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Turner SG, Pillemer K, Demetres M, Heaney K, Joshi S, Luebke M, Messay G, Reid MC. Physical pain among family caregivers to older adults: A scoping review of the literature. J Am Geriatr Soc 2024; 72:2853-2865. [PMID: 38895995 PMCID: PMC11368645 DOI: 10.1111/jgs.19037] [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: 10/12/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps. METHODS We searched multiple databases spanning from January 2012 to July 2023, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (e.g., study design/methodology, pain measurement, caregiver pain type, and major findings). RESULTS We identified 46 eligible studies conducted in the United States (n = 19) and internationally (n = 27). Studies often focused on caregivers for older adults with specific health conditions, such as cancer (n = 11), dementia (n = 8), or stroke (n = 3). The most commonly employed pain measure was a single-item dichotomous question about pain (n = 16), followed by a visual numeric or visual analog scale (n = 11). Nine studies (five randomized controlled trials) reported on five caregiver pain management interventions, including yoga/exercise programs and caregiver education programs. DISCUSSION Existing research on family caregivers' pain offers an important foundation. However, more robust research designs are necessary. We identify possibilities for future studies in addition to opportunities for systematic investigations to support the family caregivers being relied upon to care for the increasing number of older adults.
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Affiliation(s)
- Shelbie G Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - Karl Pillemer
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Kathleen Heaney
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - Sama Joshi
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Matthew Luebke
- College of Human Ecology, Cornell University, Ithaca, New York, USA
- Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Gelila Messay
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
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Turner SG, Robinson JRM, Pillemer KA, Reid MC. Prevalence Estimates of Arthritis and Activity-Limiting Pain Among Family Caregivers to Older Adults. THE GERONTOLOGIST 2024; 64:gnad124. [PMID: 37656675 PMCID: PMC11020308 DOI: 10.1093/geront/gnad124] [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: 04/24/2023] [Indexed: 09/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Little is known about the prevalence of physical pain among family caregivers to older adults. We used national survey data to assess the relative prevalence of caregivers' arthritis and activity-limiting bothersome pain by caregiver and care-recipient characteristics to identify which caregivers may be at a higher risk for physical pain. RESEARCH DESIGN AND METHODS We analyzed data collected from 1,930 caregivers who participated in the National Study on Caregiving (2017). We utilized modified Poisson models to estimate adjusted associations of caregiver and care-recipient characteristics with the relative prevalence of arthritis and bothersome pain. RESULTS Forty percent of caregivers had a lifetime diagnosis of arthritis. Seventy-five percent of caregivers with arthritis reported bothersome pain, nearly 30% of whom endorsed bothersome pain that limited their activities on most or every day of the previous month (i.e., activity-limiting bothersome pain). Regardless of whether they had arthritis, 51% of the sample reported bothersome pain in the previous month, 24% of whom indicated activity-limiting bothersome pain. Caregivers who were older or more highly educated had a higher prevalence of arthritis. Black caregivers had a lower prevalence of arthritis and activity-limiting bothersome pain compared to White caregivers. Caregivers with physical difficulty providing care had a higher prevalence of arthritis and activity-limiting bothersome pain than caregivers without physical difficulty providing care. DISCUSSION AND IMPLICATIONS Arthritis and activity-limiting bothersome pain are highly prevalent among caregivers. Given increased prevalence of pain among certain caregivers, it may be efficient to target these groups for pain management interventions.
