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Lee Y, Vance DE, Batey DS. The Unique Challenges of Older Informal Caregivers Living With HIV in the U.S. Deep South: A Qualitative Study. J Assoc Nurses AIDS Care 2024; 35:409-421. [PMID: 39137418 DOI: 10.1097/jnc.0000000000000484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2024]
Abstract
ABSTRACT As people with HIV live longer and healthier, it has become more likely that they will assume a caregiver role for their families and/or friends. Yet, there is a significant gap in the literature that older caregivers with HIV (OCWH) have not received attention from practitioners and researchers. To fill the gap, our qualitative study was conducted with OCWH ( N = 19) to explore various themes such as adjustment to caregiving, caregiving responsibilities, HIV and other health issues, support systems, caregiving outcomes, needs assessment, cognitive health, and the impact of COVID-19. Results indicated that each OCWH faced their own unique challenges (e.g., severity of health conditions, intense caregiving responsibilities, caregiving situation, lack of social support/transportation/financial means), but they expressed positive and fulfilling caregiving outcomes. Understanding the lived experiences of OCWH is requisite to develop holistic service programs to meet their caregiving needs while supporting their HIV health and co-occurring health conditions.
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Affiliation(s)
- Yookyong Lee
- Yookyong Lee, PhD, MSW, is an Associate Professor, Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA. David E. Vance, PhD, MGS, is a Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. D. Scott Batey, PhD, MSW, is an Associate Professor, School of Social Work at Tulane University, New Orleans, Louisiana, USA
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2
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Petry SE, Lara L, Boucher NA. Older Caregivers: Who They Are and How to Support Them. J Aging Soc Policy 2024; 36:589-602. [PMID: 35290168 DOI: 10.1080/08959420.2022.2051683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 11/12/2021] [Indexed: 10/18/2022]
Abstract
Caregivers play a crucial role in providing health and social supports to their family and friends. Older adults who take on caregiving roles are themselves uniquely vulnerable to negative health and financial effects due to their age and underlying health risks. Many caregivers do not receive adequate support - either formally or informally - exacerbating the strains of providing care. Racial and ethnic minority caregivers may be less likely to report receiving support in their role and face additional challenges. We describe these caregivers over 65 and the burdens they face. We recommend community health workers, direct compensation, and normalization of respite care to support these essential care workers in their role and as they age.
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Affiliation(s)
- Sarah E Petry
- Doctoral Student, Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
| | - Luz Lara
- Director of Senior Services, Union Settlement, New York, New York, USA
| | - Nathan A Boucher
- Doctoral Student, Sanford School of Public Policy, Duke University, Durham, North Carolina, USA
- Health Research Specialist, Center of Innovation to Accelerate Discovery and Practice Transformation (ADAPT), Durham, North Carolina, USA
- Associate Professor, School of Medicine, Duke University, Durham, North Carolina, USA
- Core Faculty, Duke- Duke University, Durham, North Carolina, USA
- Senior Fellow, Center for the Study of Aging and Human Development, Duke University School of Medicine, Durham, North Carolina, USA
- Associate Research Professor, Sanford School of Public Policy, Duke University, Durham, USA
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Swartzell KL, Fulton JS, von Gaudecker JR. Older Adult Caregivers' Perspectives on Wound Care Resources: A Qualitative Study. Res Gerontol Nurs 2023; 16:194-201. [PMID: 37159391 DOI: 10.3928/19404921-20230503-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
With an aging population, increasing numbers of older adults are assuming a caregiving role, including performing complex care procedures, such as wound care. Access to and use of resources are associated with better physical and mental health for caregivers. A thematic analysis of qualitative interviews with adult caregivers aged ≥65 years performing wound care identified seven resources supportive of the caregiver role, including: (a) access to expert guidance from health care professionals; (b) written instructions; (c) relationships with health care professionals for obtaining wound care supplies; (d) need for additional medical equipment; (e) financial resources; (f) coverage for caregiver personal time; and (g) select persons for caregiver social and emotional support. Given that older adults are increasingly cast into caregiver roles in the home setting, providing resources to sustain care recipients and their caregivers is critical. [Research in Gerontological Nursing, 16(4), 194-201.].
