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Liao D, Pulido MD, Liu Y. Coping, surviving, or thriving: A scoping review examining social support for migrant care workers through four theoretical lenses. Soc Sci Med 2024; 360:117335. [PMID: 39303532 DOI: 10.1016/j.socscimed.2024.117335] [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: 04/07/2024] [Revised: 07/17/2024] [Accepted: 09/10/2024] [Indexed: 09/22/2024]
Abstract
RATIONALE Migrant care workers (MCWs) play a crucial role in addressing healthcare workforce shortages in many developed countries. Existing reviews document the significant challenges MCWs face-such as language barriers, interpersonal discrimination, and sexual harassment-and describe the social support that MCWs receive, but ambiguous application and heterogeneous measurement of theoretical constructs have thus far precluded researchers from deriving generalizable insights about how various types of social support positively and negatively impact MCWs' well-being. Therefore, we conducted a scoping review on this topic and organized the literature using four theoretical perspectives on social support. OBJECTIVE To synthesize interdisciplinary research on social support for MCWs and extend existing reviews, we conducted a scoping review of 56 empirical studies to understand how these studies conceptualize and operationalize social support for MCWs and the theoretical and methodological approaches they adopt. FINDINGS Our findings suggest that scholars have implicitly and explicitly adopted a wide array of theoretical perspectives (e.g., stress and coping, social constructivism), with few studies engaging theories in substantive ways. The reviewed studies have demonstrated both positive and negative implications of social support for MCWs' well-being. However, these studies heavily focus on the social support MCWs receive, whereas the negative impacts of MCWs' unmet support needs remain under-investigated. Although empirical studies use diverse methodologies to study this topic, most quantitative studies approach social support from a stress and coping perspective. We advocate for researchers conducting quantitative studies to adopt a critical consciousness and work toward statistically modeling how the intersectionality of MCWs' identities and the multi-level nature of MCWs' power positions within their social networks may impact whether MCWs successfully obtain the support they need to thrive.
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Affiliation(s)
- Danni Liao
- University of Kentucky, 263 Blazer Dining, Lexington, KY, 40506-0012, USA.
| | - Manuel D Pulido
- California State University Long Beach, 1250 Bellflower Boulevard, Long Beach, CA, 90840, USA.
| | - Yang Liu
- No. 2 North Road, The West 3rd Ring Road, Beijing Foreign Studies University, Beijing, 100089, China.
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2
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Grenz A, von Kutzleben M. Conceptualisations of good care and conflicts in live-in migrant care arrangements for people with dementia - perspectives of family caregivers in Germany. BMC Geriatr 2024; 24:702. [PMID: 39182025 PMCID: PMC11344310 DOI: 10.1186/s12877-024-05283-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 08/05/2024] [Indexed: 08/27/2024] Open
Abstract
BACKGROUND In Germany, live-in migrant carers provide essential social, emotional and physical support to a growing number of community-dwelling people with dementia. However, opaque legal regulations and employment models as well as a lack of formal supervision for families employing live-in migrant carers contribute to the vulnerability of these already strained arrangements. This study analyses the family caregivers' perspective, their conceptualisations of good dementia live-in migrant care and conflicts that arise in live-in care arrangements. METHODS The study adopted a qualitative-explorative approach. We conducted focus groups with family caregivers (n = 15) to learn about their perspectives on and experiences with live-in care as a model of home-based dementia care. Due to the restrictions of the COVID-19 pandemic, data collection took place online, which enabled us to include participants from all over Germany in our sample. Data were analysed with qualitative content analysis. RESULTS In this paper, two main categories, Indicators of good live-in migrant care for people with dementia and perceived conflicts, are presented. We identified indicators applied by family caregivers to assess the quality of care provided by migrant live-in carers and its outcomes for the person with dementia. These relate primarily to interpersonal and emotional aspects and a person-centred attitude towards the person with dementia. Conflicts arise when the needs and personalities within the triad do not match, due to intransparent and unreliable work of and communication with the placement agencies, or permanent crisis as a result of the German model with alternating live-in carers. CONCLUSION Our findings point to the complex dynamics and relationships within live-in care triads and support the theoretical assumption that taking into account the needs of all actors involved is essential for good and stable care arrangements. The conceptualisations of family caregivers of good dementia live-in migrant care offer starting points for a scientific as well as a social and health policy debate about the future regulation of this model of care.
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Affiliation(s)
- Adele Grenz
- Division of Prevention and Rehabilitation Research, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstrasse 140, D - 26111, Oldenburg, Oldenburg, Germany
| | - Milena von Kutzleben
- Division of Prevention and Rehabilitation Research, Carl von Ossietzky Universität Oldenburg, Ammerländer Heerstrasse 140, D - 26111, Oldenburg, Oldenburg, Germany.
