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Duangjina T, Hershberger PE, Gruss V, Fritschi C. Resilience in family caregivers of Asian older people with dementia: An integrative review. J Adv Nurs 2024. [PMID: 38863175 DOI: 10.1111/jan.16272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024]
Abstract
AIM To identify factors associated with resilience in family caregivers of Asian older people with dementia based on Luthar and Cicchetti's definition of resilience. DESIGN Integrative review of resilience in family caregivers of Asian older people with dementia reported by studies with quantitative and qualitative research designs. DATA SOURCES Databases used for the literature search included CINAHL, PubMed, EMBASE, PsycINFO and Google Scholar. REVIEW METHODS A total of 565 potentially relevant studies published between January 1985 and March 2024 were screened, and 27 articles met the inclusion criteria. RESULTS Family caregivers were most commonly adult children of care recipients, female and providing care in their home. Two themes emerged from the review: factors associated with adversity (dementia severity, caregiver role strain, stigma, family stress, female gender, low income and low education) and factors associated with positive adaptational outcomes (positive aspect of caregiving, social support and religiosity/spirituality). CONCLUSION In our review of Asian research, four new factors-caregiver role strain, stigma, family stress and positive aspects of caregiving-emerged alongside those previously identified in Western studies. A paradigm shift was observed from a focus on factors associated with adversity to factors associated with positive adaptational outcomes, particularly after the issuance of the WHO's 2017 global action plan for dementia. However, a gap remains between WHO policy recommendations and actual research, with studies often neglecting to address gender and socioeconomic factors. IMPACT The review findings will broaden healthcare providers' understanding of resilience in dementia caregivers and use them to develop comprehensive programmes aimed at reducing factors associated with adversity and enhancing those associated with positive adaptational outcomes. This approach can be customized to incorporate Asian cultural values, empowering caregivers to navigate challenges more effectively. NO PATIENT OR PUBLIC CONTRIBUTION This paper is an integrative review and does not include patient or public contributions.
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Affiliation(s)
- Thitinan Duangjina
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia E Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Cynthia Fritschi
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
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Mulati N, Aung MN, Moolphate S, Aung TNN, Koyanagi Y, Supakankunti S, Yuasa M. Disparity in the Burden of Caring for Older Persons between Families Living in Housing Estates and Traditional Communities in Thailand. Eur J Investig Health Psychol Educ 2024; 14:1514-1526. [PMID: 38921066 PMCID: PMC11202914 DOI: 10.3390/ejihpe14060100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2024] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Thailand's rapid population aging and reliance on family-based long-term care requires research into disparities in family caregiver burden. Since the type of residence matters to the caregiving outcome, this research aimed to examine the difference in caregiver burden between residents of private housing estates and traditional village communities. This cross-sectional study was conducted with 1276 family caregivers of community-dwelling Thai older adults, in Chiang Mai province, Thailand. The caregiver burden was examined using the Caregiver Burden Inventory (CBI), and the care recipients' dependency status was examined using Barthel's Activity of Daily Living (ADL). Descriptive analysis, multivariate analysis of variance test, and multiple logistic regression analysis were performed. Family caregivers living in a traditional village community were 1.607 times more likely to experience emotional burden (adj. OR 1.607, 95% CI: 1.049, 2.462) and 2.743 times more likely to experience overall caregiver burden (adj. OR: 1.163, 95% CI: 1.163, 6.471) compared to those in the private housing estate group. Our findings showed significant differences in caregiver burden based on residential area, contributing with insights to evidence-based policies, interventions, and programs to minimize disparities and promote family caregivers' health and well-being.
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Affiliation(s)
- Nadila Mulati
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (N.M.); (M.Y.)
| | - Myo Nyein Aung
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (N.M.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
- Advanced Research Institute for Health Sciences, Juntendo University, Tokyo 113-8421, Japan
| | - Saiyud Moolphate
- Department of Public Health, Faculty of Science and Technology, Chiang Mai Rajabhat University, Chiang Mai 50300, Thailand;
| | - Thin Nyein Nyein Aung
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand;
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Yuka Koyanagi
- Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences, Tokyo 135-0063, Japan;
| | - Siripen Supakankunti
- Centre of Excellence for Health Economics, Faculty of Economics, Chulalongkorn University, Bangkok 10330, Thailand;
| | - Motoyuki Yuasa
- Department of Global Health Research, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (N.M.); (M.Y.)
