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Gorenko J, McDowell C, Tamburri N, Dujela C, Smith AP, Sheets DJ, MacDonald SWS. Social and leisure engagement moderates the association between care partner distress and cognitive status of care recipients with dementia. J Clin Exp Neuropsychol 2024:1-13. [PMID: 39373013 DOI: 10.1080/13803395.2024.2406586] [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: 12/18/2023] [Accepted: 09/12/2024] [Indexed: 10/08/2024]
Abstract
OBJECTIVES Despite the established impact of care recipient cognitive impairment on care partner (CP) distress, limited quantitative research has explored how social and leisure engagement may moderate this relationship, offering a potential avenue for enhancing well-being in both care partners and recipients. The current study therefore examined the between- and within-dyad associations between cognitive impairment of persons with dementia (PwD) and their family CP's distress, and whether social and leisure activity moderated this relationship. METHODS Data were utilized from dyads (PwD, n = 33, and their CPs, n = 34) engaged in the Voices in Motion project, a social-cognitive choral intervention for PwD and their family CPs. Measures indexing PwD cognitive status, CP distress, and PwD and CP social and leisure engagement were assessed using an intensive repeated-measures burst design, with multilevel models of change employed to disaggregate between- and within-person effects. RESULTS Diminished cognitive functioning in PwD was associated with increased CP distress (p < 0.01) between-dyads; however, this relationship was not significant within-dyads. The between-dyad association was significantly moderated by the extent of social and leisure engagement of both CPs (p < .001) and PwD (p = .04). Follow-up simple slopes demonstrated that, at mean- and high-levels (+1SD) of social and leisure engagement for PwD and/or CP, increased PwD cognitive function significantly predicted lower CP distress. CONCLUSION The significant moderating influence of social and leisure engagement of dyads underscores the protective role of such engagement for reducing care-related distress. Activity engagement for CPs and PwD may help modulate the deleterious impact of PwD cognitive impairment and attenuate CP distress. These findings highlight the potential for dyadic interventions that promote social and leisure activities to mitigate caregiving challenges and enhance quality of life for both CPs and PwD.
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Affiliation(s)
- Julie Gorenko
- Department of Psychology, University of Calgary, Calgary, Canada
| | - Cynthia McDowell
- Department of Psychology, University of Victoria, Victoria, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
| | | | - Carren Dujela
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
| | - André P Smith
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
- Department of Sociology, University of Victoria, Victoria, Canada
| | - Debra J Sheets
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
- School of Nursing, University of Victoria, Victoria, Canada
| | - Stuart W S MacDonald
- Department of Psychology, University of Victoria, Victoria, Canada
- Institute on Aging and Lifelong Health, University of Victoria, Victoria, Canada
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2
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Kim B, Wister A, Mitchell B, Li L, Kadowaki L. Healthcare system navigation difficulties among informal caregivers of older adults: a logistic regression analysis of social capital, caregiving support and utilization factors. BMC Health Serv Res 2024; 24:1159. [PMID: 39354489 PMCID: PMC11443938 DOI: 10.1186/s12913-024-11549-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/05/2024] [Indexed: 10/03/2024] Open
Abstract
BACKGROUND Informal caregivers of older adults play a vital role in improving the degree to which older adults access community and healthcare services in a seamless and timely manner. They are fulfilling important navigation and support roles for their older care recipients. However, there is still little knowledge of the most significant facilitators and barriers to effective and efficient system navigation among caregivers. This paper aims to fill these knowledge gaps through investigation of the key factors (i.e., social capital/cohesion, caregiving supports, and utilization factors) affecting navigation difficulties faced by informal caregivers of older adults. METHODS The Behavioural-Ecological Framework of Healthcare Access and Navigation (BEAN) model is used to frame the study. Using the General Social Survey on Caregiving and Care Receiving 2018, we analyzed 2,733 informal caregivers whose primary care recipients were aged 65 or older. Hierarchical logistic regression was conducted to identify the relationship between system navigation difficulties among informal caregivers and four sequentially ordered blocks of predictors: (1) sociodemographic (2), social capital/cohesion (3), caregiving supports, and (4) healthcare demand. RESULTS The fully adjusted model showed that the probability of reporting navigation difficulties was lower for caregivers with social capital/cohesion compared to those without social capital/cohesion. In comparison, the probability of reporting navigation difficulties was higher among caregivers with caregiving support and among caregivers whose care receivers use a higher amount of health service use. Several sociodemographic covariates were also identified. CONCLUSION Our findings support certain aspects of the BEAN model. This study extends our understanding of potential facilitators and barriers that informal caregivers of older adults face while navigating complex community and health systems. There is a need to implement coordinated schemes and health policies especially for older adults with mental/neurological issues to address the challenges of their caregivers given the specific vulnerability identified in this study. The need for further research using different approaches to examine the disproportionate impact of COVID-19 on caregivers' system navigation experience is crucial.
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Affiliation(s)
- Boah Kim
- Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada.
- Gerontology Research Centre, Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada.
| | - Andrew Wister
- Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
- Gerontology Research Centre, Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
| | - Barbara Mitchell
- Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
- Department of Sociology & Anthropology, Simon Fraser University, 8888 University Drive, Burnaby, BC, V5A 1S6, Canada
| | - Lun Li
- Gerontology Research Centre, Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
- School of Social Work, MacEwan University, 9-510A2, 10700 104 Ave NW, Edmonton, AB, T5J 4S2, Canada
| | - Laura Kadowaki
- Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
- Gerontology Research Centre, Department of Gerontology, Simon Fraser University, 2800-515 Hastings Street, Vancouver, BC, V6B 5K3, Canada
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3
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Iovino P, Marcomini I, Rasero L, Manara DF, Vellone E, Villa G. Psychometric characteristics of the multidimensional scale of perceived social support in ostomy patients and their caregivers. J Health Psychol 2024:13591053241278169. [PMID: 39295230 DOI: 10.1177/13591053241278169] [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: 09/21/2024] Open
Abstract
Despite the importance of social support in ostomy care, the Multidimensional Scale of Perceived Social Support (MSPSS) does not appear to be validated in the context of ostomy care. This study evaluated the psychometric characteristics of MSPSS in ostomy patients and their informal caregivers. The MSPSS was tested in a sample of 775 participants with confirmatory factor analysis. Internal consistency reliability was assessed with the ordinal Omega coefficient. Criterion-related validity was ascertained via hypothesis testing by correlating the scores of the MSPSS with other measures. MSPSS for patients and caregivers has a three-factor structure with a good fit. Internal consistency reliability of the factors was excellent. Concurrent validity was supported by the negative correlations between MSPSS scores with depression and stoma-related QoL, and the positive correlations with perceived mutuality. Our research indicates that the MSPSS is a sound measure of social support for ostomy patients and their caregivers.
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Affiliation(s)
| | | | | | | | - Ercole Vellone
- University of Rome Tor Vergata, Italy
- Wroclaw Medical University, Wroclaw, Poland
| | - Giulia Villa
- Vita-Salute San Raffaele University, Milan, Italy
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4
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Sadeghi-Mahalli N, Mohammadi-Shahboulaghi F, Arsalani N, Fallahi-Khoshknab M, Foroughan M, Atazadeh M. Factors affecting support: experiences of Iranian older spousal caregivers of people with Alzheimer's disease and their support resources. Aging Ment Health 2024:1-9. [PMID: 39097934 DOI: 10.1080/13607863.2024.2385453] [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] [Received: 02/22/2024] [Accepted: 07/22/2024] [Indexed: 08/06/2024]
Abstract
OBJECTIVES Older spouses are a significant part of family caregivers of patients with Alzheimer's disease (AD) and need support. Evidence suggests that different factors influence the support of older spousal caregivers. However, there is little evidence about these factors in developing countries like Iran. This study aimed to identify the factors affecting the support of Iranian older spousal caregivers of people with AD. METHOD This qualitative study used Graneheim and Lundman's conventional content analysis approach. Through purposive sampling, 10 caregivers, three family members, and three professionals were recruited from various cognitive clinics and centers. In-depth and semi-structured interviews were used to collect data and continued until conceptual saturation was achieved. RESULTS Two themes were derived from the data as factors affecting support, which included (1) caregiver's support-seeking (complexity of the patient's condition, caregiver's geriatric health, the burden of caring for a spouse with AD, marital bond quality, caregiver's support-phobic beliefs, caregiver's awareness of care) and (2) capacities of support resources (supportive family, supportiveness of society, formal systems' capability to provide support services). CONCLUSION The present study provided practical information about the factors influencing the support of older spousal caregivers. Healthcare providers and policymakers can use these concepts to improve the support process by strengthening caregivers' support-seeking motivation and enhancing capacities in support resources.
