open Nurs 2020; 6:2377960820949111. [PMID: 33415300 PMCID: PMC7774442 DOI: 10.1177/2377960820949111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 07/19/2020] [Indexed: 12/22/2022] Open
Abstract
Introduction Caregivers of persons with dementia experience challenges that can make
preparing for end-of-life particularly difficult. Feeling prepared for death
is associated with caregiver well-being in bereavement and is promoted by
strategies supporting a palliative approach. Further conceptualization of
caregiver preparedness for death of persons with dementia is needed to guide
the practice of healthcare providers and to inform development of a
preparedness questionnaire. Objectives We aimed to: 1) explore the end-of-life experiences of caregivers of persons
with dementia to understand factors perceived as influencing preparedness;
and 2) identify the core concepts (i.e., components), barriers and
facilitators of preparedness for death. Methods This study used an interpretive descriptive design. Semi-structured
interviews were conducted with sixteen bereaved caregivers of persons with
dementia, recruited from long-term care homes in Ontario. Data was analyzed
through reflexive thematic analysis. Findings Four themes were interpreted including: ‘A crazy rollercoaster at the end’
which described the journey of caregivers at end-of-life. The journey
provided context for the development of core concepts (i.e., components) of
preparedness represented by three themes: ‘A sense of control, ‘Doing right’
and ‘Coming to terms’. Conclusion The study findings serve to expand the conceptualization of preparedness and
can guide improvements to practice in long-term care. Core concepts,
facilitators and influential factors of preparedness will provide the
conceptual basis and content to develop the Caring Ahead: Preparing for
End-of-Life with Dementia questionnaire.
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Affiliation(s)
- Pamela Durepos
- School of Nursing, Faculty of Health Sciences, McMaster University.,Canadian Frailty Network, Kingston, Ontario, Canada.,Hamilton Health Sciences Corporation, Hamilton, Ontario, Canada
| | - Jenny Ploeg
- School of Nursing, Faculty of Health Sciences, McMaster University.,Aging, Community and Health Research Unit, Hamilton, Ontario, Canada
| | | | - Noori Akhtar-Danesh
- School of Nursing, Faculty of Health Sciences, McMaster University.,Aging, Community and Health Research Unit, Hamilton, Ontario, Canada
| | - Sharon Kaasalainen
- School of Nursing, Faculty of Health Sciences, McMaster University.,Aging, Community and Health Research Unit, Hamilton, Ontario, Canada
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38
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Yang WFZ, Liu J, Chan YH, Griva K, Kuparasundram S, Mahendran R. Validation of the Needs Assessment of Family Caregivers-Cancer scale in an Asian population. BMC Psychol 2020; 8:84. [PMID: 32787927 PMCID: PMC7424999 DOI: 10.1186/s40359-020-00445-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 07/20/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The Needs Assessment of Family Caregivers- Cancer (NAFC-C) scale is shown to have adequate psychometric properties in assessing family caregiver needs during the cancer journey and its psychometric properties have been studied only in Western populations. This study sought to validate the NAFC-C in an Asian population for wider applicability. METHODS Participants (n = 363) completed questions on sociodemographics, the Depression Anxiety Stress Scale, the Zarit Burden Interview, the Caregiver Quality of Life Index-Cancer scale, and the NAFC-C. RESULTS Results revealed good internal consistency, test-retest reliability, and concurrent validity of the NAFC-C. Confirmatory factor analysis did not demonstrate a good fit of the NAFC-C in our sample. Exploratory factor analysis revealed a similar factor structure in this study's population. Further reliability and validity analyses with the EFA factor structure demonstrated similar reliability and validity assessments. CONCLUSIONS The NAFC-C is shown to be applicable in an Asian population. It would be a useful instrument for determining family caregivers' needs and to inform future interventions to address those needs and improve or maintain quality of life in both patients and their caregivers.
