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Sánchez-Alcón M, Sosa-Cordobés E, Garrido-Fernández A, Sánchez-Ramos JL, Ramos-Pichardo JD. Psychometric properties of a Spanish version of the MM-CGI-SF in caregivers of people with dementia. J Am Geriatr Soc 2024; 72:201-208. [PMID: 37800646 DOI: 10.1111/jgs.18623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/24/2023] [Accepted: 09/09/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Caregivers of people with dementia may experience characteristic grief linked to present and anticipated losses before the physical death of the care recipient occurs, which is related to physical and mental health problems. The Marwit-Meuser Caregiver Inventory-Short Form (MM-CGI-SF) is an instrument that assesses this type of grief. Since there are no studies on an adaptation of the MM-CGI-SF to the Spanish population, the aim of the study was to evaluate its psychometric properties in a sample of caregivers of dementia patients. METHODS A cross-sectional study was carried out. The tool was translated and adapted into Spanish, which was administered to 250 caregivers of people with dementia in the province of Huelva, together with other related instruments. Descriptive statistics and internal consistency reliability were calculated using Cronbach's alpha, for the total questionnaire and for each subscale. A confirmatory factor analysis (CFA) was performed and the Spanish version of the MM-CGI-SF was correlated with the rest of the variables by calculating Spearman's correlation coefficient. RESULTS 80.4% of the participants were female and had high levels of caregiver grief (x ¯ = 64.62, SD = 14.86). Cronbach's alpha for the general questionnaire was 0.927 and between 0.822-0.854 for its subscales. The fit values of the CFA were: x2 = 202.033, degrees of freedom = 121, x2 /df = 1.670, TLI = 0.954, CFI = 0.963, SRMR = 0.047, RMSEA = 0.052; and all the correlations were statistically significant. CONCLUSIONS The Spanish version of the MM-CGI-SF shows adequate psychometric properties. Thanks to this instrument, health professionals may measure caregiver grief, get closer to the reality of dementia care, and evaluate the effectiveness of interventions to manage this grief.
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Crawley S, Sampson EL, Moore KJ, Kupeli N, West E. Grief in family carers of people living with dementia: A systematic review. Int Psychogeriatr 2023; 35:477-508. [PMID: 35086600 DOI: 10.1017/s1041610221002787] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Grief research in family carers of people with dementia has increased. We aimed to report the prevalence of pre-death and post-death grief and to synthesize associated factors and the relationship between pre-death factors and post-death grief and services used to manage grief. DESIGN (Prospero protocol: CRD42020165071) We systematically reviewed literature from PsycINFO, MEDLINE, CINAHL, and ASSIA until April 2020. Effectiveness of intervention data and studies not written in English were excluded; qualitative studies were additionally excluded during study selection. Study quality was assessed using the Mixed Methods Appraisal Tool. Evidence was narratively summarized. PARTICIPANTS Family non-paid carers of somebody with any dementia type. MEASUREMENTS Validated measures of pre-death and/or post-death grief. RESULTS We included quantitative data from 55 studies (44 rated as high quality). Most included solely spouse or adult child carers. Forty-one studies reported pre-death grief, 12 post-death grief, and 6 service use; eight were longitudinal. 17% met the Prolonged Grief Disorder criteria pre-death (n = 1) and 6-26% (n = 4) of participants met the Complicated Grief criteria post-death. Being a spouse, less educated, caring for somebody with advanced dementia, and greater burden and depression were associated with higher pre-death grief. Lower education level and depression were predictive of higher post-death grief. Pre-death factors found to influence post-death grief were grief and depression. Limited service use evidence was reported. CONCLUSION Awareness of characteristics which increase the likelihood of higher grief can help identify those in need of support. Future research should focus on what supports or services are beneficial to grief experiences.
