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Su Q, Fan L. Impact of caregiving on mental, self-rated, and physical health: evidence from the China health and retirement longitudinal study. Qual Life Res 2024; 33:1-10. [PMID: 38644418 DOI: 10.1007/s11136-024-03659-3] [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] [Accepted: 03/27/2024] [Indexed: 04/23/2024]
Abstract
OBJECTIVES Given the escalating demand for care services, understanding the impact of informal caregiving, providing unpaid care for family members, on own health is essential. This study longitudinally analyzed the association of caregiving (and different caregiver types) with mental, physical, and self-rated health. Urban-rural, gender, and employment heterogeneity were further investigated. METHOD Based on three-wave data (2011, 2013, and 2018) from the China Health and Retirement Longitudinal Study, we used growth curve models to assess the impact of informal caregiving (providing care to family members) and caregiver types (caregivers to grandchildren, parents, spouses, or multiple family members) on three health outcomes (depressive symptoms, self-rated health, and activities of daily living limitations). RESULTS Our study included 13,377 individuals. Results showed a negative correlation of caregiving with mental, physical, and self-rated health. Compared to noncaregivers, spousal caregivers and multiple caregivers were both associated with worsening mental, self-rated, and physical health. In contrast, adult child caregivers were only negatively associated with mental health, and grandparent caregiving did not significantly affect any health outcomes. Further heterogeneity analysis showed that gender did not moderate the relationship between caregiving and health, whereas the negative association between caregiving and health was more pronounced among the rural population and those employed in agriculture. DISCUSSION Findings from the present study suggest that caregiving is detrimental to health, and recommend considering caregiver type when examining caregiving and health. These findings have vital implications for policymakers in addressing the challenges of structuring and implementing a sustainable informal care system.
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Affiliation(s)
- Qing Su
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing, 210009, China
| | - Lijun Fan
- School of Public Health, Southeast University, No.87 Dingjiaqiao, Nanjing, 210009, China.
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Denham AMJ, Haracz K, Bird ML, Bonevski B, Spratt NJ, Turner A, Chow WZ, Larkin M, Mabotuwana N, Janssen H. Non-pharmacological interventions to improve mental health outcomes among female carers of people living with a neurological condition: a systematic review. Disabil Rehabil 2024:1-18. [PMID: 38859798 DOI: 10.1080/09638288.2024.2360648] [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: 09/22/2023] [Accepted: 05/22/2024] [Indexed: 06/12/2024]
Abstract
PURPOSE This systematic review aims to examine the effectiveness of non-pharmacological interventions for improving mental health outcomes among female carers of people living with a neurological condition. MATERIALS AND METHODS A narrative synthesis of English-language randomized controlled trials was undertaken. RESULTS 18 unique studies were included. Intervention components that were found to have improved mental health outcomes were: delivered in person, to groups, on an intermittent schedule with ≥10 sessions; had a duration between 3-6 months; and were facilitated by research staff or allied health professionals. As the review had few robust studies, results of mental health outcomes reported in studies assessed as low risk of bias were highlighted in the review. Psychoeducation interventions, cognitive behavioural interventions, and support group interventions were found to improve depression. Psychoeducation interventions were also found to improve burden. CONCLUSIONS There is a clear need for adequately powered, high-quality randomised controlled trials to determine the effectiveness of non-pharmacological interventions for female carers of people living with a neurological condition.
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Affiliation(s)
- A M J Denham
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - K Haracz
- School of Health Sciences, University of Newcastle, Callaghan, Australia
| | - M L Bird
- School of Health Sciences, University of Tasmania, Hobart, Australia
| | - B Bonevski
- Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - N J Spratt
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
- Heart and Stroke Program, Hunter Medical Research Institute, Newcastle, Australia
- Department of Neurology, John Hunter Hospital, Newcastle, Australia
| | - A Turner
- IMPACT - The Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Australia
| | - W Z Chow
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Queenstown, Singapore
| | - M Larkin
- School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, UK
| | - N Mabotuwana
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
| | - H Janssen
- School of Health Sciences, University of Newcastle, Callaghan, Australia
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, Australia
- Hunter Stroke Service, Hunter New England Local Health District, New Lambton Heights, Australia
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Huertas-Domingo C, Losada-Baltar A, Gallego-Alberto L, García-Batalloso I, García-García L, Márquez-González M. Profiles of Dementia Caregivers according to Psychosocial and Resource Variables. Importance of Kinship. THE SPANISH JOURNAL OF PSYCHOLOGY 2024; 27:e15. [PMID: 38769838 DOI: 10.1017/sjp.2024.15] [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] [Indexed: 05/22/2024]
Abstract
The present study aims to analyze the existence of different profiles in family caregivers of people with dementia according to psychosocial and resource variables. In addition, it aims to study whether there is a greater representation of each kinship group in each of the profiles and if there are differences in emotional distress among such profiles considering the kinship with the care-recipient. Participants were 288 family dementia caregivers, divided into four kinship groups (wives, husbands, sons and daughters). Psychosocial (familism, dysfunctional thoughts and experiential avoidance), resource (leisure activities and social support) and outcomes (depressive, anxious and guilt symptomatology) variables were collected. A hierarchical cluster analysis using Ward's method, an exploratory factor analysis of two fixed factors and contingency tables were performed. Five clusters were obtained: Low psychosocial vulnerability-High resources, Low psychosocial vulnerability-Low resources, Mixed, High psychosocial vulnerability-High resources, and High psychosocial vulnerability-Low resources. Results suggested that clusters associated with lower distress were the Low psychosocial vulnerability-High resources and the High psychosocial vulnerability-High resources. Clusters associated with higher distress were the Low psychosocial vulnerability-Low resources and Mixed. High levels of dysfunctional thoughts, familism and experiential avoidance do not always have a maladaptive function. This could depend on sociocultural and resource variables such as the kinship with the caregiver or perceived social support. The identification of profiles of family caregivers potentially needing protection and vulnerable to psychological distress could help to increase the effectiveness of interventions aimed at this population.
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Abken E, Ferretti MT, Castro-Aldrete L, Santuccione Chadha A, Tartaglia MC. The impact of informant-related characteristics including sex/gender on assessment of Alzheimer's disease symptoms and severity. Front Glob Womens Health 2024; 5:1326881. [PMID: 38605937 PMCID: PMC11007195 DOI: 10.3389/fgwh.2024.1326881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/14/2024] [Indexed: 04/13/2024] Open
Affiliation(s)
- E. Abken
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
- London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - M. T. Ferretti
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
- Center for Alzheimer Studies, Karolinska Institute, Stockholm, Sweden
| | | | | | - M. C. Tartaglia
- Women’s Brain Project, Guntershausen bei Aadorf, Switzerland
- Tanz Centre for Research in Neurodegenerative Disease, University of Toronto, Toronto, ON, Canada
- Memory Clinic, Krembil Brain Institute, University Health Network, Toronto, ON, Canada
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Vargas-Gonzalez JC, Chadha AS, Castro-Aldrete L, Ferretti MT, Tartaglia C. Informant characteristics are associated with the Clinical Dementia Rating Sum of Boxes scores in the Alzheimer's Disease patients participating in the National Alzheimer's Coordinating Center Uniform Data Set. RESEARCH SQUARE 2024:rs.3.rs-3982448. [PMID: 38559129 PMCID: PMC10980151 DOI: 10.21203/rs.3.rs-3982448/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Background The Clinical Dementia Rating® Sum of Boxes (CDR®-SB) is used to stage dementia severity; it is one of the most common outcome measurements in Alzheimer's Disease (AD) research and clinical trials. The CDR®-SB requires an informant to provide input to stage a patient's dementia severity. The effect of the informant's characteristics on the CDR®-SB is unknown. We aimed to evaluate the effect of the informant's sex, relationship to the patient, and frequency of contact on the CDR®-SB scores in patients with Alzheimer's Disease with mild cognitive impairment or dementia included in the National Alzheimer's Coordinating Center Uniform Data Set (NACC-UDS). Methods We included all participants from the NACC-UDS that had AD as diagnosis, and information about the Mini-Mental State Examination or Montreal Cognitive Assessment scores, informant sex, relationship to patient and frequency of contact; we also analyzed the possible interaction between these characteristics on the CDR®-SB as the outcome. We performed a multilevel linear regression analysis. Results We included data from 20636 participants, totalling 47727 visits. Patients' age was 74.0 ± 9.4 years and 54.1% were females. Informant characteristics were mean age of 66.2 ± 13.2 years, 69.1% were females, and the relationship to patients was 60.5% spouse or partner, 26.7% children and 12.8% other relation. The CDR®-SB scores were 0.20 higher (CI 95%: 0.11 to 0.29) when the informant was female. When comparing to informant's relationship with the baseline being spouse or partner, the CDR®-SB was 0.39 higher (CI 95%: 0.25 to 0.53) when the informant was the patient's child and 0.18 lower (CI 95%: -0.35 to -0.01) if relationship was other. Regarding the frequency of contact, CDR®-SB scores were 0.38 higher (CI95%: 0.28 to 0.47) when contact was at least once a week, 0.65 higher (CI95%: 0.52 to 0.78) when contact was daily, and 0.57 higher (CI95%: 0.46 to 0.69) when informant was living with the patient, baseline was a frequency of less than once per week. Finally, the interaction between informant relationships other and female patients showed a 0.24 higher CDR®-SB score (CI95%: 0.03 to 0.46). Conclusions We found that the CDR®-SB scores are significantly modified by informant characteristics and frequency of contact in the NACC-UDS patients with AD diagnosis. These findings hold clinical significance as informant characteristics ideally should not impact the staging of AD patients, and any such effects could introduce bias into clinical evaluations in clinical trials. Future research endeavours should investigate strategies to address and mitigate the influence of these confounding variables.
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Ruyant Belabbas E, Manceau C, Wawrziczny E. The relationship at the heart of the experience of daughter caregivers of a parent with dementia: An interpretative phenomenological analysis. DEMENTIA 2024; 23:175-190. [PMID: 38078431 DOI: 10.1177/14713012231220223] [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] [Indexed: 12/21/2023]
Abstract
BACKGROUND Parents with dementia require emotional, physical, psychological and financial support from their child caregivers to continue living at home. Daughter caregivers have been shown to be more involved in self-care and household tasks and to experience higher levels of distress than son caregivers. OBJECTIVE The aim of this study was to investigate the experience of daughter caregivers who provide informal care for a parent with dementia living in their own home. METHOD Semi-structured interviews were conducted with 11 daughter caregivers of a parent with Alzheimer's disease. Interviews were analysed using Interpretative Phenomenological Analysis. RESULTS Three axes emerged from the analyses: [1] the before conditions the after: the quality of the previous relationship with the parent with Alzheimer's disease is a determining factor and allows the identification of three profiles of daughter caregivers: 'the grateful', 'the resentful' and 'the ambivalent', [2] when the relationship protects against the sense of burden: the feeling of being invaded by the caregiving situation is influenced by the quality of the relationship with the parent with Alzheimer's disease, and [3] alone or almost: the support network is desired when it is absent but kept at arm's length when it is present. DISCUSSION The results underline the importance of assessing the quality of attachment and supporting the relationship with the parent (especially when the relationship prior to the disease was difficult). Daughter caregivers should also be encouraged to delegate tasks and refocus their actions related to their values. Family mediation sessions may be planned to improve the organisation of care and set up an efficient collaboration.