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Affiliation(s)
- Winson Fu Zun Yang
- National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074 Singapore
- Department of Psychological Science, Texas Tech University, Box 42051, Lubbock, TX 79409-2051 USA
| | - Jianlin Liu
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, Faculty of Medicine, National University of Singapore, Singapore, Singapore
- Institute of Mental Health, 10 Buangkok View, Buangkok Green Medical Park, Singapore, 539747 Singapore
| | - Yiong Huak Chan
- Dean’s Office, Yong Loo Lin School of Medicine, National University of Singapore, NUHS Tower Block, Level 11, 1E Kent Ridge Road, Singapore, 119228 Singapore
| | - Konstadina Griva
- Lee Kong Chian School of Medicine, Imperial College & Nanyang Technological University, 59 Nanyang Drive, Experimental Medicine Building, Singapore, 636921 Singapore
| | - Sangita Kuparasundram
- SingHealth Residency, Ministry of Health Holdings, 1 Maritime Square, Singapore, 009253 Singapore
| | - Rathi Mahendran
- National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074 Singapore
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, Faculty of Medicine, National University of Singapore, Singapore, Singapore
- Academic Development Department, Duke-NUS Medical School, 8 College Road, Singapore, 169857 Singapore
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39
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Sampson EL, Anderson JE, Candy B, Davies N, Ellis-Smith C, Gola A, Harding R, Kenten C, Kupeli N, Mead S, Moore KJ, Omar RZ, Sleeman KE, Stewart R, Ward J, Warren JD, Evans CJ. Empowering Better End-of-Life Dementia Care (EMBED-Care): A mixed methods protocol to achieve integrated person-centred care across settings. Int J Geriatr Psychiatry 2020; 35:820-832. [PMID: 31854477 DOI: 10.1002/gps.5251] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/07/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVES Globally, the number of people with dementia who have palliative care needs will increase fourfold over the next 40 years. The Empowering Better End-of-Life Dementia Care (EMBED-Care) Programme aims to deliver a step change in care through a large sequential study, spanning multiple work streams. METHODS We will use mixed methods across settings where people with dementia live and die: their own homes, care homes, and hospitals. Beginning with policy syntheses and reviews of interventions, we will develop a conceptual framework and underpinning theory of change. We will use linked data sets to explore current service use, care transitions, and inequalities and predict future need for end-of-life dementia care. Longitudinal cohort studies of people with dementia (including young onset and prion dementias) and their carers will describe care transitions, quality of life, symptoms, formal and informal care provision, and costs. Data will be synthesised, underpinned by the Knowledge-to-Action Implementation Framework, to design a novel complex intervention to support assessment, decision making, and communication between patients, carers, and inter-professional teams. This will be feasibility and pilot tested in UK settings. Patient and public involvement and engagement, innovative work with artists, policymakers, and third sector organisations are embedded to drive impact. We will build research capacity and develop an international network for excellence in dementia palliative care. CONCLUSIONS EMBED-Care will help us understand current and future need, develop novel cost-effective care innovations, build research capacity, and promote international collaborations in research and practice to ensure people live and die well with dementia.
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Affiliation(s)
- Elizabeth L Sampson
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,Barnet Enfield and Haringey Mental Health Trust Liaison Psychiatry Team, North Middlesex University Hospital, London, UK
| | - Janet E Anderson
- Department of Adult Nursing, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Bridget Candy
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Nathan Davies
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK.,Centre for Population Ageing Studies, Research Department of Primary Care and Population Health, University College London, London, UK
| | - Clare Ellis-Smith
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Anna Gola
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Charlotte Kenten
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Nuriye Kupeli
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Simon Mead
- National Prion Clinic, National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Foundation Trust, London, UK.,MRC Prion Unit at UCL, Institute of Prion Diseases, UCL, London, UK
| | - Kirsten J Moore
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Rumana Z Omar
- Department of Statistical Science, University College London, London, UK
| | - Katherine E Sleeman
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Robert Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Jane Ward
- Marie Curie Palliative Care Research Department, Division of Psychiatry, University College London, London, UK
| | - Jason D Warren
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Catherine J Evans
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,Sussex Community NHS Foundation Trust, Brighton, UK
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40
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Li Z, Tse M, Tang A. The Effectiveness of a Dyadic Pain Management Program for Community-Dwelling Older Adults with Chronic Pain: A Pilot Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144966. [PMID: 32660159 PMCID: PMC7400324 DOI: 10.3390/ijerph17144966] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023]
Abstract
Background: Chronic pain is a major health problem among older adults and their informal caregivers, which has negative effects on their physical and psychological status. The dyadic pain management program (DPMP) is provided to community-dwelling older adults and informal caregivers to help the dyads reduce pain symptoms, improve the quality of life, develop good exercise habits, as well as cope and break the vicious circle of pain. Methods: A pilot randomized controlled trial was designed and all the dyads were randomly divided into two groups: the DPMP group and control group. Dyads in the DPMP group participated in an 8-week DPMP (4-week face-to-face program and 4-week home-based program), whereas dyads in the control group received one page of simple pain-related information. Results: In total, 64 dyads participated in this study. For baseline comparisons, no significant differences were found between the two groups. After the interventions, the pain score was significantly reduced from 4.25 to 2.57 in the experimental group, respectively. In the repeated measures ANOVA, the differences in pain score (F = 107.787, p < 0.001, d = 0.777) was statistically significant for the group-by-time interaction. After the interventions, the experimental group participants demonstrated significantly higher pain self-efficacy compared with the control group (F = 80.535, p < 0.001, d = 0.722). Furthermore, the elderly increased exercise time significantly (F = 111.212, p < 0.001, d = 0.782) and reported developing good exercise habits. Conclusions: These results provide preliminary support for the effectiveness of a DPMP for relieving the symptoms of chronic pain among the elderly.
