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Liang X, Zhang X, Young CA, Ma Y, Ye Q, Zheng D, Jin G. Depressive and anxiety symptoms in caregivers of children with congenital ectopia lentis: a prospective cross-sectional study. BMJ Open 2024; 14:e082159. [PMID: 39153797 DOI: 10.1136/bmjopen-2023-082159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2024] Open
Abstract
OBJECTIVES To evaluate the frequency and severity of depressive and anxiety symptoms and explore possible risk factors among caregivers of children with congenital ectopia lentis (CEL). DESIGN A prospective cross-sectional study was conducted. PARTICIPANTS 108 patients and 108 informal caregivers (mainly parents) were included. Participants were grouped based on whether patients had systemic abnormalities: group 1 were children without systemic abnormalities and group 2 were children with systemic abnormalities. OUTCOME MEASURES The 9-item Patient Health Questionnaire (PHQ-9) and the 7-item Generalized Anxiety Disorder Scale (GAD-7) were used to assess depressive and anxiety symptoms, respectively. RESULTS More than half of caregivers (51.9%) have depressive or anxiety symptoms of some degree. 38.0% of caregivers suffered from both depressive and anxiety symptoms. 19.4% of caregivers had moderate to severe depressive symptoms (PHQ-9 score ≥10) while 16.7% reported moderate to severe anxiety symptoms (GAD-7 score ≥10). Between the two groups, the mean PHQ-9 and GAD-7 scores significantly differed (p=0.026 in PHQ-9; p=0.018 in GAD-7). The proportion of caregivers with moderate to severe symptoms was greater in group 2 than in group 1. In addition, there was a significant positive correlation between PHQ-9 and GAD-7 scores (r=0.827; p<0.001). Furthermore, best corrected visual acuity in the better eye of patients was positively correlated with both the PHQ-9 and GAD-7 scores (r=0.314, p<0.05 in PHQ-9; r=0.325, p<0.05 in GAD-7). CONCLUSIONS Depressive and anxiety symptoms were common in caregivers of children with CEL, especially among those whose children had other systemic disease manifestations or low vision. This study illustrates the importance of depressive and anxiety symptom screening for these caregivers to implement effective psychological interventions and support strategies.
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Affiliation(s)
- Xiaolin Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Xinyu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | | | - Yiyuan Ma
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Qian Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou 510060, China
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Xiong K, Zhang Q, Mao H, Zhou W, Huang Q, Liang Y. Association of spouse's vision impairment with depressive symptoms and cognitive decline in partner: A nationally representative study in China. J Affect Disord 2024; 355:392-398. [PMID: 38531494 DOI: 10.1016/j.jad.2024.03.097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Revised: 03/17/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Although several previous studies have reported on the relationship between vision impairment and caregiver mental health, mixed results were obtained, and only one study reported the association between spousal vision impairment and partner depression. Therefore, our study aimed to examine the association between spousal vision impairment and the partner's depressive symptoms and cognitive decline. METHODS This cross-sectional study gathered baseline data from the China Health and Retirement Longitudinal Study (CHARLS) in 2011. A total of 10,956 couples were included in the study. Vision impairment was assessed by respondents' self-reported distance or near vision. Multivariate logistic and linear regression were conducted to evaluate the association between the spouse's vision impairment and the partner's depressive symptoms and cognitive function. RESULTS The prevalence of partners with depressive symptoms was significantly higher among spouses with vision impairment than among those without (43.3 % vs. 32.5 %; P < 0.001), and cognitive function was significantly lower (spousal vision impairment 14.4 ± 4.5 vs. no spousal vision impairment 15.5 ± 4.6; P < 0.001). After fully adjusting for potential confounders, the partner had greater odds of depressive symptoms for spouses with vision impairment than for those without (odds ratio: 1.525; 95 % confidence interval [CI]: 1.387 to 1.677). Furthermore, spousal vision impairment was negatively associated with the partner's cognitive function (β = -0.640; 95 % CI: -0.840 to -0.440). Sensitivity analysis was performed, and consistent results were obtained (all P < 0.05). LIMITATIONS Visual function was assessed by self-reporting. CONCLUSIONS A spouse's vision impairment is associated with depressive symptoms and cognitive decline in the partner. The findings imply the importance of considering the partner's mental health when managing their spouse's vision impairment.
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Affiliation(s)
- Kun Xiong
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Qi'ao Zhang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Huiyan Mao
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Wenzhe Zhou
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Qiangjie Huang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China
| | - Yuanbo Liang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325027, China.
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Sheikhbardsiri H, Tavan A, Afshar PJ, Salahi S, Heidari-Jamebozorgi M. Investigating the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with COVID-19 patients in Iran. BMC PRIMARY CARE 2022; 23:165. [PMID: 35773628 PMCID: PMC9247935 DOI: 10.1186/s12875-022-01772-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/15/2022] [Indexed: 11/10/2022]
Abstract
Background The caregivers of patients with covid-19 face constant responsibilities such as providing personal, health, and social care to family, which can be physically, and emotionally exhausting resulting in a considerable stress burden. Therefore, given the importance of the subject, this study aimed to investigate the burden of disease dimensions (time-dependent, developmental, physical, social and emotional) among family caregivers with covid-19 patients in Iran. Methods This cross-sectional study was conducted one year after the onset of the Covid-19 outbreak in Iran. Family caregivers of Covid-19 patients discharged from the hospitals in Kerman city, Iran, were chosen by simple randomization (n = 1500). Data were collected utilizing a demographic characteristics inventory created by the researcher as well as the Novak and Guest Caregiver Burden Inventory. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as Kolmogorov–Smirnov, T-test, ANOVA, and Multivariate Linear Regression were used for data analysis using the 20, SPSS Inc., Chicago, IL Software at the level of P < 0.05. Results The results demonstrated that the mean score of family caregiver burden was 2.61±0.6 and the severity of this burden was in a moderate range. The finding showed a statistical difference was seen between the family caregiver burden mean score of participants in terms of gender, duration of treatment, age and employed status. The multivariable linear regression model showed demographic variables of caregivers included (female, married, employed, elderly, low income and poor education) had a beneficial influence on family caregiver burden. Conclusion The findings of this study can increase the awareness of health managers, about the level of burden of disease among family caregivers from the covid-19 patients and can help to provide economic, social and psychological support programs for improvement and reducing the burden of disease of caregivers during the covid-19 outbreaks.
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Ruiz-Lozano RE, de la Rosa-Pacheco S, Hernández-Camarena JC, Garza-Garza LA, Davila-Cavazos O, Dominguez-Varela IA, Quiroga-Garza ME, Rodriguez-Garcia A. Burden and depression among informal caregivers of visually impaired patients in Mexico. Disabil Health J 2022; 15:101284. [PMID: 35337783 DOI: 10.1016/j.dhjo.2022.101284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND The needs of informal caregivers who provide care to family relatives with visual impairment are often neglected, resulting in burden and depression. OBJECTIVE To determine the degree of burden and the prevalence of major depression experienced by caregivers, defined as non-paid family relatives, of legally blind individuals in a Mexican population. METHODS Observational, single-center, cross-sectional study in adults providing care to their family relatives with visual impairment (visual acuity ≤ 20/200 in the best eye for at least 3 months). According to visual impairment degree, care provided included activities of daily living (ADL) and instrumental ADL. Burden of care was evaluated with the Zarit burden interview (ZBI)-22 and the prevalence of major depression was determined by the patient health questionnaire (PHQ)-9. RESULTS 115 patients and 115 caregivers were included. Male caregivers had significantly higher ZBI-22 (28.7 ± 15.5 vs. 19.2 ± 12.6, p = 0.001) and PHQ-9 (10.0 ± 5.5 vs. 5.3 ± 5.1, p < 0.001) scores than females. Likewise, parent caregivers of adult children and the hours of daily care were significantly associated with higher burden and depression scores. A significant linear correlation between ZBI-22 and PHQ-9 scores in caregivers was also found (r = 0.649, p < 0.001). CONCLUSIONS Male caregivers, parent caregivers of adult children, and caregivers providing greater hours of care were at higher risk of burden and depression. Upon diagnosis of visual impairment, adults providing care to visually impaired family relatives should be screened for burden and depression and referred to a mental health specialist when necessary. Tailored interventions targeting the caregivers' needs are required to reduce burden and depression.