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Affiliation(s)
- Nasim Sadeghi-Mahalli
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Farahnaz Mohammadi-Shahboulaghi
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Arsalani
- Nursing Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Mahshid Foroughan
- Geriatric Department, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Musa Atazadeh
- Iran Dementia and Alzheimer's Association, Tehran, Iran
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Talbot CV, Roe D, Anderson JG, Donnellan WJ, Wilson SA, O'Dwyer ST. Unpaid carers' experiences of supporting people with dementia to use social media. Aging Ment Health 2024; 28:977-984. [PMID: 38217299 DOI: 10.1080/13607863.2024.2301725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/30/2023] [Indexed: 01/15/2024]
Abstract
Objectives: The aim of this study was to explore unpaid carers' experiences of supporting people with dementia to use social media.Methods: Unpaid carers (n = 234) responded to an online survey about their attitudes towards people with dementia using social media and any experiences supporting this usage. Responses to closed questions were analysed using frequency analysis; qualitative data were analysed thematically.Results: Fifty-five carers (23.5%) cared for someone with dementia who used social media. Thematic analysis produced four themes: (1) carers as social media navigators; (2) social media supports care; (3) carers as social media guardians; and (4) labour-intensive work. Carers valued the social connectivity and stimulation social media provided but remained vigilant about online safety. They carefully managed the online experiences of people with dementia, balancing perceived benefits with safety, security, and caring demands.Conclusions: These findings shed light on the complexities of caring in the digital age. Many carers are supporting people with dementia in using social media, but there is little guidance on how best to do this. As older adults continue to embrace social media, carers, support organisations, and policymakers must adapt and work with technology developers to ensure safe and supportive online experiences.
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Affiliation(s)
| | - Daisy Roe
- Department of Psychology, Bournemouth University, Poole, UK
| | - Joel G Anderson
- College of Nursing, University of Tennessee-Knoxville, Knoxville, TN, USA
| | | | - Samantha A Wilson
- Centre for Applied Dementia Studies, University of Bradford, Bradford, UK
- Department of Data Science, University of Liverpool, Liverpool, UK
| | - Siobhan T O'Dwyer
- Health Services Management Centre, University of Birmingham, Birmingham, UK
- University of Exeter Medical School, University of Exeter, Exeter, UK
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Mroz EL, Schwartz AE, Valeika S, Oettingen G, Marottoli R, David D, Hagaman A, Fedus D, Monin JK. "WOOP is my safe haven": A qualitative feasibility and acceptability study of the Wish Outcome Obstacle Plan (WOOP) intervention for spouses of people living with early-stage dementia. Int J Geriatr Psychiatry 2024; 39:e6092. [PMID: 38687142 PMCID: PMC11448666 DOI: 10.1002/gps.6092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024]
Abstract
OBJECTIVES As symptoms emerge and worsen in people living with dementia, their spouses can benefit from behavioral interventions to support their adjustment as a care partner. The Wish Outcome Obstacle Plan (WOOP) intervention improves the well-being of spouses of people living with dementia early in the disease course, but intervention mechanisms and opportunities for improvement are unclear. The present study gave voice to spouses who participated in a trial of WOOP, describing how WOOP was incorporated into their lives and how it could be improved for future implementation. METHOD For this qualitative study, we conducted longitudinal semi-structured interviews among 21 spouses of people living with dementia (three interviews over three months; 63 interviews total). Codebook thematic analysis was performed. RESULTS Three meta-themes were derived: (1) assessing baseline strengths and limitations of WOOP, (2) learning from experience, and (3) fine-tuning and sustaining WOOP. Participants described how WOOP addressed their interpersonal and emotional stressors, their responses to behaviors of the person living with dementia, and their relationship quality. Considerations for future intervention delivery (e.g., solo vs. in group settings) and instructions (e.g., encouraging writing vs. thinking through the four steps of WOOP) were identified as areas of improvement. CONCLUSIONS WOOP was described as a practical, feasible, and desirable intervention for spouses at the early stages of their partner's dementia. Participants made WOOP easier to incorporate in their everyday lives by adapting the design into a mental exercise that they used as needed. Suggestions from participants specified how to make the everyday use of WOOP more feasible, sustainable, and applicable in a variety of contexts. TRIAL REGISTRATION ClinicalTrials.gov HIC 2000021852.
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Affiliation(s)
- Emily L Mroz
- Department of Geriatrics, Yale School of Medicine, New Have, Connecticut, USA
| | - Anna E Schwartz
- Social and Behavioral Sciences, Yale School of Public Health, New Have, Connecticut, USA
| | - Sarah Valeika
- Social and Behavioral Sciences, Yale School of Public Health, New Have, Connecticut, USA
| | - Gabriele Oettingen
- Department of Psychology, New York University, New York, New York, USA
- Department of Political and Social Sciences, Zeppelin University Friedrichshafen, Friedrichshafen, Germany
| | - Richard Marottoli
- Department of Geriatrics, Yale School of Medicine, New Have, Connecticut, USA
| | - Daniel David
- Rory Meyers College of Nursing, New York University, New York, New York, USA
| | - Ashley Hagaman
- Social and Behavioral Sciences, Yale School of Public Health, New Have, Connecticut, USA
| | - Donna Fedus
- Borrow My Glasses, Madison, Connecticut, USA
| | - Joan K Monin
- Social and Behavioral Sciences, Yale School of Public Health, New Have, Connecticut, USA
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7
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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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8
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Daynes-Kearney R, Gallagher S. Online Support Groups for Family Caregivers: Scoping Review. J Med Internet Res 2023; 25:e46858. [PMID: 38090796 PMCID: PMC10753418 DOI: 10.2196/46858] [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: 03/02/2023] [Revised: 10/05/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Caregiving can affect people of all ages and can have significant negative health impacts on family caregivers themselves. Research has shown that social support acts as a buffer against many negative health impacts. A common source of social support is support groups. Although traditionally, these groups were conducted in a face-to-face setting, the advent of the internet, social media applications, and the smartphone have seen online support groups (OSGs) develop as a space where many caregivers seek support. The number of OSGs has increased exponentially, but there is no clear consensus on what factors or characteristics of OSGs contribute to social support development within them or what types of OSGs are available to family caregivers. OBJECTIVE This study aimed to conduct a scoping review to contribute to the understanding of the types and characteristics of OSGs for family caregivers. METHODS Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, the CINAHL, PsychInfo, Psych Articles, Social Sciences, Communication Source, Medline, and Web of Science databases were searched for studies (caregiver focused, adults aged 18 years or older, online social support groups, caring for a living person, peer-reviewed journal publications on empirical research). In total, 19 studies were included in the review. The research questions were (1) what type of social support groups are online for adult family caregivers, (2) what the communication mediums and characteristics of these OSGs are, and (3) what psychosocial or other factors make OSGs successful or unsuccessful for participants. RESULTS In response to the first research question, we found that the majority of OSGs took place on public text-based forums and were illness specific. Where demographics were reported, participants were predominately women, White, and working with university-level education. There were a variety of caregiving relationships. For the second research question, the most common communication medium found was text-based communication, with the use of emojis, photos, and GIF (Graphics Interchange Format) files as part of these exchanges. Most frequently, the OSGs were asynchronous with a degree of anonymity, not time-limited by the frequency of contact or duration, and moderated by peer or professional moderators or facilitators. Results for the third research question explored the overarching categories of safe communication and engagement and group management. These described successful OSGs as having a focus on similar others with shared lived experiences communicated in a nonjudgmental space overseen by trained peer or professional facilitators. CONCLUSIONS There are several key considerations for OSGs to be successful for family caregivers. A general recommendation for practitioners is to give importance to building active moderation and multifaceted structures of support to meet different levels of caregiver needs and the ability to engage.
