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Engblad MA, Herstal EP, Wegener EK, Kayser L. Using an Empathetic Approach to Explore Technology Readiness and Needs for Digital Services to Assist People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1023. [PMID: 39200633 PMCID: PMC11354846 DOI: 10.3390/ijerph21081023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 07/28/2024] [Accepted: 07/30/2024] [Indexed: 09/02/2024]
Abstract
This qualitative study investigates technology readiness, i.e., self-management, social support, and digital health literacy, in people with dementia (PwD). PwD are difficult to recruit; therefore, we used an empathic approach to recruit and conduct interviews. The interviews with seven participants with dementia and two informal caregivers, guided by the READHY framework, reveal nuanced insights into their experiences. Participants demonstrate varying degrees of self-management, with informal caregivers playing pivotal roles in facilitating activities and supporting overall well-being. Cognitive challenges, such as concentration and communication difficulties, are prevalent, highlighting the importance of robust support systems. Internal and external support networks significantly influence social integration, yet societal misconceptions impede inclusion, exacerbating feelings of isolation for both participants and caregivers. Limited interaction with technology is observed, primarily reliant on caregivers for assistance. Technology may hold potential for enhancing independence and alleviating caregiver burden. As an empathetic approach eased recruitment and communication with PwD, we recommend using this approach for future studies to include participants who otherwise would not be recruited. Given that the number of participants in this study is limited to only seven PwD with moderate to severe cognitive impairment, further investigation using mixed methods, including the READHY framework, and a larger number of participants is needed to examine the generalizability of the findings.
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Affiliation(s)
- Mille Aagaard Engblad
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Øster Farimagsgade 5, 1353 Copenhagen K, Denmark (E.K.W.)
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Barrero-Mejias MA, Gómez-Martínez S, González-Moreno J, Rueda-Extremera M, Izquierdo-Sotorrio E, Cantero García M. Effectiveness of psychological interventions for reducing depressive symptomatology and overload and improving quality of life in informal caregivers of non-institutionalized dependent elderly: a systematic review. Front Med (Lausanne) 2024; 11:1394640. [PMID: 38962738 PMCID: PMC11221383 DOI: 10.3389/fmed.2024.1394640] [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] [Received: 03/01/2024] [Accepted: 05/03/2024] [Indexed: 07/05/2024] Open
Abstract
Introduction The phenomenon of aging is distinguished by profound life transformations, with the most dependent group being constituted by elderly individuals. The responsibility for their care primarily falls on the figure of the informal caregiver. The scarcity of time, the stress associated with caregiving, the financial, work-related, and personal difficulties it entails, make it a collective with high probabilities of experiencing various psychological disorders. Interventions that have shown the best results are those of multiple components, composed of various techniques that seek to adapt to the reality of the informal caregiver. Method The purpose of this study is a systematic review of effective interventions on depressive symptoms, emotional wellbeing, burden, or quality of life in informal caregivers of non-institutionalized dependents from 2018 to the present. A search was conducted in November 2023, on Pubmed, Pubmed Central, Proquest, and Scielo. The final review was conducted on 11 articles. Results The results indicate that multiple component interventions including cognitive behavioral techniques and psychoeducation in combination with stress coping techniques and social support are more effective on depressive symptoms, burden, quality of life, and increasing the social support network. Discussion Results on web-based programs demonstrate their efficacy and effectiveness, but require a greater number of trials to adjust their methodological quality and content to the idiosyncrasies of the informal caregiver.
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Affiliation(s)
| | | | | | - María Rueda-Extremera
- Faculty of Health Sciences and Education, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain
| | - Eva Izquierdo-Sotorrio
- Faculty of Health Sciences and Education, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain
| | - María Cantero García
- Faculty of Health Sciences and Education, Universidad a Distancia de Madrid (UDIMA), Madrid, Spain
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Wang S, de Almeida Mello J, S. Mittelman M, Declercq A. Feasibility, acceptability and potential helpfulness of the PROACTIVE intervention in Flanders, Belgium: A survey study. PLoS One 2023; 18:e0289952. [PMID: 37561750 PMCID: PMC10414657 DOI: 10.1371/journal.pone.0289952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 07/29/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND/OBJECTIVES This study aimed to explore the feasibility of a Flemish adaptation of the New York University Caregiver Intervention (i.e., PROACTIVE intervention) modifying the recruitment and intervention content for informal caregivers of people with early cognitive decline, and across different subgroups. A feasibility study is necessary in order to reduce research waste for intervention adaptation and evaluation. METHODS Researchers constructed, tested, and sent out a survey consisting of 43 questions on the following topics: awareness of symptoms of early cognitive decline, levels of cognitive performance using the updated Cognitive Performance Scale (CPS2), acceptability, and potential helpfulness of the intervention, and sociodemographic characteristics. Quantitative data were analyzed using descriptive statistics and logistic regression with SAS 9.4©. Qualitative data were analyzed using an inductive content analysis. RESULTS A total of 463 informal caregivers completed the survey (mean age 58.8 ± 11.8, 83.6% female). Among them, 230 respondents who cared for people with cognitive decline indicated they would probably or certainly participate in the study. Identified factors influencing the recruitment were cognition, co-habitation, education, and employment status. Over half of the target caregivers indicated almost all services from the intervention could satisfy their needs. A majority perceived the PROACTIVE intervention would be helpful (69.4%), especially the CPS2 = 3 (76.1%) and CPS2 = 4 (74.1%) subgroups. CONCLUSION The recruitment of target participants for a subsequent RCT evaluation study is feasible, and identified associated factors should be considered during the recruitment process. The PROACTIVE intervention and core components except 'peer-group participation' were perceived as helpful by most caregivers. The CPS2 = 3-4 subgroups were most accepting of the intervention and were most likely to benefit from the intervention.
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Affiliation(s)
- Shanshan Wang
- LUCAS–Centre for Care Research & Consultancy, KU Leuven, Leuven, Belgium
| | - Johanna de Almeida Mello
- LUCAS–Centre for Care Research & Consultancy, KU Leuven, Leuven, Belgium
- Department of Oral Health Sciences, Research Group Population Studies in Oral Health, KU Leuven, Leuven, Belgium
| | - Mary S. Mittelman
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America
| | - Anja Declercq
- LUCAS–Centre for Care Research & Consultancy, KU Leuven, Leuven, Belgium
- CeSO—Centre for Sociological Research, KU Leuven, Leuven, Belgium
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Zhu D, Al Mahmud A, Liu W. Social connections and participation among people with mild cognitive impairment: barriers and recommendations. Front Psychiatry 2023; 14:1188887. [PMID: 37476544 PMCID: PMC10356108 DOI: 10.3389/fpsyt.2023.1188887] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 06/20/2023] [Indexed: 07/22/2023] Open
Abstract
Objective Social connections and participation are essential for individuals with mild cognitive impairment (MCI) to prevent the progression of cognitive decline and enhance their overall well-being. However, existing research has primarily focused on environmental barriers, overlooking personal factors and the interconnected nature of these barriers. Moreover, there is a lack of understanding regarding social connections and participation challenges specific to people with MCI in low- and middle-income countries. Therefore, this study aimed to explore the barriers that hinder social connections and participation among people with MCI in China and investigate opportunities to design appropriate supportive interventions. Methods Thirty-one people with MCI (13 males and 18 females; mean age = 82.74 years, SD = 7.69; mean MoCA score = 21.26, SD = 2.44) and 13 caregivers were recruited to attend focus groups. In addition, 10 therapists were interviewed using a semi-structured interview guide. Focus groups and interviews were audio-recorded, transcribed, and analyzed using a framework analysis approach. Results We found that the ability to build social connections among people with MCI is affected by mobility challenges, intensive grandparenting responsibilities, availability of suitable activities, and feelings of exclusion in a closed-minded community environment. Personal reasons, such as lower social efficacy, inability to find suitable social activities, and intensive family responsibilities, discourage people with MCI from social participation. The digital literacy of people with MCI depends on their motivation to learn and use digital tools; people with MCI who live in a community have a higher digital literacy than those living in care centers. The motivation to achieve digital literacy is affected by perceived benefits, costs of technology use, and social influence. Conclusion Multidimensional initiatives are needed to address barriers to social connections, participation, and technology adoption among individuals with MCI. This includes organizing and engaging in social activities, promoting awareness and education on the importance of social participation, and exploring technology-based interventions to improve memory and storytelling abilities. These efforts can create a supportive environment and empower individuals with MCI to participate actively in social interactions, enhancing their overall well-being.
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Affiliation(s)
- Di Zhu
- Swinburne University of Technology, Hawthorn, VIC, Australia
- Beijing Normal University, Beijing, China
| | | | - Wei Liu
- Beijing Normal University, Beijing, China
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Paquet C, Whitehead J, Shah R, Adams AM, Dooley D, Spreng RN, Aunio AL, Dubé L. Social Prescription Interventions Addressing Social Isolation and Loneliness in Older Adults: Meta-Review Integrating On-the-Ground Resources. J Med Internet Res 2023; 25:e40213. [PMID: 37195738 PMCID: PMC10233446 DOI: 10.2196/40213] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Social prescription programs represent a viable solution to linking primary care patients to nonmedical community resources for improving patient well-being. However, their success depends on the integration of patient needs with local resources. This integration could be accelerated by digital tools that use expressive ontology to organize knowledge resources, thus enabling the seamless navigation of diverse community interventions and services tailored to the needs of individual users. This infrastructure bears particular relevance for older adults, who experience a range of social needs that impact their health, including social isolation and loneliness. An essential first step in enabling knowledge mobilization and the successful implementation of social prescription initiatives to meet the social needs of older adults is to incorporate the evidence-based academic literature on what works, with on-the-ground solutions in the community. OBJECTIVE This study aims to integrate scientific evidence with on-the-ground knowledge to build a comprehensive list of intervention terms and keywords related to reducing social isolation and loneliness in older adults. METHODS A meta-review was conducted using a search strategy combining terms related to older adult population, social isolation and loneliness, and study types relevant to reviews using 5 databases. Review extraction included intervention characteristics, outcomes (social [eg, loneliness, social isolation, and social support] or mental health [eg, psychological well-being, depression, and anxiety]), and effectiveness (reported as consistent, mixed, or not supported). Terms related to identified intervention types were extracted from the reviewed literature as well as descriptions of corresponding community services in Montréal, Canada, available from web-based regional, municipal, and community data sources. RESULTS The meta-review identified 11 intervention types addressing social isolation and loneliness in older adults by either increasing social interactions, providing instrumental support, promoting mental and physical well-being, or providing home and community care. Group-based social activities, support groups with educational elements, recreational activities, and training or use of information and communication technologies were the most effective in improving outcomes. Examples of most intervention types were found in community data sources. Terms derived from the literature that were the most commonly congruent with those describing existing community services were related to telehealth, recreational activities, and psychological therapy. However, several discrepancies were observed between review-based terms and those addressing the available services. CONCLUSIONS A range of interventions found to be effective at addressing social isolation and loneliness or their impact on mental health were identified from the literature, and many of these interventions were represented in services available to older residents in Montréal, Canada. However, different terms were occasionally used to describe or categorize similar services across data sources. Establishing an efficient means of identifying and structuring such sources is important to facilitate referrals and help-seeking behaviors of older adults and for strategic planning of resources.
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Affiliation(s)
- Catherine Paquet
- Département de Marketing, Faculté des Sciences de l'Administration, Université Laval, Québec, QC, Canada
- Centre de Recherche, Centre Hospitalier Universitaire de Québec - Université Laval, Quebec, QC, Canada
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels (INAF), Quebec, QC, Canada
| | - Jocelyne Whitehead
- Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Rishabh Shah
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
| | - Alayne Mary Adams
- Department of Family Medicine, McGill University, Montreal, QC, Canada
| | - Damion Dooley
- Centre for Infectious Disease Genomics and One Health, Simon Fraser University, Vancouver, BC, Canada
| | - R Nathan Spreng
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada
| | | | - Laurette Dubé
- Desautels Faculty of Management, McGill University, Montreal, QC, Canada
- McGill Centre for the Convergence of Health and Economics, McGill University, Montreal, QC, Canada
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Ramachandran M, Bangera K, Anita Dsouza S, Belchior P. A scoping review of family-centered interventions in dementia care. DEMENTIA 2023; 22:405-438. [PMID: 36495098 DOI: 10.1177/14713012221144485] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Families of persons living with dementia provide varying levels and forms of support to their loved ones and experience changes in familial dynamics, roles, and responsibilities over time. Family-centered care can enable their successful adaptation and participation in meaningful occupations. This scoping review aimed to explore available familycentered interventions for persons living with dementia, with a focus on occupational therapy. Three databases were searched and 31 eligible studies were found. Thirteen family-centered interventions were identified that were mostly multicomponent in nature, of which three involved occupational therapy. These interventions were investigated using a range of study designs and addressed outcomes related to the person with dementia, primary caregiver, and extended social network. With respect to study context, most interventions were developed in the United States and other Western countries with a limited number located in other contexts. The review findings underline the need for developing more family-centered interventions within occupational therapy, particularly for different contexts and cultures, and for translating available interventions to practice.