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Affiliation(s)
- Shelbie G Turner
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
| | | | - Karl A Pillemer
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - M Carrington Reid
- Weill Cornell Medical College, Division of Geriatrics and Palliative Medicine, New York City, New York, USA
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Gérain P, Wawrziczny E, Antoine P. A scoping review of intensive longitudinal methods in informal caregivers of people with dementia. BMC Geriatr 2023; 23:456. [PMID: 37488491 PMCID: PMC10367249 DOI: 10.1186/s12877-023-04123-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 06/21/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND The daily life of informal caregivers assisting individuals with dementia widely varies throughout the day and week. As an answer, an increasing number of researchers have used intensive longitudinal methods (ILMs) such as diary studies, experience sampling methods, or ecological momentary assessment. OBJECTIVES AND METHODS The present scoping review aims at synthesizing the use of ILMs in informal dementia caregivers to clarify what is currently done and how, as well as what remains unaddressed. RESULTS The screening process identified 48 studies from 22 different datasets. Synthesis of these studies showed the diversity of devices and uses of ILMs in informal care, including the exploration of associations between variables or accompanying an intervention. ILMs showed the important variability of caregiving phenomena, as well as the important association of momentary stress and well-being. Gaps were nevertheless identified, such as transparency in the construction of the tool or the absence of focus on emotions and dyads. CONCLUSIONS For now, this field of research remains in its infancy and does not seem to have reached its full potential as it has in other fields. Nevertheless, it appears that ILMs are promising tools for informal dementia caregivers as they contribute to understanding the complexity of their daily life, with changing resources and challenges. Future directions include focusing more on (emotion) regulation, temporal lags, and the use of ILMs in interventional designs. TRIAL REGISTRATION The present review was registered on OSF (osf.io/b2qr4).
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Affiliation(s)
- P Gérain
- Department of Psychology, Faculty of Educational and Psychological Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050, Brussels, Belgium.
- SCALAB - UMR 9193, University of Lille, Lille, France.
| | - E Wawrziczny
- SCALAB - UMR 9193, University of Lille, Lille, France
| | - P Antoine
- SCALAB - UMR 9193, University of Lille, Lille, France
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Ahn S, Logan JG. Perceived role overload and physical symptom experience among caregivers of older adults: The moderating effect of social support. Geriatr Nurs 2021; 43:197-205. [PMID: 34922280 DOI: 10.1016/j.gerinurse.2021.11.021] [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: 09/21/2021] [Revised: 11/25/2021] [Accepted: 11/26/2021] [Indexed: 11/04/2022]
Abstract
We investigated the association between perceived role overload and physical symptom experience, and the potential moderating effect of social support among caregivers of older adults. We analyzed data of 1,471 caregivers obtained from the 2017 National Study of Caregiving. In the survey, participants were assessed for physical symptoms (pain, limited leg strength, and low energy), symptom-related activity limitations, perceived role overload, and informal/formal support sources. We performed multiple logistic regression analyses with interaction terms. Caregivers who perceived higher role overload were more likely to experience the physical symptoms and frequent limited activities due to the symptoms. The associations of perceived role overload with pain and low energy, respectively, were attenuated among caregivers with high informal support. The moderating effect of formal support appeared to be the opposite in relation to pain. Caregivers who perceived high burden may benefit from their informal support to prevent detrimental effects of caregiving on physical health.
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Affiliation(s)
- Soojung Ahn
- Doctoral Student, School of Nursing, University of Virginia, Charlottesville, VA, USA.
| | - Jeongok G Logan
- Associate Professor, School of Nursing, University of Virginia, Charlottesville, VA, USA
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Turner SG, Hooker K, Stawski RS. Women's Self-Relevant Goal Pursuit in the Presence of Physical Pain: An Intraindividual Variability Approach. J Gerontol B Psychol Sci Soc Sci 2021; 76:1565-1573. [PMID: 32882026 DOI: 10.1093/geronb/gbaa151] [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: 02/19/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES Pursuing personal goals that are relevant to one's sense of self is important for adjusting to age-related changes. Experiences of physical pain, however, are thought to threaten both people's sense of self and their pursuit of personal goals. Although a majority of older women experience physical pain, little is known about their day-to-day regulation of their self-relevant goals in the presence of physical pain. The objectives of this study were to explore associations between physical pain and health goal pursuit on a daily basis for women who identified health as a part of their possible selves. METHODS We took an intraindividual variability approach to analyze whether there were within- and between-person differences in associations between daily pain and daily health goal progress among 62 women who provided data over the course of 100 days, yielding 4,150 occasions of data. RESULTS At the between-person level, women with higher pain on average had lower health goal pursuit on average. At the within-person level, days of higher-than-average pain were associated with lower same-day health goal progress. DISCUSSION Our results suggest that pain interrupts regulation of a self-relevant goal at a within-person-not just between-person-daily level. Future work should consider how these daily, within-person, disruptions affect broader identity processes and overall well-being.
