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Liu J, Bai S, Pan H, Huang L. Caregiver Burden and Readiness in Patients with Moderate and Severe Traumatic Brain Injury: The Chain Mediation Effect of Disease Uncertainty and Mental Resilience. World Neurosurg 2024; 185:e603-e611. [PMID: 38395354 DOI: 10.1016/j.wneu.2024.02.084] [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: 12/22/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/25/2024]
Abstract
OBJECTIVE To analyze the mediating effects of caregiver illness uncertainty and psychological resilience in caregiver burden and readiness in patients with moderate-to-severe traumatic brain injuries (TBIs). This can help improve caregiver readiness in patients with moderate-to-severe TBIs. METHODS A purposive sampling method was used to recruit patients with moderate-to-severe TBIs, and their caregivers, who were hospitalized in the Department of Neurosurgery of the Affiliated Hospital of Yangzhou University between October 2022 and August 2023. The Zarit Caregiver Burden Interview, Mishel Uncertainty In Scale for Family Member, Connor-Davidson Resilience Scale, and Caregivers Preparedness Scale, as well as general information questionnaire, were used to conduct the survey. RESULTS Caregiver readiness correlated with caregiver burden, illness uncertainty, and psychological resilience in patients with moderate-to-severe TBI (P < 0.01). Caregiver readiness was not only directly affected by caregiver burden (95% confidence interval: -0.510, -0.196) but was also affected through the chain mediation of illness uncertainty and psychological resilience (95% confidence interval: -0.146, -0.011). CONCLUSIONS Caregiver burden in patients with moderate-to-severe TBI influences caregiver readiness levels and is mediated by illness uncertainty and psychological resilience. By improving caregivers' illness uncertainty and increasing their psychological resilience, the impact of low caregiver readiness caused by high caregiver burden could be reduced.
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Affiliation(s)
- Jinteng Liu
- Department of Neurosurgery, Affiliated Hospital of Yangzhou University, Yangzhou, China; School of Nursing, Yangzhou University, Yangzhou, China
| | - Shuo Bai
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Hailong Pan
- Department of Neurosurgery, Affiliated Hospital of Yangzhou University, Yangzhou, China.
| | - Lumei Huang
- School of Nursing, Yangzhou University, Yangzhou, China
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Ngamasana EL, Zarwell M, Eberly L, Gunn LH. Difference in the physical and mental health of informal caregivers pre- and post-COVID-19 National Emergency Declaration in the United States. SSM Popul Health 2024; 25:101609. [PMID: 38313872 PMCID: PMC10837638 DOI: 10.1016/j.ssmph.2024.101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Background The burden of informal caregiving represents a chronic stressor for the informal caregivers (ICs). The study investigates differences in the physical and mental health of ICs and that of non-informal caregivers before and during COVID-19. Methods We used data from the 2019/2020 Behavioral Risk Factor Surveillance System (BRFSS) to investigate differences in the rates of days of poor physical and mental health among ICs compared to non-informal caregivers before and after the COVID-19 National Emergency Declaration (NED). A propensity score model simulated a pseudo experimental design, comparing ICs ("treated") with non-informal caregivers ("control"). A difference-in-difference regression model estimated the incidence rate ratios for days of poor physical and mental health as a function of IC status and time of care provision. Results A total of 44,583 respondents were identified with valid responses on informal caregiving status and key sociodemographic characteristics. Of those, 6.24% (n = 3073) were ICs, matched against 15,365 non-informal caregivers. In the matched sample (n = 18,848), the incidence rate for days of poor physical health among ICs was 17% (p = 0.003) higher compared to non-informal caregivers. The incidence rate for days of poor physical health was 23% (p < 0.001) lower in the post-NED compared to the pre-NED periods. The incidence rate for days of poor mental health was 44% (p < 0.001) higher among ICs compared to non-informal caregivers and 22% higher among respondents who took the survey post-NED compared to those who answered during the pre-NED period. No statistically significant differences were found between the two groups in their incidence rates for days of poor physical and mental health from the pre-to the post-NED period. Conclusion These findings suggest a need to balance between the benefits conferred by public health restrictions versus the mental health burden that may result among certain groups, including ICs, who experience higher negative mental health outcomes.
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Affiliation(s)
- Emery Lady Ngamasana
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Meagan Zarwell
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Lori Eberly
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Laura H Gunn
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Primary Care and Public Health, Imperial College London, London, UK
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3
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Han SH. Revisiting the caregiver stress process: Does family caregiving really lead to worse mental health outcomes? ADVANCES IN LIFE COURSE RESEARCH 2023; 58:100579. [PMID: 38054877 PMCID: PMC11229041 DOI: 10.1016/j.alcr.2023.100579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/16/2023] [Accepted: 10/20/2023] [Indexed: 12/07/2023]
Abstract
While the act of caregiving is often characterized as a stressful experience detrimental to mental health, recent studies are challenging this view by reporting robust health and well-being benefits linked to family caregiving. The current study attempted to provide an explanation of this apparent paradox by focusing on the role played by family health problems in the association between being a caregiver and mental health. Framed within the life course perspective and focusing on caregiving provided to aging mothers, the current study aimed 1) to demonstrate how the linkage between caregiving and depression reported in earlier studies may be misleading and 2) to further investigate whether caregiving to an aging mother may lead to any mental health benefits. Using longitudinal data drawn from the nationally representative US Health and Retirement Study, I follow adult children 50 and older who had a living mother during the observation period (N = 4812; 18,442 person-wave observations). A series of within-between random effects models were estimated to explicate how health conditions of aging mothers (i.e., disability and dementia) and caregiving transitions of adult children were associated with changes in depressive symptoms of adult children. Findings demonstrated that caregiving transitions were unrelated to depressive symptoms among adult children once the model controlled for the confounding effects of having their mother experience disability and dementia. Further, caregiving behavior was found to buffer the direct detrimental effect of maternal disability on adult children's depressive symptoms. This study adds to the growing body of research that cautions against characterizing caregiving as a chronic stressor detrimental to mental health and further echoes earlier calls for a more balanced portrayal of caregiving in policy reports and research literature.
