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Tabatabaee M, Yousefi Nooraie R, Mohammad Aghaei A, Rostam-Abadi Y, Ansari M, Sharifi S, Sharifi V. Loneliness in the presence of others: A mixed-method study of social networks of caregivers of patients with severe mental disorders. Int J Soc Psychiatry 2023; 69:190-199. [PMID: 35148620 DOI: 10.1177/00207640221077580] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND One in four families has at least one member with a mental disorder and families are the main caregivers in most patients in low and middle-income countries. Caregivers experience disruption in their routine lives, increased responsibilities, increased need for support, and changes in their network. The role of personal support networks in the health and burden of the caregivers is complex and depends on the context, cultural and socioeconomical variables. In this study, we aimed to investigate the personal support network of caregivers of patients with severe mental illness in Iran. METHODS By using a mixed-methods design, we focused on the structure and composition of caregiver networks, as well as self-perceived caregiver support. RESULTS We found that the support network of caregivers was mostly composed of immediate family members whom themselves were selectively chosen as a result of the multidimensional process of interaction between stigma, availability, and the perceived needs of caregivers. The participants mentioned economic and instrumental supports more frequently than emotional support, probably reflecting their unmet basic needs. Advocacy for providing formal systemic supports to caregivers, as well as interventions that expand caregivers personal support network is recommended. CONCLUSIONS Most participants of the study were relatively isolated and had a small network of support, mostly composed of immediate family members. Stigma was a serious source of family distress for caregivers and a limiting factor in social relationships.
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Affiliation(s)
- Maryam Tabatabaee
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Yousefi Nooraie
- Department of Public Health Sciences, School of Medicine & Dentistry, University of Rochester, Rochester, NY, USA
| | | | - Yasna Rostam-Abadi
- Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mina Ansari
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Shamim Sharifi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | - Vandad Sharifi
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
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Gregg JE, Simpson J, Nilforooshan R, Perez-Algorta G. What is the relationship between people with dementia and their caregiver's illness perceptions post-diagnosis and the impact on help-seeking behaviour? A systematic review. DEMENTIA 2021; 20:2597-2617. [PMID: 33787368 PMCID: PMC8704219 DOI: 10.1177/1471301221997291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: As the number of people with dementia increases, more families will be affected by the daily challenges of providing effective support, given its current incurable status. Once individuals are diagnosed with dementia, the earlier they access support, the more effective the outcome. However, once people receive a diagnosis, how they make sense of their dementia can impact on their help-seeking intentions. Exploring the illness beliefs of people with dementia and their caregivers and this relationship to help seeking may identify how best to facilitate early support.Aims: To systematically obtain and critically review relevant studies on the relationship between illness perceptions and help seeking of people with dementia and their caregivers.Method: A systematic search was conducted and included both quantitative and qualitative studies. The initial search was conducted in October 2018, with an adjacent search conducted in April 2020.Findings: A total of 14 articles met the inclusion criteria. Conceptually, the studies examined the association of illness perceptions and help-seeking post-diagnosis and revealed that people living with dementia and their caregivers sought help when symptoms became severe. Components of illness perceptions revealed that lack of knowledge, cultural beliefs, complexity of the healthcare system, threat to independence and acceptance were identified as major factors for delaying help seeking.Conclusion: Although research interest in the area of illness perceptions and their impact on help seeking for dementia is increasing, further work is needed to understand this area, particularly regarding the influence of the relationship between the person with dementia and their caregiver.
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Affiliation(s)
- Jane E Gregg
- Department of Health Research, 4396Lancaster University, Lanchester, UK
| | - Jane Simpson
- Department of Health Research, 4396Lancaster University, Lancaster, UK
| | - Ramin Nilforooshan
- Research & Development Department, 9490Surrey and Borders Partnership NHS Foundation Trust, Chertsey, UK
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Cadet T, Burke SL, Nedjat-Haiem F, Bakk L, Naseh M, Grudzien A, O’Driscoll J, Alcide A. Timing of Immigration Effects Asset Change Among Hispanic Caregivers of Older Family Members. JOURNAL OF FAMILY AND ECONOMIC ISSUES 2020; 42:561-572. [PMID: 33041610 PMCID: PMC7537373 DOI: 10.1007/s10834-020-09719-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 06/11/2023]
Abstract
Given the cultural value of family in Hispanic culture, older Hispanic immigrants are likely to have family caregivers. This study examined the economic implications of caring for older Hispanic adults regarding non-housing financial wealth over time. Using the 2008, 2010, and 2012 waves of the Health and Retirement Study (HRS) and RAND HRS data files, this study compares changes in the non-housing financial wealth between 2008 and 2012 by caregiving and immigration status among Hispanics. This study examined differences in assets between Hispanic caregivers and non-caregivers and more specifically examined the subpopulation of Hispanic caregivers who immigrated prior to and after 1968 as compared to U.S.-born caregivers to better understand the effect of the Immigration and Nationality Amendment Act of 1965 on asset change. Results indicate that caregiving itself did not have a statistically significant association with wealth, but the timing of immigration to the US had a statistically significant correlation (p < .05) with changes in the financial wealth. The findings of this study have implications for policy and program development targeting older adults and caregiving for this population.
