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Cannon CJ, Gray MJ. A Caregiver Perspective for Partners of PTSD Survivors: Understanding the Experiences of Partners. Behav Sci (Basel) 2024; 14:644. [PMID: 39199040 PMCID: PMC11352201 DOI: 10.3390/bs14080644] [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: 06/03/2024] [Revised: 07/10/2024] [Accepted: 07/12/2024] [Indexed: 09/01/2024] Open
Abstract
Research affirms that survivors of post-traumatic stress disorder (PTSD) experience psychological distress that affects their romantic partners, and that a bi-directional effect between PTSD symptoms and romantic relationship satisfaction exists, indicating that improvements in the romantic relationship may lead to the improved well-being of the survivor. Indeed, as romantic partners of PTSD survivors are both negatively impacted by the distress of the survivor, and romantic relationship satisfaction can affect the distress of the PTSD survivor, partners are a key stakeholder for mental health. Unfortunately, theoretical models have not adequately captured the experience of this population to properly illuminate their experience and provide appropriate treatment directives. This paper examines the informal caregiving integrative model to determine its applicability to the romantic partners of PTSD survivors with respect to the determinants, mediators, and outcomes. The current literature on romantic partners is used to evaluate the adequacy of fit, as well as to provide the components unique to partners. Future directions, clinical implications, and limitations of current research are explored based on the results of this review.
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Affiliation(s)
| | - Matt J. Gray
- Department of Psychology, University of Wyoming, Laramie, WY 82072, USA
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2
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Zhu M, Lai M, Chen R, Zhang Q. Web-Based Compassion Interventions for Family Caregivers' Mental Well-Being: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2024; 25:802-809.e3. [PMID: 38242533 DOI: 10.1016/j.jamda.2023.12.002] [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: 09/15/2023] [Revised: 12/01/2023] [Accepted: 12/01/2023] [Indexed: 01/21/2024]
Abstract
OBJECTIVES To assess the effectiveness of web-based compassion interventions on the mental well-being of family caregivers. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Randomized controlled trials of web-based compassion intervention for family caregivers. METHODS MEDLINE, Embase, PsycINFO, Web of Science, Cochrane Library, and Proquest were searched from database inception until manuscript submission date. Eligible studies included family caregivers participating in web-based compassionate interventions with reported mental wellness indicators, such as self-compassion. Two independent researchers conducted a literature review, extracted data, and assessed the quality of each study using the risk of bias 2 tool. Random effects meta-analysis was performed to pool the data, followed by subgroup analyses, sensitivity analyses, and Egger's tests. RESULTS Of 1095 studies evaluated, 8 randomized controlled trials (encompassing 1978 participants) were included, with 75% exhibiting low risk of bias and high-quality evidence. Meta-analysis results indicated positive effects of web-based compassion interventions on family caregivers' self-compassion [standardized mean difference (SMD), 0.33; 95% CI, 0.08-0.58; P = .009] and mindfulness (SMD, 0.46; 95% CI, 0.03-0.90; P = .04). These interventions also demonstrated a positive impact on reducing stress (SMD, -0.32; 95% CI, -0.59 to -0.04; P = .02) and anxiety (SMD, -0.28; 95% CI, -0.47 to -0.09; P = .003). Subgroup analyses highlighted superior self-compassion outcomes for caregivers supporting individuals with mental illness and cancer compared with those caring for individuals with Alzheimer's disease. Interventions lasting ≥8 weeks were the most common and effective. CONCLUSIONS AND IMPLICATIONS Web-based compassion interventions benefit family caregivers by enhancing self-compassion, mindfulness, and reducing anxiety and stress. More well-designed studies are suggested for future clinical applications.
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Affiliation(s)
- Manyu Zhu
- Sun Yat Sen University, School of Nursing, Guangzhou, Guangdong, China; Cardiac Intensive Care Department, Institute of Cardiovascular Disease, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Minhua Lai
- Department of Obstetrics and Gynecology, Center for Reproductive Medicine, Key Laboratory for Major Obstetric Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Rong Chen
- Sun Yat Sen University, School of Nursing, Guangzhou, Guangdong, China
| | - Qi Zhang
- Sun Yat Sen University, School of Nursing, Guangzhou, Guangdong, China.
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Castillo LIR, Tran V, Hadjistavropoulos T. Are mobile apps meeting the needs of caregivers of people living with dementia? An evaluation of existing apps for caregivers. Aging Ment Health 2024; 28:577-586. [PMID: 36775643 DOI: 10.1080/13607863.2023.2177832] [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: 11/11/2022] [Accepted: 02/02/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVES Informal caregivers of people living with dementia (ICPDs) experience stressors that can lead to adverse outcomes. Although apps for ICPDs are available, evidence to support their effectiveness is limited. This investigation was aimed at providing an evaluation of available apps for ICPDs. METHODS We conducted two studies: 1) search and evaluation of available apps; and 2) controlled trial of two apps identified in the Study 1 (NCT05217004). For Study 2, participants were randomly assigned to one of the two app-using groups or a control group. Outcome measures were administered before, post-intervention, and at a follow-up. Interviews with caregivers were conducted to examine their needs regarding the development of future apps. RESULTS Sixteen apps were examined in Study 1. Results suggest that the number and type of features present in each app may not be sufficient to address the multifaceted needs of ICPDs. In Study 2, contrary to expectation, we did not identify differences between the app-using and control conditions on our outcome measures. Participants noted several content and user-experience needs to consider in developing new apps. CONCLUSION Findings from the investigation can inform future developments of apps to address the needs of ICPDs.
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Affiliation(s)
- Louise I R Castillo
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Canada
| | - Vivian Tran
- Department of Psychology and Centre on Aging and Health, University of Regina, Regina, Canada
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Lin H, Lin R, Yan M, Lin L, Sun X, Wu M, Dai X, Lin N. Associations between preparedness, perceived stress, depression, and quality of life in family caregivers of patients with a temporary enterostomy. Eur J Oncol Nurs 2024; 70:102557. [PMID: 38581900 DOI: 10.1016/j.ejon.2024.102557] [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: 10/25/2023] [Revised: 02/19/2024] [Accepted: 03/10/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE To investigate the preparedness, perceived stress, risk of depression, and quality of life of family caregivers of patients receiving a temporary enterostomy, to provide a reference for improving the long-term care and quality of life of patients receiving a temporary enterostomy. METHODS We enrolled 181 family caregivers of patients in a hospital in China from 2021 to 2023. Responses to the General Information Questionnaire, the Chinese Caregiver Preparedness Scale, the Chinese Perceived Stress Scale, the Chinese bilingual version of the Patient Health Questionnaire-2, and the 12-item Short Form Survey were collected online. RESULTS Pearson's correlation analysis revealed that family caregivers' risk of depression was negatively correlated with their preparedness, the physical component summary score, and the mental component summary score but was positively correlated with perceived stress. Multiple linear regression analysis identified factors influencing caregiver preparedness. CONCLUSIONS These findings help healthcare personnel to identify high-risk individuals among family caregivers of patients receiving a temporary enterostomy. This provides a basis for formulating well-planned, dynamic health education programs that meet patients' needs for disease-related knowledge and care.
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Affiliation(s)
- Huayan Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Rongjin Lin
- Department of Nursing, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Nursing, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Mengting Yan
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Liying Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Xinyue Sun
- Department of Nursing, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Nursing, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Mengting Wu
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiaofeng Dai
- Department of Neurology, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Neurology, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China
| | - Na Lin
- Department of Gastrointestinal Surgery, The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China; Department of Gastrointestinal Surgery, National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University, Fuzhou, Fujian, China.
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Thompson CM, Voorhees HL, Taniguchi-Dorios E, Makos S, Pool K, Babu S. Development and Initial Assessment of an Emotional Support Provision Training Intervention for Interpersonal Support Providers in the Context of Chronic Illness. HEALTH COMMUNICATION 2024:1-14. [PMID: 38467583 DOI: 10.1080/10410236.2024.2325183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/13/2024]
Abstract
This study reports on the development and pilot testing of an emotional support provision training intervention for interpersonal support providers to those with chronic illnesses. Using findings from a needs assessment in combination with existing theory and research, we created a training framework consisting of verbal person-centered message design, empathic listening, and communicated perspective-taking. Then, we recruited 282 individuals to participate in a pre-training questionnaire, the online training module, a post-training questionnaire, and a two-week post-training questionnaire. Outcome variables included emotional support knowledge, efficacy, and intentions, as well as general support efficacy, response efficacy, and quality. Repeated measures MANCOVA revealed significant increases from T1 to T2 for all variables of interest. These increases were sustained at T3 for emotional support knowledge and efficacy, and support provision response efficacy. Participants rated the training favorably and provided helpful suggestions for improvement. This study answers the call for more theoretically-grounded support interventions that not only assess theory in real-world settings, but also help people better their supportive communication skills.
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Affiliation(s)
- Charee M Thompson
- Department of Communication, University of Illinois Urbana-Champaign
| | | | - Emiko Taniguchi-Dorios
- Communicology Program, School of Communication and Information, University of Hawai'i at Manoa
| | - Shana Makos
- Department of Communication, University of Illinois Urbana-Champaign
| | - Kirsten Pool
- Department of Communication, University of Illinois Urbana-Champaign
| | - Sara Babu
- Department of Communication, University of Illinois Urbana-Champaign
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Silaule O, Casteleijn D, Adams F, Nkosi NG. Strategies to Alleviate the Burden Experienced by Informal Caregivers of Persons With Severe Mental Disorders in Low- and Middle-Income Countries: Scoping Review. Interact J Med Res 2024; 13:e48587. [PMID: 38236636 PMCID: PMC10835589 DOI: 10.2196/48587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 08/20/2023] [Accepted: 10/04/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND There is considerable evidence of the burden of care encountered by informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. Previous studies have highlighted the need to support these informal caregivers as key players in the care of these patients. To date, limited evidence exists on the extent and types of strategies for supporting these informal caregivers in low- and middle-income countries. OBJECTIVE This scoping review aims to identify and describe the extent and type of evidence on the existing strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions in low- and middle-income countries. METHODS A systematic literature search was completed following the Joanna Briggs Institute methodology for scoping reviews. The participants, concept, and context framework was used to guide the search for literature sources across 5 databases: PubMed, MEDLINE, CINAHL, and PsycINFO for published literature and ProQuest for unpublished literature. This review included studies that reported on strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions, with a focus on studies that evaluated or recommended caregiver interventions and support strategies in low- and middle-income countries. The search was limited to studies conducted between 2001 and 2021, and only papers written in English were considered for inclusion. Using the Covidence software (Veritas Health Innovation), 2 reviewers independently screened the papers, applied the inclusion and exclusion criteria, and met biweekly to discuss and resolve conflicts. The relevant studies and reported outcomes were summarized, organized, and analyzed descriptively using numeric summary analysis and deductive content analysis. RESULTS Of the 18,342 studies identified, 44 (0.24%) met the inclusion criteria. The included studies were from 16 low- and middle-income countries in Asia, Africa, Europe, and South and North America. Most studies (21/44, 48%) were randomized controlled trials conducted in Asian countries. The identified strategies were grouped into 2 categories: implemented and recommended intervention strategies. Identified strategies included community-based interventions, psychoeducation interventions, support groups, cognitive behavioral therapy, spirituality-based interventions, and smartphone-based interventions. In addition, mindfulness and empowerment, collaborative interventions, standard care, financial and social support, counseling, occupation-based interventions, policy and legislature, and access to mental health care were identified. Psychoeducation and support group interventions were identified as common strategies for alleviating the burden of care among informal caregivers of persons with severe and enduring mental health conditions. CONCLUSIONS This review provides evidence on the types of implemented and recommended strategies for alleviating the burden of care among informal caregivers in low- and middle-income countries. Although psychoeducational interventions were the most preferred strategy for alleviating burden, their benefits were short-lived when compared with peer-led support groups. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/44268.
