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Predictors of caregiver burden in caregivers of older people with physical disabilities in a rural community. PLoS One 2022; 17:e0277177. [PMCID: PMC9635719 DOI: 10.1371/journal.pone.0277177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Caring for an aging society is a problem facing many countries including Thailand. This cross-sectional study investigated caregiver burden and related predictive factors among 69 caregivers who had older family members with physical disabilities. Burden Scale, World Health Organization Quality of Life-Bref Thai (QOL), Patient Health Questionnaire-9 (PHQ), Barthel Activity of Daily Living Index (ADL), and Lawton-Brody Instrumental Activities of Daily Living Scale (IADL) assessments were used in addition to demographic data. Thirteen caregivers (18.8%) reported no caregiver burden, 30 (43.5%) reported low-moderate burden, 21 (30.4%) reported moderate-high burden and 5 (7.2%) reported high burden. Using Fisher’s Exact Test the factors found to be significantly associated to caregiver burden were: categorical age of the caregiver (p = .000), education level of the caregiver (p = .002), relationship to the care recipient (p = .009), categorical income level of the caregiver (p = .041), QOL of the caregiver (p = .001) and ADL status of the care recipient (p = .003). Forward stepwise linear regression model revealed three factors which were PHQ score (β = .543, p < .000), ADL score (β = -.341, p = .001) and hours of care/week (β = .227, p = .017). Future studies should focus on interventions that impact depression levels, independence with activities of living and hours of care per week.
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Sezgin H, Cevheroglu S, Gök ND. Effects of care burden on the life of caregivers of the elderly: A mixed-method study model. Medicine (Baltimore) 2022; 101:e30736. [PMID: 36316833 PMCID: PMC9622675 DOI: 10.1097/md.0000000000030736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Determining the care burden of elderly caregivers in the early period allows for early intervention to protect them from the negative physical, social, and psychological effects of care. This mixed-method study aimed to determine the burden levels of caregivers of elderly individuals and evaluate their opinions on the difficulties they experienced while caregiving. This study was conducted with caregivers of 89 elderly people who were determined to need care by visiting the homes of elderly people aged 65 years and over living in Famagusta. While the KATZ index of independence in activities of daily living and the Zarit Burden Interview tool were used to collect quantitative data, face-to-face interviews were conducted with 28 selected participants to collect qualitative data. The mean age of the caregivers was 52 ± 12 years; they were mostly female spouses/children/relatives, and 29.2% had moderate-to-severe care burden perceptions. The perception of caregiver burden levels increased as the level of dependency of elderly individuals and the duration of caregiving increased. Considering that caregiving burden affects every aspect of caregivers' lives, it should be assessed regularly. To reduce care burden, it is recommended to expand home care services and short-term care facilities, use health technologies for continuous distance education and counseling in elderly care, and financially support caregivers who cannot work due to the responsibilities of providing elderly care.
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Affiliation(s)
- Handan Sezgin
- Health Sciences Faculty, Nursing Department, Eastern Mediterranean University, Famagusta, Turkey
| | - Seda Cevheroglu
- Health Sciences Faculty, Nursing Department, Eastern Mediterranean University, Famagusta, Turkey
- *Correspondence: Seda Cevheroglu, Health Sciences Faculty, Nursing Department, Eastern Mediterranean University, Via Mersin 10, Famagusta, North Cyprus 06680, Turkey (e-mail: )
| | - Nur Demet Gök
- Health Sciences Faculty, Nursing Department, Eastern Mediterranean University, Famagusta, Turkey
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Hamama-Raz Y, Nissanholtz Gannot R, Michaelis M, Beloosesky Y, Nissanholtz A. Informal caregivers' negative affect: The interplay of caregivers' resilience, aging anxiety and burden. Aging Ment Health 2022:1-7. [PMID: 36036275 DOI: 10.1080/13607863.2022.2116406] [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: 11/01/2022]
Abstract
OBJECTIVES This study focused on the negative affect of informal caregivers of older adults. In a novel investigation, the interplay of aging anxiety, caregiving burden, and resilience as a protective factor was examined, suggesting that aging anxiety and caregiving burden are mediators for the link between resilience and negative affect. METHODS In a cross-sectional design, 191 Israeli informal caregivers of older adults (65+) participated in the study. They completed questionnaires that assessed demographic and caregiving characteristics, resilience, aging anxiety, caregiving burden, and negative affect. RESULTS The findings showed a serial mediation process in which higher resilience predicted lower caregiving burden, which subsequently predicted lower aging anxiety, which subsequently predicted lower negative affect. However, the indirect path from resilience to aging anxiety and negative affect was non-significant. CONCLUSION Based on this study's findings, the aging anxiety of informal caregivers of older adults should be professionally addressed in the early stages of caregiving because it contributes to the caregiving burden and negative affect. Additionally, resilience should be enhanced by psycho-social interventions tailored to address informal caregiver challenges that often induce caregiving burden and negative affect.
