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Liu X, Wang S, Wei L, Liu Y, Bian J, Wang S, Du X. The impact of empowerment theory-based health education on Alzheimer's disease informal caregivers: a randomized controlled trial. Front Public Health 2024; 12:1393823. [PMID: 39257940 PMCID: PMC11385866 DOI: 10.3389/fpubh.2024.1393823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Accepted: 08/16/2024] [Indexed: 09/12/2024] Open
Abstract
Background There is a lack of evidence regarding the effectiveness of empowerment healthy education for caregivers of Alzheimer's patients. Objective To explore the effectiveness of the intervention of health education guided by empowerment theory on dementia knowledge, caregiving readiness, positive caregiving emotions, anxiety, and depression in informal Alzheimer's disease caregivers. Design A single-blinded, randomized controlled trial. Setting A teaching hospital in Tianjin, China. Participants Eighty caregivers of Alzheimer's disease patients. Methods Participants were recruited from the hospital and randomly assigned to either experimental or control group. The experimental group underwent a 12-weeks, one-to-one intervention of six session lasting 45-60 min each. The control group received conventional health education. Outcome measures included dementia knowledge, caregiver readiness (primary outcomes), positive caregiving emotions, anxiety, and depression (secondary outcomes). Results After 12 weeks, the intervention group exhibited significantly higher levels of dementia knowledge, caregiver readiness, and positive caregiving emotions compared with the control group. Furthermore, levels of hospitalization-related anxiety and depression were lower in the intervention group. All study results of this study showed statistically significant differences (p < 0.05). Discussion Empowerment theory-based health education appears to be an effective intervention for improving caregiver and readiness to care for caregivers of Alzheimer's disease individuals. The intervention may help reduce caregivers' anxiety and depression levels.
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Affiliation(s)
- Xiaofeng Liu
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shurui Wang
- Peking Union Medical College, Beijing, China
| | - Lirong Wei
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yun Liu
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jiping Bian
- Graduate School of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shen Wang
- Tianjin First Central Hospital, Tianjin, China
| | - Xian Du
- Department of General Surgery, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
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O'Dwyer ST, Sansom A, Mars B, Reakes L, Andrewartha C, Melluish J, Walker A, Biddle L, Slater T, Burrows D, Hastings RP, Moran P, Stallard P, Janssens A. Suicidal Thoughts and Behaviors in Parents Caring for Children with Disabilities and Long-Term Illnesses. Arch Suicide Res 2024:1-18. [PMID: 38949265 DOI: 10.1080/13811118.2024.2363230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Abstract
OBJECTIVE There is a growing body of evidence on suicide risk in family carers, but minimal research on parents caring for children with disabilities and long-term illnesses. The aim of this study was to conduct the first dedicated research on suicide risk in parent carers and identify: (1) the number of parent carers experiencing suicidal thoughts and behaviors, and (2) the risk and protective factors for suicidality in this population. METHOD A cross-sectional survey of parent carers in England (n = 750), co-produced with parent carers. Suicidal thoughts and behaviors were measured with questions from the Adult Psychiatric Morbidity Survey. Frequencies summarized the proportion of carers experiencing suicidal thoughts and behaviors. Logistic regressions identified risk and protective factors. RESULTS 42% of parents had experienced suicidal thoughts and behaviors while caring for a disabled or chronically ill child. Only half had sought help for these experiences. Depression, entrapment, dysfunctional coping, and having a mental health diagnosis prior to caring, were significant risk factors. CONCLUSION Parent carers contemplate suicide at levels that exceed those of other family carers and the general public. There is an urgent need, in policy and practice, to recognize parent carers as a priority group for prevention and intervention.
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Duangjina T, Hershberger PE, Gruss V, Fritschi C. Resilience in family caregivers of Asian older people with dementia: An integrative review. J Adv Nurs 2024. [PMID: 38863175 DOI: 10.1111/jan.16272] [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: 01/06/2024] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024]
Abstract
AIM To identify factors associated with resilience in family caregivers of Asian older people with dementia based on Luthar and Cicchetti's definition of resilience. DESIGN Integrative review of resilience in family caregivers of Asian older people with dementia reported by studies with quantitative and qualitative research designs. DATA SOURCES Databases used for the literature search included CINAHL, PubMed, EMBASE, PsycINFO and Google Scholar. REVIEW METHODS A total of 565 potentially relevant studies published between January 1985 and March 2024 were screened, and 27 articles met the inclusion criteria. RESULTS Family caregivers were most commonly adult children of care recipients, female and providing care in their home. Two themes emerged from the review: factors associated with adversity (dementia severity, caregiver role strain, stigma, family stress, female gender, low income and low education) and factors associated with positive adaptational outcomes (positive aspect of caregiving, social support and religiosity/spirituality). CONCLUSION In our review of Asian research, four new factors-caregiver role strain, stigma, family stress and positive aspects of caregiving-emerged alongside those previously identified in Western studies. A paradigm shift was observed from a focus on factors associated with adversity to factors associated with positive adaptational outcomes, particularly after the issuance of the WHO's 2017 global action plan for dementia. However, a gap remains between WHO policy recommendations and actual research, with studies often neglecting to address gender and socioeconomic factors. IMPACT The review findings will broaden healthcare providers' understanding of resilience in dementia caregivers and use them to develop comprehensive programmes aimed at reducing factors associated with adversity and enhancing those associated with positive adaptational outcomes. This approach can be customized to incorporate Asian cultural values, empowering caregivers to navigate challenges more effectively. NO PATIENT OR PUBLIC CONTRIBUTION This paper is an integrative review and does not include patient or public contributions.
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Affiliation(s)
- Thitinan Duangjina
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia E Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Cynthia Fritschi
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
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Mohamad MA, Leong Bin Abdullah MFI, Shari NI. Similarities and differences in the prevalence and risk factors of suicidal behavior between caregivers and people with dementia: a systematic review. BMC Geriatr 2024; 24:254. [PMID: 38486186 PMCID: PMC10941364 DOI: 10.1186/s12877-024-04753-4] [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: 05/13/2023] [Accepted: 01/27/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND People with dementia and their caregivers are prone to suicidal behaviors due to difficulty adjusting to their initial caregiving role and due to emotional disturbances resulting from deterioration of functioning. The present systematic review (1) explored the prevalence of and risk factors for suicidal behavior and (2) assessed the similarities and differences in the prevalence and risk factors for suicidal behavior between people with dementia and their caregivers. METHODS A comprehensive literature search for research articles published between 1950 and 2023 was carried out using major databases, such as Google Scholar, Web of Science, PubMed, Scopus, PsycINFO, EMBASE, the Cochrane Library, and Medline. RESULTS A total of 40 research articles were selected for review. A total of 12 research articles revealed that the prevalence of suicidal behavior among caregivers ranged from 4.7% to 26%. However, the risk of suicidal behavior among people with dementia was inconsistent, as only 17 out of 28 selected studies reported the risk of suicidal behavior among people with dementia. The risk factors associated with suicidal behavior among caregivers of people with dementia could be both self-related and care receiver-related factors, whereas risk factors in people with dementia were self-related factors. Notably, greater cognitive decline, which impairs individuals' ability to carry out complex acts and planning, may lower their suicidal risk. Finally, assessment of the risk of bias indicated that 95% of the selected studies had unclear risk. CONCLUSION Self-related and care receiver-related factors should be assessed among caregivers of people with dementia to evaluate the risk of suicidal behavior. In addition, we recommend evaluating suicidal risk in people with dementia in the early phase of dementia when cognitive decline is less severe. However, as the majority of the selected studies had unclear risk of bias, future studies with improved methodologies are warranted to confirm our study findings.
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Affiliation(s)
- Mohd Afifuddin Mohamad
- Department of Community Health, Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas, Pulau Pinang, 13200, Malaysia
| | | | - Nurul Izzah Shari
- School of Human Resource Development and Psychology, Faculty of Social Sciences and Humanities (FSSH), Universiti Teknologi Malaysia, Skudai, Johor, 81310, Malaysia
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Burton SD, Ailey SH, Paun O. Partner Caregiver Resilience: A Scoping Review. Res Gerontol Nurs 2024; 17:99-108. [PMID: 38364083 DOI: 10.3928/19404921-20240206-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
PURPOSE Caring for older adults with Alzheimer's disease and related dementias (ADRD) is a significant challenge for partner caregivers (i.e., committed, married, or cohabiting individuals). Understanding partner caregivers' needs is crucial to promote their well-being during the disease trajectory. The concept of resilience may help explain how ADRD partner caregivers manage in the face of significant challenges. The purpose of the current scoping review was to synthesize the qualitative evidence of the level of resilience among partner caregivers of persons with ADRD. METHOD A scoping review was conducted, which resulted in 19 research studies meeting inclusion criteria. RESULTS Findings were grouped by significant aspects of resilience as reflected in the studies reviewed, including risk and protective factors, partner caregivers' characteristics, and challenges and facilitators of resilience. Knowledge, skills, and access to social, psychological, and emotional support are needed to foster partner caregiver resilience. CONCLUSION Further resilience research is necessary to inform development of public policies, programs, and interventions tailored to the unique needs of ADRD partner caregivers. [Research in Gerontological Nursing, 17(2), 99-108.].
