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da Silva-Sauer L, Garcia RB, Fonsêca ÉKG, Fernández-Calvo B. Physical activity and its relationship to burden and health concerns in family caregivers of people with dementia. Psychogeriatrics 2024; 24:165-173. [PMID: 38037197 DOI: 10.1111/psyg.13053] [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: 05/16/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Caring for people with dementia (PwD) usually triggers stress and leads to mental and somatic health complaints (SHCs). Physical activity (PA) can provide burden relief in PwD caregivers, but it is not clear whether PA habits would contribute to reducing SHCs. This study aims to analyze the effect of PA on the relationship between burden and SHCs in a sample of family caregivers of PwD. METHODS One hundred and fifty-seven caregivers of PwD reported their PA habits, and completed the Giessen's Subjective Health Complaints Questionnaire (GBB-8) and the Zarit Burden Interview (ZBI). The relationship between PA habits, burden of care (ZBI), and SHCs (B-GBB-8 scale) was examined. Subsequently, the moderating effect of PA habits on the relationship between burden and SHCs was tested. RESULTS PA habit was inversely associated with ZBI (rbp = -0.242) and GBB-8 scores (rbp (Gastrointestinal) = -0.174; rbp (Musculoskeletal) = -0.195; rbp (Exhaustion) = -0.247; rbp (Cardiovascular) = -0.250; and rbp (Overall) = -0.257, respectively), whereas moderate positive correlations were found between ZBI and GBB-8 scores (r (Gastrointestinal) = 0.483; r (Musculoskeletal) = 0.536; r (Exhaustion) = 0.542; r (Cardiovascular) = 0.438; and r (Overall) = 0.598, respectively). The interaction effect of PA habit and burden was significant for the overall SHCs (b = -0.11; P < 0.05) and cardiovascular complaints (b = -0.06; P < 0.05). However, the association between burden and SHCs was significant (P < 0.001) only for sedentary caregivers. CONCLUSION These findings indicate that maintaining an active lifestyle through regular PA could potentially help alleviate the adverse effects of caregiver burden on somatic health among caregivers of PwD. Encouraging and endorsing PA interventions for informal caregivers might yield substantial advantages for their health and general well-being.
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Affiliation(s)
- Leandro da Silva-Sauer
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
| | - Ricardo Basso Garcia
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
| | - Égina Karoline Gonçalves Fonsêca
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
- Department of Neuroscience, University of São Paulo, Ribeirão Preto, Brazil
| | - Bernardino Fernández-Calvo
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
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Wang J, Leong IT, Johnson MK, Pei Y, Lee KH, Mittelman MS, Epstein C, Cho S, Wu B. What Matters to Chinese and Korean American Dementia Caregivers: Navigating Cultural Influences in Dementia Care from Caregivers' Perspectives. J Alzheimers Dis 2024; 98:519-538. [PMID: 38427483 DOI: 10.3233/jad-231140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Chinese and Korean Americans are among the fastest-growing minority groups in the US but face disparities in income and limited English proficiency, leading to health inequities in Alzheimer's disease and related dementias (ADRD) care. Objective This study aims to understand cultural influences in ADRD care from the perspectives of Chinese and Korean American caregivers to inform culturally sensitive support for caregivers in Asian immigrant populations. Methods We conducted a study that was part of a broader project aimed at informing the cultural adaptation of the NYU Caregiver Intervention-Enhanced Support (NYUCI-ES) program specifically for Chinese and Korean American caregivers managing multiple chronic conditions. In our interviews with 14 Chinese American and 11 Korean American caregivers, we focused on how their roles as primary caregivers were influenced by cultural and family expectations, the impact of caregiving on their personal and emotional well-being, and the specific barriers they face in accessing healthcare for themselves and their relatives with dementia. Results Cultural beliefs and values significantly influenced the perceptions and utilization of support systems among Chinese and Korean American caregivers. Family stigma and adherence to cultural norms impacted their caregiving experiences. The study also highlighted the added burden during the pandemic and the potential benefits of telehealth and information technology in ADRD care. Conclusions Developing culturally tailored, person-centered programs is crucial to meeting the unique needs of Chinese and Korean American caregivers. This research contributes to understanding and supporting this vulnerable population, promoting healthcare equity for ADRD patients and caregivers.