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Affiliation(s)
- Meena Ramachandran
- PhD student, School of Physical and Occupational Therapy, 574405McGill University, Montreal, QC, Canada; Research Coordinator, Bridgepoint Collaboratory for Research and Innovation, Toronto, QC, Canada
| | - Kshama Bangera
- PhD Scholar, Department of Occupational Therapy, 76799Manipal College of Health Professions, Manipal Academy of Higher Education, India
| | - Sebestina Anita Dsouza
- Professor, Department of Occupational Therapy, Manipal College of Health Professions, Manipal Academy of Higher Education, 76799Coordinator, Centre for Studies on Healthy Aging, Manipal Academy of Higher Education, Manipal, India
| | - Patricia Belchior
- Associate Professor, School of Physical and Occupational Therapy, 574405McGill University; Chercheure, Centre de recherche de l'Institut universitaire de gériatrie de Montréal (CRIUGM)
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Wang S, de Almeida Mello J, Declercq A. Factors associated with informal caregiver's ability to continue care: a subgroup analysis. Age Ageing 2022; 51:6931843. [PMID: 36580387 DOI: 10.1093/ageing/afac275] [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: 04/14/2022] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND/OBJECTIVE maintaining informal caregiver's ability to continue care can prevent early institutionalisation and decrease health care costs, contributing to sustainable health care. This study aims to identify factors associated with informal caregiver's ability to continue care across several degrees of cognitive decline and risk of burden. METHODS this is a cross-sectional study that collected nationwide data on frail older people and their informal caregivers living in the community. Instruments used were InterRAI Home Care, Zarit Burden Interview and questionnaire for the informal caregiver. Multivariate logistic regression analyses and a stratification of the population were performed. RESULTS a total of 8,309 people had at least one primary caregiver, and a majority of them were able to continue care (68.2%). Cognitive impairment was a risk factor for being able to continue care, even the borderline (odds ratios (ORs): 0.72; 95% CI: 0.61-0.85) or mild condition (OR: 0.52; 95% CI: 0.43-0.61). Protective factors like social participation of older people, strong family support and availability of a secondary caregiver showed the highest association in subgroups with mild cognitive impairment (ORs: 2.20, 2.08, 1.64) and in subgroups at low risk of burden (ORs: 1.91, 2.77, 1.64). CONCLUSION factors associated with informal caregiver's ability to continue care vary across several degrees of cognitive decline and risk of burden. Interventions related to family and social support resources are recommended, and informal caregivers at a lower level of risk may benefit most. Supportive counselling should be proactively provided to informal caregivers, considering the changes of associated factors with the ongoing caregiving situation.
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Affiliation(s)
- Shanshan Wang
- LUCAS-Centre for Care Research & Consultancy KU Leuven, 3000 Leuven, Belgium
| | - Johanna de Almeida Mello
- LUCAS-Centre for Care Research & Consultancy KU Leuven, 3000 Leuven, Belgium.,Population studies Oral health, Department of Oral Health Sciences KU Leuven, 3000 Leuven, Belgium
| | - Anja Declercq
- LUCAS-Centre for Care Research & Consultancy KU Leuven, 3000 Leuven, Belgium.,CeSO-Centre for Sociological Research, Faculty of Social Sciences KU Leuven, 3000 Leuven, Belgium
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Sharifipour F, Javadnoori M, Behboodi Moghadam Z, Najafian M, Cheraghian B, Abbaspoor Z. Interventions to improve social support among postpartum mothers: A systematic review. Health Promot Perspect 2022; 12:141-150. [PMID: 36276421 PMCID: PMC9508393 DOI: 10.34172/hpp.2022.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 05/15/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Poor and insufficient social support to the mother in the post-partum period impairs the effective functioning of her new role as a mother, and it is an important risk factor for the maternal depression and stress after childbirth. Thus, interventions to improve social support to mothers in their postpartum period are required. The present review aimed to investigate the effectiveness of the existing interventions aimed at improving social support among postpartum women. Methods: In this systematic review, PubMed, Scopus, Science Direct, Cochrane Library, Web of Science, EMBASE, Google Scholar, IranDoc, IranMedex, MagIran and SID were searched until January 2022. Full-text articles on the social support outcome, published in English or Persian, which used the design of randomized controlled trials (RCTs) or comparison groups and involved postpartum or pregnant women as participants were included. The quality of the studies was assessed based on the seven criteria offered by Cochrane guidelines. Results: Our review included 10 studies involving 3328 women. According to our results, the following interventions were successful in increasing social support compared to the controlled conditions: counseling with men in the prenatal period, interventions based on interpersonal psychotherapy (IPT), advanced practice nurse (APN), internet support, and home visiting in the postpartum period. Conclusion: These interventions could be provided to mothers during their prenatal or postpartum care. However, which one of these interventions is the most effective in improving social support among postpartum mothers was not identified in the present study.
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Affiliation(s)
- Foruzan Sharifipour
- Reproductive Health Promotion Research Center, Department of Midwifery, Faculty of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojgan Javadnoori
- Reproductive Health Promotion Research Center, Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Mahin Najafian
- Department of Obstetrics and Gynecology, School of Medicine, Fertility Infertility and Perinatology Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, school of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Abbaspoor
- Reproductive Health Promotion Research Center, Department of Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Gilsenan J, Gorman C, Shevlin M. Explaining caregiver burden in a large sample of UK dementia caregivers: The role of contextual factors, behavioural problems, psychological resilience, and anticipatory grief. Aging Ment Health 2022:1-8. [PMID: 35881027 DOI: 10.1080/13607863.2022.2102138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Dementia caregiver burden is a significant public health concern, affecting both the wellbeing of caregivers and their care-recipients. This study investigated a range of variables associated with caregiver burden in a large sample of UK dementia caregivers. Clinical characteristics and novel psychological constructs were used - including anticipatory grief and psychological resilience. Anticipatory grief refers to the process of experiencing loss prior to the death of a significant person. METHOD Caregivers of persons with dementia (N = 530) completed a survey obtaining the Zarit-Burden Interview (ZBI-SF) and other psychological and demographic/caregiving-related factors. RESULTS Findings illustrate that 71% of the sample experienced high levels of caregiver burden and around 95% met the criteria for clinically significant levels of burden. A regression model explained 49% of the variance in subjective caregiver burden; contextual factors (care-recipients living situation, frequency of caregiving), behavioural challenges in the care-recipient (memory-related problem behaviours), caregiver psychological resilience and caregiver anticipatory grief (heartfelt long & sadness, worry & felt isolation) were all significant variables. Caregiver anticipatory grief, followed by psychological resilience, had the strongest association with burden. CONCLUSION Caregiver anticipatory grief and psychological resilience, have a significant interaction with the clinical presentation of the dementia sufferer in explaining subjective caregiver burden. More grief and resilience-focused interventions targeting both the practical and emotional challenges are imperative to reduce burden and thus to ensure caregiver wellbeing.
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Affiliation(s)
- Jane Gilsenan
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Colin Gorman
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
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Hernández-Ascanio J, Ventura-Puertos PE, Rich-Ruiz M, Cantón-Habas V, Roldán-Villalobos AM, Pérula-de Torres LÁ. Conditions for Feasibility of a Multicomponent Intervention to Reduce Social Isolation and Loneliness in Noninstitutionalized Older Adults. Healthcare (Basel) 2022; 10:1104. [PMID: 35742155 PMCID: PMC9223082 DOI: 10.3390/healthcare10061104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/06/2022] [Accepted: 06/11/2022] [Indexed: 11/23/2022] Open
Abstract
AIMS To identify the factors conditioning the feasibility of an intervention to reduce social isolation and loneliness in noninstitutionalized older adults from the perspective of the intervention agents. DESIGN A Dimensional Grounded Theory study conducted from December 2019 to January 2020. METHODS Twelve participants were recruited from an experimental study developed in a health district of a southern Spanish city. Data were collected through focus group meetings, individual interviews, biograms, anecdote notebooks, and the field diaries of two participants not included in the other techniques. Transcripts were analyzed using thematic analysis. FINDINGS Findings were divided into three themes: (a) the elderly between the walls of loneliness, economic difficulties, losses, and the past; (b) intervention agents/volunteers between the walls of inexperience in the management of psychological/emotional processes, lack of moral authority, and difficulty in planning results adapted to the (elderly) person; and (c) intervention between the walls of (interest in) company and assistance at home, lack of involvement ("waiting for you to save them"), and withdrawal/"abandonment". CONCLUSION A profile of the specialized intervention agent, professionalized (or at least a mentored agent), with both technical and relational competencies; a clear understanding of the purposes of the intervention (empowerment, as opposed to having company or being helped with household chores) and the commitment to active participation by the elder; or adequate management of the completion of the intervention (flexibility, attachment management) are some of the main factors contributing to the feasibility of these approaches. IMPACT The findings have potential implications in the field of primary healthcare because primary and community healthcare services can implement corrections to the proposed intervention and ensure its effectiveness under feasible conditions. The nurse is shown as the most appropriate profile to conduct this intervention, although more research is needed to analyze the feasibility of this type of intervention in the daily practice of community nurses.
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Affiliation(s)
- Jose Hernández-Ascanio
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Pedro Emilio Ventura-Puertos
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Manuel Rich-Ruiz
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- CIBER on Frailty and Healthy Ageing, Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Vanesa Cantón-Habas
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
| | - Ana María Roldán-Villalobos
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- Family and Community Medicine Unit of the Córdoba-Guadalquivir Health District, 14004 Cordoba, Spain
| | - Luis Ángel Pérula-de Torres
- Maimonides Institute for Biomedical Research, Reina Sofía University Hospital, University of Cordoba, 14004 Cordoba, Spain; (J.H.-A.); (P.E.V.-P.); (V.C.-H.); (A.M.R.-V.); (L.Á.P.-d.T.)
- Family and Community Medicine Unit of the Córdoba-Guadalquivir Health District, 14004 Cordoba, Spain
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Park D, Morano C, Savage A. Understanding the role of social support and social support network for depression among informal dementia caregivers: a pilot clinical project on caregivers in NYC. SOCIAL WORK IN HEALTH CARE 2021; 60:599-613. [PMID: 34651558 DOI: 10.1080/00981389.2021.1987374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 08/23/2021] [Accepted: 09/27/2021] [Indexed: 06/13/2023]
Abstract
This study aims to explore the association of depressive symptoms with the informal social support network reported by dementia caregivers participating in a community-based caregiver support program. Caregivers in a community-based dementia caregiver program completed an intake assessment, including the social support network instrument. Measures were completed for caregivers' social support network, using the social support network instrument (SSNI). Measures also included depression, caregiver strain, basic activities of daily living, instrumental activities of daily living, and demographics. Findings suggest the effects of social supports and social network on caregivers' depressive symptoms. Caregivers who had financial supports were less likely to have depressive symptoms. Also, the frequency of contact among social network variables predicted the decrease of depressive symptoms.