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Arlotto S, Gentile S, Blin A, Durand AC, Bonin-Guillaume S. Caregiver Burden Is Reduced by Social Support Services for Non-Dependent Elderly Persons: Pre-Post Study of 569 Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13610. [PMID: 36294190 PMCID: PMC9603317 DOI: 10.3390/ijerph192013610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 10/17/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Informal care provided by family caregivers (FCGs) to elderly persons is associated with a high risk of burden and poor health status. Social support services (3S) for the elderly persons were characterized by assistance in various activities of daily living. This study aimed to analyze the impact of 3S on the burden of FCGs of elderly persons living in the community and identify factors associated with changes in their burden. METHODS This pre-post study was performed in the southeast of France: FCGs of non-dependent elderly persons still living at home who received a 3S were consecutively included. FCG burden was assessed with the Mini-Zarit scale before the setting up of the 3S (pre-3S) and 6 months after (post-3S). RESULTS A total of 569 FCGs were included in the study. Mean age of the FCGs was 62.9 years old (±13.3), 67% were women, 61.2% were children or stepchildren. Burden was present for 81% of FCGs. In most cases, 3S targeted household chores (95.8%); 59.8% of elderly persons and their FCGs were fully satisfied. The improvement in burden was greater for FCGs perceiving less obstacles post-3S in helping elderly persons (OR = 4.083) but also for FCGs fully satisfied with the 3S (OR = 2.809) and for FCGs whose perceived health status had improved post-3S (OR = 2.090). CONCLUSIONS FCGs of non-dependent elderly persons experience a burden similar to those of dependent elderly persons. The implementation of a 3S in daily life helps to reduce their burden.
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Affiliation(s)
- Sylvie Arlotto
- Service d’Evaluation Médicale, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
- Health Service Research and Quality of Life Center (EA 3279), School of Medicine, La Timone Medical Campus, Aix Marseille University, 13005 Marseille, France
| | - Stéphanie Gentile
- Service d’Evaluation Médicale, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
- Health Service Research and Quality of Life Center (EA 3279), School of Medicine, La Timone Medical Campus, Aix Marseille University, 13005 Marseille, France
| | - Alice Blin
- Service d’Evaluation Médicale, Assistance Publique Hôpitaux de Marseille, 13005 Marseille, France
| | - Anne-Claire Durand
- Health Service Research and Quality of Life Center (EA 3279), School of Medicine, La Timone Medical Campus, Aix Marseille University, 13005 Marseille, France
| | - Sylvie Bonin-Guillaume
- Neurosciences of Systems UMR-Inserm 1106, Aix Marseille University, 13005 Marseille, France
- Internal Medicine and Geriatric Department, Hôpitaux Universitaires de Marseille, Assistance Publique Hôpitaux de Marseille, 13009 Marseille, France
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Zachariou A, Filiponi M, Kaltsas A, Dimitriadis F, Champilomatis I, Paliouras A, Tsounapi P, Mamoulakis C, Takenaka A, Sofikitis N. Mirabegron Alleviates the Degree of Burden Experienced by Caregivers of Older Females with Mixed or Urge Incontinence: A Prospective Study. Clin Interv Aging 2021; 16:291-299. [PMID: 33628016 PMCID: PMC7897712 DOI: 10.2147/cia.s283737] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 01/12/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose Older people, especially women, have the highest known prevalence of urinary incontinence (UI) of any other age-group. Continual care provision for elderly incontinent females is an incredibly arduous process, yet only very few studies have investigated the issue. Aim of the study was to evaluate the impact of mirabegron’s treatment on the degree of burden experienced by caregivers of elderly female patients with UI. Patients and Methods A hundred and eighty-six caregivers of older females with mixed or urgency UI besides various conditions (strokes, post-operative recovery after major surgery, etc.) were included in the study. Group A comprised 91 patients that did not want to receive any treatment for UI. Group B consisted of 95 elderly females treated for UI with mirabegron 50 mg/daily for three months. All caregivers completed the Zarit Burden Scale (ZBS) questionnaire at the outset and after the three months. All patients completed a bladder diary at the beginning and at the end of the observation/medication period. Results Patients receiving mirabegron presented a statistically significant improvement in UI parameters. Their caregivers showed a statistically significant decrease in the ZBS total score as well as separate domains. Conclusion This pilot study confirms that mirabegron administration can improve the quality of life of older females suffering from UI while substantially relieving caregiver burden. Recognizing the physical and emotional reactions of caregivers may help health providers deliver better support and resources to meet the needs of caregivers and patients alike.
