1
|
Fakolade A, Jackson A, Cardwell KL, Finlayson M, O'Sullivan TL, Tomasone JR, Pilutti LA. DigiTRAC: Qualitative insights from knowledge users to inform the development of a Digital Toolkit for enhancing resilience among multiple sclerosis caregivers. Mult Scler Relat Disord 2024; 88:105736. [PMID: 38954857 DOI: 10.1016/j.msard.2024.105736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 06/06/2024] [Accepted: 06/19/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND Resilience-promoting resources are critically needed to support positive caregiving experiences for multiple sclerosis (MS) caregivers. A digital toolkit offers a flexible way to access and use evidence-based resources that align with MS caregivers' interests and needs over time. OBJECTIVE We explored the perspectives of key knowledge users regarding content areas, features, and other considerations to inform an MS caregiver resilience digital toolkit. METHODS Twenty-two individuals completed a demographic survey as part of this study: 11 MS family caregivers, 7 representatives of organizations providing support services for people with MS and/or caregivers, and 4 clinicians. We conducted nine semi-structured individual interviews and two focus groups. Data were analyzed using content analysis. RESULTS Participants recommended that a digital toolkit should include content focused on promoting MS caregivers' understanding of the disease, its trajectory and available management options, and enhancing caregiving skills and caregivers' ability to initiate and maintain behaviours to promote their own well-being. Features that allow for tracking and documenting care recipients' and caregivers' experiences, customization of engagement, and connectivity with other sources of support were also recommended. Participants suggested a digital toolkit should be delivered through an app with web browser capabilities accessible on smartphones, tablets, or laptops. They also acknowledged the need to consider how users' previous technology experiences and issues related to accessibility, usability, privacy and security could influence toolkit usage. CONCLUSION These findings will guide future toolkit development and evaluation. More broadly, this study joins the chorus of voices calling for critical attention to the well-being of MS family caregivers.
Collapse
Affiliation(s)
- Afolasade Fakolade
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada; Providence Care Hospital, 752 King Street West, Kingston, ON, K7L 4 X 3, Canada.
| | - Alexandra Jackson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Katherine L Cardwell
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Louise D. Acton Building, 31 George Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Tracey L O'Sullivan
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; LIFE Research Institute, Thompson Hall, 25 University Private, room 227, University of Ottawa, Ottawa, ON, K1N 6N5, Canada
| | - Jennifer R Tomasone
- School of Kinesiology and Health Studies, 200 Division Street, Queen's University, Kingston, ON, K7L 3N6, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, 200 Lees Avenue, University of Ottawa, Ottawa, ON, K1N 6N5, Canada; Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Roger Guindon Hall, 451 Smyth Road Ottawa, ON, K1H 8M5, Canada
| |
Collapse
|
2
|
Yu P, Zhang W, Li S, Luo X, Chen H, Mi J. Psychological resilience in the relationship between family function and illness uncertainty among family members of trauma patients in the intensive care unit. BMC Psychiatry 2024; 24:486. [PMID: 38961366 PMCID: PMC11223282 DOI: 10.1186/s12888-024-05883-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 06/03/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Severe trauma accounts for a main factor inducing mortality for individuals aged < 45 years in China, which requires admission to intensive care unit (ICU) to receive comprehensive treatment. Family members of patients with unanticipated and life-threatening trauma during their ICU stays often experience psychosocial distress due to illness uncertainty. Previous research has shown that family function and psychological resilience are associated with illness uncertainty, respectively. However, little is known about the current situation and interacting mechanism between family function, psychological resilience, and illness uncertainty of family members for ICU trauma patients. Therefore, this study focused on exploring the current situation and relationships between these three factors in family members for ICU trauma patients. METHODS The convenience sampling approach was adopted in the present cross-sectional survey, which involved 230 family members for ICU trauma patients from 34 hospitals in Chongqing, China. Related data were extracted with self-reporting questionnaires, which included sociodemographic characteristic questionnaire, the Family Adaptability, Partnership, Growth, Affection and Resolve Scale (APGAR), the 10-item Connor-Davidson Resilience Scale (10-CD-RISC) and the Mishel's Illness Uncertainty Scale for Family Members (MUIS-FM). Pearson correlation analysis was conducted to examine the correlations between various variables. Additionally, a structural equation model was adopted to assess the mediating effect of psychological resilience on family function and illness uncertainty. RESULTS According to our results, family members for ICU trauma patients experienced high illness uncertainty with moderate family dysfunction and low psychological resilience. Family function directly affected illness uncertainty and indirectly affected illness uncertainty through psychological resilience in family members of ICU trauma patients. CONCLUSIONS Family function and psychological resilience are the protective factors for reducing illness uncertainty. Healthcare providers should take effective measures, including family-functioning improvement and resilience-focused interventions, for alleviating illness uncertainty in family members of ICU trauma patients.
