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White Makinde K, Pitzer KA, Benson JJ, Mitchell M, Oliver DP, Demiris G, Washington KT. Does Family Functioning Matter? Understanding the Relationship Between Family Interactions and Depressive Symptoms for Caregivers of Cancer Patients. Am J Hosp Palliat Care 2024:10499091241263016. [PMID: 38881044 DOI: 10.1177/10499091241263016] [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: 06/18/2024] Open
Abstract
BACKGROUND Caregivers of cancer patients are at increased risk of depression and other health challenges. There is limited understanding of the role of the caregiver's own family members in promoting or discouraging mental wellbeing. Family functioning conceptualizes how family members interact to promote a positive family environment and has the potential to impact caregiver mental health. The purpose of this study is to assess the association between family interactions and depressive symptoms among family caregivers of cancer patients. METHODS Secondary analysis of baseline data from an NIH-funded randomized control trial of family caregivers of cancer patients recruited from academic palliative care clinics at three sites (2 Midwest, 1 East). We tested for an association between caregiver responses to the Family Quality of Life in Dementia-Family Interactions Subscale and Patient-Reported Outcomes Measurement Information System Depression Short Form 8A using a block-wise approach to linear modeling. RESULTS A total of 246 caregivers were included in analysis; caregivers were mostly White (82%), not Hispanic or Latina/o (96%), and female (65%), with an average age of 55 years. Overall, participants had high family interactions (mean 57.7, sd 11.7) and an average depressive symptom burden (t-score 52.4, SD 8.57). Family interactions was significantly negatively associated with depressive symptoms (b = -.163, se = .057) when accounting for relevant covariates. CONCLUSION Family caregivers with more positive family interactions are likely to have fewer depressive symptoms, suggesting family functioning may play a key role in bolstering family caregiver mental health and wellbeing.
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Affiliation(s)
| | - Kyle A Pitzer
- Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Jacquelyn J Benson
- Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Maysara Mitchell
- Washington University in St. Louis School of Medicine, St Louis, MO, USA
| | - Debra Parker Oliver
- Washington University in St. Louis School of Medicine, St Louis, MO, USA
- Goldfarb School of Nursing at Barnes-Jewish College, St Louis, MO, USA
| | - George Demiris
- University of Pennsylvania School of Nursing, Philadelphia, PA, USA
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Karla T Washington
- Washington University in St. Louis School of Medicine, St Louis, MO, USA
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Zhao C, Lu X, Li Y, Li J, Gao Y. Predictors of quality of life in primary caregivers of patients with heart failure: A model of health literacy and caregiving burden. Heart Lung 2024; 65:78-83. [PMID: 38442526 DOI: 10.1016/j.hrtlng.2024.02.006] [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: 10/31/2023] [Revised: 02/20/2024] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Heart Failure (HF) is a chronic disease that impairs patients' ability to care for themselves. The accumulation of caregiving activities by caregivers to patients creates stress. OBJECTIVES This study intends to investigate the mediating role of caregiving burden in the relationship between health literacy and quality of life of caregivers. METHODS This study is a cross-sectional research conducted through a questionnaire survey. A convenience sampling method was employed to select 410 primary caregivers for the study. RESULTS The overall mean score for quality of life for caregivers of patients with HF was (49.30±9.64). The results showed that the caregiving burden mediated the relationship between health literacy and quality of life, with the mediating effect accounting for 39.04 % (P < 0.05) of the total effect. CONCLUSION Caregiving burden is a mediating variable in the relationship between health literacy and quality of life. Therefore, we offer some recommendations for healthcare professionals: ①We suggest that healthcare professionals provide relevant education and training to caregivers, as this can enhance their knowledge and skills in effectively managing the health condition of patients;②Healthcare professionals can also proactively assess the caregiver's burden level and design personalized support plans based on the assessment results.