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Teasdale-Dubé A, Viau-Quesnel C, Lapierre S. Suicidal Ideation in Canadian Family Caregivers for a Person with Dementia: A Portrait of the Situation. Can J Aging 2024:1-8. [PMID: 38317578 DOI: 10.1017/s0714980824000011] [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: 02/07/2024] Open
Abstract
This study aimed to explore the prevalence of suicidal thoughts and potential associations (i.e., strength and direction) with caregiver characteristics or factors. A targeted survey was distributed to dementia caregivers aged 55+ years. Questions concerning psychological distress, suicidal thoughts while caregiving and antecedents of suicidal behaviours were administered. A sample of 71 French-speaking Canadian caregivers completed the survey between May and October 2019. Among them, 52.1 per cent (n = 37) reported suicidal ideation while providing care to a relative or a friend living with dementia. Caregivers who presented suicidal ideation reported more abusive behaviour toward the care recipient. Caregivers who reported suicidal thoughts were significantly more distressed than caregivers without them on measures of burden, depression, and anxiety. Suicidal thoughts in caregivers are important evaluation targets, primarily for the prevention of suicide, but also because caregivers who report suicidal thoughts also present a heightened risk for abusing the care recipient.
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Affiliation(s)
- Audrée Teasdale-Dubé
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Quebec Network for Research on Aging, Montreal, QC, Canada
| | - Charles Viau-Quesnel
- Quebec Network for Research on Aging, Montreal, QC, Canada
- Département de Psychoéducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Laboratoire Interdisciplinaire de Recherche en Gérontologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Sylvie Lapierre
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Quebec Network for Research on Aging, Montreal, QC, Canada
- Laboratoire Interdisciplinaire de Recherche en Gérontologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Zwar L, König HH, Hajek A. Wishing for an end? Longitudinal analysis of suicidal ideation among informal caregivers inside and outside their household in different welfare systems of Europe. Int Psychogeriatr 2023; 35:736-750. [PMID: 37587572 DOI: 10.1017/s1041610223000601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/18/2023]
Abstract
OBJECTIVE This study examines whether transition to caregiving within or outside the household is associated with changes in suicidal ideation and whether this depends on the type of caregiver relationship, the age or gender of the caregiver, or the welfare system. DESIGN Longitudinal study. SETTING Ten European countries. PARTICIPANTS Data from the Survey of Health, Ageing, and Retirement in Europe were used (waves 1, 2, 4, 5, and 6) including participants aged ≥40 years (pooled Observations = 171,848). MEASUREMENTS Suicidal ideation was measured using the Euro-D scale. Caregiving was measured as care inside and outside the household, and for different recipients. Fixed effects logistic regression analyses, adjusted for health and sociodemographic factors, were used. RESULTS Transitioning into caregiving inside the household was associated with higher odds of suicidal ideation, in particular if they transitioned into care for partners or parents and within Southern and Bismarckian welfare systems. Transitioning into caregiving outside the household was not associated with suicidal ideation, except among those transitioning into caregiving for non-relatives (higher odds of suicidal ideation), and among male and older caregivers (lower odds of suicidal ideation). Suicide ideation was higher among caregivers in Southern compared to Bismarckian or Scandinavian welfare systems. CONCLUSION Informal caregiving is associated with suicidal ideation among caregivers inside but not among all caregivers outside the household. The caregiver's characteristics, the care relationship, and the welfare system play an important role. Preventing suicidal ideation requires interventions that focus on informal caregivers and consider their individual and contextual factors.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Pac Soo V, Baker FA, Sousa TV, Odell-Miller H, Stensæth K, Wosch T, Bukowska AA, Tamplin J, Lautenschlager N, Braat S, Lamb KE. Statistical analysis plan for HOMESIDE: a randomised controlled trial for home-based family caregiver-delivered music and reading interventions for people living with dementia. Trials 2023; 24:316. [PMID: 37226214 DOI: 10.1186/s13063-023-07327-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Most people with dementia live in the community, not in residential care. Therefore, quality informal care for them is critical for managing behavioural and psychological symptoms of dementia (BPSD). Music therapy has been shown to reduce BPSD. However, no randomised controlled trial has examined the effects of music interventions delivered by caregivers in home settings. The HOME-based caregiver-delivered music intervention for people living with dementia (HOMESIDE) trial aims to evaluate the effectiveness of a 12-week music intervention in addition to standard care for BPSD. This article describes the statistical analysis plan. METHODS AND ANALYSIS HOMESIDE is a large, pragmatic international three-arm parallel-group randomised controlled trial. Dyads (persons with dementia and caregiver) in Australia, Germany, the UK, Poland and Norway were randomised to receive music and standard care, reading and standard care or standard care alone. The primary outcome is BPSD (proxy) of the person living with dementia, measured using the Neuropsychiatric Inventory-Questionnaire (NPI-Q) at 90 and 180 days post-randomisation. Longitudinal analysis will compare NPI-Q severity between music and standard care versus standard care alone. Secondary outcomes include quality of life and depression (both person with dementia and caregiver), cognition (person with dementia only), distress, resilience, competence and caregiver-patient relationship (caregiver only). Treatment effects will be obtained at 90 and 180 days post-randomisation, where applicable. Safety outcomes (adverse events, hospitalisations, deaths) will be summarised. DISCUSSION This statistical analysis plan provides a detailed methodology for the analysis of HOMESIDE and will improve the validity of the study and reduce the potential for bias. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12618001799246. Registered on November 05, 2018. CLINICALTRIALS gov NCT03907748. Registered on April 09, 2019.
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Affiliation(s)
- Vanessa Pac Soo
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia.
| | - Felicity A Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Tanara Vieira Sousa
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Anna A Bukowska
- Institute of Applied Sciences, University of Physical Education, Kraków, Poland
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Austin Health, Melbourne, VIC, Australia
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, VIC, Australia
| | - Sabine Braat
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - Karen E Lamb
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
- Methods and Implementation Support for Clinical Health (MISCH) Research Hub, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
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Clark IN, Ip-Winfield V, Murphy M, Shanahan E, Grocke D. The Bonny Method of Guided Imagery and Music for family caregivers of people with dementia: A within subject feasibility study. NORDIC JOURNAL OF MUSIC THERAPY 2022. [DOI: 10.1080/08098131.2022.2113913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2022]
Affiliation(s)
- Imogen N. Clark
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
| | | | - Melissa Murphy
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
| | | | - Denise Grocke
- Melbourne Conservatorium of Music, Faculty of Fine Arts and Music, University of Melbourne, Victoria, Australia
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Solimando L, Fasulo M, Cavallero S, Veronese N, Smith L, Vernuccio L, Bolzetta F, Dominguez LJ, Barbagallo M. Suicide risk in caregivers of people with dementia: a systematic review and meta-analysis. Aging Clin Exp Res 2022; 34:2255-2260. [PMID: 35696056 PMCID: PMC9637612 DOI: 10.1007/s40520-022-02160-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Interest in physical and mental health outcomes in caregivers of patients with dementia is increasing. However, there is limited data available on the prevalence of suicidal ideation, suicidal attempts, and suicide rates among caregivers of those with dementia. Therefore, we aimed to systematically review these outcomes to address this gap in the literature and thus provide information to inform future policy and intervention for the benefit of caregivers of dementia patients. METHODS We searched several databases from inception to the 10th November 2021, for studies investigating suicidal ideation, suicidal attempts, and suicide rates of caregivers of patients with dementia. We report data regarding suicidal ideation as prevalence, with the 95% confidence intervals (CIs), applying a random-effect model; since less than three studies were available for suicide attempt and suicide, these data are reported descriptively. RESULTS Among 194 articles, eight comprising 1,209 informal caregivers of people with dementia (mean age: 63.9 years, 74% females) were included. The prevalence of suicide ideation was 32.32% (95% CI: 16.01-48.64%; I2 = 98.5%, p < 0.0001). The prevalence of suicide ideation varied between studies from 4.69% to 77.78%. Two studies reported the rate of suicidal attempt in caregivers of patients with dementia, with the prevalence ranging from 5.9% to 16.1%. One study reported one in 17 caregivers of patients with dementia died by suicide. CONCLUSIONS The prevalence of suicide ideation is high, affecting several caregivers of patients with dementia. These findings suggest intervention and/or policy are urgently needed to address suicidal behavior in this at-risk population.