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Affiliation(s)
- Rosemary Daynes-Kearney
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
| | - Stephen Gallagher
- Study of Anxiety, Stress and Health Laboratory, Department of Psychology, University of Limerick, Limerick, Ireland
- Health Research Institute, University of Limerick, Limerick, Ireland
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9
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Windle G, Roberts J, MacLeod C, Algar-Skaife K, Sullivan MP, Brotherhood E, Jones CH, Stott J. 'I have never bounced back': resilience and living with dementia. Aging Ment Health 2023; 27:2355-2367. [PMID: 37020427 DOI: 10.1080/13607863.2023.2196248] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 03/19/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVE This work responds to the limited research about resilience when living with dementia and develops a conceptual model to inform service development and healthcare practices for this population. METHODS An iterative process of theory building across four phases of activity (scoping review n = 9 studies), stakeholder engagement (n = 7), interviews (n = 11) generated a combined sample of 87 people living with dementia and their carers, including those affected by rare dementias to explore their lived experiences. An existing framework of resilience developed in other populations served as the starting point to analyse and synthesise the findings, inspiring a new conceptual model of resilience unique to the experience of living with dementia. RESULTS The synthesis suggests resilience encompasses the daily struggles of living with a dementia; people are not flourishing, thriving or 'bouncing back', but are managing and adapting under pressure and stress. The conceptual model suggests resilience may be achieved through the collective and collaborative role of psychological strengths, practical approaches to adapting to life with dementia, continuing with hobbies, interests and activities, strong relationships with family and friends, peer support and education, participating in community activities and support from healthcare professionals. Most of these themes are not reflected in resilience outcome measures. CONCLUSIONS Practitioners adopting a strengths-based approach utilising the conceptual model at the point of diagnosis and post-diagnosis support may help individuals achieve resilience through appropriately tailored services and support. This 'resilience practice' could also extend to other degenerative or debilitating chronic conditions a person faces in their life course.
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Affiliation(s)
- Gill Windle
- Ageing and Dementia Bangor, Dementia Services Development Centre (DSDC), School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Jennifer Roberts
- Ageing and Dementia Bangor, Dementia Services Development Centre (DSDC), School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Catherine MacLeod
- Ageing and Dementia Bangor, Dementia Services Development Centre (DSDC), School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Katherine Algar-Skaife
- Department of Neuromedicine and Movement Science (INB), Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Mary Pat Sullivan
- Faculty of Education and Professional Studies, School of Social Work, Nipissing University, North Bay, Ontario, Canada
| | - Emilie Brotherhood
- Dementia Research Centre, Queen Square Institute of Neurology, University College London (UCL), London, UK
| | - Catrin Hedd Jones
- Ageing and Dementia Bangor, Dementia Services Development Centre (DSDC), School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Joshua Stott
- Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
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10
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Poe AA, Vance DE, Patrician PA, Dick TK, Puga F. Resilience in the context of dementia family caregiver mental health: A concept analysis. Arch Psychiatr Nurs 2023; 45:143-151. [PMID: 37544690 DOI: 10.1016/j.apnu.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
Resilience has been identified as a key concept for dementia family caregiver mental health; however, the concept is not well defined. A concept analysis examining dementia caregiver resilience was conducted using Rodger's Evolutionary Method. The aim of this concept analysis was to describe the historical perspective, attributes, antecedents, and consequences of resilience as it relates to dementia caregiver mental health. Key attributes of dementia caregiver resilience were acceptance, coping strategies, social support, self-appraisal, and spirituality. The results from this concept analysis provide the foundation for the development of resilience-based interventions to support the well-being of dementia family caregivers.
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Affiliation(s)
- Abigail A Poe
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - David E Vance
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Tracey K Dick
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
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11
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Donnellan WJ, Sepulveda Garcia L, Gibson SM, Butcher P, Lariviere MJ. What are the Challenges and Resilience Resources Identified by Informal Carers During the First UK COVID-19 Lockdown? A Longitudinal Qualitative Study Using Naturalistic Data. QUALITATIVE HEALTH RESEARCH 2023; 33:236-246. [PMID: 36702851 PMCID: PMC9892806 DOI: 10.1177/10497323221150131] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-19 has posed serious challenges for informal carers living in the UK. This article examines some of the specific challenges facing carers and the resources they used to manage them throughout the first UK lockdown. We used a framework approach to analyse naturalistic, longitudinal data from 30 carers taking part in 96 of Mobilise's daily Virtual Cuppas between March and July 2020. We found that lack of information and social restrictions cumulatively impacted carers' sense of certainty, control and motivation. This took an emotional toll on the carers, leading to exhaustion and burden. However, carers quickly established new routines and used humour and self-care to actively manage their wellbeing. Carers received support but also provided it to those in need, including fellow members of the caregiving community, supporting an ecological approach to carer resilience. Our findings may be used to anticipate challenges and promote protective resilience resources in future lockdowns.
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Affiliation(s)
| | | | | | - Paige Butcher
- Brain Injury Rehabilitation Trust,
Disabilities Trust, Liverpool,
UK
| | - Matthew J. Lariviere
- Centre for Research on Health and
Social Care, School for Policy Studies, University of
Bristol, Bristol, UK
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12
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Pezirkianidis C, Galanaki E, Raftopoulou G, Moraitou D, Stalikas A. Adult friendship and wellbeing: A systematic review with practical implications. Front Psychol 2023; 14:1059057. [PMID: 36760434 PMCID: PMC9902704 DOI: 10.3389/fpsyg.2023.1059057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/09/2023] [Indexed: 01/25/2023] Open
Abstract
This study aimed to systematically review research findings regarding the relationship between adult friendship and wellbeing. A multidimensional scope for wellbeing and its components with the use of the PERMA theory was adopted. A total of 38 research articles published between 2000 and 2019 were reviewed. In general, adult friendship was found to predict or at least be positively correlated with wellbeing and its components. In particular, the results showed that friendship quality and socializing with friends predict wellbeing levels. In addition, number of friends, their reactions to their friend's attempts of capitalizing positive events, support of friend's autonomy, and efforts to maintain friendship are positively correlated with wellbeing. Efforts to maintain the friendship, friendship quality, personal sense of uniqueness, perceived mattering, satisfaction of basic psychological needs, and subjective vitality mediated this relationship. However, research findings highlighted several gaps and limitations of the existing literature on the relationship between adult friendship and wellbeing components. For example, for particular wellbeing components, findings were non-existent, sparse, contradictory, fragmentary, or for specific populations only. Implications of this review for planning and implementing positive friendship interventions in several contexts, such as school, work, counseling, and society, are discussed.
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Affiliation(s)
- Christos Pezirkianidis
- Lab of Positive Psychology, Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece,*Correspondence: Christos Pezirkianidis ✉
| | - Evangelia Galanaki
- Lab of Psychology, Department of Primary Education, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Raftopoulou
- Lab of Positive Psychology, Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Despina Moraitou
- Lab of Psychology, Section of Cognitive and Experimental Psychology, Department of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece,Lab of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTH), Balkan Center, Thessaloniki, Greece
| | - Anastassios Stalikas
- Lab of Positive Psychology, Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
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Lim-Soh JW, Lee Y. Social Participation Through the Retirement Transition: Differences by Gender and Employment Status. Res Aging 2023; 45:47-59. [PMID: 35694800 DOI: 10.1177/01640275221104716] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
This study examines how retirees' formal and informal social participation change over time and investigates gendered differences. Seven waves of the Korean Longitudinal Study of Ageing track the frequency of social participation. A comparison group of employed individuals, weighted with coarsened exact matching, controls for age and time trends, and mixed model regressions estimate changes over time. Retirees show a gradual decline in the frequency of meeting friends and an abrupt decrease in the frequency of attending a social gathering, compared to their working peers. These trends are much stronger for men than women, and compound pre-existing gender differences in social participation. The more severe decline in the social participation of men is of great concern and points to the persistence of gendered employment structures into the retirement transition, putting Korean retirees at risk of social isolation and related health deterioration.