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Affiliation(s)
- Daejun Park
- Department of Social Work, Ohio University, Athens, OH, USA
| | - Carmen Morano
- School of Social Welfare, University at Albany, SUNY, Albany, NY, USA
| | - Andrea Savage
- Silberman School of Social Work, Hunter College, CUNY, New York, NY, USA
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12
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Tong F, Yu C, Wang L, Chi I, Fu F. Systematic Review of Efficacy of Interventions for Social Isolation of Older Adults. Front Psychol 2021; 12:554145. [PMID: 34557122 PMCID: PMC8452930 DOI: 10.3389/fpsyg.2021.554145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 07/06/2021] [Indexed: 11/14/2022] Open
Abstract
Background: The social isolation of older people is a growing public health concern. The proportion of older people in society has increased in recent decades, and it is estimated that ~40% of the population will be aged 50 or above within the next few decades. This systematic review aims to summarize and renew knowledge of the effectiveness of existing interventions for alleviating social isolation of older adults. Methods: Relevant electronic databases, including Cochrane Library, CINAHL, SCOPUS, and Web of Science, were searched by a systematic evaluation method. Eligible randomized controlled trial (RCT) studies were published between 1978 and 2021 in English or Chinese. The primary and secondary outcomes were social isolation and loneliness. The quality of the included RCTs was scored by the Cochrane risk-of-bias tool to assess their quality. Two independent reviewers extracted data, using a standardized form. Narrative synthesis and vote-counting methods were used to summarize and interpret study data. Results: Twenty-four RCTs were finally included in this review. There was evidence of substantial heterogeneity in the interventions delivered. The overall quality of included studies indicated a low-to-medium risk of bias. Eighteen of 24 RCTs showed at least one dimension effect on reducing social isolation. The interventions with accurate targeting of clients in social and public places had more obvious effect. The interventions in which older people are active participants also appeared more likely to be effective. In addition, group intervention activities and individual intervention interviews were effective in improving structural social support; mixed intervention, and group intervention on training support significantly improved functional social support. Conclusions: This study suggests that group and mixed intervention targeting of older adults could be helpful for alleviating social isolation problems. The use of modern technology for remote services could also present good results. More well-conducted RCTs of the effectiveness of social interventions for alleviating social isolation are needed to improve the evidence base. Especially as the debating results of remote interventions, further research in this field should be conducted.
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Affiliation(s)
- Feng Tong
- School of International Law and Sociology, Sichuan International Studies University, Chongqing, China
| | - ChengLin Yu
- School of International Law and Sociology, Sichuan International Studies University, Chongqing, China
| | - LinSen Wang
- School of Humanities and Management, Southwest Medical University, Sichuan, China
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Fang Fu
- School of Social Development and Public Policy, Fudan University, Shanghai, China
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13
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McAuliffe L, Wright BJ, Hazi A, Kinsella GJ. Social support moderates the effect of stress on the cortisol awakening response in dementia family caregivers. Physiol Behav 2021; 240:113532. [PMID: 34289401 DOI: 10.1016/j.physbeh.2021.113532] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 11/16/2022]
Abstract
Dementia caregiving has been associated with a range of adverse effects on the physical health of the caregiver. However, the specific mechanisms underlying the relationship between dementia caregiver stress and ill health remain unclear. The aim of this study was to investigate, using available prospective data, the relationship between perceived stress (burden) and pre-clinical indices of ill-health (cortisol awakening response and secretory immunoglobulin A) amongst dementia caregivers. The potential moderating effect of social support on the perceived stress-physiological stress/health relationship was also explored. Participants (N = 31) were caregivers of community-dwelling older adults living with dementia who were enroled in a psychoeducation support program and provided data (study questionnaire and saliva samples) at two timepoints (T1 and T2), 10 weeks apart. Hierarchical regressions were used to determine if changes in stress and social support predicted change in each of the physiological outcomes. Findings indicate that caregivers with more hours of care at T1, or with greater satisfaction with social support, were more likely to exhibit an adaptive cortisol awakening response at T2. Moreover, social support was found to buffer the effect of caregiver stress and hours of caregiving on the cortisol awakening response. Implications for future interventions targeting caregiver health are discussed.
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Affiliation(s)
- Linda McAuliffe
- Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Melbourne Campus Victoria 3086 Australia.
| | - Bradley J Wright
- Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Melbourne Campus Victoria 3086 Australia.
| | - Agnes Hazi
- Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Melbourne Campus Victoria 3086 Australia.
| | - Glynda J Kinsella
- Department of Psychology and Counselling, School of Psychology and Public Health, College of Science, Health & Engineering, La Trobe University, Melbourne Campus Victoria 3086 Australia.
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14
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Clarkson P, Challis D, Hughes J, Roe B, Davies L, Russell I, Orrell M, Poland F, Jolley D, Kapur N, Robinson C, Chester H, Davies S, Sutcliffe C, Peconi J, Pitts R, Fegan G, Islam S, Gillan V, Entwistle C, Beresford R, Abendstern M, Giebel C, Ahmed S, Jasper R, Usman A, Malik B, Hayhurst K. Components, impacts and costs of dementia home support: a research programme including the DESCANT RCT. PROGRAMME GRANTS FOR APPLIED RESEARCH 2021. [DOI: 10.3310/pgfar09060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Background
Over half of people with dementia live at home. We know little about what home support could be clinically effective or cost-effective in enabling them to live well.
Objectives
We aimed to (1) review evidence for components of home support, identify their presence in the literature and in services in England, and develop an appropriate economic model; (2) develop and test a practical memory support package in early-stage dementia, test the clinical effectiveness and cost-effectiveness of routine home support in later-stage dementia and design a toolkit based on this evidence; and (3) elicit the preferences of staff, carers and people with dementia for home support inputs and packages, and evaluate the cost-effectiveness of these approaches in early- and later-stage dementia.
Design
We undertook (1) an evidence synthesis, national surveys on the NHS and social care and an economic review; (2) a multicentre pragmatic randomised trial [Dementia Early Stage Cognitive Aids New Trial (DESCANT)] to estimate the clinical effectiveness and cost-effectiveness of providing memory aids and guidance to people with early-stage dementia (the DESCANT intervention), alongside process evaluation and qualitative analysis, an observational study of existing care packages in later-stage dementia along with qualitative analysis, and toolkit development to summarise this evidence; and (3) consultation with experts, staff and carers to explore the balance between informal and paid home support using case vignettes, discrete choice experiments to explore the preferences of people with dementia and carers between home support packages in early- and later-stage dementia, and cost–utility analysis building on trial and observational study.
Setting
The national surveys described Community Mental Health Teams, memory clinics and social care services across England. Recruitment to the trial was through memory services in nine NHS trusts in England and one health board in Wales. Recruitment to the observational study was through social services in 17 local authorities in England. Recruitment for the vignette and preference studies was through memory services, community centres and carers’ organisations.
Participants
People aged > 50 years with dementia within 1 year of first attendance at a memory clinic were eligible for the trial. People aged > 60 years with later-stage dementia within 3 months of a review of care needs were eligible for the observational study. We recruited staff, carers and people with dementia for the vignette and preference studies. All participants had to give written informed consent.
Main outcome measures
The trial and observational study used the Bristol Activities of Daily Living Scale as the primary outcome and also measured quality of life, capability, cognition, general psychological health and carers’ sense of competence.
Methods
Owing to the heterogeneity of interventions, methods and outcome measures, our evidence and economic reviews both used narrative synthesis. The main source of economic studies was the NHS Economic Evaluation Database. We analysed the trial and observational study by linear mixed models. We analysed the trial by ‘treatment allocated’ and used propensity scores to minimise confounding in the observational study.
Results
Our reviews and surveys identified several home support approaches of potential benefit. In early-stage dementia, the DESCANT trial had 468 randomised participants (234 intervention participants and 234 control participants), with 347 participants analysed. We found no significant effect at the primary end point of 6 months of the DESCANT intervention on any of several participant outcome measures. The primary outcome was the Bristol Activities of Daily Living Scale, for which scores range from 0 to 60, with higher scores showing greater dependence. After adjustment for differences at baseline, the mean difference was 0.38, slightly but not significantly favouring the comparator group receiving treatment as usual. The 95% confidence interval ran from –0.89 to 1.65 (p = 0.56). There was no evidence that more intensive care packages in later-stage dementia were more effective than basic care. However, formal home care appeared to help keep people at home. Staff recommended informal care that cost 88% of formal care, but for informal carers this ratio was only 62%. People with dementia preferred social and recreational activities, and carers preferred respite care and regular home care. The DESCANT intervention is probably not cost-effective in early-stage dementia, and intensive care packages are probably not cost-effective in later-stage dementia. From the perspective of the third sector, intermediate intensity packages were cheaper but less effective. Certain elements may be driving these results, notably reduced use of carers’ groups.
Limitations
Our chosen outcome measures may not reflect subtle outcomes valued by people with dementia.
Conclusions
Several approaches preferred by people with dementia and their carers have potential. However, memory aids aiming to affect daily living activities in early-stage dementia or intensive packages compared with basic care in later-stage dementia were not clinically effective or cost-effective.
Future work
Further work needs to identify what people with dementia and their carers prefer and develop more sensitive outcome measures.
Study registration
Current Controlled Trials ISRCTN12591717. The evidence synthesis is registered as PROSPERO CRD42014008890.
Funding
This project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research programme and will be published in full in Programme Grants for Applied Research; Vol. 9, No. 6. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Paul Clarkson
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - David Challis
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Jane Hughes
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Brenda Roe
- Evidence-based Practice Research Centre, Edge Hill University, Ormskirk, UK
| | - Linda Davies
- Health Economics Research Team, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Ian Russell
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Fiona Poland
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - David Jolley
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Narinder Kapur
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Catherine Robinson
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Helen Chester
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Sue Davies
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Caroline Sutcliffe
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Julie Peconi
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Rosa Pitts
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
| | - Greg Fegan
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Saiful Islam
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Vincent Gillan
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Charlotte Entwistle
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Rebecca Beresford
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Michele Abendstern
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK
| | - Saima Ahmed
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Rowan Jasper
- Social Policy Research Unit, University of York, York, UK
| | - Adeela Usman
- School of Medicine, University of Nottingham, Nottingham, UK
| | - Baber Malik
- Social Care and Society, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Karen Hayhurst
- Division of Psychology and Mental Health, University of Manchester, Manchester, UK
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15
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Yin X, Xie Q, Huang L, Liu L, Armstrong E, Zhen M, Ni J, Shi J, Tian J, Cheng W. Assessment of the Psychological Burden Among Family Caregivers of People Living with Alzheimer's Disease Using the Zarit Burden Interview. J Alzheimers Dis 2021; 82:285-291. [PMID: 34024828 DOI: 10.3233/jad-210025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND In China, family caregivers play a major role in caring for people living with Alzheimer's disease (PLWAD), but little is known about the burden this creates. OBJECTIVE This study aimed to investigate the burden among family caregivers of PLWAD and the factors influenced it. METHODS Family caregivers of PLWAD were recruited from a hospital in China from January 2018 to July 2018. All data were collected online using the Chinese version of the Zarit Burden Interview (ZBI), and the participants' sociodemographic and caregiving details were obtained. T-tests and Kruskal-Wallis H (K) tests were used to compare ZBI scores between groups. Factors related to the caregiver psychological burden were analyzed using multiple linear regression analysis. RESULTS A total of 300 participants were assessed, of which 213 (71.00%) were female. More than half of the caregivers were the patient's daughter (51.0%, n = 153). The average ZBI score of the caregivers was 43.05 (13.42). The level of burden was influenced by age, the relationship of the caregiver to the patient, the severity of AD, the caregiver's retirement status, the income level of the caregiver, and the caring time. Regression analysis showed that retired caregivers were more likely to have higher levels of burden and that burden increased with AD severity. CONCLUSION Most family caregivers of PLWAD have a considerable caregiver psychological burden. The findings increase the understanding of factors that influence family caregiver burden, and pave the way for potential interventions, such as social support and caregiver empowerment, to reduce their burden.