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Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, University of the Witwatersrand, Johannesburg, South Africa
| | - Daleen Casteleijn
- Department of Occupational Therapy, University of Pretoria, Pretoria, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula Gloria Nkosi
- Department of Nursing Education, University of the Witwatersrand, Johannesburg, South Africa
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7
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Boak J, Rasekaba T, Baxter P, Blackberry I. How is complexity measured and detected among community dwelling older people aged 65 years and over? A scoping review. J Adv Nurs 2024; 80:84-95. [PMID: 37574775 DOI: 10.1111/jan.15824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/22/2023] [Accepted: 07/29/2023] [Indexed: 08/15/2023]
Abstract
AIM To identify and explore tools that measured and detected complexity of care among community dwelling people aged 65 years and older. DATA SOURCES Databases were searched for articles published up to 23 September 2022 including CINAHL, EMBASE and MEDLINE, Cochrane database for trials and grey literature. METHODS A scoping review was conducted and reported in accordance with the PRISMA guidelines. Eligible articles included those with participants aged over 65 years, living in the community and studies that included care complexity detection or assessment and how this related to care delivered. Covidence was used to screen titles, abstracts and full-text articles. RESULTS Eighteen full texts were reviewed; four studies were included in the final review. All selected studies included people aged over 65 years living in the community. A high level of reliability for the items included in the interventions was found. The selected studies included tools for assessing older person's needs with nurses involved in the assessment. CONCLUSION The review identified four tools for measuring complexity in community dwelling older people. Two tools have the capacity to objectively measure complexity due to the holistic nature of items included and appear easy to use to support clinical judgement decisions. IMPACT The review places a spotlight on the concept of complexity and highlights the lack of definition of care complexity. The synthesized result highlights the need to explore detection of care complexity of older people further and consider ways of supporting clinical judgement and decision making of community nurses. The use of a validated tool may enhance clinical judgement regarding care complexity and may lead to a more consistent and timely approach to care. PATIENT OR PUBLIC CONTRIBUTION During the development phase, the study was presented to a consumer group from the researcher's workplace. PROSPERO REGISTRATION CRD42022299336.
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Affiliation(s)
- Jennifer Boak
- Bendigo Health, Community Nursing Service, East Bendigo, Victoria, Australia
| | - Tshepo Rasekaba
- John Richards Centre for Ageing Research, La Trobe University, Wodonga, Victoria, Australia
| | - Pamela Baxter
- School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Irene Blackberry
- John Richards Centre for Ageing Research, La Trobe University, Wodonga, Victoria, Australia
- Care Economy Research Institute, La Trobe University, Wodonga, Victoria, Australia
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Chavan PP, Weitlauf JC, LaMonte MJ, Sisto SA, Tomita M, Gallagher-Thompson D, Shadyab AH, Bidwell JT, Manson JE, Kroenke CH, Hayden KM, Hirsch CH, Mouton CP, Cannell MB, Hovey KM, Wactawski-Wende J. Caregiving and all-cause mortality in postmenopausal women: Findings from the Women's Health Initiative. J Am Geriatr Soc 2024; 72:24-36. [PMID: 37936486 PMCID: PMC10841917 DOI: 10.1111/jgs.18620] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/31/2023] [Accepted: 09/11/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Caregiving is commonly undertaken by older women. Research is mixed, however, about the impact of prolonged caregiving on their health, well-being, and mortality risk. Using a prospective study design, we examined the association of caregiving with mortality in a cohort of older women. METHODS Participants were 158,987 postmenopausal women aged 50-79 years at enrollment into the Women's Health Initiative (WHI) who provided information on current caregiving status and caregiving frequency at baseline (1993-1998) and follow-up (2004-2005). Mortality was ascertained from baseline through March of 2019. Cox regression with caregiving status defined as a time-varying exposure was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for mortality, adjusting for sociodemographic factors, smoking, and history of diabetes, hypertension, cardiovascular disease (CVD), and cancer. Stratified analyses explored whether age, race-ethnicity, depressive symptoms, frequency of caregiving, optimism, and living status modified the association between caregiver status and mortality. RESULTS At baseline, 40.7% of women (mean age 63.3 years) self-identified as caregivers. During a mean 17.5-year follow-up, all-cause mortality (50,526 deaths) was 9% lower (multivariable-adjusted HR = 0.91, 95% CI: 0.89-0.93) in caregivers compared to non-caregivers. The inverse association between caregiving and all-cause mortality did not differ according to caregiving frequency or when stratified by age, race-ethnicity, depressive symptoms, optimism, or living status (interaction p > 0.05, all). Caregiving was inversely associated with CVD and cancer mortality. CONCLUSION Among postmenopausal women residing across the United States, caregiving was associated with lower mortality. Studies detailing the type and amount of caregiving are needed to further determine its impact on older women.
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Affiliation(s)
- Prachi P. Chavan
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY
- Master of Public Health Program, School of Health Professions, Eastern Virginia Medical School, Norfolk, VA
| | - Julie C. Weitlauf
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Stanford, CA
| | - Michael J LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY
| | - Sue Ann Sisto
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, University at Buffalo-SUNY, NY
| | - Machiko Tomita
- Department of Rehabilitation Sciences, School of Public Health and Health Professions, University at Buffalo-SUNY, NY
| | | | - Aladdin H. Shadyab
- Herbert Wertheim School of Public Health and Human, University of California San Diego, Longevity Science, La Jolla, CA
| | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, Family Caregiving Institute, University of California Davis, Sacramento, CA
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Harvard University, Boston, MA
| | | | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC
| | - Calvin H. Hirsch
- Division of General Medicine, University of California Davis Medical Center, Sacramento, CA
| | - Charles P. Mouton
- Office of Provost, University of Texas Medical Branch, Galveston, TX
| | - Michael Brad Cannell
- Department of Epidemiology, Human Genetics, and Environmental Science, School of Public Health, University of Texas Health Science Center, Dallas, TX
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo-SUNY, Buffalo, NY
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Murfield J, Moyle W, O'Donovan A, Ware RS. The Role of Self-Compassion, Dispositional Mindfulness, and Emotion Regulation in the Psychological Health of Family Carers of Older Adults. Clin Gerontol 2024; 47:316-328. [PMID: 33263503 DOI: 10.1080/07317115.2020.1846650] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVES This study explored the role of compassion and dispositional mindfulness in the psychological health of family carers of older adults and tested for potential mediating effects of emotion regulation difficulties and adaptive coping strategies. METHODS A sample of 141 family carers of adults aged 65 years or older with chronic conditions completed a cross-sectional survey between July - December 2019. The survey included self-report scales that measured: self-compassion, compassion for others, compassion from others, dispositional mindfulness, depression, anxiety, stress, emotion- and problem-focused coping strategies, and difficulties in emotion regulation. RESULTS Path analyses found that increased self-compassion and increased dispositional mindfulness was associated with lower psychological distress, and that this was mediated by reduced difficulties in emotion regulation. The model had excellent fit, explaining 64.8% of the variance in psychological distress, and 52.2% of the variance in emotion regulation difficulties. CONCLUSIONS Self-compassion and dispositional mindfulness may help buffer the psychological distress of family carers of older adults, and adaptive emotion regulation is an important mechanism of change in these relationships. CLINICAL IMPLICATIONS Interventions that aim to cultivate self-compassion and mindfulness could be clinically useful in reducing psychological distress within populations of family carers of older adults by promoting adaptive emotion regulation.
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Affiliation(s)
- Jenny Murfield
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Nursing and Midwifery, Griffith University, Brisbane, Australia
| | | | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
- School of Medicine, Griffith University, Brisbane, Australia
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10
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Parks CG, Pettinger M, de Roos AJ, Tindle HA, Walitt BT, Howard BV. Life Events, Caregiving, and Risk of Autoimmune Rheumatic Diseases in the Women's Health Initiative Observational Study. Arthritis Care Res (Hoboken) 2023; 75:2519-2528. [PMID: 37230960 PMCID: PMC10798355 DOI: 10.1002/acr.25164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 05/15/2023] [Accepted: 05/23/2023] [Indexed: 05/27/2023]
Abstract
OBJECTIVE Growing evidence suggests psychosocial stressors may increase risk of developing autoimmune disease. We examined stressful life events and caregiving in relation to incident rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) in the Women's Health Initiative Observational Study cohort. METHODS The sample of postmenopausal women included 211 incident RA or SLE cases reported within 3 years after enrollment, confirmed by use of disease-modifying antirheumatic drugs (i.e., probable RA/SLE), and 76,648 noncases. Baseline questionnaires asked about life events in the past year, caregiving, and social support. We used Cox regression models to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs), adjusting for age, race/ethnicity, occupational class, education, pack-years of smoking and BMI. RESULTS Incident RA/SLE was associated with reporting 3 or more life events (e.g., age-adjusted HR 1.70 [95% CI 1.14, 2.53]; P for trend = 0.0026). Elevated HRs were noted for physical (HR 2.48 [95% CI 1.02, 6.04]) and verbal (HR 1.34 [0.89, 2.02]) abuse (P for trend = 0.0614), 2 or more interpersonal events (HR 1.23 [95% CI 0.87, 1.73]; P for trend = 0.2403), financial stress (HR 1.22 [95% CI 0.90, 1.64]), and caregiving 3 or more days per week (HR 1.25 [95% CI 0.87, 1.81]; P for trend = 0.2571). Results were similar, excluding women with baseline symptoms of depression or moderate-to-severe joint pain in the absence of diagnosed arthritis. CONCLUSION Our findings support the idea that diverse stressors may increase risk of developing probable RA or SLE in postmenopausal women, supporting the need for further studies in autoimmune rheumatic diseases, including childhood adverse events, life event trajectories, and modifying psychosocial and socioeconomic factors.
