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Shi J, Jiang C. Exploring the associations between competence in dementia care and work attitudes among formal caregivers in nursing homes. J Clin Nurs 2024. [PMID: 38590040 DOI: 10.1111/jocn.17157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
AIMS Based on the two-factor model of caregiving appraisals, this study aims to (1) investigate the relationships between competence in dementia care and job satisfaction (work attitudes in positive aspect) and turnover intention (work attitudes in negative aspect) among formal caregivers in nursing homes, and (2) examine the mediating roles of positive aspects of caregiving (caregiving appraisals in positive aspect) and caregiving burden (caregiving appraisals in negative aspect) in the above associations. DESIGN A cross-sectional design was used. Structural equation modelling was employed to test the proposed model. STROBE checklist guides the reporting of this study. METHODS Using the multistage cluster sampling method, 407 formal caregivers were selected from 43 nursing homes across 7 districts/counties in China. RESULTS The proposed model shows a good model fit. Competence in dementia care shows significant positive associations with increased job satisfaction and decreased turnover intention among formal caregivers in nursing homes. Caregiving burden and positive aspects of caregiving mediate the relationships between competence in dementia care and both job satisfaction and turnover intention. Furthermore, the relationship between positive aspects of caregiving and job satisfaction is stronger than that with turnover intention, but the relationship between caregiving burden and turnover intention is not stronger than that with job satisfaction. CONCLUSIONS The results demonstrate that the two-factor model of caregiving appraisals effectively elucidates the associations and underlying mechanisms between competence in dementia care and formal caregivers' work attitudes. Specifically, two crucial conclusions are drawn: (1) competence in dementia care is associated with higher levels of job satisfaction and lower levels of turnover intention among formal caregivers in nursing homes; (2) caregiving burden and positive aspects of caregiving serve as parallel mediators in these associations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Policymakers and nursing homes managers should implement a series of measures aimed at formal caregivers in nursing home. Specifically, allocating more resources to enhance the competence in dementia care of formal caregivers is crucial, given its significant association with elevated job satisfaction and reduced turnover intention. Besides, positive and negative caregiving appraisals emerge as proximal factors influencing work attitudes of formal caregivers. Therefore, intervention projects focused on formal caregivers in nursing home should target enhancing positive experiences and alleviating caregiving burden. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jiaming Shi
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Chaoxin Jiang
- School of Social Development, East China Normal University, Shanghai, China
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Cham CQ, Ibrahim N, Kalaman CR, Ho MC, Visvalingam U, Ahmad Shahabuddin F, Abd Rahman FN, Halim MRTA, Harbajan Singh MK, Azhar FL, Yahya AN, Roslan S, Siau CS. Factors associated with depression, anxiety, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients: A cross-sectional study. Glob Ment Health (Camb) 2024; 11:e12. [PMID: 38390253 PMCID: PMC10882176 DOI: 10.1017/gmh.2024.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 02/24/2024] Open
Abstract
Depression and anxiety are prevalent mental health issues worldwide, especially among parental caregivers. By expanding the family stress model, this cross-sectional study investigated the relevant factors associated with depressive symptoms, anxiety symptoms, and satisfaction with life among Malaysian parental caregivers of adolescent psychiatric patients. Data were collected through questionnaires (N = 207) across five major public hospitals through convenience sampling. Participants answered questionnaires measuring financial strain, caregiver burden, relationship quality, belief in mental illness, perceived COVID-19 stress, satisfaction with health services, depressive symptoms, anxiety symptoms and life satisfaction. Findings revealed that relationship quality among spouses, COVID-19 stress and caregiver burden were significantly correlated with anxiety symptoms, depressive symptoms and satisfaction with life. The multiple regression model also suggested that depressive symptoms (β = .613, p < .001), anxiety symptoms (β= .657, p < .001) and relationship quality among spouses (β = .264, p < .001) were the most influential predictors of anxiety symptoms, depressive symptoms and satisfaction with life respectively. By addressing the mental health needs of parental caregivers, this study can contribute to improving the overall quality of care and support provided to adolescent patients and their caregivers in Malaysia and beyond.