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Su JJ, Abu-Odah H, Bayuo J, Lin RSY, Luo X, Molassiotis A. Experiences of Non-Family Paid Helpers Providing Palliative Care to Stroke Patients: The Toll of Professional Informal Caregiving in a Job Lacking Recognition. J Palliat Care 2023:8258597231210138. [PMID: 37904518 DOI: 10.1177/08258597231210138] [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: 11/01/2023]
Abstract
Background: Employing non-family paid helpers has become a prevalent practice across North America, Europe, and Asia, which families adopt to alleviate the stroke care burden, allowing family to take a break from their obligations and perform other social activities. However, paid helpers' experiences of providing palliative care to stroke patients are under-explored. This study aimed to explore the caregiving experiences of non-family paid helpers providing palliative care to stroke patients. Method: A qualitative descriptive study was undertaken using purposive sampling and semi-structured individual in-depth interviews. Thematic analysis was used for data analysis. Results: Seventeen participants (mean age: 51.23 years) were included, predominantly being female (88%), and their caregiving experiences with patients ranged from four to 26 years. Participants shared that monetary compensation offset the exhaustion, familial and health sacrifices of palliative caregiving. They emphasized emotional self-management through accepting and coping or avoiding and distancing, and appreciated rewarding appraisals from stroke patients and family members. They also expressed a lack of recognition from the public, being invisible to the healthcare system/professionals, and insecurity in employment rights. Conclusions: Findings support the need for governmental initiatives to subsidize families in employing helpers to provide palliative care. Helpers perceived monetary compensation and a reciprocal caregiving relationship as the primary motives for providing care. Public recognition of this role as a helper in caregiving, contractual employment rights, and being recognized by the healthcare system and healthcare professionals are considerations in promoting quality care and alleviating a health care burden. The findings may contribute to further understanding of the experiences of non-family paid helpers in a job lacking recognition when delivering palliative care in a hospital for stroke patients. Evidence-based interventions that enhance reciprocity and recognition should be considered as part of the global initiatives to support paid helpers in palliative care.
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Affiliation(s)
- Jing Jing Su
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Hammoda Abu-Odah
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Jonathan Bayuo
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Rose Sin Yi Lin
- School of Nursing, Elaine C. Hubbard Center for Nursing Research on Aging, University of Rochester, Rochester, New York, USA
| | - Xiaoling Luo
- Geriatrics Department, Guangzhou Medical University Second Hospital, Guangzhou, China
| | - Alex Molassiotis
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
- College of Arts, Humanities and Education, University of Derby, UK
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Ho KHM, Hung MSY, Zhang Y, Bai X, Cheung DSK, Chow MCM, Lee PH, Chien WT. The perceived relationship quality with migrant domestic workers is correlated with a lower level of loneliness among community-dwelling older adults: A cross-sectional study. Arch Gerontol Geriatr 2023; 109:104952. [PMID: 36753937 DOI: 10.1016/j.archger.2023.104952] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE To explore older adults' perceived relationship quality with migrant domestic workers (MDWs) and examine the correlation between older adult/MDW (O-M) relationship quality and loneliness of community-dwelling older adults. MATERIALS AND METHODS In this cross-sectional study, older adults living with MDWs were conveniently recruited from neighbourhood elderly centers in Hong Kong. Loneliness and O-M relationship quality were assessed by the 6-item De Jong Gierveld Loneliness Scale and the mutuality scale, respectively. Older adults' demographic and functional characteristics, and MDW's nationality, spoken language and years of service in the dyad were also collected. Hierarchical multiple regression analyses were conducted to examine the contributions of 1) demographic variables and functional status, 2) MDW characteristics, 3) perceived social network and 4) perceived O-M relationship quality on loneliness. RESULTS The 178 participants [mean age 83.44 (SD 7.05 years); 155 (87.1%) women and 23 men (22.9%)] were socially lonely (1.07 ± 1.15) and close to being lonely overall (1.90 ± 1.68), and emotionally (0.84 ± 0.97). The mean O-M relationship quality was poor (1.42 ± 0.79), which was significantly correlated with overall (β= -0.33, 95% CI: -0.65 to -0.01, P value = 0.045), and social (β= -0.24, 95% CI: -0.46 to -0.01, P value = 0.04) loneliness, but not significantly correlated to emotional loneliness. CONCLUSION Better perceived O-M relationship quality is correlated with a lower level of loneliness among older adults. Strategies to improve O-M relationship quality may alleviate loneliness among older adults.
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Affiliation(s)
- Ken H M Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
| | - Maria S Y Hung
- School of Health Sciences, Caritas Institute of Higher Education, Tseung Kwan O, New Territories, Hong Kong
| | - Youjuan Zhang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
| | - Xue Bai
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Daphne S K Cheung
- School of Nursing, Faculty of Health and Social Sciences, Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Meyrick C M Chow
- School of Health Sciences, Caritas Institute of Higher Education, Tseung Kwan O, New Territories, Hong Kong
| | - Paul H Lee
- Southampton Clinical Trials Unit, University of Southampton, United Kingdoms
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong
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5
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Septi Mauludina Y, Yeni Kustanti C, Fields BE, Chang FH. A Descriptive Qualitative Study of Foreign Caregivers of Older Adult Stroke Survivors. THE GERONTOLOGIST 2023; 63:82-95. [PMID: 35660857 DOI: 10.1093/geront/gnac077] [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: 11/05/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND OBJECTIVES With a growing aging stroke population and the changing structure of the society, the demand for foreign caregivers has rapidly increased in Taiwan and many other developed countries. However, little is known regarding the perception, values, and abilities of foreign caregivers and how those may influence their quality of care. This study aimed to explore and describe the experiences of Indonesian foreign caregivers, the largest migrant working population in Taiwan, who reside with and provide support to older adults with stroke and their families. RESEARCH DESIGN AND METHODS By adopting a descriptive qualitative approach, we conducted semistructured interviews with 22 Indonesian caregivers (mean age: 36 years) who were providing care to community-dwelling older stroke survivors (age ≥ 65 years) in Taiwan. Data were analyzed through thematic analysis. RESULTS Six themes were constructed from the interviews: (a) foreign caregiver's background, (b) foreign caregiver's perception of the health and functional status of stroke survivors, (c) foreign caregiver's values and preferences, (d) consequences of caring for stroke survivors, (e) skills/abilities/knowledge of foreign caregivers to provide stroke survivors with required care, and (f) potential resources that foreign caregivers can use. DISCUSSION AND IMPLICATIONS Foreign caregivers described the positive and negative aspects of caring for stroke survivors. Differences in language, religion, culture, values, and expectations between foreign caregivers and stroke survivors influence the caregiving experience. These findings can help Taiwan and other developed countries to better support foreign caregivers providing critical care to older adults with stroke and their families.
