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Marques MJ. The quality of family relationships in dementia: Mixed methods to unravel mixed feelings. DEMENTIA 2024; 23:210-233. [PMID: 38100191 PMCID: PMC10807244 DOI: 10.1177/14713012231220759] [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] [Indexed: 12/21/2023]
Abstract
Objective: Close relationships influence health and quality of life outcomes for people with dementia and their families. Yet, we know little on the role of different relationship domains with quantitative methods having proved to have limitations in this research field. We aimed to study these relationship domains over time, contrasting the views of people with dementia and their family carers, making use of both quantitative and qualitative approaches.Methods: A convergent mixed methods design was adopted, analysing longitudinal data (four time points over three years) from 66 dyads of Portuguese community-dwelling people with dementia and their primary carers, from the EU-Actifcare project sample. Quantitative assessments used sociodemographic and clinical variables, and Positive Affect Index scores, with descriptive and inferential analyses. Qualitative data, collected through individual and joint semi-structured interviews, were explored using thematic analysis.Results: Both quantitative and qualitative findings demonstrated that some domains of relationship quality are affected in different ways, with changes occurring at different stages. Some (e.g., 'communication') may even improve after initial decline. 'Closeness' was consistently altered over time, from carers' perspectives, and played an important protective role regarding institutionalisation. Overall, changes in the relationship quality were perceived differently by people with dementia and their carers, and these divergent perspectives often led to tension. Qualitative data revealed that 'mixed feelings' (ambivalence) involve complex experiences, arguably more difficult to manage than negative feelings alone. Furthermore, perceived informal support, particularly from the extended family, and receiving formal services' assistance, seemed to facilitate positive (re)appraisals of the relationship.Conclusions: A deeper understanding of relationship quality and its domains as dementia progresses may help tailoring interventions to tackle modifiable aspects of relationships, meeting the needs and cherishing the resources of dyads and families. Timely assessments could identify relationships at risk and need for support, including for alternative caring arrangements.
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Affiliation(s)
- Maria J. Marques
- Maria J. Marques, CHRC, NOVA Medical School, Faculdade de Ciências Médicas, Universidade NOVA de Lisboa, Campo Mártires da Pátria, 130, Lisbon 1169-056, Portugal.
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Park S, Jeong K, Lee S. A Study on the Longitudinal Relationship between Changes in Depression and Cognitive Function among Older Adults Living Alone. Healthcare (Basel) 2023; 11:2712. [PMID: 37893786 PMCID: PMC10606759 DOI: 10.3390/healthcare11202712] [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: 09/17/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND As South Korea faces unprecedented population aging, this longitudinal study examined the relationship between depression and cognitive function changes in older individuals living alone. METHODS The study used data from the Korean Longitudinal Study of Aging (KLoSA). A total of 1354 participants with data available over a period of at least three years, from 2016 (wave 1) to 2020 (wave 8), were included, and latent growth modeling (LGM) was used for analysis. RESULTS Depression levels increased gradually among older individuals living alone and cognitive function declined over time among older adults living alone. Moreover, higher initial depression levels were associated with lower initial cognitive function levels and a more rapid cognitive decline over time. Therefore, it is imperative that depression be addressed as a potential cause of cognitive impairment and dementia. Furthermore, rapid increases in depression corresponded to rapid declines in cognitive function, indicating the need for continuous monitoring and intervention in cases of escalating depression, as it may negatively affect cognitive abilities. CONCLUSIONS These findings highlight the complex interplay between depression and cognitive function among older individuals living alone. Policy support to encourage participation in these programs is crucial to enhance the well-being of this vulnerable population.
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Affiliation(s)
- Soyoung Park
- Department of Social Welfare, Semyung University, 65 Semyung-ro, Jecheon 27136, Republic of Korea;
| | - Kyuhyoung Jeong
- Department of Social Welfare, Semyung University, 65 Semyung-ro, Jecheon 27136, Republic of Korea;
| | - Seoyoon Lee
- Interdisciplinary Graduate Program in Social Welfare Policy, Yonsei University, 50 Yonsei-ro, Seodaemun-gu, Seoul 03722, Republic of Korea;
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Otaka Y, Kitamura S, Suzuki M, Maeda A, Kato C, Ito R, Hirano A, Okochi Y, Mizutani K, Yoshino H, Takechi H. EFFECTS OF REHABILITATION PROGRAM FOCUSED ON IMPROVING REAL-LIFE DAILY ACTIVITIES OF PATIENTS WITH MILD COGNITIVE IMPAIRMENTS OR DEMENTIA AND THEIR CAREGIVERS. JOURNAL OF REHABILITATION MEDICINE. CLINICAL COMMUNICATIONS 2023; 6:12293. [PMID: 37829668 PMCID: PMC10566518 DOI: 10.2340/jrmcc.v6.12293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/01/2023] [Indexed: 10/14/2023]
Abstract
Objective To evaluate the effectiveness of a dyadic outpatient rehabilitation program focused on improving the real-life daily activities of patients with mild cognitive impairments or dementia and their caregivers. Design Retrospective study. Subjects Eight patients with mild cognitive impairments or dementia and their caregivers. Methods The rehabilitation program comprised eight 1-hour sessions by occupational therapists with patients and his/her caregivers. Patients were assessed for motor function, cognitive function, and quality of life, and their caregivers were assessed for depression and caregiver burden. Participants were assessed at pre-program and post-program, and 3-month follow-up. Results The scores of caregiver-assessed Quality of life in Alzheimer's disease scale in patients significantly improved at post-program (median [interquartile range], 30.0 [7.0]) compared with pre-program (27.0 [2.8], effect size = 0.77, p = 0.029). In caregivers, the Zarit Caregiver Burden Interview scores decreased significantly at post-program (16.5 [13.0]) compared with pre-program (22.0 [17.5], effect size = 0.72, p = 0.042). There were no significant differences in other assessments. Conclusions The rehabilitation program focused on real daily activities and demonstrated to improve patients' quality of life and caregivers' depression and caring burden through patient-caregiver interaction. Future enhanced follow-up systems are warranted.