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Affiliation(s)
- Christine G. Parks
- National Institute of Environmental Health Sciences, National Institute of Health, Research Triangle Park, NC
| | - Mary Pettinger
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA
| | - Anneclaire J. de Roos
- Department of Environmental & Occupational Health, Drexel University Dornsife School of Public Health, Philadelphia, PA
| | - Hilary A. Tindle
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN
- Geriatric Research Education and Clinical Centers, Veterans Affairs Tennessee Valley Healthcare System, Nashville, TN
| | - Brian T. Walitt
- National Institute of Nursing Research, National Institutes of Health, Bethesda, MD
| | - Barbara V. Howard
- Georgetown-Howard Universities Center for Clinical and Translational Science, Washington, DC, USA; MedStar Health Research Institute, Hyattsville, MD, USA
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11
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Kızılkaya M, Atuğ M. Views of Family Members Who Take Care of an Elderly Person they Live with on Ageism, Spirituality and Death in Turkey: A Qualitative Approach. JOURNAL OF RELIGION AND HEALTH 2023; 62:3095-3109. [PMID: 37266900 DOI: 10.1007/s10943-023-01837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/03/2023]
Abstract
This descriptive qualitative research examined the views of people caring for an elderly family member on ageism, spirituality, and death. A total of 12 people who lived in the same house as the elderly person they cared for made up the study sample. Data were collected via face-to-face, in-depth interviews using a structured interview format. The content analysis method was used for the data analysis. The analysis of the study data yielded three themes: the definition of ageism, the meaning of spirituality and its effects on care, and the position of death in life. The results indicated that living with and caring for an elderly individual made the lives of the family members providing care meaningful, spirituality was important in the care of elderly individuals, and caregivers could be considered at risk in terms of the burden of care. It is recommended that health professionals support caregivers sharing the same house with an elderly family member through training programs on the burden of care, spiritual care, and death.
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Affiliation(s)
- Mehtap Kızılkaya
- Department of Mental Health and Diseases Nursing, Faculty of Nursing, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Mahsun Atuğ
- Aydın Adnan Menderes University Research and Application Hospital, Aydın, Turkey
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Testoni I, Nicoletti AE, Moscato M, De Vincenzo C. A Qualitative Analysis of the Experiences of Young Patients and Caregivers Confronting Pediatric and Adolescent Oncology Diagnosis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6327. [PMID: 37510561 PMCID: PMC10378996 DOI: 10.3390/ijerph20146327] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/04/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023]
Abstract
Epidemiological studies show that new cases of young oncology patients are increasing by 400,000 every year. Psychological literature has shown that receiving an oncological diagnosis can cause significant psychological stress and discomfort. However, the experiences of young patients and their caregivers as they confront this challenge are not yet fully understood. This paper adopts a qualitative methodological approach to explore how young patients with an oncological diagnosis and their parents make sense of the experiential challenges they face. Thus, the research realized 18 semi-structured interviews, 11 of which were with pediatric and adolescent oncology patients, and 7 of which were with 6 mothers and 1 father. The qualitative thematic analysis revealed that the oncological diagnosis triggers different emotions taking the scene in the attempt to cope with the threats of meaning that the diagnosis poses. However, such intense experience promotes transformative feelings in parents and young patients, leading to important personal growth. Lastly, this article discusses the need to improve palliative psychological care competences in pediatric oncology. By providing comprehensive psychological care to young oncology patients and their families, healthcare providers can mitigate the psychological stress and pain associated with the diagnosis and treatment of cancer.
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Affiliation(s)
- Ines Testoni
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35131 Padua, Italy
- Sagol Creative Arts Therapies Research Center, Haifa 31905, Israel
| | | | - Matilde Moscato
- Sagol Creative Arts Therapies Research Center, Haifa 31905, Israel
| | - Ciro De Vincenzo
- Department of Philosophy, Sociology, Education and Applied Psychology (FISPPA), University of Padova, 35131 Padua, Italy
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Cross LA, Koren A, Dowling JS, Gonzales JE. Compassion Fatigue and Family Caregivers Caring in End-Stage Heart Failure. Res Theory Nurs Pract 2023; 37:195-213. [PMID: 37263637 DOI: 10.1891/rtnp-2022-0084] [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: 06/03/2023]
Abstract
Background: Compassion fatigue is a negative consequence impacting caregivers of chronic illness, such as heart failure. Reliance on family caregivers is expected to rise, placing importance on recognizing family caregiver characteristics that contribute to compassion fatigue. Purpose: This study specifically examined the associations of characteristics of family caregivers caring for end-stage heart failure, compassion satisfaction, social desirability, and the family caregiver-nursing provider relationship on compassion fatigue. Methods: An adapted interaction model of client health behavior guided this cross-sectional survey, which comprised a demographic questionnaire, the Professional Quality-of-Life Scale, the caregiver-provider relationship assessment, the Marlowe-Crowne Social Desirability Scale Short Form (Form C), and the Bakas Caregiving Outcomes Scale. Results: There were 127 family caregivers (FCGs), primarily those who have been a caregiver for longer than 1 year (78.4%), who completed the entire survey. Increased compassion satisfaction and positive caregiving effects were associated with decreased compassion fatigue (p < .001), while increased social desirability was associated with increased compassion fatigue (p < .001). A positive family caregiver-nursing provider relationship was related to decreased compassion fatigue (p < .001). More compassion fatigue was seen with lower spiritual status (p < .001). Implications: The chronic progression of heart failure presents opportunities for nursing providers to assess caregivers and offer frequent interventions. Family caregivers may not ask for help. Nursing providers must foster relationships with family caregivers to prevent negative consequences and mitigate compassion fatigue. Future research on the nursing provider relationship and FCGs is needed.
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Affiliation(s)
- Lisa A Cross
- School of Nursing, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA
| | - Ainat Koren
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Jacqueline S Dowling
- Solomont School of Nursing, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Joseph E Gonzales
- Department of Psychology, University of Massachusetts Lowell, Lowell, Massachusetts, USA
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Upasen R, Saengpanya W. Combating with Compassion Fatigue: The Perspective of Family Caregivers of People with Schizophrenia. Asian Nurs Res (Korean Soc Nurs Sci) 2022; 16:249-255. [PMID: 36191894 DOI: 10.1016/j.anr.2022.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 09/14/2022] [Accepted: 09/22/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The purpose of this study was to explore the coping processes used by family caregivers of individuals with schizophrenia to deal with compassion fatigue (CF). METHODS Grounded theory was used in this study. For recruitment, purposive and theoretical samplings were used to recruit participants. Data were collected from 29 family caregivers through in-depth interviews and field notes. Data were analyzed using constant and comparative methods. RESULTS The study revealed a core process for dealing with CF as "Combating with compassion fatigue" that comprised three dynamic phases: strengthening attachment with the care recipient to increase willpower, learning how to deal with the illness, and self-empowerment to fight to the physical and mental fatigue. CONCLUSIONS Family caregivers of people with a diagnosis of schizophrenia use various strategies to fight to CF. These combine the past experiences of strategies that work and new approaches. Our research will allow mental health professionals to provide basic strategies to family caregivers of people with a diagnosis of schizophrenia to help them to cope with CF.
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Affiliation(s)
| | - Weeraphol Saengpanya
- Faculty of Education, Division of Educational Psychology, Chulalongkorn University, Thailand.
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15
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Orbay İ, Baydur H, Uçan G. Compassion Fatigue in Informal Caregivers of Children with Cancer; a Section from Turkey. SOCIAL WORK IN PUBLIC HEALTH 2022; 37:729-743. [PMID: 35658822 DOI: 10.1080/19371918.2022.2085837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Compassion fatigue is the natural stress caused by the strong desire to help a valued person and alleviate the pain he/she suffers after he/she undergoes a traumatizing event. That caregiver who witnesses the physical suffering of the patient, who makes intense effort during the process deprived of the social, psychological, or economic support they need is among the reasons causing compassion fatigue. In this study, the aim was to test and describe the effects of compassion fatigue on informal caregivers of children with cancer. The study is phenomenological, a form of a qualitative study. The participants were the relatives of children with cancer. The data were obtained through in-depth interviews. The audio-recorded interviews were analyzed through the inductive thematic analysis to obtain answers to the questions. The findings were categorized under four headings which compassion fatigue was addressed: Empathy ability, compassion stress, problems experienced by the participants as components of compassion fatigue. The results of this study demonstrated that mothers were at risk of compassion fatigue. Those who give care to their relatives are faced with problems more than professionals. It is recommended that the implementation of multidisciplinary interventions that will improve caregivers' well-being, and preventive social work interventions, will prevent them from compassion fatigue.
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Affiliation(s)
- İsmail Orbay
- Department of Social Work, Faculty of Economics and Administrative Sciences, Hacettepe University, Çankaya- Ankara, Turkey
| | - Hakan Baydur
- Department of Social Work, Faculty of Health Sciences, Manisa Celal Bayar University, Yunusemre- Manisa, Turkey
| | - Gülten Uçan
- Department of Social Work, Faculty of Health Sciences, Manisa Celal Bayar University, Yunusemre- Manisa, Turkey
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16
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Khalaila R. The Relationship Between Dual Filial Piety and Caregiver Burden Among Arab Family Caregivers in Israel. Res Gerontol Nurs 2022; 15:293-302. [PMID: 36214736 DOI: 10.3928/19404921-20220930-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study examined the association between dual filial piety (FP) (reciprocal and authoritarian) and caregiver burden in adult children caregivers and attempted to understand the underlying mechanisms of these links. A cross-sectional study of 222 family caregivers of older relatives in an Arab community in Israel was performed. Data were collected via face-to-face interviews in Arabic using structured questionnaires. Bootstrapping with resampling strategies tested the multiple mediator model. Reciprocal and authoritarian components of FP were associated negatively with caregiver burden. The link with reciprocal FP was partially mediated by role engagement and relationship strain between caregiver and care recipient, whereas the link between authoritarian FP and caregiver burden was mediated by role engagement, but not by relationship strain between caregiver and care recipient. The study highlights the positive effect of cultural values (dual FP) and the underlying mechanisms working against the harmful effects of caregiving stressors in traditional societies, such as Arab-Israeli society. Practitioners should be sensitive to issues of family cultural values and family care among traditional populations. [Research in Gerontological Nursing, xx(x), xx-xx.].
