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Kojima Y, Yamada S, Kamijima K, Kogushi K, Ikeda S. Burden in caregivers of patients with schizophrenia, depression, dementia, and stroke in Japan: comparative analysis of quality of life, work productivity, and qualitative caregiving burden. BMC Psychiatry 2024; 24:591. [PMID: 39223532 PMCID: PMC11370303 DOI: 10.1186/s12888-024-06000-x] [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: 04/02/2024] [Accepted: 08/02/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND The main objective of this study was to examine the burden of schizophrenia, depression, Alzheimer's disease/dementia, and stroke on caregivers and non-caregivers in Japan. This study also aimed to provide a comparative landscape on the burden of caregiving for each disorder. METHODS The Japan National Health and Wellness Survey database, 2016 and 2018 was used in this study. Health-related quality of life (HRQoL), work productivity, and health care utilization were assessed using a self-administered, Internet-based questionnaire. The burden of caregiving experienced by each group of caregivers was compared with background-matched non-caregivers (controls) as well as with caregivers of patients with each disorder. RESULTS Caregivers of patients with schizophrenia, depression, Alzheimer's disease/dementia, or stroke had lower HRQoL, higher healthcare costs and work productivity impairment than non-caregivers. Furthermore, caregivers of patients with psychiatric disorders such as schizophrenia and depression had lower HRQoL and work productivity than caregivers of patients with Alzheimer's disease/dementia and stroke. In addition, according to the Caregiver Reaction Assessment (CRA), caregivers of patients with schizophrenia and depression were more inclined to perceive a loss in physical strength and financial burden to the same extent as their self-esteem. CONCLUSIONS This study indicated a substantial caregiving burden among caregivers of patients with psychiatric and neurological diseases in Japan. The caregiver burden of psychiatric disorders (schizophrenia and depression) was greater than that of neurological disorders (Alzheimer's disease/dementia and stroke), suggesting a need to provide support to caregivers of patients with psychiatric disorders to be better able to care for their patients. TRIAL REGISTRATION None.
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Affiliation(s)
- Yoshitsugu Kojima
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd. Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan.
| | - Sakiko Yamada
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd. Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan.
| | | | - Kentaro Kogushi
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd. Shinagawa Grand Central Tower, 2-16-4 Konan, Minato-ku, Tokyo, 108-8242, Japan
| | - Shunya Ikeda
- Department of Public Health, School of Medicine, International University of Health and Welfare, Narita, Japan
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Krupic F, Manojlovic S, Custovic S, Fazlic M, Sadic S, Kärrholm J. Influence of immigrant background on the outcome of total hip arthroplasty: better outcome in 280 native patients in Bosnia and Herzegovina than in 449 immigrants living in Sweden. Hip Int 2024; 34:74-81. [PMID: 37795618 PMCID: PMC10787385 DOI: 10.1177/11207000231182321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/06/2023]
Abstract
BACKGROUND Despite the overall success of THA, between 5 and 20% report unsatisfactory results. Several factors may cause this variable outcome. 1 of them might be ethnicity which, because of its potential social impact on living conditions, may influence quality of life too. It should be studied whether patients born and being operated in their home country Bosnia and Herzegovina (BH) had similar results as immigrants being operated in Sweden (IS). METHODS Data of 280 patients were collected prospectively from questionnaires in the BH group. Patients of the IS group were eligible if both of their parents were born outside the Nordic countries, not having Swedish as their native language. Data were gained from the Swedish Arthroplasty Registry (SAR), 449 patients were included. Outcomes were pain VAS, satisfaction VAS, EQ-VAS, and the EQ-5D. Logistic and linear regression models including age, sex, diagnosis, type of fixation, surgical incision, marital status and educational level were analysed to compare those 2 groups. RESULTS There were considerable differences in patient demographics between the 2 groups. Before the operation, patients in the BH group reported more problems with self-care and usual activities, even after adjustment for confounding factors (p < 0.0005). Patients in the IS group reported a higher EQ-VAS and more pain VAS (p < 0.0005), the difference in the EQ-VAS was not significant after adjustment for confounding factors (p = 0.41). After 1 year patients in the BH group reported better scores in all dimensions of the EQ-5D (p ⩽ 0.005) apart from self-care. After adjustment for confounding factors, patients in the BH group were more satisfied too (p < 0.0005). CONCLUSIONS Immigrated patients (IS group) seemed to experience less benefit from THA 1 year after the operation despite more symptoms preoperatively. There were considerable limitations affecting the results. Nevertheless, the data are a point of concern, and it is suggested to take more multidimensional care of immigrant patients.
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Affiliation(s)
- Ferid Krupic
- Department of Anaesthesiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Swedish Joint Arthroplasty Register, Gothenburg, Sweden
| | - Slavko Manojlovic
- School of Medicine, University of Banjaluka, Banja Luka, Bosnia and Herzegovina
| | - Svemir Custovic
- Clinic for Orthopaedics and Traumatology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Mirsad Fazlic
- Clinic for Orthopaedics and Traumatology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Sahmir Sadic
- Clinic for Orthopaedics and Traumatology, University Clinical Centre Tuzla, Tuzla, Bosnia and Herzegovina
| | - Johan Kärrholm
- Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Swedish Joint Arthroplasty Register, Gothenburg, Sweden
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Soikkeli‐Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E. Healthcare professionals' perceptions of psychosocial support for family members in palliative care inpatient units—A qualitative descriptive study. Nurs Open 2022; 10:3018-3027. [PMID: 36539588 PMCID: PMC10077415 DOI: 10.1002/nop2.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/18/2022] [Accepted: 11/25/2022] [Indexed: 12/24/2022] Open
Abstract
AIM This study aimed to describe the psychosocial support healthcare professionals in specialist palliative inpatient units provide to family members of palliative care patients. DESIGN A qualitative descriptive design. METHOD The data were collected with focus group interviews and analysed with inductive content analysis. RESULTS Altogether, 48 healthcare professionals, including physicians, registered nurses and practical nurses, participated in the study. Information sharing was recognised as an essential element of support. Methods to improve support of family members included an opportunity to allocate recourses to the families, systematic support and strengthening healthcare professionals' competence in family care. The healthcare professionals describe their perceptions of psychosocial support for family members primarily through patient care and the patient's situation rather than family needs. Direct support for the family members is realised principally by information sharing and conversations. Healthcare professionals express their opportunities to implement support focusing on family members' needs restricted by reason of organisational resources. The information can be used when developing and improving family care in palliative care context to recognise the most relevant needs from healthcare professionals' perspective and also when implementing healthcare professionals' education and training.
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Affiliation(s)
- Anu Soikkeli‐Jalonen
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
| | - Kaisa Mishina
- Department of Nursing Science University of Turku Turku Finland
- Department of Child Psychiatry University of Turku Turku Finland
- INVEST Research Flagship Centre University of Turku Turku Finland
| | - Heli Virtanen
- Department of Nursing Science University of Turku Turku Finland
| | - Andreas Charalambous
- Department of Nursing Science University of Turku Turku Finland
- Cyprus University of Technology Limassol Cyprus
| | - Elina Haavisto
- Department of Health Sciences, Faculty of Social Sciences Tampere University Tampere Finland
- Satakunta Central Hospital Pori Finland
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Anu SJ, Kaisa M, Heli V, Andreas C, Elina H. Family members’ experiences of psychosocial support in palliative care inpatient units: A descriptive qualitative study. Eur J Oncol Nurs 2022; 61:102201. [DOI: 10.1016/j.ejon.2022.102201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/08/2022] [Accepted: 09/18/2022] [Indexed: 11/26/2022]
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Bremmers LGM, Fabbricotti IN, Gräler ES, Uyl-de Groot CA, Hakkaart-van Roijen L. Assessing the impact of caregiving on informal caregivers of adults with a mental disorder in OECD countries: A systematic literature review of concepts and their respective questionnaires. PLoS One 2022; 17:e0270278. [PMID: 35802584 PMCID: PMC9269485 DOI: 10.1371/journal.pone.0270278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 06/07/2022] [Indexed: 11/19/2022] Open
Abstract
We conducted a systematic literature review to identify and review the concepts and questionnaires used to assess the impact of caregiving on caregivers for adults with a mental disorder. With our study, we aimed to provide an overview and categorize the conceptualization and operationalization of the impact of caregiving, with special attention for the complexity and multi-conceptualization of concepts. Embase, Medline, PsycInfo, Web of Science Core Collection, Cochrane Central Register of Trials, Cinahl Plus, Econlit and Google Scholar were systematically searched for articles from 1 January 2004 to 31 December 2019. Eligible articles were peer-reviewed studies that assessed the impact of caregiving for informal caregivers of adults with a reported mental disorder by means of a questionnaire. The complete study protocol can be found on PROSPERO (CRD42020157300). A total of 144 questionnaires were identified that assessed the impact of caregiving. Based on similarities in meaning, concepts were classified into 15 concept clusters. The most frequently assessed concept clusters were mental health, caregiving burden, other caregiving consequences, family impact, and overall health-related outcomes. The use of concept clusters differed per diagnosis group, with diagnoses, such as schizophrenia, using a wide range of caregiving impact concepts and other diagnoses, such as personality disorders, only using a limited range of concepts. This is the first study that identified and reviewed the concepts and questionnaires that are used to assess the impact of caregiving. Caregiving is researched from a broad array of perspectives, with the identification of a variety of concepts and dimensions and use of non-specific questionnaires. Despite increasing interest in this field of research, a high degree of variability remains abundant with limited consensus. This can partially be accredited to differences in the naming of concepts. Ultimately, this review can serve as a reference to researchers who wish to assess the impact of caregiving and require further insight into concepts and their respective questionnaires.
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Affiliation(s)
- Leonarda G. M. Bremmers
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Isabelle N. Fabbricotti
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Eleonora S. Gräler
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Carin A. Uyl-de Groot
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Leona Hakkaart-van Roijen
- Erasmus School of Health Policy & Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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The Impact of COVID-19 on the Health and Experience of the Carers of Older Family Members Living with Dementia: An Italian-Hungarian Comparative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095329. [PMID: 35564723 PMCID: PMC9104228 DOI: 10.3390/ijerph19095329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 04/22/2022] [Accepted: 04/22/2022] [Indexed: 02/04/2023]
Abstract
This quantitative study (n = 370) compares the pandemic-related experiences of the family carers of older people living with dementia during the first wave of the pandemic, in two countries with different care regimes: Italy (Mediterranean) and Hungary (Eastern European). It aims at answering the following research questions: (1) How did the pandemic affect the subjective health of carers, and what were their experiences with care-related worries and workload? (2) What factors significantly predicted negative changes in these experiences? (3) What were carers' main difficulties during the first pandemic wave? Results have shown that carers in both samples reported a worsening in mental health (Italy/Hungary: M = 2.25/2.55, SD = 0.93/0.99), and Italian carers also in general health (M = 2.54, SD = 0.98) (on a scale of 1 to 5, with values under "3" representing deterioration). Carers in both samples experienced high worry levels (Italy/Hungary: M = 4.2/3.7, SD = 0.93/0.89) and feeling overwhelmed with care tasks (M = 3.2/3.7, SD = 1.3/1.3) (on a scale of 1 to 5, higher values representing higher worry/work overload). In regression models, all of the above negative experiences were predicted by a combination of factors. Two of these factors stood out in importance due to being a predictor of more than one type of negative experience: a decline in the carer-care receiver relationship, predicting work overload, as well as general and mental health deterioration and being the child of the care receiver, predicting both high worry and subjective work overload. The top five encountered problems were the unavailability of medical and social care, difficulties with shopping (medicine included), restricted freedom, isolation, and anxiety.