Collapse
Affiliation(s)
- Peilin Yu
- The School of Nursing, Chongqing Medical University, Chongqing, China
| | - Wanzhu Zhang
- The School of Nursing, Chongqing Medical University, Chongqing, China
| | - Shijie Li
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuan Luo
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hao Chen
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Mi
- Department of Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
- The School of Nursing, Chongqing Medical University, Chongqing, China.
| |
Collapse
|
3
|
Chen B, Zhang J, Yu S, Yu NX. Trajectories and determinants of acute stress disorder during the COVID-19 centralized quarantine: A latent class growth analysis. Stress Health 2024; 40:e3351. [PMID: 38018760 DOI: 10.1002/smi.3351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/04/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
COVID-19 centralized quarantine may cause acute stress disorder (ASD). However, it is unknown how individuals present heterogeneous ASD trajectories during the COVID-19 centralized quarantine and what factors contribute to these patterns. This study aimed to identify the ASD trajectories and their determinants during the centralized quarantine period, and the mediating effects of resilience on these associations. A longitudinal survey with three waves was conducted in a randomly selected quarantine hotel in Shenzhen, China from October to November 2020. A total of 273 participants completed online measures assessing ASD symptoms, Eysenck's personality constructs of extraversion (E), neuroticism (N), psychoticism (P), and resilience on Day 1, and reported ASD symptoms on Days 7 and 14 during their 14-day centralized quarantine periods. Latent class growth analysis identified three trajectories: constantly high symptoms (CHS, 4.76%), decreasing symptoms (DS, 11.72%), and constantly low symptoms (CLS, 83.52%). The CHS and DS subgroups both reported lower E and higher N scores, but not P, compared with the CLS subgroup. Resilience mediated the effects of three personality constructs on ASD trajectories, except for the association between N and DS membership. Our study highlights the heterogeneity in stress responses to the COVID-19 centralized quarantine. The high-risk subgroup with persistent ASD symptoms was characterized by lower E and higher N. The resilience process accounted for the effects of personality in shaping distinct ASD trajectories. Our findings have implications to detect the populations vulnerable to ASD and provide insights for developing timely resilience enhancement intervention programs.
Collapse
Affiliation(s)
- Bowen Chen
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Jun Zhang
- School of Nursing, Wuhan University, Wuhan, China
| | - Shuxin Yu
- School of Nursing, Wuhan University, Wuhan, China
- The Second People's Hospital of Futian District, Shenzhen, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
4
|
Young D, Weaver J, Christie L, Genders M, Simpson GK. Building resilience among families supporting relatives with ABI in rural NSW: testing the feasibility of telephone delivery of Strength2Strength program. Brain Inj 2024; 38:84-98. [PMID: 38328973 DOI: 10.1080/02699052.2024.2304877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Strength2Strength (S2S) is a group psychoeducational program aiming to build resilience among families supporting relatives after traumatic injury. OBJECTIVE To test the feasibility, acceptability and outcomes of teleconference delivery of a 5 hour S2S program in rural New South Wales. METHODS A mixed methods design investigated the (i) convenience of telephone-based delivery; and (ii) acceptability of the program material (purpose-designed survey and the Narrative Evaluation of Intervention Interview). Program efficacy was measured with the Resilience Scale (RS) and Connor-Davidson Resilience Scale (CD-RISC); the Positive and Negative Affect Scale (PANAS); Depression, Anxiety and Stress Scale - 21 (DASS-21); Carer Assessment of Managing Index (CAMI); and Caregiver Burden Scale (CBS). Participant outcome data were collected at baseline, post program and 3 months follow-up. RESULTS 11 participants supporting adult relatives with severe brain injury completed the program. All participants and facilitators commented positively about the cost, ease of use and quality of the teleconference facility. Statistically significant gains were found between pre-program and follow-up scores on the RS, CD-RISC, PANAS-Positive, and CAMI, with statistically significant reductions found on the DASS-21 Depression Scale and CBS scores. CONCLUSION The study provides preliminary evidence for the efficacy of telephone-based delivery of S2S to family participants.