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Affiliation(s)
- Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine
| | - Shin Kitamura
- Department of Rehabilitation Medicine I, School of Medicine
- Faculty of Rehabilitation, School of Health Sciences
| | - Megumi Suzuki
- Faculty of Rehabilitation, School of Health Sciences
| | - Akiko Maeda
- Faculty of Rehabilitation, School of Health Sciences
| | - Chinami Kato
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Rena Ito
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Asuka Hirano
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Yuki Okochi
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Koji Mizutani
- Department of Rehabilitation, Fujita Health University Hospital, Aichi, Japan
| | - Hiroshi Yoshino
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Aichi, Japan
| | - Hajime Takechi
- Department of Geriatrics and Cognitive Disorders, School of Medicine, Fujita Health University, Aichi, Japan
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Nursing Staff's Observations of BPSD Amongst Older Adults with Dementia Living in a Nursing Home: A Qualitative Study. NURSING REPORTS 2023; 13:166-178. [PMID: 36810269 PMCID: PMC9944852 DOI: 10.3390/nursrep13010018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/16/2023] [Accepted: 01/26/2023] [Indexed: 02/04/2023] Open
Abstract
The majority of older adults with dementia living in a nursing home exhibit behavioral and psychological symptoms of dementia (BPSD). This behavior is difficult for residents to cope with. Early recognition of BPSD is important in order to implement personalized integrated treatment, and nursing staff are in the unique position to consistently observe residents' behavior. The aim of this study was to explore nursing staff's experiences observing BPSD of nursing home residents with dementia. A generic qualitative design was chosen. Twelve semi-structured interviews were conducted with nursing staff members until data saturation. Data were analyzed using inductive thematic analysis. Four themes were identified: "group harmony" observations from a group perspective, focused on the disturbance of group harmony; an "intuitive approach", which involves observing unconsciously and without a set method; "reactive intervention", which refers to immediate removal of observed triggers without exploring the causes of behaviors; and "sharing information", which is delayed sharing of observed behavior with other disciplines. The current way in which nursing staff observe BPSD and share observations within the multidisciplinary team explain several existing barriers to achieving high treatment fidelity for BPSD with personalized integrated treatment. Therefore, nursing staff must be educated to structure their daily observations methodologically and interprofessional collaboration improved to share their information in a timely manner.
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Marques MJ, Tan EYL, Woods B, Jelley H, Kerpershoek L, Hopper L, Irving K, Bieber A, Stephan A, Sköldunger A, Sjölund BM, Selbaek G, Røsvik J, Zanetti O, Portolani DM, Marôco J, de Vugt M, Verhey F, Gonçalves-Pereira M. Trajectories of relationship quality in dementia: a longitudinal study in eight European countries. Aging Ment Health 2022; 26:2307-2315. [PMID: 34486887 DOI: 10.1080/13607863.2021.1969641] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVES Relationship quality (RQ) between a person with dementia and a family carer may influence their health and quality of life. However, evidence regarding its course and influencing factors is limited. We aimed to explore RQ trajectories in dementia, and identify predictors of change. METHODS We analysed longitudinal data from a cohort of 350 community-dwelling people with dementia and their informal carers, participating in the Actifcare study in eight European countries. The Positive Affect Index, rated separately by both people with dementia and their carers, assessed RQ. Other measures included the Neuropsychiatric Inventory Questionnaire (regarding persons with dementia), and the Relative Stress Scale, Sense of Coherence Scale and Lubben Social Network Scale (for carers). Trajectories and influencing factors were explored applying a latent growth model (LGM). RESULTS RQ in the group of carers declined over 1 year, but RQ scores for the persons with dementia did not change. Higher stress in carers negatively influenced their baseline RQ ratings. Carer sense of coherence and being a spouse were associated with more positive baseline RQ carer assessments. Higher levels of neuropsychiatric symptoms were linked to decline in carers' RQ, whereas social support was associated with more positive RQ trajectories. CONCLUSION This study provides a valuable insight into the course of RQ. LGM proved useful to explore the factors that influence RQ trajectories and variability within- and between-persons. Our findings emphasise the importance of carer-perceived social support and sense of coherence, and of reducing neuropsychiatric symptoms, in maintaining a good RQ.