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Affiliation(s)
- Jing Wang
- College of Health and Human Services, University of New Hampshire, Durham, NH, USA
| | - I Tek Leong
- College of Nursing, NYU Rory Meyers, New York, NY, USA
| | | | - Yaolin Pei
- College of Nursing, NYU Rory Meyers, New York, NY, USA
| | - Kyung Hee Lee
- College of Nursing, NYU Rory Meyers, New York, NY, USA
- College of Nursing, Yonsei University, Seoul, South Korea
| | | | | | - Soyeon Cho
- CUNY/NY College of Technology, Brooklyn, NY, USA
| | - Bei Wu
- College of Nursing, NYU Rory Meyers, New York, NY, USA
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Carmel S, O'Rourke N, Tovel H, Raveis VH, Antler N, Cohn-Schwartz E. Social Support and Commitment to Life and Living: Bidirectional Associations in Late Life over Time. Healthcare (Basel) 2023; 11:1965. [PMID: 37444799 DOI: 10.3390/healthcare11131965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/15/2023] Open
Abstract
OBJECTIVES This study aims to enhance the understanding of longitudinal associations between two important facets of well-being in late life: social support and commitment to life and living (CTL). METHODS Structured home interviews were conducted with 824 Israelis ≥75 years of age, with three annual data collection timepoints. We hypothesized and tested a cross-lagged, longitudinal structural equation model (SEM) in which CTL and social support were assumed to predict each other over time, covarying for previously reported CTL and social support. RESULTS Social support has a positive, contemporaneous effect, predicting commitment to living at T1 and T3, while CTL predicts social support the following year (i.e., T1-T2 & T2-T3). Satisfaction with relationships significantly contributes to measurement of both latent constructs at each point of data collection. DISCUSSION Commitment to life and living and social support are intertwined phenomena. Whereas social support has a concomitant effect on CTL, the effect of CTL on social support emerges over time. This suggests that greater social support fosters greater CTL, leading older adults to nurture social networks and relationships; the effect of which is greater social support in the future. The implications of these results warrant further research over longer periods and across cultures.
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Affiliation(s)
- Sara Carmel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Norm O'Rourke
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Department of Psychology, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Hava Tovel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Victoria H Raveis
- Psychosocial Research Unit on Health, Aging and the Community, New York University College of Dentistry, New York, NY 10010-2314, USA
| | - Naama Antler
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
| | - Ella Cohn-Schwartz
- Department of Epidemiology, Biostatistics and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
- Center for Multidisciplinary Research in Aging, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva 8410501, Israel
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Associations Between Dysfunctional Thoughts, Leisure Activities, and IL-6 in Caregivers of Family Members With Dementia. Psychosom Med 2023; 85:175-181. [PMID: 36516289 DOI: 10.1097/psy.0000000000001158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Dementia caregiving is associated with negative physical health consequences, including inflammation processes. The objective of this study was to analyze the associations between dysfunctional thoughts, frequency of leisure activities, and interleukin 6 (IL-6) in a sample of dementia family caregivers. METHODS One hundred forty dementia caregivers participated in this cross-sectional study. The relationships among caregivers' dysfunctional thoughts, leisure activities, and IL-6 were adjusted for demographic characteristics, stressors, and physical and mental health indicators in a linear regression analysis. RESULTS Higher levels of dysfunctional thoughts ( t = -2.02, p = .045) were significantly associated with lower frequency of leisure activities. In turn, lower frequency of leisure activities was significantly associated with higher levels of IL-6 ( t = -2.03, p = .045). Dysfunctional thoughts were no longer significantly associated with IL-6 levels when both dysfunctional thoughts and leisure activities were included in the same model ( t = 1.78, p = .076). A significant indirect effect was found for the association between higher levels of dysfunctional thoughts and higher levels of IL-6 (standardized indirect effect = 0.036, bootstrap standard error = 0.026, 95% confidence interval = 0.0001-0.1000) through its association with fewer leisure activities. CONCLUSIONS Our findings suggest that the direct effect of caregivers' dysfunctional thoughts on IL-6 may be mediated by the impact on caregivers' frequency of leisure activities. Results suggest that training caregivers in reducing dysfunctional thoughts to thereby increase leisure activities may be useful in reducing inflammation.
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Barrera-Caballero S, Romero-Moreno R, Vara-García C, Márquez-González M, Olazarán J, Losada-Baltar A. Cognitive fusion and distress in family caregivers: the role of satisfaction with personal values. Aging Ment Health 2022:1-6. [PMID: 36165229 DOI: 10.1080/13607863.2022.2126432] [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: cognitive fusion (the tendency towards behavior that is overly regulated and influenced by cognition) and dissatisfaction with personal values are central processes of psychological inflexibility and are related to distress. Being cognitively fused may interfere with achieving satisfaction from personal values. This study analyzed the role of satisfaction with the value of caregiving and other personal values (e.g. personal growth) in the relationship between cognitive fusion and caregivers' distress.Method: a total of 287 dementia family caregivers participated in this quantitative study carried out in Madrid, Spain, from January 2016 to February 2020. We measured sociodemographic and stressor variables, cognitive fusion, caregivers' satisfaction with values and depressive and anxiety symptoms. The indirect effect of cognitive fusion on distress through caregivers' satisfaction with caregiving value and with other personal values was tested. Four hierarchical regression models were analyzed: the role of satisfaction with the caregiving value in the association between cognitive fusion and depressive (Model 1a) and anxiety (Model 1b) symptoms; and the role of satisfaction with other personal values in the association between cognitive fusion and depressive (Model 2a) and anxiety (Model 2b) symptoms.Results: the results showed an indirect effect of cognitive fusion on both depressive and anxiety symptoms only through satisfaction with other personal values. Those reporting higher cognitive fusion reported lower satisfaction with other personal values, and this association was related to higher scores in depressive and anxiety symptoms (Models 2a and 2b).Conclusion: cognitive fusion could be a variable that interferes in obtaining satisfaction from personal values, something that increases caregivers' distress.