- Faculty of International Liberal Arts, Juntendo University, Tokyo 113-8421, Japan
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Xu S, Lou VWQ, Chi I, Ng WC, Zhou J, Huang LK, Hok Ka Ma C, Jagasia M. Validating interRAI Chinese self-reported carer needs (SCaN) assessment and predicting caregiving distress among informal Chinese caregivers of older adults. BMC Geriatr 2024; 24:409. [PMID: 38720258 PMCID: PMC11080141 DOI: 10.1186/s12877-024-05014-0] [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: 01/02/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aims to (1) determine the reliability and validity of the interRAI Chinese Self-reported Carer Needs (SCaN) assessment among informal Chinese caregivers of older adults, (2) identify predictors of caregiving distress in Asian regions with long-standing Confucian values of filial piety and family responsibility. METHODS This cross-sectional study recruited 531 informal Chinese caregivers of older adults in Hong Kong, Shanghai, Taiwan, and Singapore. The scale reliability was examined using Cronbach's alphas (α) and McDonald's omega coefficient (ω). The concurrent validity and discriminant validity were assessed using Spearman rank correlations (rho). To examine the predictors of caregiving distress among informal caregivers of older adults, we employed hierarchical linear regression analyses informed by the Model of Carer Stress and Burden and categorized the predictors into six domains. RESULTS Results revealed good internal consistency reliability (α = 0.83-0.96) and concurrent validity (rho = 0.45-0.74) of the interRAI Chinese SCaN assessment. Hierarchical linear regression analysis revealed that entering the background factors, primary stressors, secondary stressors, appraisal, and exacerbating factors all significantly enhanced the model's predictability, indicating that the source of caregiving distress is multidimensional. In the full model, caregivers with longer informal care time, lack of support from family and friends, have unmet needs, experience role overload, have sleep problems, and low IADL functioning are at a higher risk of caregiving distress. CONCLUSIONS The interRAI Chinese SCaN Assessment was found to be a reliable and valid tool among the Chinese informal caregivers of older adults. It would be useful for determining family caregivers' strengths, needs, and challenges, and tailoring interventions that address the potentially modifiable factors associated with caregiving distress and maximize support. Healthcare providers working in home and community settings should be aware of the early identification of caregiving distress and routine assessment of their needs and empower them to continue taking care of their needs and providing adequate care to the care recipient.
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Affiliation(s)
- Shicheng Xu
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Iris Chi
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | | | - Jing Zhou
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Joensuu, Finland
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Lung-Kuan Huang
- St. Camillus Long-term Care Center, Yi-lan County, Taiwan
- Fo Guang University, Yi-lan County, Taiwan
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Zhang N, Tian Z, Liu X, Yu X, Wang L. Burden, coping and resilience among caregivers for patients with chronic obstructive pulmonary disease: An integrative review. J Clin Nurs 2024; 33:1346-1361. [PMID: 38071504 DOI: 10.1111/jocn.16954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 10/29/2023] [Accepted: 11/17/2023] [Indexed: 03/08/2024]
Abstract
AIM This study aims to synthesise quantitative and qualitative evidence to comprehensively examine the burden of family caregivers of chronic obstructive pulmonary disease patients and to understand their coping strategies and related resilience factors. BACKGROUND Long-term chronic obstructive pulmonary disease care causes heavy psychological and physical burden to caregivers, which is related to the coping strategies used. Resilience is a protective factor originating within the individual and has become a concept related to illness, health and care. DESIGN An integrative review. METHODS Relevant literature was comprehensively searched from China Biology Medicine, China National Knowledge Infrastructure, Wan Fang, PubMed, Embase, Web of Science and Ovid databases from the establishment of the database till January 2023, and the quality of the selected articles was evaluated. Reporting was done according to a PRISMA checklist. FINDINGS The burden of family caregivers with chronic obstructive pulmonary disease includes poor health, worry and fear, anticipatory loss and uncertainty, relationship tensions and disagreements, loss of identity and social isolation, lack of supportive knowledge and financial burden. Family caregivers used problem-centred coping, emotion-centred coping, avoidance coping, social support and dyadic coping with their patients to manage their burdens. The factors chronic obstructive pulmonary disease associated with a caregiver's resilience included a higher level of knowledge, social and familial support, a close relationship with patients, a caregiver's sense of responsibility, the patient's high self-efficacy, etc. CONCLUSIONS: The findings show that caregivers of chronic obstructive pulmonary disease patients face multiple burdens, adapt through different coping styles and have different psychological consequences, while coping style and mental health status also affect the magnitude of burden. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE The findings informed health professionals about personalised chronic obstructive pulmonary disease home care interventions to reduce caregiver burden, effectively manage illness and maintain family intimacy. NO PATIENT OR PUBLIC CONTRIBUTION No patients, families, service providers or members of the public were involved in this study.
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Affiliation(s)
- Nan Zhang
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Zheng Tian
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xinyi Liu
- School of Nursing, Tianjin Medical University, Tianjin, China
| | - Xi Yu
- Department of Respiratory, Tianjin First Central Hospital, Tianjin, China
| | - Lan Wang
- School of Nursing, Tianjin Medical University, Tianjin, China
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Zhylkybekova A, Grjibovski AM, Glushkova N, Koshmaganbetova GK. Exploring the burden and support needs of informal caregivers for the older adults in Kazakhstan: a mixed-methods study protocol. Front Public Health 2024; 11:1248104. [PMID: 38249404 PMCID: PMC10796845 DOI: 10.3389/fpubh.2023.1248104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Background The growing population of older adults, often affected by chronic illnesses, disabilities, or frailty has led to a substantial increase in the need for informal caregivers. Objective This paper is a protocol for a study that aims to investigate the effects of caregiving on informal caregivers of older adults in Kazakhstan with special emphasis on the cultural context. Methods The protocol outlines a mixed-methods study that will be conducted in four cities in Kazakhstan. A total of 400 informal caregivers of older adults with two or more limitations in Activities of Daily Living (ADL) will be recruited to participate in a survey, aiming to evaluate care-related burdens and quality of life and health-related quality of life. The Institute for Medical Technology Assessment (iMTA) Valuation of Informal Care Questionnaire (iVICQ) was selected to be the main research instrument. Additionally, a subset of participants who express their willingness to participate will be selected from the pool of survey respondents to engage in semi-structured interviews, allowing for a deeper understanding of their experiences and providing insights into their social and medical support needs. Conclusion This study will be the first investigation of the impact of caregiving on informal caregivers of older adults in Central Asia. The results will contribute to the literature by providing insights into older adults care within the specific national and cultural context of Kazakhstan with potential generalization to other Central Asian republics of the former USSR.