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Affiliation(s)
| | - Charlotte Manceau
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
| | - Emilie Wawrziczny
- Laboratory SCALab, UMR CNRS 9193, University of Lille, Villeneuve d'Ascq, France
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Rawat P, Sehar U, Bisht J, Reddy AP, Reddy PH. Alzheimer's disease and Alzheimer's disease-related dementias in Hispanics: Identifying influential factors and supporting caregivers. Ageing Res Rev 2024; 93:102178. [PMID: 38154509 PMCID: PMC10807242 DOI: 10.1016/j.arr.2023.102178] [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: 07/20/2023] [Revised: 10/04/2023] [Accepted: 12/23/2023] [Indexed: 12/30/2023]
Abstract
Alzheimer's disease (AD) and Alzheimer's disease-related dementias (ADRD) are the primary public health concerns in the United States and around the globe. AD/ADRD are irreversible mental illnesses that primarily impair memory and thought processes and may lead to cognitive decline among older individuals. The prevalence of AD/ADRD is higher in Native Americans, followed by African Americans and Hispanics. Increasing evidence suggests that Hispanics are the fastest-growing ethnic population in the USA and worldwide. Hispanics develop clinical symptoms of AD/ADRD and other comorbidities nearly seven years earlier than non-Hispanic whites. The consequences of AD/ADRD can be challenging for patients, their families, and caregivers. There is a significant increase in the burden of illness, primarily affecting Hispanic/Latino families. This is partly due to their strong sense of duty towards family, and it is exacerbated by the inadequacy of healthcare and community services that are culturally and linguistically suitable and responsive to their needs. With an increasing age population, low socioeconomic status, low education, high genetic predisposition to age-related conditions, unique cultural habits, and social behaviors, Hispanic Americans face a higher risk of AD/ADRD than other racial/ethnic groups. Our article highlights the status of Hispanic older adults with AD/ADRD. We also discussed the intervention to improve the quality of life in Hispanic caregivers.
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Affiliation(s)
- Priyanka Rawat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock 79409, TX, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA
| | - Jasbir Bisht
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock 79409, TX, USA
| | - Arubala P Reddy
- Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock 79409, TX, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA; Nutritional Sciences Department, College of Human Sciences, Texas Tech University, Lubbock 79409, TX, USA; Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA; Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA; Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock 79430, TX, USA; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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Ponti L, Cappelli F, Perfetto F, Maver P, Smorti M. Caregiver's psychological well-being and quality of relationship with cardiac amyloidosis patients. PSYCHOL HEALTH MED 2024; 29:66-78. [PMID: 38156665 DOI: 10.1080/13548506.2023.2280463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 10/31/2023] [Indexed: 01/03/2024]
Abstract
Caregivers' psychological well-being is linked to the quality of care provided for familiar with chronic illness. Despite caregivers of cardiac patients present an impaired psychological well-being, less investigated is the psychological well-being of caregivers of individuals with a rare disease such as the Transthyretin Cardiac Amyloidosis (ATTR-CA). Specifically, given that no study explored the well-being of the caregiver and the caregiver-patient relationship, this study aimed to analyze the prevalence of anxiety and depression in ATTR-CA caregivers and if these disorders were associated with patient's and caregiver's characteristics. Fifty-eight dyad caregiver-ATTR-CA patients completed the Hospital Anxiety and Depression Scale and the Network of Relationships Inventory. Moreover, ATTR-CA patients completed the Kansas City Cardiomyopathy Questionnaire, while caregivers completed the Multidimensional Scale of Social Support. Results showed that anxious caregivers (44%) reported higher conflict with patients. They had ATTR-CA relatives with a worse perception of cardiac symptoms and higher anxiety and depression. Depressed caregivers (39%) reported higher conflict with ATTR-CA relatives and lower perceived social support. Caregiver reported a high prevalence of anxiety and depression associated with worse personal relational well-being and to patient's psycho-physical condition. The care of ATTR-CA patient should consider the caregiver well-being.
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Affiliation(s)
- Lucia Ponti
- Department of Humanities, University of Urbino, Urbino, Italy
- Cardiomyopathy Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Cappelli
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- Division of Interventional Structural Cardiology, Cardiothoracovascular Department, Careggi University Hospital, Florence, Italy
| | - Federico Perfetto
- Tuscan Regional Amyloidosis Centre, Careggi University Hospital, Florence, Italy
- IV Internal Medicine Division, Careggi University Hospital, Florence, Italy
| | - Perla Maver
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
| | - Martina Smorti
- Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, Pisa, Italy
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Urbaniak A, Walsh K, Batista LG, Kafková MP, Sheridan C, Serrat R, Rothe F. Life-course transitions and exclusion from social relations in the lives of older men and women. J Aging Stud 2023; 67:101188. [PMID: 38012947 DOI: 10.1016/j.jaging.2023.101188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 11/29/2023]
Abstract
There is increasing interest across European contexts in promoting active social lives in older age, and counteracting pathways and outcomes related to social isolation and loneliness for men and women in later life. This is evidenced within national and European level policy, including the 2021 Green Paper on Ageing and its concern with understanding how risks can accrue for European ageing populations in the relational sphere. Research indicates that life-course transitions can function as a source of these risks, leading to a range of potentially exclusionary impacts for the social relations of older men and women. Findings presented in this paper are drawn from the qualitative component of a larger European mixed-methods study on exclusion from social relations (GENPATH: A life course perspective on the GENdered PATHways of social exclusion in later life, and its consequences for health and well-being). We use data from 119 in-depth interviews from four jurisdictions: Austria, Czechia, Ireland and Spain. This research employed an approach that focused on capturing lived experienced insights related to relational change across the life course, the implications of these changes for multifaceted forms of exclusion from social relations and the role of gender in patterning these changes and implications. We focused on transitions that commonly emerged across those jurisdictions for older people: onset of ill-health, bereavement, retirement and relocation. We found that these transitions translate into multidimensional experiences of exclusion from social relations in the lives of older men and women by constraining their social networks, support networks, social opportunities and intimate relationships.
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Affiliation(s)
- Anna Urbaniak
- University of Vienna, Sociology Department, Rooseveltplatz 2, 1090 Vienna, Austria; Uniwersytet Ekonomiczny w Krakowie, ul. Rakowicka 27, 31-510 Kraków, Poland.
| | - Kieran Walsh
- National University of Ireland, Galway, NUI Galway, Irish Centre for Social Gerontology, Institute for Lifecourse & Society, Corrib Village, Ireland.
| | - Lucie Galčanová Batista
- Masaryk University, Faculty of Social Studies, Office for Population Studies, Dpt. of Sociology, Jostova 10, 60200 Brno, Czechia.
| | - Marcela Petrová Kafková
- Masaryk University, Faculty of Social Studies: Brno, Czechia, Joštova 218, 602 00 Brno-střed, Czechia.
| | - Celia Sheridan
- National University of Ireland, Galway, NUI Galway, Irish Centre for Social Gerontology, Institute for Lifecourse & Society, Corrib Village, Ireland.
| | - Rodrigo Serrat
- University of Barcelona, Department of Cognition, Development and Educational Psychology, Barcelona, Spain.
| | - Franziska Rothe
- NOVA Norwegian Social Research, Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, NO-0130 Oslo, Norway.
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Ikanga J, Reyes A, Zhao L, Hill-Jarrett TG, Hammers D, Epenge E, Esambo H, Kavugho I, Esselakoy C, Gikelekele G, Tshengele N, Alonso A, Robinson-Lane SG. Exploring factors contributing to caregiver burden in family caregivers of congolese adults with suspected dementia. Int J Geriatr Psychiatry 2023; 38:e6004. [PMID: 37712695 PMCID: PMC10901182 DOI: 10.1002/gps.6004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Predicting caregiver burden in individuals with suspected dementia - is critical due to the debilitating nature of these disorders and need for caregiver support. While some examination of the factors affecting burden has been undertaken in Sub-Saharan Africa, each country presents with its own unique challenges and obstacles. This pilot study investigates predictors of caregiver burden in family caregivers of individuals with suspected dementia living in the Democratic Republic of the Congo (DRC). METHODS Linear and multiple regression analyses were conducted to explore factors associated with caregiver burden in 30 patient-caregiver dyads with the Zarit Burden Interview (ZBI) for caregiver burden evaluation. Cognitive impairments of patients were assessed using the Community Screening Instrument for Dementia, Alzheimer's Questionnaire (AQ), the African Neuropsychology Battery, and the Neuropsychiatric Symptoms Inventory (NPI). RESULTS Average caregiver burden on the ZBI was 36.1 (SD = 14.6; range = 12-58). Greater impairments in patient cognition (orientation, visuospatial, memory, executive functioning), fragility, and neuropsychiatric symptoms (delirium, agitation, depression) were predictive of caregiver burden. After controlling for AQ scores and caregiver gender, greater symptoms of depression, and worse performances on verbal memory and problem solving were associated with greater caregiver burden. CONCLUSION Worsening patient fragility, cognition, functioning, and neuropsychiatric symptoms influenced caregiver burden in caregivers of individuals with suspected cognitive impairment in the DRC. These findings are consistent with the prior literature. Future studies may wish to explore supportive factors and caregiver specific characteristics that buffer against perceived burden.
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Affiliation(s)
- Jean Ikanga
- Emory University School of Medicine, Department of Rehabilitation Medicine, Georgia, 1441 Clifton Rd NE, Atlanta, GA, 30322, USA
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Anny Reyes
- Emory University School of Medicine, Department of Rehabilitation Medicine, Georgia, 1441 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Liping Zhao
- Emory University, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta GA 30322, USA
| | - Tanisha G. Hill-Jarrett
- University of South Florida, Department of Neurosurgery and Brain Repair, Tampa, Florida, 33613, USA
- University of California, Global Brain Health Institute, San Francisco, California, 94158, USA
| | - Dustin Hammers
- Indiana university, department of neurology, Indiana, Indianapolis, IN 46202, USA
| | - Emmanuel Epenge
- University of Kinshasa, department of neurology, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Herve Esambo
- University of Kinshasa, department of neurology, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Immaculée Kavugho
- Memory Clinic of Kinshasa, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Christian Esselakoy
- University of Montreal, Department of psychology, PO BOX 6128 Centre-ville STN Montreal QC H3C 3J, CANADA
| | - Guy Gikelekele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Nathan Tshengele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Alvaro Alonso
- Emory University, School of Public Health, department of epidemiology, Georgia, Atlanta, GA, 30307, USA
| | - Sheria G. Robinson-Lane
- University of Michigan, School of Nursing, Department of Systems, Populations, and Leadership, Ann Arbor, Michigan, 48109, USA
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Kocsis-Bogar K, Ossege M, Aigner M, Wancata J, Friedrich F. Involvement, depressive symptoms, and their associations with problems and unmet needs in caregivers of adult eating disorder patients. Eat Weight Disord 2023; 28:45. [PMID: 37222833 DOI: 10.1007/s40519-023-01572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
PURPOSE This study aimed to examine the most important problems and needs caregivers of adult inpatients with eating disorders (EDs) are confronted with in their everyday lives. A further aim was to investigate the associations between problems, needs, involvement, and depression in carers. METHODS Fifty-five caregivers of inpatients with EDs (26 anorexia nervosa, 29 bulimia nervosa) completed the Carers' Needs Assessment, Beck Depression Inventory, and the Involvement Evaluation Questionnaire. The relationships between variables were tested via multiple linear regressions and mediation analyses. RESULTS The most frequent problem reported by caregivers was a lack of information about the course and treatment of the illness and consequent disappointment, whereas their most frequently reported needs were different forms of information and counselling. Problems, unmet needs, and worrying were especially high in parents compared to other caregivers. Involvement mediated significantly between problems (b = 0.26, BCa CI [0.03, 0.49]) as well as unmet needs (b = 0.32, BCa CI [0.03, 0.59]) of caregivers and their depressive symptoms. CONCLUSION Our findings underline the importance of including the problems and needs of caregivers of adult eating disorder patients in the planning of family and community interventions, to support their mental health. LEVEL OF EVIDENCE Level III: Evidence obtained from cohort or case-control analytic studies.