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Affiliation(s)
- Sae Hwang Han
- Department of Human Development and Family Sciences, University of Texas at Austin, USA; Population Research Center, University of Texas at Austin, USA; Center on Aging and Population Sciences, University of Texas at Austin, USA.
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Omura Y, Watanabe A, Shibata K, Inoue T. Evaluation of repositioning care provided by non-professionals using a caregiver-assistive device: an experimental study. Sci Rep 2023; 13:21108. [PMID: 38036654 PMCID: PMC10689424 DOI: 10.1038/s41598-023-48377-x] [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] [Received: 06/28/2023] [Accepted: 11/25/2023] [Indexed: 12/02/2023] Open
Abstract
As the population ages in Japan and worldwide, the number of informal caregivers, such as family members, providing nursing care to older individuals is increasing. Among caregiving tasks, repositioning care, which causes lower back pain, is frequent and burdensome for caregivers. Therefore, we developed a position-changing device that can adjust and support the care recipient's body in the lateral position. This was a feasibility study of the device-assisted care provided by non-professionals using the device we developed. Of the 40 healthy volunteers enrolled, 17 simulated caregivers and 17 simulated care recipients finally participated in the study. One caregiver and one care recipient were paired to engage in two types of care: device-assisted care and manual care. Furthermore, the care provided by the caregiver and received by the care recipient were evaluated. Non-professionals were able to use the device successfully and safely after a short period of practice, and both caregivers and care recipients rated the device-assisted care positively. The study results suggest that informal caregivers can also provide safe and comfortable care that is less burdensome than manual care by using a caregiver-assistive device.
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Affiliation(s)
- Yuka Omura
- Graduate School of Medical Safety Management, Jikei University of Health Care Sciences, Osaka, Japan.
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.
- Global Center for Medical Engineering and Informatics, Osaka University, Osaka, Japan.
| | - Atsuko Watanabe
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
- Faculty of Nursing, Morinomiya University of Medical Sciences, Osaka, Japan
| | - Kasumi Shibata
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
- Faculty of Nursing, Osaka Medical and Pharmaceutical University, Osaka, Japan
| | - Tomoko Inoue
- Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan
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Saketkoo LA, Russell AM, Patterson KC, Obi ON, Drent M. Sarcoidosis and frailty: recognizing factors that foster holistic resilience. Curr Opin Pulm Med 2023:00063198-990000000-00099. [PMID: 37522560 DOI: 10.1097/mcp.0000000000000990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE OF REVIEW Sarcoidosis is a multiorgan system disease exerting significant impact on biophysical, social, psychological and emotional well-being. Mortality and disability correlate to accessible, timely, expert care for sarcoidosis and its related complications. Across health conditions, positive healthcare interactions and interventions can rehabilitate unfavourable factors tied to concepts of 'frailty'. Here, we set out to introduce concepts related to frailty and their impact in the context of sarcoidosis. RECENT FINDINGS Studies examining frailty across other multiorgan and single organ-based diseases that mirror organ involvement in sarcoidosis demonstrate findings that bear relevance in sarcoidosis. Namely, factors predisposing a person to frailty are a multifactorial phenomenon which are also reflected in the lived experience of sarcoidosis; and that early diagnosis, intervention and prevention may alter a course towards more favourable health outcomes. SUMMARY Factors predisposing to frailty in other health conditions may also signal a risk in sarcoidosis. In turn, proactive health preservation - regardless of age - may lead to improved biopsychosocial reserve and health-related quality of life. Fortifying holistic resilience in sarcoidosis is anticipated to reduce risk of the occurrence and prolongation of health-related complications, and facilitate swifter recovery from biophysical complications as well as from psychosocial and emotional stressors.