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Hansen NH, Bjerrekær L, Pallesen KJ, Juul L, Fjorback LO. The effect of mental health interventions on psychological distress for informal caregivers of people with mental illness: A systematic review and meta-analysis. Front Psychiatry 2022; 13:949066. [PMID: 36276315 PMCID: PMC9583525 DOI: 10.3389/fpsyt.2022.949066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 08/25/2022] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION Informal caregivers of people with a mental illness are at increased risk of developing depression, anxiety, and stress, so preventive interventions are needed. METHOD The review was reported in PROSPERO (ID: CRD42018094454). The PsycINFO, PubMed, and Scopus databases were searched in June 2019. The Cochrane Risk of Bias and Jadad scale scores were used to assess study quality. Inclusion criteria were: RCTs of informal caregiver interventions regardless of the care receiver's mental illness and intervention modality. Interventions should be compared to a waitlist, treatment as usual or active control, taught in real-time by a mental health professional, include an outcome measure on psychological distress, and published in a peer-reviewed journal article in English. RCTs were excluded if the intervention was given in dyads (caregiver + care receiver), limited to the provision of respite care where the patient sample included a mix of both physical and psychological illnesses, unpublished, not peer-reviewed, study protocols, or dissertations. RESULTS A total of 2,148 studies were identified; of these, 44 RCT studies met the inclusion criteria, and 31 had sufficient data to conduct a meta-analysis including subgroup analysis (N = 1,899). The systematic review showed that thirty-one out of the 44 RCTs had an effect of the intervention on decreasing psychological distress. The results of the meta-analysis, which included informal caregiver interventions, compared to waitlist, treatment as usual, or active control, regardless of care-receiver mental illness or intervention modality showed a small effect of -0.32 (95% CI -0.53 to -0.11). The heterogeneity of the included studies was high (I 2 = 78). The subgroup analysis included manualized interventions lasting at least 8 weeks and the subgroup analysis that included an active control showed a small effect and low heterogeneity. Lack of active control and long-term follow-up is a limitation of most of the studies. CONCLUSION The evidence supports that several interventions improve the mental health of caregivers. Manualized interventions ≥ 8 weeks with active participation are most effective. Future RCTs should improve methodology, and research should investigate which intervention modality is most effective for what kind of caregiver. Future research should clearly specify what the included intervention components are, use longer follow-up times, and conduct mediational analyses to better understand what mechanisms create the effect of an intervention. SYSTEMATIC REVIEW REGISTRATION Identifier: CRD42018094454.
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Affiliation(s)
- Nanja Holland Hansen
- Department of Clinical Medicine, Danish Center for Mindfulness, University of Aarhus, Aarhus, Denmark
| | - Lasse Bjerrekær
- Department of Clinical Medicine, Danish Center for Mindfulness, University of Aarhus, Aarhus, Denmark
| | - Karen Johanne Pallesen
- Department of Clinical Medicine, Danish Center for Mindfulness, University of Aarhus, Aarhus, Denmark
| | - Lise Juul
- Department of Clinical Medicine, Danish Center for Mindfulness, University of Aarhus, Aarhus, Denmark
| | - Lone Overby Fjorback
- Department of Clinical Medicine, Danish Center for Mindfulness, University of Aarhus, Aarhus, Denmark
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Spatuzzi R, Vespa A, Fabbietti P, Ricciuti M, Rosati G, Guariniello L, Verrastro MAF, Attademo L, Giulietti MV. Elderly Helping Other Elderly: A Comparative Study of Family Caregiver Burden Between Patients With Dementia or Cancer at the End of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2022; 18:96-108. [PMID: 35245165 DOI: 10.1080/15524256.2022.2042459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A new reality is being observed around the world as the population ages: family caregivers, who are themselves older adults helping their ill older relatives. The aim of this study is to assess the burden of the older family caregiver assisting older patients in his or her end-of-life who are suffering from dementia or cancer. In this context, the elderly person is involved in the dual role of patient and caregiver. In this comparative study, a total of 87 older family caregivers (age ≥ 65 years) completed the Caregiver Burden Inventory (CBI) measurement. The sample was divided into 2 subgroups based on the individuals' advanced disease: Alzheimer's disease (AD) or cancer. Compared to cancer caregivers, the AD subgroup reported significantly higher scores in the CBI-emotional subscale (P = 0.006), confirmed by the evaluation of the generalized linear model (multivariate). There were no significant differences in the other CBI subscales and overall scores. According to the findings of this study, elderly who help elderly with AD are at a higher risk of experiencing an emotional burden than cancer caregivers. This data could be considered in designing interventions to reduce the caregiver burden of older family caregivers as they provide informal end-of-life care.
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Affiliation(s)
- Roberta Spatuzzi
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | - Anna Vespa
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | - Paolo Fabbietti
- Biostatistical Center, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | | | - Gerardo Rosati
- Medical Oncology Unit, "San Carlo" Hospital, Potenza, Italy
| | - Lorella Guariniello
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | | | - Luigi Attademo
- Department of Mental Health, Hospital Psychiatric Service of Diagnosis and Care at "San Carlo" Hospital, ASP Basilicata, Italian NHS, Italy
| | - Maria Velia Giulietti
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
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Secinti E, Lewson AB, Wu W, Kent EE, Mosher CE. Health-Related Quality of Life: A Comparative Analysis of Caregivers of People With Dementia, Cancer, COPD/Emphysema, and Diabetes and Noncaregivers, 2015-2018 BRFSS. Ann Behav Med 2021; 55:1130-1143. [PMID: 33761526 DOI: 10.1093/abm/kaab007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Many informal caregivers experience significant caregiving burden and report worsening health-related quality of life (HRQoL). Caregiver HRQoL may vary by disease context, but this has rarely been studied. PURPOSE Informed by the Model of Carer Stress and Burden, we compared HRQoL outcomes of prevalent groups of caregivers of people with chronic illness (i.e., dementia, cancer, chronic obstructive pulmonary disease [COPD]/emphysema, and diabetes) and noncaregivers and examined whether caregiving intensity (e.g., duration and hours) was associated with caregiver HRQoL. METHODS Using 2015-2018 Behavioral Risk Factor Surveillance System data, we identified caregivers of people with dementia (n = 4,513), cancer (n = 3,701), COPD/emphysema (n = 1,718), and diabetes (n = 2,504) and noncaregivers (n = 176,749). Regression analyses were used to compare groups. RESULTS Caregiver groups showed small, nonsignificant differences in HRQoL outcomes. Consistent with theory, all caregiver groups reported more mentally unhealthy days than noncaregivers (RRs = 1.29-1.61, ps < .001). Caregivers of people with cancer and COPD/emphysema reported more physically unhealthy days than noncaregivers (RRs = 1.17-1.24, ps < .01), and caregivers of people with diabetes reported a similar pattern (RR = 1.24, p = .01). However, general health and days of interference of poor health did not differ between caregivers and noncaregivers. Across caregiver groups, most caregiving intensity variables were unrelated to HRQoL outcomes; only greater caregiving hours were associated with more mentally unhealthy days (RR = 1.13, p < .001). CONCLUSIONS Results suggest that HRQoL decrements associated with caregiving do not vary substantially across chronic illness contexts and are largely unrelated to the perceived intensity of the caregiving. Findings support the development and implementation of strategies to optimize caregiver health across illness contexts.
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Affiliation(s)
- Ekin Secinti
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Ashley B Lewson
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
| | - Erin E Kent
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Catherine E Mosher
- Department of Psychology, Indiana University-Purdue University Indianapolis, North Blackford Street, LD, Indianapolis, IN, USA
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Majellano EC, Clark VL, Foster JM, Gibson PG, McDonald VM. "It's like being on a roller coaster": the burden of caring for people with severe asthma. ERJ Open Res 2021; 7:00812-2020. [PMID: 33855063 PMCID: PMC8039902 DOI: 10.1183/23120541.00812-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/12/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Family carers and significant others play a fundamental role in the well-being of people with severe asthma. This study aimed to investigate the challenges faced by family carers/significant others of people with severe asthma, to understand if there is an unmet need and to explore coping strategies. Methods Carers of people with severe asthma were invited to participate in a face-to-face or telephone interview. Semi-structured interviews were conducted until reaching data saturation of themes. The 20 interviews were recorded and transcribed, and analysis of data followed an inductive thematic approach. Results We report three overarching emergent themes: 1) “Caring role impacts”, which centred around the negative and positive impacts of caring on carers' well-being; 2) “Unmet needs”, which encapsulated the support needs participants desired and were categorised into unmet information, biopsychosocial needs and carers' involvement in decision-making; and 3) “Coping strategies”, which were central to the range of tools and positive approaches in dealing with caring demands. Discussion Caring for someone with severe asthma can be burdensome and may negatively affect the physical and psychosocial health of the carer. Various coping strategies are used to manage the demands of these caring roles. Carers of people with severe asthma expressed a need for informational, biopsychosocial and involvement in care decision-making support. Tailored support services that are sensitive to their needs may improve their quality of life and encourage healthcare providers to value and acknowledge the important contribution that carers make. Caring for someone with severe asthma can be burdensome, affecting the physical and psychosocial health of the supportive person negatively. Tailored support services may improve their quality of life.https://bit.ly/2KA9PWS
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Affiliation(s)
- Eleanor C Majellano
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia
| | - Vanessa L Clark
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia
| | - Juliet M Foster
- Woolcock Institute of Medical Research and The University of Sydney, Sydney, NSW, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, NSW, Australia
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Soikkeli-Jalonen A, Mishina K, Virtanen H, Charalambous A, Haavisto E. Supportive interventions for family members of very seriously ill patients in inpatient care: A systematic review. J Clin Nurs 2021; 30:2179-2201. [PMID: 33616267 DOI: 10.1111/jocn.15725] [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: 07/27/2020] [Revised: 12/19/2020] [Accepted: 02/18/2021] [Indexed: 01/10/2023]
Abstract
AIMS AND OBJECTIVES To systematically review existing literature exploring supportive interventions for family members of very seriously ill patients in inpatient care. BACKGROUND Being around a patient with a very serious illness in inpatient care setting is stressful and burdensome for family members. There is little information available on interventions that support family members of very seriously ill patients in inpatient care. DESIGN A systematic review. METHODS The literature review was conducted in May 2020 using four databases: PubMed (Medline), CINAHL, PsycINFO and Cochrane. A quality assessment was performed using the Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group by the National Heart, Lung, and Blood Institute. The PRISMA checklist was used to support specific reporting and the TIDieR checklist to form detailed descriptions of the interventions. RESULTS Of the 7165 identified studies, 11 studies were included in the review based on predetermined criteria. Interventions were based on meetings with family members, education or therapy. Mindfulness- and therapy-based interventions and multiple-session tailored interventions showed beneficial outcomes for psychological symptoms and educational interventions on preparedness and self-efficacy. Several different measuring instruments to evaluate similar outcomes, such as psychological symptoms and coping, were used. CONCLUSIONS Only a few supportive interventions for family members of very seriously ill patients in inpatient care were found, which made comparing the differences in the varying study methods and outcomes difficult. More studies on supportive interventions and their feasibility and effectiveness are essential. Further evaluation of instruments is necessary to identify the most valid and reliable ways of measuring symptoms and coping. RELEVANCE TO CLINICAL PRACTICE The results of this study can be used in clinical practice when selecting effective interventions or assessing family members' need for support. Additionally, the results can be used for guidance when developing new, effective interventions.