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Affiliation(s)
- Krisztina Kocsis-Bogar
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna Währinger Gürtel 18-20, 1090, Vienna, Austria.
| | - Michael Ossege
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Martin Aigner
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna Währinger Gürtel 18-20, 1090, Vienna, Austria
- Department of Psychiatry and Psychotherapy, Karl Landsteiner University, Krems, Austria
| | - Johannes Wancata
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Fabian Friedrich
- Clinical Division of Social Psychiatry, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna Währinger Gürtel 18-20, 1090, Vienna, Austria
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Abstract
BACKGROUND Individuals with heart failure (HF), a debilitating disease with ongoing adaptation and management, are often cared for by partner caregivers whose needs and voices are overshadowed by the demands of HF management. With multidimensional needs and complex challenges for individuals with HF, partner caregivers have to deal with uncertainty and need guidance. Given the vital role of partners, attention should be drawn toward understanding the experience of HF partner caregivers. OBJECTIVE The aim of this study was to synthesize existing qualitative evidence related to caregivers' views and experiences of caring for their partners with HF. This knowledge would assist healthcare providers to better meet the demand of partners and provide them with effective guidance. METHODS A meta-ethnography of qualitative evidence was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis recommendations for reporting systematic reviews. A comprehensive search of PubMed, Scopus, ISI Web of Science, CINAHL, PsycINFO, and EMBASE, as well as hand searches of the reference lists from included articles, was conducted. A combination of subject terms including MeSH and keywords related to HF, partner experience, and qualitative methods was used to identify studies. Studies were included if they were published in English between January 2000 and December 2020 and examined caregivers' experiences in providing care for their partner with HF by using qualitative methods. RESULTS Ten articles were included, with 178 participants, and most partners were female. Five studies were conducted in the United States, and 4 studies were conducted in Sweden. Five studies reported partners' health problems; 8 of the studies delineated the inclusion and exclusion criteria for partners. Five overarching themes emerged: shouldering the responsibility, being overloaded, bearing emotional burdens, staying positive, and "left in the dark," craving support from others. CONCLUSIONS AND CLINICAL IMPLICATIONS Given the complex roles in caring for individuals with HF, more qualitative research is strongly warranted to enhance caregivers' support and education. A deeper and more comprehensive understanding of the experiences of caregivers for partners with HF is essential for developing tailored interventions. Healthcare providers should be aware of the importance of ongoing assessment and evaluate partner caregivers' needs and assist them in providing more information and formulating coping strategies as required.
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Kaggwa MM, Najjuka SM, Mamun MA, Griffiths MD, Nyemara N, Ashaba S. Involvement and burden of informal caregivers of patients with mental illness: the mediating role of affiliated stigma. BMC Psychiatry 2023; 23:72. [PMID: 36703121 PMCID: PMC9881274 DOI: 10.1186/s12888-023-04553-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 01/17/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND The fear and lack of understanding of mental illness can lead to stigma. The stigma of mental illness affects not only individuals who suffer from it, but also the caregivers. Stigma among caregivers can lead to delay in seeking care, poor adherence to treatment and a high risk of relapse. Caregivers of patients with mental illness are at an increased risk of distress due to the burden to stigma and caregiving burden. An increase in caregivers' burden can lead to a reduction in caregivers' involvement. There is a relationship between caregivers' involvement, burden, and affiliated stigma. The present study examined the mediating role of affiliated stigma in the relationship between caregivers' burden and involvement among informal caregivers of hospital-admitted patients with mental illness in Uganda. METHODS A cross-sectional study was conducted among 428 informal caregivers (mean age: 39.6 years [SD±14.6]; females = 62.1%). Information was collected regarding sociodemographic characteristics, affiliated stigma, and the involvement and burden of informal caregivers. RESULTS The findings indicate that affiliated stigma serves as a full mediator between the caregiver's roles and involvement (β=15.97, p<0.001). Being female increased the caregivers' burden of caregiving (β= -0.23, p<0.001). CONCLUSION The findings in the present study suggest that intervention to address affiliated stigma among caregivers of patients with mental illness should be incorporated into mainstream mental health care to reduce the caregiving burden.
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Affiliation(s)
- Mark Mohan Kaggwa
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, 1410 Uganda ,African Centre for Suicide Prevention and Research, Mbarara, 379 Uganda ,grid.25073.330000 0004 1936 8227Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Sarah Maria Najjuka
- grid.11194.3c0000 0004 0620 0548Makerere University, College of Health Sciences, Kampala, Uganda
| | - Mohammed A. Mamun
- CHINTA Research Bangladesh, Savar, Dhaka 1342 Bangladesh ,grid.411808.40000 0001 0664 5967Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka 1342 Bangladesh
| | - Mark D. Griffiths
- grid.12361.370000 0001 0727 0669Psychology Department, Nottingham Trent University, 50 Shakespeare Street, Nottingham, NG1 4FQ United Kingdom
| | - Novatus Nyemara
- grid.33440.300000 0001 0232 6272Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, 1410 Uganda
| | - Scholastic Ashaba
- Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, 1410, Uganda.
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Bueno MV, Chase JAD. Gender Differences in Adverse Psychosocial Outcomes among Family Caregivers: A Systematic Review. West J Nurs Res 2023; 45:78-92. [PMID: 35614567 DOI: 10.1177/01939459221099672] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This systematic review explores gender differences in adverse psychosocial and role-related outcomes of family caregivers of older adults with chronic illnesses. Data sources for the systematic review included CINAHL, PubMed, PsycINFO, and Google Scholar. Eligible primary research focused on examining gender-based differences in psychological and emotional outcomes (e.g., burden, depression, stress) among family caregivers of an older adult with chronic illness. In total, 16 studies were included in the review with most studies using a cross-sectional design and conducted outside of the United States. Studies reported on gender differences in health outcomes such as burden, stress, and anxiety. Women caregivers had overall higher negative outcomes, but men may have more intense difficulty during the initial caregiver transition phase. Resources to address caregiver health should consider the caregiver's gender. As the older adult population grows, more caregiver research is needed and future studies to include more male caregivers.
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Affiliation(s)
- Michael V Bueno
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Jo-Ana D Chase
- Sinclair School of Nursing, University of Missouri, Columbia, Missouri, USA
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Sehar U, Rawat P, Choudhury M, Boles A, Culberson J, Khan H, Malhotra K, Basu T, Reddy PH. Comprehensive Understanding of Hispanic Caregivers: Focus on Innovative Methods and Validations. J Alzheimers Dis Rep 2022. [DOI: 10.3233/adr-220094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Alzheimer’s disease (AD) and Alzheimer’s disease-related disorders (ADRD) are late-onset, age-related progressive neurodegenerative disorders, characterized by memory loss and multiple cognitive impairments. Current research indicates that Hispanic Americans are at an increased risk for AD/ADRD and other chronic conditions such as diabetes, obesity, hypertension, and kidney disease, and given their rapid growth in numbers, this may contribute to a greater incidence of these disorders. This is particularly true for the state of Texas, where Hispanics are the largest group of ethnic minorities. Currently, AD/ADRD patients are taken care by family caregivers, which puts a tremendous burden on family caregivers who are usually older themselves. The management of disease and providing necessary/timely support for patients with AD/ADRD is a challenging task. Family caregivers support these individuals in completing basic physical needs, maintaining a safe living environment, and providing necessary planning for healthcare needs and end-of-life decisions for the remainder of the patient’s lifetime. Family caregivers are mostly over 50 years of age and provide all-day care for individuals with AD/ADRD, while also managing their health. This takes a significant toll on the caregiver’s own physiological, mental, behavioral, and social health, in addition to low economic status. The purpose of our article is to assess the status of Hispanic caregivers. We also focused on effective interventions for family caregivers of persons with AD/ADRD involving both educational and psychotherapeutic components, and a group format further enhances effectiveness. Our article discusses innovative methods and validations to support Hispanic family caregivers in rural West Texas.
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Affiliation(s)
- Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Priyanka Rawat
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Moumita Choudhury
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | | | - John Culberson
- Department of Family Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Hafiz Khan
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Keya Malhotra
- Hendrick Health System, Grace Clinic, Lubbock, TX, USA
| | - Tanisha Basu
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - P. Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Speech, Language and Hearing Sciences, School Health Professions, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Department of Public Health, School of Population and Public Health, Texas Tech University Health Sciences Center, Lubbock, TX, USA
- Hendrick Health System, Grace Clinic, Lubbock, TX, USA
- Neurology, Departments of School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX, USA
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Kawaguchi K, Ide K, Kondo K. Family social support and stability of preferences regarding place of death among older people: a 3-year longitudinal study from the Japan Gerontological Evaluation Study. Age Ageing 2022; 51:6730557. [PMID: 36173990 PMCID: PMC9521793 DOI: 10.1093/ageing/afac210] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND it remains unclear how family relationships could affect stability of end-of-life care preferences. OBJECTIVE to describe change patterns of preferred place of death (POD) among older people and to examine associations between family social support and stability of preferences regarding POD. METHODS this longitudinal study of 1,200 noninstitutionalized independent Japanese older people aged over 65 years used panel data between 2016 and 2019 from the Japan Gerontological Evaluation Study (JAGES). Preference stability was defined as the congruence of preferred POD based on questionnaires between baseline and follow-up. We performed multiple logistic regression analysis and gender-stratified analysis to examine associations between social support (spouse, children living together and children living apart) and preference stability. RESULTS only 40.9% of participants had stable preferences. For a spouse, both receiving and providing social support was associated with less stable preferences (OR: 0.63, 95% CI: 0.43-0.93; OR: 0.55, 95% CI: 0.38-0.80, respectively), and providing social support to children living apart was associated with more stable preferences (OR: 1.35, 95% CI: 1.03-1.76). In gender-stratified analysis, significant associations between preference stability and providing social support to a spouse among women (OR: 0.53, 95% CI: 0.34-0.82) and providing social support to children living apart among men (OR: 1.72, 95% CI: 1.16-2.55) were observed. CONCLUSIONS family social support was associated with the stability of preferences, and the associations differed by support resources and gender. Incorporating family members in the process of end-of-life care discussion may be necessary for establishing stable preferences.
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Affiliation(s)
| | - Kazushige Ide
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 260-8670, Japan
| | - Katsunori Kondo
- Department of Social Preventive Medical Sciences, Center for Preventive Medical Sciences, Chiba University, Chiba 260-8670, Japan,Department of Geriatric Evaluation, Center for Gerontology and Social Science, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
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Abstract
Objective: Traditional gender norms and expectations may
disproportionately constrain in-home palliative care received by women. This
scoping review aims to canvass and evaluate the literature on gender disparities
in end of life care and explore relevant themes that could inform future
research and practice. Methods: A systematic search of MEDLINE,
OVID, COCHRANE, and EMBASE was conducted using MeSH terms palliative care,
palliative medicine, terminal care, or hospice care, combined with gender
equity, sex factors, sexism, or gender disparities. Articles were limited to
those in English (2010 to 2021), focusing on end of life care, gender roles,
patients, and caregivers. Results: Of 624 articles identified, 15
met inclusion criteria for critical appraisal using the AMSTAR checklist for
systematic reviews and NICE guidelines for quantitative and qualitative studies.
Most studies were of poor to moderate quality. Thematic analyses identified 6
major themes related to gender disparities: living situation, symptom
experience, care context, care preferences, caregiving, and coping strategies.
Conclusion: Larger scale research of better quality is needed
to fully characterize gender disparities in end of life care and understand how
physicians might mitigate these disparities by building awareness of personal
gender biases, providing support to families, educating them, and initiating
care discussions that overturn traditional and stereotypic gendered
expectations.
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Affiliation(s)
- Annette D Wong
- Department of Family Medicine, 4257Queen's University, Kingston, Ontario, Canada
| | - Susan P Phillips
- Department of Family Medicine, 4257Queen's University, Kingston, Ontario, Canada
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Brinkley TE, Stites SD, Hunsberger HC, Karvonen-Gutierrez CA, Li M, Shaaban CE, Thorpe RJ, Kritchevsky SB. Research Centers Collaborative Network Workshop on Sex and Gender Differences in Aging. Innov Aging 2022; 6:igac055. [PMID: 36267320 PMCID: PMC9579719 DOI: 10.1093/geroni/igac055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Indexed: 02/03/2023] Open
Abstract
Aging affects men and women differently; however, the impact of sex and gender on the aging process is not well understood. Moreover, these 2 concepts are often conflated, which further contributes to a lack of clarity on this important issue. In an effort to better understand the relevance of sex and gender in aging research, the Research Centers Collaborative Network sponsored a 1.5-day conference on sex and gender differences in aging that brought together key thought leaders from the 6 National Institute on Aging center programs. The meeting included sessions on comparing males and females, pathophysiological differences, sex/gender in clinical care, and gender and health in the social context. Presenters from a wide array of disciplines identified opportunities for multidisciplinary research to address current gaps in the field and highlighted the need for a more systematic approach to understanding the how and why of sex/gender differences, as well as the health implications of these differences and the sex/gender biases that affect clinical treatment and outcomes. This article summarizes the proceedings of the workshop and provides several recommendations to move the field forward, such as better data collection tools to assess the intersection of sex and gender in epidemiological research; a life course perspective with attention to fetal/developmental origins and key life stages; innovative animal models to distinguish contributions from sex hormones versus sex chromosomes; and integration of sex/gender into teaching and clinical practice. Ultimately, successful implementation of these recommendations will require thoughtful investigations across the translational spectrum and increased collaborations among those with expertise in sex and gender differences.