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Affiliation(s)
- Maria J Marques
- Comprehensive Health Research Center (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
| | - Eva Y L Tan
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands.,Reinier van Arkel Mental Health Institute, 's-Hertogenbosch, The Netherlands
| | - Bob Woods
- Dementia Services Development Centre (DSDC) Wales, School of Health Sciences, Bangor University, Bangor, UK
| | - Hannah Jelley
- Dementia Services Development Centre (DSDC) Wales, School of Health Sciences, Bangor University, Bangor, UK
| | - Liselot Kerpershoek
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Louise Hopper
- School of Psychology, Dublin City University, Dublin, Ireland
| | - Kate Irving
- School of Nursing, Psychotherapy and Community Health, Dublin City University, Dublin, Ireland
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anders Sköldunger
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Britt-Marie Sjölund
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg; Department of Geriatric Medicine, Oslo University Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg; Department of Geriatric Medicine, Oslo University Hospital, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Orazio Zanetti
- Alzheimer's Research Unit-Memory Clinic, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | | | - João Marôco
- William James Center for Research, Instituto Superior de Psicologia Aplicada - Instituto Universitário (ISPA-IU), Lisboa, Portugal
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology and Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, The Netherlands
| | - Manuel Gonçalves-Pereira
- Comprehensive Health Research Center (CHRC), CEDOC, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa, Portugal
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Montañés P, Lacalle M, Carbonero D, Manzano-García G. Burden Predictors for Informal Caregivers of Older Adults in Spain: The Role of Cohabitation, Coping Strategies, Social Support, and Evaluation of Preexisting Relationships. HEALTH & SOCIAL WORK 2022; 47:284-291. [PMID: 36102835 DOI: 10.1093/hsw/hlac021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/20/2021] [Accepted: 09/15/2021] [Indexed: 06/15/2023]
Abstract
Given the role that informal caregivers play in caring for older adults and the importance of understanding the variables that may predict the burden that they experience due to caregiving, the aim of this article is to examine the relationship between different variables and the caregiver's subjective burden. Authors examined the relationship between caregivers' sociodemographic characteristics (age and gender), the context in which the care is provided (cohabiting or not), duty as a reason for taking on the role of caregiver, the evaluation of the preexisting relationship between caregiver and care recipient, as well as coping strategies and social support as predictor variables of subjective burden. For this purpose, 161 caregivers of older Spanish adults completed a questionnaire containing information on the corresponding variables. The results indicate that people cohabiting with care recipients experience a greater subjective burden than those who live apart. The caregiver's evaluation of their preexisting relationship with the care recipient and perceived family support negatively predicts the subjective burden, while maladaptive coping strategies positively predict it. These results underline the importance of considering these variables in caregiver support programs.
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Affiliation(s)
- Pilar Montañés
- PhD, is associate professor; Faculty of Legal and Social Sciences, University of La Rioja, Logroño, Spain
| | - María Lacalle
- MSW, is a social worker; Faculty of Legal and Social Sciences, University of La Rioja, Logroño, Spain
| | - Domingo Carbonero
- PhD, Faculty of Legal and Social Sciences, University of La Rioja, Logroño, Spain
| | - Guadalupe Manzano-García
- PhD, are associate professors, Faculty of Legal and Social Sciences, University of La Rioja, Logroño, Spain
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Intergenerational family relationships and the impact of behavioural variant frontotemporal dementia (bvFTD): a qualitative longitudinal study. AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x22001088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Research concerning the reciprocal influence of relationships and dementia largely focuses on dyadic relationships despite evidence that whole families are affected. Furthermore, such research generally considers more common forms of dementia such as Alzheimer's disease. Behavioural variant fronto-temporal dementia (bvFTD) primarily although not exclusively affects people below the age of 65 and is distinctly different in its impact from more common forms of dementia, affecting social cognition and therefore relational functioning. We aimed to develop a detailed understanding of intergenerational family experiences of bvFTD over time. We adopted a social constructivist and pluralist approach, using Narrative Thematic Analysis and Grounded Theory. We interviewed seven families in their own homes, including the person with bvFTD, at up to three time-points every six to nine months from 2012 to 2014, resulting in 46 interviews with 19 family members. Three super-ordinate themes were identified: Theme 1: We before bvFTD: cohesive and connected – disconnected and distant; Theme 2: Challenges experienced by us; and Theme 3: Relational outcomes: a changing we – an entrenched we. Results emphasise bvFTD brought early and significant disruption to family relationships. The interplay of prior relational functioning, involving the nature of the relationship for family members, the specific impact of bvFTD on these relationships and family member's understanding of bvFTD was critical to how each family fared over the duration of the research, and the relational outcomes they experienced. These findings suggest health-care practice could enhance its support for families living with bvFTD, through the development of tailored, family-oriented approaches to assessment and practice. Such approaches are necessary to understand how families work together and identify interventions that address the family-specific challenges bvFTD brings. The provision of tailored, relational-focused and specialised information concerning the experience of living with bvFTD is needed to flexibly address families' needs and expectations.