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Affiliation(s)
- Athanasios Zachariou
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece.,Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Maria Filiponi
- Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Aris Kaltsas
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece.,Incontinence Unit, Physical Medicine and Rehabilitation Centre EU PRATTEIN, Volos, Greece
| | - Fotios Dimitriadis
- 1 Urology Department, School of Medicine, Aristotle University, Thessaloniki, Greece
| | | | | | - Panagiota Tsounapi
- Urology Department, School of Medicine, Tottori University, Yonago, Japan
| | | | - Atsushi Takenaka
- Urology Department, School of Medicine, Tottori University, Yonago, Japan
| | - Nikolaos Sofikitis
- Urology Department, School of Medicine, Ioannina University, Ioannina, Greece
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Cohen SA, Sabik NJ, Cook SK, Azzoli AB, Mendez-Luck CA. Differences within Differences: Gender Inequalities in Caregiving Intensity Vary by Race and Ethnicity in Informal Caregivers. J Cross Cult Gerontol 2020; 34:245-263. [PMID: 31407137 DOI: 10.1007/s10823-019-09381-9] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Among the 50+ million informal caregivers in the US, substantial gender, racial/ethnic, and socioeconomic disparities in caregiving intensity are well-documented. However, those disparities may be more nuanced: gender disparities in caregiving intensity may vary by race/ethnicity (White, Black, and Hispanic) and socioeconomic status (SES). We used data from the 2011 National Study of Caregiving and applied generalized linear models to estimate associations between three measures of caregiver intensity (ADLs, IADLs, and hours caregiving/month) and the three sociodemographic factors with their interaction terms. Black female caregivers provided significantly higher levels of care than White females and males for both IADL caregiving and hours/month spent caregiving. Black caregivers spent an average of 28.5 more hours/month (95%CI 1.7-45.2) caregiving than White caregivers. These findings highlight the need to understand the complex disparities within population subgroups and how intersections between gender, race/ethnicity, and SES can be used to develop effective policies to reduce disparities and improve caregiver quality-of-life.
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Affiliation(s)
- Steven A Cohen
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI, USA.
| | - Natalie J Sabik
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, RI, USA
| | - Sarah K Cook
- Vanderbilt Institute for Clinical and Translational Research, Nashville, TN, USA
| | | | - Carolyn A Mendez-Luck
- College of Public Health and Human Sciences, Oregon State University, 401 Waldo Hall, Corvallis, OR, USA
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Trends in Geospatial Drivers of Fall-Related Hospitalizations and Asset Mapping of Fall Prevention Interventions for Vulnerable Older Adults. J Aging Health 2019; 32:328-339. [DOI: 10.1177/0898264318822381] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Objective: Given that one in four older adults suffer potentially preventable falls annually, we aimed to identify areas with (a) delivery gaps of evidence-based programs (EBPs) targeting fall prevention among older adults, namely A Matter of Balance (AMOB), and (b) high rates of fall-related hospitalizations—hotspots. Method: Analyses included multiple geospatially linked datasets. Results: EBPs were delivered ≥1 time in 84 counties in 2012 and 90 counties in 2014. Factors associated with EPB delivery gaps (absence; p<.05) included high-density older adult areas, non-fall-related hospitalization hotspots, lower population density, nonmetropolitan areas, high-density Hispanic adult areas, and areas with limited access to home health care agencies. Hotspots for fall-related hospitalization numbered 64 in 2012 and 62 in 2014. Factors associated with hotspots included low-density older adult areas, having AMOB delivered ≥1 time annually, high population density, and high-density Hispanic adult areas. Discussion: In resource-finite settings (e.g., the aging services sector), identifying high priority areas allows for precise allocation of limited resources.