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Affiliation(s)
- Tina E Brinkley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Shana D Stites
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Holly C Hunsberger
- Department of Foundational Science and Humanities, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois, USA
| | | | - Mengting Li
- School of Nursing, Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, New Jersey, USA
| | - C Elizabeth Shaaban
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Roland J Thorpe
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Eklöf B, Larsson H, Ellbin S, Jonsdottir IH, O’Dwyer S, Hansson C. The role of self-reported stressors in recovery from Exhaustion Disorder: a longitudinal study. BMC Psychiatry 2022; 22:529. [PMID: 35931962 PMCID: PMC9354432 DOI: 10.1186/s12888-022-04172-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exhaustion disorder (ED) is a stress-induced disorder characterized by physical and mental symptoms of exhaustion that can be long-lasting. Although stress exposure is essential for the development of ED, little is known regarding the role of stressors in the maintenance of ED. The aim of the study was to investigate the role of work-related stressors, private-related stressors, and adverse childhood experiences in long-term recovery from ED. METHODS A mixed methods design was used. The design was sequential, and data analysis was performed in two parts, where the first part consisted of qualitative analysis of patient records, and the second part consisted of statistical analysis of the data retrieved from the qualitative coding. Patient records from 150 patients with ED was analysed regarding work-related stressors, private-related stressors, and adverse childhood experiences. For each patient, two patient records were analysed, one from the time of diagnosis (baseline) and one from the follow-up clinical assessment, 7-12 years after diagnosis (follow-up). Out of the 150 patients, 51 individuals still fulfilled the diagnostic criteria for ED at follow-up (ED group) and 99 individuals no longer fulfilled the diagnostic criteria and were thus considered recovered (EDrec). Percentages in each group (ED and EDrec) reporting each stressor at baseline and follow-up were calculated as well as the differences in percentage points between the groups along with the 95% confidence intervals for the differences. RESULTS At baseline, significantly more EDrec patients reported quantitative demands (73% EDrec, 53% ED) and managerial responsibilities (14% EDrec, 2% ED). Private-related stressors did not differ at baseline. At follow-up, significantly more ED patients reported managerial responsibilities (8 ED, 0% EDrec) and caregiver stress (child) (24% ED, 6% EDrec) and significantly more EDrec patients reported caregiver stress (parent) (6% EDrec, 0% ED). There were no differences regarding adverse childhood experiences. CONCLUSIONS The main conclusion is that neither adverse childhood experiences nor any of the stressors at baseline are associated with long-term ED. Ongoing stressors related to having responsibility for other people, such as managerial responsibilities or caring for a child with a chronic disease or psychiatric disorder, may be associated with long-term exhaustion.
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Affiliation(s)
- Britta Eklöf
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22B, SE-413 19 Gothenburg, Sweden
| | - Hanna Larsson
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22B, SE-413 19 Gothenburg, Sweden
| | - Susanne Ellbin
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22B, SE-413 19 Gothenburg, Sweden
| | - Ingibjörg H. Jonsdottir
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22B, SE-413 19 Gothenburg, Sweden ,grid.8761.80000 0000 9919 9582School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden
| | - Siobhan O’Dwyer
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter Medical School, University of Exeter, Exeter, UK
| | - Caroline Hansson
- Institute of Stress Medicine, Region Västra Götaland, Carl Skottsbergs gata 22B, SE-413 19, Gothenburg, Sweden. .,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
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Ellison ER, Langhout RD. Critical realism methodology as a guiding framework for interdisciplinary theory enrichment: Reflections on a study of empowerment. JOURNAL OF COMMUNITY PSYCHOLOGY 2022. [PMID: 35881860 DOI: 10.1002/jcop.22919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 05/24/2022] [Accepted: 07/10/2022] [Indexed: 06/15/2023]
Abstract
Philosophy of science and ontological assumptions underpin our work as scholars, explicitly, or implicitly. In this paper, we develop empowerment theory with a critical realism (CR) lens. Through the example of a study of empowerment, we examine how can it be used as a guiding paradigm for research in community psychology (CP). We sought to increase theoretical rigor by using a CR approach to interdisciplinarity. We put empowerment into conversation with Social Reproduction Theory and Black, Indigenous, People of Color feminisms, because both represent situated knowledge that address experiences with oppression and focus on dismantling systems of oppression. We illustrate how a CR approach shaped our understanding of empowerment, and in turn, provided an analysis that was (a) more nuanced and actionable, (b) more aligned with CP values and definitions of social justice, and (c) more likely to contribute to the field by developing an intersectional anticapitalist and feminist intervention into empowerment literature. This paper highlights how, aligned with an interdisciplinary CR approach, we questioned assumptions about empowerment theory, which influenced our empirical work so that we could provide a more focused critique of unjust social arrangements, and with it, the possibility to act upon those arrangements.
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Affiliation(s)
- Erin Rose Ellison
- Psychology Department, California State University, Sacramento, Sacramento, California, USA
| | - Regina Day Langhout
- Psychology Department, University of California, Santa Cruz, Santa Cruz, California, USA
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Paul SS, Schröder-Butterfill E. The Psychological and Economic Impacts of Caregiving on Family Carers for People with Probable Dementia in Rural South India. J Cross Cult Gerontol 2022; 37:201-219. [PMID: 35779164 DOI: 10.1007/s10823-022-09455-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2022] [Indexed: 11/29/2022]
Abstract
Informal carers play a vital role in the care and well-being of older people with dementia. This article examines the psychological and economic impacts caregiving has on carers of people with suspected dementia and the mechanisms by which they cope with challenges. A mixed-method design was adopted. A baseline survey of 123 older people was undertaken in a resource-poor setting in Kerala, India, using Addenbrooke's Cognitive Examination - Malayalam Version (ACE-m) to identify those with probable dementia. This was followed by in-depth interviews with ten carers of those identified as having cognitive impairment. The data were later transcribed and thematically analysed using N-Vivo to identify main concepts and themes. Analysis of the in-depth interviews with carers revealed that dementia was often interpreted as a 'second childhood', but that this conceptualisation aided carers to cope better. Anger and irritation were the commonly expressed psychological reactions which got accentuated by lack of reciprocation of emotion on the part of care recipient. Government support through social security measures and medical care, along with traditional social practises, helped carers to tide over care expenses. These support systems lessened the psychological and economic impacts of caring. Misconstruction of the disease nature, for example by considering it a normal part of ageing, also seem inadvertently to have helped in coping with care requirements, although this comes at a cost of lower than optimal healthcare access for older people with cognitive impairment.
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Affiliation(s)
- Sherin S Paul
- Department of Community Medicine, Pushpagiri Institute of Medical Sciences and Research Centre, Thiruvalla, Kerala, India, 689101.
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Zelko E, Vrbek L, Koletnik M. Last Aid Course—The Slovenian Experience. Healthcare (Basel) 2022; 10:healthcare10071154. [PMID: 35885681 PMCID: PMC9315648 DOI: 10.3390/healthcare10071154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 11/16/2022] Open
Abstract
Educating and raising awareness among lay members of the public about palliative care can significantly improve the care for terminally ill patients and their quality of life. This paper reports on the survey aimed at assessing the experience and expectations of participants in the Last Aid course launched in Slovenia in 2019 to train hospice volunteers and promote dialogue on death and dying. The course implementation was supported by materials prepared, translated, and/or adapted from German under the PO-LAST project, which linked Slovenian medical and healthcare professionals, hospice representatives, and university students. The Last Aid course follows an international four-module curriculum that has been successfully applied in 18 countries so far. In Slovenia, the course was delivered 30 times with 21 in-person deliveries and 9 online events attended by 450 participants of different sexes, ages, and professions. The surveyed population included 250 people who returned the evaluation questionnaires by October 2020. The aim of the analysis was to gain insight that can be applied broadly in future work and research on adult education on palliative care and the erasure of death-related taboos.
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Affiliation(s)
- Erika Zelko
- Institute for General practice, Johannes Keppler University, 4020 Linz, Austria
- Department for Family Medicine, Faculty of Medicine University Maribor, Taborska cesta 8, 2000 Maribor, Slovenia
- Correspondence:
| | - Larisa Vrbek
- Cerebral Paralysis Association of Slovenia, Rožanska ulica 2, 1000 Ljubljana, Slovenia;
| | - Melita Koletnik
- Faculty of Arts, University of Maribor, 2000 Maribor, Slovenia;
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Liu J, Lou Y, Li LW, Xu H, Zhang Z. Dyadic effects on depressive symptoms of spouse caregivers and their care recipients: evidence from China. Aging Ment Health 2022:1-10. [PMID: 35694965 DOI: 10.1080/13607863.2022.2087212] [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] [Indexed: 11/01/2022]
Abstract
OBJECTIVES The likelihood of providing care to a spouse in middle and older ages has increased as life expectancy increases, but knowledge about how the caregiver and care recipient influence each other's mental health is limited. This study examined whether a partner's physical, cognitive, and mental health in a spousal caregiving dyad are associated with the other partner's depressive symptoms in China and whether the dyadic effects vary by gender. METHODS This study used data from Wave 3 (2015) and Wave 4 (2018) follow-up surveys of the China Health and Retirement Longitudinal Study (CHARLS). The analytic sample featured 1,245 dyads of care recipients aged 45 or older and their spouse caregivers. The Actor-Partner Interdependence Model was used to test the dyadic effects among all couples in the analytic sample, couples with wife caregivers and couples with husband caregivers, respectively. RESULTS We found that caregiver's depressive symptoms at Wave 3 were significantly associated with care recipient's depressive symptoms at Wave 4 in the full sample. Regardless of caregiver or care recipient roles, wives' mental health was impacted by their husbands' depressive symptoms, but not vice versa. Wife recipient's cognitive impairment was associated with husband caregiver's lower depressive symptoms. CONCLUSION This study sheds light on the mental health of couples in the context of caregiving in China. The findings indicate that interventions to support couples in a caregiving dyad need to consider the influence they have on each other, and the gender and health conditions of each in the dyad.
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Affiliation(s)
- Jinyu Liu
- School of Social Work, Columbia University, New York, NY, USA
| | - Yifan Lou
- School of Social Work, Columbia University, New York, NY, USA
| | - Lydia W Li
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Hongwei Xu
- Department of Sociology, Queens College - CUNY, New York, NY, USA
| | - Zhenmei Zhang
- Department of Sociology, Michigan State University, Ann Arbor, MI, USA
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Grycuk E, Chen Y, Almirall‐Sanchez A, Higgins D, Galvin M, Kane J, Kinchin I, Lawlor B, Rogan C, Russell G, O'Sullivan R, Leroi I, on the behalf of the CLIC Caregiver study group. Care burden, loneliness, and social isolation in caregivers of people with physical and brain health conditions in English-speaking regions: Before and during the COVID-19 pandemic. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5734. [PMID: 35574817 PMCID: PMC9324775 DOI: 10.1002/gps.5734] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 04/27/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Public health restrictions due to the COVID-19 (SARS CoV-2) pandemic have disproportionately affected informal caregivers of people living with long term health conditions. We aimed to explore levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English-speaking regions worldwide, by investigating outcomes before and during the COVID-19 pandemic. METHODS A cross-sectional anonymous online survey data from 2287 English-speaking caregivers of people with long term health conditions from four English-speaking regions (UK, Ireland, USA, New Zealand) included measures of care burden, loneliness, and social isolation, reported before and during the COVID-19 pandemic. Analyses were descriptive, followed by an ordinal regression model for predictors of burden. RESULTS Compared to pre-pandemic levels, all caregivers experienced a significant increase in burden, loneliness, and isolation. Caregivers of people with both brain health and physical conditions were the most burdened and had the highest levels of loneliness and isolation compared to caregivers of people with either a brain health or physical condition only. The increase in care burden among caregivers of people with brain health challenges was associated with caregiver's gender, moderate and severe emotional loneliness, magnitude and frequency of isolation during the pandemic, and care circumstances (cohabitation with the care recipient, restrictions on the ability to provide care). CONCLUSIONS Health and social care interventions should target caregivers' care circumstances and psychological outcomes, particularly in women, accounting for the significant additional burden of care, loneliness, and isolation resulting from pandemic-related restrictions.