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Affiliation(s)
| | - Rachel Nissanholtz Gannot
- Department of Health System Management, Ariel University, Ariel, and Myers-JDC-Brookdale Institute, Jerusalem, Israel
| | - Michal Michaelis
- Department of Acute Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Yichayaou Beloosesky
- Department of Acute Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
| | - Adaya Nissanholtz
- Department of Acute Geriatrics, Rabin Medical Center, Beilinson Hospital, Petach Tikva, Israel
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Chan MF, Al-Dhawyani AM, Al Hinai K, Al-Azri M. A cluster analysis to explore the burden of primary caregivers of children with cancer in Oman. J SPEC PEDIATR NURS 2022; 27:e12389. [PMID: 35726717 DOI: 10.1111/jspn.12389] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/28/2022] [Accepted: 06/10/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Few studies have sought to evaluate the risk burden of primary caregivers, particularly in Oman. This study aimed to explore whether different risk patterns of caregiver burden exist among the primary caregivers of Omani children with leukemia. DESIGN AND METHODS A cross-sectional study was conducted between May and November 2020. A total of 101 primary caregivers of children with leukemia were recruited from a public hospital in Oman. The Caregiver Burden Inventory (CBI) was used to assess caregiver burden. RESULTS A two-step cluster analysis indicated that the cohort was not homogeneous (silhouette value: 1.41). Caregivers in Cluster 1 (n = 42; 41.6%) were relatively older, less educated, and had a higher caregiving burden (mean CBI score: 37.7 ± 19.9). In contrast, caregivers in Cluster 2 (n = 59; 58.4%) were younger, more highly educated, and had a moderate caregiving burden (mean CBI score: 26.3 ± 13.6). As such, Clusters 1 and 2 were characterized as the "high-risk" and "moderate-risk" burden groups, respectively. PRACTICE IMPLICATIONS This study highlights the need for a policy draft to target and reduce the caregiver burden in Oman, Nursing professionals should seek to develop and implement customized care depending on the caregiver risk burden, including additional financial, psychological, and physical support. They should seek to stratify caregivers by risk burden as some groups may require additional support. However, in light of recent precautionary measures due to the current pandemic situation, such services will have to be provided online or via telephone instead of in person for the foreseeable future.
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Affiliation(s)
- Moon Fai Chan
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | | | | | - Mohammed Al-Azri
- Department of Family Medicine and Public Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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Fu W, Li J, Fang F, Zhao D, Hao W, Li S. Subjective burdens among informal caregivers of critically ill patients: a cross-sectional study in rural Shandong, China. BMC Palliat Care 2021; 20:167. [PMID: 34674691 PMCID: PMC8532289 DOI: 10.1186/s12904-021-00858-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal caregivers are the main source of care for the critically ill, especially after discharge or during the terminal stages at home. However, the concern for informal caregivers is often overshadowed by critically ill patients. The purpose of this study is to determine the influencing factors of the subjective burden of informal caregivers and to seek solutions accordingly. METHODS Between July and August 2019, a cross-sectional study was conducted in Shandong, China, focusing on family caregivers and critically ill patients. Subjective caregiver burden was measured by the Chinese version of Zarit Burden Interview (ZBI). The stress process model was used to identify conditions relevant to the caregiving burden and to assess their impact on family caregivers. RESULTS 554 samples were selected for analysis. The average scores of Zarit Caregiver Burden Interview (ZBI) scores in this study was 30.37±19.04 (n=554). ZBI scores of older, less educated, and spouse caregivers were significantly lower (4.12; 95%CI, 0.42 to 7.81; P =0.029). Objective and subjective burdens increased proportionally. Secondary role stress factors included the higher out-of-pocket (OOP) costs of critical diseases and lower household income, both of which increased caregivers' subjective burdens (1.28; 95%CI, -0.06 to 2.63; p=0.062). Formal medical aid systems played a positive role in reducing subjective caregiving burdens (-7.31; 95%CI, -13.23 to -1.40; p=0.016). CONCLUSIONS Health policies should address both the direct medical burdens and the intangible psychological burdens of critical diseases.
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Affiliation(s)
- Wenhao Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Jiajia Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| | - Feng Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Wenting Hao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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Kazemi A, Azimian J, Mafi M, Allen KA, Motalebi SA. Caregiver burden and coping strategies in caregivers of older patients with stroke. BMC Psychol 2021; 9:51. [PMID: 33794995 PMCID: PMC8017750 DOI: 10.1186/s40359-021-00556-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 03/22/2021] [Indexed: 12/14/2022] Open
Abstract
Background Coping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers. Methods A total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests.
Results The mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson’s correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032). Conclusions Caregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being. Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00556-z.
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Affiliation(s)
- Azar Kazemi
- Student Research Committee, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Jalil Azimian
- School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Maryam Mafi
- School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Kelly-Ann Allen
- Faculty of Education, Monash University, Clayton, Australia.,The Centre for Wellbeing Science, Melbourne Graduate School of Education, University of Melbourne, Parkville, Australia
| | - Seyedeh Ameneh Motalebi
- Social Determinants of Health Research Center, Research Institute for Prevention of Non-Communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran.