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Affiliation(s)
- Aliya Zhylkybekova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulbakit K. Koshmaganbetova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Isac C, Lee P. Transitional care for older adults with chronic illness: A qualitative inquiry. Int J Older People Nurs 2024; 19:e12599. [PMID: 38268312 DOI: 10.1111/opn.12599] [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: 01/21/2023] [Revised: 11/07/2023] [Accepted: 12/29/2023] [Indexed: 01/26/2024]
Abstract
BACKGROUND Improved public health strategies and medical advancements have expanded older adults' survival after acute insults from chronic diseases. The resultant increase in disability and care requirements among older adults is significant. However, transitional care interventions to support the efficient transition from acute care settings to home are primitive in developing countries like India. OBJECTIVE This qualitative survey aimed to estimate the transitional care requirements of older adults with chronic illness discharged from acute care facilities. METHODS Descriptive phenomenological approach was utilised for this qualitative study. The older adult-family caregiver dyads fulfilling the inclusion criteria were interviewed until the achievement of information saturation. The transcribed narratives between the researcher, older adults and their caregivers were thematically analysed. Consolidated Criteria for Reporting Qualitative Research (COREQ) served as the framework for reporting this research. RESULTS Thirteen older adult-caregiver dyads participated in the semi-structured interview, which yielded six themes. Older adults have a hidden self with characteristics ranging between a continuum of 'insistence' to 'giving up'. Caregiver attributes identified from this inquiry were exhaustion, engagement and empowerment. The remaining four themes which constitute the framework for the 'transitional care progression' model include 'complications are mature when identified among older adults', 'medication knowledge is proportionate with its compliance', 'ignorance of supportive care increases caregiver burden' and 'deficient follow-up practices compromise health'. CONCLUSIONS Transitional care for older adults with chronic illness is premature in developing countries. However, the needs of older adults with chronic disease and their caregivers evolved from the present study align with global perspectives. Themes generated from the current qualitative interview, blended with evidence-based interventions, yielded the transitional care progression model, which serves as the only available framework for implementing transitional care in the region. IMPLICATIONS FOR PRACTICE Future research to establish the feasibility and validity of the 'transitional care progression model' is forecasted. The model requires inclusion within the healthcare curriculum. Professional nurses prepared to implement coordinated transitional care pathways are recommended.
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Affiliation(s)
- Chandrani Isac
- Faculty of Health, Education, Medicine & Social Work, School of Nursing & Midwifery, Anglia Ruskin University, Chelmsford, UK
| | - Premila Lee
- College of Nursing, Christian Medical College, Vellore, India
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Hooley B, Otchi EH, Mayeden S, Yawson AE, Awoonor-Williams K, Tediosi F. Examining the Utilization of Social Capital by Ghanaians When Seeking Care for Chronic Diseases: A Personal Network Survey. Int J Public Health 2023; 68:1605891. [PMID: 38179319 PMCID: PMC10764420 DOI: 10.3389/ijph.2023.1605891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/29/2023] [Indexed: 01/06/2024] Open
Abstract
Objectives: With limited social security and health protection in Ghana, intergenerational support is needed by those living with NCDs, who incur recurrent costs when seeking NCD care. We measured the level of informal support received by NCD patients and identified factors that influence support provision. Methods: We surveyed 339 NCD patients from three hospitals in Ghana, who listed their social ties and answered questions about their relationship and support frequency. We analyzed the relationship between social support, demographic and health information, characteristics of social ties, and network characteristics. Results: Participants described 1,371 social ties. Nearly 60% of respondents reported difficulties in their usual work or household duties due to chronic illness, which was also the strongest predictor of support. Patients with higher wellbeing reported less social support, while older age and having co-habitant supporters were negatively associated with support, indicating caregiver burnout. Conclusion: Ghanaian NCD patients receive support from various caregivers who may not be able to handle the increasing healthcare and social needs of an aging population. Policies should therefore enhance resource pooling and inclusiveness for old age security.