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Affiliation(s)
- Luisa Solimando
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
| | - Marta Fasulo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
| | - Stefano Cavallero
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy.
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, CB1 1PT, UK
| | - Laura Vernuccio
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
| | - Francesco Bolzetta
- Medical Department, Geriatric Unit, Azienda ULSS (Unità Locale Socio Sanitaria) 3 "Serenissima", Dolo-Mirano District, Italy
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
- Faculty of Medicine and Surgery, University of Enna "Kore", Enna, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro 141, 90127, Palermo, Italy
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Hoshino J, Tamakoshi K, Hori Y, Sakakibara H. Relationships Between Care Recipients’ Psychological Symptoms and Family Caregivers’ Depressive States. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223211058814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This cross-sectional study aims to clarify the relationship between the number of behavioral and psychological symptoms in long-term care recipients and family caregivers’ depressive states. Participants were 38 family caregivers who had provided care for their relatives for 6 years or more; they were recruited from in-home care settings in Aichi, Gifu, and Shiga Prefectures, Japan. Participants answered a self-administered questionnaire assessing their depressive state using the Japanese version of the Center for Epidemiologic Studies for Depression Scale (CES-D). They also answered questions inquiring about behavioral and psychological symptoms of care recipients, including resistance to care, irritability, and feelings of persecution. Using CES-D scores, 11 participants were categorized as depressed and 27 as non-depressed. Depressive symptoms were significantly greater in those with more behavioral and psychological symptoms, following adjustment for confounding factors. The odds ratio of being in a depressive state was 9.43 higher for those with more than 4 behavioral and psychological symptoms compared to those with none, showing a distinct threshold for the influence of behavioral and psychological symptoms on depressive state. Knowing the number of behavioral and psychological symptoms of care recipients may help quickly identify depressed caregivers and alleviate depressive symptoms.
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Affiliation(s)
- Junko Hoshino
- Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Koji Tamakoshi
- Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Yoko Hori
- Happy-Net Association, Nagoya, Aichi, Japan
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12
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Kimura NRS, Baptista MAT, Dourado MCN. Differences in the predictors of the resilience between carers of people with young- and late-onset dementia: a comparative study. Dement Neuropsychol 2022; 16:292-299. [PMID: 36619842 PMCID: PMC9762387 DOI: 10.1590/1980-5764-dn-2021-0093] [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: 11/03/2021] [Revised: 01/28/2022] [Accepted: 02/14/2022] [Indexed: 01/11/2023] Open
Abstract
Resilience is a subjective process related to both protective and risk factors, external and internal to the individual. Considering the psychosocial differences between young-onset dementia (YOD) and late-onset dementia (LOD) groups, carers' resilience may not be understood in the same way in both groups. Objective The aim of this study was to compare the resilience of carers in YOD and LOD and to examine which factors might be associated with resilience in both groups of carers. Methods The study was conducted with 120 people with dementia (49 YOD) and their primary carers. The carers had their resilience, quality of life, depressive symptoms, and burden assessed and answered the sociodemographic questionnaire. We assessed care recipients' global cognition, dementia severity, social cognition, facial expression recognition, awareness of disease, the ability to perform activities of daily living, depressive symptoms, and neuropsychiatric symptoms. For data analysis, unpaired two-tailed Student's t-test and linear regressions were conducted. Results Resilience did not differ between groups (p=0.865). Resilience was inversely related to carers' depressive symptoms in both YOD (p=0.028) and LOD (p=0.005) groups. The carers' schooling (p=0.005), duration of disease (p=0.019), and depressive symptoms of care recipient (p<0.001) were related to carers' resilience only in LOD group. Conclusions The context of care, clinical status of the care recipient, and mental health resources affected the carers' resilience in the LOD group. Conversely, resilience seems to be affected only by carers' mental health in the YOD group. The understanding of these differences is crucial for the developing of intervention strategies.
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Affiliation(s)
- Nathália Ramos Santos Kimura
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Distúrbios Relacionados, Rio de Janeiro RJ, Brazil
| | - Maria Alice Tourinho Baptista
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Distúrbios Relacionados, Rio de Janeiro RJ, Brazil
| | - Marcia Cristina Nascimento Dourado
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer e Distúrbios Relacionados, Rio de Janeiro RJ, Brazil
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Asfia SKBM, Bucholc J, McCaffrey N, Mihalopoulos C, Muldowney A, Engel L. Understanding the Quality of Life Impacts of Providing Informal Care to People with Dementia: A Systematic Review of Qualitative Studies. J Alzheimers Dis 2022; 88:1293-1309. [PMID: 35754273 DOI: 10.3233/jad-220219] [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: 11/15/2022]
Abstract
BACKGROUND There is currently a lack of a comprehensive review identifying the broad scope of factors that impact quality of life (QoL) of informal carers of people with dementia to validate existing measures and inform the provision of support services for carers of people with dementia that impact QoL domains important to them. OBJECTIVE To explore and identify QoL impacts on informal carers from providing care to people with dementia. METHODS A systematic review was conducted across four databases: EMBASE, CINAHL, PsychINFO, and Medline. Eligible studies consisted of published, peer-reviewed, qualitative studies focusing on lived experiences of informal carers of people with dementia. Non-English studies and quantitative studies were excluded. Screening of included studies was conducted independently by three reviewers. A "best-fit" framework synthesis was used to combine the qualitative data, applying deductive and inductive analysis techniques. Quality assessment was conducted using the Critical Appraisal Skills Programme. RESULTS Of the 4,251 articles identified, 59 articles were included. Five main themes pertaining to QoL aspects were identified that included coping (emotion-coping and problem-coping), relationship with the person with dementia (sense of loss and change in relationship), support (formal support and informal support), interference with life (control over caring situation and freedom and independence), and health (physical health, emotional and mental health, and social health). CONCLUSION This study identified domains of QoL that are impacted by providing informal care to people living with dementia, offering a conceptual framework for instrument validation and development as well as guidance for service provision.
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Affiliation(s)
| | - Jessica Bucholc
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Nikki McCaffrey
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Cathrine Mihalopoulos
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
| | - Anne Muldowney
- Carers Australia, Unit 2/11 McKay Ln, Turner, Australian Capital Territory, Australia
| | - Lidia Engel
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
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Abstract
OBJECTIVES This pilot study aimed to describe the phenomenon of suicidal ideation among caregivers who were aged 60 and over and who provided care for a person with dementia. METHODS A qualitative study was conducted, using a descriptive method. Semi-structured interviews were administered to caregivers who had or were having suicidal thoughts whilst caring for a relative with dementia. RESULTS Six caregivers were interviewed. Four caregivers reported experiencing active suicidal ideation whilst caregiving. Two subjects mentioned wishing for the death of their care recipient. While saturation criteria were not all met themes regarding suicidal ideation types and developmental contexts emerged. Findings suggest that family conflicts, placement difficulties, exhaustion, feelings of injustice, and loneliness contributed to the development of suicidal ideation. CONCLUSIONS Suicidal distress can emerge from the dementia caregiving context and these findings highlight a complex phenomenon among caregivers. The understanding of caregivers' suicidal distress is of great importance to guide screening and intervention efforts. Research is needed to keep the implication and well-being of older caregivers. CLINICAL IMPLICATIONS Screening efforts should consider the caregiving context as a conducive environment for suicidal distress and clinicians could use this knowledge to provide specific interventions to distressed carers.
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Affiliation(s)
- Audrée Teasdale-Dubé
- Département de Psychologie, Université Du Québec À Trois-Rivières, Québec, Canada
- Quebec Network for Research on Aging, Montreal, Canada
| | - Charles Viau-Quesnel
- Quebec Network for Research on Aging, Montreal, Canada
- Département de Psychoéducation, Université Du Québec À Trois-Rivières, Québec, Canada
- Laboratoire Interdisciplinaire de Recherche En Gérontologie, Université Du Québec À Trois-Rivières, Trois-Rivières, Canada
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15
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Abstract
OBJECTIVE Suicide resilience is gaining increasing attention from researchers because of its potential role in preventing suicide. However, it has not been clearly analyzed, and there are various meanings and terms regarding this issue. The purpose of this analysis, therefore, was to conceptualize the concept of suicide resilience. METHODS Walker and Avant's method of concept analysis was used to identify the antecedents, attributes, and consequences of suicide resilience. The literature was searched using PubMed, PsychINFO, Embase, Web of Science, CINAHL, CNKI, and WanFang databases with no limitation on publication date. The search included peer-reviewed journal articles and dissertations related to suicide resilience published in English or Chinese. RESULTS 52 articles were identified to provide information for this concept analysis. Five defining attributes of suicide resilience were identified: social support, coping strategies, psychological capital, meaning in life, and sense of responsibility. Antecedents of suicide resilience were high suicide risk events, and consequences of suicide resilience were keeping vulnerable individuals stay away from or overcoming suicidality. CONCLUSIONS The result of the analysis provided a more clear definition of suicide resilience. The identified defining attributes, antecedents, and consequences can be further tested and used to develop potential interventions. Future research is needed and will help to advance our understanding of the scope.