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Affiliation(s)
- Tamara Cadet
- School of Social Work, Simmons University, 300 The Fenway, Boston, MA 02115 USA
- Harvard School of Dental Medicine, Oral Health Policy and Epidemiology, Boston, MA USA
| | - Shanna L. Burke
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL USA
| | | | | | - Mitra Naseh
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL USA
| | - Adrienne Grudzien
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL USA
| | - Janice O’Driscoll
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL USA
| | - Amary Alcide
- Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL USA
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Apesoa-Varano EC. "I know best:" women caring for kin with dementia. Soc Sci Med 2020; 256:113026. [PMID: 32474392 DOI: 10.1016/j.socscimed.2020.113026] [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] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 10/24/2022]
Abstract
The dementia care literature in the home is vast, particularly in the health sciences where the focus remains on intervention to address carer emotional distress and burden. The sociological literature on dementia care has primarily utilized the illness disruption and (bio)medicalization models to show how meaning and practices are negotiated in the non-expert setting. Instead, I apply a feminist labor process perspective to examine the question of why women dementia kin carers resist relinquishing care responsibilities to others. This qualitative grounded theory study is based on seven waves of interviews (total = 98) conducted over approximately five years with 15 Latina dementia kin carers recruited through clinic and community sites in Northern California. Findings show how Latina kin carers exercise a degree of control and autonomy over the care process because they have developed tacit knowledge and skills to craft quality care of kin. In facing the dilemma of ceding care to others they perceive as unprepared, they reject available help. This study reveals how carers maintain quality care with dignity and comfort for the care recipient and themselves.
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Affiliation(s)
- Ester Carolina Apesoa-Varano
- Betty Irene Moore School of Nursing, University of California, Davis, 2450 48th Street, Suite 2600, Sacramento, CA 95817, USA.
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5
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Balbim GM, Marques IG, Cortez C, Magallanes M, Rocha J, Marquez DX. Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer’s Disease and Related Dementia. J Cross Cult Gerontol 2019; 34:355-371. [DOI: 10.1007/s10823-019-09390-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Huang J, Pacheco Barzallo D, Rubinelli S, Münzel N, Brach M, Gemperli A. What influences the use of professional home care for individuals with spinal cord injury? A cross-sectional study on family caregivers. Spinal Cord 2019; 57:924-932. [PMID: 31127196 PMCID: PMC6892416 DOI: 10.1038/s41393-019-0296-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
STUDY DESIGN Cross-sectional survey. OBJECTIVE The objective of this study is to identify what characteristics of the family caregivers influenced the use of professional home care for persons with SCI in Switzerland. SETTING Community setting, nationwide in Switzerland. METHODS Questionnaires were filled out by the adult family caregivers of persons with SCI. Influence of characteristics of the caregivers was analyzed with regression models, adjusting for the characteristics of the person with SCI. Logistic regression was used for whether professional home care was used. Poisson regression was applied for the absolute and relative amount of professional home care. RESULTS In total, 717 family caregivers participated in the study (31% response rate). Among the participants, 33% hired professional home care for 10 h per week on average. The level of dependency of the persons with SCI had a significant influence on the utilization of care. The availability and proximity of the primary family caregiver, namely being spouse and cohabiting, reduced the amount of services used, whereas caregivers who worked full time employed more services. Higher levels of education and income increased the use of professional home care. Compared with their reference groups, caregivers with older age and those with a migratory background used comparable or larger absolute amount of professional services, which, however, represented a smaller proportion of total hours of care. CONCLUSIONS Adequate support requires consideration of the characteristics of both the caregiver and of the person with SCI. The needs of family caregivers should also be assessed systematically in the needs assessment.
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Affiliation(s)
- Jianan Huang
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Diana Pacheco Barzallo
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Sara Rubinelli
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | | | - Mirjam Brach
- Swiss Paraplegic Research, Nottwil, Switzerland
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland.
- Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
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A mismatch between supply and demand of social support in dementia care: a qualitative study on the perspectives of spousal caregivers and their social network members. Int Psychogeriatr 2018; 30:881-892. [PMID: 28606195 DOI: 10.1017/s1041610217000898] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:Access to social support contributes to feelings of independence and better social health. This qualitative study aims to investigate multi-informant perspectives on informal social support in dementia care networks. METHODS Ten spousal caregivers of people with dementia (PwD) completed an ecogram, a social network card and a semi-structured interview. The ecogram aimed to trigger subjective experiences regarding social support. Subsequently, 17 network members were interviewed. The qualitative analyses identified codes, categories, and themes. RESULTS Sixth themes emerged: (1) barriers to ask for support; (2) facilitators to ask for support; (3) barriers to offer support; (4) facilitators to offer support; (5) a mismatch between supply and demand of social support; and (6) openness in communication to repair the imbalance. DISCUSSION Integrating social network perspectives resulted in a novel model identifying a mismatch between the supply and demand of social support, strengthened by a cognitive bias: caregivers reported to think for other social network members and vice versa. Openness in communication in formal and informal care systems might repair this mismatch.
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Iribarren S, Stonbraker S, Suero-Tejeda N, Granja M, Luchsinger JA, Mittelman M, Bakken S, Lucero R. Information, communication, and online tool needs of Hispanic family caregivers of individuals with Alzheimer's disease and related dementias. Inform Health Soc Care 2018; 44:115-134. [PMID: 29504837 DOI: 10.1080/17538157.2018.1433674] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE To identify the information and communication needs of Hispanic family caregivers for individuals with Alzheimer's Disease and Related Dementias (ADRD) and the manner in which online tools may meet those needs. METHODS We conducted 11 participatory design sessions with 10 English- and 14 Spanish-speaking urban-dwelling Hispanic family caregivers and gathered data using a survey, collage assemblage, and audio and video recordings. Four investigators analyzed transcripts of audio recordings with a coding framework informed by several conceptual models. RESULTS Participants had an average age of 59.7 years, were mostly female (79.2%), and had cared for a family member with ADRD for an average of 6.5 years. All participants accessed the Internet at least once a week with 75% ≥ daily. Most used the Internet to look up health information. All participants reported caregiver attributes including awareness of the disease symptoms or behaviors. The majority reported information needs/tasks (91.7%), communication needs/tasks (87.5%), and need for online tools (79.2%). CONCLUSION Hispanic caregivers of individuals with ADRD reported key information and communication needs/tasks. Only Spanish-speaking participants reported Internet and technology use deficits suggesting the requirement for further technology support. Data show a need for online tools to meet the needs of caregivers.