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Affiliation(s)
- Lesley Ann Saketkoo
- New Orleans Scleroderma and Sarcoidosis Patient Care and Research Center
- University Medical Center - Comprehensive Pulmonary Hypertension Center and Interstitial Lung Disease Clinic Programs
- Louisiana State University School of Medicine, Section of Pulmonary Medicine
- Tulane University School of Medicine, Undergraduate Honors Department, New Orleans, Louisiana, USA
| | - Anne-Marie Russell
- Exeter Respiratory Innovations Center, University of Exeter, Exeter
- Royal Devon and Exeter NHS Foundation Trust, Devon
- Imperial College Healthcare NHS Trust, London
| | - Karen C Patterson
- Brighton & Sussex Medical School, Department of Clinical & Experimental Medicine, Falmer, UK
| | - Ogugua Ndili Obi
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA
| | - Marjolein Drent
- Interstitial Lung Diseases (ILD) Center of Excellence, Department of Pulmonology, St. Antonius Hospital, Nieuwegein
- Department of Pharmacology and Toxicology, Faculty of Health and Life Sciences, Maastricht University, Maastricht
- ILD CARE Foundation Research Team, Ede, The Netherlands
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Pavarini SCI, Bregola AG, Luchesi BM, de Oliveira NA, Ottaviani AC. Sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers: a cross-sectional study. Dement Neuropsychol 2023; 17:e20220030. [PMID: 37223833 PMCID: PMC10202313 DOI: 10.1590/1980-5764-dn-2022-0030] [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: 04/11/2022] [Revised: 07/04/2022] [Accepted: 09/01/2022] [Indexed: 05/25/2023] Open
Abstract
The task of caring can negatively affect the physical and mental health; therefore, it is important to understand which factors are associated with burden in older caregivers of older adults. Objective This study aimed to explore sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers of older adults. Methods This is a cross-sectional study developed with 349 older caregivers who were registered at a Family Health Unit of a city in the state of São Paulo, Brazil. Household interviews were conducted and data were collected on the sociodemographic (profile, family income), clinical (self-reported pain, sleep, frailty), and psychosocial (burden, family functioning, depressive symptoms, stress) characteristics of the caregivers as well as dependence on activities of daily living and cognition in the care recipients. Results Women predominated in the sample (76.5%) and mean age was 69.5 years. The mean burden score was 18.06 points, with 47.9% above the cutoff of 16 points, denoting excessive burden. The bivariate model revealed associations between burden and financial insufficiency, family dysfunction, difficulty sleeping, pain, perceived stress, depressive symptoms, frailty, and multimorbidity among the caregivers as well as worse functional and cognitive performance in the care recipients. The controlled model revealed an association between burden and depressive symptoms (β=16.75; 95%CI 1.80-31.68). Conclusions We identified an association between burden and depressive symptoms, underscoring the need for the planning and implementation of specific actions directed at caregivers in order to minimize the impact on health and to improve the quality of life.
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Affiliation(s)
- Sofia Cristina Iost Pavarini
- Universidade Federal de São Carlos, Departamento de Gerontologia, São Carlos SP, Brazil
- Universidade Federal de São Carlos, Programa de Graduação em Enfermagem, São Carlos SP, Brazil
| | | | - Bruna Moretti Luchesi
- Universidade Federal do Mato Grosso do Sul, Programa de Graduação em Enfermagem,Três Lagoas MS, Brazil
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Barbosa F, Simões Dias S, Voss G, Delerue Matos A. The Longitudinal Association between Co-Residential Care Provision and Healthcare Use among the Portuguese Population Aged 50 and Over: A SHARE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3975. [PMID: 36900986 PMCID: PMC10001838 DOI: 10.3390/ijerph20053975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/01/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers' healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers.
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Affiliation(s)
- Fátima Barbosa
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
| | - Sara Simões Dias
- Center for Innovative Care and Health Technology (CiTechCare), School of Health Sciences, Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Gina Voss
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
| | - Alice Delerue Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
- Department of Sociology, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
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Xi JY, Zhong SR, Zhou YX, Lin X, Hao YT. Effects of family multi-generational relationship on multimorbidity and healthy life expectancy for second generations: insight from the China Health and Retirement Longitudinal Study. BMC Geriatr 2023; 23:100. [PMID: 36800942 PMCID: PMC9938571 DOI: 10.1186/s12877-022-03714-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 12/23/2022] [Indexed: 02/19/2023] Open
Abstract
OBJECTIVE In the context of aging, Chinese families consisting of more than three generations (grandparents, parents, children) are the norm. The second generation (parents) and other family members may establish a downward (contact only with children) or two-way multi-generational relationship (contact with children and grandparents). These multi-generational relationships may have the potential effect on multimorbidity burden and healthy life expectancy in the second generation, but less is known about the direction and intensity of this effect. This study aims to explore this potential effect. METHODS We obtained longitudinal data from the China Health and Retirement Longitudinal Study from 2011 to 2018, which included 6,768 people. Cox proportional hazards regression was used to assess the association between multi-generational relationships and the number of multimorbidity. The Markov multi-state transition model was used to analyze the relationship between multi-generational relationships and the severity of multimorbidity. The multistate life table was used to calculate healthy life expectancy for different multi-generational relationships. RESULTS The risk of multimorbidity in two-way multi-generational relationship was 0.830 (95% CIs: 0.715, 0.963) times higher than that in downward multi-generational relationship. For mild multimorbidity burden, downward and two-way multi-generational relationship may prevent aggravation of burden. For severe multimorbidity burden, two-way multi-generational relationship may aggravate the burden. Compared with two-way multi-generational relationship, the second generations with downward multi-generational relationship has a higher healthy life expectancy at all ages. CONCLUSION In Chinese families with more than three generations, the second generations with severe multimorbidity burden may aggravate the condition by providing support to elderly grandparents, and the support provided by offspring to the second generations plays a vital positive role in improving the quality of life and narrowing the gap between healthy life expectancy and life expectancy.