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Affiliation(s)
- Brady Hooley
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Elom Hillary Otchi
- Korle Bu Teaching Hospital, Accra, Ghana
- Accra College of Medicine, Accra, Ghana
| | | | - Alfred Edwin Yawson
- Korle Bu Teaching Hospital, Accra, Ghana
- Medical School, University of Ghana, Accra, Ghana
| | - Koku Awoonor-Williams
- Department of Policy, Planning, Monitoring and Evaluation, Ghana Health Service, Accra, Ghana
| | - Fabrizio Tediosi
- Swiss Tropical and Public Health Institute (Swiss TPH), Basel, Switzerland
- University of Basel, Basel, Switzerland
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Hao XY, Guo YX, Lou JS, Cao JB, Liu M, Mi TY, Li A, You SH, Cao FY, Liu YH, Li H, Zhou ZK, Xu JM, Wu QP, Gu XP, Wang DF, Peng YM, Ma LB, Wang LY, Tong L, Mi WD. Mental health changes in elderly patients undergoing non-cardiac surgery during the COVID-19 pandemic in China. J Affect Disord 2023; 343:77-85. [PMID: 37741468 DOI: 10.1016/j.jad.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 08/27/2023] [Accepted: 09/18/2023] [Indexed: 09/25/2023]
Abstract
BACKGROUND The COVID-19 pandemic has a heavy impact on the mental health of elderly surgical patients worldwide. In particular, the elderly patients faced considerable psychological stress due to various environmental and medical factors during the outbreak. This study aims to examine changes in mental health trends among non-cardiac surgical patients aged 65 and above in China during the COVID-19 pandemic. METHODS This multi-center, convenient sampling, longitudinal observational study was conducted from April 1, 2020 to April 30, 2022. Primary outcome was the prevalence of postoperative depression. Secondary outcome was the prevalence of postoperative anxiety. Follow-up was conducted separately at 7 days and 30 days after surgery. Depression symptoms were assessed using the Patient Health Questionnaire 9 (PHQ-9) scale. Anxiety symptoms were assessed using Generalized Anxiety Disorder-7 (GAD-7) scale, with scores of ≥5 defining positive depression or anxiety symptoms. Multivariate logistic regression analysis was used to investigate risk factors of mental health status in more elderly patients undergoing non-cardiac surgery. RESULTS A total of 4639 patients were included, of whom 2279 (46.0 %) were male, 752 (15.2 %) were over the age of 75, and 4346 (93.7 %) were married. The monthly prevalence trends demonstrated that compared to the outbreak period, a significant reduction in the prevalence of depression and anxiety symptoms in elderly patients who underwent surgery during the post-pandemic period. In post-pandemic period, a statistically significant decrease in the prevalence of all severity depression and anxiety patients was noted at the 7-day follow-up, but no significant decrease was observed for severe depression and anxiety in the 30-day follow-up. In COVID-19 low-risk area, a significant overall decrease in prevalence of mental health was observed during the post-pandemic period compared to the outbreak period, including 7-day depression, 7-day anxiety, 30-day depression, and 30-day anxiety (all with P < 0.001). Female and patients with ≥2 comorbidities appeared to be more susceptible to postoperative depression and anxiety during the pandemic. LIMITATION The absence of data from the early days of the COVID-19 outbreak. CONCLUSIONS This study analyzed the prevalence of depression and anxiety in elderly non-cardiac patients during and after the COVID-19 pandemic, focusing on dimensions such as severity, risk-areas, gender, and comorbidity. Our findings revealed a significant decrease in the prevalence of depression and anxiety in elderly surgery patients during the post-pandemic period.
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Affiliation(s)
- Xin-Yu Hao
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China; National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Yong-Xin Guo
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China; National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jing-Sheng Lou
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China; National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, 100853, China
| | - Jiang-Bei Cao
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Miao Liu
- Institute of Geriatrics, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Tian-Yue Mi
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia 29208, USA
| | - Ao Li
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Shao-Hua You
- Department of Pain Medicine, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Fu-Yang Cao
- Department of Anesthesiology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing 100048, China
| | - Yan-Hong Liu
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Hao Li
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Zhi-Kang Zhou
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Jun-Mei Xu
- Department of Anesthesiology, The Second Xiang-ya Hospital of Central South University, Changsha 410011, China
| | - Qing-Ping Wu
- Department of Anesthesiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiao-Ping Gu
- Department of Anesthesiology, Drum Tower Clinical Medical College of Nanjing Medical University, Nanjing, Jiangsu 210008, China
| | - Di-Fen Wang
- Department of Critical Care Medicine, The Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou 524000, China
| | - Yu-Ming Peng
- Department of Anesthesiology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Li-Bin Ma
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Li-Yun Wang
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China
| | - Li Tong
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China.
| | - Wei-Dong Mi
- Department of Anesthesiology, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing 100853, China; National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, 100853, China.