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Affiliation(s)
| | - Kaisa Mishina
- Department of Nursing Science, University of Turku, Turku, Finland.,Department of Child Psychiatry, University of Turku, Turku, Finland
| | - Heli Virtanen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Andreas Charalambous
- Cyprus University of Technology, Limassol, Cyprus.,Department of Nursing Science, University of Turku, Turku, Finland
| | - Elina Haavisto
- Department of Nursing Science, University of Turku, Turku, Finland.,Satakunta Central Hospital, Pori, Finland
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Yoshino M, Tsukamoto K. Burden of caring for Alzheimer's disease or dementia patients in Japan, the US, and EU: results from the National Health and Wellness Survey: a cross-sectional survey. J Med Econ 2021; 24:266-278. [PMID: 33538195 DOI: 10.1080/13696998.2021.1880801] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS The growing prevalence of Alzheimer's disease (AD) worldwide has sparked the implementation of national policies to support the growing burden among caregivers of AD/dementia patients. This study aims to quantify and compare the burden of AD/dementia caregivers and evaluate how different living arrangements might impact health outcomes among caregivers in Japan, five European countries (5EU), and the United States (US). MATERIALS AND METHODS This is a cross-sectional study based on existing data from the 2018 National Health and Wellness Survey. Health outcome measures included health-related quality of life (HRQoL), health state utilities, work productivity and activity impairment (WPAI), and measurement of depression and anxiety amongst AD/dementia caregivers and non-caregivers. Pairwise comparisons between AD/dementia caregivers in Japan, 5EU, and the US were conducted. Multivariate analysis was used to compare across groups within each region, with adjustment for potential confounding effects. RESULTS A higher proportion of caregivers of AD/dementia patients in Japan were 65 years or older as compared to 5EU and US. On the contrary, female caregivers were significantly higher in the US than Japan and 5EU. The HRQoL and health state utilities index scores amongst AD/dementia caregivers were highest in Japan and lowest in the US. Caregivers in Japan incurred the lowest WPAI among the three regions. The proportion of AD/dementia patients reportedly living in an institution was highest in Japan as compared to the US and EU. Notably, US caregivers whose patients lived in an institution experienced significantly less caregiving burden as compared to caregivers whose patients lived in the community. CONCLUSIONS The caregiving burden among AD/dementia caregivers was substantial across the three regions, with similarities and differences between the West and Japan. The lower caregiving burden in Japan was potentially associated with national policies supporting long-term healthcare and institutionalized nursing care facilities for AD/dementia patients.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | - Yirong Chen
- Health Division, Kantar Health Inc., Singapore, Singapore
| | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | | | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Yoshino M, Tsukamoto K. Humanistic burden among caregivers of patients with Alzheimer's disease or dementia in Japan: a large-scale cross-sectional survey. J Med Econ 2021; 24:181-192. [PMID: 33467967 DOI: 10.1080/13696998.2021.1877149] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS As the population in Japan is rapidly aging, the prevalence of dementia, particularly Alzheimer's Disease (AD), is expected to increase, resulting in a growing need for caregivers. This study aims to quantify and compare the humanistic burden of caregivers of AD/dementia patients with caregivers of patients with other conditions in Japan. MATERIALS AND METHODS This cross-sectional study used data from the 2018 Japan National Health and Wellness Survey (NHWS). Outcome measures included the Short-Form 12-item Health Survey (SF-12) for health-related quality-of-life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, impact of health on productivity and activity, and evaluation of depression and anxiety. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects. RESULTS A total of 805 caregivers of AD/dementia patients, 1,099 other caregivers, and 27,137 non-caregivers were identified. Both AD/dementia caregivers and other caregivers had lower HRQoL and EQ-5D scores, higher total activity impairment, and more caregivers tended to experience anxiety than non-caregivers. There were no significant differences in the involvment in basic and instrumental activities of daily living (ADL) between AD/dementia caregivers and caregivers of other conditions. Notably, AD/dementia caregivers were more involved in making treatment decisions and finance management than other caregivers. Among AD/dementia caregivers caring for one patient, 395 patients lived in the community and 282 in an institution. AD/dementia caregivers whose patients lived in the community were more significantly involved in basic and instrumental ADL. Caregivers of patients with both AD/dementia and cancer had higher caregiving burden than caregivers of patients with either condition. CONCLUSIONS Caregivers of AD/dementia patients in Japan reportedly experienced significant humanistic burden which is associated with patients' living arrangements and the presence of an additional chronic condition. Therefore, provision of effective care/support is essential to relieve the burden experienced by the caregivers.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | | | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Yu CH, Cheng YA, Chen RY, Wu YL, Lin MH. Survival Analysis of Antineoplastic Treatment for Older Patients with Metastatic Non-Small-Cell Lung Cancer: A Clinical Database Study. Cancer Manag Res 2020; 12:12957-12964. [PMID: 33376393 PMCID: PMC7755879 DOI: 10.2147/cmar.s282481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/25/2020] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To explore whether antineoplastic treatment can improve overall survival (OS) in older patients with metastatic non-small-cell lung cancer (mNSCLC). PATIENTS AND METHODS Using the cancer registry database of a tertiary medical center in Taiwan, we followed patients 65 years old and above with pathologically proved mNSCLC. Chi-square test and Cox regression were used to analyze differences in clinical characteristics, the treatments they received, and factors predicting survival. Kaplan-Meier survival analysis was used to analyze OS differences. RESULTS A total of 542 older patients were diagnosed with mNSCLC from 2011 to 2017. Multivariate Cox regression showed that patients receiving targeted therapy (TT) alone, chemotherapy (CT) alone, and crossover (CO) treatment were at significantly less risk of short OS [hazard ratio (HR) 0.351, 95% confidence interval (CI), 0.257-0.479; HR 0.517, CI 0.376-0.711; and HR 0.544, CI 0.373-0.792, respectively]. Patients at significantly increased risk of short OS were those aged ≥85 years and those assigned poorer Eastern Cooperative Oncology Group Performance Status (ECOG-PS) scores (HR 1.513, CI 1.135-2.017, and HR 2.854, CI 2.188-3.724, respectively). The result of Kaplan-Meier survival analysis of 418 patients with ECOG-PS scores 0-2 suggested that patients who received antineoplastic treatments had a significantly better median OS than those receiving supportive care (SC), those receiving TT having the best result (SC, 4.00 months; TT, 21.17 months; CT, 12.83 months; CO, 15.83 months, P<0.001). CONCLUSION Antineoplastic treatments, especially TT, can improve OS for selected older patients with mNSCLC.
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Affiliation(s)
- Chin-Hsiu Yu
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan
| | - Ya-Ai Cheng
- Department of Healthcare Administration, I-Shou University, Kaohsiung, Taiwan
| | - Ru-Yih Chen
- Department of Family Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Yu-Lung Wu
- Department of Information Management, I-Shou University, Kaohsiung, Taiwan
| | - Min-Hsi Lin
- Division of Chest Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
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Choratas A, Papastavrou E, Charalambous A, Kouta C. Developing and Assessing the Effectiveness of a Nurse-Led Home-Based Educational Programme for Managing Breathlessness in Lung Cancer Patients. A Feasibility Study. Front Oncol 2020; 10:1366. [PMID: 32983967 PMCID: PMC7492635 DOI: 10.3389/fonc.2020.01366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 06/29/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction: Breathlessness is the most common and refractory symptom in lung cancer patients. Even though various educational programmes have been developed, only a few were intended for implementation in the home setting for its management. Aim: Feasibility of a study for implementing a nurse-led educational programme for breathlessness management of lung cancer patients at home. Method: A randomized feasibility study was undertaken between February 2017 and October 2018. Patients were recruited through referral from oncologists from two oncology centers in Cyprus under certain inclusion and exclusion criteria. Patients were randomized in the intervention or control group via a computer programme, and their named family caregivers (f.c.) were allocated in the same group. Participants were not blinded to group assignment. The intervention consisted of a PowerPoint presentation and implementation of three non-pharmacological interventions. The control group received usual care. Patients were assessed for breathlessness, anxiety, and depression levels, whereas f.c. were assessed for anxiety, depression, and burden levels. F.c. also assessed patients' dyspnea level. The duration of the study process for both the intervention and control group was over a period of 4 weeks. Results: Twenty-four patients and their f.c. (n = 24) were allocated equally in the intervention and control group. Five patients withdrew, and the final sample entered analysis was 19 patients and 19 family caregivers. In the intervention group n = 11 + 11, and in the control group n = 8 + 8. In the intervention group patients' breathlessness and anxiety levels showed improvement and their f.c.s in the anxiety and burden levels. Major consideration was the sample size and the recruitment of the patients by the referring oncologists. Attrition was minor during the study process. No harm was recorded by the participants of the study. Conclusions: The study provided evidence of the feasibility of the implementation of the educational programme. For the future definitive study major consideration should be patients' recruitment method in order to achieve adequate sample size. Moreover, qualitative data should be collected in relation to the intervention and the involvement of f.c. The feasibility study was registered to the Cyprus Bioethics Committee with the registration number 2016/16. There was no funding of the study.