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Affiliation(s)
- Sophie Crawley
- Marie Curie Palliative Care Research Department, Division of Psychiatry, UCL, LondonW1T 7NF, United Kingdom
| | | | - Kirsten J Moore
- Melbourne Ageing Research Collaboration, National Ageing Research Institute, Melbourne, Australia
| | - Nuriye Kupeli
- Division of Psychiatry, UCL, LondonW1T 7NF, United Kingdom
| | - Emily West
- Division of Psychiatry, UCL, LondonW1T 7NF, United Kingdom
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Mi W, Gou Z, Ma Z. Psychometric Properties of the Chinese Version of the 10-Item Social Provisions Scale in Chinese Populations. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023:1-27. [PMID: 37361345 PMCID: PMC10212227 DOI: 10.1007/s10862-023-10047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 06/28/2023]
Abstract
This study performed a cross-cultural validation of the Chinese version of the 10-item Social Provisions Scale (C-SPS-10) in Chinese populations. Study 1 examined the factor structure, internal reliability, discrimination, criterion validity, and network structure of C-SPS-10 by utilizing a sample of disaster victims in the 2021 Henan floods. Study 2 substantiated the findings of Study 1 in a general population sample. Measurement invariances between populations and between sexes in terms of the C-SPS-10 were also tested using the network approach. Study 3 used three samples to examine the test-retest reliability of the C-SPS-10 over three different time periods. The general results showed that the C-SPS-10 has excellent factor structure, internal reliability, discrimination, and criterion validity. The C-SPS-10 was confirmed to have good psychometric properties. Although the full scale functions well, problems may exist at a domain level. Moreover, the full scale of the C-SPS-10 was varied as a useful tool to capture trait-like characteristics of individuals' perceptions of social support for the general population. Supplementary Information The online version contains supplementary material available at 10.1007/s10862-023-10047-7.
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Affiliation(s)
- Wenqing Mi
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, 210023 China
| | - Zepeng Gou
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, 210023 China
| | - Zhihao Ma
- Computational Communication Collaboratory, School of Journalism and Communication, Nanjing University, Nanjing, 210023 China
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Gilsenan J, Gorman C, Shevlin M. Explaining caregiver burden in a large sample of UK dementia caregivers: The role of contextual factors, behavioural problems, psychological resilience, and anticipatory grief. Aging Ment Health 2022:1-8. [PMID: 35881027 DOI: 10.1080/13607863.2022.2102138] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Dementia caregiver burden is a significant public health concern, affecting both the wellbeing of caregivers and their care-recipients. This study investigated a range of variables associated with caregiver burden in a large sample of UK dementia caregivers. Clinical characteristics and novel psychological constructs were used - including anticipatory grief and psychological resilience. Anticipatory grief refers to the process of experiencing loss prior to the death of a significant person. METHOD Caregivers of persons with dementia (N = 530) completed a survey obtaining the Zarit-Burden Interview (ZBI-SF) and other psychological and demographic/caregiving-related factors. RESULTS Findings illustrate that 71% of the sample experienced high levels of caregiver burden and around 95% met the criteria for clinically significant levels of burden. A regression model explained 49% of the variance in subjective caregiver burden; contextual factors (care-recipients living situation, frequency of caregiving), behavioural challenges in the care-recipient (memory-related problem behaviours), caregiver psychological resilience and caregiver anticipatory grief (heartfelt long & sadness, worry & felt isolation) were all significant variables. Caregiver anticipatory grief, followed by psychological resilience, had the strongest association with burden. CONCLUSION Caregiver anticipatory grief and psychological resilience, have a significant interaction with the clinical presentation of the dementia sufferer in explaining subjective caregiver burden. More grief and resilience-focused interventions targeting both the practical and emotional challenges are imperative to reduce burden and thus to ensure caregiver wellbeing.
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Affiliation(s)
- Jane Gilsenan
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Colin Gorman
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, United Kingdom of Great Britain and Northern Ireland
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Singer J, Roberts KE, McLean E, Fadalla C, Coats T, Rogers M, Wilson MK, Godwin K, Lichtenthal WG. An examination and proposed definitions of family members' grief prior to the death of individuals with a life-limiting illness: A systematic review. Palliat Med 2022; 36:581-608. [PMID: 35196915 PMCID: PMC10098140 DOI: 10.1177/02692163221074540] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Research has extensively examined family members' grief prior to the death of an individual with a life-limiting illness but several inconsistencies in its conceptualization of related constructs, yet significant conceptualization issues exist. AIM This study aimed to identify and characterize studies published on family members grief before the death of an individual with a life-limiting illness, and propose definitions based on past studies in order to initiate conceptual clarity. DESIGN A mixed-method systematic review utilized six databases and was last conducted July 10, 2021. The search strategy was developed using Medical Subject Headings. This study was prospectively registered on PROSPERO (CRD42020166254). RESULTS One hundred thirty-four full-text articles met inclusion criteria. This review revealed across studies a wide variation in terminology, conceptualization, and characterization of grief before the death. More than 18 terms and 30 definitions have been used. In many cases, the same term (e.g. anticipatory grief) was defined differently across studies. CONCLUSIONS We found grief occurring before the death of a person with a life-limiting illness, which we termed pre-death grief, is comprised of two distinct constructs: anticipatory grief and illness-related grief. Anticipatory grief is future-oriented and is characterized by separation distress and worry about a future without the person with the life-limiting illness being physically present. Illness-related grief is present-oriented and is characterized by grief over current and ongoing losses experienced during the illness trajectory. These definitions provide the field with uniform constructs to advance the study of grief before the death of an individual with a life-limiting illness.