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Affiliation(s)
| | - Rosa Romero-Moreno
- Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - Carlos Vara-García
- Department of Psychology, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain
| | - María Márquez-González
- Department of Biological and Health Psychology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Javier Olazarán
- Service of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
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Ang S, Suen J. Receiving Social Support From Diverse Helpers: Associations With Quality of Life. Res Aging 2022; 45:399-409. [PMID: 35961019 DOI: 10.1177/01640275221120919] [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: 11/15/2022]
Abstract
More older adults now live in non-family-based households, even as the provision of support to older adults within the domestic setting becomes more salient. This study examines the determinants of having non-immediate family or non-coresident helpers in older adults' received social support networks, and its associations with quality of life. Data were from a nationally representative study of Singaporeans aged 60 and above (N = 2248) who did not live alone. Findings show that those who received help solely from persons other than their spouse or child report a lower quality of life compared to other kinds of networks. However, those who had more non-coresident helpers than co-resident helpers experienced a higher quality of life compared to those who relied mainly on co-resident helpers. We suggest that policymakers should consider supporting a wider range of informal social support arrangements and providers, as networks of received social support become increasingly diverse.
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Affiliation(s)
- Shannon Ang
- Sociology, School of Social Sciences, Nanyang Technological University, Singapore
| | - Johan Suen
- Department of Sociology and Anthropology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore
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Associations between pleasant events, activity restriction, stressors, and blood pressure in caregivers of persons with dementia. Int Psychogeriatr 2022; 34:275-285. [PMID: 34134797 DOI: 10.1017/s1041610221000715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Caring for a relative with dementia is associated with adverse consequences for cardiovascular health. Cognitive and behavioral factors, such as high perceived activity restriction and low frequency of pleasant events have been found to be associated with higher levels of blood pressure, but the role these variables play in the stress and coping process remains understudied. The objective of this study is to analyze the associations between behavioral and psychological symptoms of dementia, activity restriction, frequency of pleasant events, and mean arterial pressure. DESIGN Face-to-face interviews and cross-sectional analyses. SETTING Social services, healthcare centers, and adult day services of Comunidad de Madrid, Spain. PARTICIPANTS One hundred and two family caregivers of a spouse or parent with dementia. MEASUREMENTS Apart from various sociodemographic and health-related variables, behavioral and psychological symptoms of dementia, activity restriction, and frequency of leisure activities were assessed. In addition, measurement of blood pressure levels was conducted through an electronic sphygmomanometer. RESULTS The obtained model suggests that there is a significant indirect association between behavioral and psychological symptoms of dementia and mean arterial pressure through activity restriction and frequency of pleasant events. CONCLUSIONS The findings of this study provide preliminary support for a potential indirect effect between behavioral and psychological symptoms of dementia and blood pressure, through the effects of behavioral and psychological symptoms of dementia on the caregivers' levels of activity restriction and frequency of pleasant activities. Our manuscript provides additional support for the pleasant events and activity restriction model (Mausbach et al., 2011; Chattillion et al., 2013), by highlighting the importance of considering caregiving stressors as a source of caregivers' activity restriction in the theoretical framework of the model.
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Yoon H, Chatters L, Kao TSA, Saint-Arnault D, Northouse L. Predictors of quality of life and depression among Korean-American cancer patients and their family caregivers. Psychooncology 2018; 27:2717-2724. [PMID: 30134502 DOI: 10.1002/pon.4864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 08/05/2018] [Accepted: 08/13/2018] [Indexed: 11/08/2022]
Abstract
OBJECTIVE This study examined social, cultural, and appraisal factors associated with Korean-American cancer patients' and their family caregivers' quality of life (QOL) and depression. METHODS Data were from Korean-American cancer patients and their family caregivers (N = 60 dyads) living in the United States. Study aims were examined using descriptive statistics and multiple regression. RESULTS For patients, higher social support and lower negative appraisal of illness predicted higher patient QOL; negative appraisal of illness also predicted higher patient depression. For caregivers, older age, having fewer traditional Korean values, and more modern (individualistic) values predicted higher caregiver QOL. Caregivers who held more modern values also had less depression. CONCLUSIONS Higher support and less negative appraisal predicted better QOL in patients. For caregivers however, the type of cultural values they held (tradition or modern) was a key factor that predicted level of QOL and depression. Assessment of support and appraisal as well as attention to cultural values may enhance their QOL and reduce depression.