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Hirayama K, Kuribara T, Oshikiri M. Experiences of the older spousal caregivers of patients with cancer during palliative chemotherapy: a qualitative descriptive study. BMC Palliat Care 2023; 22:188. [PMID: 37993823 PMCID: PMC10666444 DOI: 10.1186/s12904-023-01313-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 11/17/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND Several studies have characterized the experiences of family members caring for patients undergoing chemotherapy; however, information about the experiences of older spousal caregivers with intensive caregiving burdens is unclear. Recently, more older patients have been diagnosed with cancer due to the aging population worldwide. Therefore, this study evaluated the patterns in the experiences of older spousal caregivers of patients undergoing palliative chemotherapy for advanced cancer. METHODS Qualitative research using semi-structured interviews was used in this study involving 10 older spousal caregivers of patients undergoing palliative chemotherapy at a hospital providing advanced cancer care in Japan. The data obtained were analyzed qualitatively and inductively using thematic analysis by Braun and Clarke. RESULTS Four themes were identified from the narratives of the participants in this study. The first theme was "getting used to living with the disease," indicating that the older spouses gradually became accustomed to living with the patient through continued caregiving. The second theme was "deepening view of life and death," indicating that the older spouses' views of life and death were deepened by being confronted with patients' quality of life until death. The third theme was "anxious about the future," indicating the fear regarding the patient's progressive diseases and anxiety pertaining to continuing care for the patient while dealing with their health problems. The final theme was "desire for a better rest of life," indicating that the couple felt their bond was strengthened through caregiving and wishes to live well for the rest of their lives. CONCLUSIONS The patterns in the experience of older spousal caregivers caring for patients undergoing palliative chemotherapy indicated an aspect of rebuilding their lives as they became accustomed to caregiving, while strengthening their marital bond. The caregiving process involved a mix of emotions, including anxiety about the spousal caregiver's health problems worsening. However, the caregivers recognized the value of their remaining time. Therefore, they had deep concern for the patient's comfort, concealing their feelings so that the patient would feel comfortable. This study can contribute to understanding the challenges faced and support needed by older spousal caregivers.
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Affiliation(s)
- Kengo Hirayama
- School of Nursing, Sapporo City University, Kita 11, Nishi 13, Chuo-ku, Sapporo, Japan.
| | - Tomoki Kuribara
- School of Nursing, Sapporo City University, Kita 11, Nishi 13, Chuo-ku, Sapporo, Japan
| | - Miho Oshikiri
- Department of Nursing, Sapporo Sato Hospital, 4-10-15, Fushiko 2, Higashi-ku, Sapporo, Japan
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Dalirsani Z, Ghazi A, Firouzabadi MG. Frequency of Systemic Diseases and Oral Lesions Among the Institutionalized Elderly Subjects in the Northeast of Iran. Indian J Dermatol 2023; 68:723. [PMID: 38371557 PMCID: PMC10868977 DOI: 10.4103/ijd.ijd_246_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Background With ageing, the number of systemic diseases and the consumption of drugs increase. Moreover, some oral lesions, especially denture-related lesions, are commonly observed. Aim and Objective The purpose of this study was to determine the frequency of systemic diseases and oral lesions in the elderly in the Mashhad Geriatric Institutes. Methods Institutionalized elderly people, who could cooperate for oral examination, enrolled in this descriptive cross-sectional study. The frequency of oral lesions and their systemic diseases were recorded in the self-made checklist. For statistical analysis, Student's t-test and Chi-square test were utilized. The significance level was considered to be 0.05. Results During the study, 224 elderly subjects with a mean age of 75.63 ± 11.22 years were evaluated. The mean duration of residency in the elderly nursing centres was 1.87 ± 1.37 years. Hypertension, Alzheimer's disease and diabetes were the most common systemic diseases, and about 47% of the patients had two or multiple concurrent diseases. Among participants, 97.1% had at least one oral lesion. The most common oral lesions were fissured tongue (75%), sublingual varicosity (68.3%) and hairy or coated tongue (38.4%), respectively, which are classified as normal variations of oral mucosa. The most common pathological lesions were denture stomatitis, frictional keratosis and lichenoid reactions. Conclusion Regarding to the high frequency of oral lesions among ageing people, regular examination of the oral mucosa for early detection of oral lesions and appropriate treatments is recommended.
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Affiliation(s)
- Zohreh Dalirsani
- From the Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ala Ghazi
- From the Oral and Maxillofacial Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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11
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Nemati-Vakilabad R, Khalili Z, Ghanbari-Afra L, Mirzaei A. The prevalence of elder abuse and risk factors: a cross-sectional study of community older adults. BMC Geriatr 2023; 23:616. [PMID: 37777720 PMCID: PMC10544121 DOI: 10.1186/s12877-023-04307-0] [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: 07/15/2022] [Accepted: 09/11/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND The old people population is increasing worldwide. Along with their increasing population, an increase in elder abuse cases is predicted. Elder abuse is a neglected problem, and many cases go unreported. This study was conducted to identify types of elder abuse and examine associated risk factors. METHODS This cross-sectional analytical study was conducted on 500 older people in Ardabil (northwestern Iran). Data was collected over three months, from June to September 2020. Data was collected using a demographic information form and the Domestic Elder Abuse questionnaire. The data were analyzed using SPSS software (version 22). Logistic regression was used to identify factors related to elder abuse. RESULTS The results showed that out of the 500 participants, 258 (51.6%) were male, and 242 (48.2%) were female. Among the 500 participants, 377 individuals (75/4%) reported experiencing at least one type of abuse in the past year. The highest rate of elder abuse was observed for emotional neglect (47.2%) and psychological abuse (40.8%), while the lowest rate was measured for rejection (15.4%) and physical abuse (12.4%). The results indicated that elder abuse was significantly associated with chronic illness (OR = 0.601, 95% CI: 0.391-0.922) and having 1-4 children (OR = 1.275, 95% CI: 1.137-1.430). CONCLUSION Considering the high level of elder abuse and its dangerous effects on the quality of life for older people, it is essential to develop appropriate programs to increase awareness among older people and their families.