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Affiliation(s)
- Raul E Ruiz-Lozano
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Sylvia de la Rosa-Pacheco
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Av. I. Morones Prieto No. 3000 Pte. Col. Sertoma, Monterrey, NL, CP, 64710, Mexico.
| | - Julio C Hernández-Camarena
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Lucas A Garza-Garza
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Osvaldo Davila-Cavazos
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Irving A Dominguez-Varela
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Manuel E Quiroga-Garza
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
| | - Alejandro Rodriguez-Garcia
- Tecnologico de Monterrey, School of Medicine and Health Sciences, Institute of Ophthalmology and Visual Sciences, Av. Batallon de San Patricio #112, Col. Real de San Agustin, San Pedro Garza Garcia, NL, CP, 66278, Mexico.
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Enoch J, Dickinson C, Potts J, Subramanian A. An exploratory study on support for caregivers of people with vision impairment in the UK. Ophthalmic Physiol Opt 2022; 42:858-871. [PMID: 35416314 PMCID: PMC9320821 DOI: 10.1111/opo.12989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 03/26/2022] [Accepted: 03/28/2022] [Indexed: 11/27/2022]
Abstract
Purpose Many of the UK's 2.5 million individuals living with vision loss receive support from relatives or friends (so‐called ‘informal caregivers’). However, there is limited understanding of how caregivers of people with visual impairment (PVI) are, or feel, supported by UK healthcare/statutory services and charities. This exploratory study was conducted to explore caregivers' experiences and their suggestions for enhancing support. Methods Participants self‐identifying as UK‐based caregivers of PVI (N = 100) volunteered to undertake an online survey, distributed through charity partners. The survey was comprised of the Client Satisfaction Questionnaire‐8 (CSQ‐8, a validated, self‐report measure of satisfaction with support services), Likert‐type questions and two open‐ended, free‐text questions. Interview participants (N = 22) were then selected from survey respondents, and semi‐structured interviews were conducted to focus on caregivers' ideas for improving support. The Framework Method was used for inductive analysis of the free‐text question responses and interview data. Results The mean (SD) CSQ‐8 score was 21.60 (7.2), with no significant differences by demographic, relationship or vision‐related factors, likely limited by the small subgroup sizes. Qualitative data demonstrated the heterogeneity of participating caregivers' experiences, highlighting the importance of personalised support for caregivers. Many participants advocated enhancing informational, practical, emotional and social support for caregivers, and stressed the importance of accessible services and consistent points of contact to turn to for support and advice. Conclusions Although our sample was arguably better connected to support services than the general caregiver population, this study identified concrete suggestions to improve practical, emotional and peer support for caregivers of PVI.
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Affiliation(s)
- Jamie Enoch
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
| | - Christine Dickinson
- Division of Pharmacy & Optometry, University of Manchester and the Manchester Academic Health Sciences Centre, Manchester, UK
| | | | - Ahalya Subramanian
- Division of Optometry and Visual Sciences, School of Health Sciences, City, University of London, London, UK
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A Newly Identified Impairment in Both Vision and Hearing Increases the Risk of Deterioration in Both Communication and Cognitive Performance. Can J Aging 2021; 41:363-376. [DOI: 10.1017/s0714980821000313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Abstract
Vision and hearing impairments are highly prevalent in adults 65 years of age and older. There is a need to understand their association with multiple health-related outcomes. We analyzed data from the Resident Assessment Instrument for Home Care (RAI-HC). Home care clients were followed for up to 5 years and categorized into seven unique cohorts based on whether or not they developed new vision and/or hearing impairments. An absolute standardized difference (stdiff) of at least 0.2 was considered statistically meaningful. Most clients (at least 60%) were female and 34.9 per cent developed a new sensory impairment. Those with a new concurrent vison and hearing impairment were more likely than those with no sensory impairments to experience a deterioration in receptive communication (stdiff = 0.68) and in cognitive performance (stdiff = 0.49). After multivariate adjustment, they had a twofold increased odds (adjusted odds ratio [OR] = 2.1; 95% confidence interval [CI]:1,87, 2.35) of deterioration in cognitive performance. Changes in sensory functioning are common and have important effects on multiple health-related outcomes.
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Jin I, Tang D, Gengaroli J, Nicholson Perry K, Burlutsky G, Craig A, Liew G, Mitchell P, Gopinath B. Cross-sectional study evaluating burden and depressive symptoms in family carers of persons with age-related macular degeneration in Australia. BMJ Open 2021; 11:e048658. [PMID: 34497082 PMCID: PMC8438959 DOI: 10.1136/bmjopen-2021-048658] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES We aimed to analyse the degree of carer burden and depressive symptoms in family carers of persons with age-related macular degeneration (AMD) and explore the factors independently associated with carer burden and depressive symptoms. METHODS Cross-sectional study using self-administered and interviewer-administered surveys, involving 96 family carer-care recipient pairs. Participants were identified from tertiary ophthalmology clinics in Sydney, Australia, as well as the Macular Disease Foundation of Australia database. Logistic regression, Pearson and Spearman correlation analyses were used to investigate associations of explanatory factors (family caregiving experience, carer fatigue, carer quality of life and care-recipient level of dependency) with study outcomes-carer burden and depressive symptoms. RESULTS Over one in two family carers reported experiencing mild or moderate-severe burden. More than one in five and more than one in three family carers experienced depressive symptoms and substantial fatigue, respectively. High level of care-recipient dependency was associated with greater odds of moderate-severe and mild carer burden, multivariable-adjusted OR 8.42 (95% CI 1.88 to 37.60) and OR 4.26 (95% CI 1.35 to 13.43), respectively. High levels of fatigue were associated with threefold greater odds of the carer experiencing depressive symptoms, multivariable-adjusted OR 3.47 (95% CI 1.00 to 12.05). CONCLUSIONS A substantial degree of morbidity is observed in family carers during the caregiving experience for patients with AMD. Level of dependency on the family carer and fatigue were independently associated with family carer burden and depressive symptoms. TRIAL REGISTRATION NUMBER The trial registration number is ACTRN12616001461482. The results presented in this paper are Pre-results stage.