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Affiliation(s)
- Emilia Grycuk
- Department of PsychiatrySchool of MedicineTrinity College DublinDublinIreland
| | - Yaohua Chen
- Global Brain Health InstituteTrinity College DublinDublinIreland,Lille CHU Univ. Lille, Inserm, CHU Lille, Lille Neurosciences & CognitionUMR‐S1172Degenerative and Vascular Cognitive DisordersLilleFrance
| | | | - Dawn Higgins
- Global Brain Health InstituteTrinity College DublinDublinIreland,Department of PsychologyMaynooth UniversityMaynoothIreland
| | - Miriam Galvin
- Global Brain Health InstituteTrinity College DublinDublinIreland,Academic Unit of NeurologyTrinity College DublinDublinIreland
| | - Joseph Kane
- Centre for Public HealthQueen's University BelfastBelfastUK
| | - Irina Kinchin
- Global Brain Health InstituteTrinity College DublinDublinIreland,Center for Health Policy and ManagementTrinity College DublinDublinIreland,University of Technology SydneyUltimoNew South WalesAustralia
| | - Brian Lawlor
- Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Carol Rogan
- Dementia Research Network IrelandSchool of MedicineTrinity College DublinDublinIreland
| | - Gregor Russell
- Yorkshire and Humber NIHR Clinical Research NetworkNorthern IrelandUK
| | - Roger O'Sullivan
- Institute of Public HealthBelfastIreland,Ulster UniversityColeraineUK
| | - Iracema Leroi
- Department of PsychiatrySchool of MedicineTrinity College DublinDublinIreland,Global Brain Health InstituteTrinity College DublinDublinIreland
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Park M, Jang J, Joo HJ, Kim GR, Park EC. Association Between Unequal Division of Caregiving Work and South Korean Married Women's Depressive Symptoms. Front Public Health 2022; 10:739477. [PMID: 35425757 PMCID: PMC9002231 DOI: 10.3389/fpubh.2022.739477] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 03/09/2022] [Indexed: 11/13/2022] Open
Abstract
Background: A disproportionate amount of family caregiving can negatively impact married women's mental health. This study aims to examine the relationship between depressive symptoms in South Korean women and the satisfaction with their husband's participation in family caregiving. Methods Raw data from 1,515 of the participants in the 2014, 2016, and 2018 Korean Longitudinal Survey of Women and Families were analyzed. Satisfaction with husbands' participation in family caregiving was classified as satisfied, less satisfied, and not satisfied. The survey used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. The association was examined using a generalized estimating equations model. Results Results indicated 22.2% of the participating women reported depressive symptoms. Women who reported dissatisfaction with their husband's participation in caregiving were 2.54 times more likely to report depressive symptoms than the women who were satisfied. Subgroup analysis indicated that women with higher levels of education, were more likely to have depressive symptoms when they were not satisfied with their husbands' participation in caregiving. Conclusion Married women who reported being dissatisfied with their husbands' participation in caregiving were more likely to report depressive symptoms. These results suggest the need to create environments with fair distribution of caregiving duties to minimize depressive symptoms in women.
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Affiliation(s)
- Minah Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea.,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Jieun Jang
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, United States.,Department of Hospital Administration, Yonsei University Graduate School of Public Health, Seoul, South Korea
| | - Hye Jin Joo
- Department of Public Health, Graduate School, Yonsei University, Seoul, South Korea.,Institute of Health Services Research, Yonsei University, Seoul, South Korea
| | - Gyu Ri Kim
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, South Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
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Zwar L, König HH, Hajek A. Gender Differences in Mental Health, Quality of Life, and Caregiver Burden among Informal Caregivers during the Second Wave of the COVID-19 Pandemic in Germany: A Representative, Population-Based Study. Gerontology 2022; 69:149-162. [PMID: 35390788 PMCID: PMC9148891 DOI: 10.1159/000523846] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 02/23/2022] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION This study aimed to compare the mental health, quality of life, and caregiving burden between male and female informal caregivers of older adults (≥60 years) during the second wave of the COVID-19 pandemic in Germany. METHODS The sample consisted of 301 female and 188 male informal caregivers of older adults in need of care (≥60 years). Data were used from a cross-sectional study in March 2021 that questioned a representative sample of adults aged 40 years and older from Germany. Information on informal care provision, mental health (depressive and anxiety symptoms), caregiving burden, and quality of life was assessed for the period between December 2020 and March 2021. Regression analyses, adjusted for (1) the sociodemographic background and health of the caregivers, (2) the caregiving time and caregiving tasks, and (3) the perception of impairment and danger posed by the pandemic, were conducted. RESULTS Findings of the fully adjusted model indicated a higher level of anxiety and lower quality of life among female caregivers, compared to male caregivers. Gender differences in depression and caregiver burden were not significant in analyses that controlled for care tasks and time. Moderator analyses indicated that gender differences in caregiver's anxiety levels were influenced by the danger perceived to be posed by the pandemic: among men the danger to the care recipient, and among women the danger to themselves, increased anxiety. CONCLUSION Female informal caregivers were more negatively affected than male informal caregivers during the pandemic, as indicated by higher levels of anxiety and lower quality of life. Gender differences in anxiety depended on the perceived danger posed by the pandemic. Thus, policy and pandemic measures should focus on gender-specific support of female caregivers who seem to be particularly vulnerable during the pandemic. More caregiver-specific support and information around protecting themselves and their care recipients are recommended. Also, further research on gender differences in care performance and their relation to psychosocial health outcomes is recommended.
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Affiliation(s)
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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27
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Losada-Baltar A, Vara-García C, Pedroso-Chaparro MDS, Cabrera I, Jiménez-Gonzalo L, Fernandes-Pires J, Huertas-Domingo C, Barrera-Caballero S, Gallego-Alberto L, Romero-Moreno R, Márquez-González M. Family caregivers of people with dementia in the context of the sociocultural stress and coping model: An examination of gender differences. J Women Aging 2022:1-15. [PMID: 35343403 DOI: 10.1080/08952841.2022.2052705] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The study assessed gender differences in the associations between familism dimensions, dysfunctional thoughts, and resource and outcome variables in 190 Spanish dementia family caregivers. A theoretical model was tested through path analysis, obtaining an excellent fit of the model to the data. Higher scores in the familial obligations dimension were associated with lower self-efficacy for self-care and obtaining respite and leisure frequency, and higher anxious and depressive feelings, in female caregivers only. Significant between-gender differences were obtained, suggesting that female caregivers holding strong familistic values are more vulnerable to the negative consequences of caregiving compared to male caregivers.
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Affiliation(s)
| | - Carlos Vara-García
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Isabel Cabrera
- Facultad de Psicología, Universidad Autónoma de Madrid, Madrid, Spain
| | | | | | | | | | | | - Rosa Romero-Moreno
- Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Madrid, Spain
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Garnett A, Ploeg J, Markle-Reid M, Strachan PH. Formal Health and Social Services That Directly and Indirectly Benefit Stroke Caregivers: A Scoping Review of Access and Use. Can J Nurs Res 2022; 54:211-233. [PMID: 35130749 PMCID: PMC9109593 DOI: 10.1177/08445621211019261] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Stroke can be a life altering event that necessitates considerable amounts of
formal and informal care. The impacts of stroke often persist over time
requiring ongoing support for stroke survivors. Family members provide the
majority of care and experience many life changes as a result of their
caregiving role including social, financial, employment and health impacts.
Formal supports such as counselling, respite, and health promotion initiatives
that directly benefit caregivers or benefit them indirectly through supporting
the stroke survivor, are well-placed to help caregivers manage their caregiving
role. However, to date little is known about formal service use by stroke
caregivers and the factors that influence their service use. This scoping review
provides a critique and synthesis of what is known about stroke caregivers’
access and use of formal services intended to support them. Findings suggest
that while services are available, caregivers’ ability to use them are impacted
by both facilitators and barriers. Facilitators included: sex, age, and having a
higher household income (depending on services used). Barriers included: high
cost, poor service quality and deficient knowledge/communication regarding
service availability. This review highlights a significant gap in our knowledge
of caregivers’ experience in accessing and using formal services.
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Affiliation(s)
- Anna Garnett
- Arthur Labatt Family School of Nursing, Western University, London, ON, Canada
| | - Jenny Ploeg
- School of Nursing, McMaster University, Hamilton, ON, Canada
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Xiong C, D'Souza A, El-Khechen-Richandi G, Mihailidis A, Cameron JI, Astell A, Nalder E, Colantonio A. Perceptions of Digital Technology Experiences and Development Among Family Caregivers and Technology Researchers: Qualitative Study. JMIR Form Res 2022; 6:e19967. [PMID: 35089150 PMCID: PMC8838597 DOI: 10.2196/19967] [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: 07/20/2020] [Revised: 11/20/2020] [Accepted: 12/19/2020] [Indexed: 11/13/2022] Open
Abstract
Background Caregiving is highly stressful and is associated with poor mental and physical health. Various technologies, including mobile and eHealth apps, have been developed to address caregiver needs. However, there is still a paucity of research examining the technology perceptions of informal caregivers, especially from the perspectives of sex, gender, and diversity. Objective To address the research gap and inform the development of future caregiving technologies, this study aims to examine how family caregivers perceive using technology to assist with their caregiving routines; identify the sex, gender, and diversity factors that shape these perceptions; and understand how these perceptions and needs are reflected within the current technology development process. Methods Semistructured interviews were conducted with 16 informal caregivers of individuals with a range of chronic medical conditions and 8 technology researchers involved in caregiving technology projects. Results Three main themes with subthemes were developed. The first main theme is that caregivers see a need for technology in their lives, and it comprises the following 3 subthemes: caregiving is a challenging endeavor, technology is multifaceted, and caregiver preferences facilitate technology use. The second main theme is that relationships play a vital role in mediating technology uptake, and it comprises the following 2 subthemes: the caregiver-care recipient dynamic shapes technology perceptions and caregivers rely on external sources for technology information. Finally, the third main theme is that barriers are present in the use and adoption of technology, and it comprises the following 2 subthemes: technology may not be compatible with personal values and abilities and technology that is not tailored toward caregivers lacks adoption. Conclusions The findings highlight the multifaceted role that technology can play in aiding caregiving while drawing attention to the perceived drawbacks of these technologies among caregivers. The inclusion of technology researchers in this study provides a more holistic understanding of technologies in caregiving from their initial development to their eventual uptake by caregivers.