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Affiliation(s)
- Yosika Septi Mauludina
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.,Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Beth E Fields
- Occupational Therapy Program, Department of Kinesiology, University of Wisconsin-Madison, Madison, Michigan, USA
| | - Feng-Hang Chang
- Graduate Institute of Injury Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan.,Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
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Ness TM, Silan W. "We Tried to Take Care of Her, but it Got Too Exhausting": A Study of the Transition From Family Carer to Employer. Glob Qual Nurs Res 2023; 10:23333936231202876. [PMID: 37854877 PMCID: PMC10580710 DOI: 10.1177/23333936231202876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 08/20/2023] [Accepted: 09/01/2023] [Indexed: 10/20/2023] Open
Abstract
In Taiwan an increasing number of families are employing live-in carers from abroad to cope with care responsibilities, including the Indigenous Tayal. The aim of this research was to understand the transition from Indigenous family carer to employer with older family members who have extensive care needs. Six Indigenous employers were interviewed, and a narrative hermeneutic analysis was performed. The Tayal caregivers' cases revealed that their transition to employing live-in carers was complex and filled with ethical dilemmas due to their vulnerable positions. They tried to ensure person-centered care for their family members, but by doing this they risked reproducing vulnerability when transferring their own vulnerability to the live-in carer. The results indicate the interwoven nature of care dependency when it is defined by multiple vulnerabilities, Indigeneity and migration, and the multifaceted components of cultural safety.
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Ho KHM, Wilson IM, Wong JY, McKenna L, Reisenhofer S, Efendi F, Smith GD. Overlooked by nurses: A scoping review on health stressors, problems and coping of migrant domestic workers. Nurs Open 2022; 10:1166-1179. [PMID: 36181249 PMCID: PMC9912437 DOI: 10.1002/nop2.1391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 08/16/2022] [Accepted: 09/14/2022] [Indexed: 11/06/2022] Open
Abstract
AIM The first scoping review is to map and synthesize the stressors, problems and coping strategies surrounding the health issues of migrant domestic workers. DESIGN Scoping review using Arksey and O'Malley's five-stage framework. METHODS Ten electronic databases were systematically searched by keywords for literature published between January 1995 and December 2019. Data were extracted into tables and collated and summarized into themes for presentation. RESULTS Twenty-seven reports were included in the final review. Analysis revealed that stressors to health included abuse, poor health service accessibility, ongoing financial hardship despite demanding working conditions and social isolation. Physical and mental health problems were identified for which migrant domestic workers largely depended on social networks and religion to cope with stressors and health problems. Training para-professional peer leaders of migrant domestic workers by community nurses and including them in interprofessional teams is a possible way for nurses to promote their health and well-being.
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Affiliation(s)
- Ken Hok Man Ho
- Nethersole School of Nursing, Faculty of MedicineThe Chinese University of Hong KongHong KongHong Kong SAR
| | - Ingrid M. Wilson
- Health and Social Services ClusterSingapore Institute of TechnologySingaporeSingapore
| | - Janet Yuen‐Ha Wong
- School of Nursing & Health StudiesHong Kong Metropolitan UniversityHong KongHong Kong SAR
| | - Lisa McKenna
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVictoriaAustralia
| | - Sonia Reisenhofer
- Community Wellbeing & PartnershipsBairnsdale Regional Health ServiceBairnsdaleVictoriaAustralia
| | - Ferry Efendi
- Faculty of NursingUniversitas AirlanggaSurabayaIndonesia
| | - Graeme D. Smith
- School of Health SciencesCaritas Institute of Higher EducationHong KongHong Kong SAR
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Ho KHM, Cheung DSK, Lee PH, Lam SC, Kwan RYC. Co-living with migrant domestic workers is associated with a lower level of loneliness among community-dwelling older adults: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1123-e1133. [PMID: 34288198 DOI: 10.1111/hsc.13520] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Loneliness (inclusive social loneliness and emotional loneliness) of older adults is a prominent public health issue internationally. Factors consistently associated with loneliness are age, gender, education, living arrangements, social network, and functional status. Intergenerational co-living with spouse and adult children is important for the exchange of social, emotional, practical, and financial support provided to older adults. Co-living with migrant domestic workers (MDWs) to care for older adults became an emergent phenomenon internationally, particularly in Asian countries. According to the convoy model of social relations, the effect of co-living with MDWs on older adults' loneliness is unknown. This study examined (1) the prevalence of loneliness among community-dwelling older adults; and (2) the association between co-living with MDWs and older adult loneliness. Using the Chinese version of the 6-item De Jong Gierveld Loneliness Scale on loneliness, 380 older adults were interviewed at busy points in Hong Kong, including subway stations. 35.3% of older adults experienced moderate-to-severe loneliness. Linear regression was performed to examine the association between co-living with MDWs and loneliness. The results showed that co-living with MDWs was significantly associated with lower levels of overall loneliness (β = -0.636; p = .022) and emotional loneliness (β = -0.298, p = .039), but not for social loneliness (β = -0.337, p = .084). While MDWs could be an attachment figure for older adults, they might not be effective in promoting the social integration of older adults. There is a need to investigate the barriers of social integration faced by older adults co-living with MDWs.