Collapse
Affiliation(s)
- Denise Young
- Mid Western Brain Injury Rehabilitation Program, Bathurst Health Service, Bathurst, Australia
| | - Jerre Weaver
- Inpatient Mental Health Unit, Bathurst Health Service, Bathurst, Australia
| | - Lauren Christie
- Allied Health Research Unit, St Vincent's Health Network, Sydney, Australia
- Nursing Research Institute, St Vincent's Health Network, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Michelle Genders
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, Australia
| |
Collapse
|
5
|
Muliira JK, Lazarus ER, Jacob D, Roslin H. The needs of families caring for patients with traumatic brain injury: a scoping review. Disabil Rehabil 2023:1-9. [PMID: 37933167 DOI: 10.1080/09638288.2023.2278178] [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: 05/21/2023] [Accepted: 10/28/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE This scoping review was conducted to synthesize existing literature into a map of the common needs of families caring for patients with traumatic brain injury (TBI) at home. MATERIALS AND METHODS A systematic search of studies published between January 2012 and December 2022 was conducted across databases. The selected studies reported the needs or unmet needs of patients with TBI and/or their family caregivers (FCs). RESULTS A total of 12 publications were identified. The results suggest that the common needs of families caring for patients with TBI at home include: information about TBI as a disease; information about the continuum of TBI healthcare services; information about adaptive technologies; education and skilling of FCs; psychological support and counseling; physical and occupational therapy services; follow-up care and transitional care management; respite care; peer support; financial assistance, advocacy, and legal services; emotional support from the family and community; and assistance with physical patient care and instrumental activities of daily living. CONCLUSION The mapped needs provide insight into supportive interventions required to enhance the health outcomes of patients with TBI and their families during and after rehabilitation. The needs also highlight directions for research and healthcare services for patients with TBI.
Collapse
Affiliation(s)
- Joshua K Muliira
- School of Nursing, College of Health, Ball State University, Muncie, IN, USA
| | - Eilean R Lazarus
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Devakirubai Jacob
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Hema Roslin
- Department of Adult Health and Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| |
Collapse
|
6
|
Roslin H, Muliira JK, Lazarus ER, Jacob D, Al-Habsi W, Al-Musallami F. Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury. Sultan Qaboos Univ Med J 2023; 23:493-501. [PMID: 38090237 PMCID: PMC10712375 DOI: 10.18295/squmj.6.2023.040] [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] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/19/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to explore the caregiving preparedness and caregiver burden among Omani family caregivers (FCs) of patients with acquired brain injury (ABI). Methods This prospective observational study was conducted at the neurology clinic at Khoula Hospital, Muscat, Oman, from April 2019 to December 2021. Data were collected from 119 FCs and their patients at the time of discharge from the hospital and 16 weeks post-discharge during follow-up care. The questionnaire comprised the Zarit Burden Index, the Preparedness for Caregiving Scale, the Short-Form-12 Health Survey, and a patient symptom scale. Results The FCs were predominantly female (53.8%), and the mean age was 38.27 ± 9.11 years. Most patients had moderate to severe ABI (95.8%) due to stroke (56.3%) and trauma (30.3%). The most common patient symptoms were loss of muscle strength, speech problems, mood problems, memory loss, and change in behaviour. Most FCs were found to have low caregiving preparedness (58%) at discharge, and 19.1% were found to have a high level of caregiver burden at 16 weeks post-discharge. The length of time post-injury (P <0.01), symptom severity (P <0.01) and the FCs' physical and mental health status (P <0.01 each) were found to be significant predictors of caregiving preparedness, whereas caregiver preparedness (P <0.01), symptom severity (P <0.01), and caregivers' mental health (P = 0.028) were seen as the predictors of caregiver burden. Conclusion Omani FCs of patients with ABI tend to commence the caregiver role with inadequate preparation, and shortly after, a significant number suffer high caregiver burden. Interventions focusing on the caregiver's health and training in symptom management may improve the outcomes of FCs and patients.