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Affiliation(s)
- Chen Xiong
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Andrea D'Souza
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Graziella El-Khechen-Richandi
- Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada
| | - Alex Mihailidis
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Arlene Astell
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Emily Nalder
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
| | - Angela Colantonio
- Rehabilitation Sciences Institute, University of Toronto, Toronto, ON, Canada.,Toronto Rehabilitation Institute-University Health Network, Toronto, ON, Canada.,Acquired Brain Injury Research Lab, University of Toronto, Toronto, ON, Canada.,Department of Occupational Science & Occupational Therapy, University of Toronto, Toronto, ON, Canada
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Winters-Stone KM, Lyons KS, Beer TM, Skiba MB, Hung A. A pilot feasibility study of Exercising Together© during radiation therapy for prostate cancer: a dyadic approach for patients and spouses. Pilot Feasibility Stud 2021; 7:216. [PMID: 34879873 PMCID: PMC8653603 DOI: 10.1186/s40814-021-00952-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 11/26/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Prostate cancer can negatively impact the health of patients and their spouse, particularly early on in the cancer trajectory. Purpose To determine the feasibility and acceptability of dyadic exercises during radiation therapy and preliminary efficacy on physical, mental, and relational outcomes for men and their spouses. Exercising Together©, originally designed as a 6-month dyadic resistance training program for couples post-treatment, was adapted for the radiation setting. Methods We conducted a single-group pilot feasibility study of Exercising Together© in men scheduled for radiation therapy for prostate cancer and their spouse. Couples attended supervised exercise sessions thrice weekly throughout radiation treatment and were followed up 8 weeks later. Primary outcomes were feasibility and acceptability with secondary outcomes of changes in physical (physical functioning (short physical performance battery (sPPB)), gait speed (m/s), functional capacity (400-m walk (min), physical activity (min/week)), mental (depressive symptoms (CES-D), and anxiety (SCL-90 ANX)), and relationship (Dyadic Coping, Role Overload, and Physical Intimacy Behavior Scales) health outcomes for each partner. Participants completed an evaluation post-intervention. Results Ten couples enrolled and 8 completed the intervention, attending 83% of scheduled sessions. Couple satisfaction with the intervention was high (patients: mean difference (MD) = 9.4 ± 1.9 and spouses: MD = 10.0 ± 0.0, on a 1–10 scale). At post-intervention, gait speed (MD = 0.1; 95%CI: 0.1, 0.2; p = 0.003; d = 0.94) and functional capacity (MD = −0.6; 95%CI: −0.9, 0.3; p = 0.002; d = −0.42) improved in patients and sPPB in spouses (MD = 1.3; 95%CI: 0.3, 2.2; p = 0.02; d = 0.71). Total physical activity increased non-significantly for patients and significantly for spouses at post-intervention and decreased at follow-up (MD = 179.6; 95%CI: 55.4, 303.7; p = 0.01; d = 1.35 and MD = −139.9; 95%CI: −266.5, 13.3; p = 0.03; d=1.06). Among patients, anxiety and active engagement significantly improved post-intervention (MD = −2.3; 95%CI: −3.8, 0.7; p = 0.01; d = −0.43 and MD = 2.5; 95%CI: 0.7, 4.3; p = 0.01; d = 0.98, respectively). There were modest effects on other physical, mental, and relationship health domains in patients and spouses. Conclusion A modified version of Exercising Together© is a feasible and acceptable program during radiation therapy for prostate cancer and shows preliminary evidence for improvements on physical, mental, and relational health in both patient and spouse. A larger, fully powered randomized controlled trial is warranted and could help shift the landscape toward dyadically targeted interventions. Trial registration This study was registered on ClinicalTrials.gov on February 18th, 2018 (NCT03418025).
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Affiliation(s)
| | - Karen S Lyons
- Connell School of Nursing, Boston College, Boston, MA, USA
| | - Tomasz M Beer
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Meghan B Skiba
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
| | - Arthur Hung
- Knight Cancer Institute, Oregon Health and Science University, Portland, OR, USA
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Blanck E, Fors A, Ali L, Brännström M, Ekman I. Informal carers in Sweden - striving for partnership. Int J Qual Stud Health Well-being 2021; 16:1994804. [PMID: 34720063 PMCID: PMC8567876 DOI: 10.1080/17482631.2021.1994804] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Purpose Informal carers have an important role in society through their care and support of their long-term ill relatives. Providing informal care is challenging and can lead to caregiver burden; moreover, many support needs of the carers are not met, leading to confusion, disappointment and frustration. We conducted an interview study to clarify the meaning of support given and received by informal carers to relatives with chronic obstructive pulmonary disease or chronic heart failure. Methods We purposively selected and recruited informants via participants in another study, thereby conducting interviews over the phone from June 2016 to May 2017. In total, we conducted 14 interviews with 12 informants. All interviews were transcribed verbatim and the content was analysed using a phenomenological hermeneutical approach. Result and conclusion Our comprehensive understanding of the meaning of support for these carers is twofold: it is a self-evident struggle for the good life of their relatives and that they want to be carers in partnership. The healthcare system must recognize the efforts of carers and include them in the strategic planning and operational stages of care and treatment for people with long-term illness.
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Affiliation(s)
- Elin Blanck
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Research and Development Primary Health Care, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden.,Psychiatric Department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Margareta Brännström
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Nursing, Umeå University, Campus Skellefteå, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
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Van Spall HGC, DeFilippis EM, Lee SF, Oz UE, Perez R, Healey JS, Allen LA, Voors AA, Ko DT, Thabane L, Connolly SJ. Sex-Specific Clinical Outcomes of the PACT-HF Randomized Trial. Circ Heart Fail 2021; 14:e008548. [PMID: 34711072 DOI: 10.1161/circheartfailure.121.008548] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
BACKGROUND Transitional care may have different effects in males and females hospitalized for heart failure. We assessed the sex-specific effects of a transitional care model on clinical outcomes following hospitalization for heart failure. METHODS In this stepped-wedge cluster randomized trial of adults hospitalized for heart failure in Ontario, Canada, 10 hospitals were randomized to a group of transitional care services or usual care. Outcomes in this exploratory analysis were composite all-cause readmission, emergency department visit, or death at 6 months; and composite all-cause readmission or emergency department visit at 6 months. Models were adjusted for stepped-wedge design and patient age. RESULTS Among 2494 adults, mean (SD) age was 77.7 (12.1) years, and 1258 (50.4%) were female. The first composite outcome occurred in 371 (66.3%) versus 433 (64.1%) males (hazard ratio [HR], 1.04 [95% CI, 0.86-1.26]; P=0.67) and in 326 (59.9%) versus 463 (64.8%) females (HR, 0.83 [95% CI, 0.69-1.01]; P=0.06) in the intervention and usual care groups, respectively (P=0.012 for sex interaction). The second composite outcome occurred in 357 (63.8%) versus 417 (61.7%) males (HR, 1.03 [95% CI, 0.85-1.24]; P=0.76) and 314 (57.7%) versus 450 (63.0%) females (HR, 0.81 [95% CI, 0.67-0.99]; P=0.037) in the intervention and usual care groups, respectively (P=0.024 for sex interaction). The sex differences were driven by a reduction in all-cause emergency department visits among females (HR, 0.66 [95% CI, 0.51-0.87]; P=0.003), but not males (HR, 1.10 [95% CI, 0.85-1.43]; P=0.46), receiving the intervention (P<0.001 for sex interaction). CONCLUSIONS A transitional care model offered a reduction in all-cause emergency department visits among females but not males following hospitalization for heart failure. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02112227.
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Affiliation(s)
- Harriette G C Van Spall
- Department of Medicine (H.G.C.V., J.S.H.), McMasterUniversity, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact (H.G.C.V., S.F.L., J.S.H., L.T., S.J.C.), McMasterUniversity, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton, Ontario, Canada (H.G.C.V., S.F.L., J.S.H., S.J.C.)
| | | | - Shun Fu Lee
- Department of Health Research Methods, Evidence, and Impact (H.G.C.V., S.F.L., J.S.H., L.T., S.J.C.), McMasterUniversity, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton, Ontario, Canada (H.G.C.V., S.F.L., J.S.H., S.J.C.)
| | - Urun Erbas Oz
- Institute for Clinical Evaluative Sciences, Ontario, Canada (U.E.O., R.P., D.T.K.)
| | - Richard Perez
- Institute for Clinical Evaluative Sciences, Ontario, Canada (U.E.O., R.P., D.T.K.)
| | - Jeff S Healey
- Department of Medicine (H.G.C.V., J.S.H.), McMasterUniversity, Hamilton, Ontario, Canada.,Department of Health Research Methods, Evidence, and Impact (H.G.C.V., S.F.L., J.S.H., L.T., S.J.C.), McMasterUniversity, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton, Ontario, Canada (H.G.C.V., S.F.L., J.S.H., S.J.C.)
| | - Larry A Allen
- University of Colorado School of Medicine, Aurora (L.A.A.)
| | - Adriaan A Voors
- University Medical Center Groningen, the Netherlands (A.A.V.)
| | - Dennis T Ko
- Institute for Clinical Evaluative Sciences, Ontario, Canada (U.E.O., R.P., D.T.K.).,Department of Medicine, University of Toronto, Ontario, Canada (D.T.K.)
| | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact (H.G.C.V., S.F.L., J.S.H., L.T., S.J.C.), McMasterUniversity, Hamilton, Ontario, Canada
| | - Stuart J Connolly
- Department of Health Research Methods, Evidence, and Impact (H.G.C.V., S.F.L., J.S.H., L.T., S.J.C.), McMasterUniversity, Hamilton, Ontario, Canada.,Population Health Research Institute, Hamilton, Ontario, Canada (H.G.C.V., S.F.L., J.S.H., S.J.C.)
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Campesi I, Montella A, Seghieri G, Franconi F. The Person's Care Requires a Sex and Gender Approach. J Clin Med 2021; 10:4770. [PMID: 34682891 PMCID: PMC8541070 DOI: 10.3390/jcm10204770] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/14/2021] [Accepted: 10/14/2021] [Indexed: 12/15/2022] Open
Abstract
There is an urgent need to optimize pharmacology therapy with a consideration of high interindividual variability and economic costs. A sex-gender approach (which considers men, women, and people of diverse gender identities) and the assessment of differences in sex and gender promote global health, avoiding systematic errors that generate results with low validity. Care for people should consider the single individual and his or her past and present life experiences, as well as his or her relationship with care providers. Therefore, intersectoral and interdisciplinary studies are urgently required. It is desirable to create teams made up of men and women to meet the needs of both. Finally, it is also necessary to build an alliance among regulatory and ethic authorities, statistics, informatics, the healthcare system and providers, researchers, the pharmaceutical and diagnostic industries, decision makers, and patients to overcome the gender gap in medicine and to take real care of a person in an appropriate manner.
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Affiliation(s)
- Ilaria Campesi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Andrea Montella
- Department of Biomedical Sciences, University of Sassari, 07100 Sassari, Italy;
| | - Giuseppe Seghieri
- Department of Epidemiology, Regional Health Agency of Tuscany, 50124 Florence, Italy;
| | - Flavia Franconi
- Laboratory of Sex-Gender Medicine, National Institute of Biostructures and Biosystems, 07100 Sassari, Italy;
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Zwar L, Angermeyer MC, Matschinger H, Riedel-Heller SG, König HH, Hajek A. Are informal family caregivers stigmatized differently based on their gender or employment status?: a German study on public stigma towards informal long-term caregivers of older individuals. BMC Public Health 2021; 21:1868. [PMID: 34656105 PMCID: PMC8520205 DOI: 10.1186/s12889-021-11955-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/06/2021] [Indexed: 12/02/2022] Open
Abstract
Background Stigma and informal caregiving are determinants for health and wellbeing, but few studies have examined stigma towards informal caregiving. Public stigma may be expressed differently towards caregivers depending on their gender and employment status due to societal norms. Therefore, this study analyzes if there is a difference in public stigma shown by the general population toward informal caregivers of care recipients aged 65 years or older based on the observed caregiver’s gender or working status. Methods A cross-sectional study was conducted in Germany. Data from 1038 adult participants from the general population in Germany were assessed with an Online-Survey. They were recruited with a quota-system based on the German micro census. Participants were randomly assigned to one of 16 vignettes describing a caregiving situation, which varied in the caregiver’s gender and working status, and care recipient’s gender and type of impairment. After reading the vignette, they were asked to provide sociodemographic information and complete three questionnaires on public stigma assessing their emotional (Emotional Reactions), behavioral (Social Distance) and cognitive reaction (Statements on informal caregivers) to the caregiver described in the vignette. Regression analyses, adjusted for sociodemographic data of the participants, were conducted. Results Findings indicated an association between reading about male caregivers and increased social distance, compared with reading about female caregivers. Reading about working caregivers was associated with decreased social distance and increased appreciative statements, compared to reading about non-working caregivers. Analyses after stratifying by gender of the caregiver in the vignette indicated an association between reading about female working caregivers and increased appreciative statements, compared to reading about female non-working caregivers. When stratifying by working status, an association was found between reading about male working caregivers and increased social distance, when compared to reading about female working caregivers. Conclusions This study’s findings indicate that gender and working status of the perceived informal caregivers are of relevance to the public stigma directed towards these caregivers. Male and non-working informal caregivers were shown more public stigma than female and working informal caregivers. Thus, interventions to reduce public stigma, in particular towards male and non-working caregivers, are recommended.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.
| | | | - Herbert Matschinger
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany.,Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, 20246, Hamburg, Germany
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Liu R, Chi I, Wu S. Caregiving Burden among Caregivers of People with Dementia through the Lens of Intersectionality. THE GERONTOLOGIST 2021; 62:650-661. [PMID: 34606599 DOI: 10.1093/geront/gnab146] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caregivers may be at different risks of various types of burdens by virtue of their gender and racial/ethnic status. This paper explores the differences in caregiving burdens across the intersectionality of race and gender. RESEARCH DESIGN AND METHODS Using Round 5 (conducted in 2015) and Round 7 (conducted in 2017) of National Study of Caregiving and National Health and Aging Trends Study data, the study examined differences in caregiver burdens across and within different gender and racial/ethnic groups, within the realms of financial, emotional, and physical burdens. The sample consisted of 1,206 caregivers who provided services to Medicare beneficiaries. Logistic regressions were performed to assess the three types of burdens each subgroup was experiencing. RESULTS Results indicated that within the intersectionality framework, compared to White female caregivers, Black male caregivers were 3.3 times (95% CI 1.77-6.22) more likely to experience financial burden, and Black female caregivers were 54% less likely to experience physical burden. Surprisingly, compared to White female caregivers, all the other groups were 37% (95% CI 0.41-0.95) to 71% (95% CI 0.15-0.56) less likely to have emotional burden. DISCUSSION AND IMPLICATIONS The findings highlighted that Black male caregivers are experiencing financial burden and White female caregivers are experiencing emotional burden disproportionately. To develop effective interventions and programs for dementia caregivers, a special focus should be put on monitoring the differences in the types of burdens that the above-mentioned population subgroups experience.