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van den Broek B, Rijnen S, Stiekema A, van Heugten C, Bus B. Factors related to the quality and stability of partner relationships after traumatic brain injury: A systematic literature review. Arch Phys Med Rehabil 2022; 103:2219-2231.e9. [PMID: 35395254 DOI: 10.1016/j.apmr.2022.02.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/22/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The latest literature review on partner relationships following traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted significant knowledge gaps. The current review updates and expands on this work by providing an overview of the current state of knowledge on factors related to relationship quality and stability following TBI. DATA SOURCES CINAHL, Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on April 23, 2020, for literature on factors associated with 1)relationship quality and 2)relationship stability following TBI. STUDY SELECTION English quantitative and qualitative studies investigating factors associated with relationship quality and/or stability following TBI were included. Two reviewers independently assessed eligibility. If consensus was not reached, a third reviewer's conclusion was decisive. Forty-three studies were included. DATA EXTRACTION Information regarding study objectives and characteristics, participant demographics, (in)dependent variables, and main findings was extracted. Study quality was rated using the JBI Checklist for Analytical Cross Sectional Studies and/or the CASP Checklist for Qualitative Research. Both were performed by the lead reviewer and checked by the second reviewer. DATA SYNTHESIS Thirty-eight factors related to relationship quality and/or stability were identified, covering injury characteristics (e.g., severity), body functions (e.g., personality changes), activities (e.g., communication), participation (e.g., social dependence), environment (e.g., children), and personal factors (e.g., coping strategies). CONCLUSIONS Relationship quality and stability following TBI are found to be related to a multitude of factors, including newly identified factors such as personality changes and dependence. Future research may wish to quantitatively investigate factors thus far only identified in qualitative research, explore possible positive effects of TBI on relationships, study the experiences of same-sex couples, and include the perspectives of both partners with and without the injury.
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Affiliation(s)
- Brenda van den Broek
- Multidisciplinary Specialist Centre for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands; School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands; Limburg Brain Injury Centre, Maastricht, the Netherlands.
| | - Sophie Rijnen
- Multidisciplinary Specialist Centre for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands; Limburg Brain Injury Centre, Maastricht, the Netherlands
| | - Annemarie Stiekema
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands; Limburg Brain Injury Centre, Maastricht, the Netherlands
| | - Caroline van Heugten
- School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands; Limburg Brain Injury Centre, Maastricht, the Netherlands; Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Boudewijn Bus
- Multidisciplinary Specialist Centre for Brain Injury and Neuropsychiatry, GGZ Oost Brabant, Boekel, the Netherlands; Limburg Brain Injury Centre, Maastricht, the Netherlands
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Lewis MA, Riley GA. Are spousal carers’ perceptions of continuity and discontinuity within the relationship influenced by the symptoms of dementia? DEMENTIA 2021; 20:2294-2306. [PMID: 34724844 PMCID: PMC8564249 DOI: 10.1177/1471301221994311] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Some spousal carers experience their current relationship with the person with
dementia as a continuation of the loving relationship they shared prior to the
onset of dementia. For others, the experience is one of discontinuity; the prior
relationship is lost and replaced with a different kind of relationship. The aim
of this study was to investigate whether these differences are associated with
particular symptoms of dementia. Thirty-five spousal carers completed the
Birmingham Relationship Continuity Measure, the
Revised Memory and Behavior Checklist (providing scores
relating to cognitive decline, depression and challenging interpersonal
behaviour), the Communicative Effectiveness Index and the
Bristol Activities of Daily Living Scale. Experiencing
discontinuity in the relationship was significantly correlated with
communication difficulties, challenging interpersonal behaviour and the need for
assistance in activities of daily living, but not with cognitive decline or
depression. In a multiple regression, only the measures of challenging
interpersonal behaviour and activities of daily living made significant unique
contributions to the variance in continuity/discontinuity scores. Discontinuity
is associated with reduced psychological well-being for the spousal carer and
the provision of less person-centred care. Understanding which symptoms are more
likely to lead to discontinuity allows the identification of those at risk of
these experiences. Those at risk may require support to enable them to make
sense of, and adjust to, certain symptoms of dementia in a way that has a less
negative impact on their relationship.