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Affiliation(s)
- Reza Nemati-Vakilabad
- School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, 141973317, Iran
| | - Zahra Khalili
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran.
| | - Leila Ghanbari-Afra
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | - Alireza Mirzaei
- Department of Emergency Nursing, School of Nursing and Midwifery, Ardabil University of Medical Sciences, Ardabil, Iran
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12
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Chang CP, Ho TF, Snyder J, Dodson M, Deshmukh V, Newman M, Date A, Henry NL, Hashibe M. Breast cancer survivorship and sexual dysfunction: a population-based cohort study. Breast Cancer Res Treat 2023; 200:103-113. [PMID: 37160510 PMCID: PMC10382144 DOI: 10.1007/s10549-023-06953-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 04/23/2023] [Indexed: 05/11/2023]
Abstract
BACKGROUND Breast cancer is the most common non-skin cancer in women and an increasing number of people are living as breast cancer survivors. While the prognosis of breast cancer continues to improve, the rates of sexual dysfunction and the risk related to cancer treatments have not been well characterized in a population-based study. METHODS We identified a cohort of 19,709 breast cancer survivors diagnosed between 1997 and 2017 from the Utah Cancer Registry, and 93,389 cancer-free women who were matched by age and birth state from the Utah Population Database. Sexual dysfunction diagnoses were identified through ICD-9 and ICD-10 codes from electronic medical records and statewide healthcare facilities data. Cox proportional hazard models were used to estimate hazard ratios for risk of sexual dysfunction. RESULTS Breast cancer survivors were at higher risk of sexual dysfunction diagnosis (9.1% versus 6.9%, HR 1.60, 95% CI 1.51-1.70) compared to the general population. This risk increased 2.05-fold within 1 to 5 years after cancer diagnosis (95% CI 1.89-2.22) and 3.05-fold in individuals diagnosed with cancer at < 50 years of age (95% CI 2.65-3.51). Cancer treatments including endocrine therapy, chemotherapy and radiation therapy were associated with an increased risk of sexual dysfunction among breast cancer survivors. CONCLUSIONS Risk of sexual dysfunction in breast cancer survivors is higher than in the general population, but may be underdiagnosed in the clinical setting. Health care professionals should be encouraged to address the topic of sexual health early on in the treatment of breast cancer, and routinely screen patients for symptoms of sexual dysfunction.
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Affiliation(s)
- Chun-Pin Chang
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Tiffany F Ho
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - John Snyder
- Intermountain Healthcare, Salt Lake City, UT, USA
| | - Mark Dodson
- Intermountain Healthcare, Salt Lake City, UT, USA
- Department of Obstetrics and Gynecology, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Vikrant Deshmukh
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Michael Newman
- University of Utah Health Sciences Center, Salt Lake City, UT, USA
| | - Ankita Date
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - N Lynn Henry
- Division of Hematology/Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mia Hashibe
- Division of Public Health, Department of Family & Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
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13
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Bueno MV, Chase JAD. Gender Differences in Adverse Psychosocial Outcomes among Family Caregivers: A Systematic Review. West J Nurs Res 2023; 45:78-92. [PMID: 35614567 DOI: 10.1177/01939459221099672] [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] [Indexed: 11/15/2022]
Abstract
This systematic review explores gender differences in adverse psychosocial and role-related outcomes of family caregivers of older adults with chronic illnesses. Data sources for the systematic review included CINAHL, PubMed, PsycINFO, and Google Scholar. Eligible primary research focused on examining gender-based differences in psychological and emotional outcomes (e.g., burden, depression, stress) among family caregivers of an older adult with chronic illness. In total, 16 studies were included in the review with most studies using a cross-sectional design and conducted outside of the United States. Studies reported on gender differences in health outcomes such as burden, stress, and anxiety. Women caregivers had overall higher negative outcomes, but men may have more intense difficulty during the initial caregiver transition phase. Resources to address caregiver health should consider the caregiver's gender. As the older adult population grows, more caregiver research is needed and future studies to include more male caregivers.
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Affiliation(s)
- Michael V Bueno
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Jo-Ana D Chase
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
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Reynaud D, Bruneau L. Feasibility and acceptance of self-hypnosis to reduce chronic stress levels on family in-home caregivers of elderly people: protocol for the POSSAID pilot, randomised, wait-list controlled trial. BMJ Open 2022; 12:e066749. [PMID: 36585135 PMCID: PMC9809277 DOI: 10.1136/bmjopen-2022-066749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
INTRODUCTION Family members who care for elderly people experience high levels of chronic stress because of the intensive assistance they provide permanently to those who are losing their autonomy. Often considered a burden, this stress causes serious consequences to their health and worsens their quality of life (QoL). Reducing caregivers' chronic stress via self-hypnosis protocols may be an effective treatment. The objective is to evaluate the feasibility and acceptance of self-hypnosis protocols taught by hypnotherapy-trained nurses to reduce the chronic stress of in-family caregivers. METHODS AND ANALYSIS This study is a prospective, monocentric, non-blinded, parallel, pilot, randomised waitlist-controlled trial that will be conducted at the University Hospital of Reunion Island. Sixty participants will be randomly allocated to one of two groups: a self-hypnosis group (intervention) or a waitlist control group. After an 8-week training programme, intervention participants will practice self-hypnosis for ten minutes/day over 8 weeks and subsequently be followed up for 16 weeks thereafter. The primary outcome is to assess the feasibility of a 16-week self-hypnosis protocol for in-family caregivers. Secondary outcomes include the evaluation of the effects of practising self-hypnosis among in-family caregivers of elderly people concerning their stress levels, sleep disorders, levels of fatigue, and QoL at 2, 4 and 8 months on an exploratory basis. ETHICS AND DISSEMINATION Ethics approval was obtained from the Institutional Ethics Committee CPP Ile de France VI-Groupe Hospitalier Pitié Salpêtrière on 14 April 2021 (ID RCB: 2021-A00009-32). All participants will receive information about the trial in verbal and written forms. They will give an oral consent which is notified in a dedicated research file prior before enrolment. Results will be published in peer-reviewed journals as well as presented and disseminated at conferences. TRIAL REGISTRATION NUMBER NCT04909970.