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Affiliation(s)
- Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Paul Hong Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Rick Yiu Cho Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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Ho KHM, Yang C, Leung AKY, Bressington D, Chien WT, Cheng Q, Cheung DSK. Peer Support and Mental Health of Migrant Domestic Workers: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7617. [PMID: 35805278 PMCID: PMC9265321 DOI: 10.3390/ijerph19137617] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/20/2022] [Indexed: 11/29/2022]
Abstract
The effectiveness of peer support in improving mental health and well-being has been well documented for vulnerable populations. However, how peer support is delivered to migrant domestic workers (MDWs) to support their mental health is still unknown. This scoping review aimed to synthesize evidence on existing peer support services for improving mental health among MDWs. We systematically searched eight electronic databases, as well as grey literature. Two reviewers independently performed title/abstract and full-text screening, and data extraction. Twelve articles were finally included. Two types of peer support were identified from the included studies, i.e., mutual aid and para-professional trained peer support. MDWs mainly seek support from peers through mutual aid for emotional comfort. The study's findings suggest that the para-professional peer support training program was highly feasible and culturally appropriate for MDWs. However, several barriers were identified to affect the successful implementation of peer support, such as concerns about emotion contagion among peers, worries about disclosure of personal information, and lack of support from health professionals. Culture-specific peer support programs should be developed in the future to overcome these barriers to promote more effective mental health practices.
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Affiliation(s)
- Ken Hok Man Ho
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Alex Kwun Yat Leung
- Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China; (A.K.Y.L.); (Q.C.)
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin 0815, Australia;
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong SAR, Shatin, N.T., Hong Kong SAR, China; (C.Y.); (W.T.C.)
| | - Qijin Cheng
- Department of Social Work, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong SAR, China; (A.K.Y.L.); (Q.C.)
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, China;
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Tan SY, Poh L, Lim J. Governance of Assisted Living in Singapore: Lessons for Aging Countries. Front Public Health 2022; 10:868246. [PMID: 35774566 PMCID: PMC9237405 DOI: 10.3389/fpubh.2022.868246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
A global trend toward aging populations means that the challenge of providing adequate long-term care to older people looms large in many countries. In Singapore, a public discourse revolving around the expansion of assisted living to create age-friendly environments in long-term care has emerged. This study examines Singapore's experience in developing regulations for assisted living by documenting the different levels of regulation in place and by identifying the regulatory gaps remaining to govern assisted living. Anchoring in a conceptual framework on the governance of assisted living, different regulatory components of assisted living at the micro-, meso-, and macro-levels are analyzed. Using a case study method, primary and secondary data examining the experiences of governing and implementing assisted living in Singapore were collected. Analysis was conducted using a thematic analysis approach. Micro- and some macro-level regulations, which include admission assessment, staffing, and infrastructural requirements for assisted living, are maturing and evolving, while meso-level regulations, such as operational management, the monitoring framework, and stipulations for training requirements for staff, remain a work-in-progress in Singapore. The regulations for assisted living are currently primarily guided by soft laws, such as practice guidelines; the government has committed toward enacting permanent regulations for all long-term care facilities with the phased implementation of the Health Care Services Act from 2021 to 2023. We conclude that assisted living, despite the early stage of its development in Singapore, is a viable care model that should be expanded to meet the rising demand for care on the part of a majority of older people, who fall in the middle of the care continuum (that is, they can neither live independently nor need complete institutionalization). We also propose five policy recommendations for all aging countries to strengthen the governance of assisted living in long-term care. These include establishing (i) clear provisions on care quality assessment and the redress of grievance, (ii) minimum standards of care, (iii) differential regulations for assisted living, (iv) routine care assessment, and, (v) applying technology in assisted living facilities to address a shortage of care workers.