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Affiliation(s)
| | - Mimi Tse
- Correspondence: ; Tel.: +85-2-2766-6541
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41
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Brites R, Brandão T, Moniz Pereira F, Hipólito J, Nunes O. Effects of supporting patients with dementia: A study with dyads. Perspect Psychiatr Care 2020; 56:614-620. [PMID: 31970779 DOI: 10.1111/ppc.12476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 01/11/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE This study aimed to examine the factors associated with the development of higher burden in informal caregivers of patients with dementia, using dyadic data. DESIGN AND METHODS Seventy-two dyads of patients with dementia and their informal caregivers were assessed, the former in terms of behavioral-psychological symptoms and autonomy, the latter in terms of burden and individual needs. FINDINGS Caregivers at risk for developing higher burden are those who are female, whose care recipient present psychiatric symptoms and lower autonomy, and those who recognize the need for more information/support. PRACTICE IMPLICATIONS Interventions should offer caregivers the tools to provide care, maintaining their psychological well-being. Interventions should target not only common aspects of caregiver burden but also the specificities of caring for a person with dementia.
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Affiliation(s)
- Rute Brites
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal.,Centro de Psicologia, Universidade do Porto, Porto, Portugal
| | - Francisco Moniz Pereira
- Centro Hospitalar Psiquiátrico de Lisboa, Departamento de Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - João Hipólito
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
| | - Odete Nunes
- Departamento de Psicologia, Centro de Investigação em Psicologia, Universidade Autónoma de Lisboa, Lisboa, Portugal
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Defining the content of a minimal dataset for acquired brain injury using a Delphi procedure. Health Qual Life Outcomes 2020; 18:30. [PMID: 32066447 PMCID: PMC7027079 DOI: 10.1186/s12955-020-01286-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 02/10/2020] [Indexed: 12/17/2022] Open
Abstract
Background The lack of consistency in outcome measurement within the field of acquired brain injury (ABI) leads to incomparability of collected data and, consequently, reduced generalisation of findings. We aim to develop a set of standardised measures which can be used to obtain the minimum amount of data necessary to characterise ABI-patients across all healthcare sectors and disciplines and in every stage of recovery; i.e., an ABI-specific minimal dataset (MDS-ABI). The current study was conducted to identify the core outcome domains for adults with ABI (what to measure?) and to select the most suitable measurements within these domains (how to measure it?). Methods An initial comprehensive set of outcome domains and measurement instruments relevant for measuring the consequences of ABI was identified by a literature study. The selection of relevant domains was based on the International Classification of Functioning, Disability and Health framework. Measurement instruments were included in the Delphi procedure when they met pre-set requirements. A three-round Delphi study was conducted among Dutch experts (n = 48) using iterative web-based surveys to prioritise the proposed domains and instruments for the MDS-ABI. Throughout all rounds, participants could recommend additional or alternative domains and measurement instruments, and were fed back the collated group responses of the previous round. Results Response rates ranged from 89 to 100%. After three rounds, the expert panel reached consensus (≥51%) on the inclusion of 12 outcome domains (demographics, injury characteristics, comorbidity, cognitive functioning, emotional functioning, energy, mobility, self-care, communication, participation, social support and quality of life), measured with six measurement instruments, two screening questions and a registry of demographic- and injury information. No consensus was reached on how to measure quality of life. Conclusions The current study achieved consensus on the content of a minimal dataset for patients with ABI. The current version of the MDS-ABI will be evaluated and optimised if necessary in the near future.