Collapse
Affiliation(s)
- Hema Roslin
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Eilean R. Lazarus
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Devakirubai Jacob
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Warda Al-Habsi
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
| | - Fatma Al-Musallami
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
| |
Collapse
|
7
|
Rasmussen MS, Howe EI, Andelic N, Soberg HL. Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach. NeuroRehabilitation 2023; 52:47-58. [PMID: 36617761 PMCID: PMC9912729 DOI: 10.3233/nre-220131] [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] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed. OBJECTIVE To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach. METHODS Secondary analysis of data collected at baseline in a randomized controlled trial. Structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV. RESULTS Hundred and twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data. CONCLUSION Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with family functioning. These resources should be further assessed in patients and their families, to identify factors that can be strengthened through TBI rehabilitation intervention.
Collapse
Affiliation(s)
- Mari S. Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I. Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
| |
Collapse
|
8
|
Matérne M, Simpson G, Jarl G, Appelros P, Arvidsson-Lindvall M. Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2119676. [PMID: 36062839 PMCID: PMC9467624 DOI: 10.1080/17482631.2022.2119676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. MATERIAL AND METHOD Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. RESULTS The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. CONCLUSION Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.
Collapse
Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Grahame Simpson
- John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| |
Collapse
|
9
|
Cardwell K, McKenna O, Steffener J, Pilutti L, Fakolade A. Profiles of resilience in multiple sclerosis family care-partners: A Canadian cross-sectional study. Mult Scler J Exp Transl Clin 2022; 8:20552173221138935. [PMID: 36452463 PMCID: PMC9703521 DOI: 10.1177/20552173221138935] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 10/28/2022] [Indexed: 11/17/2023] Open
Abstract
Background Psychological resilience may play an important role in protecting multiple sclerosis care-partners from the negative effects of their support role. However, predictors of resilience in this population have yet to be identified. Objectives To identify characteristics predictive of psychological resilience in multiple sclerosis care-partners as informed by the Ecological Model of Resilience. Methods Informal multiple sclerosis care-partners (n = 540) completed an online survey. Psychological resilience was measured using the 25-item Connor-Davidson Resilience Scale. Sociodemographic and care-context predictors of resilience were analyzed using hierarchical regression. Results The mean resilience score was 59.0 (SD = 7.6) out of a possible 100. Sociodemographic variables accounted for 31% of the variance in resilience scores in multiple sclerosis care-partners. When care-context variables were incorporated into the model, 55% of variance was explained (F[7,320] = 26.824, p < 0.001). Each group of variables remained significant in both low disability and high disability models. Social support was the only individual variable that remained significant across all models (p < 0.05). Conclusions Multiple sclerosis care-partners differ strikingly from other caregiving populations. Both sociodemographic and care-context variables were found to promote or hinder resilience in multiple sclerosis care-partners. Social support, in particular, may be an important target for promoting resilience in multiple sclerosis care-partners and could be leveraged in future initiatives.
Collapse
Affiliation(s)
- Katherine Cardwell
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Jason Steffener
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lara Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- University of Ottawa Brain and Mind Research Institute, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
| |
Collapse
|
10
|
Kuang Y, Wang M, Yu NX, Jia S, Guan T, Zhang X, Zhang Y, Lu J, Wang A. Family resilience of patients requiring long-term care: A meta-synthesis of qualitative studies. J Clin Nurs 2022. [PMID: 36030397 DOI: 10.1111/jocn.16500] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/05/2022] [Accepted: 08/09/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Long-term care of patients with chronic illnesses is an important global public health issue, compromising the well-being of family members and the family functioning. Previous studies have examined the interactive experiences and processes of various systems in the families coping with long-term care stress; however, these studies have not been systematically reviewed and integrated. AIMS This review aimed to synthesise the existing qualitative evidence on the experiences and processes of family resilience operate in families providing long-term care for patients with chronic illnesses and to provide suggestions for the development of interventions in future studies. MATERIALS & METHODS We searched databases including PubMed, CINAHL, EMBASE, Web of Science, ProQuest and CNKI from their inception to March 2022. We used the JBI Critical Appraisal Tool for qualitative studies to evaluate the quality of the included studies was evaluated according to. We followed The Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. The results were integrated using the thematic and content analysis method. RESULTS Fourteen studies from eight countries covering 11 diseases reported on the experiences and coping processes of long-term care families. Based on McCubbin's Resiliency Model of Family Stress, Adjustment and Adaptation (FAAR), five analytical themes were synthesised: stressors (risk factors), family belief system, internal family coping strategies, external support and resilient adaptation indicators; the relationships between themes and subthemes were illustrated. DISCUSSION This review synthesized qualitative evidence on the experiences and processes of family resilience operate in families providing long-term care. The results of this study found that the cognition and belief of family members regarding dilemmas have a two-way effect and act on the adaptation process of family members. In family adaptation, spirituality, hope, internal and external support are extremely important. In 14 studies, caregivers were from different countries with intercultural differences, but due to less reports on this content, it is difficult to compare the differences or impact that culture or ethnicity may have. CONCLUSIONS Family resilience plays an important role in coping with stressors associated with the long-term care of a loved one through family belief systems, internal support systems and external support systems. The development of family resilience-based interventions for long-term care families should consider the family as a whole and further construct a multidisciplinary, multilevel and multi-type social support network to enhance family resilience.