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Affiliation(s)
- Ivan Jin
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Diana Tang
- Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Jessica Gengaroli
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, New South Wales, Australia
| | - Kathryn Nicholson Perry
- Discipline of Psychological Science, Australian College of Applied Psychology, Sydney, New South Wales, Australia
| | - George Burlutsky
- Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
| | - Ashley Craig
- Northern Clinical School, University of Sydney, St Leonards, New South Wales, Australia
| | - Gerald Liew
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Paul Mitchell
- Centre for Vision Research, University of Sydney, Sydney, New South Wales, Australia
| | - Bamini Gopinath
- Macquarie University Hearing, Macquarie University, Sydney, New South Wales, Australia
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Testing the Efficacy of Family Health-Model of REBT on Family Values and Quality of Family Life Among Parents of Children with Visual Impairment. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2021; 40:252-277. [PMID: 34393360 PMCID: PMC8355570 DOI: 10.1007/s10942-021-00409-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2021] [Indexed: 01/24/2023]
Abstract
The high rate of negative thinking in family circles due to the presence of children with visual impairment has grossly affects the quality of family life. In the case of Nigeria, low quality of family life is prevalent among parents of children with visual loss. This study attempts to validate the efficacy of a rational emotional family health therapy in addressing family values and quality of life among parents of children with visual impairment in Enugu state Nigeria. A group randomized controlled design, participants comprised 132 parents whose children were living with visual impairment in Enugu state, Nigeria. The participants in REFHP-group were exposed to a 12-session treatment programme whereas their counterparts in the waitlisted control group did not receive this intervention. Two measures-Family Quality of Life Scale and Family Value Scale were utilized in assessing the participants at three time points. Data analyses were completed using repeated measures ANOVA. Findings revealed that rational emotive family health therapy had a significantly positive effect on increasing family values and quality of family life among the study participants of the treatment group. This study contributes to the scholarship on the efficacy of rational emotive family health therapy in improving family values and quality of family life among parents of children with visual impairment.
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Varadaraj V, Swiatek KS, Chung SE, Ehrlich JR, Assi L, Wolff JL, Swenor BK. Caring for Older Adults With Self-Reported Vision Impairment: Findings from the National Study of Caregiving. Am J Ophthalmol 2021; 227:211-221. [PMID: 33831341 PMCID: PMC8817230 DOI: 10.1016/j.ajo.2021.03.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 03/15/2021] [Accepted: 03/18/2021] [Indexed: 01/19/2023]
Abstract
PURPOSE The purpose of this study was to examine caregiving relationships for older adults with vision impairment (VI). DESIGN Cross-sectional study with a nationally representative sample. METHODS Setting: the National Health and Aging Trends Study linked to the National Study of Caregiving, Year 2011. STUDY POPULATION 1,776 family or unpaid caregivers to community-dwelling Medicare beneficiaries age ≥65 years old. OUTCOME MEASUREMENT in the preceding month, 1) the number of hours of care provided; 2) the valued activities affected by caregiving; and 3) the odds of experiencing substantial emotional, financial, and physical difficulty related to providing care. EXPOSURE VI was defined as a report of blindness or difficulty with distance or near vision. RESULTS Among 1,776 caregivers, 428 caregivers spent an average ± standard error (SE) of 111 ± 9.1 hours per month assisting older adults with VI, whereas 1,348 spent an average of 72 ± 3.3 hours assisting older adults without VI. In fully adjusted negative binomial regression analyses, caregivers of older adults with VI spent 36% more hours (incident rate ratio [IRR]: 1.36; 95% confidence interval [CI]: 1.15-1.60) providing care and reported having 61% more valued activities affected (IRR: 1.61; 95% CI: 1.23-2.10) than caregivers of older adults without VI. In fully adjusted logistic regression analyses, caregivers of older adults with VI had greater odds of emotional (odds ratio [OR]: 1.46; 95% CI: 1.04-2.03) but not financial (OR: 1.33; 95% CI: 0.87-2.03) or physical (OR: 1.13; 95% CI: 0.74-1.74) difficulty related to providing care than caregivers of older adults without VI. CONCLUSIONS These results suggest that caring for older adults with VI places different demands on time and emotional wellbeing than caring for older adults without VI, but no differences in financial or physical difficulties.
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Affiliation(s)
- Varshini Varadaraj
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA,The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA
| | | | - Shang-En Chung
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Joshua R. Ehrlich
- Center for Eye Policy and Innovation, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Lama Assi
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA
| | - Jennifer L. Wolff
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Lipitz Center for Integrated Health Care, and the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bonnielin K. Swenor
- Johns Hopkins Wilmer Eye Institute, Baltimore, MD, USA,The Johns Hopkins Disability Health Research Center, Johns Hopkins University, Baltimore, MD, USA,Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Hazzan AA, Haibach-Beach P, Lieberman L, Williams J. Interventions for quality of life and related outcomes among unpaid caregivers of older adults with visual impairments: A scoping review. BRITISH JOURNAL OF VISUAL IMPAIRMENT 2021. [DOI: 10.1177/02646196211019064] [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]
Abstract
Unpaid family caregivers play a critical role in the care of older adults with visual impairments. Caring for older adults with visual impairments requires much time and energy, often resulting in psychological stress and reduced quality of life for the unpaid caregiver. However, there is a paucity of data on the impact of caregiving on quality of life and related outcomes among these caregivers. The purpose of this study was to conduct a scoping review examining issues of quality of life, health, stress, burden, and barriers among unpaid caregivers of older adults with visual impairments. The study also aimed to summarize interventions for addressing these issues. This study followed the Arksey and O’Malley five-stage approach for scoping reviews. We performed a search of published peer-reviewed articles available in PubMed, CINAHL Complete, and PsycINFO to identify relevant studies. Two reviewers conducted the screening of titles, abstracts, and full-texts. A total of 24 articles were eligible for full-text screening from the 452 records identified, and 5 articles met the final inclusion criteria. The following four themes were identified: (1) prevalence of quality of life–related barriers among unpaid caregivers of older adults with visual impairments; (2) adverse events among unpaid caregivers of older adults with visual impairments; (3) interventions for unpaid caregivers of older adults with visual impairments; and (4) potential impacts of intervention on unpaid caregivers of older adults with visual impairments. These findings point to a lack of interventions for unpaid caregivers of older adults with visual impairments, despite the prevalence of quality of life–related barriers and adverse events in this population. This study aligns with the social model of disability as it relates to the failure of the system to meet the needs of older adults with visual impairments. Research addressing these issues is urgently needed.