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Khalaila R. Does emotional empathy moderate the association between caregiver burden and burnout among Arab family caregivers of older relatives? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2478-e2488. [PMID: 35285558 DOI: 10.1111/hsc.13689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/09/2021] [Accepted: 12/09/2021] [Indexed: 06/14/2023]
Abstract
The purpose of this study was to examine the associations between caregiver's burden and three components of burnout (emotional exhaustion, depersonalisation, and sense of personal accomplishment) among family caregivers, as well as the moderating effects of emotional empathy on these associations. We conducted a cross-sectional study of 300 informal caregivers caring for their elderly relatives in the Arab community in Israel, using face-to-face structured interviews in Arabic. Three hierarchical regressions were applied to examine the factors related to each of the burnout components. Additional bootstrapping with resampling strategies was used to test the moderation effects of emotional empathy. The results showed positive correlations between caregiver's burden and two burnout components, emotional exhaustion and depersonalisation, but not with personal accomplishment. Greater emotional exhaustion and depersonalisation levels were related to higher emotional empathy. Perceived social support is linked negatively with emotional exhaustion and depersonalisation levels, and positively with personal accomplishment. In addition, emotional empathy emerged as a moderator in the associations between caregiver burden and two components of burnout: emotional exhaustion and depersonalisation. Interventions for familial caregivers should aim to heighten social support and to educate caregivers on effectively regulating their emotional empathy to reduce caregiver's burden and burnout.
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18
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Xue M, Chen X, Zhao H, Zhao Y, Li J, Chen W. Understanding the experiences of older caregivers of patients with lung cancer during palliative chemotherapy in China: a qualitative study. Support Care Cancer 2022; 30:8011-8018. [PMID: 35764692 DOI: 10.1007/s00520-022-07247-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/20/2022] [Indexed: 11/28/2022]
Abstract
PURPOSE Although there has been an increase in research on caregivers of patients with cancer, there has been little focus on the specific experiences of older caregivers of patients with lung cancer and the effect of their cultural backgrounds on their experiences. This study explored the caregiver experience among the ageing population in China. METHODS Older caregivers of patients with lung cancer undergoing palliative chemotherapy were recruited. Data were collected using a qualitative descriptive design involving semi-structured interviews, which were recorded, transcribed verbatim and analysed qualitatively using inductive content analysis. RESULTS Eighteen caregivers aged 61-81 years completed the interviews. The following four themes were identified: physical difficulty, living with ambivalence, perception of role and role-related behaviour changes. These themes enabled a greater understanding of role-related behaviours in older caregivers and their challenges in addressing biological and psychosocial challenges related to older age. CONCLUSION The present study highlighted the vulnerability and perceived challenges of the role of older caregivers. These findings help lay the foundation for interventions to improve the care provided to caregivers and their health outcomes, especially caregivers with chronic conditions.
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Affiliation(s)
- Min Xue
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, People's Republic of China
| | - Xiaoyun Chen
- Shandong Women's University, 2399 Daxue Road, Jinan, Shandong, 250300, People's Republic of China
| | - Haiyan Zhao
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, People's Republic of China
| | - Yumei Zhao
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, People's Republic of China
| | - Jing Li
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, People's Republic of China
| | - Weijuan Chen
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, No. 324, Jingwuweiqi Road, Jinan, Shandong, 250021, People's Republic of China.
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Velloze IG, Jester DJ, Jeste DV, Mausbach BT. Interventions to reduce loneliness in caregivers: An integrative review of the literature. Psychiatry Res 2022; 311:114508. [PMID: 35334424 DOI: 10.1016/j.psychres.2022.114508] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 01/07/2023]
Abstract
Older adults are at an increased risk of loneliness. Many also serve as informal caregivers for persons with dementia and other disabling conditions, further predisposing them to loneliness. The primary objective was to assess current loneliness interventions for caregivers to inform development of effective therapies to improve their quality of life. An integrative review of the literature was conducted using five electronic databases and 12 studies were included for further analysis. Data were extracted regarding the type of intervention implemented, caregiver characteristics, and intervention effects. Five main intervention types emerged: mindful meditation, computer applications, music therapy, peer support, and community programs. Most care recipients had dementia, and most caregivers were spouses. Peer support was the most frequently utilized intervention, and common intervention strategies included providing emotional support, expanding one's social network, and supplying psychoeducational materials. Most interventions had methodological limitations and demonstrated small effect sizes. Hence, there remains a continued need for well-designed interventions that target loneliness in informal caregiver. Caregivers may benefit from interventions that expand their social network to improve their emotional regulation and understanding of their role. Further research on the role of group versus individual therapy is necessary to strengthen interventions and broaden their application.
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Affiliation(s)
- Isabelle G Velloze
- Drexel University College of Medicine, Philadelphia, PA, United States of America
| | - Dylan J Jester
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America; Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, United States of America
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America; Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, California, United States of America; Department of Neurosciences, University of California San Diego, La Jolla, California, United States of America
| | - Brent T Mausbach
- Department of Psychiatry, University of California San Diego, La Jolla, California, United States of America.
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20
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Liao X, Wang J, Zhang F, Luo Z, Zeng Y, Wang G. The levels and related factors of compassion fatigue and compassion satisfaction among family caregivers: A systematic review and meta-analysis of observational studies. Geriatr Nurs 2022; 45:1-8. [DOI: 10.1016/j.gerinurse.2022.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/12/2022] [Accepted: 02/12/2022] [Indexed: 12/19/2022]
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21
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Hosseini L, Sharif Nia H, Ashghali Farahani M. Development and Psychometric Evaluation of Family Caregivers' Hardiness Scale: A Sequential-Exploratory Mixed-Method Study. Front Psychol 2022; 13:807049. [PMID: 35432109 PMCID: PMC9010881 DOI: 10.3389/fpsyg.2022.807049] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Caring for patients with Alzheimer's disease (AD) is a stressful situation and an overwhelming task for family caregivers. Therefore, these caregivers need to have their hardiness empowered to provide proper and appropriate care to these older adults. From the introduction of the concept of hardiness, few studies have been conducted to assess the hardiness of caregivers of patients with AD. Presumably, one reason for this knowledge gap is the lack of a proper scale to evaluate hardiness in this group. This study was conducted to develop a reliable and valid Family Caregivers' Hardiness Scale (FCHS) to measure this concept accurately among Iranian family caregivers sample. Methods This study is a cross-sectional study with a sequential-exploratory mixed-method approach. The concept of family caregivers' hardiness was clarified using deductive content analysis, and item pools were generated. In the psychometric step, the samples were 435 family caregivers with a mean age of 50.26 (SD ± 13.24), and the data were gathered via an online form questionnaire. In this step, the items of the FCHS were evaluated using face and content validity. Then, the factor structure was determined and confirmed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) followed by convergent and divergent validity, respectively. Finally, scale reliability, including stability, and internal consistency were evaluated. Results The finding revealed that FCHS consists of five factors, namely, "Religious Coping" (5 items), "Self-Management" (6 items), "Empathic Communication" (3 items), "Family Affective Commitment" (3 items), and "Purposeful Interaction" (4 items) that explained 58.72% of the total variance. The results of CFA showed a good model fit. Reliability showed acceptable internal consistency and stability. Conclusion Based on the results of the psychometric evaluation of the FCHS, turned out that the concept of hardiness in Iranian family caregivers is a multidimensional concept that is most focused on individual-cultural values, emotional family relationships, and social relationships. The designed scale also has acceptable validity and reliability features that can be used in future studies to measure this concept in family caregivers.
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Affiliation(s)
- Lida Hosseini
- School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery, Mazandaran University of Medical Sciences, Sari, Iran
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22
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Racine L, Ford H, Johnson L, Fowler-Kerry S. An integrative review of Indigenous informal caregiving in the context of dementia care. J Adv Nurs 2021; 78:895-917. [PMID: 34806198 DOI: 10.1111/jan.15102] [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: 06/20/2021] [Revised: 09/24/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
AIMS To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. DESIGN Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. DATA SOURCES A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. REVIEW METHODS Fifty-one studies met the research question and the inclusion criteria. RESULTS Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers' experiences, pre-dementia community education and family and community-centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community-based approaches. CONCLUSION This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers' roles and tasks. IMPACT This review highlights the necessity of having community and family-based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Harris Ford
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Letitia Johnson
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan Fowler-Kerry
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Schaffler-Schaden D, Krutter S, Seymer A, Eßl-Maurer R, Flamm M, Osterbrink J. Caring for a Relative with Dementia: Determinants and Gender Differences of Caregiver Burden in the Rural Setting. Brain Sci 2021; 11:brainsci11111511. [PMID: 34827510 PMCID: PMC8615550 DOI: 10.3390/brainsci11111511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Dementia is a progressive disease that puts substantial strain on caregivers. Many persons with dementia (PwDs) receive care from a relative. Since male and female caregivers experience different issues related to stress, it is important to meet their different needs to prevent the early nursing home placement of PwDs. This study investigated the multifactorial aspects of caregiver burden and explored gender differences in caregiver burden in a rural setting. This was a cross sectional study that administered anonymous questionnaires to family caregivers of PwDs. Caregiver burden was assessed using the Burden Scale for Family Caregivers-short version. A path model was used to determine the multivariate associations between the variables. To reflect the multifaceted aspects of caregiver burden, we used Pearlin's model with its four dimensions. A total of 113 family caregivers responded to our survey. The overall burden of caregivers was moderate. According to the path model, gender differences were predictors of caregiver burden. The behaviour of the person with dementia and cohabitation had direct effects on caregiver burden. Our results suggest that the experiences of men and women caring for a PwD are different and highlight the need for tailored support in dementia care.
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Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
- Correspondence:
| | - Simon Krutter
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Alexander Seymer
- Department of Sociology, Paris Lodron University, 5020 Salzburg, Austria;
| | - Roland Eßl-Maurer
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Jürgen Osterbrink
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
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Koch A, Kozhumam AS, Seeler E, Docherty SL, Brandon D. Multiple Roles of Parental Caregivers of Children with Complex Life-Threatening Conditions: A Qualitative Descriptive Analysis. J Pediatr Nurs 2021; 61:67-74. [PMID: 33780717 PMCID: PMC8464614 DOI: 10.1016/j.pedn.2021.03.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Children born with Complex Life-Threatening Conditions (CLTCs) often require complex and specialized services. Parents of children with CLTCs balance the role of caregiver with other responsibilities of employment, education, relationships, and self-care. The purpose of this paper is to describe the challenges for parents serving as caregivers of children with CLTCs and their intersection with health care provider expectations through utilization and adaptation of the role theory framework. DESIGN/METHODS We employed a qualitative descriptive design, secondary analysis of a longitudinal study on parent and provider decision making for children with CLTC. There were 218 interviews from sixty-one parents of 35 infants with prematurity, bone marrow transplant, and/or complex cardiac disease, followed for one year unless death occurred. Content analysis and thematic generation were performed capturing the various parental roles embedded within provider expectations of informal parental caregiving. RESULTS Results showed that parents of children with CLTCs serve multidimensional roles, including that of informal nurse and care coordinator, while maintaining additional personal roles as parent and family provider. Parents experienced challenges as caregivers that were shaped by perceived expectations of health care providers as well as lack of support, often leading to role strain, conflict, overload, and sometimes exit. CONCLUSIONS Parents of children with CLTCs experience both common and unique challenges inn balancing multiple roles as an informal caregiver. Despite utilizing positive coping mechanisms, their status as parent caregiver carries significant risk for role strain and overload. We recommend the implementation of strategies for increasing parental support and family-centered care.