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Affiliation(s)
- Meryl A Lewis
- Centre for Applied Psychology, University of Birmingham, Birmingham, UK
| | - Gerard A Riley
- Centre for Applied Psychology, University of Birmingham, Birmingham, UK
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Lester EG, Silverman IH, Gates MV, Lin A, Vranceanu AM. Associations Between Gender, Resiliency Factors, and Anxiety in Neuro-ICU Caregivers: a Prospective Study. Int J Behav Med 2020; 27:677-686. [PMID: 32488793 DOI: 10.1007/s12529-020-09907-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Informal caregivers of patients admitted to the neuroscience intensive care unit (Neuro-ICU) are at risk for developing chronic anxiety. Resiliency factors may reduce risk, yet their differential effects for female and male caregivers have not been studied in this population. We aim to examine interactions between gender and baseline resiliency factors and anxiety at baseline, 3 months, and 6 months. METHOD Prospectively studied caregivers (N = 96) of patients admitted to the Neuro-ICU completed baseline sociodemographics and resiliency measures (coping, mindfulness, self-efficacy, intimate care, and caregiver preparedness), and anxiety severity at baseline (hospitalization), 3 months, and 6 months. RESULTS Baseline anxiety predicted future anxiety (3 and 6 months). Caregivers who reported high (versus low) baseline coping, mindfulness, self-efficacy, and preparedness for caregiving reported lower baseline anxiety (ps ≤ 0.012). An interaction between caregiver gender and baseline mindfulness was seen at 3 months (p = 0.021), with high mindfulness males reporting lower anxiety than high mindfulness females, and low mindfulness males reporting higher anxiety than low mindfulness females. CONCLUSION Results emphasize the protective role of resilience in the trajectory of anxiety among informal caregivers. Findings emphasize the need to rapidly deploy skills-based treatment to Neuro-ICU caregivers to prevent future development and maintenance of anxiety, specifically emphasizing mindfulness in male caregivers.
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Affiliation(s)
- Ethan G Lester
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA.,Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Ilyssa H Silverman
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA
| | - Melissa V Gates
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA
| | - Ann Lin
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA
| | - Ana-Maria Vranceanu
- Integrated Brain Health Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, One Bowdoin Square, 1st Floor, Suite 100, Boston, MA, 02114, USA. .,Neuroscience Intensive Care Unit, Massachusetts General Hospital, Boston, MA, USA. .,Harvard Medical School, Boston, MA, USA.
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Rippon I, Quinn C, Martyr A, Morris R, Nelis SM, Jones IR, Victor CR, Clare L. The impact of relationship quality on life satisfaction and well-being in dementia caregiving dyads: findings from the IDEAL study. Aging Ment Health 2020; 24:1411-1420. [PMID: 31140291 DOI: 10.1080/13607863.2019.1617238] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Objectives: The quality of the relationship between people with dementia and their informal caregiver maybe an important determinant of life satisfaction and well-being for both members of the dyad. Taking a dyadic perspective, the aim of this study was to examine whether self- and partner-rated relationship quality influences life satisfaction and well-being for both people with dementia and their caregivers.Design and methods: Using data from 1283 dyads in the Improving the Experience of Dementia and Enhancing Active Life (IDEAL) cohort, we examined the impact of current relationship quality on life satisfaction and well-being in dementia caregiving dyads. Data were analysed using the Actor-Partner Interdependence Model (APIM) framework.Results: Self-rated relationship quality was associated with own life satisfaction and well-being for both people with dementia and caregivers. Partner-rated relationship quality did not influence own life satisfaction or well-being for either member of the dyad.Conclusion: This study is the first to use the APIM framework to explore the dyadic associations between relationship quality and life satisfaction and well-being in a large cohort of dementia caregiving dyads. The obtained findings suggest that the individual perception of the quality of the caregiving relationship held by each member of the caregiving dyad is an important factor for that member's life satisfaction and well-being, while the partner's perception of relationship quality is not. The findings highlight the importance of considering the individual perspective of both the person with dementia and the caregiver and enabling each to maintain positive perceptions of relationship quality.