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Affiliation(s)
- Sarah Iribarren
- a Department of Biobehavioral Nursing and Health Informatics , University of Washington , Seattle , WA , USA
| | - Samantha Stonbraker
- b Columbia University School of Nursing, Columbia University , New York , NY , USA
| | - Niurka Suero-Tejeda
- b Columbia University School of Nursing, Columbia University , New York , NY , USA
| | - Maribel Granja
- c National Center for Children in Poverty , Mailman School of Public Health, Columbia University , New York , NY , USA
| | - José A Luchsinger
- d Departments of Medicine and Epidemiology , Columbia University Medical Center , New York , NY , USA
| | - Mary Mittelman
- e Departments of Psychiatry and Rehabilitative Medicine , New York University School of Medicine , New York , NY , USA
| | - Suzanne Bakken
- b Columbia University School of Nursing, Columbia University , New York , NY , USA.,f Department of Biomedical Informatics , Columbia University , New York , NY , USA
| | - Robert Lucero
- g Department of Family, Community, and Health System Science, University of Florida , Gainesville , FL , USA.,h Center for Latin American Studies , University of Florida , Gainesville , FL , USA
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Luchsinger JA, Burgio L, Mittelman M, Dunner I, Levine JA, Kong J, Silver S, Ramirez M, Teresi JA. Northern Manhattan Hispanic Caregiver Intervention Effectiveness Study: protocol of a pragmatic randomised trial comparing the effectiveness of two established interventions for informal caregivers of persons with dementia. BMJ Open 2016. [PMID: 27888180 DOI: 10.1136/bmjopen-201601408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
INTRODUCTION The prevalence of dementia is increasing without a known cure, resulting in an increasing number of informal caregivers. Caring for a person with dementia results in increased stress and depressive symptoms. There are several behavioural interventions designed to alleviate stress and depressive symptoms in caregivers of persons with dementia with evidence of efficacy. Two of the best-known interventions are the New York University Caregiver Intervention (NYUCI) and the Resources for Enhancing Alzheimer's Caregivers Health (REACH). The effectiveness of the NYUCI and REACH has never been compared. There is also a paucity of data on which interventions are more effective in Hispanics in New York City. Thus, we proposed the Northern Manhattan Hispanic Caregiver intervention Effectiveness Study (NHiCE), a pragmatic clinical trial designed to compare the effectiveness of adaptations of the NYUCI and the REACH in informal Hispanic caregivers of persons with dementia in New York City. METHODS AND ANALYSIS NHiCE is a 6-month randomised controlled trial comparing the effectiveness of adaptations of the NYUCI and REACH among 200 Hispanic informal adult caregivers of persons with dementia. The planned number of sessions of the NYUCI and REACH are similar. The primary outcome measures are changes from baseline to 6 months in the Zarit Caregiver Burden Scale and Geriatric Depression Scale. Our primary approach to analyses will be intent-to-treat. The primary analyses will use mixed random effects models, and a full information maximum likelihood approach, with sensitivity analyses using generalised estimating equation. ETHICS AND DISSEMINATION NHiCE is approved by the Institutional Review Board of Columbia University Medical Center (protocol AAAM5150). A Data Safety Monitoring Board monitors the progress of the study. Dissemination will include reports of the characteristics of the study participants, as well as a report of the results of the clinical trial. TRIAL REGISTRATION NUMBER NCT02092987, Pre-results.
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Affiliation(s)
- José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, New York, USA
| | - Louis Burgio
- Burgio Geriatric Consulting, Tuscaloosa, Alabama, USA
| | - Mary Mittelman
- Departments of Psychiatry and Rehabilitation Medicine, New York University School of Medicine, New York, New York, USA
| | - Ilana Dunner
- Riverstone Senior Life Services, New York, New York, USA
| | | | - Jian Kong
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Stephanie Silver
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
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Luchsinger JA, Burgio L, Mittelman M, Dunner I, Levine JA, Kong J, Silver S, Ramirez M, Teresi JA. Northern Manhattan Hispanic Caregiver Intervention Effectiveness Study: protocol of a pragmatic randomised trial comparing the effectiveness of two established interventions for informal caregivers of persons with dementia. BMJ Open 2016; 6:e014082. [PMID: 27888180 PMCID: PMC5168522 DOI: 10.1136/bmjopen-2016-014082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION The prevalence of dementia is increasing without a known cure, resulting in an increasing number of informal caregivers. Caring for a person with dementia results in increased stress and depressive symptoms. There are several behavioural interventions designed to alleviate stress and depressive symptoms in caregivers of persons with dementia with evidence of efficacy. Two of the best-known interventions are the New York University Caregiver Intervention (NYUCI) and the Resources for Enhancing Alzheimer's Caregivers Health (REACH). The effectiveness of the NYUCI and REACH has never been compared. There is also a paucity of data on which interventions are more effective in Hispanics in New York City. Thus, we proposed the Northern Manhattan Hispanic Caregiver intervention Effectiveness Study (NHiCE), a pragmatic clinical trial designed to compare the effectiveness of adaptations of the NYUCI and the REACH in informal Hispanic caregivers of persons with dementia in New York City. METHODS AND ANALYSIS NHiCE is a 6-month randomised controlled trial comparing the effectiveness of adaptations of the NYUCI and REACH among 200 Hispanic informal adult caregivers of persons with dementia. The planned number of sessions of the NYUCI and REACH are similar. The primary outcome measures are changes from baseline to 6 months in the Zarit Caregiver Burden Scale and Geriatric Depression Scale. Our primary approach to analyses will be intent-to-treat. The primary analyses will use mixed random effects models, and a full information maximum likelihood approach, with sensitivity analyses using generalised estimating equation. ETHICS AND DISSEMINATION NHiCE is approved by the Institutional Review Board of Columbia University Medical Center (protocol AAAM5150). A Data Safety Monitoring Board monitors the progress of the study. Dissemination will include reports of the characteristics of the study participants, as well as a report of the results of the clinical trial. TRIAL REGISTRATION NUMBER NCT02092987, Pre-results.