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Affiliation(s)
- Jonathan Singer
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Kailey E Roberts
- Ferkauf Graduate School of Psychology, Yeshiva University, New York, NY, USA
| | - Elisabeth McLean
- Department of Psychological Science, Texas Tech University, Lubbock, TX, USA
| | - Carol Fadalla
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Taylor Coats
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Madeline Rogers
- Center for Research on End-of-Life Care, Weill Cornell Medicine, New York, NY, USA
| | | | - Kendra Godwin
- Medical Library, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Wendy G Lichtenthal
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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Gilsenan J, Gorman C, Shevlin M. Exploratory factor analysis of the caregiver grief inventory in a large UK sample of dementia carers. Aging Ment Health 2022; 26:320-327. [PMID: 33148009 DOI: 10.1080/13607863.2020.1839856] [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: 10/23/2022]
Abstract
OBJECTIVES Anticipatory grief (AG) is the process of experiencing loss prior to the death of a significant person. Coping with this multifaceted experience in the context of dementia caregiving is a relatively novel, yet significant area in caregiving literature. The Marwit-Meuser Caregiver Grief Inventory (MM-CGI) and its abbreviated MM-CGI-Short-Form (MM-CGI-SF) is the most widely used scale measuring AG. However, limited research has employed robust analytical strategies to assess its dimensional structure. This study employed contemporary factor analytical techniques to assess the dimensional structure of the MM-CGI/SF. METHOD Caregivers of persons with dementia (n = 508) completed a survey containing MM-CGI/SF and other associated psychological measures. Exploratory factor analysis was employed to compare eight alternative factor analytical models to determine the optimal model. Internal-consistency reliability was assessed by Cronbach's α and construct validity was assessed by Spearman's correlation-coefficient. RESULTS The best fitting model was the MM-CGI-SF three factor model (Personal Sacrifice and Burden, Heartfelt Sadness and Longing and Worry and Felt Isolation). The MM-CGI-SF three factor model demonstrated internal consistency reliability and factor correlations with associated psychological measures indicated construct validity. CONCLUSION The MM-CGI-SF three factor model demonstrated adequate fit and utility, however, the Worry and Felt Isolation subscale needs further replication and revision to assess its dimensionality. The MM-CGI-SF is the more useful tool due to its brevity and better model fit.