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Affiliation(s)
- Hyojin Yoon
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA
| | - Linda Chatters
- School of Social Work, School of Public Health, University of Michigan, Ann Arbor, MI, USA
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Hawken T, Turner-Cobb J, Barnett J. Coping and adjustment in caregivers: A systematic review. Health Psychol Open 2018; 5:2055102918810659. [PMID: 30450216 PMCID: PMC6236498 DOI: 10.1177/2055102918810659] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This systematic review assessed coping and adjustment in caregivers of all ages to provide a synthesis of existing literature in the context of methodological approaches and underlying theory. Four databases were searched. Reference lists, citations and experts were consulted. In total, 27 studies (13 quantitative and 14 qualitative) were included. Coping factors associated with adjustment (problem- versus emotion-focussed coping and cognitive strategies) and psychosocial factors associated with physiological adjustment (trait anxiety, coping style and social support) were identified. Results raised methodological issues. Future research requires physiological adjustment measures and longitudinal assessment of the long-term impact of childhood caregiving. Findings inform future caregiver research and interventions.
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Ang S, Malhotra R. Expressive social support buffers the impact of care-related work interruptions on caregivers' depressive symptoms. Aging Ment Health 2018; 22:755-763. [PMID: 28426235 PMCID: PMC6105318 DOI: 10.1080/13607863.2017.1317329] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To assess if expressive and instrumental social support from family and friends moderate the association of care-related work interruptions (e.g. leaving work for the older adult's doctor appointment) with depressive symptoms among working family caregivers of older adults. METHODS Data were from the Singapore Survey on Informal Caregiving (SSIC). A subsample of 662 dyads, each comprising an older care-recipient [home-dwelling Singaporean aged 75 and older receiving human assistance for at least one activity of daily living (ADL)] and his/her working family caregiver, was analysed. Caregiver depressive symptoms were assessed using the Center for Epidemiologic Studies Depression scale. Care-related work interruptions were scaled through the Mokken scaling procedure. Expressive social support was assessed using a scale by Pearlin and co-workers. Instrumental social support was based on the hours of ADL help provided to the care-recipient by any family member or friend, on behalf of the primary caregiver. A linear regression model, with interaction terms, assessed expressive and instrumental social support as moderators of the association of care-related work interruptions with caregiver depressive symptoms. RESULTS More care-related work interruptions were associated with more caregiver depressive symptoms. And, this association was moderated by expressive, but not instrumental, social support. CONCLUSION Our findings conform to previous qualitative work suggesting that caregivers' mental health may not benefit from instrumental support, but from receiving expressive support instead. Initiatives for improving the care experience of working caregivers of older adults should focus on promoting expressive support from their friends and family.
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Affiliation(s)
- Shannon Ang
- Department of Sociology, University of Michigan, Ann Arbor, MI, USA
- Population Studies Center, University of Michigan, Ann Arbor, MI, USA
- Sociology Programme, School of Social Sciences, Nanyang Technological University, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Al Sawah S, Daly RP, Foster SA, Naegeli AN, Benjamin K, Doll H, Bond G, Moshkovich O, Alarcón GS. The caregiver burden in lupus: findings from UNVEIL, a national online lupus survey in the United States. Lupus 2016; 26:54-61. [DOI: 10.1177/0961203316651743] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Accepted: 04/26/2016] [Indexed: 11/16/2022]
Abstract
Objectives: Lupus imposes a substantial burden on patients; however, little is known about its impact on those caring for patients with the disease. In this study, we examined the impact ‘caring for patients with lupus’ has on caregivers from their own perspective. Methods: UNVEIL was a one-time online national cross-sectional survey developed in partnership with the Lupus Foundation of America and fielded targeting the US Lupus Foundation of America constituents in 2014. Eligible caregivers were adults who self-identified as unpaid caregivers of patients with lupus. Eligible caregivers had to complete a series of sociodemographic questions as well as a series of well established outcome measures, such as the Short Form 12v2 Health Survey, the Work Productivity and Activity Index, the Caregiver Burden Inventory, and the Perceived Benefits of Caregiving Scale. Results: A total of 253 caregivers completed the survey. The majority of caregivers (90.1%) were aged 60 years or younger, more than half (54.2%) were men, and more than half (59.7%) identified themselves as either a spouse or a partner to the patient with lupus they were caring for. Overall health-related quality of life was close to the norm mean of the general US population. Caregivers who were employed missed an average of 12.8% of paid work time due to caregiving responsibilities and reported a 33.5% reduction in on-the-job effectiveness. Nearly half of the caregivers surveyed (49.4%) indicated that their caregiving responsibilities impacted their ability to socialize with friends, and almost all caregivers (97.6%) reported experiencing increased anxiety and stress in relation to their caregiving role. Conclusions: Caregiving for patients with lupus has a substantial impact on the work productivity and the social and emotional functioning of caregivers. Healthcare professionals and policymakers should continually assess the impact of healthcare decisions on the well-being of those caring for patients with lupus.