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Affiliation(s)
- Aristides Choratas
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
- *Correspondence: Aristides Choratas
| | | | - Andreas Charalambous
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
- Nursing Department, University of Turku, Turku, Finland
| | - Christiana Kouta
- Nursing Department, Cyprus University of Technology, Limassol, Cyprus
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16
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Papa R, Efthymiou A, Lamura G, Piccinini F, Onorati G, Papastavrou E, Tsitsi T, Casu G, Boccaletti L, Manattini A, Seneca R, Vaz de Carvalho C, Durão R, Barbabella F, Andréasson F, Magnusson L, Hanson E. Review and Selection of Online Resources for Carers of Frail Adults or Older People in Five European Countries: Mixed-Methods Study. JMIR Mhealth Uhealth 2020; 8:e14618. [PMID: 32554378 PMCID: PMC7330736 DOI: 10.2196/14618] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 12/02/2019] [Accepted: 03/30/2020] [Indexed: 02/02/2023] Open
Abstract
Background Informal carers have a crucial role in the care of older people, but they are at risk of social isolation and psychological exhaustion. Web-based services like apps and websites are increasingly used to support informal carers in addressing some of their needs and tasks, such as health monitoring of their loved ones, information and communication, and stress management. Despite the growing number of available solutions, the lack of knowledge or skills of carers about the solutions often prevent their usage. Objective This study aimed to review and select apps and websites offering functionalities useful for informal carers of frail adults or older people in 5 European countries (Cyprus, Greece, Italy, Portugal, and Sweden). Methods A systematic online search was conducted from January 2017 to mid-March 2017 using selected keywords, followed by an assessment based on a set of commonly agreed criteria and standardized tools. Selected resources were rated and classified in terms of scope. Focus groups with informal carers were conducted to validate the list and the classification of resources. The activities were conducted in parallel in the participating countries using common protocols and guidelines, a standardization process, and scheduled group discussions. Results From a total of 406 eligible resources retrieved, 138 apps and 86 websites met the inclusion criteria. Half of the selected resources (109/224, 48.7%) were disease-specific, and the remaining resources included information and utilities on a variety of themes. Only 38 resources (38/224, 17.0%) were devoted specifically to carers, addressing the management of health disturbances and diseases of the care recipient and focusing primarily on neurodegenerative diseases. Focus groups with the carers showed that almost all participants had no previous knowledge of any resource specifically targeting carers, even if interest was expressed towards carer-focused resources. The main barriers for using the resources were low digital skills of the carers and reliability of health-related apps and websites. Results of the focus groups led to a new taxonomy of the resources, comprising 4 categories: carer’s wellbeing, managing health and diseases of the care recipient, useful contacts, and technologies for eldercare. Conclusions The review process allowed the identification of online resources of good quality. However, these resources are still scarce due to a lack of reliability and usability that prevent users from properly benefiting from most of the resources. The involvement of end users provided added value to the resource classification and highlighted the gap between the potential benefits from using information and communication technologies and the real use of online resources by carers.
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Affiliation(s)
- Roberta Papa
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Areti Efthymiou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Flavia Piccinini
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Giulia Onorati
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy
| | - Evridiki Papastavrou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Theologia Tsitsi
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Giulia Casu
- Department of Psychology, University of Bologna, Bologna, Italy.,Anziani e Non Solo - social cooperative, Carpi, Italy
| | | | | | - Rita Seneca
- Anziani e Non Solo - social cooperative, Carpi, Italy
| | | | | | - Francesco Barbabella
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA, Ancona, Italy.,Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Frida Andréasson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden
| | - Lennart Magnusson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.,Swedish Family Care Competence Centre, Kalmar, Sweden
| | - Elizabeth Hanson
- Department of Health and Caring Sciences, Linnaeus University, Kalmar, Sweden.,Swedish Family Care Competence Centre, Kalmar, Sweden
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17
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Bachner YG, Morad M, Sroussi C, O'Rourke N. Direct and indirect predictors of burden among Bedouin caregivers of family members with terminal cancer in Israel. Aging Ment Health 2020; 24:575-581. [PMID: 30744391 DOI: 10.1080/13607863.2019.1570080] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: The diverse demands of cancer care, which require time, psychological, physical, and material resources, often lead to caregiver burden. Studies with caregivers from ethnic minority groups suggest that they have unique beliefs and may experience different perceptions of role demands and caregiving. The aim of this study was to identify direct and indirect predictors of burden among Bedouin caregivers of family members with terminal cancer in Israel.Methods: A total of 101 Bedouin family caregivers of terminal cancer patients participated in this study. Participants were recruited from the oncology department of the largest medical center in southern Israel. The questionnaire battery included the Arabic version of the Zarit Burden Interview and other reliable measures validated for cancer caregiving. We performed path analyses on data allowing us to identify hypothesized, and un-hypothesized predictors of burden in this understudied population.Results: Most caregivers were adult children, followed by spouses, siblings and other family members. In our model, caregiver burden was directly predicted by depressive symptoms and (absence of) social support. Burden was indirectly predicted by quality of life (via depressive symptoms), optimism (via social support), emotional exhaustion (via quality of life and depressive symptoms) and mortality communication (via emotional exhaustion, quality of life and depressive symptoms).Conclusion: Social support and depression are the most important factors among all studied measures. Culturally-tailored intervention programs are required to foster community care and mitigate burden for Bedouin and other ethnic minority groups in Israel.
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Affiliation(s)
- Y G Bachner
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - M Morad
- Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - C Sroussi
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - N O'Rourke
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.,The Center for Multidisciplinary Research in Aging, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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18
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Davis NJ, Clark PC, Johnson TM, Wyman JF. Feasibility of Tele-Prompt: A tablet-based prompted voiding intervention to support informal caregivers of older adults with urinary incontinence. Geriatr Nurs 2020; 41:411-420. [PMID: 31987698 DOI: 10.1016/j.gerinurse.2020.01.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/01/2020] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
Urinary incontinence (UI) is a highly prevalent condition, burdening older adults and their informal caregivers. This study explored the development and feasibility of a 6-week evidence-based, educational/skill building program delivered via tablet-personal computer aimed at developing informal caregiver UI knowledge; and enhancing informal caregiver skill set in prompted voiding and toileting strategies. Caregivers also received individualized weekly coaching sessions from a nurse expert. Feasibility and preliminary efficacy were tested in three caregiver/care-recipient dyads. Recruitment of eligible participants through community-based resources was a challenge to feasibility. Most caregivers found the technology acceptable, but adherence to prompted voiding was inconsistent. All caregivers rated the intervention highly, reported improvements in their care-recipient's urine leakage, found access to a UI expert beneficial, and would recommend it to a friend. The results suggest that the tablet-facilitated intervention was feasible and acceptable to informal caregivers and showed promise for improving both caregiver and care recipient outcomes.
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Affiliation(s)
- Nicole J Davis
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, United States; School of Nursing, Clemson University, 605 Grove Rd. Greenville, SC 29605, United States.
| | - Patricia C Clark
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 3995, Atlanta, GA 30302, United States.
| | - Theodore M Johnson
- Schools of Medicine, Public Health and Nursing, Emory University, 1841 Clifton Rd NE, Atlanta, GA 30329, United States; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center (GRECC), Department of Veterans Affairs, 1670 Clairmont Rd., Atlanta, GA 30033, United States.
| | - Jean F Wyman
- School of Nursing, University of Minnesota, 5-140 Weaver-Densford Hall, 308 Harvard Street SE, Minneapolis, MN 55455, United States.
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Efthymiou A, Middleton N, Charalambous A, Papastavrou E. Adapting the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) in a Sample of Greek and Cypriot Carers of People With Dementia: Reliability and Validation Study. J Med Internet Res 2019; 21:e12504. [PMID: 31778120 PMCID: PMC6908974 DOI: 10.2196/12504] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 05/28/2019] [Accepted: 08/31/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND As the population ages, many more people will be in need of long-term care. According to a recent report by Alzheimer's Disease International and the Karolinska Institute, 84% of people with dementia are cared for at home and 16% in nursing homes. Several Web-based interventions have been developed to assist the work of carers at home. Measuring the levels of electronic health (eHealth) literacy is of top priority to facilitate inclusion of this population and develop training programs to enhance eHealth literacy skills. OBJECTIVE This study aimed to adapt the eHealth Literacy Scale (eHeals) for carers of people with dementia, who speak Greek as their native language and live in Greece and Cyprus, and to test the reliability and validity of the scale for carers. METHODS The content validity of the eHealth Literacy Scale for Carers of People With Chronic Diseases (eHeals-Carer) was assessed with an expert panel (N=10). A descriptive study with face-to-face interviews among 101 primary carers of people with dementia was conducted. In addition to the eHeals-Carer to assess their perceived eHealth literacy, participants responded to a brief questionnaire regarding characteristics of internet use and provided sociodemographic data. The internal consistency of the tool and the construct validity via an exploratory factor analysis (EFA) were explored. RESULTS The Mean Item-Level Content Validity Index (CVI) and Scale-Level CVI Average was 0.93. The participants were mostly women (75.2%, 76/101), aged less than 60 years (67.3%, 68/101) with secondary education. The internal consistency was estimated at a Cronbach alpha of .83. Two factors were extracted from the EFA: information seeking questions 1 to 5 (factor 1) and evaluation questions 6 to 8 (factor 2). CONCLUSIONS eHeals-Carer is the first perceived eHealth literacy tool adapted for carers of people with dementia. The use of Web-based services available for carers could help them and improve the health care system in the long term. In Greece and Cyprus, there is a lack of services, and improving the digital skills of carers could provide them with the means to support themselves at home and improve care provision. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/resprot.8080.
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Affiliation(s)
- Areti Efthymiou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Nicos Middleton
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Andreas Charalambous
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Department of Nursing, Faculty of Health Sciences, University of Turku, Turku, Finland
| | - Evridiki Papastavrou
- Department of Nursing, Faculty of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
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Otero P, Torres ÁJ, Vázquez FL, Blanco V, Ferraces MJ, Díaz O. Does the Disease of the Person Receiving Care Affect the Emotional State of Non-professional Caregivers? Front Psychol 2019; 10:1144. [PMID: 31156524 PMCID: PMC6529816 DOI: 10.3389/fpsyg.2019.01144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Accepted: 04/30/2019] [Indexed: 11/26/2022] Open
Abstract
Research on mental health of non-professional caregivers has focused on caregivers of people with specific diseases, especially dementia. Less is known about caregivers of people with other diseases. The aims of this study were (a) to determine the caregivers’ emotional state in a random sample of caregivers of people in situations of dependency, (b) to analyze the association between each disease of the care-recipient (a variety of 23 diseases included in the International Classification of Diseases) and the emotional state of the caregiver, and (c) based on the theoretical model, to analyze the relationship of the different study variables in the appearance of the emotional distress of the caregiver. A sample of 491 non-professional caregivers was selected randomly (89.0% women, average age 55.3 years). Trained psychologists collected sociodemographic and care-related characteristics and evaluated the global emotional distress, somatic symptoms, anxiety-insomnia, social dysfunction, depression, probable mental disorder case, self-esteem, and social support. It was found that (a) the caregivers showed moderate emotional distress, and 33.8% presented a probable mental disorder. (b) Caring for a care-recipient with cat’s cry syndrome or epilepsy was related to suffering from social dysfunction, and caring for a care-recipient with autism was related to having a probable mental health case. (c) Social support mediated the relationship between social class, daily hours of care, monthly family income, self-esteem and global emotional distress. There is an important impact on the emotional state of the caregivers. This impact was similar in caregivers of care-recipients with different diseases, except in caregivers caring for a care-recipient with cat’s cry syndrome or epilepsy (related to social dysfunction), and in caregivers caring for a care-recipient with autism (related to having a probable mental health case).