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Affiliation(s)
- Choy Qing Cham
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Norhayati Ibrahim
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Clarisse Roswini Kalaman
- Center for Healthy Ageing and Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Meng Chuan Ho
- Centre for Pre-U Studies, UCSI University (Springhill Campus), Port Dickson, Malaysia
| | - Uma Visvalingam
- Department of Psychiatry and Mental Health, Hospital Sungai Buloh, Sungai Buloh, Malaysia
| | | | - Fairuz Nazri Abd Rahman
- Psychiatry Department, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd Radzi Tarmizi A Halim
- Faculty of Business, Economics and Social Development, Universiti Malaysia Terengganu, Kuala Nerus, Malaysia
| | | | - Fatin Liyana Azhar
- Department of Psychological Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Amira Najiha Yahya
- Department of Educational Psychology and Counselling, Faculty of Education, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Samsilah Roslan
- Department of Foundation of Education, Faculty of Educational Studies, Universiti Putra Malaysia, Serdang, Malaysia
| | - Ching Sin Siau
- Center for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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van Lieshout TS, Vonk S, Driehuis E, Roeterdink AJ, Goto NA, Vogels T, Kooijman W, Bart J, Broese van Groenou MI, van Jaarsveld BC, Abrahams AC. Exploring experiences and health-related quality of life of caregivers of patients who start home dialysis: study protocol for a prospective, multicentre cohort study. BMJ Open 2022; 12:e064172. [PMID: 36356997 PMCID: PMC9660610 DOI: 10.1136/bmjopen-2022-064172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
INTRODUCTION Starting dialysis not only has a major impact on the life of patients but also on their informal caregivers. Previous research shows greater burden and lower quality of life among caregivers of dialysis patients compared with the general population. Unfortunately, the evidence on the course of both positive and negative experience in caregivers of incident dialysis patients is scarce. Furthermore, well-designed, prospective, multicentre studies comparing caregiving of home dialysis patients with in-centre dialysis patients are lacking. This paper proposes a protocol to assess the trajectory of experiences (both positive and negative) and quality of life of caregivers of home dialysis patients compared with caregivers of in-centre dialysis patients. METHODS AND ANALYSIS This paper presents a protocol for a prospective, observational, multicentre cohort study which extends the ongoing Dutch nOcturnal and hoME dialysis Study To Improve Clinical Outcomes (DOMESTICO). This study will include at least 200 adult caregivers of patients who start dialysis therapy and have been included in the DOMESTICO study. Positive experiences of the caregivers will be the primary outcome parameter of this study, and negative experiences and health-related quality of life the secondary outcome parameters. Required support will be investigated as an exploratory finding. Outcome parameters will be assessed at baseline, and at 6 and 12 months after start of dialysis using validated questionnaires. ETHICS AND DISSEMINATION Ethical approval for this study has been obtained from the Medical Research Ethics Committee of the Amsterdam University Medical Centre. The results of this study will be disseminated by publication in a peer-reviewed journal and through presentations at conferences and seminars.