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Affiliation(s)
- Chunli Zhao
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Xiuying Lu
- University of Electronic Science and Technology, Chengdu, Sichuan Province 610042, China.
| | - Yunying Li
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Juan Li
- Guang yuan Central Hospital, Guang yuan, Sichuan Province, China
| | - Yuling Gao
- The First People's Central Hospital, Guang yuan, Sichuan Province, China
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Liu YC, Chou MC, Chiang MC, Hang CL, Chen SM, Chung ML, Lin CY, Huang TY. A Biomarker of Stress and Self-reported Caregiving Distress Predict Poor Quality of Life in Family Caregivers of Patients With Heart Failure. J Cardiovasc Nurs 2023:00005082-990000000-00140. [PMID: 37830903 DOI: 10.1097/jcn.0000000000001050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
BACKGROUND Family caregivers are at a high risk for low quality of life due to caregiving-related stress. Caregivers' stress is commonly assessed using self-reported measures, which reflect relatively subjective and long-term stress related to caregiving, but objective biological markers of stress are rarely used for caregivers. The purposes of this study were (1) to determine whether caregiver characteristics were associated with stress assessed using a stress biomarker (serum cortisol) and a self-reported caregiving distress measure (Caregiver Burden Inventory) and (2) to determine the predictability of both stress measures for quality of life in caregivers of patients with heart failure. METHODS Taiwanese family caregivers (N = 113; mean age, 54.5 years; 70.8% female) of patients with heart failure completed surveys including caregiving distress and quality of life measured by the Caregiver Burden Inventory and the Short Form-36 (physical and psychological well-being subscales), respectively, and provided blood samples for serum cortisol. Independent t tests, correlation, and hierarchical regression were conducted. RESULTS Single caregivers had higher serum cortisol levels than married caregivers (P = .002). Men had significantly higher serum cortisol levels than women (P = .010), but men reported lower caregiving distress than women (P = .049). Both serum cortisol (β = -0.32, P = .012) and caregiving distress (β = -0.29, P = .018) were significant predictors of quality of life in the physical well-being scale while controlling for caregivers' characteristics and depressive symptoms. Serum cortisol (β = -0.28, P = .026) and caregiving distress (β = -0.25, P = .027) also predicted quality of life in the psychological well-being scale. CONCLUSIONS Serum cortisol and self-reported caregiving distress have similar predictability for quality of life in family caregivers of patients with heart failure. Reducing stress and caregiving distress is critical to improving quality of life in this population.
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Chen X, Xiao X, Huang X, Wang R, Yang J, Yang L, Wang Y, Zhou C. Empowerment and quality of life: the mediating role of self-efficacy and health literacy among spousal caregivers in China. Health Promot Int 2023; 38:daad133. [PMID: 37874985 DOI: 10.1093/heapro/daad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
The aim of this study was to explore the chain mediation model of self-efficacy and health literacy between empowerment and quality of life among spousal caregivers of disabled elderly based on 'Marriage Binding'. From December 2020 to June 2022, the cross-sectional study was conducted in hospitals and communities, in Guangdong, Fujian, Sichuan, Hunan, Jiangxi, Guangxi and Yunnan provinces, China. Descriptive statistics were used to describe the demographic data and four main variables, including empowerment, self-efficacy, health literacy and quality of life. Spearman correlation analysis was used to analyze the correlation between the four main research variables. Multiple Linear Regression and bootstrap analysis were used to analyze the direct and indirect effects among them. Any two variables of spousal caregivers were correlated among empowerment, self-efficacy, health literacy and quality of life. Self-efficacy and health literacy can separately and sequentially mediate the relationship between empowerment and quality of life. To improve the quality of life of spousal caregivers of disabled elderly, the mediating role of self-efficacy, the mediating role of health literacy and the chain mediating role of self-efficacy and health literacy should take effect. In the future, some intervention studies should be taken to enhance the effects of those variables that may be beneficial for improving quality of life of spousal caregivers of disabled elderly.
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Affiliation(s)
- Xuan Chen
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
- School of Nursing, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Xiuying Xiao
- Department of Nursing, Zhuhai Fifth People's Hospital, Zhuhai, Guangdong, 519090, PR China
| | - Xiu'e Huang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Run Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Jing Yang
- Department of Nursing, Long Gang Districy People's Hospital of Shen Zhen, ShenZhen, Guangdong, 518172, PR China
| | - Lingli Yang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Yiling Wang
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
| | - Chunlan Zhou
- Department of Nursing, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, 510515, PR China
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Bidwell JT, Conway C, Babicheva V, Lee CS. Person with Heart Failure and Care Partner Dyads: Current Knowledge, Challenges, and Future Directions: State-of-the-Art Review. J Card Fail 2023; 29:1187-1206. [PMID: 36958392 PMCID: PMC10514243 DOI: 10.1016/j.cardfail.2023.02.017] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/07/2023] [Accepted: 02/23/2023] [Indexed: 03/25/2023]
Abstract
Over the past decade, there has been substantial growth in heart failure (HF) research that focuses on persons with HF and their care partners (family members or other close friends that provide unpaid support) as an interdependent team, or care dyad. In this state-of-the-art review, we use a dyadic lens to identify and summarize current research on HF care dyads, from qualitative studies, to nonexperimental quantitative studies, to randomized controlled trials. Although much work has been done, this literature is younger and less well-developed than care dyad literatures from other conditions (eg, cancer, Alzheimer's disease). We discuss the substantial challenges and limitations in this body of work, with an eye toward addressing common issues that impact rigor. We also look toward future directions, and discuss the promise dyadic research holds for improving patient, care partner, and relationship health.