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Affiliation(s)
- Jun-Yan Xi
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Si-Rui Zhong
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Yu-Xiao Zhou
- grid.12981.330000 0001 2360 039XDepartment of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080 China
| | - Xiao Lin
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080, China.
| | - Yuan-Tao Hao
- Department of Medical Statistics, School of Public Health, Sun Yat-Sen University, 74Th Zhongshan 2Nd Rd, Yuexiu District, Guangzhou, 510080, China. .,Peking University Center for Public Health and Epidemic Preparedness & Response, Xueyuan Road, Haidian District, 100191, Beijing, China. .,Sun Yat-Sen Global Health Institute, Sun Yat-Sen University, Guangzhou, 510080, China. .,Center for Health Information Research, Sun Yat-Sen University, Guangzhou, 510080, China.
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Coumoundouros C, Farrand P, Hamilton A, von Essen L, Sanderman R, Woodford J. Cognitive behavioural therapy self-help intervention preferences among informal caregivers of adults with chronic kidney disease: an online cross-sectional survey. BMC Nephrol 2023; 24:4. [PMID: 36600229 PMCID: PMC9812545 DOI: 10.1186/s12882-022-03052-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Informal caregivers (i.e. family and friends) provide essential support to people with chronic kidney disease (CKD). Many informal caregivers experience mental health problems such as anxiety and depression due to the caregiving role, and commonly have unmet psychological support needs. One potential solution is cognitive behavioural therapy (CBT) self-help interventions that are less reliant on extensive involvement of healthcare professionals, which may increase access. Within the intervention development phase of the MRC framework, the study's primary objective was to examine informal caregivers' self-help intervention preferences (e.g. delivery format, content). Secondary objectives were to describe the informal caregiver's situation (e.g. type of care activities) and mental health (symptoms of depression, anxiety, and stress). METHODS An online cross-sectional survey conducted in the United Kingdom. Informal caregivers of adults living with CKD were recruited via social media, websites, newsletters, magazine articles, a podcast episode, and paid Facebook advertisements. The survey examined: informal caregiver characteristics; care recipient characteristics; self-help intervention preferences; and informal caregiver's mental health using the DASS-21. Data were analysed using descriptive statistics. RESULTS Sixty-five informal caregivers participated. The majority (85%) were female, caring for a male (77%) spouse/partner (74%). Responses indicated 58% of informal caregivers were experiencing at least mild depression. In total, 48% indicated they were likely to use a CBT self-help intervention, preferring an intervention provided via internet (e.g. website) (64%), workbook (56%), or individually in-person (54%). Regarding content, interventions should cover a wide range of topics including living with CKD, support services, informal caregiver's physical health, and diet. Overall, 48% reported a preference for a supported intervention, with support delivered in-person or via email by a trained professional at a community organisation. CONCLUSIONS Results suggest CBT self-help interventions may be an acceptable way to provide psychological support to informal caregivers, however the study is limited by the small sample size. A wide range of intervention preferences were identified indicating a need to tailor intervention content and delivery to enhance acceptability and engagement. Results will inform development of a CBT self-help intervention for informal caregivers of people with CKD.
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Affiliation(s)
- Chelsea Coumoundouros
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden ,grid.8391.30000 0004 1936 8024Clinical Education, Development and Research (CEDAR), Psychology, University of Exeter, Exeter, UK
| | - Paul Farrand
- grid.8391.30000 0004 1936 8024Clinical Education, Development and Research (CEDAR), Psychology, University of Exeter, Exeter, UK
| | - Alexander Hamilton
- grid.8391.30000 0004 1936 8024Faculty of Health and Life Sciences, University of Exeter Medical School, University of Exeter, Exeter, UK ,Exeter Kidney Unit, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK
| | - Louise von Essen
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden
| | - Robbert Sanderman
- grid.4494.d0000 0000 9558 4598Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Joanne Woodford
- grid.8993.b0000 0004 1936 9457Department of Women’s and Children’s Health, Healthcare Sciences and E-Health, Uppsala University, Uppsala, Sweden
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Jarde A, Romano E, Afaq S, Elsony A, Lin Y, Huque R, Elsey H, Siddiqi K, Stubbs B, Siddiqi N. Prevalence and risks of tuberculosis multimorbidity in low-income and middle-income countries: a meta-review. BMJ Open 2022; 12:e060906. [PMID: 36175100 PMCID: PMC9528681 DOI: 10.1136/bmjopen-2022-060906] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Co-occurrence of tuberculosis (TB) with other chronic conditions (TB multimorbidity) increases complexity of management and adversely affects health outcomes. We aimed to map the prevalence of the co-occurrence of one or more chronic conditions in people with TB and associated health risks by systematically reviewing previously published systematic reviews. DESIGN Systematic review of systematic reviews (meta-review). SETTING Low-income and middle-income countries (LMICs). PAPERS We searched in Medline, Embase, PsycINFO, Social Sciences Citation Index, Science Citation Index, Emerging Sources Citation Index and Conference Proceedings Citation Index, and the WHO Global Index Medicus from inception to 23 October 2020, contacted authors and reviewed reference lists. Pairs of independent reviewers screened titles, abstracts and full texts, extracted data and assessed the included reviews' quality (AMSTAR2). We included systematic reviews reporting data for people in LMICs with TB multimorbidity and synthesised them narratively. We excluded reviews focused on children or specific subgroups (eg, incarcerated people). PRIMARY AND SECONDARY OUTCOME MEASURES Prevalence or risk of TB multimorbidity (primary); any measure of burden of disease (secondary). RESULTS From the 7557 search results, 54 were included, representing >6 296 000 people with TB. We found that the most prevalent conditions in people with TB were depression (45.19%, 95% CI: 38.04% to 52.55%, 25 studies, 4903 participants, I2=96.28%, high quality), HIV (31.81%, 95% CI: 27.83% to 36.07%, 68 studies, 62 696 participants, I2=98%, high quality) and diabetes mellitus (17.7%, 95% CI: 15.1% to 20.0.5%, 48 studies, 48,036 participants, I2=98.3%, critically low quality). CONCLUSIONS We identified several chronic conditions that co-occur in a significant proportion of people with TB. Although limited by varying quality and gaps in the literature, this first meta-review of TB multimorbidity highlights the magnitude of additional ill health burden due to chronic conditions on people with TB. PROSPERO REGISTRATION NUMBER CRD42020209012.