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Affiliation(s)
- Isla Rippon
- College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Catherine Quinn
- The Centre for Applied Dementia Studies, University of Bradford, Bradford, UK.,REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Robin Morris
- Department of Psychology, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Sharon M Nelis
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - Ian Rees Jones
- Wales Institute for Social and Economic Research, Data and Methods, Cardiff University, Cardiff, UK
| | - Christina R Victor
- College of Health and Life Sciences, Brunel University London, Uxbridge, UK
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
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Mortazavizadeh Z, Maercker A, Roth T, Savaskan E, Forstmeier S. Quality of the caregiving relationship and quality of life in mild Alzheimer's dementia. Psychogeriatrics 2020; 20:568-577. [PMID: 32219988 DOI: 10.1111/psyg.12546] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 02/13/2020] [Accepted: 03/03/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND The present study aims to investigate the quality of the dyadic relationship between mild Alzheimer patients and their caregivers. The main objective is to evaluate the consistency, agreement and validity of the German version of the Scale for Quality of the Current Relationship in Caregiving (SQCRC). The secondary objective was to examine the association of relationship quality with quality of life (QOL) in patients with mild Alzheimer's disease (AD) and their caregivers. METHODS In this study, a sample of 50 patients diagnosed with mild AD and their primary caregivers were included. Participants underwent a full neuropsychological evaluation. The quality of the relationship between persons with AD and their caregivers was assessed using the SQCRC. Furthermore, other scales of relationship quality, well-being of the person with AD, and well-being of the caregiver were used. RESULTS The results showed that the SQCRC has a good internal consistency and high validity. Also, relationship quality as rated by the AD patients (r = 0.37, P < 0.1) and their caregivers (r = 0.51, P < 0.1) was significantly correlated with QOL. CONCLUSIONS The findings suggest that many persons with mild AD can rate their relationship quality and that the patient's self-rated relationship quality is a substantial predictor of their QOL.
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Affiliation(s)
- Zeinab Mortazavizadeh
- Developmental Psychology and Clinical Psychology of the Lifespan, Institute of Psychology, University of Siegen, Siegen, Germany
| | - Andreas Maercker
- Psychopathology and Clinical Interventions, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Tanja Roth
- Clinical Psychology and Psychotherapy Research, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Egemen Savaskan
- Department of Gerontopsychiatry, Psychiatric University Hospital, University of Zurich, Zurich, Switzerland
| | - Simon Forstmeier
- Developmental Psychology and Clinical Psychology of the Lifespan, Institute of Psychology, University of Siegen, Siegen, Germany
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Clarke C, Woods B, Moniz-Cook E, Mountain G, Øksnebjerg L, Chattat R, Diaz A, Gove D, Vernooij-Dassen M, Wolverson E. Measuring the well-being of people with dementia: a conceptual scoping review. Health Qual Life Outcomes 2020; 18:249. [PMID: 32709238 PMCID: PMC7382062 DOI: 10.1186/s12955-020-01440-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 06/05/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Enabling people with dementia to 'live well' is a policy and research priority in many countries. However, instruments for measuring outcomes of psychosocial interventions designed to promote well-being in dementia are often derived from a symptom-focused, loss/deficit approach, or from broad quality of life concepts. A pan-European dementia working group called for research on the development of an alternative asset/strengths-based conceptual framework of well-being in dementia. This paper takes forward this recommendation by developing such a framework and using this to map relevant self-report outcome measures. METHODS Three scoping reviews of published studies were conducted iteratively. First, we examined the literature on lived experiences of well-being and quality of life in people with dementia and then the wider dementia literature for application of well-being constructs. The synthesised findings generated conceptual domains of well-being in people with dementia. Corresponding self-report instruments used in dementia research were scoped, categorised within the conceptual framework and their potential value in measuring outcomes for people with dementia was examined. FINDINGS Six conceptual domains for the measurement of well-being and 35 self-report instruments that have been used with people with dementia were identified. Six instruments were developed specifically for people with dementia, five were derived from the gerontological literature and 24 from the well-being literature. Fifteen instruments and one sub-scale have been examined for psychometric properties amongst people with dementia. To date, 20 have been used as outcome measures, with seven measuring change over time. A number of identified instruments utilise traditional retrospective Likert-scaling response formats, limiting their potential for use with some groups of people with dementia. CONCLUSION An assets/strengths-based framework is presented, outlining structural domains for selecting self-report measures of well-being in people with dementia. It provides a foundation for enhancing research into processes and outcomes of psychosocial interventions, including instrument development, more precise matching of intervention aims with outcome measurement, and newer technology-based 'in-the-moment' measurement.