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Hajek A, Kretzler B, König HH. Informal caregiving for adults, loneliness and social isolation: a study protocol for a systematic review. BMJ Open 2021; 11:e044902. [PMID: 33947734 PMCID: PMC8098962 DOI: 10.1136/bmjopen-2020-044902] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Some empirical studies have identified an association between informal caregiving for adults and loneliness or social isolation. However, there is a lack of a review systematically synthesising empirical studies that have examined these associations. Hence, the aim of this systematic review is to provide an overview of evidence from observational studies. METHODS AND ANALYSIS Three electronic databases (Medline, PsycINFO, CINAHL) will be searched (presumably in May 2021), and reference lists of included studies will be searched manually. Cross-sectional and longitudinal observational studies examining the association between informal caregiving for adults and loneliness or social isolation will be included. Studies focusing on grandchildren care or private care for chronically ill children will be excluded. Data extraction will include information related to study design, definition and measurement of informal caregiving, loneliness and social isolation, sample characteristics, statistical analysis and main results. The quality of the studies will be evaluated using the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Two reviewers will perform the selection of studies, data extraction and assessment of study quality. Figures and tables will be used to summarise and report results. A narrative summary of the findings will be provided. If data permit, a meta-analysis will be conducted. ETHICS AND DISSEMINATION No primary data will be collected. Therefore, approval by an ethics committee is not required. We plan to publish our findings in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42020193099.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Zwar L, König HH, Hajek A. Psychosocial consequences of transitioning into informal caregiving in male and female caregivers: Findings from a population-based panel study. Soc Sci Med 2020; 264:113281. [DOI: 10.1016/j.socscimed.2020.113281] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/15/2020] [Accepted: 08/02/2020] [Indexed: 01/13/2023]
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Varadaraj V, Chung SE, Swiatek KS, Sheehan OC, Deemer A, Ehrlich JR, Wolff JL, Assi L, Roth DL, Swenor BK. Caring for Older Adults With Vision Impairment and Dementia. Innov Aging 2020; 4:igaa043. [PMID: 33209994 PMCID: PMC7657090 DOI: 10.1093/geroni/igaa043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Dementia and vision impairment (VI) are common among older adults but little is known about caregiving in this context. RESEARCH DESIGN AND METHODS We used data from the 2011 National Health and Aging Trends Study, a nationally representative survey of Medicare beneficiaries, linked to their family/unpaid helpers from the National Study of Caregiving. Vision impairment was defined as self-reported blindness or difficulty with distance/near vision. Probable dementia was based on survey report, interviews, and cognitive tests. Our outcomes included hours of care provided, and number of valued activities (scored 0-4) affected by caregiving, per month. RESULTS Among 1,776 caregivers, 898 (55.1%, weighted) assisted older adults without dementia or VI, 450 (21.9%) with dementia only, 224 (13.0%) with VI only, and 204 (10.0%) with dementia and VI. In fully adjusted negative binomial regression analyses, caregivers of individuals with dementia and VI spent 1.7 times as many hours (95% confidence interval [CI] = 1.4-2.2) providing care than caregivers of those without either impairment; however, caregivers of individuals with dementia only (95% CI = 1.1-1.6) and VI only (95% CI = 1.1-1.6) spent 1.3 times more hours. Additionally, caregivers of individuals with dementia and VI had 3.2 times as many valued activities affected (95% CI = 2.2-4.6), while caregivers of dementia only and VI only reported 1.9 times (95% CI = 1.4-2.6) and 1.3 times (95% CI = 0.9-1.8) more activities affected, respectively. DISCUSSION AND IMPLICATIONS Our results suggest that caring for older adults with VI involves similar time demands as caring for older adults with dementia, but that participation impacts are greater when caring for older adults with both dementia and VI.
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Affiliation(s)
- Varshini Varadaraj
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland
| | - Shang-En Chung
- Johns Hopkins University Center on Aging and Health, Baltimore, Maryland
| | | | - Orla C Sheehan
- Johns Hopkins University Center on Aging and Health, Baltimore, Maryland
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley Deemer
- Lions Vision Research and Rehabilitation Center, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Joshua R Ehrlich
- Department of Ophthalmology and Visual Sciences, Center for Eye Policy and Innovation, University of Michigan, Ann Arbor
- Institute for Health Care Policy and Innovation, University of Michigan, Ann Arbor
| | - Jennifer L Wolff
- Division of Geriatric Medicine and Gerontology, Johns Hopkins University School of Medicine, Baltimore, Maryland
- Roger C. Lipitz Center for Integrated Health Care, and the Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lama Assi
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland
| | - David L Roth
- Johns Hopkins University Center on Aging and Health, Baltimore, Maryland
| | - Bonnielin K Swenor
- Dana Center for Preventive Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland
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Viriato D, Bennett N, Sidhu R, Hancock E, Lomax H, Trueman D, MacLaren RE. An Economic Evaluation of Voretigene Neparvovec for the Treatment of Biallelic RPE65-Mediated Inherited Retinal Dystrophies in the UK. Adv Ther 2020; 37:1233-1247. [PMID: 32034665 PMCID: PMC7089725 DOI: 10.1007/s12325-020-01243-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Voretigene neparvovec (VN) is a gene therapy and the first approved pharmacological treatment for biallelic RPE65-mediated inherited retinal dystrophies (IRD), a rare condition that starts in early life and causes vision to progressively deteriorate towards complete blindness. In a phase III trial, treatment with VN significantly improved functional vision and visual function, and in October 2019 the National Institute for Health and Care Excellence (NICE) Highly Specialised Technologies (HST) process recommended VN for patients in England and Wales. We assessed the cost-effectiveness of VN compared with best supportive care (BSC) in individuals with biallelic RPE65-mediated IRD in the UK. METHODS A Markov model was developed to estimate the incremental cost per quality-adjusted life-year (QALY) gained for VN compared with BSC, from the perspective of the UK National Health Service and Personal Social Services. Phase III trial data were used to inform transition probabilities up to year 1, after which the treatment effect was assumed to be maintained for 40 years, followed by a decline in vision. A bespoke elicitation exercise involving clinical experts, patients and carers was conducted to estimate utility values for each model health state. RESULTS At list price, VN is associated with incremental costs of £612,404 and incremental QALYs of 6.4, resulting in an incremental cost-effectiveness ratio (ICER) of £95,072 per QALY gained. Voretigene neparvovec is associated with a significant undiscounted QALY gain (20.5) and is therefore eligible for additional QALY weighting under the NICE HST process; an ICER of up to £205,000 per QALY gained could be considered cost-effective under this framework. CONCLUSION The results of the model show VN to be a cost-effective use of healthcare resources in the UK at list price. The availability of a commercial discount in the UK (as considered in the NICE appraisal) means that in reality the ICER will be even lower. Plain language summary available for this article.
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Affiliation(s)
| | | | - Raisa Sidhu
- Novartis Pharmaceuticals UK Limited, London, UK
| | | | | | | | - Robert E MacLaren
- Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust and NIHR Oxford Biomedical Research Centre, Oxford, UK
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Rao A, Raj N, Padhy D, Sarangi S. Perspectives and impediment to eye care in caregivers of children with childhood glaucoma. Indian J Ophthalmol 2020; 68:798-804. [PMID: 32317449 PMCID: PMC7350503 DOI: 10.4103/ijo.ijo_753_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Purpose: To study the perceptions, attitude, knowledge of the disease, and impediments to seeking early eye care in caregivers of children with childhood glaucoma. Methods: The study included new and old children diagnosed with childhood glaucoma (which included congenital glaucoma and developmental glaucoma) at a tertiary hospital of east India. The caregivers were administered a video-based questionnaire through open-ended questions intended to collect demographic and other personal details such as caregiver's socioeconomic status, knowledge, attitude towards eye health, and other social barriers. The responses were analyzed using thematic analysis technique into different buckets such as social status, knowledge/attitude, and sociocultural beliefs while individual responses in each bucket were analyzed. Results: Of a total of 43 patients included, >75% of patients came from places >200 km from the eye care centre with >50% coming from >300 km. Most patients presented either <1 year (42%, n = 18) or >3 years (52%, n = 22) with only 2% (n = 3) presenting between 1–3 years of age. The mother was the first person of contact to diagnose the eye abnormality in >45% of patients. Comparing differences among children who presented within 1 year of first diagnosis and those that presented later, caregivers hailing from long-distance >200 km from an eye care center, monthly income <5000 INR, and those with social/cultural taboos (like children's eyes should not be operated) were more likely to seek delayed eye care for congenital glaucoma, P < 0.001. Conclusion: Impediments in seeking early eye care for blinding diseases in children (including distance from the nearest hospital, low socioeconomic constraints, and sociocultural beliefs/taboos) mandate serious policies towards improving education about eye disease and eye health among caregivers.