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Affiliation(s)
- S Al Sawah
- Eli Lilly and Company, Indianapolis, USA
| | - R P Daly
- Lupus Foundation of America, Inc., Washington, USA
| | - S A Foster
- Eli Lilly and Company, Indianapolis, USA
| | | | | | | | - G Bond
- ICON COA, Gaithersburg, USA
| | | | - G S Alarcón
- University of Alabama at Birmingham, Birmingham, USA
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Lee VYW, Seah WY, Kang AWC, Khoo EYH, Mooppil N, Griva K. Managing multiple chronic conditions in Singapore - Exploring the perspectives and experiences of family caregivers of patients with diabetes and end stage renal disease on haemodialysis. Psychol Health 2016; 31:1220-36. [PMID: 27356152 DOI: 10.1080/08870446.2016.1203921] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Diabetes mellitus (DM) is the commonest cause of end stage renal disease (ESRD). Despite increasing DM-ESRD prevalence and high dependency on care, there is a lack of literature on DM-ESRD caregivers. We sought to explore the perspectives and experiences of caregivers of patients with DM undergoing haemodialysis in Singapore. DESIGN This study employed an exploratory, qualitative design comprising in-depth interviews with caregivers of DM-ESRD patients. METHODS Semi-structured interviews were conducted with a sample of 20 family caregivers (54.2 ± 12.6 years; 75% female) of DM-ESRD patients. Data were analysed using Thematic Analysis. RESULTS Key caregiving challenges identified were managing diet, care recipients' emotions and mobility dependence. Patients' emotional reactions caused interpersonal conflicts and hindered treatment management. Difficulties in dietary management were linked to patients' erratic appetite, caregivers' lack/poor understanding of the dietary guidelines and caregivers' low perceived competence. Limited resources in terms of social support and finances were also noted. Physical and psychological well-being and employment were adversely affected by caregiving role. CONCLUSION This study highlights distinctive aspects of the DM-ESRD caregiving experience, which impact on caregivers' health and challenge care. Disease management programmes should be expanded to support caregivers in dealing with multimorbidity.
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Affiliation(s)
- Vanessa Y W Lee
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Wei Ying Seah
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Augustine W C Kang
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Eric Y H Khoo
- b Department of Medicine , Yong Loo Lin School of Medicine , National University of Singapore , Singapore , Singapore
| | | | - Konstadina Griva
- a Department of Psychology , National University of Singapore , Singapore , Singapore.,d Health Services Research Group , City University London , London , UK
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Capistrant BD. Caregiving for Older Adults and the Caregivers’ Health: an Epidemiologic Review. CURR EPIDEMIOL REP 2016. [DOI: 10.1007/s40471-016-0064-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Miyawaki CE. A Review of Ethnicity, Culture, and Acculturation Among Asian Caregivers of Older Adults (2000-2012). SAGE OPEN 2015; 5:10.1177/2158244014566365. [PMID: 26229736 PMCID: PMC4517686 DOI: 10.1177/2158244014566365] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
This review identified domains of care experiences among studies of Chinese, Filipino, Japanese, Korean, and Vietnamese caregivers in the United States and Canada between 2000 and 2012. Using a narrative approach, 46 peer-reviewed journal articles were found through electronic databases and references. Considering caregivers' assimilation to host countries, attention was given to their culture, socioeconomic resources, immigrant status, filial responsibility, generation, and acculturation. Three primary domains were identified across subgroups. The caregivers' experiences domain was a strong sense of filial responsibility and its varied effects on caregiving experience; in the cultural values domain, reciprocity, and familism. In the acculturation domain, caregivers' generations influenced their experiences. Because our society is rapidly changing demographically and culturally, studies of older adults and their caregivers that are not only inclusive of all racial/ethnic groups but also sensitive to specific racial/ethnic and cultural subgroup differences are necessary to inform policy and practice.