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Affiliation(s)
- Si Ying Tan
- Leadership Institute for Global Health Transformation, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- *Correspondence: Si Ying Tan
| | - Luting Poh
- Department of Pharmacology, Memory Aging and Cognition Centre, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jeremy Lim
- Leadership Institute for Global Health Transformation, Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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Yuan Q, Zhang Y, Samari E, Jeyagurunathan A, Tan GTH, Devi F, Wang P, Magadi H, Goveas R, Ng LL, Subramaniam M. The impact of having foreign domestic workers on informal caregivers of persons with dementia - findings from a multi-method research in Singapore. BMC Geriatr 2022; 22:305. [PMID: 35395748 PMCID: PMC8993210 DOI: 10.1186/s12877-022-03002-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/29/2022] [Indexed: 11/16/2022] Open
Abstract
Background Informal caregivers of persons with dementia (PWDs) sometimes engage foreign domestic workers (FDWs) to support their caregiving journey. However, there has not been much research to establish if this is really beneficial. The current study aims to investigate whether engaging FDWs specifically for caregiving of PWDs truly moderates caregiver stress and to explore caregivers’ experiences of engaging FDWs. Methods A multi-method study design with a quantitative and qualitative sub-study was adopted. For the quantitative sub-study, 282 informal caregivers of PWDs were recruited. Propensity score matching analysis was used. For the qualitative sub-study, 15 informal caregivers with FDWs were interviewed. Inductive thematic analysis was conducted. Results The quantitative sub-study confirmed that engaging FDWs did moderate the depressive symptoms of informal dementia caregivers (marginal effect = -3.35, p = 0.0497). However, such support did not affect their caregiving burden, self-efficacy, and perceived positive aspects of caregiving. The qualitative sub-study suggested that engaging FDWs is an ambivalent experience, which entails both support and challenges. Conclusions The current study confirmed previous research findings, that engaging FDWs moderated depressive symptoms among caregivers of PWDs, and it could be through their physical support such as in daily caregiving activities. Policy-makers may consider providing more subsidies to caregivers caring for PWDs with mobility issues to hire FDWs. They may also consider providing training to FDWs on dementia caregiving skills and improving the intake of such training as this might be helpful for both FDWs and caregivers during this journey.
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Affiliation(s)
- Qi Yuan
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Gregory Tee Hng Tan
- School of Social Sciences, Singapore Management University, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Buangkok Green, Medical Park, 10 Buangkok View, Singapore, 539747, Singapore
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12
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Ang KW, Koh YLE, Wang XF, Yusoff AM, Tan AM, Poh XYC, Zhang N, Tan NC. Pilot cross-sectional study of foreign domestic workers supporting the basic healthcare needs of older persons in the community. BMJ Open 2022; 12:e051877. [PMID: 35351699 PMCID: PMC8961118 DOI: 10.1136/bmjopen-2021-051877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE This pilot study aimed to determine the proportions, level of knowledge, anxiety and confidence of foreign domestic workers (FDWs) who were involved in supporting the healthcare needs of older persons with long-term non-communicable diseases. DESIGN The pilot study used a cross-sectional and descriptive design.FDWs who accompanied the older adults attending a primary healthcare setting in Singapore. 100 eligible FDWs' demographic data, knowledge and confidence level of caregiving in food preparation, medication supervision, exercise, blood pressure (BP), blood glucose (BG) monitoring and anxiety level assessed by the Generalised Anxiety Disorder-7 scale were recorded. Descriptive statistics were performed and presented. Items on confidence were regrouped into two groups of 'very' versus 'no/a little/moderate'. Knowledge scores and caregiving tasks were assessed with items on confidence using Mann-Whitney U test and χ2 test, respectively. RESULTS The FDWs were from Indonesia (60%), Philippines (23%) and Myanmar (14%). Their mean age was 33 years with an average of 5.8 years working experience; 62% self-reported previous caregiver training for elderly. The mean age of care-recipients was 81 years. Knowledge of FDWs on BP and BG monitoring was low (<50% answered correctly). Among the 55 FDWs who were required to perform BP monitoring, 45.5% lack confidence. Similarly, 40% of the 30 FDWs were not confident in performing BG monitoring. Those with very high confidence levels had higher knowledge on BP and BG monitoring. Of those who were involved in medication supervision (n=86), 36% lacked confidence. The majority of the FDWs (96%) were not affected by anxiety in managing these healthcare tasks for older persons. CONCLUSION More than half of the FDWs supported healthcare needs of older persons but they had inadequate knowledge and lacked confidence in performing the healthcare-related tasks.
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Affiliation(s)
- Kim Wai Ang
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
| | | | | | | | | | | | | | - Ngiap Chuan Tan
- SingHealth Polyclinics, Singapore
- SingHealth-Duke NUS Family Academic Clinical Programme, Singapore
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Pangaribuan SM, Lin YK, Lin MF, Chang HJ. Mediating Effects of Coping Strategies on the Relationship Between Mental Health and Quality of Life Among Indonesian Female Migrant Workers in Taiwan. J Transcult Nurs 2021; 33:178-189. [PMID: 34784809 DOI: 10.1177/10436596211057289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Mental health is a major concern among migrant workers worldwide. More than 200,846 female migrant workers in Taiwan are from Indonesia. The study's purpose was to investigate mediating effects of coping strategies on the relationship between mental health problems and the quality of life (QoL). METHOD This cross-sectional study was conducted in Taiwan. In total, 500 Indonesian female migrant workers completed four questionnaires. A mediation test was conducted to estimate direct and indirect effects. RESULTS Coping strategies, namely substance use, behavioral disengagement, denial, and religious dedication, partially mediated the relationship between mental health problems (depression, anxiety, and stress) and QoL among Indonesian female migrant workers in Taiwan. DISCUSSION Health promotion programs should be developed for Indonesian female migrant workers in Taiwan to help them detect and overcome their mental health problems. Interventions that facilitate effective coping strategies should be administered to improve their QoL.