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Affiliation(s)
- Danielle Reynaud
- Centre Hospitalier Universitaire(CHU) de La Réunion - site sud, Saint-Denis, Réunion
| | - Léa Bruneau
- Unité de Soutien Méthodologique, CHU de la Réunion, Saint-Denis, Réunion
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15
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Suzuki M, Kimura Y, Otobe Y, Koyama S, Terao Y, Kojima I, Masuda H, Tanaka S, Yamada M. The effect of care receivers' dysphagia severity on caregiver burden among family caregivers. Geriatr Gerontol Int 2022; 22:870-875. [DOI: 10.1111/ggi.14468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 07/11/2022] [Accepted: 08/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Mizue Suzuki
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tokyo Japan
| | - Yosuke Kimura
- College of Science and Engineering, Health and Sports Technology Course Kanto Gakuin University Yokohama Japan
| | - Yuhei Otobe
- School of Medicine, Department of Rehabilitation Science Physical Therapy Course, Osaka Metropolitan University Habikino Japan
| | - Shingo Koyama
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tokyo Japan
| | - Yusuke Terao
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tokyo Japan
| | - Iwao Kojima
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tokyo Japan
| | - Hiroaki Masuda
- Graduate School of Comprehensive Human Sciences University of Tsukuba Tokyo Japan
| | - Shu Tanaka
- Major of Physical Therapy, Department of Rehabilitation School of Health Sciences, Tokyo University of Technology Tokyo Japan
| | - Minoru Yamada
- Faculty of Human Sciences University of Tsukuba Tokyo Japan
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16
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O'Gara G, Wiseman T, Doyle AM, Pattison N. Chronic illness and critical care-A qualitative exploration of family experience and need. Nurs Crit Care 2022. [PMID: 35833675 DOI: 10.1111/nicc.12817] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND People with chronic illnesses such as cancer and cardiovascular disease are living longer and often require the support of critical care services. Current health care provision means patients may be discharged home once clinically stable despite still having high care demands including social, emotional, or physical needs. Families are often required to assume caregiving roles. Research into family burden using quantitative methods has increased awareness, however, little qualitative work exists and the development of support interventions for families is required. AIMS To explore the experience and needs of family members of people with an existing chronic illness who are admitted to the Critical Care Unit (CCU), and to identify the desired components of a family support intervention in the form of a resource toolkit. STUDY DESIGN A qualitative exploration of family experience and need, and content development for a resource toolkit using focus group methodology. Two focus groups and one face-to-face interview were conducted involving nine adult (≥18 years) family members of adult patients with chronic illness admitted to critical care in the preceding 9 months across two specialist hospitals in the UK. These were digitally recorded, transcribed, and thematically analysed. FINDINGS Four themes were identified: importance of communication, need for support, trauma of chronic illness, and having to provide "Do-it-Yourself" care. The immense responsibility of families to provide care throughout the illness trajectory is highlighted. Understandable information is essential for a family support toolkit. CONCLUSION Family members often view a critical care episode broadly from diagnosis through to recovery/rehabilitation. Basic communication training skills within critical care should be ensured, alongside coordination of simple solutions. The potential traumatic impact on families should be highlighted early within the pathway, and positive aspects used to harness essential family support. A simple and coordinated approach to a toolkit is preferred. RELEVANCE TO CLINICAL PRACTICE This study highlights that a critical care experience may impact broadly beyond CCU, and the importance of informing patients and families of this potential experience, prior to or on admission, to aid preparation. Further highlighted is the need for contemporaneous and accurate information from clinicians involved in care. Families report a better experience when there is good collaboration across critical care services and admitting clinical teams. Early involvement of families in overall discharge planning is essential to allow patients and families to adjust and plan for recovery.