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Affiliation(s)
- Jeremy W Lim-Soh
- Centre for Ageing Research and Education, 37580Duke-NUS Medical School, National University of Singapore, Singapore
| | - Yeonjin Lee
- Department of Sociology, 34967Kookmin University, Seoul, Korea
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14
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Donnellan WJ, Hirons A, Clarke K, Muinos C, McCabe L. Exploring Resilience in UK-Based Domiciliary Care Workers before and during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16128. [PMID: 36498201 PMCID: PMC9739467 DOI: 10.3390/ijerph192316128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/28/2022] [Accepted: 11/30/2022] [Indexed: 06/17/2023]
Abstract
Domiciliary carers (DCs) provide an invaluable service that enables people living with dementia (PLWD) to remain living in their own homes for as long as possible. We know a lot about the negative impacts of providing domiciliary care and recent evidence suggests that this was exacerbated by the COVID-19 pandemic. However, we know much less about how these DCs manage the stressors associated with their roles. The current study adopts a resilience perspective to identify the resources that DCs caring for PLWD draw on to manage the stress associated with their roles before and during the COVID-19 pandemic. We conducted semi-structured interviews with 19 DCs from across the UK. Data were analysed using a directed qualitative content analysis. Themes included: healthy boundaries; motivation to care; psychological attributes; managing work; and support. The findings have implications for employers and may go some way towards improving DC working conditions, retaining staff, and attracting new DCs in the future.
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15
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McKenna O, Fakolade A, Cardwell K, Pilutti LA. A continuum of languishing to flourishing: exploring experiences of psychological resilience in multiple sclerosis family caregivers. Int J Qual Stud Health Well-being 2022; 17:2135480. [PMID: 36333904 PMCID: PMC9645274 DOI: 10.1080/17482631.2022.2135480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2022] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Resilience research in family caregiving in chronic neurological conditions is growing, but multiple sclerosis (MS) caregivers are noticeably absent from this body of work. MS caregivers represent a unique population due to the disease's early onset, prolonged life expectancy, and heterogeneity. As such, this study aimed to explore MS caregivers' conceptualizations of resilience, examine MS caregivers' experiences of resilience development, and determine which assets and resources influence resilience in this role. METHODS Twenty-four Canadian MS caregivers were recruited. Semi-structured in-depth interviews were conducted with questions derived from an ecological resilience framework. Data were analysed using reflexive thematic analysis. RESULTS Themes constructed a cyclical resilience model, beginning with encounters with hardship and extending to thriving adjustment. Subthemes included reports of additive challenges, impactful individual and community resources, and multi-level adaptive pathways. Within this cycle, the achievement of healthy adjustment exerted a positive feedback function and informed future responses to lifelong challenges. CONCLUSIONS Despite the salience of resilience processes within caregiver testimonies, inadequate resources at societal levels were evident. These findings afford researchers and decision-makers relevant information for designing and implementing resilience-building interventions for MS caregivers that attend to contextual factors and current systemic support deficiencies.
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Affiliation(s)
- Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
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16
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The impact of social isolation due to the COVID-19 pandemic on patients with dementia and caregivers. Acta Neuropsychiatr 2022; 34:276-281. [PMID: 35369891 DOI: 10.1017/neu.2022.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Social distancing to limit COVID-19 transmission has led to extensive lifestyle changes, including for people with dementia (PWD). The aim of this study, therefore, was to assess the impact of lockdown on the mental health of PWD and their carers. METHODS Forty-five carers of PWD completed a telephone interview during the baseline assessment of the SOLITUDE study to gather information on life conditions and changes in symptoms of PWD during lockdown. Associations between changes in symptoms of PWD and carers' concerns and mental health were investigated. RESULTS About 44% of carers experienced anxiety and irritability and reported changes in behavioural and cognitive symptoms in PWD. These changes were associated with worse carers' mental health and concerns about faster disease progression (χ2 = 13.542, p < 0.001). CONCLUSION COVID-19-related social isolation has had a negative impact on patients' and carers' mental health. Potential long-term neurocognitive consequences require further investigation.
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17
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Sabatini S, Martyr A, Gamble LD, Jones IR, Collins R, Matthews FE, Victor CR, Quinn C, Pentecost C, Thom JM, Clare L. Profiles of social, cultural, and economic capital as longitudinal predictors of stress, positive experiences of caring, and depression among spousal carers of people with dementia. Aging Ment Health 2022:1-9. [PMID: 35899421 DOI: 10.1080/13607863.2022.2098920] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE We explored (1) social, cultural, and economic capital in spousal carers of people with dementia; (2) profiles of carers with different levels of capital; (3) whether the identified profiles differ in levels of stress and positive experiences of caring, and likelihood of depression over time. METHODS Baseline (2014-2016), 12-month, and 24-month follow-up data were analyzed for 984 coresident spousal carers of people with dementia. We assessed social, cultural, and economic capital, stress, positive experiences of caring, depression. RESULTS On average, carers reported infrequent social and cultural participation. Most carers were not socially isolated, trusted their neighbours, had education at least to age 16, and had an income aligned with the 2014 UK average. We identified four groups of carers with different levels of capital. Although on average stress was low, depression was infrequent, and positive experiences of caring were moderately frequent, the group of carers with lowest capital was the least stressed and reported the most positive experiences of caring over time. Compared to the two groups with better capital, those with poorer capital were more likely to be depressed over time. CONCLUSION Social, cultural, and economic resources may decrease likelihood of depression, but not stress, in carers of people with dementia.
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Affiliation(s)
- Serena Sabatini
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Anthony Martyr
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Laura D Gamble
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle, United Kingdom
| | - Ian R Jones
- Wales Institute for Social and Economic Research and Data (WISERD), Cardiff University, Cardiff, United Kingdom
| | - Rachel Collins
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Fiona E Matthews
- Wales Institute for Social and Economic Research and Data (WISERD), Cardiff University, Cardiff, United Kingdom
| | - Christina R Victor
- Department of Health Sciences, College of Health, Medicine and Life Sciences, Brunel University London, Bath, United Kingdom
| | - Catherine Quinn
- The Centre for Applied Dementia Studies, University of Bradford, Bradford, United Kingdom.,Wolfson Centre for Applied Health Research, Bradford, United Kingdom
| | - Claire Pentecost
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
| | - Jeanette M Thom
- Faculty of Medicine and Health, University of New South Wales (UNSW), Sydney, Australia
| | - Linda Clare
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom.,NIHR Applied Research Collaboration South, West Peninsula, United Kingdom
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18
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Hargreaves S, Sbaffi L, Ford N. Information seeking amongst informal caregivers of people with dementia: a qualitative study. JOURNAL OF DOCUMENTATION 2022. [DOI: 10.1108/jd-03-2022-0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThis paper both supports previous findings relating to, and presents new insights into: the information needs and the information seeking processes of a sample of informal caregivers of people with dementia (in relation to their own needs and the interrelated needs of the people they are caring for); the extent to which such information needs are and are not being met; and the factors facilitating and hindering access to the right information.Design/methodology/approachThe study adopted a qualitative approach in the form of a thematic analysis of in-depth, semi-structured interviews with a sample of 20 informal caregivers from a range of different age groups, genders and caring roles.FindingsThematic analysis identified significant informational challenges, with a common perception that information seeking was onerous, requiring a proactive approach. Further challenges arose from a perceived lack of focus on carer needs coming up against the boundaries of professional knowledge and inconsistent information provision across the sample. Distance carers faced specific issues. A second theme of negative impacts described burdens arising from: difficulties in accessing information from a complex array of support services closure or change in services and unfulfilled information needs. Participants employed strategies to enable access to information, for example, being open about their caring role; and building formal or informal support networks. It is important to address emotional as well as cognitive dimensions of information needs.Practical implicationsThis research highlights a need for health and social care, practice and policy to acknowledge and address information needs of this diverse population and build resilience. Above all, information seeking and sharing must be understood within the context of the emotional impact of caring, and recognition of these twin needs is crucial.Originality/valueWhilst previous research has focussed on identifying specific needs and knowledge acquisition at cross-sections, a more holistic understanding of experiences is underexplored. This approach is needed to take into account broader contexts, diversity of experiences and different caring roles, e.g. primary and secondary carers, and in situ and distance carers.
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19
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The Burden of Caring for Dependent Older People and the Resultant Risk of Depression in Family Primary Caregivers in Italy. SUSTAINABILITY 2022. [DOI: 10.3390/su14063375] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Long-Term Care (LTC) for older people in need of care is a critical issue affecting the quality of life of family caregivers (as well as older people), encompassing both negative and positive caregiving experiences. Providing support to family caregivers is essential because they play a crucial role in sharing the societal burden of LTC for the growing frail older population. By presenting the results of a survey carried out in 2019–2020 in Central Italy, this study aims to describe the characteristics and estimate by a multivariate logistic model the correlates of depressive symptoms in 369 primary caregivers of dependent older people. Caregivers are mostly women who provide a high amount of care in terms of weekly hours as a result of insufficient assistance from public or private care services. More than half of the sample show depressive symptoms, indicating a fairly serious situation. Perceived burden is a strong predictor of depression. The findings offer suggestions and policy implications. The fragmentation of the care context should be addressed by allocating sufficient funding to expand the supply of public in-kind services and integrate cash-for-care schemes, thus alleviating the burden and mitigating the negative consequences of care on physical and mental health.