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Affiliation(s)
- Ruotong Liu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
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Kaur N, Puria A, Kumar A, Chaudhury S, Goyal E, Singh VP. Caregiver burden among working women and homemakers taking care of psychiatric patients. Ind Psychiatry J 2021; 30:S166-S171. [PMID: 34908684 PMCID: PMC8611542 DOI: 10.4103/0972-6748.328809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/19/2021] [Accepted: 06/21/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Caregiver burden is defined as the physical, psychological or emotional, social, and financial problem that can be experienced by the members of family caring for impaired person. In India, women are twice more likely to become caregivers than men, despite emergence of men as caregivers. AIM The aim of the study is to assess burden of illness among working women and homemakers taking care of psychiatric patients. MATERIALS AND METHODS This hospital-based, descriptive, cross-sectional comparative study was conducted on the caregivers who were recruited from outdoor patient department of psychiatry department of a tertiary care hospital attached to a medical college. Women who were 30-45 years old, working or homemakers and who were taking care of psychiatric patients diagnosed with schizophrenia and Bipolar affective disorder (BAPD) of either sex. Caregivers were first-degree relatives of patients. Sociodemographic data were recorded using a special performa and caregiver burden was assessed using caregiver burden questionnaire. RESULTS Overall mean caregiver burden scores in Group 1 and Group 2 were 55.66 ± 4.09 and 58.16 ± 3.97, respectively, with statistically significant difference (P < 0.05). CONCLUSION Caregiver burden was more among working women compared to homemaker women.
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Affiliation(s)
- Navneet Kaur
- Department of Psychiatry, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
| | - Alka Puria
- Department of Biochemistry, DMCH, Laheriasarai, Darbhanga, Bihar, India
| | - Ajay Kumar
- Department of Psychiatry, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
| | - Suprakash Chaudhury
- Department of Psychiatry, Dr. D. Y. Patil Medical College, Pune, Maharashtra, India
| | - Ekram Goyal
- Department of Psychiatry, Government Medical College, Rajindra Hospital, Patiala, Punjab, India
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Jeon SY, Kim JL. Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors. J Alzheimers Dis 2021; 84:995-1003. [PMID: 34602480 DOI: 10.3233/jad-210694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. OBJECTIVE This study examined the impact of the care recipient's cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. METHODS Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. RESULTS SCGs caring for a demented spouse showed significantly higher depression scores (t = -3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006). Decreased care recipients' cognition was significantly correlated with higher GDS (β= -0.593, t = -4.471, p < 0.001) and higher MNA scores (β= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (β= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care recipients' cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = -1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. CONCLUSION This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.
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Affiliation(s)
- So Yeon Jeon
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jeong Lan Kim
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea.,Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
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Abstract
Soraya Seedat and Marta Rondon examine how gender inequities in the time allocated to unpaid work, exacerbated by covid-19, are affecting women’s mental health
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Affiliation(s)
- Soraya Seedat
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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Lee K, Yefimova M, Puga F, Pickering CE. Gender Differences in Caregiver Burden Among Family Caregivers of Persons With Dementia. J Gerontol Nurs 2021; 47:33-42. [PMID: 34191655 DOI: 10.3928/00989134-20210610-03] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The current study aimed to identify gender-dependent factors that influence caregiver burden among family caregivers of persons with dementia through secondary data analysis. We used a nationally representative survey of 379 family caregivers of persons with dementia completed in 2014. We examined factors affecting the burden experience of male and female caregivers, guided by the stress process model, using hierarchical regression. The analytic sample included 159 males (42%) and 220 females (58%). For males, age of care recipient, being an adult child, social support, instrumental activities of daily living performed, and caregiving impact on caregivers' health influenced burden. For females, co-residence, social support, caregivers' current health, and caregiving impact on caregivers' health impacted burden. Understanding gender differences related to caregiving burden is beneficial for developing effective targeted interventions that support the caregiving role and improve the quality of life of caregivers. [Journal of Gerontological Nursing, 47(7), 33-42.].
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40
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Zhou J, Walker A. The impact of community care services on the preference for ageing in place in urban China. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1041-1050. [PMID: 32783285 DOI: 10.1111/hsc.13138] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/05/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
This paper examines the relationship between community care services and ageing in place in urban China. Using data from the 2010 Sample Survey on Aged Population in Urban/Rural China, and within the framework of a revised version of Andersen's model, the paper applies multilevel models and analyses the effects of community care on the preference between ageing in place and institutional care, and reveals that ageing in place is preferred even in urban China. However, the existence of community care services had no significant effect on the preference for ageing in place. The paper concludes by arguing that China needs to develop its community care services and promote the idea of community care in both culture and policy. Realising ageing in place also requires a multidisciplinary approach. A model of shared care, between family and state, is particularly appropriate for China.
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Affiliation(s)
- Junshan Zhou
- School of Criminology, People's Public Security University of China, Beijing, China
| | - Alan Walker
- Social Policy & Social Gerontology, Department of Sociological Studies, The University of Sheffield, Sheffield, UK
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41
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van der Heide I, Heins MJ, van Hout HPJ, Verheij RA, Francke AL, Joling KJ. How Transitions in Dementia Care Trajectories Affect Health Problems in Partners: A Longitudinal Analysis With Linked Health and Administrative Data. J Gerontol B Psychol Sci Soc Sci 2021; 76:1186-1194. [PMID: 33249493 DOI: 10.1093/geronb/gbaa204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To evaluate whether the prevalence of health problems in cohabiting partners of people with dementia differs between the year before and the year after 3 transitions: the diagnosis of dementia, institutionalization, and the death of the person with dementia. METHODS Individuals with dementia and their partners were identified on the basis of data in the electronic health records (EHRs) of 451 Dutch general practices. EHRs were also the data source on their health problems, which were linked to the Dutch population registry and health administration data with demographic characteristics, date of institutionalization, and date of death. Differences in the prevalence of 16 groups of health problems and of specific health problems in partners during the year before and the year after the 3 transitions were examined using a generalized estimating equation. RESULTS About 1,110 partners of persons with dementia were identified. Problems related to the illness and/or loss of the person with dementia were significantly more prevalent in the year after the dementia diagnosis (32% vs. 17%) and in the year after the death of the person with dementia (59% vs. 41%) than in the years before. Unspecified health problems were more prevalent in the year after the diagnosis than in the year before (30% vs. 22%). After institutionalization, an increase was found in digestive problems and urological problems (30% vs. 18% and 24% vs. 17%). DISCUSSION Transitions during the dementia care trajectory, namely, the diagnosis, institutionalization, and death of the person with dementia, significantly affect the cohabiting partner's health.
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Affiliation(s)
- Iris van der Heide
- Nivel, Netherlands Institute of Health Services Research, Utrecht, The Netherlands
| | - Marianne J Heins
- Nivel, Netherlands Institute of Health Services Research, Utrecht, The Netherlands
| | - Hein P J van Hout
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Robert A Verheij
- Nivel, Netherlands Institute of Health Services Research, Utrecht, The Netherlands
| | - Anneke L Francke
- Nivel, Netherlands Institute of Health Services Research, Utrecht, The Netherlands.,Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Karlijn J Joling
- Department of General Practice and Elderly Care Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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The association of depression with use of prescription drugs in adults with noncommunicable diseases: Based on NHANES in 2005-2016. J Affect Disord 2021; 288:148-153. [PMID: 33895416 DOI: 10.1016/j.jad.2021.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND It is not clear how the noncommunicable diseases (NCDs) performed in the association of depression with use of prescription drugs. METHODS This cross-sectional study involved 20,836 participants with at least one NCDs who aged over 20 years old in the National Health and Nutrition Examination Survey (NHANES) from 2005-2016. Ordinal logistic regression under complex sampling was used to examine the association of depression with use of prescription drugs in patients with different categories of NCDs. RESULT Among patients with respiratory diseases (OR: 1.41, 95% CI: 1.13-1.76), genitourinary diseases (OR: 1.59, 95% CI: 1.28-1.98), and cardiovascular diseases (OR: 1.43, 95% CI: 1.27-1.60), the risk of depression was higher among those who used prescription drugs than those who did not. The results showed that the association of depression with use of prescription drugs was significantly stronger, especially in patients with genitourinary diseases ≥65 years of age (OR: 1.91, 95% CI: 1.01-3.61). Trend analysis showed that the categories of prescription drugs used and the risk of depression was significantly statistically different (P for trend <0.001). LIMITATIONS Self-reported prevalence of depression may differ from actual prevalence of depression. The categories of NCDs studied in this article are limited and the association between specific drugs and depression is not analyzed. CONCLUSIONS In patients with NCDs, use of prescription drugs increased the risk of depression, and this risk increased significantly, especially in patients with genitourinary diseases who aged over 65 years. The risk of depression was increasing with the categories of prescription drugs used.
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Cohen SA, Ahmed N, Brown MJ, Meucci MR, Greaney ML. Rural-urban differences in informal caregiving and health-related quality of life. J Rural Health 2021; 38:442-456. [PMID: 33956360 DOI: 10.1111/jrh.12581] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Rural-urban health disparities are pervasive among older adults. Rural US locations have a disproportionately high population of older adults, have reduced access to services, and are therefore more reliant on family and friends for care. However, little is known about rural-urban disparities among the 40+ million informal caregivers nationwide. There is a critical need to understand how rural-urban disparities impact caregiving experiences and health-related quality of life (HRQoL). The objectives of this study were to assess rural-urban differences in informal caregiving status, caregiving intensity (caregiving hours/week and types of care provided), and caregiver HRQoL. METHODS Data were abstracted from the 2018 Behavioral Risk Factor Surveillance System. The primary measure of rural-urban status was "metropolitan status." Associations between rural-urban status and caregiving and rural-urban differences in caregiving intensity and HRQoL were examined using generalized linear models, controlling for confounding and accounting for complex sampling. RESULTS Rural respondents were more likely to be caregivers than urban respondents (OR = 1.17, 95% CI: 1.02-1.34). After adjustment for confounders, rural caregivers were more likely than urban caregivers to provide 20 or more hours of caregiving per week (OR 1.38, 95% CI: 1.07-1.77), although the findings for health and HRQoL were somewhat mixed. CONCLUSION Results indicate that rural older adults offer more care than urban counterparts, which may have implications for caregiver health, well-being, and quality of life. These results can inform policies designed to improve caregiver health, and facilitate the translation and adaptation of existing policies, programs, and interventions to address rural caregivers' needs.