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Affiliation(s)
- Xinlu Wang
- School of Nursing, Wenzhou Medical University, Wenzhou, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, China
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16
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McKee GB, Perrin PB, Rodriguez-Agudelo Y, Plaza SLO, Quijano-Martinez MC, Kuzu D, Ohayagha C, Pugh M, Arango-Lasprilla JC. Suicidal ideation after acute traumatic brain injury: A longitudinal actor-partner interdependence model of patients and caregivers in Latin America. Rehabil Psychol 2021; 66:433-441. [PMID: 34871029 DOI: 10.1037/rep0000395] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE Traumatic brain injury (TBI) is associated with depression, anxiety, and even suicidality in individuals with TBI and in caregivers. Moreover, emotional functioning in individuals with TBI is linked with caregiver functioning. However, no known studies to date have examined linkages in suicidal ideation in individuals with TBI and family caregivers. This is especially important in Latin America, where TBI rates are high, and where cultural norms influence family caregiving. This study examined associations among self-reported suicidal ideation in individuals with TBI and their primary caregivers over time in Mexico and Colombia. Research Method/Design: A total of 109 individuals and their primary caregivers completed measures during hospitalization for TBI and at 2- and 4-months posthospitalization. The primary outcome was Item 9 from the Spanish version of the Patient Health Questionnaire-9, assessing for thoughts of death or suicide in the previous 2 weeks. RESULTS Patients and caregivers reported high levels of suicidal ideation (18.3%-22.4% and 12.4%-15.7%, respectively) at each time point, and suicidal ideation at one time point strongly predicted ideation at the next. When patients endorsed suicidal ideation in the hospital, their caregivers tended to endorse suicidal ideation 2 months later. Although unaccounted for variables could be driving these relationships, they may also provide possible evidence of causal preponderance between patient and caregiver suicidal ideation post-TBI. CONCLUSIONS/IMPLICATIONS Clinicians and rehabilitation specialists can use these findings to inform suicide risk assessment by expanding these practices to caregivers of patients who endorsed suicidal ideation. Interventions after TBI should incorporate caregivers given this study showed significant interdependence of suicidality between patients and caregivers. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Grace B McKee
- Advanced Fellowship Program in Mental Illness Research and Treatment
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17
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O'Dwyer ST, Janssens A, Sansom A, Biddle L, Mars B, Slater T, Moran P, Stallard P, Melluish J, Reakes L, Walker A, Andrewartha C, Hastings RP. Suicidality in family caregivers of people with long-term illnesses and disabilities: A scoping review. Compr Psychiatry 2021; 110:152261. [PMID: 34332205 DOI: 10.1016/j.comppsych.2021.152261] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 05/26/2021] [Accepted: 06/21/2021] [Indexed: 10/20/2022] Open
Abstract
An emerging body of international research suggests family caregivers may be a high-risk group for suicide, but the evidence has not been synthesised. Forty-eight peer-reviewed journal articles were included in this review, spanning low-, middle-, and high-income countries and a variety of illnesses and disabilities. The proportion of caregivers experiencing suicidal ideation ranged from 2.7% to 71%, with evidence of suicide attempts, deaths by suicide, and deaths by homicide-suicide also reported. Risk and protective factors varied across studies and there was little consideration of differences by caregiving relationship, type of illness/disability, or country. There is sufficient evidence to warrant concern for caregivers around the world and prompt action in policy and practice, but more rigorous research is required to draw clear, nuanced conclusions about risk and inform evidence-based prevention and intervention.
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Affiliation(s)
- Siobhan T O'Dwyer
- University of Exeter Medical School, College of Medicine and Heath, University of Exeter, Heavitree Rd, Exeter EX1 2LU, United Kingdom; National Institute for Health Research Applied Research Collaboration South West Peninsula (NIHR PenARC), United Kingdom.
| | - Astrid Janssens
- User Perspectives and Community-based Interventions, Department of Public Health, University of Southern Denmark, J.B. Winslows Vej 9B, 1(st) Floor, 5000 Odense C, Denmark; Centre for Innovative Medical Technology, Odense University Hospital, Denmark
| | - Anna Sansom
- University of Exeter Medical School, College of Medicine and Heath, University of Exeter, Heavitree Rd, Exeter EX1 2LU, United Kingdom
| | - Lucy Biddle
- The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Research Foundation, United Kingdom; Bristol Medical School, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom
| | - Becky Mars
- National Institute for Health Research (NIHR), Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, United Kingdom; Bristol Medical School, University of Bristol, Oakfield House, Bristol BS8 2BN, United Kingdom
| | - Thomas Slater
- School of Social Sciences, Cardiff University, 2.14B Glamorgan Building, King Edward VII Avenue, Cardiff CF10 3WT, United Kingdom
| | - Paul Moran
- Population Health Sciences, Bristol Medical School, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol BS8 2PS, United Kingdom; The National Institute for Health Research Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Research Foundation, United Kingdom
| | - Paul Stallard
- Department of Health, University of Bath, Bath BA2 7AY, United Kingdom
| | | | | | | | | | - Richard P Hastings
- Centre for Educational Development, Appraisal and Research (CEDAR), University of Warwick, Coventry CV4 7AL, United Kingdom; Centre for Developmental Psychiatry and Psychology, Monash University, Australia
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18
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Ma SW, Lai S, Yang YY, Zhou Z, Yang BT, Zheng GZY, Gao J, Lu L. Relationships Between Anxiety Symptoms, Hopelessness and Suicidal Ideation Among Parental Caregivers of Mandarin-Speaking Children With Speech Impairment: The Mediating Effect of Depressive Symptoms. Front Psychiatry 2021; 12:648885. [PMID: 33986701 PMCID: PMC8110902 DOI: 10.3389/fpsyt.2021.648885] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 03/22/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Determining the mental health status of parents who chronically care for a child with speech impairment is important for developing appropriate interventions to improve both parents' and children's health and achieve a win-win situation. Unfortunately, no study in China has explored this issue. This study investigated the differences in four aspects of mental health between maternal and paternal caregivers for the Mandarin-speaking children with speech impairment and determine whether depressive symptoms mediate the relationships between anxiety symptoms and suicidal ideation, hopelessness and suicidal ideation. Methods: This cross-sectional questionnaire survey was conducted in February 2020 by sending a link to the predesigned electronic questionnaire in WeChat. Standardized assessment tools were employed. Hierarchical multiple logistic regression was conducted to examine the associations between various factors and suicidal ideation, and two separate structural equation models were performed to evaluate the mediating effects of depressive symptoms in the relationship between anxiety symptoms and suicidal ideation as well as between hopelessness and suicidal ideation. Results: This study included 446 parental caregivers of Mandarin-speaking children with speech impairment. Paternal caregivers had greater score than maternal caregivers on loss of motivation (one of the subdomains of hopelessness). Somatic complications of the child (OR = 2.73, 95% CI: 1.09-6.67) and depressive symptoms (OR = 3.38, 95% CI: 1.83-6.30) were positively associated with caregivers' suicidal ideation. Having speech therapy of child (OR = 0.54, 95% CI: 0.29-0.98) was negatively correlated with caregivers' suicidal ideation. There was direct effect of depressive symptoms on suicidal ideation. Depressive symptoms play mediating roles on the relationships between anxiety symptoms (β = 0.171, p < 0.001) as well as between hopelessness and suicidal ideation (β = 0.187, p < 0.001). Conclusions: Paternal and maternal caregivers of Mandarin-speaking children with speech impairment suffered from mental health problems. Preventive strategies and interventions to ameliorate parental psychological well-being, and health care policies to increase the accessibility to speech therapy care of children with speech impairment are imperative.