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Affiliation(s)
- Xuejun Yin
- College of Administration, Beijing University of Chinese Medicine, Beijing, China.,The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Qixing Xie
- College of Administration, Beijing University of Chinese Medicine, Beijing, China.,Peking Union Medical College Hospital, Beijing, China
| | - Lieyu Huang
- College of Administration, Beijing University of Chinese Medicine, Beijing, China.,Office of Policy and Planning Research, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Liming Liu
- College of Administration, Beijing University of Chinese Medicine, Beijing, China
| | - Elizabeth Armstrong
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, Australia.,School of Population Health, The University of New South Wales, Sydney, Australia
| | - Miaomiao Zhen
- Beijing Gulou Hospital of Traditional Chinese Medicine, Beijing, China
| | - Jingnian Ni
- Neurology Centre at Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jing Shi
- Neurology Centre at Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jingzhou Tian
- Neurology Centre at Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Wei Cheng
- College of Administration, Beijing University of Chinese Medicine, Beijing, China.,National Institute of Chinese Medicine Development and Strategy,Beijing, China
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16
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Wang S, de Almeida Mello J, Declercq A. Development and evaluation of an intervention on suPpoRting infOrmal cAregivers of older people with early CogniTIVe declinE (PROACTIVE): a study protocol based on the Medical Research Council framework. BMJ Open 2021; 11:e047529. [PMID: 33495265 PMCID: PMC7839908 DOI: 10.1136/bmjopen-2020-047529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Caring for people with cognitive problems can have an impact on informal caregivers' health and well-being, and especially increases pressure on healthcare systems due to an increasing ageing society. In response to a higher demand of informal care, evidence suggests that timely support for informal caregivers is essential. The New York University Caregiver Intervention (NYUCI) has proven consistent effectiveness and high adaptability over 30 years. This study has three main objectives: to develop and evaluate the Flemish adaptation of the NYUCI in the context of caregiving for older people with early cognitive decline; to explore the causal mechanism of changes in caregivers' health and well-being and to evaluate the validity and feasibility of the interRAI Family Carer Needs Assessment in Flanders. METHODS AND ANALYSIS Guided by Medical Research Council framework, this study covers the development and evaluation phases of the adapted NYUCI, named PROACTIVE-suPpoRting infOrmal cAregivers of older people with early CogniTIVe declinE. In the development phase, we will identify the evidence base and prominent theory, and develop the PROACTIVE intervention in the Flemish context. In the evaluation phase, we will evaluate the PROACTIVE intervention with a pretest and posttest design in 1 year. Quantitative data will be collected with the BelRAI Screener, the BelRAI Social Supplement and the interRAI Family Carer Needs Assessment at baseline and follow-up points (at 4, 8 and 12 months). Qualitative data will be collected using counselling logs, evaluation forms and focus groups. Quantitative data and qualitative data will be analysed with SAS 9.4 software and NVivo software, respectively. Efficacy and process evaluation of the intervention will be performed. ETHICS AND DISSEMINATION This study has been approved by the Ethics Committee of KU Leuven with a dossier number G-2020-1771-R2(MAR). Findings will be disseminated through community information sessions, peer-reviewed publications and national and international conference presentations.
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Affiliation(s)
- Shanshan Wang
- Centre for Care Research & Consultancy(LUCAS), KU Leuven, Leuven, Belgium
| | | | - Anja Declercq
- Centre for Care Research & Consultancy(LUCAS) and Centre for Sociological Research (CeSO), KU Leuven, Leuven, Belgium
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17
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Hajisadeghian R, Ghezelbash S, Mehrabi T. The Effects of a Psychosocial Support Program on Perceived Stress of Family Caregivers of Patients with Mental Disorders. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:47-53. [PMID: 33954098 PMCID: PMC8074740 DOI: 10.4103/ijnmr.ijnmr_36_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 02/22/2020] [Accepted: 10/10/2020] [Indexed: 11/10/2022]
Abstract
Background: Taking caring of patients with mental disorders is stressful and people who take care of these patients need to receive enough support and training to overcome this challenging situation. The present study was aimed at investigating the effects of a psychosocial support program on perceived stress of family caregivers of patients with mental disorders. Materials and Methods: This randomized controlled clinical trial was performed on 64 family caregivers of patients with mental disorders referred to Noor and Hazrat-e-Ali Asghar hospital in Isfahan, Iran, in 2018-19. The participants were randomly assigned to the intervention and control groups using a random number table. In the intervention group, the training program was held in 6 sessions of 90-minute training classes twice a week. Data were collected using a demographic characteristics form and the Perceived Stress Scale (PSS) before, immediately after, and 1 month after the intervention. Descriptive and inferential statistical tests such as Chi-square, Mann-Whitney, independent t-test, repeated measures ANOVA, and Kolmogorov-Smirnov test were used to analyze the data in SPSS software. Results: The result of the study showed that the total mean score of perceived stress in the intervention group was significantly less than the control group immediately after (F2=66.29, p<0.001) and 1 month after the intervention (F2=66.29, p<0.001). Conclusions: Delivering a training program on the different dimensions of support family caregivers need will reduce the perceived stress of family caregivers of patients with mental disorders. Therefore, the implementation of this intervention is recommended in this group of caregivers.
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Affiliation(s)
- Reihaneh Hajisadeghian
- Student in Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Sima Ghezelbash
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Tayebeh Mehrabi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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18
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Sołtys A, Tyburski E. Predictors of mental health problems in formal and informal caregivers of patients with Alzheimer's disease. BMC Psychiatry 2020; 20:435. [PMID: 32887576 PMCID: PMC7487573 DOI: 10.1186/s12888-020-02822-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 08/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Caring for a person with Alzheimer's disease (AD) is associated with significant mental burden e.g., depression and anxiety, and difficulties with social, familial, and professional functioning. To date, few studies have examined variables which would allow for a comprehensive and detailed study of the relationship between personal resources and caregiver health status, with a majority of studies focusing on factors that contribute to increased caregiver's burden. Moreover, the available evidence fails to address differences in the functioning of formal and informal carers. Paying proper attention to the problems of nursing home staff can help identify important risk factors. Therefore, this study compared mental health problems in informal and formal caregivers and examined the relationship between mental resources and mental health problems in both groups of caregivers. METHODS This cross-sectional study examined 100 formal (n = 50) and informal (n = 50) caregivers of AD patients. Personal resources were measured with the Social Support Questionnaire (SSQ), the Generalized Self-Efficacy Scale (GSES), and the Sense of Coherence Questionnaire (SCQ), while mental health was assessed with the Depression Assessment Questionnaire (DAQ) and the General Health Questionnaire (GHQ). Multivariate stepwise regression was performed separately for both investigated groups. RESULTS There were no significant differences between informal and formal caregivers in terms of psychological variables, i.e., sense of coherence, social support, self-efficacy, or mental health problems. In contrast, there were different significant predictors of mental health problems in both groups. Comprehensibility (SCQ) was a significant predictor of mental health problems measured by DAQ and self-efficacy (GSES) was a significant predictor of mental health problems measured by GHQ in informal caregivers. For formal caregivers, emotional support (SSQ) and comprehensibility (SCQ) were significant predictors of mental health problems measured by DAQ, while tangible support (SSQ) and meaningfulness (SCQ) were significant predictors of mental health problems measured by GHQ. CONCLUSIONS Personal resources are significant predictors of mental health outcomes in caregivers of AD patients. Preventive actions should therefore include assessment of factors affecting caregivers' mental health in order to provide them with necessary care and create appropriate support groups.
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Affiliation(s)
- Anna Sołtys
- Institute of Psychology, University of Szczecin, 69 Krakowska str, 71-017 Szczecin, Poland
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, 10 Kutrzeby str, 61-719 Poznan, Poland
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19
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Source of Social Support and Caregiving Self-Efficacy on Caregiver Burden and Patient's Quality of Life: A Path Analysis on Patients with Palliative Care Needs and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155457. [PMID: 32751147 PMCID: PMC7432213 DOI: 10.3390/ijerph17155457] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022]
Abstract
Few studies have explored the inter-relationships of sources of social support and caregiving self-efficacy with caregiver burden and patient’s quality of life among patients with palliative care needs and their caregivers. This study tested the associations of two sources of social support (family and friends) and the mediating role of caregiving self-efficacy on caregiver burden and patient’s quality of life. A convenience sample of 225 patient–caregiver dyads recruited between September 2016 and May 2017 from three hospitals in Hong Kong was included in the current analysis. Results showed that the final model provided a satisfactory fit (SRMR = 0.070, R-RMSEA = 0.055 and R-CFI = 0.926) with the data, as good as the hypothesized model did (p = 0.326). Significant associations were detected. Family support had a significant negative indirect effect on caregiver burden and a significant positive indirect effect on patient’s quality of life through caregiving self-efficacy, whereas friend support had a significant positive direct effect on caregiver burden but a minimal effect, if any, on patient’s quality of life. These findings emphasized (1) the importance of caregiving self-efficacy in improving caregiver burden and patient’s quality of life and that (2) sources of social support may be an important dimension moderating the associations of caregiving self-efficacy with caregiver burden and patient’s quality of life.
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20
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Baniqued MG, Ballecer BAP, Ballesteros BDC, Balmonte JRR, Bancud EMF, Rebueno MCDR, Macindo JRB. Social support from nurses and non-adherence with directly observed therapy (DOTS) maintenance phase among patients with tuberculosis in Metro Manila, Philippines. Public Health Nurs 2020; 37:339-346. [PMID: 32077135 DOI: 10.1111/phn.12714] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Revised: 01/26/2020] [Accepted: 01/28/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the influence of community health nurses' social support on non-adherence with the maintenance phase of directly observed therapy (DOTS) among patients with tuberculosis (TB). DESIGN Prospective-cohort. SAMPLE One hundred purposively selected patients with TB starting with DOTS maintenance phase. MEASUREMENTS Participants answered the robotfoto and Berlin Social Support Scale (BSSS) to assess demographics and social support provided by nurses. Non-adherence was measured using the attendance record and documented in an abstraction form. Cox proportion-hazards regression determined the influence of social support provided by nurses to non-adherence. RESULTS With a median adherence of 3 weeks, 15% of the sample was non-adherent. The hazard of non-adherence was lower with high perceived emotional support (HR = 0.25, p = .046), perceived instrumental support (HR = 0.20, p = .044), perceived support seeking (HR = 0.27, p = .045), and received emotional support (HR = 0.45, p = .045). High received emotional support increased non-adherence (HR = 2.65, p = .039). CONCLUSION Social support from nurses influenced DOTS non-adherence among patients with TB, a critical issue in the development of drug-resistance. Perceived emotional, instrumental, support seeking and received emotional support decreased the hazard of non-adherence, while received emotional support increased non-adherence. This study highlights the need to promote positive perception of instrumental support needs. Appropriate interventions should be provided to promote support-seeking skills.
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Affiliation(s)
- Mikee G Baniqued
- College of Nursing, University of Santo Tomas, Manila, Philippines
| | | | | | | | | | | | - John Rey B Macindo
- Faculty of Management and Development Studies, University of the Philippines - Open University, Laguna, Philippines.,Nursing Service Division, AMOSUP Seamen's Hospital, Manila, Philippines
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21
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Isik AT, Soysal P, Solmi M, Veronese N. Bidirectional relationship between caregiver burden and neuropsychiatric symptoms in patients with Alzheimer's disease: A narrative review. Int J Geriatr Psychiatry 2019; 34:1326-1334. [PMID: 30198597 DOI: 10.1002/gps.4965] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2017] [Accepted: 07/25/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The aim of this review is to make a state of the art of the potential influence of neuropsychiatric symptoms (NPs) on caregiver stress and vice versa. METHODS We searched PubMed and Google Scholar for potential eligible articles. RESULTS Patients with Alzheimer's disease (AD) usually need high levels of care in all activities of daily living, most of them provided by family members, friends, or informal caregivers. Caregivers have to cope with both age-related conditions and dementia-related factors. Therefore, caregiving in dementia is more difficult and stressful than caregiving for older adults, affected by other conditions. Neuropsychiatric symptoms, such as anxiety, agitation, disinhibition, aggressive behavior, and sleep disturbances are more closely related to caregiver burden, and associated with more negative outcomes such as decline in their general health, quality of life, and social isolation. Caregiver burden worsens relationship between caregiver and patients with AD. Thus, this relationship may increase the frequency and severity of NPs. Predictors of burden were being a woman, a spouse, and old person with immature coping mechanisms, social isolation, with insufficient knowledge about dementia, poor premorbid relationship with patient, and high levels of negative expressed emotions. CONCLUSION Because of the bidirectional relationship between caregiver burden and NPs, the active management strategies of dementia care should include early identification and treatment risk factors for both caregiver stress and NPs in patients with AD. Therefore, to improve one of them can be exert beneficial for the other.
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Affiliation(s)
- Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Marco Solmi
- Department of Neurosciences, University of Padova, Padova, Italy.,Centro Neuroscienze Cognitive, University of Padua, Padua, Italy
| | - Nicola Veronese
- Geriatrics Unit, Department of Geriatric Care, OrthoGeriatrics and Rehabilitation, E.O. Galliera Hospital, National Relevance and High Specialization Hospital, Genoa, Italy.,Neuroscience Institute, Aging Branch, National Research Council, Padova, Italy
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Moeini B, Barati M, Farhadian M, Heydari Ara M. The effectiveness of an educational intervention to enhance happiness in Iranian older people: Applying social support theory. Australas J Ageing 2019; 39:e86-e93. [PMID: 31325220 DOI: 10.1111/ajag.12702] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 06/13/2019] [Accepted: 06/18/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study was to explore the effectiveness of an educational program based on social support theory (SST) to enhance happiness in older adults (60-75 years) in Hamadan (Iran) in 2017. METHODS This study was a quasi-experimental intervention with a control group, consisting of 60 participants and an intervention group of 40 participants. The research instruments included the Oxford Argyle Happiness Inventory and a questionnaire derived from SST. RESULTS The findings showed that there was a significant difference between the scores of happiness, social support and their components in the intervention group compared to the control group three months after the intervention. CONCLUSION The study results indicate that an educational intervention to promote happiness using social support can play a pivotal role in the mental health, life satisfaction and happiness of older adults.