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Affiliation(s)
- Steven A Cohen
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Neelam Ahmed
- Department of Biological Sciences, College of Environmental and Life Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Monique J Brown
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Marissa R Meucci
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA
| | - Mary L Greaney
- Department of Health Studies, College of Health Sciences, University of Rhode Island, Kingston, Rhode Island, USA
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Sociocultural Influences on the Feeling of Loneliness of Family Caregivers of People with Dementia: The Role of Kinship. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094700. [PMID: 33925135 PMCID: PMC8125119 DOI: 10.3390/ijerph18094700] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 04/22/2021] [Accepted: 04/26/2021] [Indexed: 11/25/2022]
Abstract
The extent to which familism, dysfunctional thoughts, and coping variables contribute to explaining feelings of loneliness in caregivers, controlling for kinship, is analyzed. Participants were 273 family caregivers of people with dementia. Sociodemographic variables, familism, dysfunctional thoughts, coping strategies for requesting and receiving help, perceived social support, and leisure activities were assessed. The fit of a theoretical model for explaining the effect of cultural and psychological variables on feelings of loneliness in each kinship group was tested. No significant differences in the distribution of loneliness by kinship were found. Higher levels of familism are associated with more dysfunctional thoughts, that are linked to more maladaptive strategies for coping with caring (e.g., less social support and fewer leisure activities). This in turn is associated with higher scores in the feeling of loneliness. The model bore particular relevance to the group of daughters, husbands, and sons, yet not in the case of wives. Sociocultural and coping factors associated with the caring process seem to play an important role in explaining feelings of loneliness in caregivers. Sociocultural factors associated with the care process seem to play an important role in explaining feelings of loneliness in caregivers.
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Jawahir S, Tan EH, Tan YR, Mohd Noh SN, Ab Rahim I. The impacts of caregiving intensity on informal caregivers in Malaysia: findings from a national survey. BMC Health Serv Res 2021; 21:391. [PMID: 33906646 PMCID: PMC8077883 DOI: 10.1186/s12913-021-06412-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Provision of informal care may adversely affect health, daily and social activities of the informal caregivers, but few studies have examined these effects in relation to caregiving intensity. This study examined the predictive factors associated with the effects of caregiving roles on health, daily and social activities of informal caregivers, accounting for caregiving intensity. METHODS Data of adults aged 18 years and over from the National Health and Morbidity Survey 2019 were used. Respondent's demographic, socioeconomic, health, and caregiving-related characteristics were described using complex samples analysis. Logistic regression analysis was performed to examine the factors affecting health, daily and social activities of caregivers, accounting for caregiving intensity. RESULTS Five point one percent of adults in Malaysia provided informal care. High intensity caregivers were more likely to be actively employed and provided longer duration of care compared with low intensity caregivers. For low intensity caregiving, females, those aged 35-59 years, and those with long-term condition were more likely to have negative effects on health. Daily activities of non-Malays were more likely to be affected, while no factor was found significantly associated with effect on social activities. For high intensity caregiving, caregivers aged 60 and over, those received training and those without assistance were more likely to have negative effects on health. Daily activities of those without assistance were more likely to be affected. Social activities of non-Malays, those received training and those providing care for 2 years or more were more likely to be affected. CONCLUSIONS Our study indicates that both low- and high-intensity caregivers have common features, with the exception of employment status and care duration. Caregiving, regardless of intensity, has a significant impact on caregivers. In order to reduce the negative consequences of caregiving responsibilities, all caregivers need assistance from the community and government, that is customised to their needs. By addressing the factors contributing to the negative effects of caregiving, a continuation of informal caregiving can be sustained through policies supporting the growing demand for informal care necessitated by an ageing population and higher life expectancy in Malaysia.
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Affiliation(s)
- Suhana Jawahir
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia.
| | - Ee Hong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Yeung R'ong Tan
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Sarah Nurain Mohd Noh
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
| | - Iqbal Ab Rahim
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health Malaysia, Blok B2, Kompleks NIH, No. 1, Jalan Setia Murni U13/52, Seksyen U13 Setia Alam, 40170, Shah Alam, Selangor, Malaysia
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Jiménez-Gonzalo L, Romero-Moreno R, Pedroso-Chaparro MDS, Gallego-Alberto L, Barrera-Caballero S, Olazarán J, Losada-Baltar A. Psychometric properties of the Insomnia Severity Index in a sample of family dementia caregivers. Sleep Med 2021; 82:65-70. [PMID: 33901927 DOI: 10.1016/j.sleep.2021.03.036] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/13/2021] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVES Family caregivers of people with dementia frequently report sleep problems that are linked to depressive and anxious symptoms. However, data are needed regarding the psychometric properties of specific measures of sleep problems in caregiving populations. The aim of this study is to analyse the psychometric properties of the Insomnia Severity Index (ISI; Morin, 1993) in a Spanish dementia caregiver sample. METHODS 271 participants took part in face-to face interviews where, along with sociodemographic variables, caregivers' sleep problems, depressive and anxious symptoms were measured. The psychometric properties of the ISI were analysed through Confirmatory Factor Analysis (CFA) and analysis of the internal consistency and convergent and criterion validity. RESULTS The Spanish version of the Insomnia Severity Index showed adequate indices of internal consistency (Cronbach's alpha = 0.78) in our sample of family caregivers of people with dementia. A one-factor structure provided a better fit to the data than two- and three-factor structures. The ISI was significantly associated with lower sleep quality, less average sleep time per day and lower self-perception of vitality, as well as with higher depressive and anxious symptoms. Differences in ISI scores were found between people with and without depressive and anxious symptoms. Statistically significant gender-based differences in sleep problems were also found, with female caregivers showing higher sleep problems. CONCLUSIONS The ISI is a reliable and valid instrument to assess the subjective severity of sleep problems in the family dementia caregiver population and may be a useful instrument in intervention and research settings. Additional evidence was also provided of the importance of considering sleep problems in the studied population.
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Affiliation(s)
| | | | | | | | | | - Javier Olazarán
- Service of Neurology, HGU Gregorio Marañón, Madrid, Spain; Maria Wolff Foundation, Madrid, Spain
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Choi H. Giving or receiving spouse care and marital satisfaction among older Korean individuals. Soc Sci Med 2021; 272:112071. [PMID: 30826052 DOI: 10.1016/j.socscimed.2018.12.012] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 11/06/2018] [Accepted: 12/08/2018] [Indexed: 12/15/2022]
Abstract
Health challenges are expected in later life, but they may place older married adults in Korea at greater risk than in the past due to increasing risks of extended morbidity associated with a longer lifespan, and limited availability of traditional long-term care provided by children in an extended family context. As spouse care has become more prevalent among older adults, the present study examined whether provision or receipt of spouse care might be differentially associated with marital quality for men and women, and whether availability of care from adult children (i.e., sons, daughters, or children-in-law) might moderate the association between receipt of spouse care and marital satisfaction. The analytic sample was drawn from five waves of the Korean Longitudinal Study of Ageing (2006-2014), consisting of married individuals, with both age 60 years or older at Wave 1. For analyses, multilevel models were estimated using SAS PROC MIXED. Findings showed that first, for men, becoming a caregiver for their wife was associated with a small increase in marital satisfaction; the transition to spouse caregiving was associated with a decline in marital satisfaction for women. Secondly, transitioning to receiving spouse care was associated with a decline in marital satisfaction among men, but an increase in marital satisfaction for women. Third, new care from daughters in the form of (I)ADL assistance was associated with a benefit to marital satisfaction among men and women who began to receive care from their spouses. Overall, findings highlighted Korean families in transition. Marriage might fare better in a more recent form of family care-husbands providing care for their wives. In addition, daughters might play a bigger role in family care now compared to daughters-in-law, the designated provider of family care under the Confucian patriarchal system.
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Liu J. Spouse and Adult-Child Dementia Caregivers in Chinese American Families: Who Are More Stressed Out? J Am Med Dir Assoc 2021; 22:1512-1517. [PMID: 33453175 DOI: 10.1016/j.jamda.2020.12.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/21/2020] [Accepted: 12/07/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Though many studies have explored differences between spouses and adult children in dementia care, empirical evidence is lacking on racial- and ethnic-minority populations. To fill this research gap, this study examined care tasks, caregiver burden, and depressive symptoms of Chinese spouse and adult-child caregivers in dementia care. Guided by the stress process model, this study asked 3 questions: Do spouse and adult-child caregivers take up different care tasks and experience different levels of caregiver burden and depressive symptoms? Does gender moderate the differences between spouse and adult-child caregivers? Whether care tasks and burden mediate the association between being a spouse/adult-child caregiver and depressive symptoms? SETTING AND PARTICIPANTS Data were collected from a questionnaire-based survey of Chinese Americans who provided care for their family members with dementia in New York City. The analytical sample included 126 Chinese spouse or adult-child caregivers. METHODS Care tasks was indicated by intensity of 8 types of care tasks. Caregiver burden and depressive symptoms were measured by Zarit's Burden Interview and the 10-item Center for Epidemiologic Studies Depression Scale. Linear regression, interaction term (spouse/adult-child caregiver by gender), and path analysis were conducted to address the 3 questions. RESULTS The results of linear regression show no significant difference in care tasks between the 2 groups, but spouse caregivers had significantly higher levels of caregiver burden and depressive symptoms than adult children. Wives had higher levels of caregiver burden and depressive symptoms than husbands, daughters, and sons. Caregiver burden mediated the association between being a spouse caregiver and higher depressive symptoms, whereas care tasks did not shape such association. CONCLUSIONS AND IMPLICATIONS This study highlighted the emotional stress of Chinese American older adults in providing care for their spouses. The findings indicate the necessity of developing culturally meaningful activities to support Chinese American spouse caregivers.
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Affiliation(s)
- Jinyu Liu
- School of Social Work, Columbia University, New York, NY, USA.
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Morrison V, Williams K. Gaining Longitudinal Accounts of Carers' Experiences Using IPA and Photograph Elicitation. Front Psychol 2020; 11:521382. [PMID: 33343434 PMCID: PMC7746611 DOI: 10.3389/fpsyg.2020.521382] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 08/26/2020] [Indexed: 01/19/2023] Open
Abstract
Fluctuations in positive and negative caregiving experiences remain only partially explained as the significant variability over time of potential predictive factors themselves is understudied. The current study aims to gain considerable insight into caregiving experiences and perceptions over time by using photovoice methodology to support semi-structured interviews. A case study, longitudinal design is taken with three female caregivers who provide detailed insight into their caregivers' experiences over a 12 month period. The interview transcripts were analyzed using IPA- Interpretative Phenomenological Analysis. This innovative combination of methods resulted in the emergence of three related themes which included consuming the role, feeling consumed by the role, and letting go of the role. The idiographic approach taken allowed both within case differences to be examined over time, and also between carer differences to be highlighted. Implications of illness type and its characteristics, and of attachment and relationship quality with the care recipient were seen in terms of how and when the caregivers moved between the themes identified. The use of others' support or respite care is examined vis-a vis caregiver's own beliefs, emotions, relationship attachment and motivations to care. Caregivers self-efficacy beliefs also shifted over time and were influential in caregiver experience as the care recipient condition or needs changed. No previous studies have found that negative caregiving consequences are, in part, under volitional control and yet our data on the underlying reasons for consuming caregiving or allowing themselves to consume, would suggest this may in part be true. This is important because it suggests that interventions to support caregivers should address relational and motivational factors more fully.
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Affiliation(s)
- Val Morrison
- School of Psychology, Bangor University, Bangor, United Kingdom
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Hertler C, Seiler A, Gramatzki D, Schettle M, Blum D. Sex-specific and gender-specific aspects in patient-reported outcomes. ESMO Open 2020; 5:e000837. [PMID: 33184099 PMCID: PMC7662538 DOI: 10.1136/esmoopen-2020-000837] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 09/22/2020] [Accepted: 10/07/2020] [Indexed: 01/10/2023] Open
Abstract
Patient-reported outcomes (PROs) are important tools in patient-centred medicine and allow for individual assessment of symptom burden and aspects of patients’ quality of life. While sex and gender differences have emerged in preclinical and clinical medicine, these differences are not adequately represented in the development and use of patient-reported outcome measures. However, even in personalised approaches, undesirable biases may occur when samples are unbalanced for certain characteristics, such as sex or gender. This review summarises the current status of the literature and trends in PROs with a focus on sex and gender aspects.
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Affiliation(s)
- Caroline Hertler
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
| | - Annina Seiler
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Dorothee Gramatzki
- Department of Neurology, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Markus Schettle
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - David Blum
- Department of Radiation Oncology and Competence Center for Palliative Care, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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