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Affiliation(s)
- Si-Wei Ma
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China.,School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.,Research Center of Stomatology, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Sha Lai
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Yan-Yan Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | - Zhongliang Zhou
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Bin-Ting Yang
- Key Laboratory of Shaanxi Province for Craniofacial Precision Medicine Research, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
| | | | - Jianmin Gao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, China
| | - Li Lu
- Team IETO, Bordeaux Population Health Research Center, INSERM, Université de Bordeaux, Bordeaux, France
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19
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Zhou Y, O'Hara A, Ishado E, Borson S, Sadak T. Developing a new behavioral framework for dementia care partner resilience (CP-R): A mixed research synthesis. THE GERONTOLOGIST 2020; 62:e265-e281. [PMID: 33367603 DOI: 10.1093/geront/gnaa218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caring for a person living with dementia requires resilience, the capacity to recover and grow from challenging situations. Despite the increasing interest in assessing and promoting resilience for dementia care partners, behaviors that indicate this attribute are not well known. The goal of this study is to synthesize the literature to identify resilience-related behaviors and develop a new framework for future validation and intervention research. RESEARCH DESIGN AND METHODS We searched English-language peer-reviewed articles (January 1991 - June 2019) reporting qualitative or quantitative descriptions of resilience-related behaviors among dementia care partners. Thematic analysis was used to categorize behaviors into domains, identify the relationships among them, and generate a thematic map. RESULTS Sixteen articles were identified according to predefined inclusion criteria. Four domains emerged: (1) problem-response behaviors (problem-solving, problem-distancing); (2) self-growth behaviors (self-care activities, spiritual-related activities, and developing and maintaining meaningful social relationships); (3) help-related behaviors (help-seeking and help-receiving), and (4) learning-related behaviors (learning from others and reflection). Definitions of each domain, identification of corresponding behaviors, and formulation of Care Partner Resilience (CP-R) behavioral framework were informed by this mixed research synthesis and other relevant literature. DISCUSSION AND IMPLICATIONS The CP-R framework emerged as a result of a new focus on identifying and cultivating strengths instead of evaluating strain and burden. It serves as a useful foundation for understanding the impact of specific behaviors on dementia care partner resilience. Once validated, this framework will inform the development of future measures, research, interventions, and policies for dementia care partners.
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Affiliation(s)
- Yuanjin Zhou
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Avery O'Hara
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Emily Ishado
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Soo Borson
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Tatiana Sadak
- School of Nursing, University of Washington, Seattle, Washington, USA
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20
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Durán-Gómez N, Guerrero-Martín J, Pérez-Civantos D, López Jurado CF, Palomo-López P, Cáceres MC. Understanding Resilience Factors Among Caregivers of People with Alzheimer's Disease in Spain. Psychol Res Behav Manag 2020; 13:1011-1025. [PMID: 33262666 PMCID: PMC7700077 DOI: 10.2147/prbm.s274758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/02/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) caregivers resilience involves the interaction between different risk and protective factors. Context of care, objective stressors, perceived stressors caregiver assessment, mediators factors and consequences of care were associated with resilience. We have developed a more integrated and operational conceptual model of resilience and care than previous models in our sociocultural environment. PURPOSE To assess the resilience of caregivers of people with AD and the related factors grouped according to an established operational conceptual model of Alzheimer´s caregivers stress. PATIENTS AND METHODS A total of 120 primary informal caregivers of AD persons in Badajoz (Spain) were included in a cross-sectional design. The following variables have been measured on AD persons and caregivers: socio-demographic data, dependency level, cognitive decline, neuropsychiatric and behavioral symptoms, anxiety, depression, severity of somatic symptoms, level of burden, self-esteem, coping, social support, health-related quality of life (HRQOL) and resilience. RESULTS Most of the caregivers reported symptoms of anxiety (63.3%) and depression (62.5%). We found out higher levels of resilience in caregivers with lower dependence caring (p=0.004). Higher resilience levels of caregivers were related to minor depressive (p=0.006) and anxiety symptoms (p=0.000), and higher HRQOL (p=0.000). Coping dimension mostly used was problem-based strategies such as active coping, positive reinterpretation and acceptance (p= 0.000). CONCLUSION Those caregivers reporting higher levels of resilience exhibited moderate to intense indicators of burden, fewer symptoms of depression and anxiety and fewer somatic symptoms. They also used adequate problem-focused coping strategies, showed higher levels of HRQOL and demonstrated an appropriate perception of social support. Despite the fact that the characteristics relating to the care context and to social support exert an undeniable influence on caregiver resilience, it would appear that the caregiver's own intra-psychic resources reveal stronger correlations. RELEVANCE FOR CLINICAL PRACTICE The early and accurate identification of caregivers with lower levels of resilience could enable the implementation of vital psychological and educative support interventions to help caregivers to improve their well-being.
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21
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Palacio G C, Krikorian A, Gómez-Romero MJ, Limonero JT. Resilience in Caregivers: A Systematic Review. Am J Hosp Palliat Care 2019; 37:648-658. [DOI: 10.1177/1049909119893977] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Background: Resilience is a multidimensional construct that explains why people facing the consequences of adversity and stress can have a positive outcome, emphasizing adjustment to experiences that are perceived as threatening. Objective: The aim of this study is to review the construct of resilience and associated variables in caregivers of patients with chronic, advanced illness and at the end of life. Methods: The review included studies published between January 2009 and January 2019, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guide reporting. The Medline, ScienceDirect, HINARI, PsychINFO, and SciELO databases were used for bibliographic exploration to identify research studies that examined the impact of resilience on adaptation and overall well-being in caregivers of patients with chronic and advanced illness. Results: A total of 23 quantitative and qualitative studies were identified whose aim was to describe the role of resilience in adaptation and coping in caregivers. In these studies, resilience was associated with a positive impact on the quality of life and emotional distress. Communication and social support increase resilient coping strategies. In most selected articles, the sampling strategy used was convenience sampling. Data collection used evaluation scales related to resilience and associated variables for quantitative studies, and semistructured interviews were used for qualitative studies. Conclusion: Promoting a resilient coping style in caregivers reduces the distress that normally results from illness-related changes in the biopsychosocial and spiritual dimensions. A resilient coping style can diminish the risk of stress and burden, and promote adaptation in the caregiver.
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Affiliation(s)
- Carolina Palacio G
- Instituto de Cancerología, Clínica las Americas, Medellín, Colombia
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
| | - Alicia Krikorian
- Pain and Palliative Care Group, School of Health Sciences, Universidad Pontificia Bolivariana in Medellín, Colombia
| | - María José Gómez-Romero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
- Egarsat Mutua Colaboradora con la Seguridad Social n 276, Terrassa, Barcelona, Spain
| | - Joaquín T. Limonero
- School of Psychology, Universidad Autónoma de Barcelona, Barcelona, Spain
- Research Group on Stress and Health, School of Psychology, Autonomous University of Barcelona, Barcelona, Spain
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22
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Baker FA, Bloska J, Braat S, Bukowska A, Clark I, Hsu MH, Kvamme T, Lautenschlager N, Lee YEC, Smrokowska-Reichmann A, Sousa TV, Stensaeth KA, Tamplin J, Wosch T, Odell-Miller H. HOMESIDE: home-based family caregiver-delivered music and reading interventions for people living with dementia: protocol of a randomised controlled trial. BMJ Open 2019; 9:e031332. [PMID: 31748300 PMCID: PMC6886975 DOI: 10.1136/bmjopen-2019-031332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Pharmacological interventions to address behavioural and psychological symptoms of dementia (BPSD) can have undesirable side effects, therefore non-pharmacological approaches to managing symptoms may be preferable. Past studies show that music therapy can reduce BPSD, and other studies have explored how formal caregivers use music in their caring roles. However, no randomised study has examined the effects on BPSD of music interventions delivered by informal caregivers (CGs) in the home setting. Our project aims to address the need for improved informal care by training cohabiting family CGs to implement music interventions that target BPSD, and the quality of life (QoL) and well-being of people with dementia (PwD) and CGs. METHODS AND ANALYSIS A large international three-arm parallel-group randomised controlled trial will recruit a sample of 495 dyads from Australia, Germany, UK, Poland and Norway. Dyads will be randomised equally to standard care (SC), a home-based music programme plus SC, or a home-based reading programme plus SC for 12 weeks. The primary outcome is BPSD of PwD (measured using the Neuropsychiatric Inventory-Questionnaire). Secondary outcomes will examine relationship quality between CG and PwD, depression, resilience, competence, QoL for CG and QoL for PwD. Outcomes will be collected at baseline, at the end of the 12-week intervention and at 6 months post randomisation. Resource Utilisation in Dementia will be used to collect economic data across the life of the intervention and at 6-month follow-up. We hypothesise that the music programme plus SC will generate better results than SC alone (primary comparison) and the reading programme plus SC (secondary comparison). ETHICS AND DISSEMINATION Ethical approval has been obtained for all countries. Results will be presented at national and international conferences and published in scientific journals and disseminated to consumer and caregiver representatives and the community. TRIAL REGISTRATION NUMBERS ACTRN12618001799246p; NCT03907748.
