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Starr LT, Bullock K, Washington K, Aryal S, Parker Oliver D, Demiris G. Anxiety, Depression, Quality of Life, Caregiver Burden, and Perceptions of Caregiver-Centered Communication among Black and White Hospice Family Caregivers. J Palliat Med 2022; 25:596-605. [PMID: 34793244 PMCID: PMC8982115 DOI: 10.1089/jpm.2021.0302] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Anxiety, depression, and reduced quality of life (QOL) are common problems for hospice family caregivers, but it is unknown if disparities in these experiences exist among Black and White caregivers. Objectives: To compare anxiety, depression, QOL, caregiver burden, and perceptions of caregiver-centered hospice team communication between Black and White hospice family caregivers. Design: Secondary analysis of baseline data from two randomized clinical trials. Setting/Subjects: Seven hundred twenty-two Black and White hospice family caregivers ages 18+ from Midwestern and Northeastern United States. Measurements: Measures included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire (PHQ-9), Caregiver Quality-of-Life Index-Revised (CQLI-R), Zarit Burden Interview (ZBI-7), and Caregiver-Centered Communication Questionnaire (CCCQ). Results: Black and White caregivers differed across demographic and socioeconomic variables. Nearly one-third of hospice family caregivers reported moderate-to-severe anxiety (32.1%) and moderate-to-severe depressive symptoms (32.0%). White caregivers reported lower QOL than Black caregivers (p = 0.04), specifically in emotional (p = 0.02) and social (p = 0.0005) domains. In multiple regression analyses controlling for caregiver and patient factors, we found no racial differences in depression, anxiety, QOL, caregiver burden, or perceptions of caregiver-centered hospice communication. Conclusions: Despite demographic and socioeconomic differences, Black and White hospice family caregivers experience similarly high levels of anxiety, depression, burden, and perceptions of hospice communication. Interventions to support hospice family caregivers across racial groups and research that identifies factors that mediate social determinants of health in this population are needed. The development and validation of culture-concordant mental health screening tools in racially diverse populations is recommended. Trial registration: ClinicalTrials.gov NCT02929108 and ClinicalTrials.gov NCT01444027.
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Affiliation(s)
- Lauren T. Starr
- Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Karen Bullock
- Department of Social Work, College of Humanities and Social Sciences, North Carolina State University, Raleigh, North Carolina, USA
| | - Karla Washington
- Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Subhash Aryal
- BECCA (Biostatistics * Evaluation * Collaboration * Consultation * Analysis) Lab, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Debra Parker Oliver
- Division of Palliative Medicine, School of Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
- Barnes Jewish College, Goldfarb School of Nursing, St. Louis, Missouri, USA
| | - George Demiris
- Department of Biobehavioral and Health Sciences, NewCourtland Center for Transitions and Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Hines-Martin V, Starks S, Hermann C, Smith M, Chatman JM. Understanding Culture in Context: An Important Next Step for Patient Emotional Well-Being and Nursing. Nurs Clin North Am 2019; 54:609-623. [PMID: 31703785 DOI: 10.1016/j.cnur.2019.08.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The impact of culture on health has gained considerable importance in care delivery. This review discusses the complex interaction of culture and social determinants, and the combined impact of these on emotional well-being. Examples of this interaction are presented and recommendations for change within nursing to improve care are discussed.
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Affiliation(s)
- Vicki Hines-Martin
- School of Nursing, University of Louisville, Room 4055 Building K, HSC, Louisville, KY 40202, USA.
| | - Shaquita Starks
- Department of Health Promotion and Disease Prevention, Advanced Practice & Doctoral Studies, College of Nursing, The University of Tennessee, The University of Tennessee Health Sciences Center, 920 Madison Avenue, #534, Memphis, TN 38163, USA
| | - Carla Hermann
- Indiana University Southeast, School of Nursing, 4201 Grant Line Road, New Albany, IN 47150, USA
| | - Montray Smith
- School of Nursing, University of Louisville, Room 3049, Building K, HSC, 555 South Floyd Street, Louisville, KY 40202, USA
| | - Jade Montanez Chatman
- School of Nursing, University of Louisville, Room 4053, Building K, HSC, 555 South Floyd Street, Louisville, KY 40202, USA
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Starks SA, Graff JC, Wicks MN. Factors Associated With Quality of Life of Family Caregivers of Dialysis Recipients. West J Nurs Res 2019; 42:177-186. [PMID: 31096890 DOI: 10.1177/0193945919849816] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Chronic kidney failure may contribute to the diminished quality of life of African American women who care for adults affected by the disorder. Few studies document the quality of life of these caregivers. For this descriptive correlational study, caregiver demographic, caregiver burden, depressive symptoms, family functioning, and quality-of-life self-report data from 75 African American women were extracted from an existing database. Ferrans' Conceptual Model of Quality of Life guided the selection of study variables. Several significant associations were found. Caregiver education, employment status, marital status, and caregiver burden explained 63% of the variance in the caregivers' quality of life. Findings support the need to explore further and design interventions to improve the quality of life of working African American women supporting individuals with chronic kidney failure.
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Affiliation(s)
| | - J Carolyn Graff
- The University of Tennessee Health Science Center, Memphis, USA
| | - Mona N Wicks
- The University of Tennessee Health Science Center, Memphis, USA
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Hu Z, Oh S, Ha TW, Hong JT, Oh KW. Sleep-Aids Derived from Natural Products. Biomol Ther (Seoul) 2018; 26:343-349. [PMID: 29929351 PMCID: PMC6029681 DOI: 10.4062/biomolther.2018.099] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 06/07/2018] [Accepted: 06/07/2018] [Indexed: 11/17/2022] Open
Abstract
Although drugs such as barbiturates and benzodiazepines are often used for the treatment of insomnia, they are associated with various side effects such as habituations, tolerance and addiction. Alternatively, natural products with minimal unwanted effects have been preferred for the treatment of acute and/or mild insomnia, with additional benefits of overall health-promotion. Basic and clinical researches on the mechanisms of action of natural products have been carried out so far in insomnia treatments. Recent studies have been focusing on diverse chemical components available in natural products, with an interest of developing drugs that can improve sleep duration and quality. In the last 15 years, our co-workers have been actively looking for candidate substances from natural products that can relieve insomnia. This review is, therefore, intended to bring pharmacological data regarding to the effects of natural products on sleep duration and quality, mainly through the activation of GABAA receptors. It is imperative that phytochemicals will provide useful information during electroencephalography (EEG) analysis and serve as an alternative medications for insomnia patients who are reluctant to use conventional drugs.
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Affiliation(s)
- Zhenzhen Hu
- Department of Pathophysiology, College of Basic Medicine, Nanchang University, Nanchang, Jiangxi 33006, China
| | - Seikwan Oh
- Department of Molecular Medicine and TIDRC, School of Medicine, Ewha Womans University, Seoul 07985, Republic of Korea
| | - Tae-Woo Ha
- Department of Pharmacy, College of Pharmacy, Chungbuk National University, Osong 28160, Republic of Korea
| | - Jin-Tae Hong
- Department of Pharmacy, College of Pharmacy, Chungbuk National University, Osong 28160, Republic of Korea
| | - Ki-Wan Oh
- Department of Pharmacy, College of Pharmacy, Chungbuk National University, Osong 28160, Republic of Korea
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