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Oliveira D, Sousa L, Aubeeluck A. What would most help improve the quality of life of older family carers of people with dementia? A qualitative study of carers' views. DEMENTIA 2018; 19:939-950. [PMID: 30079764 DOI: 10.1177/1471301218791906] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Older family carers of people with dementia provide a substantial amount of care for people with dementia in the UK. Caregiving can be stressful and burdensome for these individuals, who are also experiencing psychological and physical changes resulting from their own ageing process. However, little is known about what impacts their quality of life, how this can be improved and what we should prioritise. This brief report asks one simple question to older family carers of people living with dementia – “What would most help improve your quality of life as a carer?” Qualitative data were collected from 150 carers who completed an anonymous paper survey during the development and validation of a quality of life tool for use with this population (DQoL-OC). Participants were individuals aged 60 and over and were providing care for a family member with dementia at home in the UK. Carers were recruited from a variety of voluntary organizations, community-based carers’ groups, health services and via online forums. A thematic approach was used to analyse the carers’ comments and three main overarching themes were identified. The quality of life of older family carers can be enhanced by having more time away from caregiving, accessing health and social services that are dementia friendly and by having economic support. Future care, policies and research should aim to address these key areas in order to promote better quality of life for older carers of people with dementia. Further implications for practice, policy and research are discussed.
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Affiliation(s)
- Deborah Oliveira
- Institute of Mental Health, Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
| | - Lidia Sousa
- Department of Psychiatry and Mental Health, Santa Maria University Hospital, Lisbon, Portugal
| | - Aimee Aubeeluck
- Faculty of Medicine & Health Sciences, University of Nottingham, Nottingham, UK
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Kalomo EN, Lee KH, Lightfoot E, Freeman R. Resilience among older caregivers in rural Namibia: The role of financial status, social support and health. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:605-622. [PMID: 29683784 DOI: 10.1080/01634372.2018.1467524] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Namibia has one of the highest human immunodeficiency virus (HIV) prevalence rates and one of the highest rates of orphanhood in the world, and older caregivers provide much of the care to Namibians living with HIV and acquired immune deficiency syndrome (AIDS) (UNAIDS, 2014). In this study, the authors explore how financial status, social support, and health were related to the resilience of caregivers caring for people affected by HIV and AIDS in rural northern Namibia, Africa. METHOD Data were collected through a structured interview from (N = 147) caregivers from the Zambezi region. RESULTS Findings from this study show that employment and physical health were significantly associated with increased resilience in older caregivers. DISCUSSION Our findings point to the need for employment assistance and health services to improve the resilience of caregivers caring for people living with HIV and AIDS. We conclude that there is a need for more vigorous concerted efforts from public and private sector practitioners and policy makers to create more sustained formal employment opportunities and intervention programs aimed at improving the overall health of older HIV caregivers, especially those residing in rural HIV endemic communities in developing countries.
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Affiliation(s)
| | - Kyoung Hag Lee
- a School of Social Work , Wichita State University , Fairmount
| | | | - Rachel Freeman
- c Department of Social Work , University of Namibia , Windhoek , Namibia
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10
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Zale EL, Heinhuis TJ, Tehan T, Salgueiro D, Rosand J, Vranceanu AM. Resiliency is independently associated with greater quality of life among informal caregivers to neuroscience intensive care unit patients. Gen Hosp Psychiatry 2018; 52:27-33. [PMID: 29549820 DOI: 10.1016/j.genhosppsych.2018.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 02/22/2018] [Accepted: 02/27/2018] [Indexed: 02/08/2023]
Abstract
OBJECTIVE Every year, millions of Americans become informal caregivers to loved ones admitted to Neuroscience Intensive Care Units (Neuro-ICU), and face challenges to Quality of Life (QoL). This study sought to identify associations between resiliency, distress, and caregiver QoL at time of Neuro-ICU admission. METHODS Informal caregivers (N = 79, Mage = 53, 64% female) of Neuro-ICU patients were recruited and completed self-report questionnaires during the hospitalization. We used hierarchical regression to test relative contributions of caregiver mindfulness, perceived coping abilities, and preparedness for caregiving to caregiver QoL, above-and-beyond non-modifiable patient and caregiver factors (e.g., gender) and caregiver psychological distress (i.e., anxiety, depression, history of mental health conditions). RESULTS Preparedness for caregiving was uniquely and positively associated with Physical Health QoL (sr2 = 0.07, p = 0.001), Social QoL (sr2 = 0.05, p = 0.021), and Environmental QoL (sr2 = 0.14, p < 0.001), even after accounting for psychological distress. Mindfulness was uniquely and positively associated with Physical Health QoL (sr2 = 0.12, p < 0.001) and Psychological QoL (sr2 = 0.07, p = 0.004), above-and-beyond variance accounted for by psychological distress. CONCLUSIONS Mindfulness and preparedness for caregiving emerged as consistent, unique resiliency factors associated with greater caregiver QoL across QoL dimensions. Results highlight the importance of resiliency factors in QoL among Neuro-ICU caregivers and the need for early interventions to support resiliency.