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Lupón M, Armayones M, Cardona G. Quality of life among parents of children with visual impairment: A literature review. RESEARCH IN DEVELOPMENTAL DISABILITIES 2018; 83:120-131. [PMID: 30195210 DOI: 10.1016/j.ridd.2018.08.013] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 01/31/2018] [Accepted: 08/28/2018] [Indexed: 06/08/2023]
Abstract
AIMS To describe the experience of parents caregiving children with visual impairment (VI), to determine how their quality of life (QoL) is assessed, and to summarize QoL indicators through a review of the literature. METHODS A thematic search through PubMed, PsycINFO, ProQuest and ERIC databases was performed of articles published in English in peer-reviewed journals between 1996 and 2016. Publications were included if they referred to both children or adolescents with VI and their parents, or the family context. The complete selection process disclosed 37 papers suitable for review. RESULTS Researchers mainly used ad hoc interviews and questionnaires to investigate this topic. Two specific tools, the CarCGQoL (congenital glaucoma) and the OTI (congenital cataract), were identified. Most of the information collected referred to the parents' opinion concerning professional services, their needs and worries, the impact of VI on their emotional well-being and the strategies to assist parents to cope and adjust to the situation. CONCLUSIONS The experience of caring for a child with VI is mainly influenced by psychosocial factors. Information and guidance to understand the child's visual condition are insufficient, and the available resources reinforce concerns of caregivers regarding the child's opportunities, expressed as negative emotional reactions.
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Affiliation(s)
- Marta Lupón
- Psychology, Health & ICT (PSINET) - Universitat Oberta de Catalunya, Rambla del Poblenou, 156, Barcelona, Spain; Vision, Optometry and Health (VOS) Research Group - Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, Terrassa, Spain.
| | - Manuel Armayones
- Psychology, Health & ICT (PSINET) - Universitat Oberta de Catalunya, Rambla del Poblenou, 156, Barcelona, Spain.
| | - Genís Cardona
- Vision, Optometry and Health (VOS) Research Group - Department of Optics and Optometry, Universitat Politècnica de Catalunya, Violinista Vellsolà, 37, Terrassa, Spain.
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Hanemoto T, Hikichi Y, Kikuchi N, Kozawa T. The impact of different anti-vascular endothelial growth factor treatment regimens on reducing burden for caregivers and patients with wet age-related macular degeneration in a single-center real-world Japanese setting. PLoS One 2017; 12:e0189035. [PMID: 29220371 PMCID: PMC5722328 DOI: 10.1371/journal.pone.0189035] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/19/2017] [Indexed: 12/02/2022] Open
Abstract
Objective To describe the burden associated with different anti-vascular endothelial growth factor (VEGF) treatment strategies for wet age-related macular degeneration (wAMD) in a real-word setting in Japan. Methods Single-center, cross-sectional survey of caregivers of patients with wAMD performed in a hospital in Mito-City, a rural area in Japan. Caregiver burden was evaluated using the Burden Index of Caregivers (BIC-11), and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression scale. Retrospective medical chart review was conducted to monitor resource use and visual acuity outcomes in patients. The productivity loss of caregivers accompanying patients on hospital visits was estimated using the human capital method. Results Seventy-one patient-caregiver pairs were included. Most caregivers were female (74.6%), spouse/partner (54.9%), employed (46.5%), and the primary caregiver (85.9%). Patients received anti-VEGF treatment as follows: treat-and-extend (T&E; n = 42), switch (from as-needed [PRN] to T&E; n = 18), PRN (n = 10), and other (n = 1). Caregiver-related burden (total BIC-11 scores) were 4.29 (T&E) 4.60 (PRN), and 5.33 (switch) (p = NS). The mean number of hospital visits was lower with T&E than PRN (7.88 vs. 14.0 [p = 0.00674] in year 1 and 5.68 vs. 9.0 in year 2). For patients who switched from PRN to T&E, the mean number of hospital visits decreased from 13.21 to 7.43 (p<0.0001) in the first year after switch. The productivity loss associated with accompanying patients to the hospital was lower for caregivers of patients receiving T&E than PRN (mean differences: 74,456.04 JPY [p = 0.00284] in year 1 and 40843.14 JPY in year 2), and was also reduced for caregivers of patients who switched from PRN to T&E. Conclusion wAMD treatment with anti-VEGF agents via T&E reduced hospital visits compared with PRN, where associated monitoring visits are necessary to provide good patient outcomes. T&E was associated with a reduction trend in caregiver burden, including time and costs.
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Affiliation(s)
- Tsukasa Hanemoto
- Department of Ophthalmology, Kozawa Eye Hospital, Ibaraki, Japan
- * E-mail:
| | - Yusuke Hikichi
- Market Access, Health Economics and Outcomes Research, Bayer Yakuhin, Ltd., Tokyo, Japan
| | | | - Tadahiko Kozawa
- Department of Ophthalmology, Kozawa Eye Hospital, Ibaraki, Japan
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Khare S, Rohatgi J, Bhatia MS, Dhaliwal U. Burden and depression in primary caregivers of persons with visual impairment. Indian J Ophthalmol 2017; 64:572-7. [PMID: 27688278 PMCID: PMC5056544 DOI: 10.4103/0301-4738.191493] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Context: Caregivers who assist persons with visual impairment often neglect their needs, resulting in burden and depression. Rehabilitation efforts, directed to the disabled, seldom target the caregiver. Aim: To assess burden and depression in persons caring for blind individuals. Settings and Design: This was a cross-sectional study carried out in the outpatient department of a tertiary-level teaching hospital in New Delhi. Materials and Methods: Institutional Ethical Board approval was obtained and written informed consent too was obtained from the participants involved in this study. Persons with best-corrected vision <20/200 in the better eye, and their primary caregivers, were recruited. We recorded demography, other illness/disability, household income, relationship with disabled person, and caregiver burden (Caregiver Burden Scale) and depression (Centre for Epidemiologic Studies Depression Scale). Statistical Analysis: Statistical analysis was carried out using SPSS version 20 (Released 2011. Armonk, NY: IBM Corp.); range, average, and standard deviation were determined for age, burden, and depression. The association between burden and depression was determined using Pearson's correlation; the relationship between degree of disability and caregiver burden and depression was determined using unpaired t-test; using multiple linear regression, factors were found to be statistically significant; significance was taken at P < 0.05. Results: Twenty-seven (53.0%) men and 24 (47.0%) women had visual impairment. Most caregivers (n = 40; 81.6%) were first-degree relatives or a spouse; 32 (65%) had schooling <5 years; and 29 (59%) were unemployed. Depression ranged from 21 to 52 (average 43.2 ± 5.71); it correlated with degree of disability (P = 0.012), household income (r = −0.320; P = 0.025), and burden (r = 0.616; P < 0.001). Burden ranged from 30 to 73 (average 54.5 ± 6.73) and correlated with degree of disability (P = 0.006). On multiple linear regression, burden predicted depression (r = 0.557; P < 0.001). Conclusions: Caregivers merit community support, financial benefit, interventions to diagnose and treat depression, and training in coping. Centers that provide disability certification could offer counseling.