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Affiliation(s)
- José A Luchsinger
- Departments of Medicine andEpidemiology, Columbia University Medical Center, New York, New York, USA
| | - Louis Burgio
- Burgio Geriatric Consulting, Tuscaloosa, Alabama, USA
| | - Mary Mittelman
- Departments of Psychiatry and Rehabilitation Medicine, New York University School of Medicine,New York, New York, USA
| | - Ilana Dunner
- Riverstone Senior Life Services, New York, New York, USA
| | | | - Jian Kong
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Stephanie Silver
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, Bronx, New York, USA
- Weill Cornell Medical College, New York, New York, USA
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Van Liew C, Santoro M, Kothari D, Wooldridge J, Cronan TA. "Experience Keeps a Dear School": the Effects of Ethnicity and Caregiving Experience on Hiring a Healthcare Advocate. J Cross Cult Gerontol 2016; 31:409-426. [PMID: 27631311 DOI: 10.1007/s10823-016-9306-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
In the present study, ethnic differences in evaluating the severity and associated needs of medical complications experienced by an elderly man and the likelihood of seeking professional assistance (i.e., hire a healthcare advocate [HCA]) to care for him, and for one's own family or parent should they become ill, as a function of previous caregiving experience, were investigated. The 974 participants were White, Black, Hispanic, or Asian/Pacific Islander. They read a hypothetical vignette about a 75-year-old man, Daryl, who was experiencing health problems. Participants were instructed to imagine that they were James, Daryl's son, and asked to indicate how severe his condition(s) were, how much medical assistance he would require, and how likely they would be to hire an HCA to assist him. They were also asked to report whether they previously had assisted a parent with activities of daily living (Assistance) and whether they would be likely to hire an HCA in the future if 1) a family member or 2) a parent, specifically, became ill. Two, 2 (Assistance) × 4 (Ethnicity) multivariate analyses of covariance (MANCOVA) were performed to assess differential responses among individuals of different ethnicities as a function of previous caregiver experience. A priori interaction contrasts were examined to determine whether Black, Hispanic, or Asian/Pacific Islander participants differed on the outcomes from White participants as a function of previous caregiver experience. There were no significant differences between Black or Asian/Pacific Islander and White participants, but Hispanic participants assigned significantly higher severity and need for medical assistance ratings and were significantly more likely to indicate that they would seek assistance from an HCA with respect to the vignette and for their own parents in the future if they had provided caregiving to a parent in the past, whereas White participants were less likely to seek assistance from an HCA if they had provided caregiving in the past to a parent. Although ethnic differences in evaluations of Daryl's condition and in the reported likelihoods of hiring an HCA in various contexts as a function of previous caregiving experience were limited, there are important inter-cultural differences to recognize. It may be important in future research to assess ethnic differences in the expectations and experiences of caregiving.
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Affiliation(s)
- Charles Van Liew
- Department of Psychology, San Diego State University, San Diego, CA, USA.
| | - Maya Santoro
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
| | - Dhwani Kothari
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | | | - Terry A Cronan
- Department of Psychology, San Diego State University, San Diego, CA, USA
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, CA, USA
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12
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Effectiveness of a fotonovela for reducing depression and stress in Latino dementia family caregivers. Alzheimer Dis Assoc Disord 2016; 29:146-53. [PMID: 25590939 DOI: 10.1097/wad.0000000000000077] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The clinical need to address stress and depression in Latino dementia caregivers (CGs) combined with low health literacy and less accurate knowledge of dementia motivated the development of a pictorial tool [called a fotonovela (FN)] to teach (a) coping skills for caregiver (CG) stress; (b) self-assessment of depression; and (c) encourage improved utilization of available resources. To test the effectiveness of the FN, 110 of 147 Latino CGs, who were randomly assigned to the Fotonovela Condition (FNC) or the Usual Information Condition (UIC), were included in the final analyses. Self-report measures were given at baseline and post intervention. Results showed that FNC CGs demonstrated significantly greater reductions in level of depressive symptoms than UIC CGs. A significant decrease in level of stress due to memory and behavioral problems exhibited by their loved ones was similar in both groups. The FNC CGs reported that the FN was more helpful and that they referred to it more often than the UIC CGs did with regard to the informational materials they were provided about dementia. In conclusion, a culturally tailored FN can be an effective tool for Latino CGs given their high unmet needs for assistance and various barriers in accessing resources.