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Affiliation(s)
- T S van Lieshout
- Department of Nephrology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Internal Medicine, Northwest Clinics, Alkmaar, the Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - S Vonk
- Department of Nephrology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - E Driehuis
- Department of Nephrology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - A J Roeterdink
- Department of Nephrology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - N A Goto
- Department of Geriatric Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
- Department of Geriatric Medicine, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands
| | - Tjfm Vogels
- Dialysis Center Maxima, Maxima Medical Center, Eindhoven, the Netherlands
| | - Wcs Kooijman
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Jaj Bart
- Dutch Kidney Patients Association, Bussum, the Netherlands
| | - M I Broese van Groenou
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - B C van Jaarsveld
- Department of Nephrology, Amsterdam UMC location Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Diapriva Dialysis Center, Amsterdam, the Netherlands
| | - A C Abrahams
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Utrecht, the Netherlands
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Ong ZL, Chew EYH, Glass GF, Chan EY. Four of a kind: Salient caregiver archetypes to better understand the psychosocial needs and behavioral patterns of dementia caregivers in Singapore. Geriatr Nurs 2022; 43:299-308. [PMID: 34991053 DOI: 10.1016/j.gerinurse.2021.12.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Family caregivers' lived experiences are often perceived as a homogenous entity, preventing effective identification of unique caregiving needs and appropriate support. Our study examined and classified the varying dementia caregiving experiences in an Asian setting, through establishing caregiver archetypes. METHODS Secondary analysis of semi-structured interviews conducted with 16 dementia family caregivers in a Singapore hospital was performed. Thematic analysis and typological analysis were utilized. RESULTS Four caregiver archetypes (Reluctant, Ambivalent, Enlightened, and Selfless) were identified: Reluctant caregivers possessed poor understanding of dementia and experienced immeasurable distress; Ambivalent caregivers carried mixed feelings towards caregiving and felt unsupported; Enlightened caregivers preserved care-recipients' dignity and accepted challenges with priority on sustainable care; Selfless caregivers were overly-devoted and enmeshed in the caregiver identity. CONCLUSION Our findings are useful in providing a framework for: (1) rapid understanding of informal caregivers' varying needs, (2) targeted support in a holistic caregiver-centered manner.
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Affiliation(s)
- Zhi Lei Ong
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore
| | | | | | - Ee-Yuee Chan
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore; Alice Lee Center of Nursing Studies, National University of Singapore, Singapore.
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Robison JT, Shugrue NA, Fortinsky RH, Fabius CD, Baker K, Porter M, Grady JJ. A New Stage of the Caregiving Career: Informal Caregiving After Long-Term Institutionalization. THE GERONTOLOGIST 2020; 61:1211-1220. [PMID: 33170252 DOI: 10.1093/geront/gnaa185] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The "unexpected career" of caregiving has previously been conceptualized in stages: community care through institutional placement/residence, ending with death of the care recipient. Transition programs such as Money Follows the Person (MFP) created a new stage of the caregiving career, caring for someone post-long-term institutionalization, about which little is known. Using Pearlin's Caregiver Stress Process Model, this study explores effects on caregivers from the return of their loved ones to the community after a long-term institutional stay. RESEARCH DESIGN AND METHODS Cross-sectional surveys of 656 caregivers of persons transitioned through Connecticut's MFP program 2014-18, completed 6 months post-transition. RESULTS Regardless of the age/disability of the care recipient, and despite experiencing high caregiving intensity, caregivers experienced less burden, anxiety, and depression, and higher benefits of caregiving than demonstrated in literature for the general caregiving population. Most felt less stressed than before and during the participant's institutional stay. Factors associated with worse outcomes included worry about safety, strained finances, missing work, and desiring additional services. Black and Hispanic caregivers experienced lower burden and anxiety and higher benefits of caregiving than White caregivers. DISCUSSION AND IMPLICATIONS By providing community supports to participants, transition programs can have broad ancillary benefits for caregivers and improve outcomes in the Pearlin model, lessening potentially deleterious effects of an unexpected return to intensive caregiving duties after institutional placement. Positive results for Black and Hispanic caregivers may reflect cultural expectations in caring for family that buffer the adverse effects of caregiving.
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Affiliation(s)
- Julie T Robison
- Center on Aging, UConn Health, Farmington, Connecticut.,Department of Public Health Sciences, UConn Health, Farmington, Connecticut
| | | | - Richard H Fortinsky
- Center on Aging, UConn Health, Farmington, Connecticut.,Department of Public Health Sciences, UConn Health, Farmington, Connecticut
| | - Chanee D Fabius
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Kristin Baker
- Center on Aging, UConn Health, Farmington, Connecticut
| | - Martha Porter
- Center on Aging, UConn Health, Farmington, Connecticut
| | - James J Grady
- Department of Public Health Sciences, UConn Health, Farmington, Connecticut
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