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Affiliation(s)
- Patricia Otero
- Department of Psychology, University of A Coruña, A Coruña, Spain
| | - Ángela J Torres
- Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando L Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Vanessa Blanco
- Department of Evolutive and Educational Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - María J Ferraces
- Department of Social, Basic and Methodological Psychology, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Olga Díaz
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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21
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Charalambous A, Berger AM, Matthews E, Balachandran DD, Papastavrou E, Palesh O. Cancer-related fatigue and sleep deficiency in cancer care continuum: concepts, assessment, clusters, and management. Support Care Cancer 2019; 27:2747-2753. [DOI: 10.1007/s00520-019-04746-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Accepted: 03/08/2019] [Indexed: 01/16/2023]
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22
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Karg N, Graessel E, Randzio O, Pendergrass A. Dementia as a predictor of care-related quality of life in informal caregivers: a cross-sectional study to investigate differences in health-related outcomes between dementia and non-dementia caregivers. BMC Geriatr 2018; 18:189. [PMID: 30139354 PMCID: PMC6108112 DOI: 10.1186/s12877-018-0885-1] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background The objectives of this study with a large sample of informal caregivers (CG) were a) to compare health-related outcomes of CGs caring for a patient with dementia and those caring for a relative with another chronic disease and b) to check whether dementia is a predictor of CG’s care-related quality of life (QoL) in CarerQoL-7D. Methods This cross-sectional study involved self-reported data from 386 informal CGs who applied for an initial grade or upgrade of the care level of the care recipient at the Medical Service of Compulsory Health Insurance Funds of Bavaria (Germany). By obtaining data this way, systematic biases often associated with the acquisition of CGs were prevented. Bivariate and multiple analyses were conducted using a univariate covariance model (ANCOVA). Results Bivariate analyses showed significantly higher levels of subjective burden and lower QoL in the dementia group. No significant differences were found in terms of physical health and depressiveness, though there was a tendency suggesting higher levels of depressiveness in dementia CGs. Multiple analysis explaining QoL by dementia status after controlling for CG’s sex, age and employment status revealed a significant effect of dementia, suggesting caregiving for a dementia patient was associated with lower QoL. Conclusions Results of the study suggest that caring for a relative with dementia is associated with poorer health, i.e. greater levels of subjective burden and depressiveness, and predicts lower QoL in CGs. These findings emphasize the importance of specific interventions aiming to support informal CGs of dementia patients.
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Affiliation(s)
- Nina Karg
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany.
| | - Elmar Graessel
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Ottilie Randzio
- Medical Service of Compulsory Health Insurance Funds (MDK) of Bavaria, Haidenauplatz 1, D-81667, Munich, Germany
| | - Anna Pendergrass
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
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Comparison of the lived experiences of family caregivers of patients with dementia and of patients with cancer in Indonesia. Int Psychogeriatr 2018; 30:903-914. [PMID: 28870266 PMCID: PMC6088529 DOI: 10.1017/s1041610217001508] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
UNLABELLED ABSTRACTBackground:Dementia, even more than cancer, demands long-term care. While in Indonesia cancer is accepted as a disease requiring caregiving, dementia is still considered "a normal condition." These differences might affect the experiences of caregivers, especially those relating to social health, the subject of our study. We aim to describe and compare the lived experiences of family caregivers of patients with cancer (PWC) with those of patients with dementia (PWD) in Yogyakarta, Indonesia, and to explore the role of their social health in these experiences. METHOD A qualitative design was applied. In-depth face-to-face interviews were conducted with PWC and PWD caregivers in two outpatient clinics of a tertiary hospital. The constant comparative method was applied to analyze the data that were interpreted using the concept of social health to explore the experiences of the caregivers. We used Atlas.ti software. RESULTS Three themes were identified: problems with caregiving, dealing with problems, and beliefs in caregiving. We found more similarities than differences in the experiences of caregivers in both groups. Half of the categories were related to social health: challenges, consequences, hiding, social support, and the caregiver's approach. The organization of dementia care is characterized by simplicity and direct ties between medical specialists, PWD, and caregivers, whereas cancer care encounters coordination problems. CONCLUSIONS Family caregivers of both groups mostly had similar experiences of the caregiving process. Gaining a better understanding of the specific experiences of caregivers, and their social health, opens new avenues for interventions to improve their quality of life.
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Al-Daken LI, Ahmad MM. Predictors of burden and quality of sleep among family caregivers of patients with cancer. Support Care Cancer 2018; 26:3967-3973. [DOI: 10.1007/s00520-018-4287-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 05/21/2018] [Indexed: 10/16/2022]
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Saria MG, Courchesne NS, Evangelista L, Carter JL, MacManus DA, Gorman MK, Nyamathi AM, Phillips LR, Piccioni DE, Kesari S, Maliski SL. Anxiety and Depression Associated With Burden in Caregivers of Patients With Brain Metastases. Oncol Nurs Forum 2018; 44:306-315. [PMID: 28635984 DOI: 10.1188/17.onf.306-315] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To describe and examine the relationship between caregiver burden and the affective disorders anxiety and depression in caregivers of patients with brain metastases.
. DESIGN Cross-sectional, descriptive, correlational.
. SETTING Moores Cancer Center at the University of California, San Diego.
. SAMPLE 56 family caregivers of patients with brain metastases from solid tumors at other primary sites.
. METHODS Self-administered survey.
. MAIN RESEARCH VARIABLES Caregiver burden, anxiety, and depression.
. FINDINGS With the exception of caregiver esteem, no statistically significant relationships were noted between impact on schedule, a dimension of caregiver burden, and screening positive for affective disorders.
. CONCLUSIONS Findings from this study support previous reports indicating that the odds of having anxiety and depressive symptoms are greater in family caregivers who report higher levels of caregiver burden.
. IMPLICATIONS FOR NURSING The identification and management of caregiver burden are important considerations for a comprehensive cancer care program. Addressing the needs of the cancer caregiver, who is at heightened risk for various psychological, physical, financial, and social problems, is increasingly vital.
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Affiliation(s)
- Marlon G Saria
- John Wayne Cancer Institute at Providence Saint John's Health Center
| | | | | | | | | | | | | | | | | | - Santosh Kesari
- John Wayne Cancer Institute at Providence Saint John's Health Center
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26
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Gilbert SM, Nemeth L, Amella E, Edlund B, Burggraf V. Adult Children and the Transition of Aging Parents. Issues Ment Health Nurs 2018; 39:374-381. [PMID: 29505326 DOI: 10.1080/01612840.2018.1434842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
This study explores the experiences of adult children as they transition their functionally and/or cognitively declining aging parents from independent living to supervised housing. A qualitative grounded theory approach was used to chronicle the experiences of adult children as their caregiving responsibilities intensified and their parents' health declined. Purposive, snowball sampling was used to enlist adult children (n = 16) who were in the process of transitioning an aging parent from an independent living situation to one providing assistance with everyday care and tasks. Semi-structured telephone interviews were conducted and designed to follow a pattern of increased frailty of the parent(s) and escalating involvement of the adult child. Two major themes emerged from the data: Changing places and everlasting love. Adult children began to intervene when cognitive or physical declines compromised the safety and well-being of the older adult and began to assume responsibility for day-to-day needs. As disabilities intensified, adult children relied on siblings, friends, social services, and health care providers to assist in planning and implementing caregiving responsibilities. Deep respect and abiding love of the aging parent(s) sustained the adult child throughout the caregiving experience.
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Affiliation(s)
- Sarah M Gilbert
- a Radford University Waldron College of Health and Human Services , School of Nursing , Radford , Virginia , USA
| | - Lynne Nemeth
- b Medical University of South Carolina , College of Nursing , Charleston , South Carolina , USA
| | - Elaine Amella
- b Medical University of South Carolina , College of Nursing , Charleston , South Carolina , USA
| | - Barbara Edlund
- b Medical University of South Carolina , College of Nursing , Charleston , South Carolina , USA
| | - Virginia Burggraf
- a Radford University Waldron College of Health and Human Services , School of Nursing , Radford , Virginia , USA
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27
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Sruamsiri R, Mori Y, Mahlich J. Productivity loss of caregivers of schizophrenia patients: a cross-sectional survey in Japan. J Ment Health 2018; 27:583-587. [DOI: 10.1080/09638237.2018.1466048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
| | - Yasuhiro Mori
- Department of Psychiatry, Aichi Medical University, Nagakute, Japan, and
| | - Jörg Mahlich
- Health Economics, Janssen Pharmaceutical K.K, Tokyo, Japan,
- Düsseldorf Institute for Competition Economics (DICE), University of Düsseldorf, Düsseldorf, Germany
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28
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Huang X, Fox KR, Ribeiro JD, Franklin JC. Psychosis as a risk factor for suicidal thoughts and behaviors: a meta-analysis of longitudinal studies. Psychol Med 2018; 48:765-776. [PMID: 28805179 DOI: 10.1017/s0033291717002136] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Research has long noted higher prevalence rates of suicidal thoughts and behaviors among individuals with psychotic symptoms. Major theories have proposed several explanations to account for this association. Given the differences in the literature regarding the operationalization of psychosis and sample characteristics, a quantitative review is needed to determine to what extent and how psychosis confers risk for suicidality. METHODS We searched PsycInfo, PubMed, and GoogleScholar for studies published before 1 January 2016. To be included in the analysis, studies must have used at least one psychosis-related factor to longitudinally predict suicide ideation, attempt, or death. The initial search yielded 2541 studies. Fifty studies were retained for analysis, yielding 128 statistical tests. RESULTS Suicide death was the most commonly studied outcome (43.0%), followed by attempt (39.1%) and ideation (18.0%). The median follow-up length was 7.5 years. Overall, psychosis significantly conferred risk across three outcomes, with weighted mean ORs of 1.70 (1.39-2.08) for ideation, 1.36 (1.25-1.48) for attempt, and 1.40 (1.14-1.72) for death. Detailed analyses indicated that positive symptoms consistently conferred risk across outcomes; negative symptoms were not significantly associated with ideation, and were protective against death. Some small moderator effects were detected for sample characteristics. CONCLUSIONS Psychosis is a significant risk factor for suicide ideation, attempt, and death. The finding that positive symptoms increased suicide risk and negative symptoms seemed to decrease risk sheds light on the potential mechanisms for the association between psychosis and suicidality. We note several limitations of the literature and offer suggestions for future directions.