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Affiliation(s)
- Babak Moeini
- Social Determinants of Health Research Centre & Department of Public Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Research Center for Behavioral Disorders and Substance use & Public Health, Department, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Maryam Farhadian
- Department of Biostatistics, School of Public Health and Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Milad Heydari Ara
- Public Health Department, Hamadan University of Medical Sciences, Hamadan, Iran
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García-Valverde E, Badia M, Orgaz MB, Gónzalez-Ingelmo E. The influence of songwriting on quality of life of family caregivers of people with dementia: An exploratory study. NORDIC JOURNAL OF MUSIC THERAPY 2019. [DOI: 10.1080/08098131.2019.1630666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Esther García-Valverde
- National Reference Centre for Alzheimer’s disease and Dementia Care of IMSERSO, Salamanca, Spain
| | - Marta Badia
- Department of Personality, Assessment and Psychological Treatment of University of Salamanca, Salamanca, Spain
| | - Mª Begoña Orgaz
- Department of Basic Psychology, Psychobiology, and Methodology of Behavioral Sciences of University of Salamanca, Salamanca, Spain
| | - Elena Gónzalez-Ingelmo
- National Reference Centre for Alzheimer’s disease and Dementia Care of IMSERSO, Salamanca, Spain
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Gaugler JE, Reese M, Mittelman MS. The Effects of a Comprehensive Psychosocial Intervention on Secondary Stressors and Social Support for Adult Child Caregivers of Persons With Dementia. Innov Aging 2018; 2:igy015. [PMID: 30009268 PMCID: PMC6037049 DOI: 10.1093/geroni/igy015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Indexed: 11/12/2022] Open
Abstract
Background and Objectives Many evaluations of nonpharmacologic interventions for family members of persons with Alzheimer's disease or related dementias (ADRDs) exist, but few consider effects on outcomes that are pertinent to caregivers' roles and relationships. The current study evaluated the efficacy of the New York University Caregiver Intervention-Adult Child (NYUCI-AC) on perceptions of family conflict, role conflict (effects of family caregiving and time, family, and social life), and perceived social support for adult child caregivers of relatives with ADRD over a 3-year period. Research Design and Methods A single-blinded randomized controlled trial design was used. One-hundred and seven adult child caregivers were enrolled in the NYUCI-AC and randomly assigned to a treatment or contact control group. Assessments were scheduled to be completed every 4 months during the first year of participation and every 6 months thereafter for up to 3 years. Individual growth curve models were utilized to ascertain the effects of the NYUCI-AC on change in family conflict, role conflict, and perceptions of social support. Results Among the entire sample, role conflict significantly (p < .05) declined and satisfaction with instrumental assistance increased over the course of the study, whereas family conflict slightly increased over the initial study period and then declined slightly. The findings indicated that the NYUCI-AC did not exert statistically significant effects on changes in family conflict, role conflict, or perceptions of social support over the 3-year study period. Discussion and Implications Although the clinical content of some dementia caregiver interventions is tailored to the specific needs of each caregiver and family, the outcomes selected to judge the efficacy of these interventions might not follow similar principles. Incorporating clinical content and evaluation outcomes that are family-centered will help to advance the state of the art of dementia caregiving interventions.
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Affiliation(s)
- Joseph E Gaugler
- Division of Health Policy & Management, School of Public Health, Minneapolis
| | - Mark Reese
- Families and LTC Projects, School of Nursing, University of Minnesota, Minneapolis
| | - Mary S Mittelman
- Department of Psychiatry, NYU School of Medicine, NYU Langone Health, New York, New York
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Abrahams R, Liu KPY, Bissett M, Fahey P, Cheung KSL, Bye R, Chaudhary K, Chu LW. Effectiveness of interventions for co-residing family caregivers of people with dementia: Systematic review and meta-analysis. Aust Occup Ther J 2018. [DOI: 10.1111/1440-1630.12464] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Rebecca Abrahams
- School of Science and Health; Western Sydney University; Sydney NSW Australia
| | - Karen P. Y. Liu
- School of Science and Health; Western Sydney University; Sydney NSW Australia
| | - Michelle Bissett
- School of Allied Health Sciences; Griffith University; Gold Coast QLD Australia
| | - Paul Fahey
- School of Science and Health; Western Sydney University; Sydney NSW Australia
| | - Karen S. L. Cheung
- Mindlink Research Centre; Hong Kong
- Sau Po Center on Ageing; The University of Hong Kong; Hong Kong
| | - Rosalind Bye
- School of Science and Health; Western Sydney University; Sydney NSW Australia
| | - Katrina Chaudhary
- School of Science and Health; Western Sydney University; Sydney NSW Australia
| | - Leung-Wing Chu
- Sau Po Center on Ageing; The University of Hong Kong; Hong Kong
- Division of Geriatric Medicine; Department of Medicine; The University of Hong Kong; Hong Kong
- Alzheimer's Disease Research Network; The University of Hong Kong; Hong Kong
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Kaufman JE, Lee Y, Vaughon W, Unuigbe A, Gallo WT. Depression Associated With Transitions Into and Out of Spousal Caregiving. Int J Aging Hum Dev 2018; 88:127-149. [PMID: 29382211 DOI: 10.1177/0091415018754310] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study investigates depressive symptoms among spousal caregivers in three groups: those who become caregivers, those who continue care, and those who exit caregiving, compared with those who remain non-caregivers. We also examine depressive symptoms among widowed caregivers by length of bereavement. We use four waves of the U.S. Health and Retirement Study (2006, 2008, 2010, and 2012), for a total of 43,262 observations. Findings show elevated levels of depressive symptoms for new caregivers, continuing caregivers, and exit caregivers. Among exit caregivers, symptoms were elevated when measured in the first 15 months after the spouse’s death but declined thereafter. These findings add to the evidence that spousal caregiving carries a risk for depression, and symptoms are likely to peak near the end of the caregiving episode. These results underscore the need to provide support to newly widowed individuals.
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Affiliation(s)
- Jennifer E Kaufman
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
| | - Yeonjung Lee
- Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada
| | - Wendy Vaughon
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
| | - Aig Unuigbe
- Graduate Center, City University of New York, NY, USA
| | - William T Gallo
- Graduate School of Public Health and Health Policy, City University of New York, NY, USA
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Khazaeian S, Kariman N, Ebadi A, Nasiri M. The impact of social capital and social support on the health of female-headed households: a systematic review. Electron Physician 2017; 9:6027-6034. [PMID: 29560156 PMCID: PMC5843430 DOI: 10.19082/6027] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 09/06/2017] [Indexed: 11/20/2022] Open
Abstract
Background and aim Social capital and social support as determinants of health play an important role in the health of female heads of households. Considering the increasing number of female-headed families in Iran and the world, this study was conducted to systematically review the impact of social capital and social support on the health of female heads of households. Methods This study was conducted as a systematic review in September 2016. Its data were collected from available papers in different databases including Iranmedex, Magiran, Scientific Information Database (SID), Irandoc, Scopus, Science Direct, PubMed and Google Scholar. Using advanced search, all published papers from 2000 to 2015 with full text were selected using related keywords. After reviewing by browsers and adapting to the inclusion and exclusion criteria, 15 papers were entered into the study. The Strengthening the Reporting of Observational Studies in epidemiology (STROBE) checklist was used to evaluate the quality of papers. Results Based on the findings of these studies, there was a significant relationship between social capital and its components (trust, sense of belonging and social participation) as well as all aspects of health. Additionally, social support and its dimensions (emotional, instrumental and informational) affected health; however, among these dimensions, instrumental support of a stronger predictor was concerned with health, especially mental health. Conclusion Social factors such as social capital and social support are effective on human health, particularly health of female-headed households, since they affect proactive identity and increase information resources, collaboration as well as collective decisions and actions. Furthermore, they provide emotional and instrumental support to group members and prevent further health problems.
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Affiliation(s)
- Somayyeh Khazaeian
- Ph.D. Candidate of Reproductive Health, Student Research Committee, Department of Midwifery and Reproductive Health, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nourossadat Kariman
- Ph.D. of Reproductive Health, Assistant Professor, Midwifery and Reproductive Health Research Center, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Ph.D. in Nursing, Professor, Behavioral Sciences Research Center, School of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Ph.D. in Biostatistics, Assistant Professor, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Clarkson P, Hughes J, Roe B, Giebel CM, Jolley D, Poland F, Abendstern M, Chester H, Challis D. Systematic review: Effective home support in dementia care, components and impacts - Stage 2, effectiveness of home support interventions. J Adv Nurs 2017; 74:507-527. [DOI: 10.1111/jan.13460] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/11/2017] [Indexed: 01/20/2023]
Affiliation(s)
- Paul Clarkson
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Jane Hughes
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Brenda Roe
- Faculty of Health & Social Care; Evidence-based Practice Research Centre; Edge Hill University; Ormskirk UK
| | - Clarissa M. Giebel
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - David Jolley
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Fiona Poland
- School of Health Sciences; University of East Anglia; Norwich UK
| | - Michele Abendstern
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - Helen Chester
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
| | - David Challis
- Personal Social Services Research Unit; Division of Population Health; Health Services Research and Primary Care; School of Health Sciences; Faculty of Biology, Medicine and Health; University of Manchester; Manchester Academic Health Science Centre; Manchester UK
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Orouji MA, Shojaeizadeh D, Sadeghi R, Rafiei M. Effects of a theory-driven educational package and social support on durability of cigarette smoking cessation behavior: A community-based program. Electron Physician 2017; 9:5331-5338. [PMID: 29038718 PMCID: PMC5633234 DOI: 10.19082/5331] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/20/2022] Open
Abstract
Background According to a World Health Organization (WHO) report, the prevalence of smoking in Iranian individuals aged 15–64 is up to 12%. Objective The aim of the current study was to determine the durability of smoking cessation behavior based on a trans-theoretical model. Methods This educational experimental study was conducted on smokers in Khomein City, Iran, in 2015. Sampling was done through a public announcement and then a random allocation of participants into two study group (50 persons) and control group (60 persons). Tools to gather data were as follows: an individual characteristics form and DiClemente’s stages of change, Velicer’s self-efficacy, Prochaska’s processes of change, Velicer’s decisional balance, and Fagerstrom’s nicotine dependency questionnaires. The study group received five sessions of 45-minute individual counseling each and were followed-up three and six months later. Data were analyzed by SPSS version 16, using paired-samples t-test, independent-samples t-test, and chi-square. Results Within six months of follow-up, 20 persons (40%) of the intervention group reached the maintenance stage of smoking cessation, while no one from controls managed to do that. Except for the perceived barriers and benefits of smoking cessation, all other constructs of the trans-theoretical model (cognitive and behavioral processes and smoking temptation) showed significant changes among the intervention group during six months’ follow-up (p<0.05). There was no significant relationship between variables of having smoker friends, occupation, marital status, education status, and success or failure in cigarette smoking cessation (p>0.05). Conclusion According to our study, selection of cigarette smokers who are willing to quit, delivery of individual counseling according to specific personal characteristics, and also provision of free nicotine replacement therapies should be taken into account in cigarette smoking cessation programs.
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Affiliation(s)
- Mohammad Ali Orouji
- Ph.D. Student of Health Education and Promotion, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Ph.D. of Health Education and Promotion, Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Roya Sadeghi
- Ph.D. of Health Education and Promotion, Associate Professor, Department of Health Promotion and Education, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Rafiei
- Ph.D. of Biostatistics, Professor, Department of Biostatistics and epidemiology, School of medicine, Arak University of Medical Sciences, Arak, Iran
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Abstract
In this issue of Psychosomatic Medicine, Mausbach and colleagues report that Alzheimer's disease caregivers who engage in more pleasant leisure activities had lower blood pressure for 5 years compared with those who engage in fewer leisure activities. This novel finding suggests that something as simple as taking more walks in the park or more time for reading books could protect the physical health of caregivers. In this editorial, we review possible mechanisms linking pleasant leisure activities with lower blood pressure in caregivers and discuss potential barriers that prevent caregivers from engaging in pleasant leisure activities. One possibility is that caregivers may not give themselves "permission" to take time away from caregiving, or feel guilty or selfish for doing so. Another impediment may be lack of outside assistance or support that would be needed to take time for leisure activities. Primary health care providers may play an important role in helping caregivers overcome these obstacles. In addition, public policy innovations are needed to meet the increasing societal demands on the psychological and medical consequences of caregiver burden.