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Affiliation(s)
- Shubhank Khare
- Department of Ophthalmology, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Jolly Rohatgi
- Department of Ophthalmology, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Manjeet Singh Bhatia
- Department of Psychiatry, University College of Medical Sciences and GTB Hospital, New Delhi, India
| | - Upreet Dhaliwal
- Department of Ophthalmology, University College of Medical Sciences and GTB Hospital, New Delhi, India
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Braich PS, Kuriakose RK, Khokhar NS, Donaldson JC, McCulley TJ. Factors associated with multiple recurrences of nonspecific orbital inflammation aka orbital pseudotumor. Int Ophthalmol 2017. [DOI: 10.1007/s10792-017-0610-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Young MT, Melvani RT, Khan FA, Braich PS, Bansal S. Association of Intraocular Pressure With Human Immunodeficiency Virus. Am J Ophthalmol 2017; 176:203-209. [PMID: 28147228 DOI: 10.1016/j.ajo.2017.01.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Revised: 01/19/2017] [Accepted: 01/20/2017] [Indexed: 11/15/2022]
Abstract
PURPOSE Prior studies have shown an association between human immunodeficiency virus (HIV) and reduced intraocular pressures (IOP). The purpose of this study was to determine if patients with HIV on highly active antiretroviral therapy (HAART) had any difference in their IOP compared with patients without HIV or with HIV who are not on HAART. DESIGN Retrospective cross-sectional study. METHODS We included 400 patients from our academic eye center between 2000 and 2016. Group 1 (G1) consisted of patients with HIV on HAART (n = 176), Group 2 (G2) consisted of patients with HIV who were not on HAART (n = 48), and Group 3 (G3) consisted of controls without HIV (n = 176). An analysis of variance (ANOVA) was performed to compare mean IOP values. Multivariate linear and logistic regression models were performed to assess factors impacting IOP. Difference in IOP was the primary outcome being measured. RESULTS The mean IOPs in mm Hg were 13.7 ± 5.1 (G1), 13.1 ± 3.6 (G2), and 17.3 ± 3.8 (G3), P < .01. In regression modeling, having a CD4 count ≤700 cells/mm3 contributed to a 2.1 mm Hg decrease in IOP. Patients with HIV were 7 times more likely to have an IOP ≤10 mm Hg, and patients with a CD4 count ≤700 cells/mm3 were 13 times more likely to have an IOP ≤10 mm Hg. CONCLUSIONS Absolute CD4 counts may play a role in IOP fluctuations. This association was found in patients with HIV regardless of whether patients were on HAART.
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Affiliation(s)
- Matthew T Young
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia.
| | - Rakhi T Melvani
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia
| | - Faraaz A Khan
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia
| | - Puneet S Braich
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Surbhi Bansal
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, Virginia
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Kusaba T, Sato K, Fukuma S, Yamada Y, Matsui Y, Matsuda S, Ando T, Sakushima K, Fukuhara S. Influence of family dynamics on burden among family caregivers in aging Japan. Fam Pract 2016; 33:466-70. [PMID: 27450988 PMCID: PMC5022125 DOI: 10.1093/fampra/cmw062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. OBJECTIVE To examine the influence of family dynamics on burden experienced by family caregivers. METHODS We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver's activity of daily living and cognitive function. RESULTS Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). CONCLUSION Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver's degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers.
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Affiliation(s)
- Tesshu Kusaba
- The Hokkaido Centre for Family Medicine, Hokkaido, Japan
| | - Kotaro Sato
- The Hokkaido Centre for Family Medicine, Hokkaido, Japan
| | - Shingo Fukuma
- Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and
| | - Yukari Yamada
- Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and
| | | | | | - Takashi Ando
- The Hokkaido Centre for Family Medicine, Hokkaido, Japan
| | - Ken Sakushima
- Department of Regulatory Science, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Shunichi Fukuhara
- Department of Healthcare Epidemiology, Kyoto University School of Public Health and Graduate School of Medicine, Kyoto, Japan, Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, Fukushima, Japan, Institute for Health Outcomes and Process Evaluation Research (iHope International), Kyoto, Japan and
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Kuriakose RK, Khan Z, Almeida DRP, Braich PS. Depression and burden among the caregivers of visually impaired patients: a systematic review. Int Ophthalmol 2016; 37:767-777. [PMID: 27473225 DOI: 10.1007/s10792-016-0296-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 07/14/2016] [Indexed: 11/29/2022]
Abstract
Caregiving has evolved as an important issue not only for those receiving care, but for those providing it as well. While caregiving allows those with disabilities to better adapt, it has been shown to take a toll on the caregiver on various levels, such as invoking depression and burden. The purpose of this study was to perform a systematic review of the literature pertaining to depression and burden among caregivers of patients with visual impairment. A comprehensive literature search using multiple databases was conducted to include all articles on burden of care or depression among the caregivers of the visually impaired. Nine studies were included in this review. There was demonstrable association of depression and burden with the caregivers of the visually impaired. Communication theory, emotional contagion, and care burden were cited as factors associated with depression in these studies. A number of other elements were also identified to play a role in depression and burden, such as providing greater hours of supervision to the patient, multiple chronic conditions in the patient or caregiver, patient not completing vision rehabilitation, and female gender of the caregiver. By identifying those at risk for decreased quality of life outcomes, health care providers may be able to alter the management of the visually impaired, such as advocating the use of vision rehabilitation clinics in order to minimize the caregiver burden and depression.
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Affiliation(s)
- Robin K Kuriakose
- Department of Ophthalmology, Nelson Clinic, Virginia Commonwealth University School of Medicine, 401 N 11th St, Suite 439, 4th Floor, Richmond, VA, 23298, USA
| | - Zainab Khan
- Department of Ophthalmology, Hotel Dieu Hospital, Queen's University, Kingston, ON, Canada
| | | | - Puneet S Braich
- Department of Ophthalmology, Nelson Clinic, Virginia Commonwealth University School of Medicine, 401 N 11th St, Suite 439, 4th Floor, Richmond, VA, 23298, USA.
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Mohanty S, Pradhan B, Hankey A. Upper extremity strength and motor speed in children with visual impairment following a 16-week yoga training program. ISOKINET EXERC SCI 2016. [DOI: 10.3233/ies-150607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Braich PS, Jackson M, Knohl SJ, Bhoiwala D, Gandham SB, Almeida D. Burden and Depression in Caregivers of Blind Patients in New York State. Ophthalmic Epidemiol 2016; 23:162-70. [PMID: 26953611 DOI: 10.3109/09286586.2015.1099684] [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: 11/13/2022]
Abstract
PURPOSE To describe the degree of burden of care and the proportion at risk of depression among individuals caring for legally blind patients. METHODS We performed a cross-sectional study of 486 individuals providing care to their family members who were legally blind. Best-corrected visual acuity of the better-seeing eye in patients determined group placement: Group 1, 20/200-10/200; group 2, 10/200 to light perception (LP); group 3, no light perception (NLP); group VF, visual field loss to <20 central degrees. Burden was evaluated using the Burden Index of Caregivers (BIC-11) and the prevalence at risk of depression was determined by the Center for Epidemiologic Studies Depression (CES-D) scale. RESULTS Total mean BIC-11 scores ranged from 8.78 ± 4.82 (group 1) to 12.03 ± 5.22 (group 3; p = 0.04). Daily hours spent on close supervision, intensity of caregiving and presence of multiple chronic illnesses in caregivers were the significant covariates affecting BIC-11 scores (p < 0.05). The prevalence of caregivers at risk of depression increased with vision loss from 6.9% (group 1) to 17.9% (group 3; p < 0.05). Female caregivers had an odds ratio (OR) of 2.89 for depression (95% confidence interval, CI, 1.07-3.97; p = 0.04). Caregivers with ≥2 comorbidities had OR 4.24 (95% CI 2.41-6.11) for risk of depression (p < 0.01). CONCLUSION Burden of care was highest among caregivers who provided greater hours of supervision. Patients with more limitations in their activities of daily living had caregivers who reported higher burden. Female caregivers and caregivers with multiple chronic illnesses were at higher risk of depression.