Collapse
Affiliation(s)
- Yi Kuang
- School of Nursing, Fudan University, Shanghai, China
| | - Meng Wang
- School of Nursing, Fudan University, Shanghai, China
| | - Nancy Xiaonan Yu
- Department of Social Science and Behavioral Sciences, City University of Hong Kong, Hong Kong, China
| | - Shoumei Jia
- School of Nursing, Fudan University, Shanghai, China
| | - Tingyu Guan
- School of Nursing, Fudan University, Shanghai, China
| | | | - Yuyi Zhang
- School of Nursing, Fudan University, Shanghai, China
| | - Jun Lu
- Department of Health Policy and Management, School of Public Health, Fudan University, Shanghai, China.,China Research Center on Disability Issues, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medcine, Huashan Hospital, Fudan University, Shanghai, China
| | - Anni Wang
- School of Nursing, Fudan University, Shanghai, China
| |
Collapse
|
11
|
Paasila JM, Smith E, Daher M, Simpson GK. Reasons for living, positive psychological constructs and their relationship with suicide ideation in people with moderate to severe traumatic brain injury: A cross-sectional study. Neuropsychol Rehabil 2022; 32:2125-2146. [PMID: 35862622 DOI: 10.1080/09602011.2022.2100795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Positive psychological constructs such as reasons for living, self-esteem and resilience have previously been shown to act as protective psychological barriers against negative psychological outcomes, including suicide ideation in both clinical populations and the general population. This study aims to explore the positive psychological constructs of reasons for living, self-esteem, resilience and their relationship with suicide ideation and predictors of suicide ideation (depression, hopelessness) for N = 50 people who have a severe TBI and are currently receiving community rehabilitation at Liverpool Brain Injury Rehabilitation Unit (LBIRU), NSW. Results indicated good reliability for the use of the RFLI with people who have TBI, with the most frequently endorsed subscale (range 0-5) being "survival and coping beliefs" (4.7 ± 1.0) and the least frequently being "fear of suicide" (2.2 ± 1.1). The shortened version of the RFLI (BRFLI) also displayed good reliability. Positive psychological constructs (reasons for living, resilience, self-esteem) were all significantly inversely associated with suicide and suicide predictors (depression, hopelessness). This study suggests that positive psychological constructs can act as a buffer against suicide ideation after moderate to severe TBI.
Collapse
Affiliation(s)
- Josephine M Paasila
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,School of Psychology, Western Sydney University, Sydney, Australia.,Australian Health Services Research Institute, University of Wollongong, Wollongong, Australia
| | - Evelyn Smith
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia.,John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney, Australia.,Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
12
|
McKenna O, Fakolade A, Cardwell K, Langlois N, Jiang K, Pilutti LA. Towards conceptual convergence: A systematic review of psychological resilience in family caregivers of persons living with chronic neurological conditions. Health Expect 2021; 25:4-37. [PMID: 34676951 PMCID: PMC8849377 DOI: 10.1111/hex.13374] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 01/28/2023] Open
Abstract
Background The demand for family caregiving in persons with chronic neurological conditions (CNCs) is increasing. Psychological resilience may empower and protect caregivers in their role. Thus, a synthesis of resilience evidence within this specific population is warranted. Aim In this systematic review we aimed to: (1) examine the origins and conceptualizations of resilience; (2) summarize current resilience measurement tools; and (3) synthesize correlates, predictors and outcomes of resilience in family caregivers of persons with CNCs. Design We sourced English articles published up to July 2020 across five databases using search terms involving CNCs, family caregivers and resilience. Results A total of 50 studies were retained. Nearly half (44%) of the studies used trait‐based resilience definitions, while about one third (36%) used process‐based definitions. Twelve different resilience scales were used, revealing mostly moderate to high‐resilience levels. Findings confirmed that resilience is related to multiple indicators of healthy functioning (e.g., quality of life, social support, positive coping), as it buffers against negative outcomes of burden and distress. Discordance relating to the interaction between resilience and demographic, sociocultural and environmental factors was apparent. Conclusions Incongruity remains with respect to how resilience is defined and assessed, despite consistent definitional concepts of healthy adaptation and equilibrium. The array of implications of resilience for well‐being confirms the potential for resilience to be leveraged within caregiver health promotion initiatives via policy and practice. Patient or Public Contribution The findings may inform future recommendations for researchers and practitioners to develop high‐quality resilience‐building interventions and programmes to better mobilize and support this vulnerable group.