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Affiliation(s)
- Amie Koch
- Duke University School of Nursing, Family Nurse Practitioner Transitions Lifecare, Nurse Practitioner Lincoln Community Health Clinic, NC, United States of America.
| | - Arthi S Kozhumam
- Duke University, Global Health Institute, NC, United States of America
| | - Erika Seeler
- Duke University, School of Nursing, NC, United States of America
| | | | - Debra Brandon
- Duke University, School of Nursing, NC, United States of America
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25
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Ebadi A, Sajadi SA, Moradian ST, Akbari R. Psychological consequences for family caregivers of patients receiving hemodialysis: threat or opportunity? BMC Psychol 2021; 9:154. [PMID: 34620241 PMCID: PMC8496675 DOI: 10.1186/s40359-021-00667-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 09/30/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Family caregivers of patients receiving hemodialysis experience physical and psychological disorders. They are unfortunately neglected. The aim of this study was to explain the psychological consequences for family caregivers of patients receiving hemodialysis. METHODS This qualitative inductive conventional content analysis research approach was conducted in Tehran, Iran. Nineteen hemodialysis patient caregivers were enrolled via purposive sampling. Data collection was conducted through in-depth and semi-structured interviews until reaching data saturation. All interviews were recorded, transcribed, imported into the Open Code Software, and analyzed using the Graneheim and Lundman methods. RESULTS The results included two main categories: (1) threats to the psychological integrity; (2) development of capabilities. The first main category comprised the sub-categories of "care-related negative feelings and emotions," care-related stress and its behavioral impacts on care, "psychological disorders arising from care provision," and "impaired quality and quantity of sleep." The second main category comprised of the sub-categories of "care-related positive feelings and emotions" and "coping strategies." CONCLUSIONS The present study showed that though caring for hemodialysis patients threatens the caregiver's psychological integrity, it provides the opportunity of development capabilities.
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Affiliation(s)
- Abbas Ebadi
- Behavioral Sciences Research Center, Lifestyle Institute, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyedeh Azam Sajadi
- Department of Nursing Management, Faculty of Nursing, Aja University of Medical Sciences, Kaj St., Shariati St, Tehran, Iran.
| | - Seyed Tayeb Moradian
- Atherosclerosis Research Center, Nursing Faculty, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Roghayeh Akbari
- Department of Nephrology, School of Medicine, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Luchetti M, Terracciano A, Stephan Y, Aschwanden D, Sutin AR. Personality and psychological health in caregivers of older relatives: a case-control study. Aging Ment Health 2021; 25:1692-1700. [PMID: 32347105 PMCID: PMC7606331 DOI: 10.1080/13607863.2020.1758907] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Being a caregiver of an older adult is often associated with poor psychological outcomes and stress. Individual differences, such as personality, may moderate responses to caregiving. In this study, we examined (a) personality and psychological health of family caregivers compared to non-caregivers and (b) tested interactions between caregiver status and personality (both domains and facets) in predicting psychological outcomes. METHODS Data were from an online sample of caregivers of older relatives (N = 491; 71.9% females) and matched controls (N = 491). Participants completed the Big Five Inventory-2 and a comprehensive set of psychological health and well-being measures. RESULTS Compared to non-caregivers, caregivers had higher neuroticism, lower energy level (extraversion facet) and higher compassion (agreeableness facet). They also reported higher depression, anxiety, loneliness, and lower well-being and life satisfaction. Personality traits and facets had strong associations with psychological outcomes, and these associations were similar across the two groups. Only a few significant interactions between caregiver status and personality were found: For instance, higher neuroticism (in particular, higher scores on anxiety and depression facets) exacerbated anxiety among caregivers. CONCLUSIONS Personality is a relevant correlate of psychological health. In the context of caregiving, its assessment may help to identify caregivers at risk of poor outcomes and inform intervention programs. Further research is needed to replicate the findings and investigate longitudinal interrelations among variables.
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Affiliation(s)
- Martina Luchetti
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Antonio Terracciano
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | | | - Damaris Aschwanden
- Department of Geriatrics, College of Medicine, Florida State University, Tallahassee, FL, USA
| | - Angelina R Sutin
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, FL, USA
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Shah R, Ali FM, Finlay AY, Salek MS. Family reported outcomes, an unmet need in the management of a patient's disease: appraisal of the literature. Health Qual Life Outcomes 2021; 19:194. [PMID: 34353345 PMCID: PMC8339395 DOI: 10.1186/s12955-021-01819-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 07/07/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A person's chronic health condition or disability can have a huge impact on the quality of life (QoL) of the whole family, but this important impact is often ignored. This literature review aims to understand the impact of patients' disease on family members across all medical specialities, and appraise existing generic and disease-specific family quality of life (QoL) measures. METHODS The databases Medline, EMBASE, CINHAL, ASSIA, PsycINFO and Scopus were searched for original articles in English measuring the impact of health conditions on patients' family members/partner using a valid instrument. RESULTS Of 114 articles screened, 86 met the inclusion criteria. They explored the impact of a relative's disease on 14,661 family members, mostly 'parents' or 'mothers', using 50 different instruments across 18 specialities including neurology, oncology and dermatology, in 33 countries including the USA, China and Australia. These studies revealed a huge impact of patients' illness on family members. An appraisal of family QoL instruments identified 48 instruments, 42 disease/speciality specific and six generic measures. Five of the six generics are aimed at carers of children, people with disability or restricted to chronic disease. The only generic instrument that measures the impact of any condition on family members across all specialities is the Family Reported Outcome Measure (FROM-16). Although most instruments demonstrated good reliability and validity, only 11 reported responsiveness and only one reported the minimal clinically important difference. CONCLUSIONS Family members' QoL is greatly impacted by a relative's condition. To support family members, there is a need for a generic tool that offers flexibility and brevity for use in clinical settings across all areas of medicine. FROM-16 could be the tool of choice, provided its robustness is demonstrated with further validation of its psychometric properties.
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Affiliation(s)
- R. Shah
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F. M. Ali
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - A. Y. Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - M. S. Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
- Institute of Medicines Development, Cardiff, UK
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Marín-Maicas P, Corchón S, Ambrosio L, Portillo MC. Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7294. [PMID: 34299745 PMCID: PMC8305191 DOI: 10.3390/ijerph18147294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family's needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand "the process of living with LTCs" from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.
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Affiliation(s)
| | - Silvia Corchón
- Faculty of Nursing and Chiropody, University of Valencia, 46010 Valencia, Spain
| | - Leire Ambrosio
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
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Experiences of family caregivers of patients with COVID-19. BMC FAMILY PRACTICE 2021; 22:137. [PMID: 34187368 PMCID: PMC8241402 DOI: 10.1186/s12875-021-01489-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 06/10/2021] [Indexed: 12/23/2022]
Abstract
Background Family caregivers of patients with COVID-19 face many challenges that affect their physical and mental health. Aim The aim of the present study was to explore experiences of family caregivers of patients with COVID-19. Methods This phenomenological study was performed based on 13 family caregivers who had experience in home caring for patients with COVID-19. Data were collected through purposive sampling with in-depth semi-structured interviews. The Colaizzi's 7-step method was used to determine themes. The MAXQDA10 software was used to manage qualitative data analysis. Results Thirteen family caregivers participated. Five main themes describe family caregivers' experiences of caring for patients with COVID-19: nature of the disease; unmet needs; unpleasant physical, psychological, and social experiences; care facilitators and positive experiences. Conclusion Information and financial support for COVID-19 should be provided to family caregivers. Also, community members should embrace patients and family caregivers and reinforce the positive experiences of caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01489-7.
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30
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Murfield J, Moyle W, O'Donovan A. Experiences of compassion among family carers of older adults: Qualitative content analysis of survey free-text comments. Scand J Caring Sci 2021; 36:1006-1015. [PMID: 34096636 DOI: 10.1111/scs.13010] [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: 01/03/2021] [Accepted: 04/30/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To provide qualitative insight into the experiences of compassion (to self, to others and from others) among family carers of older adults by exploring the written responses provided within a cross-sectional survey that asked about carers' levels of compassion, mindfulness, emotion regulation, coping strategies and psychological health. METHODS Family carers of adults aged ≥65 years from around the world completed the survey between July and December 2019. To provide carers with an opportunity to describe experiences in their own words and expand on issues beyond the limits of closed-response items, the survey included eight free-text boxes. These appeared after each self-report measure and at the end of the survey. From a total of 127 carers providing 504 written responses, inductive qualitative content analysis identified and evaluated 245 comments from 105 family carers' that were about their experiences of compassion (to self, to others and from others). RESULTS Some family carers perceived a lack of compassion, both for themselves and from others, and several barriers to carers' openness to receiving compassion were identified. Factors influencing carers' compassion to others in general included how carers were feeling themselves, the person it was directed towards and the situation. Within the caregiving relationship specifically, this included care recipients' level of need and behaviour. CONCLUSIONS Findings provide qualitative understanding about family carers' realities of compassion (to self, to others and from others) within their role and highlight the applicability and warranted focus of compassion-based approaches within family caregiving research and practice.