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Affiliation(s)
| | - Yen-Kuang Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei
| | - Mei-Feng Lin
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
| | - Hsiu-Ju Chang
- College of Nursing, Department of Nursing, National Yang Ming Chiao Tung University, Taipei City, Taiwan
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Kist Bakof K, Morais Machado L, Rocha Iensen G, Iwersen Faria S, Silva Rodrigues I, Passaglia Schuch A, Jacques Schuch N, Boeck CR. Stress and its contribution to the development of depression symptoms are reduced in caregivers of elderly with higher educational level. Stress 2021; 24:676-685. [PMID: 33461390 DOI: 10.1080/10253890.2021.1876659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Caregivers of elderly people with neurodegenerative diseases are highly vulnerable to stressful situations and mood disorders due to their work conditions. Stress has been associated with an increased risk of developing depression, and studies have supported that caffeine consumption can act as an independent protective factor for disorder. This study investigated indexes of stress and depression symptoms in caregivers of the elderly with neurodegenerative diseases, their caffeine intake and the association between stress and depressive symptoms with the salivary biomarkers cortisol, nitric oxide and DNA damage. Participants (n = 81) were recruited from the community between July 2018 and April 2019. Stress was assessed using Lipp's Inventory of Stress Symptoms, and depressive symptoms were measured using the Hamilton Depressive Rating Scale. Participants provided a 72-hour recall of their diet to measure caffeine intake. Saliva samples were used to measure cortisol and nitric oxide. DNA damage was measured through micronuclei frequency after swabbing on the buccal mucosa. The majority of caregivers displayed stress and depressive symptoms. Stress was associated with educational level, tobacco use and total DNA damage. The indexes found in this population were not associated with caffeine intake or other salivary biomarkers, indicating that only some salivary molecules could be used as biomarkers for stress-related disorders. Caregivers of the elderly are exposed to stressful situations daily, however, we observed that educational level can reduce the psychological symptoms of stress and thus reduce the negative impact on quality of life.
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Affiliation(s)
- Karstyn Kist Bakof
- Programa de Pós-graduação em Nanociências, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
| | - Laura Morais Machado
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
- Curso de Psicologia, Universidade Luterana do Brasil - ULBRA, Cachoeira do Sul, RS, Brazil
| | - Gabriela Rocha Iensen
- Programa de Pós-graduação em Nanociências, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
| | - Sophia Iwersen Faria
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Ismália Silva Rodrigues
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - André Passaglia Schuch
- Departamento de Bioquímica e Biologia Molecular, Universidade Federal de Santa Maria - UFSM, Santa Maria, RS, Brazil
| | - Natielen Jacques Schuch
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
| | - Carina Rodrigues Boeck
- Programa de Pós-graduação em Nanociências, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
- Mestrado em Ciências da Saúde e da Vida, Universidade Franciscana - UFN, Santa Maria, RS, Brazil
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Wang Y, Tyagi S, Hoenig H, Lee KE, Venketasubramanian N, Menon E, De Silva DA, Yap P, Tan BY, Young SH, Ng YS, Tu TM, Ang YH, Kong KH, Singh R, Merchant RA, Chang HM, Ning C, Cheong A, Koh GCH. Burden of informal care in stroke survivors and its determinants: a prospective observational study in an Asian setting. BMC Public Health 2021; 21:1945. [PMID: 34702247 PMCID: PMC8547090 DOI: 10.1186/s12889-021-11991-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 10/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal caregiving is an integral part of post-stroke recovery with strenuous caregiving demands often resulting in caregiving burden, threatening sustainability of caregiving and potentially impacting stroke survivor's outcomes. Our study aimed to examine and quantify objective and subjective informal care burden after stroke; and to explore the factors associated with informal care burden in Singapore. METHODS Stroke patients and their informal caregivers were recruited from all five tertiary hospitals in Singapore from December 2010 to September 2013. Informal care comprised of assistance provided by informal caregivers with any of the activities of daily living. Informal care burden was measured by patients' likelihood of requiring informal care, hours of informal care required, and informal caregivers' Zarit's Burden Score. We examined informal care burden at 3-months and 12-months post-stroke. Generalized linear regressions were applied with control variables including patients' and informal caregivers' demographic characteristics, arrangement of informal care, and patients' health status including stroke severity (measured using National Institute of Health Stroke Scale), functional status (measured using Modified Rankin Scale), self-reported depression, and common comorbidities. RESULTS Three hundred and five patients and 263 patients were examined at 3-months and 12-months. Around 35% were female and 60% were Chinese. Sixty three percent and 49% of the patients required informal care at 3-months and 12-months point, respectively. Among those who required informal care, average hours required per week were 64.3 h at 3-months and 76.6 h at 12-months point. Patients with higher functional dependency were more likely to require informal care at both time points, and required more hours of informal care at 3-months point. Female informal caregivers and those caring for patients with higher functional dependency reported higher Zarit's Burden. While informal caregivers who worked full-time reported higher burden, those caring for married stroke patients reported lower burden at 3-months point. Informal caregivers who co-cared with foreign domestic workers, i.e.: stay-in migrant female waged domestic workers, reported lower burden. CONCLUSIONS Informal care burden remains high up to 12-months post-stroke. Factors such as functional dependency, stroke severity, informal caregiver gender and co-caring with foreign domestic workers were associated with informal care burden.