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Chan A, Malhotra C, Malhotra R, Rush AJ, Østbye T. Health Impacts of Caregiving for Older Adults With Functional Limitations. J Aging Health 2013; 25:998-1012. [DOI: 10.1177/0898264313494801] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: To estimate the health impact, in terms of depression, self-rated health, and health services utilization, of providing care to older adults (75+) requiring human assistance in at least one activity of daily living (ADL) limitation. Method: Data from 1,077 caregivers and 318 noncaregivers, interviewed in the Singapore Survey on Informal Caregiving, was used to examine differences in depressive symptoms, self-rated health, and number of outpatient visits in the last 1 month between caregivers and noncaregivers. Multivariate models for the outcomes, adjusting for characteristics of the caregiver/noncaregiver and care-recipient/potential care recipient, were run. Results: Caregivers were more depressed, had poorer self-rated health, and had a higher rate of outpatient visits in the past month compared to noncaregivers. Discussion: The study indicates the need for support services to family caregivers of older adults with ADL limitations.
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Affiliation(s)
- Angelique Chan
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
- Department of Sociology, National University of Singapore, Singapore
| | - Chetna Malhotra
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Rahul Malhotra
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Augustus John Rush
- Office of Clinical Sciences, Duke-NUS Graduate Medical School, Singapore
| | - Truls Østbye
- Program in Health Services and Systems Research, Duke-National University of Singapore Graduate Medical School, Singapore
- Department of Community and Family Medicine, Duke University, USA
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Yu Y, Hu J, Efird JT, McCoy TP. Social support, coping strategies and health-related quality of life among primary caregivers of stroke survivors in China. J Clin Nurs 2013; 22:2160-71. [DOI: 10.1111/jocn.12251] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2012] [Indexed: 01/22/2023]
Affiliation(s)
- Yunhong Yu
- Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology; Wuhan China
| | - Jie Hu
- University of North Carolina at Greensboro; Greensboro NC USA
| | - Jimmy T Efird
- Center for Health Disparities (Biostatistics Unit) and Department of Public Health; Brody School of Medicine; Eastern Carolina University; Greenville NC USA
| | - Thomas P McCoy
- University of North Carolina at Greensboro; Greensboro NC USA
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Gallagher S, Whiteley J. Social support is associated with blood pressure responses in parents caring for children with developmental disabilities. RESEARCH IN DEVELOPMENTAL DISABILITIES 2012; 33:2099-105. [PMID: 22771985 DOI: 10.1016/j.ridd.2012.06.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 06/11/2012] [Accepted: 06/11/2012] [Indexed: 05/25/2023]
Abstract
The present study tested whether parents caring for children with developmental disabilities would have higher blood pressure compared to parents of typically developing children (controls). It also examined the psychosocial factors underlying this observation. Thirty-five parents of children with developmental disability and thirty controls completed standard measures of perceived stress, child challenging behaviours and social support and wore an ambulatory blood pressure (BP) monitor throughout the day, for one day. Relative to controls, parents caring for children with developmental disabilities reported poorer psychosocial functioning and had a higher mean systolic BP. Of the psychosocial predictors, only social support was found to be predictive. Moreover, variations in social support accounted for some of the between group differences with the β for parental group attenuated from .42 to .34 in regression analyses. It appears that social support may influence blood pressure responses in parental caregivers. Finally, our findings underscore the importance of providing psychosocial interventions to improve the health of family caregivers.
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Affiliation(s)
- Stephen Gallagher
- Centre for Social Issues, Department of Psychology, University of Limerick, Ireland.
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18
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Tan SB, Williams AF, Morris ME. Experiences of caregivers of people with Parkinson’s disease in Singapore: a qualitative analysis. J Clin Nurs 2012; 21:2235-46. [DOI: 10.1111/j.1365-2702.2012.04146.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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19
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Vaingankar JA, Subramaniam M, Abdin E, He VYF, Chong SA. “How Much Can I Take?”: Predictors of Perceived Burden for Relatives of People with Chronic Illness. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n5p212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Introduction: Chronic illnesses are common and have detrimental effects not only on the affected individuals but also on their families. These negative consequences on the physical and psychological health of caregivers constitute the burden of care. We investigate the predictors of perceived burden of care among relatives of people with any chronic physical or mental illness using secondary data from a nationwide survey in Singapore. Materials and Methods: A cross-sectional household survey was conducted among adult residents of age 18 years and above and data were analysed to explore the predictors of high perceived burden of care. Two thousand four hundred and fifty-eight respondents having at least 1 close relative with any chronic physical and/or mental illness were included. Results: Majority of the respondents had at least 1 close family member with physical illness (88.3%)—the most common illnesses reported were memory problems (86.9%), physical disability (74.8%), heart problems (70.1%) and cancer (62.2%). About 30.9% (n = 723) perceived high burden resulting from their relatives’ health condition. Logistic analysis showed that women were more likely (OR 1.58, P = 0.0026) and Malays were less likely (OR 0.68, P = 0.0044) to perceive burden. Those who were able to open up to their family or friends (OR 1.65, P = 0.0162) and those who had dysthymia had higher odds (OR 4.91, respectively, P =0.0364) of perceiving burden. Conclusion: Our results suggest that regardless of the nature of the chronic illnesses, gender or ethnicity, the capacity to open up to family or friends and the mental health status of caregivers can predict their perceived burden. The results provide valuable preliminary information for planning social policies and interventions for improving the well-being of caregivers.