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Affiliation(s)
| | - Eugenia Romano
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Saima Afaq
- Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | | | - Yan Lin
- International Union Against Tuberculosis and Lung Disease, Beijing, China
| | - Rumana Huque
- Economics, University of Dhaka, Dhaka, Bangladesh
| | - Helen Elsey
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
| | - B Stubbs
- Department of Psychological Medicine, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Najma Siddiqi
- Department of Health Sciences, University of York, York, UK
- Hull York Medical School, Hull, UK
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Amar S, Biderman A, Carmel S, Bachner YG. Elderly Caregivers' Awareness of Caregiving Health Risks. Healthcare (Basel) 2022; 10:healthcare10061034. [PMID: 35742085 PMCID: PMC9222691 DOI: 10.3390/healthcare10061034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 05/30/2022] [Accepted: 05/31/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this study was to assess the level of awareness of elderly primary caregivers of being at physical and mental health risk due to their caregiving role, as well as to examine the impact of sociodemographic characteristics, patient care characteristics, and situational variables on caregivers’ awareness. Data were collected by interview of a sample of primary caregivers aged 60+. A total of 202 primary caregivers responded positively, representing a response rate of 65% (202/311). We found a low−moderate level of awareness. The final multivariate regression analysis (F (12, 179) = 21.26, p < 0.000) revealed six variables, out of nearly 30, that are associated with a high percentage (59%) of the variability of caregivers’ awareness, namely caregiving burden, caregivers’ self-rated health, patient’s disease severity, caregiver gender, number of children, and familial relation to the patient. Action may be taken to raise caregivers’ awareness. Such interventions would possibly contribute to the quality of life and health of caregivers, enable the optimal treatment of the patient, and reduce the costs imposed on the health system and society in general.
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Affiliation(s)
- Shimon Amar
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;
- Clalit Health Services, Southern District, Beer-Sheva 84105, Israel
- Correspondence: ; Fax: +972-8-6477405
| | - Aya Biderman
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel;
- Clalit Health Services, Southern District, Beer-Sheva 84105, Israel
| | - Sara Carmel
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; (S.C.); (Y.G.B.)
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
| | - Yaacov G. Bachner
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel; (S.C.); (Y.G.B.)
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 84105, Israel
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Measurement, Associated Factors, and Gender Implications of Care Views towards Older Persons with Disabilities: The Case of Trinidad. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09490-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chammem R, Domi S, Schott AM. Perceptions and Experiences of Older Persons in Two Types of Institution in France: Foster Care Family Institution and Medico-Social One. Front Public Health 2021; 9:684776. [PMID: 34552901 PMCID: PMC8450456 DOI: 10.3389/fpubh.2021.684776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/09/2021] [Indexed: 11/13/2022] Open
Abstract
Background: The rapid increase in the number of older people with loss of autonomy and requiring human support, medical services, and adapted accommodation is a challenge in many countries. Beside institutions for older people, foster care families may offer an interesting innovative and affordable alternative that should to be evaluated. As the place of living has a major impact on the quality of life, our objective was to compare the perceptions and experience of older adults depending on the type of accommodation in which they live in. Methods: This study was based on a mixed method approach, with a quantitative assessment and a qualitative study with semi-structured interviews conducted with older people living in two different types of institutions: medico-social institution and foster care families. We explored the perceptions and the quality of life of the participants. Results: Institutionalization, chosen or not, can represent a trauma for older people as it disrupts their personal habits. Participants described medico-social institutions as an institutional framework supported by a strict professional team and rules, as impersonal structures (i.e., somewhat neutral), and as offering a very present, prepared, and respected reception protocol on the first day of arrival, which remained marked in memories. On the other hand, foster care families were considered as more spontaneous and family-oriented structures relying on internal and negotiable rules, offering personalized and close support in the face of loss of autonomy, but in which the reception protocol on the first day of arrival was almost absent. Conclusions: Foster care families and medico-social institutions presented different advantages and disadvantages from the point of view of the participants. This can help health policy makers to rethink the way seniors are housed by taking into consideration their perception and quality of life.