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Affiliation(s)
- Jane Gilsenan
- School of Psychology, Ulster University, Coleraine, UK
| | - Colin Gorman
- School of Psychology, Ulster University, Coleraine, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
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Liu CC, Lee CF, Chang T, Liao JJ. Exploring the Relationship between the Caregiver's Stress Load and Dementia Patient Behavior: A Case Study of Dementia Specialist Outpatient Data from the Southern Medical Center of Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17144989. [PMID: 32664394 PMCID: PMC7399981 DOI: 10.3390/ijerph17144989] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/05/2020] [Accepted: 07/07/2020] [Indexed: 11/16/2022]
Abstract
The aim of this study was to explore the relationship between caregivers' stress loads and dementia patient behavior, including the correlation of "patient behavior" (severity and frequency), "social care system", and "stress levels of caregivers". The research method was based on the analysis of survey data collected at a dementia specialist outpatient clinic of a medical center in southern Taiwan from November 2013 to May 2015. Those surveyed by the center included patients who visited the hospital, and their caregivers completed a questionnaire survey. During the study period, a total of 558 questionnaires for 279 pairs were distributed, and all questionnaires were recovered. According to the survey statistics, the average age of the caregivers interviewed was 53.1 years; women accounted for 61.3% of respondents, and the duration of care exceeded three years. In terms of education, most respondents were college/university graduates. The most common surveyed relationship was that of children acting as the caregiver to a parent, and the average age of the patients was 77.73 years. Most caregivers were found to live with the patients (75.3%). In terms of severity and frequency, the surveyed items with the highest average scores were both the "delusion" item of the "patient behavior" facet, the "mental support"(mean = 1.97; standard deviation, SD = 0.869) item of the "social care system" facet, and the "social life stress" (mean = 2.26, SD = 1.510) item of the "Stress levels of caregivers" facet. The research results show that the "patient behavior" and "Stress levels of caregivers" facets have a significant positive correlation, and the "social care system" and "Stress levels of caregivers" facets have a significant negative correlation. In the future, priority of service planning and implementation of long-term policy should be given to home care, since this is a cultural characteristic of Taiwan. In circumstances where a primary caregiver takes care of family members, the patient's behavior, length of care, mental support, and social life issues are key items that should be considered in the social welfare control service to alleviate the load of dementia patients on family caregivers.
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Affiliation(s)
- Cheng-Chang Liu
- Graduate School of Design, National Yunlin University of Science and Technology (YunTech), Yunlin 64002, Taiwan;
| | - Chang-Franw Lee
- Graduate School of Design, National Yunlin University of Science and Technology (YunTech), Yunlin 64002, Taiwan;
- Correspondence: ; Tel.: +886-5-534-2601 (ext. 6128)
| | - Tung Chang
- Doctoral Program, Graduate School of Engineering Science and Technology, YunTech, Yunlin 64002, Taiwan;
| | - Jing-Jing Liao
- Department of Business Administration, TransWorld University, Yunlin 64002, Taiwan;
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Chan I, Yap P, Wee SL, Liew TM. The three dimensions of caregiver grief in dementia caregiving: Validity and utility of the subscales of the Marwit-Meuser Caregiver Grief Inventory. Int J Geriatr Psychiatry 2020; 35:213-222. [PMID: 31736107 PMCID: PMC7004032 DOI: 10.1002/gps.5238] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 11/07/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The experience of grief in family caregivers as they provide care for persons with dementia is often overlooked. The Marwit-Meuser Caregiver Grief Inventory (MM-CGI) is one among the few scales that capture such experiences. In a recent study, MM-CGI was found to contain three subscales identifying dimensions of loss in caregivers-Personal-Sacrifice Burden (PSB), Heartfelt Sadness, Longing, and Worry (HSLW), and Felt Isolation (FI). We aimed to evaluate the validity and utility of these dimensions in a multiethnic Asian population. METHODS Family caregivers (n = 394) completed MM-CGI and scales assessing caregiver burden, depression, and gains. Internal consistency reliability was examined using Cronbach α; test-retest reliability using intraclass correlation coefficient; and construct validity using Pearson correlation coefficient. The utility of the MM-CGI dimensions was evaluated by comparing caregivers with high subscale scores across dementia stages and caregiving relationship. RESULTS The three dimensions of MM-CGI exhibited adequate internal consistency, test-retest reliability, construct validity, and known-group validity. PSB correlated most strongly with caregiver burden (r = 0.78); HSLW with caregiver depression (r = 0.75); and FI with caregiver burden and caregiver depression (r = 0.60, respectively). Caregivers with high total grief scores tended to experience most difficulty with HSLW (90.8%), followed by PSB (75.4%) and FI (46.2%). The three dimensions also increased across the dementia stages, with FI higher in mild dementia, PSB higher in moderate dementia, and HSLW higher in severe dementia. Spousal caregivers experienced most difficulty in HSLW, whereas children caregivers experienced similar levels of difficulty across the dimensions. CONCLUSIONS The three dimensions of MM-CGI captured distinct aspects of caregiver grief in a multiethnic Asian population and would enable more individualized assessments and interventions for caregiver grief.