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Affiliation(s)
- Felicity Anne Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jodie Bloska
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Sabine Braat
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Anna Bukowska
- Department of Occupational Therapy, University of Physical Education, Kraków, Poland
| | - Imogen Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | - Ming H Hsu
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
| | - Tone Kvamme
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Nicola Lautenschlager
- Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, Victoria, Australia
| | - Young-Eun Claire Lee
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | | | - Tanara Vieira Sousa
- School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Karette A Stensaeth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, Victoria, Australia
- Austin Health, Melbourne, Victoria, Australia
| | - Thomas Wosch
- Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Würzburg, Germany
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, UK
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23
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Ying J, Yap P, Gandhi M, Liew TM. Validity and Utility of the Center for Epidemiological Studies Depression Scale for Detecting Depression in Family Caregivers of Persons with Dementia. Dement Geriatr Cogn Disord 2019; 47:323-334. [PMID: 31307034 PMCID: PMC6878745 DOI: 10.1159/000500940] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 05/13/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND/AIMS The psychometric properties of Center for Epidemiological Studies Depression Scale (CES-D) have never been substantively investigated in caregivers of persons with dementia (PwD). We evaluated the validity and reliability of CES-D for detecting caregiver depression in dementia, and assessed whether CES-D could provide added utility beyond Zarit Burden Interview (ZBI). METHOD Family caregivers of community-dwelling PwD (n = 394) completed self-administered questionnaires containing CES-D. Factorial validity was evaluated with confirmatory factor analysis; convergent and discriminant validity with Pearson's correlation coefficient; known-group validity by comparing across key variables; and internal consistency reliability with Cronbach's α. Cohen's κ was used to compare the agreement between those with depression (CES-D ≥16) and those with high caregiver burden (ZBI >60). RESULTS CES-D demonstrated convergent, discriminant and known-group validity, consistent with a priori hypotheses. The original four-factor model of CES-D produced the best model-fit indices. Internal consistency reliability was good for the CES-D total scale (α = 0.92), but lower for the Positive affect and Interpersonal problems subscales (α = 0.70-0.74). Forty-five percent of the caregivers had depression as identified by CES-D (95% CI 40-50%), but most of them were not identified by high ZBI scores (κ = 0.16). CONCLUSIONS CES-D is a valid and reliable scale for detecting caregiver depression in dementia. It has added utility, beyond that of a caregiver burden scale, in identifying a subgroup of caregivers with depression but not burden. However, two subscales (Positive affect and Interpersonal problems) may require caution in interpretation among non-Caucasian caregivers.
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Affiliation(s)
- Jiangbo Ying
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore,Geriatric Education and Research Institute, Singapore, Singapore
| | - Mihir Gandhi
- Biostatistics, Singapore Clinical Research Institute, Singapore, Singapore,Centre for Quantitative Medicine, Duke-NUS Medical School, Singapore, Singapore
| | - Tau Ming Liew
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore, .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore,
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Dos Santos Treichel CA, da Rosa Jardim VM, Prado Kantorski L, Guimarães Lima M. Prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders. J Clin Nurs 2019; 28:3470-3477. [PMID: 31162868 DOI: 10.1111/jocn.14938] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 05/18/2019] [Accepted: 05/26/2019] [Indexed: 11/27/2022]
Abstract
AIMS AND OBJECTIVES This study aimed to analyse the prevalence and factors associated with suicidal ideation among family caregivers of people with mental disorders. BACKGROUND Studies conducted with family caregivers of people with dementia and cancer point out a high prevalence of suicidal ideation among these subjects; however, this aspect has not yet been investigated among family caregivers of people with mental disorders. DESIGN This is a cross-sectional study, conducted with 537 family caregivers of patients from 16 Psychosocial Care Centers (CAPS) of the 21st Health Region of the state of Rio Grande do Sul, Brazil. METHODS Question 17 of the Self-Reporting Questionnaire (SRQ-20) was used for suicidal ideation screening. The prevalence of suicidal ideation was calculated according to sociodemographic and care variables, with confidence interval estimate (95% CI). Crude and adjusted odds ratios were calculated by logistic regression. The Guidelines to Reporting of Observational Studies in Epidemiology (STROBE Statement) was adhered in this study (See File S1). RESULTS The prevalence of suicidal ideation found in this study for the 30 days preceding the interview was 12.5% (95% CI: 10-15). The factors associated with the outcome were lower age, lower schooling, feeling of burden, self-report of stress problem and dissatisfaction with family relationships. CONCLUSION The prevalence of suicidal ideation among the studied family caregivers was high and strongly associated with issues regarding care, showing the need for interventions that provide support. RELEVANCE FOR CLINICAL PRACTICE Nurses are a large part of the workforce of the community mental health services. The careful characterisation of the subjects who show suicidal ideation, as performed in this study, may reveal specificities capable of refining the diagnostic potential for establishment of action plans in a timely manner, avoiding possible attempts or even the consummation of suicide.
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Affiliation(s)
| | | | | | - Margareth Guimarães Lima
- Department of Collective Health, School of Medical Sciences, University of Campinas, Campinas, Brazil
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Tamplin J, Clark IN, Lee YEC, Baker FA. Remini-Sing: A Feasibility Study of Therapeutic Group Singing to Support Relationship Quality and Wellbeing for Community-Dwelling People Living With Dementia and Their Family Caregivers. Front Med (Lausanne) 2018; 5:245. [PMID: 30234118 PMCID: PMC6127293 DOI: 10.3389/fmed.2018.00245] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 08/13/2018] [Indexed: 11/30/2022] Open
Abstract
Background: Living at home following a diagnosis of dementia can be difficult for both the person living with dementia (PwD) and their family caregivers (FCG). Active group music participation may provide an avenue for emotional release, offer psychosocial support to caregivers and stimulate meaningful interaction between caregivers and loved ones with dementia. Therapeutic music interventions also have the capacity to facilitate reminiscence and social engagement and can help to manage challenging symptoms associated with dementia, such as anxiety, apathy, and agitation. Method: This feasibility study examined the acceptability of a 20-week therapeutic group singing intervention (Remini-Sing) and quantitative research assessments for PwD/FCG dyads living in the community. Quantitative measures for the following outcomes were tested for sensitivity and acceptability: relationship quality (PwD and FCG); life satisfaction, caregiver satisfaction, flourishing, and depression for FCGs; and anxiety, apathy, agitation, and quality of life for PwD. Quantitative assessments were conducted before, during (midway) and after 20 weeks of participation in a therapeutic singing group attended by the PwD and FCG together. The Remini-Sing intervention incorporated vocal warm ups, singing familiar songs, learning new songs, and opportunities for social interaction. Qualitative interviews were conducted with all dyads that completed the intervention. Results: Twelve PWD/FCG dyads were recruited and enrolled in the study. High participation and retention rates indicated that the intervention was received favorably by participants. There were no statistically significant changes on measures from pre to post intervention. However, favorable baseline scores on relationship quality and wellbeing measures were sustained over the 20-week intervention. The testing of these measures for feasibility also revealed that some were too difficult for PwD and thus yielded questionable results, some were potentially less relevant, and there were likely floor and ceiling effects on several of the measures utilized. Conclusions: This study demonstrated good feasibility for a research protocol and therapeutic group singing intervention for community-dwelling PwD and their FCGs. Participant reflections and researcher observations yielded useful information guiding the selection of quantitative outcome measures for future research in this area.
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Affiliation(s)
- Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N Clark
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Young-Eun C Lee
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A Baker
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, VIC, Australia
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Aoun SM, Toye C, Slatyer S, Robinson A, Beattie E. A person-centred approach to family carer needs assessment and support in dementia community care in Western Australia. HEALTH & SOCIAL CARE IN THE COMMUNITY 2018; 26:e578-e586. [PMID: 29635883 DOI: 10.1111/hsc.12575] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
This feasibility study aimed to identify and address the support needs of family carers (FCs) of people living with dementia and to assess whether the use of the Carer Support Needs Assessment Tool (CSNAT) intervention in home-based care was acceptable and relevant to FCs. The CSNAT intervention comprised two FC support needs assessment visits, 7 weeks apart, plus associated actions addressing prioritised needs by the Client Care Advisors of a community care service in Western Australia in 2015. Telephone interviews were conducted with FCs on their experience using the CSNAT at the end of the intervention. Twenty-one FCs were involved in the intervention and 15 of them completed the feedback interviews. Care recipients had moderate to severe dementia. The top five support needs reported by FCs were: having time to yourself in the day; knowing what to expect in the future; practical help in the home; looking after your own health and dealing with your feelings and worries. Three themes summarised their experience: a straightforward structured approach; awareness, acknowledgement and acceptance of their situation; and provision of support. FCs appreciated the opportunity to be heard and acknowledged, to have their practical and psychosocial support needs facilitated, to identify what is important to them and to receive a response in a timely manner. The CSNAT approach offered a structured carer-led, person-centred, supportive intervention that facilitated discussion between the family carer and the service provider about support needs and strategies to address them.