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Affiliation(s)
- X Huang
- Department of Psychology,Florida State University,Tallahassee, FL,USA
| | - K R Fox
- Department of Psychology,Harvard University,Cambridge, MA,USA
| | - J D Ribeiro
- Department of Psychology,Florida State University,Tallahassee, FL,USA
| | - J C Franklin
- Department of Psychology,Florida State University,Tallahassee, FL,USA
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29
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Maguire A, Rosato M, O'Reilly D. Mental health and morbidity of caregivers and co-residents of individuals with dementia: a quasi-experimental design. Int J Geriatr Psychiatry 2017; 32:1104-1113. [PMID: 27594205 DOI: 10.1002/gps.4573] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Revised: 08/03/2016] [Accepted: 08/10/2016] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To determine if providing informal care to a co-resident with dementia symptoms places an additional risk on the likelihood of poor mental health or mortality compared with co-resident non-caregivers. DESIGN A quasi-experimental design of caregiving and non-caregiving co-residents of individuals with dementia symptoms provides a natural comparator for the additive effects of caregiving on top of living with an individual with dementia symptoms. METHODS Census records, providing information on household structure, intensity of caregiving, presence of dementia symptoms and self-reported mental health were linked to mortality records over the following 33 months. Multi-level regression models were constructed to determine the risk of poor mental health and death in co-resident caregivers of individuals with dementia symptoms compared with co-resident non-caregivers, adjusting for the clustering of individuals within households. RESULTS The cohort consisted of 10 982 co-residents (55.1% caregivers), with 12.1% of non-caregivers reporting poor mental health compared with 8.4% of intense caregivers (>20 h of care per week). During follow-up, the cohort experienced 560 deaths (245 to caregivers). Overall, caregiving co-residents were at no greater risk of poor mental health but had lower mortality risk than non-caregiving co-residents (adjusted odds ratio (ORadj) = 0.93, 95% confidence interval (CI) 0.79, 1.10 and ORadj = 0.67, 95% CI 0.56, 0.81, respectively); this lower mortality risk was also seen amongst the most intensive caregivers (ORadj = 0.65, 95% CI 0.53, 0.79). CONCLUSION Caregiving poses no additional risk to mental health over and above the risk associated with merely living with someone with dementia and is associated with a lower mortality risk compared with non-caregiving co-residents. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Aideen Maguire
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Michael Rosato
- Bamford Centre for Mental Health and Wellbeing, Ulster University, Coleraine, UK
| | - Dermot O'Reilly
- Centre for Public Health, Queen's University Belfast, Belfast, UK
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30
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Hsu T, Loscalzo M, Ramani R, Forman S, Popplewell L, Clark K, Katheria V, Strowbridge R, Rinehart R, Smith D, Matthews K, Dillehunt J, Feng T, Smith D, Sun C, Hurria A. Are Disagreements in Caregiver and Patient Assessment of Patient Health Associated with Increased Caregiver Burden in Caregivers of Older Adults with Cancer? Oncologist 2017; 22:1383-1391. [PMID: 28808093 PMCID: PMC5679832 DOI: 10.1634/theoncologist.2017-0085] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 06/08/2017] [Indexed: 12/27/2022] Open
Abstract
Cancer‐related therapy is increasingly administered in the outpatient setting, resulting in increased dependence on caregivers suggest to provide physical and emotional support to patients. This article describes differences in patient versus caregiver assessments of patient health, considering caregiver perceptions of the patient's health and abilities compared to that reported by the patient. Background. As patients age, caregivers increasingly provide essential support and patient information. We sought to determine if patient‐caregiver assessments of patient health differ and if differences contribute to burden in caregivers of older adults with cancer. Materials and Methods. One hundred patients, aged ≥65, and their caregivers independently assessed patient function, comorbidity, nutrition, social activity, social support, and mental health. Caregivers completed the Caregiver Strain Index (CSI). Patient‐caregiver assessments were compared using the Wilcoxon signed rank test and paired t test. Association between caregiver burden and differences between patient‐caregiver assessments was examined using generalized linear regression. Results. Median patient age was 70 (range 65–91) and 70% had advanced disease. Sixty percent of patients reported requiring help with instrumental activities of daily living (IADLs); most had good social support (median Medical Outcomes Study [MOS]‐Social Support Survey score 92) and mental health (median Mental Health Inventory score 85). Caregivers were a median age of 66 (range 28–85), 73% female, 68% spousal caregivers, and 79% lived with the patient. Caregivers rated patients as having poorer physical function (more IADLs dependency [p = .008], lower Karnofsky Performance Status [p = .02], lower MOS‐Physical Function [p < .0001]), poorer mental health (p = .0002), and having more social support (p = .03) than patients themselves. Three‐quarters of caregivers experienced some caregiver burden (mean CSI score 3.1). Only differences in patient‐caregiver assessment of the patient's need for help with IADLs were associated with increased caregiver burden (p = .03). Conclusion. Patient‐caregiver assessments of patient function, mental health, and social support differ. However, only differences in assessment of IADLs dependency were associated with increased caregiver burden. Implications for Practice. As patients age, there is a higher incidence of frailty and cognitive impairments. As a result, caregivers play an increasingly vital role in providing information about patient health to healthcare providers, which is used to help healthcare providers tailor treatments and optimize patient health. These findings highlight that caregiver reporting in older adults with cancer may not replace patient reporting in those older adults who are otherwise able to self‐report. Furthermore, clinicians should check for caregiver burden in caregivers who report providing more help with instrumental activities of daily living than patients themselves report and provide appropriate support as needed.
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Affiliation(s)
- Tina Hsu
- City of Hope National Medical Center, Duarte, California, USA
| | | | - Rupal Ramani
- City of Hope National Medical Center, Duarte, California, USA
| | - Stephen Forman
- City of Hope National Medical Center, Duarte, California, USA
| | | | - Karen Clark
- City of Hope National Medical Center, Duarte, California, USA
| | - Vani Katheria
- City of Hope National Medical Center, Duarte, California, USA
| | - Rex Strowbridge
- City of Hope National Medical Center, Duarte, California, USA
| | | | - Dan Smith
- City of Hope National Medical Center, Duarte, California, USA
| | - Keith Matthews
- City of Hope National Medical Center, Duarte, California, USA
| | - Jeff Dillehunt
- City of Hope National Medical Center, Duarte, California, USA
| | - Tao Feng
- City of Hope National Medical Center, Duarte, California, USA
| | - David Smith
- City of Hope National Medical Center, Duarte, California, USA
| | - Canlan Sun
- City of Hope National Medical Center, Duarte, California, USA
| | - Arti Hurria
- City of Hope National Medical Center, Duarte, California, USA
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31
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Wilks CR, Valenstein-Mah H, Tran H, King AM, Lungu A, Linehan MM. Dialectical Behavior Therapy Skills for Families of Individuals With Behavioral Disorders: Initial Feasibility and Outcomes. COGNITIVE AND BEHAVIORAL PRACTICE 2017. [DOI: 10.1016/j.cbpra.2016.06.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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32
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Charalambous A, Papastavrou E, Valkeapää K, Zabalegui A, Ingadóttir B, Lemonidou C, Fatkulina N, Jouko K, Leino-Kilpi H. Content of Orthopedic Patient Education Provided by Nurses in Seven European Countries. Clin Nurs Res 2017; 27:770-789. [DOI: 10.1177/1054773817713178] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Patients’ and their significant others’ education during the perioperative phase is an important and challenging aspect of care. This study explored the content of education provided by nurses to arthroplasty patients and their significant others. Data were collected with the Education of Patients–NURSE content (EPNURSE-Content), Received Knowledge of Hospital Patient (RKhp), and Received Knowledge of Significant Other (RKso) scales. The results showed that the content of education emphasized biophysiological and functional needs, differed between countries, and was related to how physically demanding nurses found their job to be and the amount of education provided. There is congruence between the received knowledge of patients and their significant others in relation to the content of education provided by nurses. The findings can support nurses in developing aid material for patients and significant others explaining the nature of education and advising them what to expect and how to optimize their participation in the process.
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Affiliation(s)
| | | | - K. Valkeapää
- University of Turku, Finland
- Finnish Defense Research Agency, Finland
- Social and Health Care, Lahti University of Applied Sciences, Lahti, Finland
| | | | - B. Ingadóttir
- University of Iceland, Reykjavík, Iceland
- Linköping University, Sweden
| | - C. Lemonidou
- National and Kapodistrian University of Athens, Greece
| | - N. Fatkulina
- Klaipeda University, Lithuania
- Vilnius University, Lithuania
| | | | - H. Leino-Kilpi
- University of Turku, Finland
- Turku University Hospital, Finland
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33
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Cromhout PF, Latocha KM, Olsen MH, Suppli NP, Christensen J, Johansen C, Dalton SO. First use of antidepressant medication in male partners of women with breast cancer in Denmark from 1998 to 2011. Psychooncology 2017; 26:2269-2275. [PMID: 28511290 DOI: 10.1002/pon.4459] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 03/31/2017] [Accepted: 05/12/2017] [Indexed: 11/06/2022]
Abstract
OBJECTIVE A diagnosis of breast cancer disrupts the life of the patient, but also the partner may experience adverse psychological effects. We examined partners' risk for first use of antidepressant medication, as a proxy for pharmacologically treated depression. METHODS By linkage of national registers, we identified 1 420 592 depression-free men living with a cancer-free female partner in 1998 to 2011. During follow-up, breast cancer was diagnosed in female partners of 26 256 men. In Poisson regression models, we estimated the rate ratios for first use of antidepressant medication compared to partners of breast cancer-free women. Cox regression analyses examined associations between exposed partners' sociodemographic characteristics, somatic comorbidity, death of female partner, and first use of antidepressant medication. RESULTS Male partners of women with breast cancer had an increased rate ratio of 1.08 (95% CI, 1.03-1.13) for first use of antidepressant medication compared to the background population, corresponding to excess absolute risk of 12 cases per 10 000 person-years. This increased risk persisted throughout 14 years of follow-up. Higher age, shorter education, somatic comorbidity, and death of female partner were associated with increased risk among men whose partner had breast cancer. CONCLUSION The modest, but long term, increased risk for first use of antidepressant medication calls for attention by health care professionals to symptoms of depression among partners of breast cancer patients.
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Affiliation(s)
- Pernille F Cromhout
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
| | - Kristine M Latocha
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
| | - Maja H Olsen
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
| | - Nis P Suppli
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
| | - Jane Christensen
- Danish Cancer Society Research Center, Statistics and Pharmaco-epidemiology, Copenhagen, Denmark
| | - Christoffer Johansen
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark.,Clinic of Oncology, University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Susanne O Dalton
- Danish Cancer Society Research Center, Unit of Survivorship, Copenhagen, Denmark
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Saria MG, Nyamathi A, Phillips LR, Stanton AL, Evangelista L, Kesari S, Maliski S. The Hidden Morbidity of Cancer: Burden in Caregivers of Patients with Brain Metastases. Nurs Clin North Am 2017; 52:159-178. [PMID: 28189161 DOI: 10.1016/j.cnur.2016.10.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Caregiving is a highly individualized experience. Although numerous articles have been published on caregiver burden from a variety of diagnoses and conditions, this article presents the unique features of caregiving in patients with brain metastases. Improved long-term survival, concerns about disease recurrence or progression, the cancer experience (initial diagnosis, treatment, survivorship, recurrence, progression, and end of life), and the increasing complexity of cancer treatments add to the demands placed on the caregivers of patients with brain metastases. Health care professionals must identify caregiver burden and administer the appropriate interventions, which must be as unique and individualized as the caregivers' experiences.