Key words: Mental illness, Social support, Subjective burden
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20
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Lee Y, Choi S. Korean American Dementia Caregivers’ Attitudes Toward Caregiving. J Appl Gerontol 2012; 32:422-42. [DOI: 10.1177/0733464811431163] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore how Korean American family caregivers view the services they offer to patients with dementia. It also investigated the roles of social networks and satisfaction with social support on attitudes toward caregiving. Social network, satisfaction with social support, demographic characteristics, caregiving-related stress factors, and cultural factors were examined. We used a convenience sample of 85 Korean American dementia caregivers. The results from hierarchical multiple regression models show that the level of satisfaction with social support significantly contributed to Korean American caregivers’ attitudes toward working with patients with dementia, while no statistically significant associate was found for social network. Higher levels of satisfaction with social support were associated with greater positive attitudes toward caregiving among Korean American caregivers ( b = 0.26, p = .024). The implications for mental health professionals and policy makers are discussed.
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Abstract
Caregiving to elderly parents, in India, is primarily provided by adult children. This study aims at understanding the issues and concerns relating to elderly parental caregiving in the contemporary Indian sociocultural context. Qualitative methods have been used in this study to collect the data based on phenomenological principles. Data for this study was collected through in-depth interviews with 15 couples who were recruited through purposive and snowball method. Finding of the study highlighted five main themes: (a) The emotional bonding; (b) Implications on caregiver; (c) Impact on finance; (d) Who takes the responsibility and (e) Being a daughter. This study has tried to highlight that in India, being a collectivist nation, there are various aspects relating to elderly parental caregiving which affect the caregiver in different ways in the sociocultural context.
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22
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Roepke SK, Allison M, von Känel R, Mausbach BT, Chattillion EA, Harmell AL, Patterson TL, Dimsdale JE, Mills PJ, Ziegler MG, Ancoli-Israel S, Grant I. Relationship between chronic stress and carotid intima-media thickness (IMT) in elderly Alzheimer's disease caregivers. Stress 2012; 15:121-9. [PMID: 21790484 PMCID: PMC3223262 DOI: 10.3109/10253890.2011.596866] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The stress associated with providing care for a spouse diagnosed with Alzheimer's disease can have adverse effects on cardiovascular health. One potential explanation is that chronic caregiving stress may contribute to the development of atherosclerosis. The purpose of this study was to determine whether the duration that one has provided care is associated with the degree of atherosclerotic burden, as measured by carotid artery intima-media thickness (IMT). One hundred and ten Alzheimer caregivers [mean age 74 ± 8 (SD) years, 69% female] underwent in-home assessment of carotid artery IMT via B-mode ultrasonography. Data regarding medical history, blood pressure, and multiple indicators of caregiving stress were also collected. Multiple regression indicated that duration of care was positively associated with IMT measured in the internal/bifurcation segments of the carotid artery (β = 0.202, p = 0.044) independent of risk factors such as age, gender, body mass index, smoking history, sleep quality, hypertension status, and caregiving stressors. Duration of care was positively associated with IMT in the common carotid artery, but the relationship was not significant. These findings provide more evidence of the link between chronic caregiving stress and cardiovascular disease and indicate that enduring the experience of caregiving over a period of years might be associated with atherosclerotic burden.
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Affiliation(s)
- Susan K Roepke
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Matthew Allison
- Department of Family and Preventative Medicine, University of California, San Diego, La Jolla, CA
| | - Roland von Känel
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Department of General Internal Medicine, Inselspital, Bern University Hospital, and University of Bern, Switzerland
| | - Brent T Mausbach
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Elizabeth A Chattillion
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | | | - Thomas L Patterson
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Joel E Dimsdale
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Paul J Mills
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Michael G Ziegler
- Department of Medicine, University of California San Diego, La Jolla, CA
| | - Sonia Ancoli-Israel
- San Diego State University/University of California, San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
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23
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Casado B, Sacco P. Correlates of Caregiver Burden Among Family Caregivers of Older Korean Americans. J Gerontol B Psychol Sci Soc Sci 2011; 67:331-6. [DOI: 10.1093/geronb/gbr115] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Abstract
The recent aging trend in the United States has resulted in exponential growth in the number of informal dementia caregivers. Caring for a family member with dementia has been associated with negative health outcomes that are likely related to physiologic changes resulting from stress. However, caregiving is not always associated with health morbidity. In this review, we highlight resilience factors that appear to have a beneficial relationship with health outcomes. Specifically, we highlight 11 studies that examined the relationship of one of three broad resilience domains (personal mastery, self-efficacy, and coping style) to caregiver health outcomes. Our main findings were that higher levels of personal mastery and self-efficacy, and increased use of positive coping strategies appear to have a protective effect on various health outcomes in dementia caregivers. Continued research is warranted to help guide prospective directions for caregiver interventions focusing on increasing caregiver resilience and the corresponding impact on caregiver health.