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Care burden and its predictive factors in parents of newly diagnosed children with acute lymphoblastic leukemia in academic hospitals in China. Support Care Cancer 2017; 25:3703-3713. [DOI: 10.1007/s00520-017-3796-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 06/12/2017] [Indexed: 12/12/2022]
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Vandepitte S, Van Den Noortgate N, Putman K, Verhaeghe S, Faes K, Annemans L. Effectiveness of Supporting Informal Caregivers of People with Dementia: A Systematic Review of Randomized and Non-Randomized Controlled Trials. J Alzheimers Dis 2017; 52:929-65. [PMID: 27079704 DOI: 10.3233/jad-151011] [Citation(s) in RCA: 76] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dementia is known as a major public health problem affecting both patients and caregivers, and placing a high financial strain upon society. In community-dwelling patients, it is important to support informal caregivers in order to help them sustain their demanding role. Previous reviews about effectiveness of such supporting strategies often included a small number of studies, focused only on particular supportive types, particular outcomes, or solely on caregivers. OBJECTIVE A general systematic review was conducted investigating effectiveness of different supportive strategies on at least the well-being of the caregiver or the care-recipient. METHODS A systematic literature search was conducted in Web of Science and PubMed. An adapted version of the Downs and Black (1998) checklist was used to assess methodological quality. A new classification was developed to group different types of caregiver support. RESULTS Fifty-three papers met the inclusion criteria. Although 87% of the interventions were to some extent effective, methods and findings were rather inconsistent. Psychoeducational interventions generally lead to positive outcomes for caregivers, and delay permanent institutionalization of care-recipients. Cognitive behavioral therapy decreases dysfunctional thoughts among caregivers. Occupational therapy decreases behavioral problems among patients and improves self-efficacy of caregivers. In general, those interventions tailored on individual level generate better outcomes. Comparative research on respite care was very rare. CONCLUSIONS Despite methodological inconsistency, supporting caregivers appears to be an effective strategy often improving well-being of caregiver or care-recipient and resulting in additional benefits for society. However, there is a need for more research on the (cost)-effectiveness of respite care.
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Affiliation(s)
- Sophie Vandepitte
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium
| | - Nele Van Den Noortgate
- Faculty of Medicine and Health Sciences, Department of Internal Medicine, Ghent University, Brussels, Belgium
| | - Koen Putman
- Faculty of Medicine and Pharmacy, Department of Medical Sociology, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sofie Verhaeghe
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium
| | - Kristof Faes
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium
| | - Lieven Annemans
- Faculty of Medicine and Health Sciences, Department of Public Health, Ghent University, Belgium
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Fauth EB, Jackson MA, Walberg DK, Lee NE, Easom LR, Alston G, Ramos A, Felten K, LaRue A, Mittelman M. External Validity of the New York University Caregiver Intervention: Key Caregiver Outcomes Across Multiple Demonstration Projects. J Appl Gerontol 2017. [DOI: 10.1177/0733464817714564] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Purpose of the Study: The Administration on Aging funded six New York University Caregiver Intervention (NYUCI) demonstration projects, a counseling/support intervention targeting dementia caregivers and families. Three sites (Georgia, Utah, Wisconsin) pooled data to inform external validity in nonresearch settings. This study (a) assesses collective changes over time, and (b) compares outcomes across sites on caregiver burden, depressive symptoms, satisfaction with social support, family conflict, and quality of life. Design and Methods: Data included baseline/preintervention ( N = 294) and follow-up visits (approximately 4, 8, 12 months). Results: Linear mixed models showed that social support satisfaction increased ( p < .05) and family conflict decreased ( p < .05; Cohen’s d = 0.49 and 0.35, respectively). Marginally significant findings emerged for quality of life increases ( p = .05) and burden decreases ( p < .10). Depressive symptoms remained stable. Slopes did not differ much by site. Implications: NYUCI demonstrated external validity in nonresearch settings across diverse caregiver samples.
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Affiliation(s)
| | | | | | | | | | - Gayle Alston
- Georgia Southwestern State University, Americus, USA
| | - Angel Ramos
- Georgia Southwestern State University, Americus, USA
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Tadaka E, Kono A, Ito E, Kanaya Y, Dai Y, Imamatsu Y, Itoi W. Development of a community's self-efficacy scale for preventing social isolation among community-dwelling older people (Mimamori Scale). BMC Public Health 2016; 16:1198. [PMID: 27894279 PMCID: PMC5127097 DOI: 10.1186/s12889-016-3857-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2016] [Accepted: 11/18/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Among older people in developed countries, social isolation leading to solitary death has become a public health issue of vital importance. Such isolation could be prevented by monitoring at-risk individuals at the neighborhood level and by implementing supportive networks at the community level. However, a means of measuring community confidence in these measures has not been established. This study is aimed at developing the Community's Self-Efficacy Scale (CSES; Mimamori scale in Japanese) for community members preventing social isolation among older people. METHODS The CSES is a self-administered questionnaire developed on the basis of Bandura's self-efficacy theory. The survey was given to a general population (GEN) sample (n = 6,000) and community volunteer (CVOL) sample (n = 1,297). Construct validity was determined using confirmatory factor analysis. Internal consistency was calculated using Cronbach's alpha. The Generative Concern Scale (GCS-R) and Brief Sense of Community Scale (BSCS) were also administered to assess criterion-related validity of the CSES. RESULTS In total, 3,484 and 859 valid responses were received in the GEN and CVOL groups, respectively. The confirmatory factor analysis identified eight items from two domains-community network and neighborhood watch-with goodness of fit index = 0.984, adjusted goodness of fit index = 0.970, comparative fit index = 0.988, and root mean square error of approximation = 0.047. Cronbach's alpha for the entire CSES was 0.87 and for the subscales was 0.80 and higher. The score of the entire CSES was positively correlated with the GCS-R in both the GEN (r = 0.80, p < 0.001) and CVOL (r = 0.86, p < 0.001) samples. CONCLUSIONS The CSES demonstrated adequate reliability and validity for assessing a community's self-efficacy to aid in its preventing social isolation among older people. The scale is potentially useful for promoting health policies, practices, and interventions within communities. This may help prevent social isolation among older people and contribute to overall well-being in aging societies in Japan and abroad.
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Affiliation(s)
- Etsuko Tadaka
- Department of Community Health Nursing, Faculty of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Ayumi Kono
- Department of Home Health Care Nursing, School of Nursing, Osaka City University, 1-5-17 Asahi, Abeno-ku, Osaka, 545-0051 Japan
| | - Eriko Ito
- Department of Community Health Nursing, Faculty of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004 Japan
| | - Yukiko Kanaya
- Department of Home Health Care Nursing, School of Nursing, Osaka City University, 1-5-17 Asahi, Abeno-ku, Osaka, 545-0051 Japan
| | - Yuka Dai
- Kamakura Women’s University, 6-1-3 Ōfuna, Kamakura, Kanagawa 247-0056 Japan
| | - Yuki Imamatsu
- Soka University, 1-236 Tangi-machi, Hachioji, Tokyo, 192-8577 Japan
| | - Waka Itoi
- Teikyo University of Science, 2-2-1 Senjusakuragi, Adachi-ku, Tokyo, 120-0045 Japan
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Gené-Badia J, Ruiz-Sánchez M, Obiols-Masó N, Oliveras Puig L, Lagarda Jiménez E. [Social isolation and loneliness: What can we do as Primary Care teams?]. Aten Primaria 2016; 48:604-609. [PMID: 27667145 PMCID: PMC6877840 DOI: 10.1016/j.aprim.2016.03.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2016] [Accepted: 03/20/2016] [Indexed: 12/02/2022] Open
Abstract
La soledad y el aislamiento social son condicionantes de salud emergentes en la población anciana, especialmente en las personas viudas, hiperfrecuentadoras y con problemas crónicos y depresión. La soledad es la sensación subjetiva de tener menor afecto y cercanía de lo deseado en el ámbito íntimo o relacional. El aislamiento social es la situación objetiva de contar con mínimos contactos con otras personas. Su contribución al incremento de la morbimortalidad es comparable al de otros factores de riesgo bien conocidos sobre los que actuamos a diario desde los equipos de atención primaria. Se discuten estrategias para identificar estos problemas en nuestros pacientes y para realizar intervenciones basadas en la evidencia científica tanto a nivel individual como comunitario en cooperación con otros recursos de la comunidad. El equipo de atención primaria ha de promover la autonomía de estos pacientes, facilitar su sociabilidad y actuar sobre sus pensamientos sociales maladaptativos que dificultan su integración social.
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Affiliation(s)
- Joan Gené-Badia
- Institut Català de la Salut, Barcelona, España; CAPSBE, Consorci d'Atenció Primària de l'Eixample, Barcelona, España; Universitat de Barcelona, Barcelona, España; Servei de Medicina Preventiva i Epidemiologia, Hospital Clínic de Barcelona, Barcelona, España.
| | - Marina Ruiz-Sánchez
- CAPSBE, Consorci d'Atenció Primària de l'Eixample, Barcelona, España; Servei de Medicina Preventiva i Epidemiologia, Hospital Clínic de Barcelona, Barcelona, España
| | - Núria Obiols-Masó
- CAPSBE, Consorci d'Atenció Primària de l'Eixample, Barcelona, España; Servei de Medicina Preventiva i Epidemiologia, Hospital Clínic de Barcelona, Barcelona, España
| | - Laura Oliveras Puig
- Universitat de Barcelona, Barcelona, España; Servei de Medicina Preventiva i Epidemiologia, Hospital Clínic de Barcelona, Barcelona, España
| | - Elena Lagarda Jiménez
- CAPSBE, Consorci d'Atenció Primària de l'Eixample, Barcelona, España; Servei de Medicina Preventiva i Epidemiologia, Hospital Clínic de Barcelona, Barcelona, España
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Mullins J, Bliss DZ, Rolnick S, Henre CA, Jackson J. Barriers to Communication With a Healthcare Provider and Health Literacy About Incontinence Among Informal Caregivers of Individuals With Dementia. J Wound Ostomy Continence Nurs 2016; 43:539-44. [PMID: 27607750 PMCID: PMC5017302 DOI: 10.1097/won.0000000000000263] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to examine barriers to communicating with healthcare professionals and health literacy about incontinence among different types of informal caregivers of individuals with Alzheimer disease (AD). DESIGN Descriptive secondary analysis. SUBJECTS AND SETTING The sample included 48 family/friend adult caregivers of individuals who had AD. Seventy-five percent were female; their mean age was 64 ± 14 years (mean ± SD). Caregivers were spouses (44%), daughters (31%), or extended family members/friends (25%). Nearly half (48%) of caregivers had a racially or ethnically diverse background; 58% of their care recipients had incontinence. METHODS Data were collected via focus groups, interviews, and written surveys. Verbal responses were audiotaped, transcribed, and analyzed for themes by caregiver type using content analysis. RESULTS Caregivers of persons with AD described role-related barriers to improving health literacy about incontinence and its management. Main themes of barriers emerged for each type of role that were emotive in nature for daughters, experiential for both spouse caregivers, system related for husbands, and relational (being perceived as an outsider) for extended family/friends. CONCLUSIONS Nurse continence specialists have an important role in raising health literacy about incontinence and its management for informal caregivers of individual with AD. Results inform the development of interventions that are tailored to the type of caregiver as recommended by national health literacy initiatives with the aim of improving outcomes such as incontinence of care recipients.