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Affiliation(s)
- Yi Wang
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Shilpa Tyagi
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Helen Hoenig
- Physical Medicine and Rehabilitation Service, Durham VA Medical Centre, 508 Fulton St, Durham, NC, 27705, USA
| | - Kim En Lee
- Lee Kim En Neurology Pte Ltd, Mount Elizabeth, #11-14/15, Mount Elizabeth Medical Centre, Singapore, 228510, Singapore
| | - Narayanaswamy Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, 585 North Bridge Rd, Level 9 Raffles Specialist Centre, Singapore, 188770, Singapore
| | - Edward Menon
- St. Andrew's Community Hospital, 8 Simei Street 3, Singapore, 529895, Singapore
| | - Deidre Anne De Silva
- National Neuroscience Institute, Singapore General Hospital campus, 11 Jln Tan Tock Seng, Level 1, Singapore, 308433, Singapore
| | - Philip Yap
- Dept of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Central Yishun, Singapore, 768828, Singapore
| | - Boon Yeow Tan
- St. Luke's Hospital, 2 Street 11 Bukit Batok, Singapore, 659674, Singapore
| | - Sherry H Young
- Department of Rehabilitation Medicine, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Yee Sien Ng
- Department of Rehabilitation Medicine, Singapore General Hospital, Outram Rd, Singapore, 169608, Singapore
| | - Tian Ming Tu
- Department of Neurology, National Neuroscience Institute, Neurology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Level 1, Singapore, 308433, Singapore
| | - Yan Hoon Ang
- Dept of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Central Yishun, Singapore, 768828, Singapore
| | - Keng He Kong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore, 308433, Singapore
| | - Rajinder Singh
- Department of Neurology, National Neuroscience Institute, Neurology, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Level 1, Singapore, 308433, Singapore
| | - Reshma A Merchant
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, 117597, Singapore
| | - Hui Meng Chang
- National Neuroscience Institute, Singapore General Hospital campus, 11 Jln Tan Tock Seng, Level 1, Singapore, 308433, Singapore
| | - Chou Ning
- Department of Neurosurgery, National University Hospital, 5 Lower Kent Ridge Rd, Singapore, 119074, Singapore
| | - Angela Cheong
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, Singapore, 117549, Singapore.
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The global care network and its impact on sending and receiving countries: current knowledge and future directions. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21000027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Research concerning the effects of migrants on elder care in affluent receiving countries has been substantial, but we know little about the effects of migrant care on elder care in sending countries. There also is limited research on elder care in the context of the return migration of migrant care workers. This theoretical article explores the potential relevance of a social network perspective, which views individuals and countries as being interconnected even when they are miles apart. A multi-level framework that considers macro-, meso- and micro-level perspectives is introduced to better account for current migrant care arrangements. The macro-level perspective takes into account country-level characteristics including policies, geography and cultural preferences; the meso-level perspective takes into account the characteristics of the entire network, which may spread over different countries; and the micro-level perspective concerns the unique characteristics of the individuals who make up the network. This approach proposes that the effects of migrant home care go way beyond the care recipient–care-giver dyads or triads to incorporate many individuals and countries that are transnationally interconnected via the work of care. This article also aims to increase public and scientific awareness to the potential impact of migrant care and return migration on elder care in the sending countries by stressing a transnational social network perspective.
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Troy C, Anna T, Perez C JJ, Liu J. Personal Determinants of Burden Among Indonesian Female Caregivers of Older Adults in Taiwan. J Appl Gerontol 2020; 41:217-226. [PMID: 33238777 DOI: 10.1177/0733464820972888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Families increasingly employ foreign domestic workers (FDWs) to care for older loved ones. Caregiver burden reflects FDWs' difficulty adapting to work demands. We test hypothesized associations between burden and six personal characteristics: children, marriage, education, Chinese proficiency, eldercare experience, and non-eldercare experience. METHOD In total, 299 Indonesian FDWs in Taiwan completed the Zarit Burden Interview. Exploratory factor analysis identified the dimensions of burden. Multiple and multinomial regressions related the variables to overall burden, burden dimensions, and burden severity. RESULTS Four dimensions were found: personal strain, role strain, dependency, and guilt. Children were negatively associated with burden, role strain, dependency, and guilt. Chinese proficiency was negatively associated with severity and guilt. Eldercare experience was positively associated with severity and personal strain. Marriage was non-monotonically related to severity. CONCLUSION Caregivers whose earnings benefit their children may be more likely to thrive in Taiwan. Language training may boost caregiver performance and host family satisfaction.