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Affiliation(s)
- Jenny Murfield
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, Griffith University, Brisbane, Qld, Australia.,School of Nursing and Midwifery, Griffith University, Brisbane, Qld, Australia
| | - Analise O'Donovan
- Griffith Health Group, Griffith University, Brisbane, Qld, Australia
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Schwabenbauer AK, Knight CM, Downing N, Morreale-Karl M, Mlinac ME. Adapting a whole health model to home-based primary care: Bridging person-driven priorities with veteran and family-centered geriatric care. FAMILIES, SYSTEMS & HEALTH : THE JOURNAL OF COLLABORATIVE FAMILY HEALTHCARE 2021; 39:374-393. [PMID: 34410781 PMCID: PMC8406673 DOI: 10.1037/fsh0000613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Through the integration of Whole Health for Life into the Department of Veterans Affairs (VA) health care system, the VA aims to transform health care delivery from a disease management approach to one that embraces person-centered care. The home-based primary care (HBPC) program is a care model that, within the VA, provides holistic primary care services to homebound veterans with multiple chronic medical conditions, mental health issues, and functional declines. These veterans may have limited access to VA programs delivered in a traditional outpatient format. This article describes adaptations to the whole health model of care that could improve its accessibility and applicability to HBPC veterans, caregivers, and the interdisciplinary teams that serve this population. These modifications are informed by whole-person geriatric and gerontological and family-systems theories and address population-based differences in the focus and approach to care. The focus on care is expanded to (a) reflect the importance of attending to caregiver needs and well-being and (b) shift from a preventative model to one that prioritizes resilience and maintenance. The approach to care emphasizes alternative modes of delivery, adaptations to interventions, and integration of geriatric-specific medical considerations into the self-care domains and more directly centers the collaboration between family, the VA, and community partners. This adapted model also addresses the unique needs of health care teams providing in-home services to medically complex veterans and offers suggestions for enhancing self-care and preventing burnout. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Cynthia M. Knight
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Nicole Downing
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
| | - Michelle Morreale-Karl
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Medicine, Harvard Medical School
| | - Michelle E. Mlinac
- Veterans Affairs Boston Healthcare System, Boston, Massachusetts, United States
- Department of Psychiatry, Harvard Medical School
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Hsieh CC, Lin ZZ, Ho CC, Yu CJ, Chen HJ, Chen YW, Hsiao FH. The Short- and Long-term Causal Relationships Between Self-compassion, Trait Mindfulness, Caregiver Stress, and Depressive Symptoms in Family Caregivers of Patients with Lung Cancer. Mindfulness (N Y) 2021; 12:1812-1821. [PMID: 33968270 PMCID: PMC8096886 DOI: 10.1007/s12671-021-01642-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/28/2021] [Indexed: 11/28/2022]
Abstract
Objectives Using a prospective longitudinal design, this paper examines a serial mediation model of the associations between self-compassion, trait mindfulness, caregiver stress, and depressive symptoms among the family caregivers of patients with lung cancer. Methods A four-wave design was used, with initial assessment (T1) and three follow-ups, at the 2nd month (T2), the 5th month (T3), and the 8th month (T4). A total of 123 family caregivers completed the baseline measurements, including caregiver stress, self-compassion, trait mindfulness, and depressive symptoms. Data were analyzed by serial mediation models to determine the causal ordering of these variables. Results Nearly one-quarter of the family caregivers suffered from clinically significant depressive symptoms and the severity of their depression remained unchanged throughout the 8-month follow-up period. Both cross-sectional and longitudinal path analyses revealed that the relationship between self-compassion and depressive symptoms was mediated sequentially by trait mindfulness and caregiver stress. The subscale analysis indicated that the association of higher compassionate action with fewer depressive symptoms was through chain-mediating effects of higher mindful awareness and lower caregiver stress. Conclusions Family caregivers who have higher levels of self-compassion tend to have more mindfulness; greater mindfulness leads to lower levels of perceived caregiving stress which, in turn, links to fewer symptoms of depression. Both self-compassion and mindfulness could be regarded as protective factors for caregivers to reduce caregiving stress and depression.
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Affiliation(s)
- Chia-Chen Hsieh
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Zhong-Zhe Lin
- Department of Medical Oncology, National Taiwan University Cancer Center, Taipei, Taiwan
| | - Chao-Chi Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Chong-Jen Yu
- National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan.,College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsiu-Jung Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei, Taiwan
| | - Yu-Wen Chen
- Department of Social Work, National Taiwan University, Taipei, Taiwan
| | - Fei-Hsiu Hsiao
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan.,Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan
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Abstract
Nurses on the front lines of health care are impacted psychologically by their work and may experience secondary traumatic stress. The literature contains several different terms to explore concepts that describe the impact of traumatic patient experiences on the nurse, making it difficult to differentiate the concepts. Using the Walker and Avant method of analysis, the author reviewed nursing-specific publications within the last 10 years and seminal works to develop a purer meaning of secondary traumatic stress and distinguish it from other related terms. A more precise definition of secondary traumatic stress will allow for the advancement of research related to awareness and prevention in nursing.
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Rodríguez-González AM, Rodríguez-Míguez E, Claveria A. Determinants of caregiving burden among informal caregivers of adult care recipients with chronic illness. J Clin Nurs 2021; 30:1335-1346. [PMID: 33528913 DOI: 10.1111/jocn.15683] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/26/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic disease. The effect of task type and patient-caregiver interaction is also analysed. BACKGROUND Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient-caregiver interaction. DESIGN Correlational study. METHODS One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index-6 Dimensions (DEP-6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies. RESULTS Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP-6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels. CONCLUSIONS These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction. RELEVANCE TO CLINICAL PRACTICE The findings indicate that the socio-sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.
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Affiliation(s)
- Ana-María Rodríguez-González
- University of Vigo, Vigo, Spain.,Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Cantabrian Health Service, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Department of Applied Economics, University of Vigo, Vigo, Spain.,Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
| | - Ana Claveria
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Quality and Research Unit, EOXI Vigo, Galician Health Service, Vigo, Spain
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35
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The Mediating Effect of Depression on the Relationship between Social Support, Spirituality and Burnout in Family Members of Patients with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041727. [PMID: 33578997 PMCID: PMC7916776 DOI: 10.3390/ijerph18041727] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 02/05/2021] [Accepted: 02/06/2021] [Indexed: 11/16/2022]
Abstract
When the treatment process of cancer patients changes to outpatient treatment, the burden on family members increases and they often experience burnout. Burnout not only effects the family members themselves but may also have a negative effect on the health of the cancer patient. Therefore, healthcare providers should evaluate burnout in the family members of cancer patients and actively make efforts towards their burnout management. This study investigated the mediating effect of depression on the relationship between social support, spirituality, and burnout in family members of patients with cancer. Participants were 151 family members of patients with cancer who were receiving chemotherapy as outpatients at a single university hospital in Korea. Data was collected from 2 March to 31 May 2016, using self-reported questionnaires. Collected data was analyzed with t-tests, analysis of variance (ANOVA), Pearson's correlations, Baron and Kenny's three-step regression method, and the Sobel test. The participants' mean burnout was below the median. The participants' depression partially mediated the relationship of both social support and spirituality on burnout. Strategies to assess depression and strengthen social support and spirituality should be developed to manage burnout in family members'.
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36
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Unsar S, Erol O, Ozdemir O. Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. Eur J Oncol Nurs 2021; 50:101882. [PMID: 33421929 DOI: 10.1016/j.ejon.2020.101882] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 11/13/2020] [Accepted: 11/20/2020] [Indexed: 12/24/2022]
Abstract
PURPOSE The purpose of this cross-sectional study was to determine the caregiving burden, depression and anxiety of family caregivers of Turkish patients with cancer and the affecting factors. METHODS This cross-sectional study was conducted between January-May 2018 with one hundred and fifty-eight caregivers and one hundred and fifty-eight patients with cancer who were treated at a university hospital in Edirne, Turkey. Data were collected with a questionnaire form, Zarit Burden Interview (ZBI) Scale and the Hospital Anxiety Depression Scale (HADS). RESULTS This study found that 51.3% of the patients with cancer were male, 70.3% of the caregivers were female and more than half of them (57.0%) were the spouses of the patients. The mean ZBI score of the caregivers was 24.62 ± 14.19. There was a positive relationship between the ZBI scores and HADS scores of family caregivers (p < 0.05). As the caregiving burden of caregivers increased, their anxiety and depression levels were increased too. It was found that as the caregiving duration of family caregivers increased, the caregiving burden increased, and caregivers' anxiety depression scores got worse (p < 0.05). In the multivariate analysis, the duration of caregiving per day/hours, ECOG score and the age of the caregiver independently affected the caregiving burden (p < 0.05). As the functional status of the patient with cancer got worse, caregiving burden increased. Caregiving burden was found to be higher in those who were younger, female and giving care for longer times per day (p < 0.05). CONCLUSION This study found that as the caregiving burden and caregivers' daily patient care duration increased, the level of anxiety and depression increased too. Caregivers of patients with cancer should take appropriate psychological intervention to decrease their distress. In addition, we thought that healthcare professionals must consider the factors affecting the caregiving burden which affect the patient care directly.
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Affiliation(s)
- Serap Unsar
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozgul Erol
- Trakya University, Faculty of Health Sciences, Department of Internal Medicine Nursing, Balkan Campus, Edirne, Turkey.
| | - Ozlem Ozdemir
- Kırklareli University, School of Health, Health Management Department, Kırklareli, Turkey.
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37
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Hosseini L, Sharif Nia H, Ashghali Farahani M. Hardiness in Family Caregivers During Caring From Persons With Alzheimer's Disease: A Deductive Content Analysis Study. Front Psychiatry 2021; 12:770717. [PMID: 35069280 PMCID: PMC8766820 DOI: 10.3389/fpsyt.2021.770717] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 12/14/2021] [Indexed: 11/24/2022] Open
Abstract
Objective: This study was designed to describe the experiences of family Caregivers' hardiness in caring for Alzheimer's Patients. Methods: The deductive content analysis method was performed between April 2020 and February 2021 in one of the teaching hospitals in Iran. Fourteen family caregivers of Alzheimer's patients were selected using purposive and snowballing sampling and the data were collected by semi-structured interviews. After that, data were analyzed using Elo and Kingas steps. Results: The results of this study showed that based on the experiences of family caregivers, the family caregivers' hardiness in caring for Alzheimer's patients is a feature of cognitive ability to deal with stressful care situations and consists of five dimensions of commitment, control, challenge, communication and culture with 22 generic categories that they were nested into this five dimension. Conclusion: Family caregivers' hardiness is a trait related to the individual and environmental factors, and the prevailing social and cultural conditions affect the individual's perception and experience of hardship and threats, as well as his/her understanding of protective factors and how to use them. Therefore, hardiness should not be interpreted as a simple approach regardless of culture.
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Affiliation(s)
- Lida Hosseini
- School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Sharif Nia
- School of Nursing and Midwifery Amol, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mansoureh Ashghali Farahani
- Nursing Care Research Center, Medical-Surgical Nursing Department, School of Nursing and Midwifery, Iran University of Medical Science, Tehran, Iran
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Zakeri MA, Bazmandegan G, Ganjeh H, Zakeri M, Mollaahmadi S, Anbariyan A, Kamiab Z. Is nurses' clinical competence associated with their compassion satisfaction, burnout and secondary traumatic stress? A cross-sectional study. Nurs Open 2021; 8:354-363. [PMID: 33318843 PMCID: PMC7729795 DOI: 10.1002/nop2.636] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/10/2020] [Accepted: 09/07/2020] [Indexed: 11/18/2022] Open
Abstract
Aim The current study aimed to investigate the relationship between clinical competence and subscale of professional quality of life (ProQOL). Methods This cross-sectional study was conducted from November 2018 to May 2019 on 291 nurses working in public hospitals in south Iran (Rafsanjan). The nurses were selected by convenience sampling method. Data were collected using the ProQOL questionnaire that included three subscales: compassion satisfaction, secondary traumatic stress and burnout and the Competency Inventory for Registered Nurse (CIRN) that measured clinical competence. Results A significant positive relationship was observed between compassion satisfaction and clinical competence. A significant negative association was found between compassion satisfaction and secondary traumatic stress/burnout and also between secondary traumatic stress and clinical competence. The results of regression analysis indicated that compassion satisfaction was the best predictor of secondary traumatic stress (R2 = 65%), burnout (R2 = 40%) and clinical competence (R2 = 12%). Moreover, secondary traumatic stress was found to be the best predictor of compassion satisfaction (R2 = 53%).