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Affiliation(s)
- Ivana Chan
- Geriatric Education and Research InstituteSingapore
| | - Philip Yap
- Geriatric Education and Research InstituteSingapore,Department of Geriatric Medicine, Khoo Teck Puat HospitalSingapore
| | - Shiou Liang Wee
- Geriatric Education and Research InstituteSingapore,Health and Social Sciences ClusterSingapore Institute of TechnologySingapore
| | - Tau Ming Liew
- Department of Geriatric PsychiatryInstitute of Mental HealthSingapore,Psychotherapy ServiceInstitute of Mental HealthSingapore,Saw Swee Hock School of Public HealthNational University of SingaporeSingapore
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Jain FA, Connolly CG, Moore LC, Leuchter AF, Abrams M, Ben-Yelles RW, Chang SE, Ramirez Gomez LA, Huey N, Lavretsky H, Iacoboni M. Grief, Mindfulness and Neural Predictors of Improvement in Family Dementia Caregivers. Front Hum Neurosci 2019; 13:155. [PMID: 31156412 PMCID: PMC6530345 DOI: 10.3389/fnhum.2019.00155] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Accepted: 04/24/2019] [Indexed: 01/09/2023] Open
Abstract
Background: Family dementia caregivers often suffer from an immense toll of grief while caring for their loved ones. We sought to identify the clinical relationship between grief, depression and mindfulness and identify neural predictors of symptomatology and improvement. Methods: Twenty three family dementia caregivers were assessed at baseline for grief, mindfulness and depression, of which 17 underwent functional magnetic resonance imaging (fMRI). During fMRI, caregivers were shown faces of either their dementia-stricken relative or that of a stranger, paired with grief-related or neutral words. In nine subjects, post fMRI scans were also obtained after 4 weeks of either guided imagery or relaxation. Robust regression was used to predict changes in symptoms with longitudinal brain activation (BA) changes as the dependent variable. Results: Grief and depression symptoms were correlated (r = 0.50, p = 0.01), and both were negatively correlated with mindfulness (r = -0.70, p = 0.0002; r = -0.52, p = 0.01). Relative to viewing strangers, caregivers showed pictures of their loved ones (picture factor) exhibited increased activation in the dorsal anterior cingulate gyrus and precuneus. Improvement in grief but not mindfulness or depression was predicted by increased relative BA in the precuneus and anterior cingulate (different subregions from baseline). Viewing grief-related vs. neutral words elicited activity in the medial prefrontal cortex and precuneus. Conclusions: Caregiver grief, depression and mindfulness are interrelated but have at least partially nonoverlapping neural mechanisms. Picture and word stimuli related to caregiver grief evoked brain activity in regions previously identified with bereavement grief. These activation foci might be useful as biomarkers of treatment response.
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Affiliation(s)
- Felipe A. Jain
- Depression Clinical and Research Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Colm G. Connolly
- Department of Biomedical Sciences, College of Medicine, Florida State University, Tallahassee, FL, United States
| | - Leonardo C. Moore
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Institute for Simulation and Training, University of Central Florida, Orlando, FL, United States
| | - Andrew F. Leuchter
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Michelle Abrams
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Ramzi W. Ben-Yelles
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Sarah E. Chang
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, United States
| | - Liliana A. Ramirez Gomez
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Nora Huey
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Marco Iacoboni
- Department of Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Ahmanson-Lovelace Brain Mapping Center, Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, United States
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10
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Abstract
Chinese family caregivers of dementia patients suffer considerable grief in their caregiving activity; little research has been conducted on dementia caregivers' grief in China. This study aims to (a) confirm the factor structure of the Mandarin version of the Marwit-Meuser Caregiver Grief Inventory-Short Form (MM-CGI-SF), (b) evaluate the levels of family caregivers' grief, and (c) explore the best predictors of family caregivers' grief. A cross-sectional study was conducted to collect data from 91 caregivers of dementia patients. The Mandarin version of the MM-CGI-SF had a three-factor structure. Family caregivers' grief was at an average level. Family caregivers' monthly household income and caring time per day predicted their own grief. The Mandarin version of the MM-CGI-SF possessed the same factor structure as the original English version, and the Chinese family caregivers experienced an average grief which was predicted by the monthly household income and caring time per day of the caregivers.