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Luchsinger JA, Tipiani D, Torres-Patiño G, Silver S, Eimicke JP, Ramirez M, Teresi J, Mittelman M. Characteristics and mental health of Hispanic dementia caregivers in New York City. Am J Alzheimers Dis Other Demen 2015; 30:584-90. [PMID: 25635108 PMCID: PMC4519428 DOI: 10.1177/1533317514568340] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Dementia prevalence and related caregiving burden are increasing, particularly among Hispanics. We studied the characteristics and mental health of Hispanic caregivers in New York City. METHODS We recruited 139 Hispanic family caregivers. We collected data on sociodemographic characteristics and predictors of caregiver burden, measured with the Zarit Caregiver Burden Scale, and depressive symptoms, measured with the Geriatric Depression Scale. RESULTS The mean age was 59.3 ± 10.4 years. The majority of caregivers were daughters and earned less than US$30 000 a year. In multivariate analyses with linear regression, lower satisfaction with social networks was associated with higher caregiver burden and a greater number of depressive symptoms. Higher dementia severity was associated with higher caregiver burden, while higher caregiver comorbidities were associated with higher depressive symptoms. CONCLUSIONS Caregiver comorbidities and satisfaction with social support may be targets for intervention that could improve caregiver burden and depressive symptoms among Hispanic caregivers.
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Affiliation(s)
- José A Luchsinger
- Departments of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA Departments of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Dante Tipiani
- Departments of Epidemiology, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Gabriela Torres-Patiño
- Departments of Medicine, College of Physicians and Surgeons, Columbia University Medical Center, New York, NY, USA
| | - Stephanie Silver
- Research Division, Hebrew Home for the Aged at Riverdale, New York, NY, USA
| | - Joseph P Eimicke
- Research Division, Hebrew Home for the Aged at Riverdale, New York, NY, USA
| | - Mildred Ramirez
- Research Division, Hebrew Home for the Aged at Riverdale, New York, NY, USA
| | - Jeanne Teresi
- Research Division, Hebrew Home for the Aged at Riverdale, New York, NY, USA
| | - Mary Mittelman
- Department of Psychiatry, New York University, New York, NY, USA
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Werner P, Goldstein D, Karpas DS, Chan L, Lai C. Help-seeking for dementia: a systematic review of the literature. Alzheimer Dis Assoc Disord 2015; 28:299-310. [PMID: 25321607 DOI: 10.1097/wad.0000000000000065] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Help-seeking (HS) for dementia presents a great challenge, especially because a timely and appropriate HS process might be associated with better outcomes for the person with dementia, their caregivers, and society. A clear understanding of the HS concept and its measurement in the area of dementia might improve the effectiveness of the process. AIMS The aims of our systematic review were: (1) to systematically obtain and evaluate the relevant literature on HS and dementia; and (2) to summarize current research findings and draw conclusions for future research and clinical care in this area. METHOD A systematic review of the literature on HS and dementia was conducted up till June 2013. RESULTS From the 478 retrieved articles, 48 were included in the review. Conceptually, the studies examined professional and nonprofessional sources of help; showed preference for seeking help from close relatives followed by primary health caregivers; and identified inadequate knowledge and stigmatic beliefs as the main barriers to HS. The majority of the studies did not rely on a theoretical framework. CONCLUSIONS Although the body of literature in the area of HS and dementia is growing, several conceptual and methodological limitations still have to be resolved to advance knowledge in the area.
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Affiliation(s)
- Perla Werner
- *Department of Community Mental Health †Center for Research and Study of Aging, University of Haifa, Haifa, Israel ‡Ho Cheung Shuk Yuen Charitable Foundation, Hong Kong §Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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C. Arévalo-Flechas L, Acton G, I. Escamilla M, N. Bonner P, L. Lewis S. Latino Alzheimer's caregivers: what is important to them? JOURNAL OF MANAGERIAL PSYCHOLOGY 2014. [DOI: 10.1108/jmp-11-2012-0357] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pagán-Ortiz ME, Cortés DE, Rudloff N, Weitzman P, Levkoff S. Use of an online community to provide support to caregivers of people with dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:694-709. [PMID: 24689359 PMCID: PMC4127129 DOI: 10.1080/01634372.2014.901998] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.
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Rosenthal Gelman C, Sokoloff T, Graziani N, Arias E, Peralta A. Individually-tailored support for ethnically-diverse caregivers: enhancing our understanding of what is needed and what works. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:662-680. [PMID: 24621198 DOI: 10.1080/01634372.2014.881451] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Family caregivers play a crucial role in maintaining older adults in the community, often at great cost to themselves. We discuss a program serving ethnically-diverse caregivers in New York, offering, on average, 11 case-management hr per client. Participants reported statistically significantly reduced stress and burden. Respite was the most requested service, belying an assumption underlying policies and services that families, particularly among minority populations, can and will care for their older members. Thus, services must be carefully tailored to meet actual caregiver needs, including provision of alternatives that reduce caregiver involvement. We discuss practice and policy implications.