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Affiliation(s)
- Emily L Zale
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Tessa J Heinhuis
- Psychology Department, University of Amsterdam, Amsterdam, Netherlands
| | - Tara Tehan
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Danielle Salgueiro
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Jonathan Rosand
- Neuroscience Intensive Care Unit, Institute for Brain Health, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Department of Psychiatry, Integrated Brain Health Clinical and Research Program, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
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Saban KL, Griffin JM, Urban A, Janusek MA, Pape TLB, Collins E. Perceived health, caregiver burden, and quality of life in women partners providing care to Veterans with traumatic brain injury. ACTA ACUST UNITED AC 2018; 53:681-692. [PMID: 27997670 DOI: 10.1682/jrrd.2015.07.0143] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 12/17/2015] [Indexed: 11/05/2022]
Abstract
Families of Veterans with traumatic brain injury (TBI) are often faced with providing long-term informal care to their loved one. However, little is known about how their perceived health and caregiving burden contribute to their quality of life (QOL). The purpose of this descriptive study was to describe perceived health, somatic symptoms, caregiver burden, and perceived QOL and to identify the extent to which these variables are associated with QOL in female partners/spouses of Veterans with TBI. Participants completed a written questionnaire including the Patient Health Questionnaire-15, Caregiver Reaction Assessment, Quality of Life Index, and the general health subscale of the 12-Item Short Form Survey version 2. Caregivers reported moderate levels of QOL, and over a quarter of the sample reported high levels of somatic symptoms, particularly fatigue and sleep disturbance. Age, perceived general health, somatic symptoms, the five subscales of caregiver burden (self-esteem, disrupted schedule, effect on finances, lack of family support, and effect on health) predicted QOL and explained 64% of its variance (adjusted r2 = 0.64, F(8,31) = 9.59). However, only somatic symptoms and the caregiver burden subscales of self-esteem and effect on finances were significant predictors in the model. These findings have implications for development of family-centered interventions to enhance the QOL of informal caregivers of Veterans with TBI.
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Affiliation(s)
- Karen L Saban
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Department of Veterans Affairs (VA) Hospital, Hines, IL.,Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic College of Medicine, Rochester, MN.,Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN
| | | | | | - Theresa Louise-Bender Pape
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Department of Veterans Affairs (VA) Hospital, Hines, IL.,Department of Physical Medicine & Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Eileen Collins
- Center of Innovation for Complex Chronic Healthcare, Edward Hines Jr. Department of Veterans Affairs (VA) Hospital, Hines, IL.,Department of Biobehavioral Health Science, University of Illinois at Chicago, Chicago, IL
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Rozario PA, Simpson GM. Social Support and Self-Rated Health of African American Women Informal Caregivers: Urban and Rural Differences. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2018; 61:16-30. [PMID: 29058529 DOI: 10.1080/01634372.2017.1391918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In this study, we examined how geographic location might differently influence social support and self-rated health for rural and urban African American women caregivers. We used cross-sectional data from 253 urban and 263 rural women primary caregivers. Controlling for key demographic factors, we regressed caregivers' self-rated health on social engagement, structural, and functional aspects of social support for urban and rural caregivers separately. The perception of family functioning was positively associated with urban and rural caregivers' self-rated health. Urban caregivers reported having significantly more contact with their family and more informal helpers compared to rural caregivers. Furthermore, church attendance, a measure of social engagement, was significant for urban caregivers' self-rated health, but not rural caregivers. Our findings affirmed the importance of foregrounding context and disaggregating social support, and point to the need for interventions targeting family functioning and paying attention to geographic location.