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Affiliation(s)
- Geraldine O'Gara
- Applied Health Research, Royal Marsden NHS Foundation Trust, London, UK
| | - Theresa Wiseman
- Applied Health Research, Royal Marsden NHS Foundation Trust, London, UK
| | - Anne-Marie Doyle
- Department of Psychological Medicine, Royal Brompton Hospital, London, UK
| | - Natalie Pattison
- School of Health and Social Work, University of Hertfordshire/East and North Herts NHS Trust, Hertfordshire, UK
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Rosa WE, Banerjee SC, Maingi S. Family caregiver inclusion is not a level playing field: toward equity for the chosen families of sexual and gender minority patients. Palliat Care Soc Pract 2022; 16:26323524221092459. [PMID: 35462621 PMCID: PMC9021511 DOI: 10.1177/26323524221092459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Affiliation(s)
- William E Rosa
- Assistant Attending Behavioral Scientist, Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, 641 Lexington Avenue, 7th fl., New York, NY 10022, USA
| | - Smita C Banerjee
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Shail Maingi
- Dana-Farber, South Shore Hospital, South Weymouth, MA, USA
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A Comprehensive Assessment of Informal Caregivers of Patients in a Primary Healthcare Home-Care Program. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111588. [PMID: 34770102 PMCID: PMC8583293 DOI: 10.3390/ijerph182111588] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/24/2022]
Abstract
Studies of the characteristics of informal caregivers and associated factors have focused on care-receiver disease or caregiver social and psychological traits; however, an integral description may provide better understanding of informal caregivers’ problems. A multicenter cross-sectional study in primary healthcare centers was performed in Barcelona (Spain). Participants were a random sample of informal caregivers of patients in a home-care program. Primary outcomes were health-related quality of life and caregiver burden, and related factors were sociodemographic data, clinical and risk factors, social support and social characteristics, use of healthcare services, and care receivers’ status. In total, 104 informal caregivers were included (mean age 68.25 years); 81.73% were female, 54.81% were retired, 58.65% had high comorbidity, and 48.08% of care receivers had severe dependence. Adjusted multivariate regression models showed health-related quality of life and the caregivers’ burden were affected by comorbidity, age, time of care, and dependency of care receiver, while social support and depression also showed relative importance. Aging, chronic diseases, and comorbidity should be included when explaining informal caregivers’ health status and wellbeing. The effectiveness of interventions to support informal caregivers should comprehensively evaluate caregivers when designing programs, centering interventions on informal caregivers and not care receivers’ conditions.
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Otsuki N, Yamamoto R, Sakaguchi Y, Masukawa K, Morita T, Kizawa Y, Tsuneto S, Shima Y, Fukui S, Miyashita M. Care needs level in long-term care insurance system and family caregivers' self-perceived time-dependent burden in patients with home palliative care for cancer: a cross-sectional study. Support Care Cancer 2021; 30:1587-1596. [PMID: 34542734 DOI: 10.1007/s00520-021-06579-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/14/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Although home care improves patients' quality of life (QOL), several studies have suggested that home care lowers the QOL of family caregivers and decreases their mortality. To alleviate the deleterious impact of home care on caregivers, the major burdens on caregivers and the clinical characteristics of the caregivers vulnerable to the major burden needs to be clarified. METHOD A survey questionnaire was distributed to 710 family caregivers of patients with cancer in Japan, and 342 valid responses were obtained (valid response rate: 48.2%). The Burden Index of Caregivers was used to identify the major burden on caregivers. To assess the associations of the patients' care needs level and other clinically relevant factors with the major burden, a multivariable-adjusted logistic regression model was used. RESULTS The time-dependent burden was identified as a major burden. An adjusted model showed a nonlinear association between the care needs level and the time-dependent burden, in which the caregivers of the patients who required moderate care needs level had the highest time-dependent burden [adjusted odds ratio of none, mild, moderate, and severe care needs levels: 0.50 (95% confidence interval 0.07-2.12), 1.08 (0.43-2.57), 1.87 (1.01-3.52), and 1.00 (reference), respectively]. Additionally, older patients and younger caregivers were significantly associated with a time-dependent burden. CONCLUSION The time-dependent burden was highest in caregivers at the moderate care needs level and younger caregivers. An imbalance between the demand and supply of care services may be improved by considering the clinical characteristics of both patients and caregivers.
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Affiliation(s)
- Naoko Otsuki
- Division of Health Science, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, Japan
- Tokyo Medical and Dental University Graduate School of Health Care Sciences, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Ryohei Yamamoto
- Health and Counseling Center, Osaka University, 1-17 Machikaneyama, Toyonaka, Osaka, 560-0043, Japan.
- Department of Nephrology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
- Health Promotion and Regulation, Department of Health Promotion Medicine, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, Japan.
| | - Yukihiro Sakaguchi
- Kwansei Gakuin University School of Human Welfare Studies, 1-1-155, Uegahara, Nishinomiya, Japan
| | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan
| | - Tatsuya Morita
- Division of Palliative and Supportive Care, Seirei Mikatahara Hospital, 3453 Mikatahara, Kita, Hamamatsu, Japan
| | - Yoshiyuki Kizawa
- Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, 53 Kawaharacho, Shogoin, Sakyo-ku, Kyoto, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, 1-3-1, Amakubo, Tsukuba, Ibaraki, Japan
| | - Sakiko Fukui
- Tokyo Medical and Dental University Graduate School of Health Care Sciences, 1-5-45, Yushima, Bunkyo-ku, Tokyo, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, 2-1 Seiryo-machi, Aoba-ku, Sendai, Japan
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