Collapse
Affiliation(s)
- Odessa McKenna
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nigèle Langlois
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - Karen Jiang
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| |
Collapse
|
13
|
Simpson GK, Anderson MI, Daher M, Jones KF, Morey P. Testing a Model of Resilience in Family Members of Relatives with Traumatic Brain Injury vs Spinal Cord Injury: Multigroup Analysis. Arch Phys Med Rehabil 2021; 102:2325-2334. [PMID: 34358498 DOI: 10.1016/j.apmr.2021.06.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To test a model comprising explanatory (neurologic impairment, coping, personality) and mediating (resilience, self-efficacy, hope, social support) variables on psychological adjustment and burden among family caregivers of individuals with traumatic brain injury (TBI) vs spinal cord injury (SCI). DESIGN Structural equation modeling with multigroup analysis. SETTING Six rehabilitation centers across New South Wales and Queensland, Australia. PARTICIPANTS A total of 181 family members (N=181; 131 TBI, 50 SCI). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Connor-Davidson Resilience Scale, Eysenck Personality Questionnaire, Ways of Coping Questionnaire, General Self-Efficacy Scale, Herth Hope Scale, Medical Outcome Study Social Support Survey; and 4 measures of psychological adjustment including: Caregiver Burden Scale, Medical Outcomes Survey Short Form-36 (SF-36), General Health Questionnaire-28, and Positive and Negative Affect Scale. RESULTS The model for the aggregated sample demonstrated a very good model fit (χ2=47.42, df=39, ρ=0.167, normed fit index=.962, incremental fit index=.993, Tucker-Lewis index=.985, comparative fit index=.993, root-mean-squared error of approximation=.035). Multi-group analysis found significant commonalities in the pattern of relationships among variables across the 2 groups. In the only differences found, neuroticism was significantly more influential on burden in family members supporting individuals with TBI than family members of individuals with SCI. Furthermore, problem-focused coping was statistically more influential on positive affect in family members of individuals with TBI when compared with family members of individuals with SCI. CONCLUSIONS The study found significant similarities in the patterns of resilience and psychological adjustment among family caregivers of individuals with TBI and SCI.
Collapse
Affiliation(s)
- Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney; Liverpool Brain Injury Rehabilitation Unit, Liverpool Hospital, Sydney.