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Affiliation(s)
- Marlon Garzo Saria
- Clinical Trials and Research, John Wayne Cancer Institute, Providence Saint John's Health Center, University of California, Los Angeles, School of Nursing, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA.
| | - Adeline Nyamathi
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA
| | - Linda R Phillips
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA
| | - Annette L Stanton
- Department of Psychology, University of California, Los Angeles, 1285 Franz Hall, Box 951563, Los Angeles, CA 90095-1563, USA
| | - Lorraine Evangelista
- Nursing Science, University of California, Irvine, 106 Berk Hall, Irvine, CA 92697-3959, USA
| | - Santosh Kesari
- Department of Translational Neuro-Oncology and Neurotherapeutics, John Wayne Cancer Institute, Providence Saint John's Health Center, 2200 Santa Monica Boulevard, Santa Monica, CA 90404, USA
| | - Sally Maliski
- University of California, Los Angeles, School of Nursing, 700 Tiverton Avenue, Los Angeles, CA 90095, USA; University of Kansas Medical Center, University of Kansas School of Nursing, Mail Stop 2029, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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Caregiver Burden Among Caregivers of Individuals With Severe Mental Illness: Testing the Moderation and Mediation Models of Resilience. Arch Psychiatr Nurs 2017; 31:24-30. [PMID: 28104054 DOI: 10.1016/j.apnu.2016.07.019] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2015] [Revised: 07/29/2016] [Accepted: 07/29/2016] [Indexed: 12/14/2022]
Abstract
The association between the socio-demographic characteristics of caregivers, such as gender and caregiver burden, is well documented; however, the process underlying this relationship is poorly understood. Based on the stress process model, we designed a cross-sectional study to examine the mediating and moderating effect of resilience on the relationship between gender and caregiver burden. Caregivers of individuals with severe mental illness (n=201) were recruited in two psychiatric outpatient clinics in Malaysia. The relationship between the gender of the caregiver and caregiver burden was mediated by resilience, thus supporting the stress process model. The findings from the present research contribute to the growing evidence of the interaction between socio-demographic variables of caregivers and resilience, and caregiver burden.
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Schmidt SJ, Schultze-Lutter F, Bendall S, Groth N, Michel C, Inderbitzin N, Schimmelmann BG, Hubl D, Nelson B. Mediators Linking Childhood Adversities and Trauma to Suicidality in Individuals at Risk for Psychosis. Front Psychiatry 2017; 8:242. [PMID: 29249990 PMCID: PMC5715383 DOI: 10.3389/fpsyt.2017.00242] [Citation(s) in RCA: 14] [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: 06/21/2017] [Accepted: 11/06/2017] [Indexed: 12/29/2022] Open
Abstract
Suicidality is highly prevalent in patients at clinical high risk (CHR) for psychosis. Childhood adversities and trauma are generally predictive of suicidality. However, the differential effects of adversity/trauma-domains and CHR-criteria, i.e., ultra-high risk and basic symptom criteria, on suicidality remain unclear. Furthermore, the underlying mechanisms and, thus, worthwhile targets for suicide-prevention are still poorly understood. Therefore, structural equation modeling was used to test theory-driven models in 73 CHR-patients. Mediators were psychological variables, i.e., beliefs about one's own competencies as well as the controllability of events and coping styles. In addition, symptomatic variables (depressiveness, basic symptoms, attenuated psychotic symptoms) were hypothesized to mediate the effect of psychological mediators on suicidality as the final outcome variable. Results showed two independent pathways. In the first pathway, emotional and sexual but not physical adversity/trauma was associated with suicidality, which was mediated by dysfunctional competence/control beliefs, a lack of positive coping-strategies and depressiveness. In the second pathway, cognitive basic symptoms but not attenuated psychotic symptoms mediated the relationship between trauma/adversity and suicidality. CHR-patients are, thus, particularly prone to suicidality if adversity/trauma is followed by the development of depressiveness. Regarding the second pathway, this is the first study showing that adversity/trauma led to suicidality through an increased risk for psychosis as indicated by cognitive basic symptoms. As insight is generally associated with suicidality, this may explain why self-experienced basic symptoms increase the risk for it. Consequently, these mediators should be monitored regularly and targeted by integrated interventions as early as possible to enhance resilience against suicidality.
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Affiliation(s)
- Stefanie J Schmidt
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Frauke Schultze-Lutter
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | - Sarah Bendall
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Nicola Groth
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Developmental Clinical Psychology Research Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Nadja Inderbitzin
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Benno G Schimmelmann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,University Hospital of Child and Adolescent Psychiatry, University Hospital Hamburg Eppendorf, Hamburg, Germany
| | - Daniela Hubl
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Barnaby Nelson
- Orygen, The National Centre of Excellence in Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia.,Centre for Youth Mental Health, University of Melbourne, Melbourne, VIC, Australia
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Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord 2016; 18:183-91. [PMID: 27004622 DOI: 10.1111/bdi.12379] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.
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Affiliation(s)
- Deborah A Perlick
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Lesley Berk
- Mental Health and Wellbeing Research Centre, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Richard Kaczynski
- Veterans Affairs New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jodi Gonzalez
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Bruce Link
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, NY, USA.,Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Savannah Grier
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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Lee Y, Tak Y. Experiences of Spouses of Patients with Hematologic Malignancies: Finding a Way to Get Out of the Endless Tunnel. ASIAN ONCOLOGY NURSING 2016. [DOI: 10.5388/aon.2016.16.1.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Youngshin Lee
- Department of Nursing, Asan Medical Center, Seoul, Korea
| | - Youngran Tak
- College of Nursing, Hanyang University, Seoul, Korea
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Figueiredo D, Jácome C, Gabriel R, Marques A. Family care in chronic obstructive pulmonary disease: what happens when the carer is a man? Scand J Caring Sci 2015; 30:721-730. [DOI: 10.1111/scs.12298] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 09/02/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Daniela Figueiredo
- School of Health Sciences; University of Aveiro (ESSUA); Aveiro Portugal
- Research member at Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS.UA); Aveiro Portugal
| | - Cristina Jácome
- School of Health Sciences; University of Aveiro (ESSUA); Aveiro Portugal
| | - Raquel Gabriel
- School of Health Sciences; University of Aveiro (ESSUA); Aveiro Portugal
| | - Alda Marques
- School of Health Sciences; University of Aveiro (ESSUA); Aveiro Portugal
- Research member at Centro de Investigação em Tecnologias e Serviços de Saúde (CINTESIS.UA); Aveiro Portugal
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Rha SY, Park Y, Song SK, Lee CE, Lee J. Caregiving burden and the quality of life of family caregivers of cancer patients: the relationship and correlates. Eur J Oncol Nurs 2015; 19:376-82. [DOI: 10.1016/j.ejon.2015.01.004] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/06/2015] [Accepted: 01/15/2015] [Indexed: 01/20/2023]
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Lewis LF. Caregiving for a loved one with dementia at the end of life: an emergent theory of rediscovering. Am J Alzheimers Dis Other Demen 2015; 30:488-96. [PMID: 25425737 PMCID: PMC10852728 DOI: 10.1177/1533317514559829] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Millions face the challenges of caregiving for a loved one with dementia. A classic Glaserian grounded theory methodology was used to discover the problem that caregivers of individuals with dementia face at the end of life and how they attempt to resolve that problem. Data were collected from a theoretical sample of 101 participants through in-person interviews, online interviews, book and blog memoirs of caregivers, and participant observation. Constant comparative method revealed a basic social psychological problem of role entrapment. Caregivers attempt to resolve this problem through a 5-stage basic social psychological process of rediscovering including missing the past, sacrificing self, yearning for escape, reclaiming identity, and finding joy. Health care professionals can support caregivers through this journey by validating, preparing caregivers for future stages, and encouraging natural coping strategies identified in this process. This study provides a substantive theory that may serve as a framework for future studies.
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Affiliation(s)
- Laura Foran Lewis
- College of Nursing and Health Sciences, University of Vermont, Burlington, VT 05405, USA
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Gupta S, Isherwood G, Jones K, Van Impe K. Assessing health status in informal schizophrenia caregivers compared with health status in non-caregivers and caregivers of other conditions. BMC Psychiatry 2015; 15:162. [PMID: 26194890 PMCID: PMC4509463 DOI: 10.1186/s12888-015-0547-1] [Citation(s) in RCA: 102] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research indicates schizophrenia is a cause of burden for patients and caregivers. This study examined health-related quality of life (HRQoL) and comorbidities experienced by informal schizophrenia caregivers compared with non-caregivers and caregivers of adults with other conditions (e.g., Alzheimer's disease, cancer, and stroke). METHODS Data were obtained from the 5EU (France, Germany, Italy, Spain, UK) National Health and Wellness Survey, an online questionnaire that is representative of the total 5EU adult (18+ years) population. Respondents provided information on HRQoL (SF-36v2: mental and physical component summary (MCS, PCS) and SF-6D (health utility) scores), items from the Caregiver Reaction Assessment (strongly disagree to strongly agree) and comorbidities (sleep difficulties, insomnia, pain, headaches, heartburn, anxiety, depression) experienced in the past 12 months. Schizophrenia caregivers (n = 398) were matched to non-caregivers (n = 158,989) and caregivers of other conditions (n = 14,341) on baseline characteristics via propensity scores. Chi-square tests and ANOVAs were used to determine significant differences across groups. RESULTS The average age of schizophrenia caregivers was 45.3 years (SD = 15.8), and 59.6% were female. After matching, schizophrenia caregivers reported lower MCS (40.3 vs. 45.9), PCS (46.8 vs. 49.0), and health utilities (0.64 vs. 0.71) compared with non-caregivers (all p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties (42.7% vs. 28.5%), insomnia (32.4% vs. 18.5%), pain (39.7% vs. 30.4%), headaches (48.0% vs. 42.0%), heartburn (31.7% vs. 22.9%), anxiety (37.9% vs. 23.6%), and depression (29.4% vs. 19.4%) than non-caregivers. Comparing schizophrenia caregivers and other caregivers, schizophrenia caregivers reported lower MCS (40.3 vs. 42.7, p < 0.001), and health utilities (0.64 vs. 0.67, p < 0.001). Schizophrenia caregivers were more likely to experience sleep difficulties, insomnia, pain, and anxiety than other caregivers. Almost 60% of schizophrenia caregivers agree/strongly agree that caring for the patient is important to them, but only 31.9% agree/strongly agree that they have the financial resources to provide adequate care. CONCLUSIONS Schizophrenia caregivers reported worse HRQoL than non-caregivers and caregivers of other conditions. Providing care for an adult relative with schizophrenia is important to caregivers, but caregivers need more resources to provide adequate care. Providing informal schizophrenia caregivers with support services to help better manage patients may improve their health status.