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Affiliation(s)
- Shelbie G Turner
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Karen Hooker
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
| | - Robert S Stawski
- School of Social and Behavioral Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis
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Barata A, Hoogland AI, Hyland KA, Otto AK, Kommalapati A, Jayani RV, Irizarry-Arroyo N, Collier A, Rodriguez Y, Welniak TL, Booth-Jones M, Logue J, Small BJ, Jain MD, Reblin M, Locke FL, Jim HSL. Quality of life in caregivers of patients receiving chimeric antigen receptor T-cell therapy. Psychooncology 2021; 30:1294-1301. [PMID: 33739548 PMCID: PMC9828891 DOI: 10.1002/pon.5674] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 03/06/2021] [Indexed: 01/12/2023]
Abstract
OBJECTIVE Informal family caregivers provide critical support for patients receiving chimeric antigen receptor (CAR) T-cell therapy. However, caregivers' experiences are largely unstudied. This study examined quality of life (QOL; physical functioning, pain, fatigue, anxiety, and depression), caregiving burden, and treatment-related distress in caregivers in the first 6 months after CAR T-cell therapy, when caregivers were expected to be most involved in providing care. Relationships between patients' clinical course and caregiver outcomes were also explored. METHODS Caregivers completed measures examining QOL and burden before patients' CAR T-cell therapy and at days 90 and 180. Treatment-related distress was assessed at days 90 and 180. Patients' clinical variables were extracted from medical charts. Change in outcomes was assessed using means and 99% confidence intervals. Association of change in outcomes with patient clinical variables was assessed with backward elimination analysis. RESULTS A total of 99 caregivers (mean age 59, 73% female) provided data. Regarding QOL, pain was significantly higher than population norms at baseline but improved by day 180 (p < .01). Conversely, anxiety worsened over time (p < .01). Caregiver burden and treatment-related distress did not change over time. Worsening caregiver depression by day 180 was associated with lower patient baseline performance status (p < .01). Worse caregiver treatment-related distress at day 180 was associated with lower performance status, intensive care unit admission, and lack of disease response at day 90 (ps < 0.01). CONCLUSIONS Some CAR T-cell therapy caregivers experience pain, anxiety, and burden, which may be associated patients' health status. Further research is warranted regarding the experience of CAR T-cell therapy caregivers.
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Affiliation(s)
- Anna Barata
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Aasha I. Hoogland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Kelly A. Hyland
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA,Department of Psychology, University of South Florida, Tampa, Florida, USA
| | - Amy K. Otto
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Anuhya Kommalapati
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Reena V. Jayani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | | | - Aaron Collier
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Yvelise Rodriguez
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Taylor L. Welniak
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Margaret Booth-Jones
- Department of Supportive Care Medicine, Moffitt Cancer Center, Tampa, Florida, USA
| | - Jennifer Logue
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Brent J. Small
- School of Aging Studies, University of South Florida, Tampa, Florida, USA
| | - Michael D. Jain
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Maija Reblin
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
| | - Frederick L. Locke
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, Moffitt Cancer Center, Tampa, Florida, USA
| | - Heather S. L. Jim
- Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, Florida, USA
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Al Ghassani A, Rababa M, Abu Khait A. Agitation in people with dementia: A concept analysis. Nurs Forum 2021; 56:1015-1023. [PMID: 34227111 DOI: 10.1111/nuf.12629] [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: 02/23/2021] [Revised: 05/31/2021] [Accepted: 06/23/2021] [Indexed: 11/30/2022]
Abstract
AIM This article aims to clarify the concept of agitation in people with dementia (PWD) by identifying its attributes, antecedents, and consequences to propose an operational definition of the concept. BACKGROUND Agitation is a recurrent behavior problem for many people with and without dementia, which results in psychosocial distress. The current literature lacks the conceptual clarity of agitation, which limits its effective nursing management. DATA SOURCES Several databases search was utilized that comprise computer searches of PsycINFO, MEDLINE (PubMed), the Cumulative Index of Nursing and Allied Health of data between the years 1970 and 2013. DESIGN Concept analysis. REVIEW METHODS Rodgers' Evolutionary Method of concept analysis (2000) was employed as a guide for analyzing the agitation concept. RESULTS Four main attributes were used to describe and propose a definition of agitation in PWD: disruptive behaviors, repetitiveness, inappropriateness, and aggression. CONCLUSION This analysis provides an operational definition that will improve knowledge of investigating relevant issues to agitation, which can be used by nurses and family caregivers when managing and preventing agitation in PWD.