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Affiliation(s)
| | - Yun Li
- The First Affiliated Hospital of Wenzhou Medical University, China
| | - Ping Li
- Wenzhou Medical University, China
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11
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Lo HHM, Ho WC, Lau ENS, Lo CW, Mak WWS, Ng SM, Wong SYS, Wong JOY, Lui SSY, Lo CSL, Lin ECL, Poon MF, Choi K, Leung CWC. A Brief Mindfulness-Based Family Psychoeducation Intervention for Chinese Young Adults With First Episode Psychosis: A Study Protocol. Front Psychol 2019; 10:516. [PMID: 30915004 PMCID: PMC6421292 DOI: 10.3389/fpsyg.2019.00516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 02/21/2019] [Indexed: 12/21/2022] Open
Abstract
Family psychoeducation (FPE) has been recommended as a major component in the treatment of psychosis. Many previous studies have implemented an intensive program design that often only emphasized improvements in patients' illness outcomes but the benefits for caregivers were limited. There have been calls for a time-limited but cost-effective FPE program to mitigate the looming reality of the suffering of people with psychosis and their families. A Brief Mindfulness-Based Family Psychoeducation for psychosis program is developed to reduce caregivers' burden and promote young adult's recovery. A randomized controlled trial will be conducted to compare this intervention with an ordinary FPE intervention. Both arms will involve six sessions, with a total contact time of 12 h. 300 caregivers of young adults who have experienced first episode psychosis within last 3 years will be recruited. Program effectiveness will be assessed by comparing outcomes measuring the caregivers' burden, mental health symptoms, positive well-being, and the young adult's mental health symptoms during the study and at 9-month post-randomization. The role of expressed emotions, interpersonal mindfulness, and non-attachment in mediating these outcomes will be explored. An additional qualitative approach Photovoice is selected to explore the complex family experiences and the benefits of mindfulness from the caregivers' personal perspectives. Trial Registration: The trial is registered with the United States Clinical Trials Registry (ClinicalTrials.gov): NCT03688009.
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Affiliation(s)
- Herman Hay-Ming Lo
- Department of Applied Social Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Wing-Chung Ho
- Department of Social and Behavioural Sciences, The City University of Hong Kong, Kowloon, Hong Kong
| | - Elsa Ngar-Sze Lau
- Department of Special Education and Counselling, The Education University of Hong Kong, Tai Po, Hong Kong
| | - Chun-Wai Lo
- Specialist in Psychiatry, Private Practice, Hong Kong, Hong Kong
| | - Winnie W. S. Mak
- Department of Psychology, The Chinese University of Hong Kong, Shatin, China
| | - Siu-Man Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong
| | - Samuel Yeung-Shan Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Simon S. Y. Lui
- Department of Psychiatry, Castle Peak Hospital, Hong Kong, Hong Kong
| | - Cola Siu-Lin Lo
- Department of Psychiatry, Castle Peak Hospital, Hong Kong, Hong Kong
| | | | - Man-Fai Poon
- Integrative Community Centre for Mental Wellness, Baptist Oi Kwan Social Service, Hong Kong, Hong Kong
| | - Kong Choi
- Integrative Community Centre for Mental Wellness, Richmond Fellowship of Hong Kong, Hong Kong, Hong Kong
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Cheung DSK, Ho KHM, Cheung TF, Lam SC, Tse MMY. Anticipatory grief of spousal and adult children caregivers of people with dementia. BMC Palliat Care 2018; 17:124. [PMID: 30458746 PMCID: PMC6247750 DOI: 10.1186/s12904-018-0376-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anticipatory grief (AG) among caregivers of people with dementia is common and has been found to be related to negative health outcomes. Previous studies showed different patterns of AG between spousal and adult children caregivers of people with dementia (PWD) at different stages; however, the levels of such grief are not yet compared. The findings in Western studies are very limited, and inconsistencies have also been found in Asian studies. METHODS One hundred and eight primary caregivers (54 spousal and 54 adult children) of community-dwelling PWD were recruited from elderly community services sectors in Hong Kong, China through quota sampling. The demographics, AG (measured by the Marwit-Meuser Caregiver Grief Inventory-short form), subjective caregiver burden, and well-being of the participants were assessed. A Functional Assessment Staging Test was used to grade the stages of dementia of the PWD. In this study, those in stages 4 and 5 were regarded as being at an earlier stage, and those in stages 6 and 7 at a later stage of dementia. The Mann-Whitney U-test and the Chi-square test were used to compare the variables between spousal and adult children caregivers, and the Kruskal-Wallis test was used to compare the outcomes among the sub-groups (spousal caregivers caring for relatives with earlier/later stage dementia; and adult children caregivers caring for relatives with earlier/later stage dementia). A post-hoc analysis was also conducted to identify differences between the sub-groups. Pearson's correlation was performed to investigate the bivariate relationships among AG, subjective caregiver burden, and well-being. RESULTS The results showed that spousal caregivers caring for relatives in a later stage of dementia experienced the highest level of AG and subjective caregiving burden, as compared with spousal caregivers caring for relatives in an earlier stage of dementia and adult children caregivers. Well-being was significantly negatively correlated with AG and subjective caregiver burden, while AG was also significantly correlated with subjective caregiver burden. CONCLUSION This study found that spousal caregivers of relatives in a later stage of dementia have significantly higher levels of AG, warranting special attention and extra support from palliative professionals.