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Affiliation(s)
| | - Serge Domi
- Department of Sociology, Crifondo, Martinique
| | - Anne Marie Schott
- University Claude Bernard Lyon 1, Lyon, France.,Hospices Civils de Lyon, Lyon, France
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Davis C, Namasivayam-MacDonald AM, Shune SE. Contributors to Poststroke Dysphagia-Related Caregiver Burden. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2021; 30:1061-1073. [PMID: 33789060 DOI: 10.1044/2021_ajslp-20-00250] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose Caregiver burden negatively impacts both stroke survivor and caregiver well-being. Thus, it is important to better understand the individual- and dyadic-level variables that may contribute to dysphagia-related caregiver burden. The aim of this preliminary study was to identify survivor-, caregiver-, and dyadic-specific factors associated with burden in couples experiencing poststroke dysphagia. Method Twenty-eight stroke survivors ("care recipients") with dysphagia and their spouses ("caregivers") participated. Care recipients and caregivers completed a survey from which scores for the following variables were derived: dysphagia-related caregiver burden, survivor- and spouse-perceived impact of dysphagia on mealtimes (social, mealtime logistics), dyadic congruence on perceived impact, International Dysphagia Diet Standardisation Initiative Functional Diet Scale, Swallowing-Related Quality of Life Scale, and Stroke Impact Scale (cognitive, emotional, physical, and social domains). Spearman's rho and point biserial correlation coefficients were calculated to determine the factors related to caregiver burden. Results Increased burden was significantly associated with greater care recipient- and spouse-perceived impact of dysphagia on mealtime logistics; however, burden was not associated with measures of dyadic congruence of perceived impact. Notably, increased burden was also associated with increased diet restrictiveness and decreased swallow-specific quality of life. Dysphagia-related caregiver burden was not associated with measures of stroke impact/severity across any domain. Conclusions Factors related to dysphagia-related caregiver burden are multifactorial and include both care recipient (e.g., International Dysphagia Diet Standardisation Initiative Functional Diet Scale, Swallowing-Related Quality of Life Scale, perceived impact of dysphagia on mealtime logistics) and caregiver (e.g., perceived impact of dysphagia on mealtime logistics) variables. The results of this preliminary investigation support the need to incorporate aspects of counseling and family-centered care into our management practices, a growing area of interest for speech-language pathologists.
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Affiliation(s)
- Cameron Davis
- Communication Disorders and Sciences Program, University of Oregon, Eugene
| | | | - Samantha E Shune
- Communication Disorders and Sciences Program, University of Oregon, Eugene
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15
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Wang Y, Li J, Ding L, Feng Y, Tang X, Sun L, Zhou C. The effect of socioeconomic status on informal caregiving for parents among adult married females: evidence from China. BMC Geriatr 2021; 21:164. [PMID: 33676412 PMCID: PMC7937217 DOI: 10.1186/s12877-021-02094-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 02/16/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Married female caregivers face a higher risk of an informal care burden than other caregivers. No study has explored the effect of socioeconomic status (SES) on the intensity of informal care provided by married female caregivers in China. The purpose of this study is to empirically examine how the SES of married female caregivers affects the intensity of the informal care they provide for their parents/parents-in-law in China. METHODS The data for this study were drawn from 8 waves of the China Health and Nutrition Survey (CHNS). The respondents were married women whose parents/parents-in-law needed care and lived in the same city as them. SES was defined based on four indicators: education, economic status, employment status, and hukou (China's household registration system). Informal caregivers were divided into three categories: non-caregivers (0 h/week), low-intensity caregivers (less than 10 h/week), and high-intensity caregivers (10 h/week and above). Multinomial logistic regression analysis was used to examine the relation between SES and the likelihood of a low- and high-intensity caregiving among married female caregivers, adjusting for age, family characteristics and survey wave. RESULTS Of the 2661 respondents, high-intensity and low-intensity caregivers accounted for 16.35 and 21.27%, respectively. The multinomial logistic regression results showed that the likelihood of being a high-intensity caregiver versus (vs. a non-caregiver) increased as the caregiver's educational attainment increased (p < 0.05), and that high economic status was related to the likelihood of being a high-intensity caregiver, but this relationship was only significant at the 10% level. Urban females were 1.34 times more likely than their rural counterparts to provide low-intensity care vs. no care (p < 0.05) and were 1.33 times more likely to provide high-intensity care vs. no care (p < 0.05). Employed females were 1.25 times more likely than those unemployed females to provide low-intensity care vs. no care (p < 0.05). CONCLUSIONS Differences in SES were found between high-intensity caregivers and low-intensity caregivers. Women with high educational attainment and urban hukou were more likely to provide high-intensity informal care, and women who were employed and had urban hukou were more likely to provide low-intensity care.