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Affiliation(s)
- Jean Mullins
- Jean Mullins, BSN, RN, University of Minnesota School of Nursing, Minneapolis. Donna Z. Bliss, PhD, RN, FAAN, FGSA, University of Minnesota School of Nursing, Minneapolis. Sharon Rolnick, PhD, HealthPartners Research Foundation, Bloomington, Minnesota. Casey Arntson Henre, BSN, RN, University of Minnesota School of Nursing, Minneapolis. Jody Jackson, BSN, RN, HealthPartners Research Foundation, Bloomington, Minnesota
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Lino VTS, Rodrigues NCP, Camacho LAB, OʼDwyer G, Lima ISD, Andrade MKDN, Atie S. [Prevalence of overburden in caregivers of dependent elderly and associated factors in a poor area of Rio de Janeiro, Brazil]. CAD SAUDE PUBLICA 2016; 32:S0102-311X2016000605001. [PMID: 27333144 DOI: 10.1590/0102-311x00060115] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 02/22/2016] [Indexed: 11/21/2022] Open
Abstract
Population aging has led to increased dependency and overburden of family caregivers of dependent elderly. The aim was to verify prevalence of family caregivers overburden and associated factors in a poor and violent area of Rio de Janeiro, Brazil. This was a cross-sectional study of 140 elderly and family caregivers, focusing on social support, abuse, cohabitation, and family caregivers overburden, in addition to dependency, cognitive decline, and depression in the elderly. Multiple logistic models were constructed to explain family caregivers overburden. The following characteristics of the elderly were associated with family caregivers overburden: age (OR = 0.94; p < 0.002), depression (OR = 2.59; p < 0.005), and cognitive decline (OR = 3.19; p < 0.03). As for family caregivers characteristics, only social support remained relevant (OR = 2.35; p < 0.005). In conclusion, investigating and treating depression and dementia in the elderly and promoting support for their caregivers can contribute to the effective management of family caregivers overburden and improve quality of care for both.
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Affiliation(s)
- Valéria Teresa Saraiva Lino
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Nadia Cristina Pinheiro Rodrigues
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Luiz Antônio Bastos Camacho
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Gisele OʼDwyer
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Idenalva Silva de Lima
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Mônica Kramer de Noronha Andrade
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
| | - Soraya Atie
- Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil, Fundação Oswaldo Cruz, Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro , Brazil
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Lathan C, Wallace AS, Shewbridge R, Ng N, Morrison G, Resnick HE. Cognitive Health Assessment and Establishment of a Virtual Cohort of Dementia Caregivers. Dement Geriatr Cogn Dis Extra 2016; 6:98-107. [PMID: 27099613 PMCID: PMC4836114 DOI: 10.1159/000444390] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Many factors impact caregivers’ cognitive health and, by extension, their ability to provide care. This study examined the relationship between psychosocial factors and cognitive performance among dementia caregivers and established a virtual cohort of caregivers for future research. Methods Data on 527 caregivers were collected via a Web-based survey that assessed cognitive performance. Caregiver data were compared to corresponding data from 527 age-, race-, gender-, and education-matched controls from a normative database. Caregiver self-reported sleep, stress, health, and social support were also assessed. Results Caregivers performed significantly worse than controls on 3 of 5 cognitive subtests. Stress, sleep, perceived support, self-rated health, years of caregiving, race, and gender were significant predictors of cognitive performance. Conclusion In this sample of dementia caregivers, psychosocial factors interacted in complex ways to impact cognitive performance. Further investigation is needed to better understand how these factors affect cognitive performance among caregivers. This could be accomplished by the establishment of a virtual cohort that facilitates the development of digital tools to support the evaluation and management of caregiver needs in a manner that helps them remain effective in their caregiving roles.
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Affiliation(s)
| | | | | | - Nicole Ng
- Lumos Labs, San Francisco, Calif., USA
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Dam AEH, de Vugt ME, Klinkenberg IPM, Verhey FRJ, van Boxtel MPJ. A systematic review of social support interventions for caregivers of people with dementia: Are they doing what they promise? Maturitas 2016; 85:117-30. [PMID: 26857890 DOI: 10.1016/j.maturitas.2015.12.008] [Citation(s) in RCA: 156] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Revised: 12/17/2015] [Accepted: 12/20/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Social support interventions for caregivers of persons with dementia (PwD) are important because informal carers often rely on their social networks for support. This systematic review synthesises findings from research on social support interventions, and examines their methodological quality and effectiveness on caregiver social support and well-being variables. METHODS A systematic literature search utilised five databases. Papers were selected when the primary aim of the intervention was to improve social support. Quality of papers was assessed by the Level of Evidence grade and the criteria list from the Cochrane Back Review Group. RESULTS 39 papers were identified and classified into 4 social support intervention categories: befriending and peer support, family support and social network interventions, support groups, and remote interventions using the internet or telephone. Content, intensity, uptake, effectiveness and quality of interventions varied widely. In general, the level of evidence was low. Most studies measured effect on well-being variables, while few examined social support outcomes. Multi-component social support interventions were most effective. Evidence suggested, also a caregiver benefit from remote interventions. Generally, results were inconsistent; some papers demonstrated beneficial results, while others demonstrated no improvement on social support and well-being variables. Social support outcomes were more positively evaluated when qualitative outcome measures rather than quantitative measures were used. CONCLUSIONS Although multi-component social support interventions may improve caregiver well-being, there is insufficient evidence to conclude whether a change in social support is the underlying mediating factor. The inclusion, validation and operationalization of caregiver social support measures deserve more attention.
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Affiliation(s)
- Alieske E H Dam
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Inge P M Klinkenberg
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Frans R J Verhey
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
| | - Martin P J van Boxtel
- Department of Psychiatry and Neuropsychology/Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.
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Nay R, Bauer M, Fetherstonhaugh D, Moyle W, Tarzia L, McAuliffe L. Social participation and family carers of people living with dementia in Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2015; 23:550-558. [PMID: 25471283 DOI: 10.1111/hsc.12163] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/19/2014] [Indexed: 06/04/2023]
Abstract
This paper reports on a study exploring the experiences and meaning of social participation for family carers of people living with dementia. Participants were 33 family carers (17 spouses and 16 adult children) of older adults diagnosed with dementia (any stage or type) who responded to advertisements by the national Alzheimer's association, Alzheimer's Australia. Data were collected through semi-structured face-to-face and/or telephone interviews using an interview guide, which included prompts such as 'Tell me about what social participation means to you', and 'How did this change…'. The methods of grounded theory were drawn upon to guide sampling and analysis of data, which continued until theoretical saturation was achieved and occurred over the period September 2011 to March 2012. Data arising from the interviews were analysed line-by-line and coded and categorised using the constant comparative method, with codes clustered into themes and with abstraction from the themes to arrive at the core process. The core category arising from the data was adaptation, which encompassed four main themes: autonomy to choose; the impact of care-giving; employing strategies; and establishing meaningful connections. Carers went through a process whereby the ways in which they had previously participated socially were compromised, which often prompted an exploration of new ways in which to remain socially engaged.
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Affiliation(s)
- Rhonda Nay
- Australian Centre for Evidence Based Aged Care (ACEBAC), Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Michael Bauer
- Australian Centre for Evidence Based Aged Care (ACEBAC), Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care (ACEBAC), Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Wendy Moyle
- Griffith Health Institute, Griffith University, Brisbane, Queensland, Australia
| | - Laura Tarzia
- Australian Centre for Evidence Based Aged Care (ACEBAC), Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care (ACEBAC), Faculty of Health Sciences, La Trobe University, Melbourne, Victoria, Australia
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Uchino BN. Understanding the Links Between Social Support and Physical Health: A Life-Span Perspective With Emphasis on the Separability of Perceived and Received Support. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2015; 4:236-55. [PMID: 26158961 DOI: 10.1111/j.1745-6924.2009.01122.x] [Citation(s) in RCA: 601] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Social support has been reliably related to physical health outcomes. However, the conceptual basis of such links needs greater development. In this article, I argue for a life-span perspective on social support and health that takes into account distinct antecedent processes and mechanisms that are related to measures of support over time. Such a view highlights the need to distinguish measures of perceived and received support and its links to more specific diseases (e.g., chronic, acute) and stages of disease development (e.g., incidence). I discuss both the novel implications of these theoretical arguments for research on social support and physical health, as well as the potential intervention approaches that are apparent from this perspective.
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Shnall A. Public advocacy and community engagement: interventions for individuals with young-onset dementia and their families. Psychiatr Clin North Am 2015; 38:353-62. [PMID: 25998121 DOI: 10.1016/j.psc.2015.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Individuals and families affected by young-onset dementia (YOD) deal with multiple difficulties related to the altered timing of the dementias. These individuals and families are overlooked by the health care and social support systems because there are few tailored services/policies for younger people affected by dementia. This article suggests how public advocacy and interventions at the clinical and community levels can support people living with YOD, in particular the spouses, who provide most of the care.
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Affiliation(s)
- Adriana Shnall
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Toronto, ON M5S1A1, Canada; Sam and Ida Ross Memory Clinic, Baycrest Health Sciences, 3560 Bathurst, ON M6A 2E1, Canada.
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Ejem DB, Drentea P, Clay OJ. The effects of caregiver emotional stress on the depressive symptomatology of the care recipient. Aging Ment Health 2015; 19:55-62. [PMID: 24866207 DOI: 10.1080/13607863.2014.915919] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVES Depression is a leading mental health issue affecting elderly individuals worldwide. Previous research widely neglects caregiver emotional stress as a probable contributing factor of depression in the elderly. This study investigated caregiver emotional stress as a chronic life stressor of an elderly care recipient using the life stress paradigm as the theoretical foundation. METHODS The relationships between caregiver emotional stress and care receiver depressive symptoms, as well as other social and psychological mediation factors, were investigated using the 2004 wave of the National Long-Term Care Study (NLTCS). The NLTCS is a nationally representative longitudinal study used to identify frail and disabled elderly Medicare recipients living in the United States. The analytic sample of this study included 1340 caregiver-care receiver dyads who were asked a series of questions concerning their mental health (i.e. emotional stress and depressive symptoms), as well as the availability of social and psychological resources. RESULTS Overall, the results showed that high levels of emotional stress reported by the caregiver were associated with a higher likelihood of the disabled care receiver reporting depressive symptoms. CONCLUSION The findings of this investigation point to the importance of studying caregivers and care receivers as dyads as the stress associated with the caregiving role affects each member.