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Affiliation(s)
- Julie T Bidwell
- University of California Davis Betty Irene Moore School of Nursing, Sacramento, California.
| | - Catherine Conway
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Viktoriya Babicheva
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
| | - Christopher S Lee
- Boston College William F. Connell School of Nursing, Chestnut Hill, Massachusetts
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Cubero-Plazas L, Sancho-Cantus D, de la Rubia Ortí JE, Prieto-Contreras L, Forero-Rincón O, Cunha-Pérez C. Impact of Family Function on the Quality of Life and Health Perception of Non-Institutionalized Dementia Patients. J Alzheimers Dis 2023:JAD230324. [PMID: 37355908 DOI: 10.3233/jad-230324] [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: 06/26/2023]
Abstract
BACKGROUND Dementia is one of the pathologies that has increased the most among the older population (mainly Alzheimer's disease), and it has a direct impact on the quality of life (QoL), cognitive performance, and health of these patients. Family functionality can play a role in this QoL if these patients are not institutionalized. OBJECTIVE To analyze the role of family function in the QoL and health perception of non-institutionalized dementia patients, as well as related variables such as anxiety, depression, optimism, or pessimism. METHODS Cross-sectional study with a sample of 54 patients diagnosed with some type of dementia, non-institutionalized, or in outpatient care, from different centers in the province of Valencia (Spain). The EQ-5D, MMSE, Apgar Family or general health, and Goldberg anxiety and depression questionnaires were utilized. RESULTS The correlation of the Apgar Family with the General Health Questionnaire-new onset problems variable (GHQ) and Chronicity and General Health Questionnaire-chronic problems (CGHQ) of the Goldberg Quality of Life questionnaire was statistically significant and negative (GHQ r = -0.310; p = 0.034. CGHQ r = -0.363; p = 0.012); as well as between Apgar Family and Anxiety-Depression (r = -0.341; p = 0.020). The correlation of the Apgar Family with the Life Orientation Test-Pessimism variable (LOT) was statistically significant and negative (r = -0.270; p = 0.061). Finally, severe dysfunction of Apgar Family has a negative correlation with self-perception of health (p = 0.036 B = -16.589) determined by the Visual Analogue Scale (VAS). CONCLUSION Family functionality directly influences anxiety, depression, optimism, and pessimism. This could explain why family function is related to the QoL of patients and their self-perception of health.
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Zhao Q, Mei J, Zhang X, Dong X, Zhang Y, Fan X. Determining Holistic Factors Related to Depressive Symptoms in Patients With Heart Failure. Clin Nurs Res 2023; 32:359-365. [PMID: 36068938 DOI: 10.1177/10547738221121437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Identifying modifiable factors associated with depressive symptoms is important to develop corresponding strategies. This study aimed to determine the holistic factors related to depressive symptoms in heart failure (HF) patients. It was a secondary analysis of a cross-sectional study. We recruited 329 hospitalized HF patients from two hospitals in China. It is found that HF patients had a relatively high proportion (28.27%) of depressive symptoms. Red blood cell distribution width (RDW) (β = .222, p = .011) and physical symptoms (β = .151, p < .001) were positively associated with depressive symptoms, whereas resilience (β = -.241, p < .01) and family functioning (β = -.288, p = .001) were negatively associated with depressive symptoms. Thus, early screening and management of depressive symptoms are warranted. RDW may serve as a marker for screening depressive symptoms. Moreover, interventions focused on relieving physical symptoms and enhancing resilience and family functioning may reduce depressive symptoms.
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Affiliation(s)
- Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | | | - Xiuting Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaoyu Dong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Yilin Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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