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Rabiei L, Eslami AA, Abbasi M, Afzali SM, Hosseini SM, Masoudi R. Evaluating the Effect of Family-Centered Intervention Program on Care Burden and Self-Efficacy of Hemodialysis Patient Caregivers Based on Social Cognitive Theory: A Randomized Clinical Trial Study. Korean J Fam Med 2020; 41:84-90. [PMID: 31958941 PMCID: PMC7093670 DOI: 10.4082/kjfm.18.0079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 05/14/2019] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Caregivers of hemodialysis patients spend a large amount of time providing care to these patients while tolerating fatigue and stress. This study evaluated a family-centered empowerment program on the care burden and self-efficacy of hemodialysis patient caregivers based on social cognitive theory. METHODS In this randomized clinical trial, 70 family caregivers of hemodialysis patients in Isfahan, Iran, were selected and randomly allocated to intervention and control groups, in 2015-2016. Two questionnaires were used to collect the family caregivers' characteristics, care burden, and self-efficacy, and patients' negative and positive outcomes expectancies. Data were analyzed using SPSS before, immediately after, and 2 months after the intervention. RESULTS There was no significant difference in the mean scores of care burden, positive outcomes expectancies, negative outcomes expectancies, and self-efficacy between the two groups before the intervention. However, there were significant differences in the post-test and follow-up data analyses (P<0.05). CONCLUSION Given the degenerative nature of chronic kidney disease, it can be considered as a source of long-term and chronic stress for caregivers. Therefore, by implementing an empowerment program, caregiving behaviors can be improved, positive outcomes expectancies can be increased, and negative outcomes expectancies can be reduced.
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Affiliation(s)
- Leili Rabiei
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ahmad Ali Eslami
- Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Abbasi
- Department of Nursing, School of Nursing and Midwifery, Qom Univers ity of Medical Sciences, Qom, Iran
| | - Seyed Mohammad Afzali
- Department of Nursing, School of Nursing and Midwifery, Shahrekord Univers ity of Medical Sciences, Shahrekord, Iran
| | - Seyed Masih Hosseini
- Department of Histology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Reza Masoudi
- Community-Oriented Nursing Midwifery Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Rodríguez-González AM, Rodríguez-Míguez E. A meta-analysis of the association between caregiver burden and the dependent’s illness. J Women Aging 2019; 32:220-235. [DOI: 10.1080/08952841.2019.1700728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Ana-María Rodríguez-González
- Department of Psychosocioeducational analysis and intervention, University of Vigo, Vigo, Spain
- Fundación Biomédica Galicia Sur, Vigo, Spain
- Department of Social work, Cantabrian Service Health, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Fundación Biomédica Galicia Sur, Vigo, Spain
- Department of Applied Economics, University of Vigo, Vigo, Spain
- Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
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45
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Perpiñá-Galvañ J, Orts-Beneito N, Fernández-Alcántara M, García-Sanjuán S, García-Caro MP, Cabañero-Martínez MJ. Level of Burden and Health-Related Quality of Life in Caregivers of Palliative Care Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4806. [PMID: 31795461 PMCID: PMC6926780 DOI: 10.3390/ijerph16234806] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 11/19/2019] [Accepted: 11/24/2019] [Indexed: 12/19/2022]
Abstract
The complexity of palliative care means that the emotional distress and burden that primary family caregivers suffer under can be particularly high. The objective of this study was to determine the level of burden endured by these primary family caregivers and to identify the variables that predict it in the caregiving relatives of people who require home-based palliative care. A descriptive-correlational cross-sectional study was conducted. Socio-demographic and clinical data were collected from caregivers through a self-administered questionnaire that included questions from the 12-Item Short Form Health Survey (SF-12), Zarit Caregiver Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS), Brief Resilient Coping Scale (BRCS), Post Traumatic Growth Inventory (PTGI), and Fatigue Assessment Scale (FAS). A total of 77 caregivers participated; 66.2% were women, and the mean age was 61.5 years. Most (62.3%) were providing care to cancer patients. From among these data, the presence of anxiety as a clinical problem (48.1%), a high average fatigue score (FAS) of 23.0 (SD = 8.5), and the prevalence of intense overload (41.6%) stood out. We found statistically significant correlations between the variables of burden, fatigue, post-traumatic growth, anxiety, and depression, with the latter two being the main predictive variables of burden. In addition, caregiver burden was associated with a worsening of health. Identifying the factors that influence the appearance of overburden will allow the specific needs of careers to be assessed in order to offer them emotional support within the healthcare environment.
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Affiliation(s)
- Juana Perpiñá-Galvañ
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | - Núria Orts-Beneito
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | - Manuel Fernández-Alcántara
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
- Department of Health Psychology, University of Alicante, 03690 Alicante, Spain
| | - Sofía García-Sanjuán
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
| | | | - María José Cabañero-Martínez
- Department of Nursing, University of Alicante, 03690 Alicante, Spain; (J.P.-G.); (S.G.-S.); (M.J.C.-M.)