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Affiliation(s)
- Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Room GH526, Hung Hom, Kowloon, Hong Kong.
| | - Ken Hok Man Ho
- School of Nursing, Tung Wah College, Room KPC 16/F, 31 Wylie Road, Homantin, Kowloon, Hong Kong
| | - Tsz Fung Cheung
- School of Nursing, The Hong Kong Polytechnic University, Room A133, Hung Hom, Kowloon, Hong Kong
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Room GH523, Hung Hom, Kowloon, Hong Kong
| | - Mimi Mun Yee Tse
- School of Nursing, The Hong Kong Polytechnic University, Room FG425, Hung Hom, Kowloon, Hong Kong
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Liew TM, Yap P, Luo N, Hia SB, Koh GCH, Tai BC. Detecting pre-death grief in family caregivers of persons with dementia: measurement equivalence of the Mandarin-Chinese version of Marwit-Meuser caregiver grief inventory. BMC Geriatr 2018; 18:114. [PMID: 29751741 PMCID: PMC5948857 DOI: 10.1186/s12877-018-0804-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 05/01/2018] [Indexed: 11/16/2022] Open
Abstract
Background Pre-death grief (PDG) is a key challenge faced by caregivers of persons with dementia (PWD). Marwit-Meuser Caregiver Grief Inventory (MM-CGI) and its abbreviated MM-CGI-Short-Form (MM-CGI-SF) are among the few empirically-developed scales that detect PDG. However, they have not had a Mandarin-Chinese version even though Chinese-speaking populations have among the largest number of PWD. We produced a Mandarin-Chinese version of MM-CGI and evaluated whether it had equivalent scores and similar psychometric properties to the English version. Methods We produced the Chinese MM-CGI through the methods of forward-backward translation and cognitive debriefing. Then, we recruited family caregivers of PWD (n = 394) to complete either the Chinese (n = 103) or English (n = 291) version. The two versions were compared in their score-difference (adjusting for potential confounders using multiple linear regression), internal-consistency reliability (using Cronbach’s α) and test-retest reliability (using intraclass correlation-coefficient), known-group validity (based on the relationship with the PWD and stage of dementia) and construct validity (using Spearman’s correlation-coefficient). Results The two versions showed similar mean scores, with the adjusted score-difference of 1.2 (90% CI -5.6 to 7.9) for MM-CGI and − 0.4 (90% CI -2.9 to 2.1) for MM-CGI-SF. The 90% CI for adjusted score-difference fell within predefined equivalence-margin (±8 for MM-CGI and ± 3 for MM-CGI-SF) and indicated equivalence of the scores. The two versions also demonstrated similar characteristics in reliability and validity. Conclusions The Chinese MM-CGI opens the way for PDG assessment and intervention among Chinese-speaking caregivers. Establishing its measurement equivalence with the English version paves the way for cross-cultural research on PDG in dementia caregiving. Electronic supplementary material The online version of this article (10.1186/s12877-018-0804-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Tau Ming Liew
- Department of Geriatric Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore. .,Psychotherapy Service, Institute of Mental Health, Singapore, Singapore. .,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
| | - Philip Yap
- Department of Geriatric Medicine, Khoo Teck Puat Hospital, Singapore, Singapore.,Geriatric Education and Research Institute, Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Soo Boon Hia
- Department of Geriatric Psychiatry, Institute of Mental Health, 10 Buangkok View, Singapore, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Bee Choo Tai
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
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