| | | | - Maysaa Daher
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Liverpool, Sydney; Brain Injury Rehabilitation Directorate, Agency for Clinical Innovation, NSW Health, Sydney
| | - Kate F Jones
- Institute for Ethics and Society, The University of Notre Dame, Sydney, Australia
| | - Peter Morey
- School of Nursing and Health, Avondale University, Sydney
| |
Collapse
|
14
|
Othman H, Ludin SM, Saidi S, Awang MS. The needs of traumatic brain injury survivors' caregivers and the implication required during the COVID-19 pandemic: Public health issues. J Public Health Res 2021; 10. [PMID: 33855403 PMCID: PMC8129743 DOI: 10.4081/jphr.2021.2205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 03/19/2021] [Indexed: 12/03/2022] Open
Abstract
Background: Traumatic brain injury (TBI) survivors require attention and dependence from their primary caregiver. This is because TBI is a defect that affects both the psychological and physical functions of the victim. Caregivers play an essential role in providing the adequate care victims need to adjust to the new problems they may experience due to their condition, as family members alone may not be able to provide for their needs. In particular, TBI caregivers may face specific challenges when assisting their patients in handling unexpected changes to their daily routines. Therefore, this quantitative study aims to explore the needs of caregivers, their coping mechanisms towards stressful and traumatic circumstances, and how they provide care to their loved ones during the COVID-19 pandemic. Design and Methods: It was conducted with ten caregivers of individuals suffering from traumatic brain injury, that were selected using a theoretical sampling method. Data were obtained using a semi-structured interview guide, which helped the caregivers provide their responses. Meanwhile, data analysis was performed using the NVIVO analysis software. Results: The results showed that there were, three significant themes namely, (a) Support needed, (b) the information need for care, and (c) developing self-resilience. The results also showed that caregivers really need support from the various parties, and the participants lack information on specific care techniques for the severe traumatic brain injury (TBI) survivors. Conclusions: In conclusion, caregivers require approval and seek more useful information to provide excellent care to their loved ones. Being aware of the caregiver’s needs would enable them to offer improved customized care. Significance for public health Caregiving is an issue affecting the quality of life for millions of individuals and demands attention from all communities. Though the funding and jurisdiction for public health initiatives comes from the federal and state government, local communities still deal with most of the burdens and practicalities of public health issues. Meanwhile, historically, scientists and practitioners alike rarely considered caregiving to be a public health issue.
Collapse
Affiliation(s)
- Hamidah Othman
- Critical Care Nursing Department, Kulliyyah of Nursing, International Islamic University Malaysia (IIUM), Kuantan, Pahang.
| | - Salizar Mohamed Ludin
- Critical Care Nursing Department, Kulliyyah of Nursing, International Islamic University Malaysia (IIUM), Kuantan, Pahang.
| | - Sanisah Saidi
- Medical-Surgical Nursing Department, Kulliyyah of Nursing, International Islamic University Malaysia (IIUM), Kuantan, Pahang.
| | - Mohamed Saufi Awang
- Kulliyyah of Medicine, International Islamic University Malaysia (IIUM), Kuantan, Pahang.
| |
Collapse
|
15
|
Mental Health and Family Functioning in Patients and Their Family Members after Traumatic Brain Injury: A Cross-Sectional Study. Brain Sci 2020; 10:brainsci10100670. [PMID: 32992808 PMCID: PMC7600942 DOI: 10.3390/brainsci10100670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 11/17/2022] Open
Abstract
Traumatic brain injury (TBI) affects the family as a whole. This study aimed to describe and compare mental health and family functioning in TBI patients and their family members, and to identify individual and family-related factors that were associated with mental health. It was conducted at an urban, specialized, TBI outpatient clinic and included 61 patients with mild to severe TBI and 63 family members. Baseline demographics and injury-related data were collected, and the participants answered standardized, self-reported questionnaires 6-18 months post-injury that assessed mental health; general health; family functioning, communication, and satisfaction; depression and anxiety; self-efficacy; resilience; and condition-specific quality of life. The patients reported significantly worse mental health, depression, resilience, self-efficacy, and general health compared with the family members. Patients and family members had similar perceptions, showing balanced family functioning, high family communication levels, and moderate family satisfaction. Factors significantly associated with mental health in patients and family members were depression, anxiety, and resilience, explaining 56% of the variance (p < 0.001). Family-related factors were not associated with mental health. The disease burden was mainly on the patients; however, the family members also reported emotional distress. Family-targeted interventions across the TBI continuum should be considered.
Collapse
|
16
|
Gibbs LAL, Anderson MI, Simpson GK, Jones KF. Spirituality and resilience among family caregivers of survivors of stroke: A scoping review. NeuroRehabilitation 2020; 46:41-52. [PMID: 32039873 DOI: 10.3233/nre-192946] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Stroke is the leading cause of disability in Australia and the third-leading cause of disability worldwide and a significant burden on caregivers. OBJECTIVE To map the extent, range and nature of the literature investigating spirituality and resilience among family caregivers of survivors of stroke. METHOD A scoping review. RESULTS Six studies were identified, conducted in the United States, United Kingdom, China and Turkey. These included two quantitative, one experimental and three qualitative designs. No studies linked spirituality to resilience. For the qualitative studies, spirituality was the primary focus of one, and the secondary focus of two others. Qualitative data reflected the lived experience of caregivers drawing upon spirituality to help cope with the burden of caregiving. For the two quantitative studies, spirituality was measured as a secondary focus and showed no significant links between spirituality or adjustment in caregivers. The one experimental study comprised a psycho-educational intervention focused on building resilience, finding a significant increase in social support not reflected in a matched control group. Clinical implications suggested the need for strength-based interventions, including spiritual needs and religious beliefs of the family caregiver. CONCLUSIONS Spirituality and resilience following stroke are essential factors in caregiver adjustment following stroke. Further research with a focus on causality and the link between spirituality, resilience and adjustment in this population is needed.