- Institute of Health and Biomedical Research of Alicante (ISABIAL-FISABIO Foundation), 03010 Alicante, Spain;
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46
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Kent ML, Jannace K, Highland KB, Dimarzio M, Tran J, Gonzalez S, Buckenmaier CC. Caregiver Patient Reported Outcomes Measurement Information System (PROMIS) profiles in patients undergoing total joint arthroplasty and spine surgery: a prospective observational cohort study. Reg Anesth Pain Med 2019:rapm-2019-100380. [PMID: 31694933 DOI: 10.1136/rapm-2019-100380] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2019] [Revised: 05/08/2019] [Accepted: 05/29/2019] [Indexed: 11/03/2022]
Abstract
BACKGROUND/OBJECTIVE The role of caregiver psychosocial characteristics and their relation to postsurgical caregiving capability remains unclear. The objective of this study was to explore caregiver psychosocial variables following surgery of patients undergoing total joint arthroplasty and spine surgery. METHODS A prospective observational study was conducted where questionnaires were administered to caregivers preoperatively and 1 week/2 weeks/1 month postoperatively. Measures included demographics, caregiver activities and National Institutes of Health Patient Reported Outcomes Measurement Information System (NIH PROMIS) item banks. Bivariate analysis assessed differences between participants reporting baseline pain and those reporting no baseline pain. Generalized estimating equation models examined PROMIS T-scores across time. RESULTS 190 caregivers were enrolled and completed surveys. 18% of caregivers reported experiencing a painful condition where they experienced pain during most days of the week. Across all time points, the majority of caregivers reported no worse than mild impairment across PROMIS scores. Compared with baseline, caregivers reported lower PROMIS satisfaction with social roles across all postoperative time points (p<0.001) and higher depression and fatigue at postoperative day 7 (p=0.002) and 14 (p=0.006). PROMIS sleep disturbance was only higher at day 7 (p=0.01). Caregivers reporting a baseline pain condition reported PROMIS scores indicative of higher anxiety (p=0.02), depression (p=0.003), sleep disturbances (p<0.001) and fatigue (p<0.001) and lower levels of satisfaction with social roles (p=0.002) compared with those caregivers without baseline pain. CONCLUSION While there were transient worsening in PROMIS scores, it is unclear whether these were clinically meaningful. Postsurgical caregivers reporting baseline pain were characterized by worse functioning across all PROMIS scales.
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Affiliation(s)
- Michael L Kent
- Anesthesiology, Duke University Hospital, Durham, North Carolina, USA
| | - Kalyn Jannace
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
| | - Krista B Highland
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
| | - Maria Dimarzio
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
| | - Julie Tran
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
| | - Sara Gonzalez
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
| | - Chester C Buckenmaier
- Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
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48
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Bosch L, Kanis M, Dunn J, Stewart KA, Kröse B. How Is the Caregiver Doing? Capturing Caregivers' Experiences With a Reflective Toolkit. JMIR Ment Health 2019; 6:e13688. [PMID: 31140435 PMCID: PMC6707576 DOI: 10.2196/13688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 04/03/2019] [Accepted: 04/04/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND This paper describes the Co-Care-KIT, a reflective toolkit designed to provide insights into the diverse experiences of home-based informal caregivers during the delivery of care to a relative or loved one. OBJECTIVE The aim of this study was to evaluate the toolkit, including a custom-designed journal, tools for photography-based experience sampling, and heart rate tracking, which enables caregivers to collect and reflect on their positive and negative daily experiences in situ. METHODS A 2-week field study with informal caregivers (N=7) was conducted to evaluate the Co-Care-KIT and to capture their daily personal emotional experiences. The collected data samples were analyzed and used for collaborative dialogue between the researcher and caregiver. RESULTS The results suggest that the toolkit (1) increased caregivers' awareness of their own well-being through in situ reflection on their experiences; (2) empowered caregivers to share their identities and experiences as a caregiver within their social networks; (3) enabled the capturing of particularly positive experiences; and (4) provided caregivers reassurance with regards to their own mental health. CONCLUSION By enabling capturing and collaborative reflection, the kit helped to gain a new understanding of caregivers' day-to-day needs and emotional experiences.