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Affiliation(s)
- Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Jiajia Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Lulu Ding
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Yuejing Feng
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Xue Tang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Long Sun
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012 China
- NHC Key Laboratory of Health Economics and Policy Research, Shandong University, 44 Wen-hua-xi Road, Jinan, 250012 Shandong China
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Tuberculosis and Non-Communicable Disease Multimorbidity: An Analysis of the World Health Survey in 48 Low- and Middle-Income Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052439. [PMID: 33801381 PMCID: PMC7967573 DOI: 10.3390/ijerph18052439] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 02/23/2021] [Accepted: 02/26/2021] [Indexed: 01/02/2023]
Abstract
Tuberculosis (TB) is a leading cause of mortality in low- and middle-income countries (LMICs). TB multimorbidity [TB and ≥1 non-communicable diseases (NCDs)] is common, but studies are sparse. Cross-sectional, community-based data including adults from 21 low-income countries and 27 middle-income countries were utilized from the World Health Survey. Associations between 9 NCDs and TB were assessed with multivariable logistic regression analysis. Years lived with disability (YLDs) were calculated using disability weights provided by the 2017 Global Burden of Disease Study. Eight out of 9 NCDs (all except visual impairment) were associated with TB (odds ratio (OR) ranging from 1.38-4.0). Prevalence of self-reported TB increased linearly with increasing numbers of NCDs. Compared to those with no NCDs, those who had 1, 2, 3, 4, and ≥5 NCDs had 2.61 (95% confidence interval (CI) = 2.14-3.22), 4.71 (95%CI = 3.67-6.11), 6.96 (95%CI = 4.95-9.87), 10.59 (95%CI = 7.10-15.80), and 19.89 (95%CI = 11.13-35.52) times higher odds for TB. Among those with TB, the most prevalent combinations of NCDs were angina and depression, followed by angina and arthritis. For people with TB, the YLDs were three times higher than in people without multimorbidity or TB, and a third of the YLDs were attributable to NCDs. Urgent research to understand, prevent and manage NCDs in people with TB in LMICs is needed.
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Sánchez-Arenas R, Doubova SV, Bernabe-Garcia M, Gregory MA, Mejía-Alonso LA, Orihuela-Rodríguez O, Paredes-Manjarrez C, Colín-Martínez T, Mujica-Morales I, Grijalva-Otero I, Basurto-Acevedo L, Manuel-Apolinar L, Cuadros-Moreno J, Bernal-Diaz A, Shigematsu R. Double-task exercise programmes to strengthen cognitive and vascular health in older adults at risk of cognitive decline: protocol for a randomised clinical trial. BMJ Open 2020; 10:e039723. [PMID: 33380479 PMCID: PMC7780518 DOI: 10.1136/bmjopen-2020-039723] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Cognitive and physical declines are frequent causes of disability among older adults (OAs) in Mexico that imposes significant burden on the health system and OAs' families. Programmes to prevent or delay OAs' cognitive and physical decline are scarce. METHODS AND ANALYSIS A double-blind randomised clinical trial will be conducted. The study will aim to evaluate two 24-week double-task (aerobic and cognitive) square-stepping exercise programmes for OAs at risk of cognitive decline-one programme with and another without caregiver participation-and to compare these with an aerobic-balance-stretching exercise programme (control group). 300 OAs (100 per group) affiliated with the Mexican Institute of Social Security (IMSS) between 60 and 65 years of age with self-reported cognitive concerns will participate. They will be stratified by education level and randomly allocated to the groups. The intervention will last 24 weeks, and the effect of each programme will be evaluated 12, 24 and 52 weeks after the intervention. Participants' demographic and clinical characteristics will be collected at baseline. The outcomes will include: (1) general cognitive function; (2) specific cognitive functions; (3) dual-task gait; (4) blood pressure; (5) carotid intima-media thickness; (6) OAs' health-related quality of life; and (7) caregiver burden. The effects of the interventions on each outcome variable will be examined using a repeated-measures analysis of variance (ANOVA), with study groups as the between-subjects variable and time as the within-subject variable. ETHICS AND DISSEMINATION The study was approved by the IMSS Ethics and Research Committees (registration number: 2018-785-095). All participants will sign a consent form prior to their participation. The study results will be disseminated to the IMSS authorities, healthcare providers and the research community. TRIAL REGISTRATION NUMBER ClinicalTrials.gov (NCT04068376).