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Affiliation(s)
- Samar M Aoun
- Palliative Care Unit, School of Psychology and Public Health, La Trobe University, Melbourne, Vic., Australia
- Institute of Health Research, Notre Dame University, Fremantle, WA, Australia
| | - Chris Toye
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Susan Slatyer
- School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia
- Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - Andrew Robinson
- Wicking Dementia Research and Education Centre, School of Nursing, University of Tasmania, Hobart, TAS, Australia
| | - Elizabeth Beattie
- Dementia Collaborative Research Centre (DCRC) Carers and Consumers, School of Nursing, Queensland University of Technology, Brisbane, Qld, Australia
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Parkinson B. Risk of suicidal thinking in caregivers of people with dementia should be assessed and monitored by health professionals. Evid Based Nurs 2018; 21:73. [PMID: 29871867 DOI: 10.1136/eb-2018-102930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2018] [Indexed: 11/03/2022]
Affiliation(s)
- Ben Parkinson
- Nursing and Community Health, Glasgow Caledonian University, Glasgow, UK
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Petriwskyj A, Parker D, O'Dwyer S, Moyle W, Nucifora N. Interventions to build resilience in family caregivers of people living with dementia: a comprehensive systematic review. ACTA ACUST UNITED AC 2018; 14:238-73. [PMID: 27532659 DOI: 10.11124/jbisrir-2016-002555] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Recent studies have indicated that family caregivers of people with dementia have higher rates of depression, anxiety and hopelessness, as well as higher levels of burden, stress and distress. Not all caregivers, however, succumb to the negative effects of caring. Caregivers who are able to recover from, resist or adapt to the physical and psychological demands of caring can be considered "resilient". OBJECTIVES The objective of this review was to examine the existing evidence regarding interventions for building resilience in family caregivers of people living with dementia. INCLUSION CRITERIA TYPES OF PARTICIPANTS This review considered studies that included family caregivers of people with dementia. TYPES OF INTERVENTION(S)/PHENOMENA OF INTEREST Studies investigating interventions to build resilience in family caregivers were considered by the review. For qualitative studies, the phenomena of interest were family caregivers' experiences of the interventions including factors affecting implementation and their subjective experience of outcomes. CONTEXT Studies conducted in any cultural or geographical context and any settings including participants' homes in the community, residential aged care or hospital, medical or allied health practice were considered for inclusion. TYPES OF STUDIES Quantitative studies incorporating experimental and descriptive study designs and qualitative studies, including, but not limited to, phenomenology, grounded theory, ethnography, action research and feminist research were considered for inclusion. OUTCOMES Quantitative studies were included that contained either objective or subjective outcome measures (or a combination of both). In cases in which proxy measures of resilience were used, only those papers that explicitly related the aims of the intervention and the measurement of outcomes to resilience itself were considered for inclusion. Proxies could include, but were not limited to, self-efficacy, locus of control, perceived burden, psychological wellbeing, strength, coping, positive adjustment and resourcefulness. Qualitative studies were similarly considered for inclusion if they explicitly related the aims of the intervention to resilience. SEARCH STRATEGY Eleven electronic databases were searched for research studies published in English in or after 1990. METHODOLOGICAL QUALITY Quantitative and qualitative studies selected for retrieval were assessed by two independent reviewers for methodological validity using standardized critical appraisal instruments from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI). DATA EXTRACTION Quantitative and qualitative data were extracted from publications included in the review using the standardized data extraction tools from JBI-MAStARI and JBI-QARI. DATA SYNTHESIS It was not possible to pool quantitative findings for statistical meta-analysis using JBI-MAStARI. Qualitative research findings were too limited to be pooled using the JBI-QARI. The findings are presented in narrative form. RESULTS The review included three publications reporting one quantitative intervention study and one mixed-method intervention study. There was a lack of available studies and, of the two intervention studies that were identified, neither found any statistically significant change in quantitative measures of resilience. Qualitative data suggested positive impacts of a poetry writing intervention and a positive experience of the intervention. CONCLUSION IMPLICATIONS FOR PRACTICE The studies differed in both the nature of the intervention and the way resilience was conceptualized and operationalized. Consequently, it was not possible to offer any recommendations for practice. IMPLICATIONS FOR RESEARCH Implications for research relate to the development of a more comprehensive theory of resilience in family caregivers that can be used to develop and rigorously evaluate reliable and valid measures of resilience in line with that theory. Further, well-designed, sufficiently powered intervention studies informed by theory are needed.
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Affiliation(s)
- Andrea Petriwskyj
- 1The University of Queensland, School of Nursing, Midwifery and Social Work and the Australian Centre for Evidence Based Community Care: a Collaborating Centre of the Joanna Briggs Institute, The University of Queensland, Brisbane, Queensland 2The Centre for Applied Nursing Research, Ingham Medical Research Institute, Sydney, New South Wales 3Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
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Joling KJ, O'Dwyer ST, Hertogh CM, van Hout HP. The occurrence and persistence of thoughts of suicide, self-harm and death in family caregivers of people with dementia: a longitudinal data analysis over 2 years. Int J Geriatr Psychiatry 2018; 33:263-270. [PMID: 28379646 PMCID: PMC5811919 DOI: 10.1002/gps.4708] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 03/02/2017] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Family caregivers of people with dementia often report high levels of stress and depression, but little is known about those who contemplate suicide or self-harm. This study explores thoughts of suicide, self-harm and death in dementia caregivers and investigates the characteristics that distinguish them from those without such thoughts. METHODS Data were collected every 3 months, for 24 months, from 192 family caregivers of people with dementia living in the Netherlands. Caregivers did not have a clinical depression or anxiety disorder at baseline. Suicide-related thoughts were measured with an item from the Mini International Neuropsychiatric Interview, a diagnostic instrument for DSM-IV mental disorders. Fisher exact, analysis of variance or Kruskal-Wallis tests compared the characteristics of caregivers who had contemplated suicide with two comparison groups. RESULTS Within 24 months, 76 caregivers reported symptoms of a potential depression and were further assessed for suicidal thoughts. Nine carers (11.8%, 4.7% of the total sample) reported suicidal thoughts with three of those at multiple points. Caregivers with suicidal thoughts had more severe depressive and anxious symptoms, had a lower sense of competence and mastery, felt less happy and experienced more health problems, less family support and more feelings of loneliness than caregivers who had not. CONCLUSION Suicidal thoughts are present in dementia caregivers and can persist across the care trajectory. Various psychological and social characteristics significantly distinguish caregivers with suicidal thoughts from those without. More research is needed to enable the identification of high-risk caregivers and provide an evidence base for the development of preventive strategies and interventions. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.
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Affiliation(s)
- Karlijn J. Joling
- Amsterdam Public Health research instituteVU University Medical CentreAmsterdamThe Netherlands
| | - Siobhan T. O'Dwyer
- Amsterdam Public Health research instituteVU University Medical CentreAmsterdamThe Netherlands
| | - Cees M.P.M. Hertogh
- Amsterdam Public Health research instituteVU University Medical CentreAmsterdamThe Netherlands
| | - Hein P.J. van Hout
- Amsterdam Public Health research instituteVU University Medical CentreAmsterdamThe Netherlands
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Gerino E, Rollè L, Sechi C, Brustia P. Loneliness, Resilience, Mental Health, and Quality of Life in Old Age: A Structural Equation Model. Front Psychol 2017; 8:2003. [PMID: 29184526 PMCID: PMC5694593 DOI: 10.3389/fpsyg.2017.02003] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Accepted: 11/01/2017] [Indexed: 11/28/2022] Open
Abstract
Objectives: In the scientific literature on aging, a recent core issue has been the role of individuals' internal and external resources, which are considered intrinsically connected, in contributing synergistically to physical and psychological quality of life (QoL). The current study investigates the way in which psychological factors-such as, loneliness, resilience, and mental states, in terms of depression and anxiety symptoms-affect the perceived QoL among elderly individuals. Method: Data from 290 elderly Italian participants were used to study the mediation effects of both mental health and resilience to elucidate the relationship between loneliness and psychophysical QoL. Results: The best model we obtained supports the mediation effect of both resilience and mental health between loneliness and mental and physical QoL. These results highlight that loneliness influences mental and physical QoL via two pathways, with the impact of loneliness mediated by mental health and resilience dimensions. Conclusions: The findings suggest the importance of the support that elderly people receive from social relationships. In terms of clinical interventions, the reduction of loneliness could be an important factor in primary prevention or the recovery process. A way to reduce levels of mental distress could be represented by the increasing of resilience and self-efficacy and reduction of loneliness dissatisfaction. A high degree of resiliency contributes to increasing perceived life quality at the physical and psychological levels, and at the same time, reducing anxiety and depressive symptoms.