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Affiliation(s)
- Caroline Rosenthal Gelman
- a Silberman School of Social Work and Hartford Silberman Center of Excellence in Aging and Diversity, Hunter College , New York , New York , USA
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18
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Chakrabarti S. Cultural aspects of caregiver burden in psychiatric disorders. World J Psychiatry 2013; 3:85-92. [DOI: 10.5498/wjp.v3.i4.85] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/21/2013] [Accepted: 11/16/2013] [Indexed: 02/05/2023] Open
Abstract
Caring for a mentally ill family member is well known to be mostly a stressful, distressing and burdensome experience. The dominant model for examining the process of caregiving has been the stress-appraisal-coping paradigm, in which interactions between stressors, appraisals, coping, and various mediators produce the eventual outcomes in terms of distress or well-being among caregivers. Ethnic and cultural factors have traditionally received the least research attention as mediators of the caregiving process. However, a large body of accumulated research evidence has clearly demonstrated that culturally-defined values, norms, and roles are among the major determinants of the caregiving experience. This research is based mainly on cross-cultural comparisons between caregivers of minority ethnic groups residing in the West and the native Caucasian population. It has been supplemented, to a limited extent, by research carried out among caregivers belonging to different cultures and residing in their countries of origin. Most of this research has been carried out among caregivers of elderly people with dementia; other psychiatric disorders such as schizophrenia have received much less attention. Results of this research have documented important differences in caregiving experiences and outcomes across cultural and ethnic groups. Cultural factors which could mediate these differences have been identified, and theories, which could provide a coherent framework to understand these differences, proposed. Though limited by methodological difficulties, this research has provided important insights into the impact of cultural and ethnic factors on the whole spectrum of the caregiving experiences. An improved understanding of the area is, nevertheless, required because it will eventually help in devising appropriate ways to reduce burden and distress among caregivers from diverse ethnic and cultural groups.
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Hernandez M, Barrio C, Yamada AM. Hope and burden among Latino families of adults with schizophrenia. FAMILY PROCESS 2013; 52:697-708. [PMID: 24329411 PMCID: PMC5032651 DOI: 10.1111/famp.12042] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examined hope and family burden among Latino families of individuals with schizophrenia. The sample consisted of 54 family members, one family member per outpatient adult recruited from public mental health programs in a diverse urban community. Hierarchical linear regression analyses were used to test the hypothesis that the family member's increased hope for the patient's future would be associated with decreased family burden beyond effects explained by the patient's length of illness and severity of symptoms. Results supported the study hypothesis. Family hope for the patient's future was associated with four of five types of family burden. Findings point to the prominent role of hope as a source of resilience for Latino families dealing with severe mental illness of a loved one.
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Affiliation(s)
- Mercedes Hernandez
- School of Social Work, University of Southern California, Los Angeles, CA
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20
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Gelman CR. Familismo and its impact on the family caregiving of Latinos with Alzheimer's disease: a complex narrative. Res Aging 2012; 36:40-71. [PMID: 25651600 DOI: 10.1177/0164027512469213] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite the long-held view that Latinos' value and reliance on family leads to greater involvement of extended family in caring for sick members and reduced perception of burden, some research reports low levels of social support and high levels of distress among Latino caregivers. We explore this seeming discrepancy in a qualitative study of 41 Latino caregivers of family members with Alzheimer's disease, interviewing them regarding the role of familism in their caregiving experience. For some it facilitates caregiving in the traditional, expected manner. Other caregivers disavow its current relevance. Yet others feel a contrast between familism, which they may value in a general, abstract way and more personal, immediate negative feelings they are experiencing from caregiving. We discuss these complex, multidimensional findings, the variation among caregivers, and present implications for practice, policy, and research.
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Daire AP, Mitcham-Smith M. Culturally Sensitive Dementia Caregiving Models and Clinical Practice. ADULTSPAN JOURNAL 2011. [DOI: 10.1002/j.2161-0029.2006.tb00011.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Keeping it in the family: when Mexican American older adults choose not to use home healthcare services. ACTA ACUST UNITED AC 2011; 29:282-90. [PMID: 21543918 DOI: 10.1097/nhh.0b013e3182173859] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mexican American elders are more functionally impaired and chronically ill than Anglo elders, yet use home care services less. The purpose of this study was to describe the cultural norms that influence Mexican American elders and their caregivers not to use home care services. A secondary analysis using descriptive ethnography was conducted. Thematic analysis was used to analyze Mexican American elders' (N = 4) and family caregivers' (N = 3) individual interviews. The overall finding was the category, "We Take Care of our Own!" This finding represented how Mexican American families faced increasing needs of elders at home in the context of their cultural norm of familism. The cultural findings, "Taking Care of Our Own!" were similar to those by elders who had chosen to use home care services in a previous study. Recognizing the importance of this norm, which is central to the culture, may shape interdisciplinary interventions that support traditional Mexican American family values, yet bring skilled or supportive help into the home. Interventions to increase the use of home care services by Latino families can contribute solutions to the national agenda to reduce healthcare disparities.
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El-Sayed AM, Scarborough P, Galea S. Ethnic inequalities in obesity among children and adults in the UK: a systematic review of the literature. Obes Rev 2011; 12:e516-34. [PMID: 21348920 DOI: 10.1111/j.1467-789x.2010.00829.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Ethnic minority groups are growing as a proportion of the British population. Although disparate, literature suggests inequalities in obesity risk within and among ethnic minority groups relative to Caucasians in the UK. We summarize and appraise the existing peer-reviewed literature about the prevalence and determinants of obesity among ethnic minority groups relative to Caucasians among children and adults in the UK. There was no consensus about obesity prevalence relative to Caucasians among South Asian or Black children or among South Asian adults relative to Caucasians. Black adults generally had higher risk for obesity than Caucasians. Both Chinese children and adults had lower risk for obesity than Caucasians. Few studies have considered differences in the aetiology of obesity by ethnicity. The lack of consensus regarding obesity risk among large ethnic minority groups relative to Caucasians in the UK, and the paucity of studies concerned with differences in obesity aetiology by ethnicity warrant further research in this area. Certain obesity metrics may bias obesity prevalence among particular ethnic groups relative to Caucasians. We summarize key methodological limitations to the current literature and suggest avenues for future research.