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Ho KHM, Smith GD. A discursive paper on the importance of health literacy among foreign domestic workers during outbreaks of communicable diseases. J Clin Nurs 2020; 29:4827-4833. [PMID: 32956550 DOI: 10.1111/jocn.15495] [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] [Received: 06/19/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 01/25/2023]
Abstract
AIM Using an integrated model of health literacy, we discuss the importance of health literacy among foreign domestic workers in the provision of informal caregiving during outbreaks of communicable diseases. COVID-19 pandemic is used as an example. BACKGROUND Adequate health literacy in the population is known to be important for the prevention of communicable diseases. Foreign domestic workers, a group of marginalised caregivers in private households, are generally presumed to have limited health literacy because of numerous socio-cultural disadvantages. To date, there is limited evidence that these informal healthcare providers receive support from community-based nurses. DESIGN A discursive paper. CONCLUSION Foreign domestic workers, with varying levels of health literacy, may be viewed either as a resource to break the chain of infection or as a potential reservoir of communicable diseases in the community. Meanwhile, restrictions imposed in response to diseases transmissions (e.g. stay-at-home measures for COVID-19) may directly exacerbate the social support received by these foreign domestic works and their ability to access health-related information. There are also concerns about their ability to appraise and evaluate information related to communicable diseases at a time when fake news and misinformation are being disseminated through social media. Language and cultural barriers are important issues that need to be addressed to ensure that foreign domestic workers are in a position to follow public health recommendations. RELEVANCE TO CLINICAL PRACTICE Nurses hold an important position in empowering foreign domestic workers with adequate health literacy, by engaging groups of foreign domestic workers in the community and their consulates in planning educational programmes and effectively disseminating information. At a time of global pandemic, an assessment of the health literacy levels of foreign domestic workers in places like Hong Kong is urgently required.
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Affiliation(s)
- Ken Hok Man Ho
- School of Nursing, Tung Wah College, Hong Kong, Hong Kong SAR, China
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19
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Tay M, Kong KH. Caregiver burden in familial caregivers and foreign domestic workers of patients with traumatic brain injury in a multi-ethnic Asian population. Brain Inj 2020; 34:1513-1517. [PMID: 32835512 DOI: 10.1080/02699052.2020.1809709] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the prevalence and risk factors associated with caregiver burden in familial caregivers and foreign domestic workers of patients with severe traumatic brain injury. METHODS A total of 77 caregivers were consecutively recruited, who were either familial caregivers or foreign domestic workers. All caregivers were evaluated with the Zarit Burden Index (ZBI), Patient Health Questionnaire-9 (PHQ-9), and General Anxiety Disorder 7-item (GAD-7) scale. Logistic regression analysis was conducted to determine factors associated with caregiver burden. RESULTS The majority of participants were familial caregivers (N = 60), of which 70% experienced significant caregiver burden. In this group, 10.0% caregivers had clinically significant depression and 16.7% caregivers who had clinically significant anxiety. On multivariate analysis, factors found to be associated with caregiver burden were Glasgow Outcome Scale Extended (GOSE) of <7, presence of neuropsychiatric complications, and presence of anxiety. There was also a high prevalence of caregiver burden in foreign domestic workers (29.4%). CONCLUSION There is a high rate of caregiver burden in both familial caregivers and foreign domestic workers who care for patients with severe traumatic brain injury. Caregivers experiencing stress should also be monitored for the presence of anxiety or depression.
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Affiliation(s)
- Matthew Tay
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Center , Singapore
| | - Keng He Kong
- Department of Rehabilitation Medicine, Tan Tock Seng Hospital Rehabilitation Center , Singapore
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20
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Chu SY, Tan CL. Perception on the Quality of Life, Communication and Life Satisfaction among Individuals with Parkison's and Their Caregivers. Ethiop J Health Sci 2019; 29:551-558. [PMID: 31666775 PMCID: PMC6813271 DOI: 10.4314/ejhs.v29i5.4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Accepted: 09/07/2019] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Speech impairment, which reduces Quality of Life (QOL), frequently occurs in individuals with Parkinson's disease (PD). As speaking is required for social interaction, speech impairment can reduce one's life satisfaction. Although QOL has been well-studied in individuals with PD, the QOL of their caregivers has seldom been investigated. This study compared the QOL of individuals with PD and their caregivers. The relationships between QOL, self-rated speech scale, and life satisfaction level were examined. METHOD A total of 20 individuals with PD and their caregivers completed the Parkinson's disease Questionnaire-39 (PDQ-39) scale and the Life Satisfaction Scale (LSS). In addition, PD participants were asked to complete the Self-Rated Speech Scale (SRSS) to rate their speech intelligibility. RESULT PD participants reported significantly lower QOL scores than their caregivers. However, there was no difference between the two groups on the social support and stigma dimensions, indicating that both groups reported similar levels of social support and stigma in their daily lives. A moderate significant correlation was observed between the LSS and PDQ-39 scores in the PD group, suggesting that life satisfaction could affect their QOL. Moreover, moderate correlation was found between the LSS and SRSS, showing that participants self-reported speech intelligibility has an impact on their life satisfaction. CONCLUSION In general, individuals with PD showed lower QOL than their caregivers. Given that the SRSS, LSS and QOL are moderately correlated, identifying patients' perception on their speech intelligibility and life satisfaction could help clinicians to better understand their patients' needs when delivering speech therapy services.
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Affiliation(s)
- Shin Ying Chu
- Faculty of Health Sciences, Centre for Healthy Ageing and Wellness (H-CARE), Speech Sciences Programme, KUALA LUMPUR, Malaysia
| | - Chai Li Tan
- Faculty of Health Sciences, Speech Sciences Programme, KUALA LUMPUR, Malaysia
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