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Affiliation(s)
- Puneet S Braich
- a Department of Ophthalmology , Virginia Commonwealth University , Richmond , VA , USA
| | - Matthew Jackson
- b Department of Internal Medicine , SUNY Upstate Medical University , Syracuse , NY , USA
| | - Stephen J Knohl
- b Department of Internal Medicine , SUNY Upstate Medical University , Syracuse , NY , USA
| | - Devang Bhoiwala
- c Department of Ophthalmology , Albany Medical College , Albany , NY , USA
| | - Sai B Gandham
- c Department of Ophthalmology , Albany Medical College , Albany , NY , USA
| | - David Almeida
- d Department of Ophthalmology , University of Iowa , Iowa City , IA , USA
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Burden and Depression among Caregivers of Visually Impaired Patients in a Canadian Population. Adv Med 2016; 2016:4683427. [PMID: 27051859 PMCID: PMC4802024 DOI: 10.1155/2016/4683427] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 01/24/2016] [Indexed: 11/18/2022] Open
Abstract
Purpose/Background. This study reports the degree of burden and the proportion at risk for depression among individuals who provide care to visually impaired patients. Study Design. This is clinic-based, cross-sectional survey in a tertiary care hospital. Methods. Caregivers were considered unpaid family members for patients whose sole impairment was visual. Patients were stratified by vision in their better seeing eye into two groups: Group 1 had visual acuity between 6/18 and 6/60 and Group 2 were those who had 6/60 or worse. Burden was evaluated by the Burden Index of Caregivers and the prevalence of being at risk for depression was determined by the Center for Epidemiologic Studies Depression scale. Results. 236 caregivers of 236 patients were included. Total mean BIC scores were higher in Group 2. Female caregivers, caregivers providing greater hours of care, and caregivers of patients who have not completed vision rehabilitation programs are at higher risk for depression.
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Estimation of depression prevalence in patients with Stargardt disease using PHQ-9 and Zung scores. Eur J Ophthalmol 2015; 26:268-72. [PMID: 26541115 DOI: 10.5301/ejo.5000700] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the psychological impact and depression prevalence in patients with Stargardt disease. METHODS We conducted a case-control study including 39 patients with Stargardt disease and 32 age- and sex-matched healthy controls. All participants underwent a complete ophthalmologic examination and completed the Patient Health Questionnaire-9 (PHQ-9) and the Zung Depression Inventory questionnaire. Results were analyzed using IBM SPSS 22.0 software. RESULTS The patient group consisted of 19 men and 20 women with mean age of 36.9 ± 5.4 years and control group of 19 men and 13 women with mean age of 42.5 ± 10.1 years. The mean values of PHQ-9 and Zung scores for patients and healthy individuals were 10.9 ± 4.9, 46.7 ± 11.1, 6.7 ± 5.4, and 41.1 ± 8.5, respectively. There were statistically significant differences between the 2 groups in PHQ-9 scores (independent samples t test: p = 0.001), but not in Zung scores (Mann-Whitney test: p = 0.053). The PHQ-9 and Zung scores appeared to be moderately but significantly correlated (Pearson coefficient 0.44, p<0.0001). In addition, PHQ-9 score seems to be raised along with age, whereas both scores are low when best-corrected visual acuity is high. CONCLUSIONS Patients with Stargardt disease exhibited more depressive symptoms compared to healthy individuals according mainly to PHQ-9 scores. Moderate depression was significantly correlated visual function decline.
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Dyslipidemia and its association with meibomian gland dysfunction. Int Ophthalmol 2015; 36:469-76. [DOI: 10.1007/s10792-015-0149-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/19/2015] [Indexed: 10/22/2022]
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Braich PS, Aggarwal S, Mukhtar S, Almeida DR. Nosocomial keratitis caused by methicillin-resistant Staphylococcus aureus: case report and preventative measures. J Community Hosp Intern Med Perspect 2015; 5:28769. [PMID: 26486112 PMCID: PMC4612473 DOI: 10.3402/jchimp.v5.28769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 08/17/2015] [Indexed: 12/03/2022] Open
Abstract
A 47-year-old African-American woman was admitted to the intensive care unit of our community hospital for respiratory failure secondary to severe decompensated heart failure, requiring intubation. In the ensuing days, she developed a methicillin-resistant Staphylococcus aureus (MRSA) infection of the cornea, despite no growth of MRSA in multiple blood, sputum, and urine cultures. This unexpected corneal infection complicated her hospital stay, and increased morbidity and disease-related cost. Risk factors, warning signs, and preventative measures for MRSA keratitis secondary to lagophthalmos (inability to completely close one's eyelids) are outlined in this case report. Implementing simple precautions such as taping eyelids shut or using artificial lubrication may reduce patient morbidity and disease-related costs. These recommendations are directed to non-ophthalmic clinicians who provide care to patients in settings where MRSA colonization is widespread.
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Affiliation(s)
- Puneet S Braich
- Department of Ophthalmology, Virginia Commonwealth University, Richmond, VA, USA;
| | - Shruti Aggarwal
- Department of Ophthalmology, University of Virginia, Charlottesville, VA, USA
| | - Sabrina Mukhtar
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - David Rp Almeida
- Department of Ophthalmology, VitreoRetinal Surgery, PA, Minneapolis, MN, USA
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Ton TG, Mackenzie C, Molyneux DH. The burden of mental health in lymphatic filariasis. Infect Dis Poverty 2015; 4:34. [PMID: 26229599 PMCID: PMC4520254 DOI: 10.1186/s40249-015-0068-7] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 07/20/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Neglected Tropical Diseases (NTDs) afflict around one billion individuals in the poorest parts of the world with many more at risk. Lymphatic filariasis is one of the most prevalent of the infections and causes significant morbidity in those who suffer the clinical conditions, particularly lymphedema and hydrocele. Depressive illness has been recognised as a prevalent disability in those with the disease because of the stigmatising nature of the condition. No estimates of the burden of depressive illness of any neglected tropical disease have been undertaken to date despite the recognition that such diseases have major consequences for mental health not only for patients but also their caregivers. METHODS We developed a mathematical model to calculate the burden of Disability- Adjusted Life Years (DALY) attributable to depressive illness in lymphatic filariasis and that of their caregivers using standard methods for calculating DALYs. Estimates of numbers with clinical disease was based on published estimates in 2012 and the numbers with depressive illness from the available literature. RESULTS We calculated that the burden of depressive illness in filariasis patients was 5.09 million disability-adjusted life years (DALYs) and 229,537 DALYs attributable to their caregivers. These figures are around twice that of 2.78 million DALYs attributed to filariasis by the Global Burden of Disease study of 2010. CONCLUSIONS Lymphatic filariasis and other neglected tropical diseases, notably Buruli Ulcer, cutaneous leishmaniasis, leprosy, yaws, onchocerciasis and trachoma cause significant co morbidity associated with mental illness in patients. Studies to assess the prevalence of the burden of this co-morbidity should be incorporated into any future assessment of the Global Burden of neglected tropical diseases. The prevalence of depressive illness in caregivers who support those who suffer from these conditions is required. Such assessments are critical for neglected tropical diseases which have such a huge global prevalence and thus will contribute a significant burden of co-morbidity attributable to mental illness.