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Affiliation(s)
- Mohammad Ali Zakeri
- Non‐Communicable Diseases Research CenterRafsanjan University of Medical SciencesRafsanjanIran
| | - Gholamreza Bazmandegan
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
- Department of Family Medicine, Ali‐Ibn Abi‐Talib Hospital, School of MedicineRafsanjan University of Medical SciencesRafsanjanIran
| | - Hamid Ganjeh
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Maryam Zakeri
- Physiology‐Pharmacology Research Center, Research Institute of Basic Medical SciencesRafsanjan University of Medical SciencesRafsanjanIran
| | - Sekineh Mollaahmadi
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Ali Anbariyan
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
| | - Zahra Kamiab
- Clinical Research Development Unit, Ali‐Ibn Abi‐Talib HospitalRafsanjan University of Medical SciencesRafsanjanIran
- Department of Family Medicine, Ali‐Ibn Abi‐Talib Hospital, School of MedicineRafsanjan University of Medical SciencesRafsanjanIran
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39
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Kochuvilayil A, Varma RP. Caregiver Burden among Informal Caregivers in the Kerala Palliative Care Program: Development and Validation of the Achutha Menon Centre-Caregiver Burden Inventory. J Palliat Med 2020; 24:1197-1205. [PMID: 33372853 DOI: 10.1089/jpm.2020.0477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Family caregivers of bedridden or homebound patients are at risk of adverse physical and psychological outcomes. There is a need for a culturally adapted and valid instrument for measuring caregiver burden in palliative care programs. Objective: To develop a reliable and valid instrument to measure the self-perceived burden of informal caregivers of patients with serious health-related suffering. Design/Setting: "Caregiver burden" was conceptualized based on literature review and in-depth interviews. Content validity assessment, cognitive interviews, and a cross-sectional survey were used to develop and validate the instrument. The study was set within the primary palliative care program in Kerala, India. Subjects: Ten palliative care professionals and 10 caregivers were engaged for the content validity assessment and cognitive interviews, respectively. The cross-sectional survey was conducted among 221 (males = 21) family caregivers in Kollam district, Kerala. The Institutional Ethics Committee of the Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum reviewed and cleared the study. Measurements: Underlying factors were identified by using principal axis factoring. The corresponding sub-scales and a composite scale were tested for internal consistency, construct validity, reproducibility, floor and ceiling effects, and interpretability. Results: Two factors that explained 29.5% of the variance were extracted. Two sub-scales-consequences of caregiving and lack of financial security-were derived. The final nine-item Likert-type Achutha Menon Centre-Caregiver Burden Inventory (AMC-CBI) had a content validity index of 0.77, Cronbach's alpha of 0.82, and high test-retest reliability (ρ = 0.87, p < 0.001). Conclusion: The AMC-CBI is a valid and reliable instrument for burden assessment of caregivers of patients served by the home-based palliative care program in Kerala, India.
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Affiliation(s)
- Arsha Kochuvilayil
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Ravi Prasad Varma
- Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
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Merlo EM, Stoian AP, Motofei IG, Settineri S. Clinical Psychological Figures in Healthcare Professionals: Resilience and Maladjustment as the "Cost of Care". Front Psychol 2020; 11:607783. [PMID: 33335503 PMCID: PMC7736062 DOI: 10.3389/fpsyg.2020.607783] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/23/2020] [Indexed: 11/30/2022] Open
Abstract
Background: The health professionals are involved in the paths of care for patients with different medical conditions. Their life is frequently characterized by psychopathological outcomes so that it is possible to identify consistent burdens. Besides the possibility to develop pathological outcomes, some protective factors such as resilience play a fundamental role in facilitating the adaptation process and the management of maladaptive patterns. Personal characteristics and specific indexes such as burdens and resilience are essential variables useful to study in-depth ongoing conditions and possible interventions. The study was aimed at highlighting the presence and the relations among factors as personal variables, burdens, and resilience, to understand health professionals' specific structure and functions. Methods: The observation group was composed of 210 participants, 55 males (26.2%), and 155 females (73.8%), aged from 18 to 30 years old with a mean age of 25.92 years old (SD = 3.33). The study considered personal characteristics of the subjects, such as age, gender, years of study, days of work per week, hours of work per week, and years of work. Our study had been conducted with the use of measures related to burdens (Caregivers Burden Inventory) and resilience (Resilience Scale for Adults). Results: The performed analyses consisted of descriptive statistics, correlations, and regressions among the considered variables. Several significant correlations emerged among personal characteristics, CBI, and RSA variables. Specifically, age and work commitment indexes appeared to be significantly related to the development of burdens, differently from the years of study. Significant correlations emerged among personal and RSA variables, indicating precise directions for both domains. Age and gender were identified as predictors to perform multivariate regression analyses concerning CBI factors. Significant dependence relations emerged with reference to all CBI variables. Conclusion: Pathological outcomes and resilience factors represent two sides of the health professionals' experiences, also known as “invisible patients.” Greater knowledge about present conditions and future possibilities is a well-known need in literature so that the current analyses considered fundamental factors. In line with state of the art, future studies are needed in order to deepen elusive phenomena underlying maladjustment.
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Affiliation(s)
- Emanuele Maria Merlo
- Department of Cognitive Sciences, Psychology, Educational and Cultural Studies (COSPECS), University of Messina, Messina, Italy.,CRISCAT (International Research Center for Theoretical and Applied Cognitive Sciences), University of Messina and Universitary Consortium of Eastern Mediterranean, Noto (CUMO), Noto, Italy
| | - Anca Pantea Stoian
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,National Institute of Diabetes, Nutrition and Metabolic Diseases "N. C. Paulescu," Bucharest, Romania
| | - Ion G Motofei
- Faculty of General Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - Salvatore Settineri
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
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Lee Y, Bierman A, Penning M. Psychological Well-Being Among Informal Caregivers in the Canadian Longitudinal Study on Aging: Why the Location of Care Matters. J Gerontol B Psychol Sci Soc Sci 2020; 75:2207-2218. [PMID: 32906145 PMCID: PMC7664311 DOI: 10.1093/geronb/gbaa159] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objectives A caregiving stress perspective suggests that caregiving harms psychological well-being in informal caregivers, whereas a caregiving rewards perspective suggests that provision of care benefits psychological well-being. This research examines whether both perspectives apply to caregiving experiences, but differently by the primary location of caregiving (i.e., in-home, other residence, and institution), as well as by gender. Methods We analyzed depression and life satisfaction in the nationally representative Canadian Longitudinal Study on Aging (N = 48,648), first comparing noncaregivers (N = 27,699) to a combined caregiver group (N = 20,949) and then stratifying caregivers by the primary location of care. Results When considered as a single group, caregivers suffered relative to noncaregivers in terms of life satisfaction and depression. When stratified by the location of care, only in-home caregivers reported both greater depression and lower life satisfaction. Nonresidential caregivers did not differ significantly in levels of depression from noncaregivers and reported higher life satisfaction. Institutional caregivers reported greater depression than noncaregivers, but did not differ significantly in life satisfaction. These patterns were stronger among women than men. Discussion Both the caregiving stress and caregiving rewards perspectives are applicable to the caregiving experience, with the stress perspective more applicable to in-home caregivers and the rewards perspective more relevant to nonresidential caregivers. Recommendations include targeted practice focused on the location of care as well as the gender of the caregiver. Given that nonresidential caregivers actually benefit from providing care, interventions need to focus on identifying and bolstering positive aspects of the caregiving experience.
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Affiliation(s)
- Yeonjung Lee
- Faculty of Social Work, University of Calgary, Alberta, Canada
| | - Alex Bierman
- Department of Sociology, University of Calgary, Alberta, Canada
| | - Margaret Penning
- Department of Sociology, University of Victoria, British Columbia, Canada
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High Burden among Older Family Caregivers is Associated with High Prevalence of Symptoms: Data from the Swedish Study "Good Aging in Skåne (GÅS)". J Aging Res 2020; 2020:5272130. [PMID: 32774920 PMCID: PMC7399755 DOI: 10.1155/2020/5272130] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 06/15/2020] [Accepted: 07/03/2020] [Indexed: 11/18/2022] Open
Abstract
Background/Aim Certain groups of informal caregivers have been shown to have worse health compared to noncaregivers. The aim of this cross-sectional study was to explore the health and gender aspects of caregiving in an older Swedish population. Methods Our study included 5457 participants from the longitudinal, general population study “Good Aging in Skåne.” A total of 33 self-reported symptoms were obtained from questionnaires and were then divided into seven domains: depressive, musculoskeletal, gastrourinary, symptoms related to head, cardiopulmonary, symptoms related to tension, and metabolic symptoms. Multivariate logistic regression analysis was performed to assess the risk of developing symptoms in each of the seven domains, regarding caregiving burden and caregiving in relation to gender. Results We found that caregivers, compared to noncaregivers, had a higher prevalence for depressive and tension-related symptoms. High-burden caregivers exhibited significantly more individual symptoms and a higher prevalence of symptoms in the depressive, tension, and gastrourinary domains of symptoms compared to both low-burden caregivers and noncaregivers. More than 79% of high-burden caregivers reported general fatigue, and over half of the high-burden caregivers experience depressive mood. Female caregivers showed a significantly higher risk of reporting depressive symptoms (OR = 1.54, 95% CI 1.19–1.98) and tension-related symptoms compared to male caregivers. Conclusion Depressive and tension-related symptoms were more common in caregivers, especially in high-burden caregivers. High-burden caregivers might be at a risk of adverse mental health, and this highlights the need to offer proper support to these groups.