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Affiliation(s)
- Philip A Rozario
- a Adelphi University , School of Social Work , Garden City , NY , USA
| | - Gaynell M Simpson
- b HDRTP RCMAR Scholar, Hartford Faculty Scholar, University of Alabama , School of Social Work , Tuscaloosa , AL , USA
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13
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Intimate personal violence and caregiving: Influences on physical and mental health in middle-aged women. Maturitas 2017; 102:34-40. [DOI: 10.1016/j.maturitas.2017.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 05/02/2017] [Accepted: 05/03/2017] [Indexed: 11/23/2022]
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Changes in Depressive Symptoms among Older Adults with Multiple Chronic Conditions: Role of Positive and Negative Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 14:ijerph14010016. [PMID: 28035968 PMCID: PMC5295267 DOI: 10.3390/ijerph14010016] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 12/16/2016] [Accepted: 12/19/2016] [Indexed: 11/26/2022]
Abstract
Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006–2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression. A linear mixed model with repeated measures was used to estimate the effect of MCC on depression and its interactions with positive and negative social support in explaining depression among older adults. Varying forms of social support played different moderating roles in depressive symptomatology among older adults with MCC. Positive spousal support significantly weakened the deleterious effect of MCC on depression. Conversely, all negative social support from spouse, children, other family, and friends significantly strengthened the deleterious effect of MCC on depression. Minimizing negative social support and maximizing positive spousal support can reduce depression caused by MCC and lead to successful aging among older adults.
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15
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Kim S, Knight BG. Caregiving Subgroups Differences in the Associations Between the Resilience Resources and Life Satisfaction. J Appl Gerontol 2016; 37:1540-1563. [PMID: 27655236 DOI: 10.1177/0733464816669804] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Using a model of resilience, this study compared the direct and indirect associations between resilience resources (sense of mastery, openness to experience, emotion regulation, and social support) and life satisfaction among caregiving subgroups (spouses, adult-children, and parents). Participants were included from the survey of Midlife in the United States (MIDUS II). Estimates of direct and indirect relationships between the resources and life satisfaction were calculated for each subgroup, and differences in the relationships between subgroups were tested. The direct positive relationships between sense of mastery and life satisfaction were significant and stronger for spouses and parents than for adult-children. In contrast, an indirect relationship through social support between the two variables was stronger for adult-children than for spouses. Openness to experience had a direct positive link to life satisfaction among spouses, and emotion regulation was directly related to life satisfaction among parents. We suggested targeted interventions for caregiving subgroups.
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Affiliation(s)
| | - Bob G Knight
- 2 University of Southern Queensland, Toowoomba, Australia
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Danilovich M, Xiang X, Pinto D. Factors That Influence Self-Reported Health Changes With Caregiving. J Aging Health 2016; 29:1444-1458. [PMID: 27511956 DOI: 10.1177/0898264316663576] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study examined factors associated with the self-reported change in health status as a result of caregiving. METHOD Multinomial logistic regression were performed to examine the sociodemographic characteristics, care recipients' characteristics, and caregiving experiences that affect caregivers' perceptions of health affected by caregiving using data from 1,087 caregiver respondents in the Caregiving in the U.S. 2015 data set. Data were collected through an online or telephone survey of randomly selected adults in 50 states. RESULTS Worsened self-reported health with caregiving occurred for caregivers aged 50 to 64, racial/ethnic minorities, those who lived within 20 min of the care recipient's home, the presence of cognitive deficits, prolonged caregiving, and limited availability of accessible and affordable care services. Importantly, the feeling of choice in taking on care responsibilities was associated with an over fourfold increase in the odds ratio (OR) of better health in response to caregiving (OR = 4.21; confidence interval [CI] = [1.95, 9.08]; p < .001). DISCUSSION Results suggest that improving accessibility of social service resources to assist caregivers in being better supported and having more choice in caregiving responsibilities may foster a positive change in health status with caregiving.