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Affiliation(s)
- A M El-Sayed
- Department of Public Health, University of Oxford, Oxford, UK.
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Ahmadi H, Montaser‐Kouhsari L, Nowroozi MR, Bazargan‐Hejazi S. Male Infertility and Depression: A Neglected Problem in the Middle East. J Sex Med 2011; 8:824-30. [DOI: 10.1111/j.1743-6109.2010.02155.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Napoles AM, Chadiha L, Eversley R, Moreno-John G. Reviews: developing culturally sensitive dementia caregiver interventions: are we there yet? Am J Alzheimers Dis Other Demen 2010; 25:389-406. [PMID: 20508244 DOI: 10.1177/1533317510370957] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite evidence of ethnic differences in family caregivers' experiences, the extent to which caregiver interventions are culturally tailored to address these differences is unknown. A systematic review of literature published from 1980 to 2009 identified: differences in caregiving experiences of African American, Latino, and Chinese American caregivers; psychosocial support interventions in these groups; and cultural tailoring of interventions. Ethnic differences in caregiving occurred at multiple levels (intrapersonal, interpersonal, environmental) and in multiple domains (psychosocial health, life satisfaction, caregiving appraisals, spirituality, coping, self-efficacy, physical functioning, social support, filial responsibility, familism, views toward elders, use of formal services and health care). Only 18 of 47 intervention articles reported outcomes by caregiver ethnicity. Only 11 reported cultural tailoring; 8 were from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) initiative. Cultural tailoring addressed familism, language, literacy, protecting elders, and logistical barriers. Results suggest that more caregiver intervention studies evaluating systematically the benefits of cultural tailoring are needed.
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Affiliation(s)
- Anna M Napoles
- Center for Aging in Diverse Communities, Division of General Internal Medicine, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA 94118, USA.
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Gelman CR. Learning from recruitment challenges: barriers to diagnosis, treatment, and research participation for Latinos with symptoms of Alzheimer's disease. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2010; 53:94-113. [PMID: 20029704 PMCID: PMC4049338 DOI: 10.1080/01634370903361847] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
This article discusses barriers to diagnosis and treatment of Alzheimer's disease (AD) and concomitantly to participation in AD research as elicited from 29 potential Latino participants who ultimately did not enroll in a study evaluating a caregiver intervention. Nearly half of all individuals contacting the researcher about the intervention study failed to meet criteria stipulating an existing AD diagnosis. Barriers to obtaining a diagnosis include lack of knowledge about AD, perceptions of memory loss as normal aging, and structural barriers to accessing care. A quarter of caregivers contacting the researcher felt too overwhelmed to participate. Many of these barriers have been previously identified as challenges to treatment, suggesting this is not just a methodological research problem, but inextricably tied to larger issues of AD knowledge and service accessibility. Engaging Latino communities equitably in the assessment of needs and the process of addressing them, thus ensuring the validity and applicability of the research and findings, is important both for increasing this group's participation in relevant studies and for addressing existing health disparities.
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Crist JD, McEwen MM, Herrera AP, Kim SS, Pasvogel A, Hepworth JT. Caregiving burden, acculturation, familism, and Mexican American elders' use of home care services. Res Theory Nurs Pract 2009; 23:165-80. [PMID: 19769211 DOI: 10.1891/1541-6577.23.3.165] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Caregiving burden has been shown to predict use of home care services among Anglo Americans. In a previous study, only one of two dimensions of caregiving burden predicted such use among Mexican American caregivers. Because acculturation and familism may affect burden, we conducted analyses to test three hypotheses: increased acculturation decreases familism; decreased familism increases burden; and increased burden increases use of home care services. Among 140 Mexican American family caregivers, acculturation was positively correlated with familism; familism was not significantly correlated with burden; objective burden was positively correlated with use of home care services, and objective and subjective burden significantly interacted in their effect on the use of home care services. Targeted interventions may be needed to increase use of home care services and preserve the well-being of Mexican American elders and caregivers.
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Affiliation(s)
- Janice D Crist
- College of Nursing, The University of Arizona, Tucson, AZ 85721-0203, USA.
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Gallagher-Thompson D, Gray HL, Dupart T, Jimenez D, Thompson LW. Effectiveness of Cognitive/Behavioral Small Group Intervention for Reduction of Depression and Stress in Non-Hispanic White and Hispanic/Latino Women Dementia Family Caregivers: Outcomes and Mediators of Change. JOURNAL OF RATIONAL-EMOTIVE AND COGNITIVE-BEHAVIOR THERAPY 2008; 26:286-303. [PMID: 25067886 DOI: 10.1007/s10942-008-0087-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This study enrolled 184 middle-aged and older women (95 Non-Hispanic White and 89 Hispanic/Latino) who provided in-home hands-on care to an elderly relative with Alzheimer's disease or another form of dementia. Within ethnic group they were randomly assigned to either a CBT-based small group intervention program called "Coping with Caregiving" (CWC) that taught a variety of cognitive and behavioral skills to reduce stress and depression, or to a minimal telephone based control condition (TSC). Intervention lasted about 4 months; one post-treatment assessment was completed 6 months after baseline by interviewers blind to the intervention condition. Interviews and interventions were conducted in English or Spanish by trained staff. Results indicated that those in the CWC (regardless of ethnicity) showed greater improvement from pre to post intervention than those in the TSC on measures of depressive symptoms, overall life stress, and caregiving-specific stress. In order to investigate if these changes may have been related to one proposed mechanism of change in CBT (skill utilization), a new measure was constructed. Change in frequency of use and perceived helpfulness of adaptive coping skills were assessed in all caregivers. Results indicated that caregivers in CWC reported greater frequency of use, and greater perceived helpfulness, of these skills at post intervention compared to caregivers in the TSC. Improvement measured by dependent measures was correlated with an increase in these indices for those in the CWC. Tests for mediation suggest that effective skill utilization may mediate the effect of treatment on outcome. Implications of these findings are discussed and recommendations provided for future research.