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Affiliation(s)
- Shaloo Gupta
- Health Outcomes Practice, Kantar Health, 1 Independence Way, Suite 220, Princeton, NJ, 08540, USA.
| | | | - Kevin Jones
- European Federation of Associations of Families of People with Mental Illness, Diestsevest 100, B-3000, Leuven, Belgium.
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The adverse mental health of carers: Does the patient diagnosis play a role? Maturitas 2015; 82:134-8. [PMID: 26163076 DOI: 10.1016/j.maturitas.2015.06.034] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2015] [Revised: 06/13/2015] [Accepted: 06/16/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The adverse mental health effects of caring have been studied, frequently in carers of people with dementia. Less is known about the mental health of carers of people with other conditions. This study compared depression and burden in older carers looking after people with a variety of conditions. DESIGN, METHODS AND MEASURES Over 200 older carers interested in participating in the Improving Mood through Physical Activity in Carers and Care-recipient Trial were included in this cross-sectional study, using the Geriatric Depression Scale (GDS) and Zarit Burden Inventory (ZBI). RESULTS Overall there were 43% of carers who were depressed and a quarter of them reported moderate-to-severe burden. Carers of people with physical conditions had the highest levels of depression and burden. Patient diagnosis, hours spent caring, and burden were associated with depression, while hours spent caring and carer depression were associated with burden. These factors contributed approximately 25-30% of the variance of depression and burden, respectively. CONCLUSIONS The diagnosis of the patient was a factor associated with depression, and older carers of people with physical conditions were at the highest risk. It is important for clinicians to assess the mental health of all carers, regardless of the patient diagnosis.
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Simpson C, Carter P. The Impact of Living Arrangements on Dementia Caregivers' Sleep Quality. Am J Alzheimers Dis Other Demen 2015; 30:352-9. [PMID: 25425735 PMCID: PMC10852977 DOI: 10.1177/1533317514559828] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In the United States half of the 15 million informal caregivers of persons with Alzheimer's disease or a related dementia (PWDs) do not live with the PWD. This paper compares the sleep quality and health of 59 community-dwelling caregivers living with the PWD and 21 living apart from the PWD. Variables of interest were caregiving experience (hours caregiving, problematic behaviors of the PWD, caregivers' perception of dementia severity), sleep quality, and health (perceived health, stress, and depressive symptoms). Parametric unpaired t tests were used to calculate the differences between key variables. Multiple regression models were constructed, controlling for age, gender, behavior index, and dementia severity to examine the variance explained by living arrangements on sleep quality and health. Caregivers living apart from the PWD experienced the same level of poor sleep quality as did caregivers living with the PWD. The living arrangements of the caregiver did not make a unique contribution to sleep quality or health variables except for reports of unhealthy days. Given the importance of good quality sleep for health, the findings highlight the importance of evaluating caregivers living apart from the PWD for sleep problems with the same level of concern as one would have for those living with the PWD.
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Affiliation(s)
- Cherie Simpson
- School of Nursing, University of Texas at Austin, Austin, TX, USA
| | - Patricia Carter
- School of Nursing, University of Texas at Austin, Austin, TX, USA
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45
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Sigurdardottir AK, Leino-Kilpi H, Charalambous A, Katajisto J, Stark ÅJ, Sourtzi P, Zabalegui A, Valkeapää K. Fulfilment of knowledge expectations among family members of patients undergoing arthroplasty: a European perspective. Scand J Caring Sci 2015; 29:615-24. [PMID: 25648518 DOI: 10.1111/scs.12199] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 11/03/2014] [Indexed: 11/30/2022]
Abstract
In the recovery process of arthroplasty patients, their family members play an important role due to short hospital stay and increased age of patients. Family members need to have knowledge to be able to support the patient. The aim of this study was to explore expected and received knowledge in family members of arthroplasty patients and describe the relationships between the differences in received and expected knowledge and background factors, country, information and control preferences and access to knowledge. The study was conducted in six European countries (Cyprus, Greece, Finland, Iceland, Spain and Sweden). The study design was cross-cultural, prospective and comparative with two measurement points: pre-operative and at discharge from hospital. Knowledge Expectations of significant other-scale and Krantz Health Opinion Survey were used before surgery and Received Knowledge of significant other-scale and Access to Knowledge at discharge. Patients undergoing elective hip or knee arthroplasty in seventeen hospitals were asked to identify one family member. The sample size was decided by power calculation. A total of 615 participants answered the questionnaires at both measurements. Family members perceived to receive less knowledge than they expected to have, most unfulfilled knowledge expectations were in the financial, social and experiential dimensions of knowledge. Seventy-four per cent of participants had unfulfilled knowledge expectations. Increased access to information from healthcare providers decreased the difference between received and expected knowledge. Compared to family members in southern Europe, those in the Nordic countries had more unfulfilled knowledge expectations and less access to information from healthcare providers. The evidence from this study highlights the need to involve the family members in the educational approach.
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Affiliation(s)
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Andreas Charalambous
- Department of Nursing Science, University of Turku, Turku, Finland.,Cyprus University of Technology, Limassol, Cyprus
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Åsa Johansson Stark
- Department of Social and Welfare Studies, Linköping University, Campus Norrköping, Sweden
| | | | | | - Kirsi Valkeapää
- Department of Nursing Science, University of Turku, Turku, Finland.,Lahti University of Applied Sciences, Lahti, Finland
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Cowl AL, Gaugler JE. Efficacy of Creative Arts Therapy in Treatment of Alzheimer’s Disease and Dementia: A Systematic Literature Review. ACTIVITIES ADAPTATION & AGING 2014. [DOI: 10.1080/01924788.2014.966547] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Stansfeld S, Smuk M, Onwumere J, Clark C, Pike C, McManus S, Harris J, Bebbington P. Stressors and common mental disorder in informal carers--an analysis of the English Adult Psychiatric Morbidity Survey 2007. Soc Sci Med 2014; 120:190-8. [PMID: 25259657 PMCID: PMC4224501 DOI: 10.1016/j.socscimed.2014.09.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 08/18/2014] [Accepted: 09/14/2014] [Indexed: 11/19/2022]
Abstract
This study investigates potential explanations of the association between caring and common mental disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring--such as domestic violence and debt--and if so whether this explains their elevated rates of mental disorder. We analysed differences between carers and non-carers in common mental disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR=1.64 95% CI 1.37-1.97), suicidal thoughts in the last week (OR=2.71 95% CI 1.31-5.62) and fatigue (OR=1.33 95% CI 1.14-1.54) was increased in carers. However, caring remained independently associated with CMD (OR=1.58 1.30-1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives.
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Affiliation(s)
- Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
| | - Melanie Smuk
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Juliana Onwumere
- Department of Psychology, King's College London, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AZ UK
| | - Charlotte Clark
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Cleo Pike
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Sally McManus
- NatCen Social Research, 35 Northampton Square, London EC1V 0AX UK
| | - Jenny Harris
- Florence Nightingale School of Nursing and Midwifery, Kings College, London, UK
| | - Paul Bebbington
- UCL Mental Health Sciences Unit, 2nd Floor, Charles Bell House 67-73, Riding House Street, London W1W 7EJ, UK
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Figueiredo D, Gabriel R, Jácome C, Cruz J, Marques A. Caring for relatives with chronic obstructive pulmonary disease: how does the disease severity impact on family carers? Aging Ment Health 2014; 18:385-93. [PMID: 24053489 DOI: 10.1080/13607863.2013.837146] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Chronic Obstructive Pulmonary Disease (COPD) is a major cause of disability, morbidity and mortality in old age, representing a significant burden for families. However, information on the impacts of caring for relatives with COPD on carers' psychological health is limited. This study aimed to analyse the subjective burden of family carers of people with early and advanced COPD and its predictor variables. METHODS A cross-sectional study was conducted. A structured questionnaire was used to collect socio-demographics and care-giving characteristics. Self-rated physical and mental health were measured by two items from the International Classification of Functioning, Disability and Health checklist. The Hospital Anxiety and Depression Scale was used to assess anxiety and depression. Subjective burden was assessed with the Carers' Assessment of Difficulties Index (CADI). Descriptive and inferential analyses were performed. RESULTS A total of 167 family carers participated: 113 were caring for people with early and 54 with advanced COPD. Both groups presented anxiety/depression symptoms. Those caring for people with advanced COPD reported higher subjective burden, more depression symptoms and poorer self-rated mental health than those caring for early COPD. Advanced COPD (coefficient 6.7), depression (coefficient 6.3), anxiety (coefficient 5.6), care-giving hours per week (coefficient 3.2) and self-rated mental health (coefficient 2.8) were significant predictors of carers' subjective burden. CONCLUSION The findings suggest that the gradual course of COPD imposes an increasing physical and emotional burden on carers, with negative impacts on their psychological health. The study highlights the relevance of early interventions in the context of COPD to prevent carers' burden.
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Affiliation(s)
- Daniela Figueiredo
- a School of Health Sciences , University of Aveiro (ESSUA) , Aveiro, Portugal
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Abstract
The need for home care is increasing in Canada, yet little is known about the home care experience of clients and their families. Uncovering the meaning of the home care experience is an important step towards developing understanding and public awareness. We explored the experiences of home care using arts-based methods and individual interviews with 11 participants (one client and 10 family caregivers). Participants discussed the numerous ways formal home care and family caregiving affected their lives, how they coped with these effects, their experiences in hospitals or assisted living facilities, and aspects of the home care experience they liked or disliked. Participants agreed that home care facilitated a better quality of life for families and clients, although they acknowledged some challenges with it. The artistic outputs produced by participants facilitated interview dialogue and fostered understanding of key themes within the research team.
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Stenberg U, Ekstedt M, Olsson M, Ruland CM. Living close to a person with cancer: a review of the international literature and implications for social work practice. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:531-555. [PMID: 24611782 DOI: 10.1080/01634372.2014.881450] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
To help family caregivers (FCs), social workers need to understand the complexity of FC's experiences and challenges. For this systematic review, several relevant, multidisciplinary electronic databases were searched. Of 1,643 titles identified, 108 articles met the inclusion criteria and are included in this review. Various experiences, symptoms, and burden related to caregiving responsibilities are described and discussed. The understanding evolving from this study about the FC's own health risk, caregiver burden, and experiences over time can enhance a social worker's awareness of an FC's challenging situation and the potential impact this has on the FC's ability to provide care to the patient.
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Affiliation(s)
- Una Stenberg
- a Center for Shared Decision Making and Collaborative Care Research and Section for Physiotherapy and Social Medicine, Oslo University Hospital , Oslo , Norway
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