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Laganà L, Prilutsky RR. A Pilot Psychometric Study on the Validation of the Older Women's Non-Medical Stress Scale (OWN-MSS) on an Ethnically Diverse Sample. JOURNAL OF GERIATRICS AND PALLIATIVE CARE 2016; 4. [PMID: 27390770 DOI: 10.13188/2373-1133.1000014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Older women often experience various types of stressors, including the death of a spouse and associated financial stress (often with a lack of social support), emotional stress due to factors such as caregiving and being single, and the challenges of the aging process. These circumstances could produce or aggravate anxious symptomatology that can in turn compound the negative effects of aging. A brief scale of perceived stress that is not confounded with health status and covers multiple culturally relevant potential stressors is needed for quick use in busy medical settings. AIM To assess the reliability and the validity of an original stress scale designed to measure perceptions of stress beyond health status in a non-clinical convenience sample of community-dwelling older women. METHOD In this cross-sectional pilot investigation, via conducting item-total correlations and correlational tests of validity, we studied the psychometric properties of our measure using data from volunteer older subjects (mainly low-income and from non-Caucasian backgrounds). The domains covered by the nine items of the tool were selected based on a literature review of common stressors experienced by older adults, especially by older women. Data were collected face-to-face using a demographic list, a well-established depression measure, a brief posttraumatic stress disorder (PTSD) screener, and our 9-item stress tool. Primary outcomes: reliability and validity of the scale of older women's non-medical stress. Secondary outcomes: demographic characteristics of the sample and correlations between stress items. RESULTS Based on our sample of older women (N=40, mean age 71 years), good internal consistency between the items of the stress scale was found (Cronbach's a=.66). The findings of the data analyses also revealed that our psychometric tool has good convergent validity with the PTSD screener (r=.53). Moreover, in contrast with most other stress tools, it has strong discriminant validity (r=.11) with a well-validated depression scale. CONCLUSION Our results suggest that this new measure is psychometrically strong. Future research directions encompass using larger samples, ideally including older men with the modification of the scale's name, as well as validating this tool against more measures. Clinical implications of our findings are briefly discussed.
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Affiliation(s)
- Luciana Laganà
- Department of Psychology, California State University Northridge, Northridge, California, USA
| | - Roxanne R Prilutsky
- Clinical Geriatric and General Private Practice, Roxanne Prilutsky, Ph.D. A Psychology Corporation, Pasadena, California, USA
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Unson C, Flynn D, Glendon MA, Haymes E, Sancho D. Dementia and Caregiver Stress: An Application of the Reconceptualized Uncertainty in Illness Theory. Issues Ment Health Nurs 2015; 36:439-46. [PMID: 26241570 DOI: 10.3109/01612840.2014.993052] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The Reconceptualized Uncertainty in Illness Theory (RUIT) was used to investigate antecedents to, appraisals of, and ways of coping with stressful caregiving. Four focus groups with caregivers (8 males and 16 females) of relatives with dementia were conducted; 15 cared for their parents and the remainder cared for their spouses. They were recruited from an adult care center and other community settings in a metropolitan area in New England. The discussions were audiotaped and transcribed verbatim. Two researchers independently coded the transcripts. Thematic analysis was structured according to the RUIT. The study is unique in its application to caregivers as opposed to patients and to all of the elements of the RUIT. Caregivers experience uncertainty in similar ways to patients with life-altering illness. Symptom severity--lack of personal boundaries, repetitive and aggressive behaviors, and the need for constant care--was the most frequent source of stress. The appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strains, and loss of freedom. Self-improvement and self-care were important aspects of coping. Spirituality and humor were other coping skills that respondents used. Not all respondents said they were coping and some also reported that support from health care providers was not always helpful. Nurses can help improve coping by explaining the factors that contribute to caregiver strain and uncertainty, and by assisting caregivers to anticipate the effects of the caregiving role.