Collapse
Affiliation(s)
| | | | - Grahame Kenneth Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute of Applied Medical Research, Sydney, NSW, Australia.,School of Human Services and Social Work, Griffith University, Gold Coast, QLD, Australia
| | - Kate Fiona Jones
- School of Human Services and Social Work, Griffith University, Gold Coast, QLD, Australia.,Royal Rehab Centre, Ryde, NSW, Australia.,Menzies Health Institute, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|
17
|
Keniş-Coşkun Ö, Atabay CE, Şekeroğlu A, Akdeniz E, Kasil B, Bozkurt G, Karadağ-Saygı E. The Relationship Between Caregiver Burden and Resilience and Quality of Life in a Turkish Pediatric Rehabilitation Facility. J Pediatr Nurs 2020; 52:e108-e113. [PMID: 31676209 DOI: 10.1016/j.pedn.2019.10.014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2019] [Revised: 10/25/2019] [Accepted: 10/25/2019] [Indexed: 12/13/2022]
Abstract
PURPOSE To investigate the effect of caregiver burden, resilience, and quality of life of the parents of patients who are followed-up in a tertiary pediatric rehabilitation clinic. DESIGN AND METHODS This is a correlational cross-sectional study. Parents of patients who attend to utilize pediatric rehabilitation outpatient clinics of a tertiary center on a regular basis were invited to participate. All participants filled in the Zarit Caregiver Burden (ZCB) scale, Family Resilience scale (FRS) and Nottingham Health Profile (NHP). RESULTS A total of 107 patient and caregiver dyads were included. Fifty-five (51%) patients had cerebral palsy, 10 (9%) had spina bifida and 42 (39%) had other neurodevelopmental disorders. Eighty-one (75%) of the caregivers were mothers. There was a significant difference in the caregiver burden between ambulatory children (Mean ZCB score 30.11 ± 13.56) and non-ambulatory patients (Mean ZCB score 37.22 ± 13.91) (p = .01). There were moderate negative correlations between caregiver burden and FRS commitment to life and FRS self-sufficiency subscales. Caregiver burden significantly positively correlated with all NHP domains. CONCLUSIONS Caregiver burden is significantly higher in parents of non-ambulatory children when compared to ambulatory children in the pediatric rehabilitation setting. Caregiver burden and resilience correlated on moderate levels, but the factors influencing them are still unclear. PRACTICE IMPLICATIONS Healthcare and social support should be given to all caregivers in pediatric rehabilitation setting, but more so to the caregivers of non-ambulatory patients.
Collapse
Affiliation(s)
- Özge Keniş-Coşkun
- Marmara University Medical Faculty, Physical Medicine and Rehabilitation Department, Istanbul, Turkey.
| | | | | | | | | | | | - Evrim Karadağ-Saygı
- Marmara University Medical Faculty, Physical Medicine and Rehabilitation Department, Istanbul, Turkey
| |
Collapse
|
18
|
Simpson GK, Anderson MI, Jones KF, Genders M, Gopinath B. Do spirituality, resilience and hope mediate outcomes among family caregivers after traumatic brain injury or spinal cord injury? A structural equation modelling approach. NeuroRehabilitation 2020; 46:3-15. [DOI: 10.3233/nre-192945] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Grahame Kenneth Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney NSW, Australia
- John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney University, Sydney NSW, Australia
| | | | - Kate Fiona Jones
- Royal Rehab, Ryde NSW, Australia
- Menzies Health Institute, Griffith University, Gold Coast QLD, Australia
| | - Michelle Genders
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney NSW, Australia
- John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney University, Sydney NSW, Australia
| | - Bamini Gopinath
- John Walsh Centre of Rehabilitation Research, Kolling Institute, Sydney University, Sydney NSW, Australia
| |
Collapse
|