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20
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Enhancing psychological resilience at the cusp of older ages: the role of social networks. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x2100180x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Prior research has established a positive association between social support and psychological resilience. In this study, we seek to examine whether and to what extent aspects of individuals’ social network – specifically size (how many relatives and friends one has) and strength (how often did one communicate with close network members and at the time of important decisions) – are related to greater psychological resilience. We use data pertaining to 1,609 respondents from the Panel on Ageing and Transitions in Health Survey (PATHS), 2016–2017, a national study of 1,654 older midlife adults, aged 50–59, in Singapore. We estimate the relationship between social networks and psychological resilience, using inverse probability weighted regression adjustment to account for the possibility of a selection bias whereby individuals with larger or stronger social networks may be more resilient at the outset. We find that strong social networks are associated with greater psychological resilience among older midlife adults, regardless of the size of the network. Having a large social network is associated with greater resilience only if it is also a strong network. Maintaining stronger, even if small, social networks may enable individuals at the cusp of older ages to be better prepared to deal with stressful life events and challenges associated with older midlife.
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21
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McKenna O, Fakolade A, Cardwell K, Langlois N, Jiang K, Pilutti LA. Towards conceptual convergence: A systematic review of psychological resilience in family caregivers of persons living with chronic neurological conditions. Health Expect 2021; 25:4-37. [PMID: 34676951 PMCID: PMC8849377 DOI: 10.1111/hex.13374] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 08/31/2021] [Accepted: 09/17/2021] [Indexed: 01/28/2023] Open
Abstract
Background The demand for family caregiving in persons with chronic neurological conditions (CNCs) is increasing. Psychological resilience may empower and protect caregivers in their role. Thus, a synthesis of resilience evidence within this specific population is warranted. Aim In this systematic review we aimed to: (1) examine the origins and conceptualizations of resilience; (2) summarize current resilience measurement tools; and (3) synthesize correlates, predictors and outcomes of resilience in family caregivers of persons with CNCs. Design We sourced English articles published up to July 2020 across five databases using search terms involving CNCs, family caregivers and resilience. Results A total of 50 studies were retained. Nearly half (44%) of the studies used trait‐based resilience definitions, while about one third (36%) used process‐based definitions. Twelve different resilience scales were used, revealing mostly moderate to high‐resilience levels. Findings confirmed that resilience is related to multiple indicators of healthy functioning (e.g., quality of life, social support, positive coping), as it buffers against negative outcomes of burden and distress. Discordance relating to the interaction between resilience and demographic, sociocultural and environmental factors was apparent. Conclusions Incongruity remains with respect to how resilience is defined and assessed, despite consistent definitional concepts of healthy adaptation and equilibrium. The array of implications of resilience for well‐being confirms the potential for resilience to be leveraged within caregiver health promotion initiatives via policy and practice. Patient or Public Contribution The findings may inform future recommendations for researchers and practitioners to develop high‐quality resilience‐building interventions and programmes to better mobilize and support this vulnerable group.
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Affiliation(s)
- Odessa McKenna
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | | | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Nigèle Langlois
- Health Sciences Library, University of Ottawa, Ottawa, Canada
| | - Karen Jiang
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada.,Brain and Mind Research Institute, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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22
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Tokovska M, Nour MM, Sørensen A, Småland Goth U. Informal caregivers and psychosocial support: Analysis of European Dementia Policy documents. J Public Health Res 2021; 11. [PMID: 34579521 PMCID: PMC8874860 DOI: 10.4081/jphr.2021.2416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/13/2021] [Indexed: 11/23/2022] Open
Abstract
Various countries in Europe have different strategies for promoting care solutions for dementia challenges. The different approaches of Austria, Belgium, Czechia, Denmark, Finland, Germany, Gibraltar, Ireland, Israel, Malta, Nederland, Norway, Sweden and the United Kingdom (Scotland and Wales) were investigated. Dementia has a significant social, psychological and economic impact on the individual, family and society. As the disease progresses dementia sufferers become increasingly dependent. As many dementia sufferers are at home during the initial stages, the physical, emotional, and social demands of the dementia sufferers are often covered by informal caregivers. This study, therefore, aims to investigate the integration of psychosocial interventions for comprehensive care pertaining to informal caregivers of people with dementia in Europe. Furthermore, the study will highlight how implementation of technologies might enable psychosocial support of informal caregivers. The data is based on 15 national dementia strategies from various European countries. Data was based on preexisting coding systems with the predefined keywords and analyzed by qualitative content analysis by four of the authors. Our results show that psychosocial support is provided in various modalities and that informal caregivers need to be supported by a psychosocial approach. Due to this need the national dementia strategies should include measures to reduce the emotional burden of informal caregivers. Psychosocial support provided to informal caregivers in a comprehensive and systematic way is likely to enable informal caregivers to handle the emotional, cognitive, and behavioral consequences of the disease and its treatment, while helping to maintain their work-life balance. Significance for public health This study has important public health impacts on informal caregivers in a European context. The study reveals that the European countries of Alzheimer Europe - especially policymakers, social and healthcare providers and non-government organizations - should update or prepare the necessary national dementia strategies, promote benchlearning, improve international collaboration and systematically manage those who provide psychosocial support.
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Affiliation(s)
| | - Magde Mohamed Nour
- School of Health Science, Kristiania University College, Oslo; Department of Information Science and Media Studies, University of Bergen, Bergen.
| | - Anette Sørensen
- School of Health Science, Kristiania University College, Oslo.
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23
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Muruthi JR, Green A, Ehlinger PP, Osa ML, Yang D. Sociodemographic, Health, and Caregiving Patterns of Aging Caregivers in Oregon: Gender Comparisons and the Role of Leisure Activities. Int J Aging Hum Dev 2021; 94:362-382. [PMID: 34514858 DOI: 10.1177/00914150211040458] [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: 11/16/2022]
Abstract
Recent studies have projected an increase in aging informal caregivers who are often dealing with their frailty. However, little is known about their health, caregiving factors, or coping resources that promote health. Informed by lifespan perspective and health behavior models, this study examined the gender differences in health and caregiving profiles of aging informal caregivers and investigated the association between leisure activity and unhealthy days. A sample of 565 informal caregivers (>50 years) was drawn from the Oregon version of the 2017 Behavioral Risk Factor Surveillance System. Descriptive analyses revealed that the caregivers were mainly women between 60 and 69, White non-Hispanic, married, college graduates, retired and healthinsured. Negative binomial regression showed that leisure activities were related to fewer odds of reporting unhealthy days for most comparison scenarios. Findings emphasize the importance of accounting for group differences and similarities in understanding health and caregiving factors among informal caregivers.
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Affiliation(s)
- James R Muruthi
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Aubrey Green
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Peter P Ehlinger
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Maggie L Osa
- Department of Counseling Psychology and Human Services, 143853University of Oregon, Eugene, USA
| | - Di Yang
- Department of Education Studies, University of Oregon, Eugene, USA
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24
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Hanna K, Giebel C, Butchard S, Tetlow H, Ward K, Shenton J, Cannon J, Komuravelli A, Gaughan A, Eley R, Rogers C, Rajagopal M, Limbert S, Callaghan S, Whittington R, Shaw L, Donnellan W, Gabbay M. Resilience and supporting people living with dementia during the time of COVID-19; A qualitative study. DEMENTIA 2021; 21:250-269. [PMID: 34346231 PMCID: PMC8721689 DOI: 10.1177/14713012211036601] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES To explore the different factors of resilience for people living with dementia and unpaid carers, in response to sudden changes in care and lifestyle during the COVID-19 pandemic. METHODS Unpaid carers and people living with dementia were offered telephone interviews in April 2020 to discuss their experiences since the COVID-19 pandemic. Participants were asked about the benefits and challenges of accessing dementia support, as well as coping, symptoms, strategies and impacts. Each transcript was analysed using inductive and deductive thematic analysis by two researchers. FINDINGS Semi-structured interviews from 50 participants (n = 42 unpaid carers and n = 8 people living with dementia) reported protective and risk factors of resilience concerning (1) communication, (2) adaptations, (3) support networks and (4) lifestyle factors and coping mechanisms. CONCLUSIONS Resilience factors considered both organisational factors for external support, along with individual coping mechanisms. Organisations and social support services should consider resilience factors in future service planning, to better support people living with dementia, or caring someone living with dementia, during times of great stress. The ecological model of resilience established from this research refers to resilience during times of unexpected change in the COVID-19 pandemic; however, it could be considered relevant in other periods of high stress within this cohort.