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Affiliation(s)
- Christine Unson
- Southern Connecticut State University, Department of Public Health , New Haven, Connecticut , USA
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Smith ML, Ahn S, Jiang L, Kulinski KP, Ory MG. Factors associated with Hispanic adults attending spanish-language disease self-management program workshops and workshop completion. Front Public Health 2015; 2:155. [PMID: 25964900 PMCID: PMC4410508 DOI: 10.3389/fpubh.2014.00155] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 09/08/2014] [Indexed: 11/20/2022] Open
Abstract
Many factors influence ways in which middle-aged and older Hispanic adults prefer to receive health-related information. While Spanish-language disease management programs are increasingly offered in community and healthcare settings, less is known about their utilization among the Hispanic population. This study aimed to identify participant and workshop factors associated with middle-aged and older Hispanic adults attending Spanish-language disease self-management program workshops and receiving the recommended intervention dose (i.e., successful workshop completion is defined as attending four or more of the six workshop sessions). Data were analyzed from 12,208 Hispanic adults collected during a national dissemination of the Stanford suite of Chronic Disease Self-Management Education (CDSME) programs spanning 45 states, the District of Columbia, and Puerto Rico. Two logistic regression analyses were performed. Over 65% of participants attended Spanish-language workshops, and 78.3% of participants successfully completed workshops. Relative to participants in English-language workshops, participants who attended Spanish-language CDSME workshops were more likely to successfully complete workshops, as were those aged 80 years and older, females, and those who lived alone. Participants who were aged 50–79 years and female were significantly more likely to attend Spanish-language workshops than their counterparts under age 50. Conversely, those with more chronic conditions were less likely to attend Spanish-language workshops. Those who attended workshops with more participants and where the Hispanic population was less affluent were more likely to attend Spanish-language workshops. This study provides insight into Spanish-language CDSME program recruitment and utilization with implications for program adoption in underserved Hispanic community settings.
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Affiliation(s)
- Matthew Lee Smith
- Department of Health Promotion and Behavior, College of Public Health, The University of Georgia , Athens, GA , USA
| | - SangNam Ahn
- Division of Health Systems Management and Policy, School of Public Health, The University of Memphis , Memphis, TN , USA ; Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, School of Public Health , College Station, TX , USA
| | - Luohua Jiang
- Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, School of Public Health , College Station, TX , USA
| | | | - Marcia G Ory
- Department of Health Promotion and Community Health Sciences, Texas A&M Health Science Center, School of Public Health , College Station, TX , USA
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Pucciarelli G, Savini S, Byun E, Simeone S, Barbaranelli C, Vela RJ, Alvaro R, Vellone E. Psychometric properties of the Caregiver Preparedness Scale in caregivers of stroke survivors. Heart Lung 2014; 43:555-60. [PMID: 25239706 DOI: 10.1016/j.hrtlng.2014.08.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 08/19/2014] [Accepted: 08/19/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate the psychometric characteristics of the Caregiver Preparedness Scale (CPS) in caregivers of stroke survivors. BACKGROUND Caregiver preparedness can have an important impact on both the caregiver and the stroke survivor. The validity and reliability of the CPS has not been tested for the stroke-caregiver population. METHODS We used a cross-sectional design to study a sample of 156 caregivers of stroke survivors. Construct validity of the CPS was evaluated by confirmatory factor analysis (CFA). Internal consistency and test-retest reliability were also evaluated. RESULTS Caregivers were, on average, 54 year old (SD = 13.2) and most were women (64.7%). CFA supported the unidimensionality of the scale (comparative fit index = 0.98). Reliability was also supported: item-reliability index and item-total correlations above 0.30; composite reliability index = 0.93; Cronbach's alpha = 0.94; factor score determinacy = 0.97; and test-retest reliability = 0.92. CONCLUSION The CPS is valid and reliable in caregivers of stroke survivors. Scores on this scale may assist health-care providers in identifying caregivers with less preparedness to provide specific interventions.
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Affiliation(s)
- Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Serenella Savini
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Eeeseung Byun
- Department of Family Health Care Nursing, University of California San Francisco School of Nursing, San Francisco, CA, USA
| | - Silvio Simeone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | | | - Raúl Juárez Vela
- Faculty of Health Sciences, University San Jorge, Zaragoza, Spain
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome "Tor Vergata", Rome, Italy.
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