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Source of Social Support and Caregiving Self-Efficacy on Caregiver Burden and Patient's Quality of Life: A Path Analysis on Patients with Palliative Care Needs and Their Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155457. [PMID: 32751147 PMCID: PMC7432213 DOI: 10.3390/ijerph17155457] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 07/25/2020] [Accepted: 07/27/2020] [Indexed: 12/13/2022]
Abstract
Few studies have explored the inter-relationships of sources of social support and caregiving self-efficacy with caregiver burden and patient’s quality of life among patients with palliative care needs and their caregivers. This study tested the associations of two sources of social support (family and friends) and the mediating role of caregiving self-efficacy on caregiver burden and patient’s quality of life. A convenience sample of 225 patient–caregiver dyads recruited between September 2016 and May 2017 from three hospitals in Hong Kong was included in the current analysis. Results showed that the final model provided a satisfactory fit (SRMR = 0.070, R-RMSEA = 0.055 and R-CFI = 0.926) with the data, as good as the hypothesized model did (p = 0.326). Significant associations were detected. Family support had a significant negative indirect effect on caregiver burden and a significant positive indirect effect on patient’s quality of life through caregiving self-efficacy, whereas friend support had a significant positive direct effect on caregiver burden but a minimal effect, if any, on patient’s quality of life. These findings emphasized (1) the importance of caregiving self-efficacy in improving caregiver burden and patient’s quality of life and that (2) sources of social support may be an important dimension moderating the associations of caregiving self-efficacy with caregiver burden and patient’s quality of life.
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Abstract
BACKGROUND Caregivers are at risk of experiencing caregiver burden. It is therefore important to determine the caregiver burden of caregivers who provide care to bedridden patients and related factors. PURPOSE The aim of this study was to determine the caregiver burden of caregivers who provide care to bedridden patients and the factors that impact this burden. METHODS This cross-sectional study was executed at a state hospital in Istanbul, Turkey, on bedridden patients registered in the home healthcare unit and their caregivers. During study period, the researchers made 312 visits to patients and their caregivers. A sociodemographic questionnaire, the Burden Interview, and the Katz Index of Independence in Activities of Daily Living were used to collect data. Descriptive statistics, an independent sample t test, one-way analysis of variance, and stepwise multiple regression analysis were used for data analysis. RESULTS The participants reported a moderate level of caregiver burden. Existing caregiver health problems, caregiver employment status, the ability of the caregiver to maintain his or her own good health, type of home, and the degree of patient dependence in terms of activities of daily living were each found to be significant predictors of caregiver burden. CONCLUSIONS/IMPLICATIONS OF PRACTICE The support provided to caregivers by home healthcare units is important in terms of protecting the physical, mental, and social health conditions of caregivers and preventing the exacerbation of caregiver burden.
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Yang Z, Tian Y, Fan Y, Liu L, Luo Y, Zhou L, Yu H. The mediating roles of caregiver social support and self-efficacy on caregiver burden in Parkinson's disease. J Affect Disord 2019; 256:302-308. [PMID: 31200168 DOI: 10.1016/j.jad.2019.05.064] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/09/2019] [Accepted: 05/27/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Most studies in Parkinson's disease (PD) have focused on the direct effects of social support and self-efficacy on caregiver burden. This study aimed to test our prediction that caregiver self-efficacy and social support were two chaining mediator variables on the paths for patient factors affecting caregiver burden, caregiver anxiety, and depression. METHOD We enrolled patients with PD and their caregivers from the First Affiliated Hospital of Shanxi Medical University in China between July and December 2017. Patients completed scales evaluating their cognition, motor function, and depression. Caregivers completed scales evaluating social support, self-efficacy, anxiety, depression, and caregiver burden. We applied Partial Least Squares Structural Equation Modeling (PLS-SEM) to analyze the mediating effects. RESULTS Caregiver self-efficacy was a partial mediator on the path of patient motor function effects on caregiver burden (Variance Accounted For, VAF = 0.741), caregiver anxiety (VAF = 0.498) and caregiver depression (VAF = 0.471). Social support for caregivers was a partial mediator on the path for patient motor function effects on caregiver self-efficacy (VAF = 0.247). Caregiver social support and self-efficacy were two chaining mediator variables on the pathway for patient motor function effects on caregiver burden (VAF = 0.768) and caregiver depression (VAF = 0.510). LIMITATIONS Our sample only met the minimum sample size requirement for the PLS-SEM and we only focused on a part of variables we collected. CONCLUSIONS Our prediction has been validated in this study. And this work supports the decision-making of health authorities and policymakers in managing caregiver social support and caregiver self-efficacy with the aim of reducing caregiver burden in PD.
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Affiliation(s)
- Zongfang Yang
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yuling Tian
- Department of Neurology, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ying Fan
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Long Liu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yanhong Luo
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Liye Zhou
- Department of Mathematics, School of Basic Medical Sciences, Shanxi Medical University, Taiyuan, China
| | - Hongmei Yu
- Department of Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China.
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