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Affiliation(s)
- Rosalinda Sánchez-Arenas
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Svetlana V Doubova
- Epidemiology and Health Services Research Unit CMN Siglo XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Mariela Bernabe-Garcia
- Medical Research Unit in Nutrition, Pediatrics Hospital, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Michel A Gregory
- School of Rehabilitation Sciences, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Laura Alejandra Mejía-Alonso
- Rehabilitation Service, Specialty Hospital, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Oscar Orihuela-Rodríguez
- Cardiology Service, Specialty Hospital, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Carlos Paredes-Manjarrez
- Image Service, Specialty Hospital, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Tania Colín-Martínez
- Continuous Admission Service, Specialty Hospital, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Irene Mujica-Morales
- Division of Occupational Risk Prevention. Occupational Health Coordination, Mexican Institute of Social Security, Mexico City, Mexico
| | - Israel Grijalva-Otero
- Medical Research Unit in Neurological Diseases, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Lourdes Basurto-Acevedo
- Research Unit in Endocrine Diseases, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Leticia Manuel-Apolinar
- Research Unit in Endocrine Diseases, National Medical Center Century XXI, Mexican Institute of Social Security, Mexico City, Mexico
| | - Juan Cuadros-Moreno
- Coordination of Health Education, Mexican Institute of Social Security, Mexico City, Mexico
| | - Arcelia Bernal-Diaz
- Aragón School of Higher Education, National Autonomous University of Mexico, Mexico City, Mexico
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Shune SE, Resnick B, Zarit SH, Namasivayam-MacDonald AM. Creation and Initial Validation of the Caregiver Analysis of Reported Experiences with Swallowing Disorders (CARES) Screening Tool. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2131-2144. [PMID: 33049154 DOI: 10.1044/2020_ajslp-20-00148] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Purpose Dysphagia is a debilitating condition with widespread consequences. Previous research has revealed dysphagia to be an independent predictor of caregiver burden. However, there is currently no systematic method of screening for or identifying dysphagia-related caregiver burden. The aim of this study was to develop a set of questions for a dysphagia-related caregiver burden screening tool, the Caregiver Analysis of Reported Experiences with Swallowing Disorders (CARES), and pilot the tool to establish preliminary validity and reliability. Method The questionnaire was developed through an iterative process by a team of clinical researchers with expertise in dysphagia, dysphagia-related and general caregiver burden, and questionnaire design. A heterogenous group of 26 family caregivers of people with dysphagia completed the CARES, along with the Eating Assessment Tool (EAT-10), the International Dysphagia Diet Standardisation Initiative Functional Diet Scale (IDDSI-FDS), and the Zarit Burden Interview (ZBI). Information on construct validity, item fit, convergent validity, internal consistency, and reliability was determined via Rasch analysis model testing, Cronbach's alpha, and Spearman's rho calculations. Results The final CARES questionnaire contained 26 items divided across two subscales. The majority of the questionnaire items fit the model, there was evidence of internal consistency across both subscales, and there were significant relationships between dysphagia-specific burden (CARES) and perceived swallowing impairment (EAT-10), general caregiver burden (ZBI), and diet restrictiveness (IDDSI-FDS). Conclusions Results from the current study provide initial support for the validity and reliability of the CARES as a screening tool for dysphagia-related burden, particularly among caregivers of adults with swallowing difficulties. While continued testing is needed across larger groups of specific patient populations, it is clear that the CARES can initiate structured conversations about dysphagia-related caregiver burden by identifying potential sources of stress and/or contention. This will allow clinicians to then identify concrete methods of reducing burden and make appropriate referrals, ultimately improving patient care.
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Affiliation(s)
- Samantha E Shune
- Communication Disorders and Sciences Program, University of Oregon, Eugene
| | | | - Steven H Zarit
- Human Development and Family Studies, The Pennsylvania State University, University Park
| | - Ashwini M Namasivayam-MacDonald
- Department of Communication Sciences and Disorders, Adelphi University, Garden City, NY
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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Shune SE, Namasivayam-MacDonald A. Dysphagia-Related Caregiver Burden: Moving Beyond the Physiological Impairment. ACTA ACUST UNITED AC 2020. [DOI: 10.1044/2020_persp-20-00067] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Purpose
The biopsychosocial ramifications of dysphagia are widespread. However, its influence on informal caregivers and families is often overlooked. Ultimately, the health and well-being of an entire family is central to care provision. This tutorial introduces readers to the current literature on dysphagia-related caregiver burden and third-party disability, illustrates the consequences of such burden on both caregivers and patients, and suggests strategies for better supporting patients' informal caregivers.
Conclusions
It is essential that speech-language pathologists recognize that the consequences of dysphagia are not limited to the impairment itself and acknowledge dysphagia's substantial impact on the entire family system. More general health care literature suggests that asking caregivers individual questions, modifying the language used to talk with them, providing them with targeted education and resources, and organizing support groups may all be beneficial for increased perceived support and self-efficacy. Ultimately, in order to best meet the needs of our patients with dysphagia, we must also better meet the needs of their families and other informal caregivers.
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Burden and Preparedness amongst Informal Caregivers of Adults with Moderate to Severe Traumatic Brain Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176386. [PMID: 32887272 PMCID: PMC7503757 DOI: 10.3390/ijerph17176386] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 01/23/2023]
Abstract
This study examined the patterns of informal (unpaid) caregiving provided to people after moderate to severe traumatic brain injury (TBI), explore the self-reported burden and preparedness for the caregiving role, and identify factors predictive of caregiver burden and preparedness. A cross-sectional cohort design was used. Informal caregivers completed the Demand and Difficulty subscales of the Caregiving Burden Scale; and the Mutuality, Preparedness, and Global Strain subscales of the Family Care Inventory. Chi-square tests and logistic regression were used to examine the relationships between caregiver and care recipient variables and preparedness for caregiving. Twenty-nine informal caregivers who reported data on themselves and people with a moderate to severe TBI were recruited (referred to as a dyad). Most caregivers were female (n = 21, 72%), lived with the care recipient (n = 20, 69%), and reported high levels of burden on both scales. While most caregivers (n = 21, 72%) felt “pretty well” or “very well” prepared for caregiving, they were least prepared to get help or information from the health system, and to deal with the stress of caregiving. No significant relationships or predictors for caregiver burden or preparedness were identified. While caregivers reported the provision of care as both highly difficult and demanding, further research is required to better understand the reasons for the variability in caregiver experience, and ultimately how to best prepare caregivers for this long-term role.
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