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Affiliation(s)
- Kerry Hanna
- Department of Primary Care & Mental Health, 4591University of Liverpool, Liverpool, UK
| | - Clarissa Giebel
- Department of Primary Care & Mental Health, 4591University of Liverpool, UK; NIHR ARC NWC, Liverpool, UK
| | - Sarah Butchard
- Department of Primary Care & Mental Health, 4591University of Liverpool, UK; NIHR ARC NWC, Liverpool, UK
| | - Hilary Tetlow
- SURF Liverpool, 4591University of Liverpool, Liverpool, UK
| | - Kym Ward
- The Brain Charity, Liverpool, UK
| | | | | | | | - Anna Gaughan
- Together In Dementia Everyday (TIDE), Liverpool, UK
| | - Ruth Eley
- Liverpool Dementia Action Alliance, Liverpool, UK
| | | | | | | | | | | | - Lisa Shaw
- Department of Modern Languages and Cultures, 4591University of Liverpool, Liverpool, UK
| | - Warren Donnellan
- Department of Psychology, 4591University of Liverpool, Liverpool, UK
| | - Mark Gabbay
- Department of Primary Care & Mental Health, 4591University of Liverpool, Liverpool, UK; NIHR ARC NWC, Liverpool, UK
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25
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Donnellan WJ, Warren JG. Emotional word use in informal carers of people living with dementia: A linguistic analysis of online discussion forums (Preprint). JMIR Aging 2021; 5:e32603. [PMID: 35713942 PMCID: PMC9250063 DOI: 10.2196/32603] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 02/21/2022] [Accepted: 03/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background Informal dementia care is uniquely stressful and necessitates effective methods of identifying and understanding the needs of potentially at-risk carers so that they can be supported and sustained in their roles. One such method is examining carers’ engagement in online support platforms. Research has explored emotional word use on online discussion forums as a proxy for underlying emotional functioning. We are not aware of any research that has analyzed the content of posts on discussion forums specific to carers of people living with dementia in order to examine their emotional states. Objective We addressed the following research questions: (1) To what extent does emotional language use differ between carers of people living with dementia and noncarers? (2) To what extent does emotional language use differ between spousal and parental carers? (3) To what extent does emotional language use differ between current and former carers? Methods We used the Linguistic Inquiry and Word Count (LIWC) program to examine emotional word use on a UK-based online forum for informal carers of people living with dementia and a discussion forum control group. Carers were separated into different subgroups for the analysis: current and former, and spousal and parental. Results We found that carers of people living with dementia used significantly more negative, but not positive, emotion words than noncarers. Spousal carers used more emotion words overall than parental carers, specifically more negative emotion words. Former carers used more emotional words overall than current carers, specifically more positive words. Conclusions The findings suggest that informal carers of people living with dementia may be at increased risk of negative emotional states relative to noncarers. Greater negativity in spousal carers may be explained by increased caregiver burden, whereas greater positivity in former carers may be explained by functional relief of caregiving responsibilities. The theoretical/applied relevance of these findings is discussed.
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26
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Blank LJ, Fleury J. Health Empowerment in Older Adult Informal Caregivers ✰. Geriatr Nurs 2021; 42:977-982. [PMID: 34256157 DOI: 10.1016/j.gerinurse.2021.06.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 06/13/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND The need to support informal caregivers is among the most overlooked challenges facing the aging population, their families, and society. Understanding the experience of well-being and resources contributing to well-being among older caregivers is essential. OBJECTIVE The purpose of this research was to explore personal strengths, social contextual resources, and the power to choose and pursue valued objectives central to well-being among older caregivers. This research was theoretically informed by the Health Empowerment Theory. METHODS Qualitative descriptive design addressed research objectives. Purposive sampling included recruitment and interviews with twenty-one older adult caregivers. Qualitative content analysis identified distinct categories and themes of meaning and supported trustworthiness. RESULTS Categories supported and extended Health Empowerment Theory among older caregivers, reflecting unique strengths, resources, and growth consistent with valued objectives, fostering well-being. DISCUSSION Findings further understanding of the ways in which caregivers move toward well-being within the context of complexity and change.
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Affiliation(s)
- Laura J Blank
- Clinical Professor, School of Nursing, Northern Arizona University, Flagstaff, AZ 86011, United States.
| | - Julie Fleury
- Professor, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ 85004, United States.
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27
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Lim-Soh JW. Social participation in widowhood: Evidence from a 12-year panel. J Gerontol B Psychol Sci Soc Sci 2021; 77:972-982. [PMID: 33914062 DOI: 10.1093/geronb/gbab072] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Social participation is important to the quality of life of older adults, especially widows. This is the first study to test whether older widows' formal and informal social participation rises or declines using multiple panel observations pre- and post-bereavement. The paper also tests the moderating effects of economic and marital satisfaction, depression, and husband's illness before death on these trends. METHODS Seven waves of the Korean Longitudinal Study of Ageing are used to track changes in four measures of social participation - meeting and contacting a child, meeting friends, and attending a formal group. A comparison group of married individuals, weighted with coarsened exact matching, controls for age and time trends. Mixed model regressions estimate the effects of widowhood over time. RESULTS Social participation shows little change before bereavement and rises significantly after bereavement for all measures. However, frequencies of meeting and contacting a child peak and decline early post-bereavement, while meeting friends and attending a group show delayed but long-lasting effects. Moderators economic and marital satisfaction are positively associated with overall social participation levels, but negatively associated with social participation post-bereavement. DISCUSSION Increased social participation after bereavement underscores the resilience of widows and the social support they receive. However, differences in timing suggest that contact with children is gradually substituted with extra-familial relationships in the long run. The negative moderating roles of economic and marital satisfaction point to a paradox where seemingly well-off individuals may be more vulnerable to widowhood.
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Affiliation(s)
- Jeremy W Lim-Soh
- Lee Kuan Yew School of Public Policy, National University of Singapore
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Yuan L, Gao Y, Pan B, Wang J, Wang Y, Gong C, Wang W, Li X. Resilience and Related Factors: A Comparison of Fathers and Mothers of Patients With Cleft Lip and/or Palate in China. Front Psychiatry 2021; 12:791555. [PMID: 35095604 PMCID: PMC8792896 DOI: 10.3389/fpsyt.2021.791555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 12/20/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Resilience has become a hot spot in the field of positive psychology to study life-change events. However, there were little information on resilience among the fathers and mothers of patients with cleft lip and/or palate respectively. The present study aimed to explore and compare the level and potential influential factors associated with resilience among fathers/mothers of patients with cleft lip and/or palate in China. Method: A cross-sectional study was carried out between April 2019 and July 2020 among fathers/mothers of patients with cleft lip and/or palate in two cleft lip and/or palate treatment centers in China. Sixty Nine fathers and 179 mothers of patients with cleft lip and/or palate were interviewed with a questionnaire on demographic variables and the Resilience Scale-14 (RS-14), Herth Hope Index (HHI), Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Parenting Stress Index-Short Form (PSI-SF) and Coping Health Inventory for Parents (CHIP). T-test/univariate one-way ANOVA, Pearson's r, hierarchical linear regression analysis were conducted to explore the influential factors of resilience. Results: Fathers of patients with cleft lip and/or palate had a higher level of resilience (77.77 ± 14.18) than mothers (74.52 ± 14.33) though without significance. Resilience was positively associated with hope, perceived social support, optimism and coping and negatively correlated with parenting stress both in the fathers and the mothers. Hierarchical linear regression analysis showed that hope (β = 0.400, P < 0.01), coping (β = 0.281, P < 0.05), job status, medical payments (β = -0.240, P < 0.05) were found to be associated with resilience among the fathers of patients with CL/P, and all four variables in the model could explain 42.8% of the variance in resilience; Hope (β = 0.225, P < 0.05), perceived social support (β = 0.194, P < 0.05), the age of patients (β = 0.189, P < 0.05) were found to be associated with resilience among the mothers, and all three variables in the model could explain 27.6% of the variance in resilience. Conclusion: Our study showed that, in China, fathers of patients with cleft lip and/or palate had a higher level of resilience than mothers though without significance. Hope was the only communal variable strongly associated with resilience among both the fathers and the mothers; besides, coping, job status and medical payments were found to be associated with resilience among the fathers; while perceived social support and the age of patients were found to be associated with resilience among the mothers. The results suggest that enhance hope in parents of patients with cleft lip and/or palate might greatly help improve their resilience. Besides, fathers and mothers need specific intervention to prompt their resilience.