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Affiliation(s)
- Chris Clarke
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
| | - Bob Woods
- DSDC Wales, Bangor University, Ardudwy, Holyhead Road, Bangor, Gwynedd LL57 2PZ UK
| | - Esme Moniz-Cook
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
| | - Gail Mountain
- School of Dementia Studies, University of Bradford, Richmond Rd, Bradford, BD7 1DP UK
| | - Laila Øksnebjerg
- Danish Dementia Research Centre, Rigshospitalet, University of Copenhagen, Section 6922, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Rabih Chattat
- Department of Psychology Università di Bologna - Via Zamboni, 33 - 40126 Bologna, Italy
| | - Ana Diaz
- Alzheimer Europe, L-1417 14, rue Dicks, Luxembourg
| | - Dianne Gove
- Alzheimer Europe, L-1417 14, rue Dicks, Luxembourg
| | - Myrra Vernooij-Dassen
- Radboud University Medical Centre, Scientific Center for Quality of Healthcare, IQ Healthcare 114, PO Box 9101, 6500HB Nijmegen, The Netherlands
| | - Emma Wolverson
- Faculty of Health Sciences, University of Hull, Hull, HU6 7RX UK
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Maltby J, Hogervorst E, Stephan B, Sun X, Tang P, Law E, Mukaetova-Ladinska EB. The Development of a Quality of Life Scale for Informal Carers for Older Adults. Gerontol Geriatr Med 2020; 6:2333721420920424. [PMID: 32490040 PMCID: PMC7238784 DOI: 10.1177/2333721420920424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 03/11/2020] [Accepted: 03/23/2020] [Indexed: 11/24/2022] Open
Abstract
Background: The aim of the study was to develop a multidimensional quality of life instrument suitable for use among individuals across cultures who have an informal care role for older persons. Methods: Participants were informal carers of older adults in the United Kingdom (n = 308), United States (n = 164), and China (n = 131). We carried out exploratory and confirmatory factor analyses of 61 items derived from the eight-factor Adult Carers Quality of Life Questionnaire with newly added items to define both traditional and nontraditional informal care roles. Results: Findings suggest a 24-item quality of life scale with a six-factor structure to caring for older adults that assesses (a) exhaustion, (b) adoption of a traditional carer role, (c) personal growth, (d) management and performance, (e) level of support, and (f) financial matters. Conclusion: We present a new scale to assess the multidimensional aspects of quality of life among those caring for older adults.
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Affiliation(s)
| | | | | | - Xu Sun
- University of Nottingham Ningbo China, China
| | - Pinyan Tang
- University of Nottingham Ningbo China, China
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15
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Marques MJ, Woods B, Hopper L, Jelley H, Irving K, Kerpershoek L, Meyer G, Bieber A, Stephan A, Sköldunger A, Sjölund BM, Selbaek G, Rosvik J, Zanetti O, Portolani E, de Vugt M, Verhey F, Gonçalves-Pereira M. Relationship quality and sense of coherence in dementia: Results of a European cohort study. Int J Geriatr Psychiatry 2019; 34:745-755. [PMID: 30729572 DOI: 10.1002/gps.5082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/03/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives. METHODS Cross-sectional data were used from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC). RESULTS Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress, and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia, and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and discrepancies was carer stress (negative feelings subscore). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two. CONCLUSIONS In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
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Affiliation(s)
- Maria J Marques
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Bob Woods
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Liselot Kerpershoek
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anders Sköldunger
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Britt-Marie Sjölund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Janne Rosvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Portolani
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Manuel Gonçalves-Pereira
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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16
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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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17
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Clark IN, Tamplin JD, Baker FA. Community-Dwelling People Living With Dementia and Their Family Caregivers Experience Enhanced Relationships and Feelings of Well-Being Following Therapeutic Group Singing: A Qualitative Thematic Analysis. Front Psychol 2018; 9:1332. [PMID: 30104994 PMCID: PMC6077620 DOI: 10.3389/fpsyg.2018.01332] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2017] [Accepted: 07/11/2018] [Indexed: 11/13/2022] Open
Abstract
The progression of dementia can severely compromise interpersonal connection and relationship quality between people living with dementia (PwD) and their family caregivers (FCG), leading to social isolation and poor quality of life for both. Therapeutic group singing (TGS) is a socially engaging, stimulating, and supportive pursuit that community-dwelling PwD and their FCG can participate in together. This study aimed to build on the findings from previous research by undertaking a thematic analysis of interviews with nine PwD (five women, four men; mean age = 79.1 years) and nine FCG (five women, four men; mean age = 75.7 years). The interviews explored participants’ perspectives and experiences of a 20-week TGS intervention, underpinned by Kitwood’s model of person-centered care. Inductive thematic analysis resulted in the emergence of five themes which described how TGS for PwD and their FCG: (1) included supportive therapeutic facilitation and design features; (2) made group singing more accessible; (3) fostered new empathic friendships; (4) enhanced relationships between PwD and FCG; and (5) led to personal feelings of wellbeing for both PwD and FCG. Affinity with others who had similar life experiences and challenges created a sense of mutual understanding and camaraderie, which made group singing accessible without fear of judgment and social stigmas. For some PwD/FCG dyads, TGS meant they could continue a lifelong passion for singing together, while others enjoyed participating in singing together for the first time. Both PwD and FCG participants described personal feelings of acceptance, improved social confidence, mood, and purpose. Further, participants valued mental stimulation from TGS such as learning new skills and memory support. A model explaining relationships between themes suggests that TGS with person-centered facilitation features for PwD/FCG dyads led to affinity among group members with ripple effects, which enhanced accessibility to group singing, the formation of empathic friendships, PwD/FCG relationship quality, and personal wellbeing for both PwD and FCG. Psychoemotional, social and cognitive benefits from TGS described by participants in this study are known to promote self-identity, healthy relationships, and quality of life. This research highlights a need for improved availability of TGS for community-dwelling PwD/FCG dyads.