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Affiliation(s)
- Thanh G.N. Ton
- />Precision Health Economics, 555 12 th Avenue, Suite 1650, Oakland, CA 94607 USA
| | - Charles Mackenzie
- />Filariasis Programmes Support Unit, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
| | - David H. Molyneux
- />LSTM NTDs, Department of Parasitology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA UK
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Gopinath B, Kifley A, Cummins R, Heraghty J, Mitchell P. Predictors of psychological distress in caregivers of older persons with wet age-related macular degeneration. Aging Ment Health 2015; 19:239-46. [PMID: 24943714 DOI: 10.1080/13607863.2014.924477] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Several studies have investigated the biopsychosocial impacts of age-related macular degeneration (AMD) in regards to the older patient, little is known about the impacts associated with caring for individuals with AMD. We aimed to determine the predictors of subjective caregiver distress and other negative outcomes associated with caring for someone with advanced AMD. METHODS Cross-sectional, self-complete survey involving 500 caregivers of persons with advanced AMD. Respondents were identified from the Macular Disease Foundation of Australia client database. Logistic regression tested the independent effects of care recipient and caregiver characteristics on study outcomes, including: caregiver psychological well-being, participation in recreational/social activities and retirement plans. RESULTS Around one third of caregivers self-reported a high level of care recipient dependence. Over one in two caregivers reported a negative state of mind. Comorbid chronic illnesses in the care recipient were associated with the caregiver reporting psychological distress, multivariable-adjusted odds ratio, OR, 1.45 (95% confidence intervals, CI, 1.14-1.86). If the care recipient was highly dependent on the caregiver, there was 99% greater likelihood of caregiver distress, OR 1.99 (95% CI 1.01-3.93). Comorbid chronic conditions in the care recipient was associated with 49% and 31% higher odds of the caregiver reporting disruption to other areas of their life and retirement plans related to the caregiving experience, respectively. CONCLUSIONS A high prevalence of caregiver distress related to caring for persons with advanced AMD was observed. Level of dependence on the caregiver and presence of comorbid chronic illnesses were independent predictors of the caregiver experiencing psychological distress.
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Affiliation(s)
- Bamini Gopinath
- a Centre for Vision Research, Department of Ophthalmology and Westmead Millennium Institute , University of Sydney , Australia
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Sun W, Wu F, Kong J, Nakahara Y, Li XY. Analysis on the psychological characteristics of patients with acute iridocyclitis. Int J Ophthalmol 2015; 8:635-6. [PMID: 26086022 DOI: 10.3980/j.issn.2222-3959.2015.03.36] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 12/01/2014] [Indexed: 11/02/2022] Open
Affiliation(s)
- Wei Sun
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
| | - Fan Wu
- Department of Psychology, the Fourth Affiliated Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
| | - Jun Kong
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
| | - Yukiko Nakahara
- Department of Medical Engineering, Faculty of Health Science, Junshin Gakuen University, Chikushioka1-1-1, Fukuoka 815-8510, Japan
| | - Xiao-Yan Li
- Department of Ophthalmology, the Fourth Affiliated Hospital of China Medical University, Eye Hospital of China Medical University, Shenyang 110005, Liaoning Province, China
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Oakley SH, Crisp CC, Estanol MV, Westermann LB, Ghodsi VC, Kleeman S, Pauls RN. Perioperative Caregiver Burden in the Geriatric Urogynecologic Population: A Prospective Cohort Study. J Gynecol Surg 2015. [DOI: 10.1089/gyn.2014.0118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- Susan H. Oakley
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
| | - Catrina C. Crisp
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
| | - Maria V. Estanol
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
- Cincinnati Urogynecology Associates, Good Samaritan Hospital, Cincinnati, OH
| | - Lauren B. Westermann
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
| | - Vivian C. Ghodsi
- Hatton Research Institute, Good Samaritan Hospital, Cincinnati, OH
| | - Steven Kleeman
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
| | - Rachel N. Pauls
- Division of Urogynecology and Pelvic Reconstructive Surgery, Good Samaritan Hospital, Cincinnati, OH
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Molyneux DH. Neglected tropical diseases: now more than just 'other diseases'--the post-2015 agenda. Int Health 2014; 6:172-80. [PMID: 24969646 DOI: 10.1093/inthealth/ihu037] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Neglected tropical diseases (NTDs) have become recognised as important health problems facing at least a billion people in the low-income countries and the poorest communities in middle-income countries. WHO plays a leading role in developing strategies to address these diseases, pharmaceutical companies provide drug donations to treat or control the NTDs and many partners from different constituencies have become increasingly committed to their control or elimination. This review looks to the post-2015 agenda and emphasises that despite the progress made over recent years, if the targets established are to be achieved, then not only will additional financial resources be required to up-scale treatments and increase access, but increased applied and operational research will be necessary to address problems and human capacity in NTD skills will need to be strengthened. Continuing advocacy for the relevance of control or elimination of NTDs must be placed in the context of universal health coverage and access to donated essential medicines for the poor as a right. The evidence that investment in NTD interventions are cost-effective and impact not only on health, but also to enhance socio-economic development, must be refined and promulgated. The global burden of disease attributable to NTDs requires reassessment to appropriately define the true burden, while the potential for unexpected events, political, climatic, environmental as well as biological, have the potential to reduce future progress towards the agreed post-2015 targets. NTD progress towards the WHO Roadmap targets and the fulfilment of the World Health Assembly Resolution 66.12 of 2013 demand continued commitment from all partner constituencies when challenges emerge.
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Affiliation(s)
- David H Molyneux
- Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
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Caregiver burden in ocular disease. Ophthalmology 2013; 120:1107-8. [PMID: 23642751 DOI: 10.1016/j.ophtha.2013.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/16/2013] [Indexed: 11/21/2022] Open
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Author reply. Ophthalmology 2013; 120:1108. [DOI: 10.1016/j.ophtha.2013.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 01/16/2013] [Indexed: 11/20/2022] Open
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Litt E, Baker MC, Molyneux D. Neglected tropical diseases and mental health: a perspective on comorbidity. Trends Parasitol 2012; 28:195-201. [PMID: 22475459 DOI: 10.1016/j.pt.2012.03.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Revised: 03/04/2012] [Accepted: 03/04/2012] [Indexed: 12/15/2022]
Abstract
Mental health conditions will be the largest contributor to the global health burden by 2030. Our review suggests that neglected tropical diseases (NTDs) predispose individuals to poor mental health. Factors predisposing to poor mental health include stigma and discrimination, exclusion from participating fully in society, reduced access to health and social services, lack of educational opportunities, exclusion from income-generation and employment opportunities, and restrictions in exercising civil and political rights. These characteristics are all features of NTDs, but the mental health of these sufferers has been ignored. This review raises an issue of concern and highlights the opportunities for research by psychiatrists and psychologists on NTDs.
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Affiliation(s)
- Elizabeth Litt
- Centre for Neglected Tropical Diseases, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK
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