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Affiliation(s)
- Lulu Yuan
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China.,School of Nursing, China Medical University, Shenyang, China
| | - Yuqin Gao
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Bochen Pan
- Shengjing Hospital, China Medical University, Shenyang, China
| | - Junyan Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Yanjie Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Caixia Gong
- West China School/Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Weiren Wang
- Liaoning Provincial Key Laboratory of Oral Diseases, Department of Nursing, School and Hospital of Stomatology, China Medical University, Shenyang, China
| | - Xiaohan Li
- School of Nursing, China Medical University, Shenyang, China
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Díaz A, Ponsoda JM, Beleña A. Optimism as a key to improving mental health in family caregivers of people living with Alzheimer's disease. Aging Ment Health 2020; 24:1662-1670. [PMID: 31960702 DOI: 10.1080/13607863.2020.1715342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: The aim of the present work was to study the serial multiple mediating role of optimism, perceived social support and subjective burden in the relationship between objective burden and psychological distress in caregivers of people with Alzheimer´s Disease (AD).Method: One hundred and forty family caregivers of people living with AD were recruited from randomly selected Alzheimer Association Centres. They answered the General Health Questionnaire (GHQ), the Life Orientation Test-Revised (LOT-R), the Functional Social Support Questionnaire (DUKE.UNC), the Zarit Burden Interview (ZBI) and questions relating to gender, age and the amount of time spent on daily caregiving.Results: Results indicated that objective burden and subjective burden were both high in these caregivers. Optimism mediated on psychological distress through social support and through subjective burden with a full mediation role. When comparisons between indirect effects were performed, optimism was the mediator with the greatest effect between objective burden and psychological distress.Conclusion: This study highlights the indirect role of optimism and the advantages that interventions in optimism training in the early stages of the person with AD could produce. Thus, alleviating subjective burden and increasing perceived social support, which would lead to an improvement in the mental health of family caregivers of people with AD.
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Affiliation(s)
- Amelia Díaz
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
| | - José M Ponsoda
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain.,Association of Relatives and Friends of Alzheimer Disease Patients and Other Dependent Patients in Cocentaina Region, Alicante, Spain
| | - Angela Beleña
- Faculty of Psychology, Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
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Cao Y, Yang F. Objective and Subjective Dementia Caregiving Burden: The Moderating Role of Immanent Justice Reasoning and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020455. [PMID: 31936738 PMCID: PMC7014207 DOI: 10.3390/ijerph17020455] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/22/2022]
Abstract
Caregiving burden significantly effects the physical and mental health of family dementia caregivers. While the association between objective caregiving burden (OCB) and subjective caregiving burden (SCB) of family dementia caregivers is well documented, little is known as with how the association is moderated by the configuration of intrapersonal resource (e.g., immanent justice reasoning) and interpersonal resource (e.g., social support). The present study collected cross-sectional data on 157 major family caregivers of non-institutionalized persons with dementia in an urbanizing region of Western China’s Sichuan Province. They responded to questions on daily time spent on caregiving, the short version of Zarit Burden Interview (ZBI), a sub-scale of a caregiver meaning scale, Social Support Rating Scale (SSRS), and demographic questions. Controlling for the demographic variables of the caregivers, this study found that the objective and subjective dementia caregiving burden were significantly associated (p < 0.001), and immanent justice reasoning was positively correlated with subjective burden (p < 0.01). Moreover, the association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both high (p < 0.001), but neutral when social support was high and immanent justice reasoning was low. The association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both low (p < 0.05), but neutral when social support was low and immanent justice reasoning was high. This research suggests the importance of developing intervention programs that consider the configuration of the external supporting resources and internal meaning-making of caregiving of the family dementia caregivers.
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Affiliation(s)
- Yanchun Cao
- Faculty of Economics and Management, East China Normal University, Shanghai 200062, China;
| | - Fan Yang
- School of International and Public Affairs, China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, China
- Correspondence:
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31
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Marini CM, Ermer AE, Fiori KL, Rauer AJ, Proulx CM. Marital Quality, Loneliness, and Depressive Symptoms Later in Life: The Moderating Role of Own and Spousal Functional Limitations. RESEARCH IN HUMAN DEVELOPMENT 2020; 17:211-234. [PMID: 34239391 DOI: 10.1080/15427609.2020.1837598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Loneliness is a mechanism through which marital quality relates to older adults' mental health. Links between marital quality, loneliness, and depressive symptoms, however, are often examined independent of older adults' functional health. The current study therefore examines whether associations between marital quality, loneliness, and depressive symptoms are contextually dependent on individuals' own (or their spouse's) functional limitations, as well as on gender. Data came from couples (N = 1084) who participated in the Health and Retirement Study (HRS), a nationally representative dataset of older adults (age 50+). We utilized data from the 2014 leave-behind psychosocial questionnaire to measure spousal support/strain and loneliness, and interview data from 2014 to measure baseline depressive symptoms and demographic covariates (e.g., race and education). Depressive symptoms in 2016 served as the focal outcome variable. Findings from a series of path models estimated in MPLUS indicated that loneliness is a mechanism through which spousal support predicts older adults' depressive symptoms. Such linkages, however, were dependent on individuals' own functional limitations and gender. For functionally limited males in particular, spousal support was shown to reduce depressive symptoms insofar as it was associated with lower levels of loneliness; otherwise, it was associated with higher levels of depressive symptoms. Such findings reinforce the importance of taking a contextualized approach when examining associations between support and emotional well-being later in life.
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Affiliation(s)
- Christina M Marini
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, USA
| | - Ashley E Ermer
- Family Science and Human Development, Montclair State University, Montclair, NJ, USA
| | - Katherine L Fiori
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, NY, USA
| | - Amy J Rauer
- Child and Family Studies, The University of Tennessee Knoxville, Knoxville, TN, USA
| | - Christine M Proulx
- Human Development and Family Science, University of Missouri, Columbia, MO, USA
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Donnellan WJ, Bennett KM, Soulsby LK. How does carer resilience change over time and care status? A qualitative longitudinal study. Aging Ment Health 2019; 23:1510-1516. [PMID: 30449140 DOI: 10.1080/13607863.2018.1503998] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Little research examines trajectories of carer resilience or the factors that facilitate or hinder resilience over time. We use qualitative longitudinal methods to examine trajectories of resilience and which assets and resources are associated with resilience and care status transitions in spousal dementia carers. Method: Based on an original sample of 23 spousal dementia carers (Donnellan, Bennett, & Soulsby, 2015 ), we conducted 13 follow-up interviews, including: 5 continuing home carers, 3 former carers (institutionalised), and 5 former carers (widowed). Results: Five participants remained resilient (stable resilient), three remained non-resilient (stable non-resilient) and four participants became resilient (non-resilient to resilient). Only one participant became non-resilient (resilient to non-resilient). Stable resilience was characterised by continuing individual assets and community resources. Carers who became resilient returned to previous resources, or gained new resources. Conclusion: Institutionalisation and widowhood are not always barriers to resilience; spousal dementia carers can remain or even become resilient over time despite deteriorating health, institutionalisation, or death of the care recipient.