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Affiliation(s)
- Dolores Gallagher-Thompson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Veterans Administration Palo Alto Health Care System, Palo Alto, CA, USA
| | - Heather L Gray
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Alzheimer's Association of Northern California/Northern Nevada, Lafayette, CA, USA
| | - Tamarra Dupart
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Veterans Administration Palo Alto Health Care System, Palo Alto, CA, USA
| | - Daniel Jimenez
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Baylor College of Medicine, Houston, TX, USA
| | - Larry W Thompson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA; Pacific Graduate School of Psychology, Palo Alto, CA, USA
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Phillips LR, Crist J. Social relationships among family caregivers: a cross-cultural comparison between Mexican Americans and non-Hispanic White caregivers. J Transcult Nurs 2008; 19:326-37. [PMID: 18669901 DOI: 10.1177/1043659608322499] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Sometimes, clinicians assume caregivers in cultural groups believed to have large social networks and strong social support need little intervention from health professionals. This longitudinal study tests five hypotheses about the social relationships of Mexican American compared to non-Hispanic White caregivers and whether negative changes in social support affect perceived health. The sample includes 66 Mexican American and 92 non-Hispanic White caregivers. Findings show that social networks and social support are similar at baseline and similarly stable for 1 year. Negative changes in social support are correlated with poorer health perceptions. Findings underscore the importance of designing interventions that are culturally competent based on what the caregiver is experiencing rather than cultural stereotypes.
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Unmet needs for mental health services for latino older adults: perspectives from consumers, family members, advocates, and service providers. Community Ment Health J 2008; 44:57-74. [PMID: 18026876 PMCID: PMC2552995 DOI: 10.1007/s10597-007-9112-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 10/17/2007] [Indexed: 10/22/2022]
Abstract
This study qualitatively assessed the need for mental health services among Latino older adults in San Diego, California. The primary mental health issue was depression. Primary organizational barriers to accessing services were language and cultural barriers secondary to a lack of translators, dearth of information on available services, and scarcity of providers representative of the Latino community. Other challenges included a lack of transportation and housing, and the need for socialization and social support. Latino older adults experienced their unmet needs in ways associated with their cultural background and minority status. Age- and culturally-appropriate services are needed to overcome these barriers.
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Ortiz F, Fitten LJ, Cummings JL, Hwang S, Fonseca M. Neuropsychiatric and behavioral symptoms in a community sample of Hispanics with Alzheimer's disease. Am J Alzheimers Dis Other Demen 2006; 21:263-73. [PMID: 16948291 PMCID: PMC10833247 DOI: 10.1177/1533317506289350] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to characterize and compare neuropsychiatric symptoms in a sample of 367 community-dwelling subjects: 70 Hispanics and 230 non-Hispanic white patients with Alzheimer's disease, and 22 Hispanics and 45 non-Hispanic white healthy age-matched controls. Neuropsychiatric symptoms were common among all patients with Alzheimer's disease. In the Alzheimer's disease groups, Hispanic subjects presented to the initial assessment with more symptoms than non-Hispanic white subjects did. In comparison to the non-Hispanic white population, the proportion of Hispanics with neuropsychiatric and behavioral symptoms was higher. These findings have implications for differential sociocultural presentations of Alzheimer's disease among ethnic/racial groups.
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Affiliation(s)
- Freddy Ortiz
- The Neuropsychiatry Research Memory Clinic, Olive View-UCLA Medical Center, Sylmar, CA 91342, USA.
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Schulze B, Rössler W. Caregiver burden in mental illness: review of measurement, findings and interventions in 2004-2005. Curr Opin Psychiatry 2005; 18:684-91. [PMID: 16639098 DOI: 10.1097/01.yco.0000179504.87613.00] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW This review summarizes recent evidence on caregiver burden in mental illness. It examines how the field has advanced in terms of measurement, results, and interventions in 2004/2005, and identifies potential for further studies. RECENT FINDINGS Burden has been studied in a much wider spectrum of diagnostic groups and types of caregivers, some brief and practical assessment tools have become available, cultural aspects of burden are better understood, and a high potential for caregiver appraisal to prevent negative consequences of burden has been identified. Recent findings afford a more comprehensive understanding of the caregiving situation and its outcomes, and may find a practical application in devising effective support strategies for family carers, which still seem to be lacking. SUMMARY Substantial progress has been made in the measurement of caregiver burden. In terms of publication quantity, the field is growing rapidly, and international interest in the area is increasing. Improvements in methodological quality are also evident. These new research developments may be taken to reflect an increasing recognition of the contribution of families-away from stigma, shame, and blame. This requires accepting relatives as caregiving experts and as genuine partners in both psychiatric practice and research.
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Affiliation(s)
- Beate Schulze
- Public Mental Health Research Division, Psychiatric University Hospital Zurich, Zurich, Switzerland.
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