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Affiliation(s)
- Lilian Bosch
- Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Marije Kanis
- Amsterdam University of Applied Sciences, Amsterdam, Netherlands
| | - Julia Dunn
- Duke University, Durham, NC, United States
| | | | - Ben Kröse
- Amsterdam University of Applied Sciences, Amsterdam, Netherlands
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Choi S, Seo J. Analysis of caregiver burden in palliative care: An integrated review. Nurs Forum 2019; 54:280-290. [PMID: 30737798 DOI: 10.1111/nuf.12328] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/03/2019] [Accepted: 01/21/2019] [Indexed: 05/17/2023]
Abstract
The inclusion of caregivers in a holistic care approach represents a basic principle in palliative care. However, many palliative care professionals have a lack of understanding of difficulties or unmet needs among caregivers. To enhance the quality of life of caregivers and the quality of care for patients, healthcare professionals should be better informed about the constructs of caregiver burden. The aim of this study is to synthesize the concept of caregiver burden in palliative care, providing implications for the caregivers and their support systems. This concept analysis study adopts the integrative review approach and the basic text analysis method (ie, word frequency). The PubMed, CINAHL, Embase, and PsycINFO databases are explored for eligible studies. From this literature search, 66 articles from 1998 to 2018 are located. After data collection is completed, the two authors independently evaluate the quality of studies published before 1 September 2018. The caregiver burden is then redefined with its attributes, antecedents, consequences, empirical referents, and facilitators. It is recommended that the multidimensional concept of caregiver burden in palliative care be measured by considering caregiver characteristics and the caregiving context.
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Affiliation(s)
- Soyoung Choi
- The Pennsylvania State University, College of Nursing, University Park, Pennsylvania
| | - JooYoung Seo
- The Pennsylvania State University, Learning and Performance Systems-Learning, Design, and Technology, University Park, Pennsylvania
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van der Steen JT, Lennaerts H, Hommel D, Augustijn B, Groot M, Hasselaar J, Bloem BR, Koopmans RTCM. Dementia and Parkinson's Disease: Similar and Divergent Challenges in Providing Palliative Care. Front Neurol 2019; 10:54. [PMID: 30915012 PMCID: PMC6421983 DOI: 10.3389/fneur.2019.00054] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2018] [Accepted: 01/16/2019] [Indexed: 12/29/2022] Open
Abstract
Dementia and Parkinson's disease are incurable neurological conditions. Patients often experience specific, complex, and varying needs along their disease trajectory. Current management typically employs a multidisciplinary team approach. Recognition is growing that this team approach should also address palliative care issues to optimize quality of life for patient and family caregivers, but it remains unclear how palliative care is best delivered. To inspire future service development and research, we compare the trajectories and conceptualization of palliative care between dementia and Parkinson's disease. Both Parkinson's disease and dementia are characterized by a protracted course, with progressive but fairly insidious development of disability. However, patients with Parkinson's disease may experience relatively stable periods initially but with time, a wide range of debilitating symptoms develops, many of which do not respond well to treatment. Eventually, dementia develops in most Parkinson patients, while motor disability develops in many dementia patients. In both diseases, symptoms such as pain, apathy, sleeping problems, falls, and a high caregiver burden are prevalent. Advance care planning has benefits in terms of being prepared before the disease progresses into a stage with communication problems or severe cognitive impairment. However, for both conditions, the protracted disease trajectories complicate conceptualization of palliative care through different stages of the disease, with pertinent questions such as when to offer what interventions pro-actively. Given the similarities and differences, we should develop palliative approaches that are partially generic and partially disease-specific. These should be integrated seamlessly with disease-specific care. Substantial research is already being performed on dementia palliative care. This may also inform the further development of palliative care for Parkinson's disease, including an evaluation of palliative interventions and services.
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Affiliation(s)
- Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
| | - Herma Lennaerts
- Departments of Neurology and Anesthesiology, Pain and Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Danny Hommel
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, Netherlands
- Groenhuysen Organisation, Roosendaal, Netherlands
| | | | - Marieke Groot
- Department of Anesthesiology, Pain and Palliative Care/Expertise Center for Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Jeroen Hasselaar
- Department of Anesthesiology, Pain and Palliative Care/Expertise Center for Palliative Care, Radboud university medical center, Nijmegen, Netherlands
| | - Bastiaan R. Bloem
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud university medical center, Nijmegen, Netherlands
| | - Raymond T. C. M. Koopmans
- Department of Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Radboudumc Alzheimer Center, Nijmegen, Netherlands
- De Waalboog “Joachim en Anna, ” Center for Specialized Geriatric Care, Nijmegen, Netherlands
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