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Juvé-Udina ME, González-Samartino M, López-Jiménez MM, Planas-Canals M, Rodríguez-Fernández H, Batuecas Duelt IJ, Tapia-Pérez M, Pons Prats M, Jiménez-Martínez E, Barberà Llorca MÀ, Asensio-Flores S, Berbis-Morelló C, Zuriguel-Pérez E, Delgado-Hito P, Rey Luque Ó, Zabalegui A, Fabrellas N, Adamuz J. Acuity, nurse staffing and workforce, missed care and patient outcomes: A cluster-unit-level descriptive comparison. J Nurs Manag 2020; 28:2216-2229. [PMID: 32384199 PMCID: PMC7754324 DOI: 10.1111/jonm.13040] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Revised: 04/20/2020] [Accepted: 05/02/2020] [Indexed: 12/23/2022]
Abstract
AIM To compare the patient acuity, nurse staffing and workforce, missed nursing care and patient outcomes among hospital unit-clusters. BACKGROUND Relationships among acuity, nurse staffing and workforce, missed nursing care and patient outcomes are not completely understood. METHOD Descriptive design with data from four unit-clusters: medical, surgical, combined and step-down units. Descriptive statistics were used to compare acuity, nurse staffing coverage, education and expertise, missed nursing care and selected nurse-sensitive outcomes. RESULTS Patient acuity in general (medical, surgical and combined) floors is similar to step-down units, with an average of 5.6 required RN hours per patient day. In general wards, available RN hours per patient day reach only 50% of required RN hours to meet patient needs. Workforce measures are comparable among unit-clusters, and average missed nursing care is 21%. Patient outcomes vary among unit-clusters. CONCLUSION Patient acuity is similar among unit-clusters, while nurse staffing coverage is halved in general wards. While RN education, expertise and missed care are comparable among unit-clusters, mortality, skin injuries and risk of family compassion fatigue rates are higher in general wards. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers play a pivotal role in hustling policymakers to address structural understaffing in general wards, to maximize patient safety outcomes.
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Affiliation(s)
- Maria-Eulàlia Juvé-Udina
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Catalan Institute of Health, Barcelona, Spain
| | - Maribel González-Samartino
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Maria Magdalena López-Jiménez
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | | | - Irene Joana Batuecas Duelt
- Multidisciplinary Nursing Research Group, VHIR Vall d'Hebron Institute of Research, Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Marta Tapia-Pérez
- Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Emilio Jiménez-Martínez
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | | | - Susana Asensio-Flores
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
| | - Carme Berbis-Morelló
- Joan XXIII University Hospital, Tarragona, Spain.,School of Nursing, Rovira i Virgili University, Tarragona, Spain
| | - Esperanza Zuriguel-Pérez
- Multidisciplinary Nursing Research Group, VHIR Vall d'Hebron Institute of Research, Barcelona, Spain.,Vall d'Hebron University Hospital, Barcelona, Spain
| | - Pilar Delgado-Hito
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain
| | - Óscar Rey Luque
- Nursing School, University of La Laguna, Tenerife, Spain.,Nuestra Señora de la Candelaria University Hospital, Santa Cruz de Tenerife, Spain
| | - Adelaida Zabalegui
- Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,IDIBAPS, August Pi i Sunyer Biomedical Research Institute, Hospital Clínic, Barcelona, Spain
| | - Núria Fabrellas
- Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,IDIBAPS, August Pi i Sunyer Biomedical Research Institute, Hospital Clínic, Barcelona, Spain
| | - Jordi Adamuz
- Nursing Research Group, IDIBELL, Bellvitge Biomedical Research Institute, Barcelona, Spain.,Faculty of Medicine and Health Sciences, Nursing School, University of Barcelona, Barcelona, Spain.,Bellvitge University Hospital, Hospitalet de Llobregat, Barcelona, Spain
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Sajadi SA, Ebadi A, Moradian ST, Akbari R. Designing and Validation of Health-Related Quality of Life Inventory for Family Caregivers of Hemodialysis Patients. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:164-176. [PMID: 32309457 PMCID: PMC7153424 DOI: 10.30476/ijcbnm.2020.83081.1118] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background: Family caregivers are important sources of care for hemodialysis patients. Although caring for a family member is a pleasant feeling,
experiencing lots of physical and psychological caregiving burden influences the quality of life among family caregivers of hemodialysis
patients. This study aimed to design and validate the quality of life inventory for family caregivers of patients on hemodialysis. Methods: A sequential-exploratory mixed method was conducted in Tehran, Iran, in 2017-2018. In the qualitative phase, the researcher conducted
in-depth semi-structured interviews with 19 participants. Finally, a pool of 93 items was extracted from this phase. Then, psychometric
properties such as face validity (Impact Score>1.5), content validity ratio (CVR>0.63), content validity index
(Item Content Validity Index: ICVI>0.78 , Scale Content Validity Index/Average: SCVI/Ave>0.8) and Kappa value
(Kappa>0.7, internal consistency (Cronbach’s alpha>0.7), relative reliability (ICC: interclass correlation coefficient),
absolute reliability (Standard Error of Measurement: SEM and Minimal Detectable Changes: MDC), convergent validity (Correlation Coefficient between 0.4-0.7),
interpretability, responsiveness, feasibility, and ceiling and floor effects were assesse. Results: The quality of life inventory for family caregivers of hemodialysis patients was developed with 34 items and five factors
(namely patient care burden, conflict, positive perception of situations, self-actualization, fear, and concern).
The findings confirm that the scale is acceptable regarding validity, reliability and other measurement features. Conclusions: This inventory is consistent with the health care status in Iran. Therefore, it can be used to measure the quality of life among family caregivers of hemodialysis patients.
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Affiliation(s)
- Seyedeh Azam Sajadi
- Department of Nursing Management, School of Nursing , Aja University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life style institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Tayeb Moradian
- Atherosclerosis Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Roghayeh Akbari
- Department of Nephrology, School of Medicine, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Leslie M, Gray RP, Eales J, Fast J, Magnaye A, Khayatzadeh-Mahani A. The care capacity goals of family carers and the role of technology in achieving them. BMC Geriatr 2020; 20:52. [PMID: 32102654 PMCID: PMC7045442 DOI: 10.1186/s12877-020-1455-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 02/03/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As global populations age, governments have come to rely heavily on family carers (FCs) to care for older adults and reduce the demands made of formal health and social care systems. Under increasing pressure, sustainability of FC's unpaid care work has become a pressing issue. Using qualitative data, this paper explores FCs' care-related work goals, and describes how those goals do, or do not, link to technology. METHODS We employed a sequential mixed-method approach using focus groups followed by an online survey about FCs' goals. We held 10 focus groups and recruited 25 FCs through a mix of convenience and snowball sampling strategies. Carer organizations helped us recruit 599 FCs from across Canada to complete an online survey. Participants' responses to an open-ended question in the survey were included in our qualitative analysis. An inductive approach was employed using qualitative thematic content analysis methods to examine and interpret the resulting data. We used NVIVO 12 software for data analysis. RESULTS We identified two care quality improvement goals of FCs providing care to older adults: enhancing and safeguarding their caregiving capacity. To enhance their capacity to care, FCs sought: 1) foreknowledge about their care recipients' changing condition, and 2) improved navigation of existing support systems. To safeguard their own wellbeing, and so to preserve their capacity to care, FCs sought to develop coping strategies as well as opportunities for mentorship and socialization. CONCLUSIONS We conclude that a paradigm shift is needed to reframe caregiving from a current deficit frame focused on failures and limitations (burden of care) towards a more empowering frame (sustainability and resiliency). The fact that FCs are seeking strategies to enhance and safeguard their capacities to provide care means they are approaching their unpaid care work from the perspective of resilience. Their goals and technology suggestions imply a shift from understanding care as a source of 'burden' towards a more 'resilient' and 'sustainable' model of caregiving. Our case study findings show that technology can assist in fostering this resiliency but that it may well be limited to the role of an intermediary that connects FCs to information, supports and peers.
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Affiliation(s)
- Myles Leslie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada
| | | | - Jacquie Eales
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
| | - Janet Fast
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew Magnaye
- Department of Human Ecology, University of Alberta, Edmonton, Alberta, Canada
| | - Akram Khayatzadeh-Mahani
- School of Public Policy, University of Calgary, Calgary, Alberta, Canada.
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
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Gérain P, Zech E. Informal Caregiver Burnout? Development of a Theoretical Framework to Understand the Impact of Caregiving. Front Psychol 2019; 10:1748. [PMID: 31428015 PMCID: PMC6689954 DOI: 10.3389/fpsyg.2019.01748] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/15/2019] [Indexed: 01/26/2023] Open
Abstract
Informal caregiving is a rewarding but demanding role. The present theoretical framework proposes to adapt the tridimensional concept of burnout to informal caregiving as a way to address the potential consequences of caregiving. This adaptation reflects caregivers' reported difficulties, as well as empirical findings on emotional exhaustion, depersonalization, and personal accomplishment as caregiving outcomes. But to understand burnout in informal caregiving contexts, it is also necessary to find ways to model it. The Informal Caregiving Integrative Model (ICIM) is thus proposed. This model is based on the integration of elements from literature on both informal caregiving stress and professional burnout. The goal of the ICIM is to emphasize the importance of every category of determinants of informal caregiver burnout (i.e., relating to the caregiver, the caregiving setting, and the sociocultural context), with a key mediating role for the caregivers' appraisal of their situation and their relationship with the care-recipient. This article is a first integrative step in the consideration of a form of burnout specific to informal caregivers and supports the design of empirical and interventional studies based on the theoretical foundation that the ICIM proposes.
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Affiliation(s)
- Pierre Gérain
- National Fund for Scientific Research, Brussels, Belgium.,Person Centred Research and Training Lab, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Emmanuelle Zech
- Person Centred Research and Training Lab, Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Yoo JI, Lee YK, Koo KH, Park YJ, Ha YC. Concerns for Older Adult Patients with Acute Hip Fracture. Yonsei Med J 2018; 59:1240-1244. [PMID: 30450859 PMCID: PMC6240565 DOI: 10.3349/ymj.2018.59.10.1240] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 09/04/2018] [Accepted: 10/02/2018] [Indexed: 02/07/2023] Open
Abstract
PURPOSE The purpose of this study was to identify concerns among older adult patients with acute hip fracture. MATERIALS AND METHODS This study was performed with 152 consecutive patients with hip fracture. Details were obtained on perioperative concerns about hip fracture using a questionnaire that was specifically designed for this study and was administered face to face upon admission. The study inclusion criteria were age older than 65 years and having experienced femur neck, intertrochanteric, or subtrochanteric fracture. The exclusion criteria were not understanding the study purpose, having difficulty communicating, or refusing to participate. RESULTS Older adult patients with acute hip fracture expressed concerns regarding excessive pain, medical staff, postoperative recovery, rehabilitation, and hospital expenses. In addition, fear of falling from the bed and anxiety regarding re-fracture were the patients' most significant concerns. CONCLUSION Older adult patients reported fear of falling from bed and re-fracture as primary concerns. To overcome these concerns, fracture liaison services to prevent re-fracture should be introduced and enforced.
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Affiliation(s)
- Jun Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Young Kyun Lee
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam, Korea
| | - Kyung Hoi Koo
- Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Sungnam, Korea
| | - Young Jin Park
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Yong Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea.
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