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26
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The cost of caregiving: Endocrine and immune implications in elderly and non elderly caregivers. Neurosci Biobehav Rev 2011; 35:1342-52. [DOI: 10.1016/j.neubiorev.2011.02.007] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2010] [Revised: 01/10/2011] [Accepted: 02/10/2011] [Indexed: 11/23/2022]
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Goins RT, Spencer SM, McGuire LC, Goldberg J, Wen Y, Henderson JA. Adult caregiving among American Indians: the role of cultural factors. THE GERONTOLOGIST 2010; 51:310-20. [PMID: 21148253 DOI: 10.1093/geront/gnq101] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
PURPOSE With a sample of American Indian adults, we estimated the prevalence of adult caregiving, assessed the demographic and cultural profile of caregivers, and examined the association between cultural factors and being a caregiver. This is the first such study conducted with American Indians. DESIGN AND METHODS Data came from a cross-sectional study of 5,207 American Indian adults residing on 2 closely related Lakota Sioux reservations in the Northern Plains and one American Indian community in the Southwest. Cultural factors included measures of cultural identity and traditional healing practices. RESULTS Seventeen percent of our sample reported being caregivers. In both the Northern Plains and Southwest, caregiving was positively correlated with younger age, being a woman, larger household size, attending and participating in Native events, and endorsement of traditional healing practices. In both regions, attendance and participation in Native events and engagement in traditional healing practices were associated with increased odds of caregiving after adjusting for covariates. Only in the Northern Plains did we find that speaking some Native language at home was associated with increased odds of being a caregiver. Examination of interaction terms indicated some sex differences in the association between cultural factors and caregiving in the Northern Plains but not in the Southwest. IMPLICATIONS Our findings indicate that greater cultural identity and engagement in traditional healing practices are related to caregiving in American Indian populations. Caregiving research, intervention efforts, and caregiving programs and services in Native communities should pay special attention to the dynamics of culture and caregiving.
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Affiliation(s)
- R Turner Goins
- Department of Community Medicine, Center on Aging, West Virginia University, Morgantown, WV 26506, USA.
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Casado BL, van Vulpen KS, Davis SL. Unmet Needs for Home and Community-Based Services Among Frail Older Americans and Their Caregivers. J Aging Health 2010; 23:529-53. [PMID: 21084723 DOI: 10.1177/0898264310387132] [Citation(s) in RCA: 92] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study examined unmet needs for home- and community-based services (HCBS) among frail older Americans. Method: Using population-based sample from the National Long-Term Care Survey, a hierarchical logistic regression analysis was conducted to examine the predictors of unmet needs for seven types of HCBS. Results: Lack of awareness, reluctance, unavailability, and affordability of services were the main reasons for unmet needs for HCBS. Factors that were associated with unmet needs included Black race/ethnicity, greater care needs (functional limitations and behavioral problems), and less informal support (substitute help and family agreement). Discussion: It is important to identify risk factors that may lead to older adults’ unmet needs for HCBS. The findings of this study charge researchers to look beyond service utilization and give more attention to service needs among those who did or could not access the services.
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Affiliation(s)
| | | | - Stacey L. Davis
- University of Maryland School of Social Work, Baltimore, MD, USA
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Chen H, Levkoff SE. The Multiverse of Inquiry: Introduction to the Special Issue on "Dementia Care and Chinese Culture". AGEING INTERNATIONAL 2010; 35:85-95. [PMID: 22068037 DOI: 10.1007/s12126-010-9061-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hongtu Chen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Knight BG, Sayegh P. Cultural values and caregiving: the updated sociocultural stress and coping model. J Gerontol B Psychol Sci Soc Sci 2009; 65B:5-13. [PMID: 19934166 DOI: 10.1093/geronb/gbp096] [Citation(s) in RCA: 297] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
This review revises the sociocultural stress and coping model for culturally diverse family caregivers proposed in 1997 by Aranda and Knight. Available research on the influence of cultural values on the stress and coping process among family caregivers supports a common core model that is consistent across ethnic groups and that links care recipients' behavior problems and functional impairments to caregivers' burden appraisals and health outcomes. Familism as a cultural value appears to be multidimensional in its effects, with obligation values often being more influential than family solidarity. The effects of cultural values and other ethnic differences in stress and coping appear to involve social support and coping styles rather than burden appraisals. Implications of the revised model for research and practice are discussed.
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Affiliation(s)
- Bob G Knight
- University of Southern California, Los Angeles, 90089-0191, USA.
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