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Affiliation(s)
- Imogen N Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Jeanette D Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
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18
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Quinlan E, Deane FP, Crowe T. Pilot of an acceptance and commitment therapy and schema group intervention for mental health carer's interpersonal problems. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.06.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Daley RT, Sugarman MA, Shirk SD, O'Connor MK. Spared emotional perception in patients with Alzheimer's disease is associated with negative caregiver outcomes. Aging Ment Health 2018; 22:595-602. [PMID: 28282729 DOI: 10.1080/13607863.2017.1286457] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Caregivers (CGs) for patients with Alzheimer's disease (AD) often experience negative mental health and relationship outcomes. Additionally, emotional perception abilities are often compromised in early AD; the relationships between these deficits and CG outcomes are unclear. The present study investigated the relationship between emotional perception abilities in AD participants and CG well-being. METHODS Participants included 28 individuals with AD, their spousal CGs, and 30 older controls (OCs). Patients and controls completed the Montreal Cognitive Assessment and Advanced Clinical Solutions: Social Perception subtest. CGs completed questionnaires related to relationship satisfaction, burden, depression, and patient neuropsychiatric symptoms and activities of daily living. RESULTS The patient group performed significantly worse than OCs on measures of cognition and emotional perception. Several significant relationships emerged between AD participant emotional perception and CG outcomes. Higher CG depression was associated with greater overall emotional perception abilities (r = .39, p = .041). Caregiver burden was positively correlated with AD participants' ability to label the emotional tones of voices (r = .47, p = .015). Relationship satisfaction was not significantly correlated with emotional perception. DISCUSSION This study replicated earlier findings of impaired emotional perception abilities in AD participants. However, preserved abilities in emotional perception were associated greater CG depression and burden. Interestingly, the CGs satisfaction with the marital relationship did not appear to be influenced by changes in emotional perception. Higher emotional engagement among couples in which one spouse has cognitive impairment may contribute to increased negative interactions and in turn a greater sense of burden and depression, while leaving the marital relationship preserved.
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Affiliation(s)
- Ryan T Daley
- a Psychology Department , Edith Nourse Rogers Memorial Bedford VAMC , Bedford , MA 01730 , USA
| | - Michael A Sugarman
- a Psychology Department , Edith Nourse Rogers Memorial Bedford VAMC , Bedford , MA 01730 , USA
| | - Steven D Shirk
- a Psychology Department , Edith Nourse Rogers Memorial Bedford VAMC , Bedford , MA 01730 , USA
| | - Maureen K O'Connor
- a Psychology Department , Edith Nourse Rogers Memorial Bedford VAMC , Bedford , MA 01730 , USA
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20
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Quinlan E, Deane FP, Crowe T, Caputi P. Do attachment anxiety and hostility mediate the relationship between experiential avoidance and interpersonal problems in mental health carers? JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2018. [DOI: 10.1016/j.jcbs.2018.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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21
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Defining and measuring irritability: Construct clarification and differentiation. Clin Psychol Rev 2017; 53:93-108. [DOI: 10.1016/j.cpr.2017.01.009] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 12/23/2016] [Accepted: 01/30/2017] [Indexed: 11/22/2022]
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22
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Laver K, Milte R, Dyer S, Crotty M. A Systematic Review and Meta-Analysis Comparing Carer Focused and Dyadic Multicomponent Interventions for Carers of People With Dementia. J Aging Health 2016; 29:1308-1349. [PMID: 27458254 PMCID: PMC5680909 DOI: 10.1177/0898264316660414] [Citation(s) in RCA: 71] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Objective: The aim of this study was to compare the efficacy of two approaches: multicomponent interventions that focus on working with the carer and dyadic interventions that work with both the carer and the person with dementia. Method: A systematic review involving a search of Medline, EMBASE, and PsycINFO in October 2015 was performed. Randomized controlled trials involving carers of people with dementia and comparing multicomponent interventions with usual care were included. Results: Pooling of all studies demonstrated that multicomponent interventions can reduce depressive symptoms, improve quality of life, reduce carer impact, and reduce behavioral and psychological symptoms of dementia as well as caregiver upset with these symptoms. We were unable to find a significant difference in the effects of dyadic interventions in comparison with carer focused interventions for these outcomes. Discussion: Although effect sizes associated with intervention are small, multicomponent interventions are relatively inexpensive to deliver, acceptable, and widely applicable.
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Affiliation(s)
- Kate Laver
- 1 Flinders University, Adelaide, South Australia, Australia.,2 NHMRC Cognitive Decline Partnership Centre, Australia
| | - Rachel Milte
- 1 Flinders University, Adelaide, South Australia, Australia.,2 NHMRC Cognitive Decline Partnership Centre, Australia
| | - Suzanne Dyer
- 1 Flinders University, Adelaide, South Australia, Australia.,2 NHMRC Cognitive Decline Partnership Centre, Australia
| | - Maria Crotty
- 1 Flinders University, Adelaide, South Australia, Australia.,2 NHMRC Cognitive Decline Partnership Centre, Australia
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