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Affiliation(s)
- Deborah B Ejem
- a Department of Sociology , University of Alabama at Birmingham , Birmingham , AL , USA
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Hind D, Mountain G, Gossage-Worrall R, Walters SJ, Duncan R, Newbould L, Rex S, Jones C, Bowling A, Cattan M, Cairns A, Cooper C, Goyder E, Edwards RT. Putting Life in Years (PLINY): a randomised controlled trial and mixed-methods process evaluation of a telephone friendship intervention to improve mental well-being in independently living older people. PUBLIC HEALTH RESEARCH 2014. [DOI: 10.3310/phr02070] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundSocial isolation in older adults is associated with morbidity. Evaluating interventions to promote social engagement is a research priority.MethodsA parallel-group randomised controlled trial was planned to evaluate whether telephone friendship (TF) improves the well-being of independently living older people. An internal pilot aimed to recruit 68 participants by 30 September 2012, with 80% retained at 6 months. Randomisation was web based and only analysts were blind to allocation. A service provider was contracted to train 10 volunteer facilitators by 1 April 2012 and 10 more by 1 September 2012. Participants were aged > 74 years with good cognitive function and living independently in an urban community. The intervention arm of the trial consisted of manualised TF with standardised training: (1) one-to-one befriending (10- to 20-minute calls once per week for up to 6 weeks made by volunteer facilitators) followed by (2) TF groups of six participants (1-hour teleconferences once per week for 12 weeks facilitated by the same volunteer). Friendship groups aimed to enhance social support and increase opportunities for social interaction to maintain well-being. This was compared with usual health and social care provision. The primary clinical outcome was the Short Form questionnaire-36 items (SF-36) mental health dimension score at 6 months post randomisation. Qualitative research assessing intervention acceptability (participants) and implementation issues (facilitators) and an intervention fidelity assessment were also carried out. Intervention implementation was documented through e-mails, meeting minutes and field notes. Acceptability was assessed through framework analysis of semistructured interviews. Two researchers coded audio recordings of telephone discussions for fidelity using a specially designed checklist.ResultsIn total, 157 people were randomised to the TF group (n = 78) or the control group (n = 79). Pilot recruitment and retention targets were met. Ten volunteers were trained by 1 September 2012; after volunteer attrition, three out of the 10 volunteers delivered the group intervention. In total, 50 out of the 78 TF participants did not receive the intervention and the trial was closed early. A total of 56 people contributed primary outcome data from the TF (n = 26) and control (n = 30) arms. The mean difference in SF-36 mental health score was 9.5 (95% confidence interval 4.5 to 14.5) after adjusting for age, sex and baseline score. Participants who were interviewed (n = 19) generally declared that the intervention was acceptable. Participant dissatisfaction with closure of the groups was reported (n = 4). Dissatisfaction focused on lack of face-to-face contact and shared interests or attitudes. Larger groups experienced better cohesion. Interviewed volunteers (n = 3) expressed a lack of clarity about procedures, anxieties about managing group dynamics and a lack of confidence in the training and in their management and found scheduling calls challenging. Training was 91–95% adherent with the checklist (39 items; three groups). Intervention fidelity ranged from 30.2% to 52.1% (28–41 items; three groups, three time points), indicating that groups were not facilitated in line with training, namely with regard to the setting of ground rules, the maintenance of confidentiality and facilitating contact between participants.ConclusionsAlthough the trial was unsuccessful for a range of logistical reasons, the experience gained is of value for the design and conduct of future trials. Participant recruitment and retention were feasible. Small voluntary sector organisations may be unable to recruit, train and retain adequate numbers of volunteers to implement new services at scale over a short time scale. Such risks might be mitigated by multicentre trials using multiple providers and specialists to recruit and manage volunteers.Trial registrationCurrent Controlled Trials ISRCTN28645428.FundingThis project was funded by the NIHR Public Health Research programme and will be published in full inPublic Health Research; Vol. 2, No. 7. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Daniel Hind
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Gail Mountain
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Stephen J Walters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Rosie Duncan
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Louise Newbould
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Saleema Rex
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Carys Jones
- Institute of Medical and Social Care Research, Bangor University, Bangor, UK
| | - Ann Bowling
- Facility of Health Sciences, University of Southampton, Southampton, UK
| | - Mima Cattan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | | | - Cindy Cooper
- Sheffield Clinical Trials Research Unit, University of Sheffield, Sheffield, UK
| | - Elizabeth Goyder
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
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Gibson AK, Anderson KA, Acocks S. Exploring the service and support needs of families with early-onset Alzheimer's disease. Am J Alzheimers Dis Other Demen 2014; 29:596-600. [PMID: 25392308 PMCID: PMC10852964 DOI: 10.1177/1533317514558160] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Although often cast as a disease of later life, a growing number of people are being diagnosed with Alzheimer's disease in their 50s and 60s. Early-onset Alzheimer's disease (EOAD) poses special challenges and needs for individuals and their caregivers, such as employment and access to services. In this cross-sectional study, the researchers surveyed 81 (N = 81) family caregivers to individuals with EOAD to identify service and support usage and need. Descriptive analyses revealed that families utilized a range of formal services (eg, adult day) and informal support from family and friends. In terms of challenges and needs, participants indicated that they struggled most with employment, benefits, and financial issues. Although most caregivers felt that they were coping well, they also indicated that their needs were not well understood by service providers and the public. These findings highlight the need to better understand and respond to the specific issues surrounding EOAD.
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Affiliation(s)
- Allison K Gibson
- Department of Social Work, Winthrop University, Rock Hill, SC, USA
| | | | - Sara Acocks
- Sunrise on the Scioto-Sunrise Senior Living, Columbus, OH, USA
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Mountain GA, Hind D, Gossage-Worrall R, Walters SJ, Duncan R, Newbould L, Rex S, Jones C, Bowling A, Cattan M, Cairns A, Cooper C, Edwards RT, Goyder EC. 'Putting Life in Years' (PLINY) telephone friendship groups research study: pilot randomised controlled trial. Trials 2014; 15:141. [PMID: 24758530 PMCID: PMC4022155 DOI: 10.1186/1745-6215-15-141] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 03/28/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Loneliness in older people is associated with poor health-related quality of life (HRQoL). We undertook a parallel-group randomised controlled trial to evaluate the effectiveness and cost-effectiveness of telephone befriending for the maintenance of HRQoL in older people. An internal pilot tested the feasibility of the trial and intervention. METHODS Participants aged >74 years, with good cognitive function, living independently in one UK city were recruited through general practices and other sources, then randomised to: (1) 6 weeks of short one-to-one telephone calls, followed by 12 weeks of group telephone calls with up to six participants, led by a trained volunteer facilitator; or (2) a control group. The main trial required the recruitment of 248 participants in a 1-year accrual window, of whom 124 were to receive telephone befriending. The pilot specified three success criteria which had to be met in order to progress the main trial to completion: recruitment of 68 participants in 95 days; retention of 80% participants at 6 months; successful delivery of telephone befriending by local franchise of national charity. The primary clinical outcome was the Short Form (36) Health Instrument (SF-36) Mental Health (MH) dimension score collected by telephone 6 months following randomisation. RESULTS We informed 9,579 older people about the study. Seventy consenting participants were randomised to the pilot in 95 days, with 56 (80%) providing valid primary outcome data (26 intervention, 30 control). Twenty-four participants randomly allocated to the research arm actually received telephone befriending due to poor recruitment and retention of volunteer facilitators. The trial was closed early as a result. The mean 6-month SF-36 MH scores were 78 (SD 18) and 71 (SD 21) for the intervention and control groups, respectively (mean difference, 7; 95% CI, -3 to 16). CONCLUSIONS Recruitment and retention of participants to a definitive trial with a recruitment window of 1 year is feasible. For the voluntary sector to recruit sufficient volunteers to match demand for telephone befriending created by trial recruitment would require the study to be run in more than one major population centre, and/or involve dedicated management of volunteers. TRIAL REGISTRATION ISRCTN28645428.
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Affiliation(s)
- Gail A Mountain
- ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Daniel Hind
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Rebecca Gossage-Worrall
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Stephen J Walters
- ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Rosie Duncan
- ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Louise Newbould
- ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Saleema Rex
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Carys Jones
- Institute of Medical and Social Care Research, Bangor University, Bangor, Gwynedd LL57 2DG, UK
| | - Ann Bowling
- School of Health Sciences, Highfield Campus, University Road, Southampton SO17 1BJ, UK
| | - Mima Cattan
- Faculty of Health and Life Sciences, University of Northumbria, Coach Lane Campus, Newcastle Upon Tyne NE7 7XA, UK
| | - Angela Cairns
- Community Network, First Floor, 12-20 Baron Street, London N1 9LL, UK
| | - Cindy Cooper
- Clinical Trials Research Unit, ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
| | - Rhiannon Tudor Edwards
- Institute of Medical and Social Care Research, Bangor University, Bangor, Gwynedd LL57 2DG, UK
| | - Elizabeth C Goyder
- ScHARR, University of Sheffield, Regent Court, 30 Regent Street, Sheffield S1 4DA, UK
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Greenwood N, Habibi R. Carer mentoring: A mixed methods investigation of a carer mentoring service. Int J Nurs Stud 2014; 51:359-69. [DOI: 10.1016/j.ijnurstu.2013.06.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 06/07/2013] [Accepted: 06/13/2013] [Indexed: 12/01/2022]
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Cameron JI, Naglie G, Gignac MAM, Bayley M, Warner G, Green T, Czerwonka A, Huijbregts M, Silver FL, Phillips SJ, Cheung AM. Randomized clinical trial of the Timing it Right Stroke Family Support Program: research protocol. BMC Health Serv Res 2014; 14:18. [PMID: 24433234 PMCID: PMC3898562 DOI: 10.1186/1472-6963-14-18] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2013] [Accepted: 01/06/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Family caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers' evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers' sense of being supported and emotional well-being. METHODS/DESIGN Our multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke, 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or 3) standard care receiving the educational resource "Let's Talk about Stroke" prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers' experiences with the education and support received and the impact on caregivers' perception of being supported and emotional well-being. DISCUSSION This research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions. TRIAL REGISTRATION ClinicalTrials.gov: NCT00958607.
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Affiliation(s)
- Jill I Cameron
- Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario M5G 1V7, Canada
- UHN Toronto Rehabilitation Institute, Toronto, Canada
| | - Gary Naglie
- Department of Medicine and Rotman Research Institute, Baycrest Health Sciences, 3560 Bathurst Street, Toronto, Ontario M6A 2E1, Canada
- Research Department, UHN Toronto Rehabilitation Institute, Toronto, Canada
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
| | - Monique A M Gignac
- UHN Toronto Western Research Institute, 399 Bathurst Street, Main Pavilion, 10-328, Toronto, ON ON M5T 2S8, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Mark Bayley
- UHN Toronto Rehabilitation Institute, University Centre, University of Toronto, 550 University Avenue, Toronto, Ontario M5G 2A2, Canada
- Department of Medicine, University of Toronto, Toronto Canada
| | - Grace Warner
- School of Occupational Therapy, Dalhousie University, 5689 University Ave, Halifax, Nova Scotia B3H 3J5, Canada
| | - Theresa Green
- Faculty of Nursing, University of Calgary, 2500 University Dr NW, Calgary AB T2N 1N4, Canada
| | - Anna Czerwonka
- Department of Occupational Science and Occupational Therapy, University of Toronto, 160-500 University Ave, Toronto, Ontario M5G 1V7, Canada
- UHN Toronto Rehabilitation Institute, Toronto, Canada
| | - Maria Huijbregts
- Family Service Toronto, 355 Church Street, Toronto, Ontario M5B 1Z8, Canada
- Department of Physical Therapy, University of Toronto, Baycrest Health Sciences, Toronto, Canada
| | - Frank L Silver
- UHN Toronto Western Hospital, 399 Bathurst Street, Toronto, ON M5T 2S8, Canada
| | - Steve J Phillips
- Department of Medicine, Division of Neurology, Dalhousie University/QEII Health Sciences Centre, 1796 Summer Street, Halifax, Nova Scotia B3H 3A7, Canada
| | - Angela M Cheung
- UHN Toronto General Hospital, 200 Elizabeth Street, 7 Eaton North - room 221, Toronto, Ontario M5G 2C4, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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Savundranayagam MY. Receiving while giving: the differential roles of receiving help and satisfaction with help on caregiver rewards among spouses and adult-children. Int J Geriatr Psychiatry 2014; 29:41-8. [PMID: 23606378 DOI: 10.1002/gps.3967] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Accepted: 03/06/2013] [Indexed: 11/09/2022]
Abstract
OBJECTIVE There is a growing body of literature on the rewards associated with caregiving and the utility of these rewards on buffering the negative consequences of caring for a family member with Alzheimer's disease. Many psychoeducational interventions aim to empower caregivers to seek and obtain help from their social support network, with the expectation that help will enable them to cope more effectively. METHODS This study investigated the impact of changes in help and changes in satisfaction with help on positive aspects of caregiving for both spouse (N = 254) and adult-child (N = 208) caregivers who attended a psychoeducational intervention. RESULTS Analyses using structural equation modeling revealed that increases in amount of help and satisfaction with help were significantly linked with increases in caregiver rewards for adult-children. However, only increases in satisfaction with help were significantly related to increases in caregiver rewards for spouses. CONCLUSIONS These group differences suggest that the quality of support is critical for spouses, whereas both quality and receiving extra help are useful for adult-child caregivers. These findings are discussed in terms of the importance of understanding the differential needs of spouse and adult-child caregivers in practice.
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Affiliation(s)
- Marie Y Savundranayagam
- School of Health Studies, Faculty of Health Sciences, Western University, London, ON, Canada
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50
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Greenwood N, Habibi R, Mackenzie A, Drennan V, Easton N. Peer support for carers: a qualitative investigation of the experiences of carers and peer volunteers. Am J Alzheimers Dis Other Demen 2013; 28:617-26. [PMID: 23813790 PMCID: PMC10852788 DOI: 10.1177/1533317513494449] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Being a carer of someone with dementia can be rewarding and also challenging. Volunteer peer support schemes for carers are being introduced, little is known about either their impact on carers and volunteers or about volunteers' and carers' experiences. This study investigated peer volunteer and carer recipient experiences of a peer support service. Thematic analysis of 13 in-depth interviews with 9 carers and 4 peer volunteers revealed that peer support helped both carers and peer volunteers through the realization that they were "not alone" in their experiences and emotions. Additional carer benefits included opportunities to talk freely about difficult experiences and learning how others cope. Volunteers found their role rewarding, describing satisfaction from putting their own experiences to good use. These findings highlight the isolation and exclusion experienced by current and former carers of people with dementia and draw attention to the benefits of peer support for both the groups.
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Affiliation(s)
- Nan Greenwood
- Faculty of Health, Social Care and Education, St George's University of London and Kingston University, London, United Kingdom.
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