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Affiliation(s)
- Amal Al Ghassani
- Community and Mental Health Department, Oman College of Health Sciences, Al Qurum, Muscat, Oman
| | - Mohammad Rababa
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Abu Khait
- Department of Community and Mental Health Nursing, Faculty of Nursing, The Hashemite University, Zarqa, Jordan
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Fuentecilla JL, Huo M, Birditt KS, Charles ST, Fingerman KL. Interpersonal Tensions and Pain Among Older Adults: The Mediating Role of Negative Mood. Res Aging 2020; 42:105-114. [PMID: 31709931 PMCID: PMC7944576 DOI: 10.1177/0164027519884765] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine whether (a) negative social encounters and physical pain are linked throughout the day, (b) negative mood mediates these associations, and (c) these associations vary by closeness with social partners. METHOD Adults aged 65+ (n = 313) completed ecological momentary assessments and reported their negative social encounters, physical pain, and mood every 3 hr throughout the day for 5-6 days. RESULTS Multilevel models revealed that negative social encounters were associated with greater pain at each 3-hr interval and that this association was mediated by negative mood during the same interval. Negative encounters with less close partners were associated with pain, but negative encounters with close partners were not. DISCUSSION Regulating older adults' negative emotions may be crucial to improving their daily pain. Further, interventions focusing on negative encounters with less close partners in daily life may help mitigate older adults' experiences of pain throughout the day.
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Affiliation(s)
| | - Meng Huo
- Department of Human Ecology, University of California, Davis, CA, USA
| | - Kira S. Birditt
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Susan T. Charles
- Department of Psychology and Social Behavior, University of California, Irvine, CA, USA
| | - Karen L. Fingerman
- Department of Human Development and Family Sciences, The University of Texas at Austin, TX, USA
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Intra- and interindividual differences in the within-person coupling between daily pain and affect of older adults. J Behav Med 2019; 43:707-722. [PMID: 31489518 DOI: 10.1007/s10865-019-00099-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 08/30/2019] [Indexed: 01/23/2023]
Abstract
The bidirectional interplay between chronic pain and negative affect is well-established in patient samples. However, less is known about the day-to-day relationship between pain and affect of older adults without severe illnesses and to what extent this association differs within and between individuals. A total of 224 participants (Mage = 77.6, SDage = 6.2) reported their daily experience of pain, impairment by their pain and affect during 21 consecutive days. Multilevel modeling results showed that on days with increased pain individuals also reported less positive affect and more negative affect. Time-lagged results indicated a temporal carry-over from yesterday's pain to today's negative affect but not to today's positive affect. Moreover, on days when individuals reported stronger impairment by their pain, they showed a stronger within-person coupling between daily pain and affect in contrast to days with a weaker experience of daily impairment. Yesterday's pain and today's negative affect were more strongly associated within individuals who reported higher levels of impairment. Interindividual differences in the within-person coupling between daily pain and affect were found with regard to general physical health conditions and general satisfaction with health. This study demonstrated the importance of focusing on within-person couplings between daily pain and affect beyond patient samples in order to better understand the maintenance of emotional stability despite daily hassles in older adults' everyday lives.
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