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Affiliation(s)
- Eva Gerino
- Department of Psychology, University of Turin, Turin, Italy
| | - Luca Rollè
- Department of Psychology, University of Turin, Turin, Italy
| | - Cristina Sechi
- Department of Pedagogy, Psychology, Philosophy, University of Cagliari, Cagliari, Italy
| | - Piera Brustia
- Department of Psychology, University of Turin, Turin, Italy
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Suicide and assisted dying in dementia: what we know and what we need to know. A narrative literature review. Int Psychogeriatr 2017; 29:1247-1259. [PMID: 28462742 DOI: 10.1017/s1041610217000679] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Evidence-based data on prevalence and risk factors of suicidal intentions and behavior in dementia are as scarce as the data on assisted dying. The present literature review aimed on summarizing the current knowledge and provides a critical discussion of the results. METHODS A systematic narrative literature review was performed using Medline, Cochrane Library, EMBASE, PSYNDEX, PSYCINFO, Sowiport, and Social Sciences Citation Index literature. RESULTS Dementia as a whole does not appear to be a risk factor for suicide completion. Nonetheless some subgroups of patients with dementia apparently have an increased risk for suicidal behavior, such as patients with psychiatric comorbidities (particularly depression) and of younger age. Furthermore, a recent diagnosis of dementia, semantic dementia, and previous suicide attempts most probably elevate the risk for suicidal intentions and behavior. The impact of other potential risk factors, such as patient's cognitive impairment profile, behavioral disturbances, social isolation, or a biomarker based presymptomatic diagnosis has not yet been investigated. Assisted dying in dementia is rare but numbers seem to increase in regions where it is legally permitted. CONCLUSION Most studies that had investigated the prevalence and risk factors for suicide in dementia had significant methodological limitations. Large prospective studies need to be conducted in order to evaluate risk factors for suicide and assisted suicide in patients with dementia and persons with very early or presymptomatic diagnoses of dementia. In clinical practice, known risk factors for suicide should be assessed in a standardized way so that appropriate action can be taken when necessary.
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Hunt B, Truran L, Reynolds F. “Like a drawing of breath”: leisure-based art-making as a source of respite and identity among older women caring for loved ones with dementia. Arts Health 2016. [DOI: 10.1080/17533015.2016.1247370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | - Lindsay Truran
- Barnet Psychiatric Liaison Team, Springwell Centre, Barnet, UK
| | - Frances Reynolds
- Division of Occupational Therapy, Brunel University London, Uxbridge, UK
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O'Dwyer ST, Moyle W, Taylor T, Creese J, Zimmer-Gembeck MJ. Homicidal ideation in family carers of people with dementia. Aging Ment Health 2016; 20:1174-1181. [PMID: 26189537 DOI: 10.1080/13607863.2015.1065793] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Family carers of people with dementia have higher than average rates of suicidal ideation, but there has been no research on homicidal ideation in this population. The aim of this study was to explore thoughts of homicide in family carers of people with dementia. METHOD A descriptive qualitative approach was taken. Twenty-one Australian carers (7 men, 14 women) participated in individual, in-depth interviews and the transcripts were analysed thematically. RESULTS Seven themes were identified in the data - active thoughts of homicide; understanding homicidal thoughts in others; passive thoughts of death; euthanasia; homicidal thoughts in other caregiving situations; abuse; and disclosing thoughts of harm. Two of the 21 participants had actively contemplated the homicide of their care recipient, four expressed a passive desire for the care recipient's death, and four reported physically or verbally abusing the care recipient. Only one carer had previously disclosed these experiences. CONCLUSION Homicidal ideation is a real and significant phenomenon among family carers of people with dementia. Service providers and health professionals are encouraged to identify and support carers contemplating homicide, but to do so in a way that recognises the broader social context of carer burden.
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Affiliation(s)
- Siobhan T O'Dwyer
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Australia
| | - Wendy Moyle
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Australia
| | - Tara Taylor
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Australia
| | - Jennifer Creese
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Australia
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Stanley IH, Hom MA, Rogers ML, Hagan CR, Joiner TE. Understanding suicide among older adults: a review of psychological and sociological theories of suicide. Aging Ment Health 2016; 20:113-22. [PMID: 25693646 DOI: 10.1080/13607863.2015.1012045] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Older adults die by suicide at a higher rate than any other age group in nearly every country globally. Suicide among older adults has been an intractable clinical and epidemiological problem for decades, due in part to an incomplete understanding of the causes of suicide, as well as imprecision in the prediction and prevention of suicidal thoughts and behaviors in later life. Theory-driven investigations hold promise in addressing these gaps by systematically identifying testable, and thus falsifiable, mechanisms that may better explain this phenomenon and also point to specific interventions. METHOD In this article, we comprehensively review key extant psychological and sociological theories of suicide and discuss each theory's applicability to the understanding and prevention of suicide among older adults. RESULTS Despite a modest number of theories of suicide, few have undergone extensive empirical investigation and scrutiny, and even fewer have been applied specifically to older adults. CONCLUSION To advance the science and contribute findings with a measurable clinical and public health impact, future research in this area, from conceptual to applied, must draw from and integrate theory.
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Affiliation(s)
- Ian H Stanley
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Melanie A Hom
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Megan L Rogers
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Christopher R Hagan
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
| | - Thomas E Joiner
- a Department of Psychology , Florida State University , Tallahassee , FL , USA
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Abstract
OBJECTIVE Two small studies have suggested that family carers of people with dementia may be a high-risk group for suicide. The objective of this study was to further explore the rate of suicidal ideation in a large sample of carers and identify psychosocial risk and protective factors. METHOD A cross-sectional survey was conducted with 566 family carers. The survey included measures of suicidality, self-efficacy, physical health, depression, anxiety, hopelessness, optimism, burden, coping strategies, and social support. RESULTS Sixteen percent of carers had contemplated suicide more than once in the previous year. There were univariate differences between suicidal and non-suicidal carers on self-efficacy, social support, coping, burden, depression, anxiety, hopelessness, optimism, reasons for living, and symptoms of dementia, as well as age and income management. In a multivariate model, age, depression, and reasons for living predicted suicidal ideation. In tests for mediation, satisfaction with social support and dysfunctional coping had indirect effects on suicidal ideation via depression. CONCLUSION Family carers of people with dementia have high rates of suicidal ideation, with depression a risk factor and increasing age and reasons for living as protective factors. Depression and reasons for living should be targeted in interventions to reduce suicide risk in dementia carers.
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Affiliation(s)
- Siobhan T O'Dwyer
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | - Wendy Moyle
- a Centre for Health Practice Innovation, Menzies Health Institute Queensland , Griffith University , Brisbane , Australia
| | | | - Diego De Leo
- c Australian Institute for Suicide Research and Prevention , Griffith University, Mt. Gravatt , Australia
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Griffiths PC, Whitney MK, Kovaleva M, Hepburn K. Development and Implementation of Tele-Savvy for Dementia Caregivers: A Department of Veterans Affairs Clinical Demonstration Project. THE GERONTOLOGIST 2015; 56:145-54. [DOI: 10.1093/geront/gnv123] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 07/10/2015] [Indexed: 11/14/2022] Open
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Lindauer A, Harvath TA. The Meanings Caregivers Ascribe to Dementia-Related Changes in Care Recipients: A Meta-Ethnography. Res Gerontol Nurs 2015; 8:39-48. [DOI: 10.3928/19404921-20141121-01] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 09/11/2014] [Indexed: 11/20/2022]
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Ervin K, Reid C. Service utilisation by carers of people with dementia in rural Victoria. Australas J Ageing 2014; 34:E1-6. [DOI: 10.1111/ajag.12162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Kaye Ervin
- Rural Health Academic Centre; University of Melbourne; Shepparton Victoria Australia
| | - Carol Reid
- Goulburn Valley Family Care; Shepparton Victoria Australia
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Ervin K, Pallant J, Reid C. Caregiver distress in dementia in rural Victoria. Australas J Ageing 2014; 34:235-40. [DOI: 10.1111/ajag.12158] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Kaye Ervin
- Rural Health Academic Centre; University of Melbourne; Melbourne Victoria Australia
| | - Julie Pallant
- Rural Health Academic Centre; University of Melbourne; Melbourne Victoria Australia
| | - Carol Reid
- Goulburn Valley Family Care; Melbourne Victoria Australia
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