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Affiliation(s)
- Warren J Donnellan
- Department of Psychological Sciences, University of Liverpool , Eleanor Rathbone Building, Bedford Street South , Liverpool , UK
| | - Kate M Bennett
- Department of Psychological Sciences, University of Liverpool , Eleanor Rathbone Building, Bedford Street South , Liverpool , UK
| | - Laura K Soulsby
- Department of Psychological Sciences, University of Liverpool , Eleanor Rathbone Building, Bedford Street South , Liverpool , UK
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Roper L, Donnellan W, Hanratty B, Bennett K. Exploring dimensions of social support and resilience when providing care at the end of life: a qualitative study. Aging Ment Health 2019; 23:1139-1145. [PMID: 30522340 DOI: 10.1080/13607863.2018.1484886] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Research shows that formal and informal social support can facilitate resilience in carers. There is a paucity of research exploring social support and resilience amongst recently bereaved informal carers. Aim: To examine how the presence or absence of distinct dimensions of social support facilitate or hinder resilience in recently bereaved informal carers. Participants: 44 bereaved carers, who had been identified by GP as 'main carer' of someone recently deceased (3-12 months), aged between 38 and 87 years old (mean= 67). Methods: Thematic analysis then the Ecological Framework of Resilience as an organisational tool to develop overarching themes in the data. We used the Sherbourne and Stewart model to identify social support that was lacking as well as social support that was present. Results: A range of social support types were identified. There was an emphasis on the importance of relationships with both health professionals and family members, including the care recipient. However, social support was not necessary for resilience if the participant had other resources. Conclusions: Social support for carers providing end of life care is almost exclusively based around end of life care 'work'. In comparison to other research our study suggests that relationships with family and health professionals are paramount. Multidimensional support is needed for carers to enhance their resilience.
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Affiliation(s)
- Louise Roper
- a Department of Health Service Research , University of Liverpool , Liverpool , UK
| | - Warren Donnellan
- b School of Psychology , University of Liverpool , Liverpool , UK
| | - Barbara Hanratty
- c Institute of Health & Society , Newcastle University , Newcastle , UK
| | - Kate Bennett
- b School of Psychology , University of Liverpool , Liverpool , UK
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Jones SM, Woodward M, Mioshi E. Social support and high resilient coping in carers of people with dementia. Geriatr Nurs 2019; 40:584-589. [PMID: 31178232 DOI: 10.1016/j.gerinurse.2019.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/21/2019] [Accepted: 05/24/2019] [Indexed: 12/18/2022]
Abstract
High resilience is associated with improved carer outcomes. Both individual factors and the availability of social support have been linked with resilience. This study was conducted to compare socio-demographic characteristics and the availability of social support for carers with low and high resilient coping, and identify if any domain of social support predicted high resilient coping in informal carers of people with dementia. The participants in this cross sectional survey included 108 informal carers of people with dementia. Findings showed the availability of emotional/informational support was most likely to predict resilient coping and tangible support the least likely. However, when controlling for all covariates, only gender predicted high resilient coping, individual social support domains were no longer significant. Therefore, as no single domain of social support has a significantly greater influence on resilient coping, service providers should enable carers to build a wide, multi-function support network.
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Affiliation(s)
- Susan May Jones
- University of East Anglia, School of Health Sciences, The Queen's Building, Norwich Research Park, Norwich, NR4 7TJ; Prestige Nursing and Care, Greenview House, 5 Manor Road Wallington, Surrey SM6 0BW, England.
| | - Michael Woodward
- University of East Anglia, School of Health Sciences, The Queen's Building, Norwich Research Park, Norwich, NR4 7TJ
| | - Eneida Mioshi
- University of East Anglia, School of Health Sciences, The Queen's Building, Norwich Research Park, Norwich, NR4 7TJ.
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Cherry MG, Ablett JR, Dickson JM, Powell D, Sikdar S, Salmon P. A qualitative study of the processes by which carers of people with dementia derive meaning from caring. Aging Ment Health 2019; 23:69-76. [PMID: 29105501 DOI: 10.1080/13607863.2017.1393792] [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] [Indexed: 10/18/2022]
Abstract
BACKGROUND Most individuals with dementia live in the community, receiving care from family or lay carers. Carers' wellbeing, and the quality of the care they provide, partly depends on their ability to derive meaning from caring for someone with dementia. Both carers' previous relationship with their relative and the caregiving process itself contribute to this sense of meaning. However, it remains unclear why some carers derive meaning from these sources, whereas others do not. OBJECTIVE To further explore the processes by which carers derive a sense of meaning from caring. METHODS Representative case sampling was used to recruit a purposive sample of 20 carers for individuals living with dementia. In-depth semi-structured interviews were audio-recorded and transcribed, and analysed using pluralist qualitative methodology. RESULTS A framework of three sources from which carers derived meaning from caring was identified, encompassing: carers' perceptions of how 'right' or 'symmetrical' caring felt in light of their current and previous relationship with the person with dementia; maintenance of a 'protected' sense of self within the care relationship; and carers' perceptions of their 'social connectedness' outside the relationships. CONCLUSION Holistic assessment based on this framework could help to tailor individualised provision of support, foster resilience and safeguard carers' well-being.
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Affiliation(s)
- M G Cherry
- a Department of Psychological Sciences , University of Liverpool , Liverpool , United Kingdom of Great Britain and Northern Ireland.,b Liverpool Cancer Psychology Service, Linda Mccartney Centre , Royal Liverpool University Hospital , Liverpool , United Kingdom of Great Britain and Northern Ireland
| | - J R Ablett
- b Liverpool Cancer Psychology Service, Linda Mccartney Centre , Royal Liverpool University Hospital , Liverpool , United Kingdom of Great Britain and Northern Ireland.,c Division of Clinical Psychology , University of Liverpool , Liverpool , United Kingdom of Great Britain and Northern Ireland
| | - J M Dickson
- a Department of Psychological Sciences , University of Liverpool , Liverpool , United Kingdom of Great Britain and Northern Ireland.,d Psychology Department (Building 30) , Edith Cowan University , Joondalup , Australia
| | - D Powell
- e Arise Clinical Psychology Liverpool , Liverpool , United Kingdom of Great Britain and Northern Ireland
| | - S Sikdar
- f Older Adults' Mental Health Team , South Sefton Community Resource Centre , Liverpool , United Kingdom of Great Britain and Northern Ireland
| | - P Salmon
- c Division of Clinical Psychology , University of Liverpool , Liverpool , United Kingdom of Great Britain and Northern Ireland
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Rabanal LI, Chatwin J, Walker A, O’Sullivan M, Williamson T. Understanding the needs and experiences of people with young onset dementia: a qualitative study. BMJ Open 2018; 8:e021166. [PMID: 30344167 PMCID: PMC6196838 DOI: 10.1136/bmjopen-2017-021166] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIM Despite an estimated 40 000 people diagnosed with young onset dementia (YOD) in the UK, there is a general lack of awareness of the condition when compared with late onset dementia. The aim of this study was to explore the experiences and needs of people living with YOD (younger than 65 years) and gain an understanding of the issues that impact on them. SETTING Participants' homes, support group premises or university rooms. PARTICIPANTS 14 people with a diagnosis of YOD from a northern UK city. DESIGN Semistructured, in-depth interviews were audio recorded, transcribed and analysed cross-sectionally following principles of interpretative phenomenological analysis. RESULTS Four superordinate themes are reported on 'process of diagnosis', 'the impact of living YOD', 'needs of people with YOD' and 'living well with YOD'. Nine subordinate themes captured participant experiences of developing cognitive difficulties, after being diagnosed with YOD, and subsequently living with the condition. Key issues that emerging included a lack of general awareness of YOD; how this can delay help seeking; commonalities in prediagnosis trajectories; retrospective understanding of prediagnosis symptom patterns; the difficulties of obtaining a firm diagnosis; the importance of face-to-face support and difficulties associated with daily living. Participants also described the emotional and psychological impact of the condition and the importance of formal and informal support networks. CONCLUSIONS People who have a diagnosis of YOD regard themselves as distinct from older people with dementia. Despite similar symptoms, the context in which they experience the condition creates a range of distinct psychosocial concerns not commonly well addressed by health and social care services. As awareness of YOD continues to grow, the development (or adaptation) of services that take into account the idiosyncratic needs of people with YOD should be addressed.
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Affiliation(s)
- Luisa I Rabanal
- Salford Institute for Dementia, University of Salford, Salford, UK
| | - John Chatwin
- Salford Institute for Dementia, University of Salford, Salford, UK
| | - Andy Walker
- Salford Institute for Dementia, University of Salford, Salford, UK
| | - Maria O’Sullivan
- Salford Institute for Dementia, University of Salford, Salford, UK
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Jones SM, Killett A, Mioshi E. What Factors Predict Family Caregivers’ Attendance at Dementia Cafés? J Alzheimers Dis 2018; 64:1337-1345. [DOI: 10.3233/jad-180377] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Susan May Jones
- School of Health Sciences, University of East Anglia, Norwich, UK
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich, UK
| | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, UK
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