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Light SW, Tomasino F, Wescott A, Sideman AB, Vela A, Possin KL, Penedo FJ, Wolf MS. Perceptions, beliefs, attitudes, and knowledge of US Latino adults pertaining to dementia and brain health: a systematic review. Aging Ment Health 2024; 28:396-407. [PMID: 37874117 PMCID: PMC10983845 DOI: 10.1080/13607863.2023.2268050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/30/2023] [Indexed: 10/25/2023]
Abstract
OBJECTIVES Latinos in the USA are 1.5 times more likely to develop Alzheimer's Disease and Related Dementias (ADRD) than non-Latino Whites. This systematic review aims to summarize current understanding of the perceptions, knowledge, beliefs, and attitudes about ADRD and brain health of Latinos to inform public health efforts addressing disparities. METHODS Searches were completed across six databases (Medline, PsycINFO, WoS, LILACS, ProQUEST, and CINAHL). Studies were required to capture attitudes and/or knowledge of ADRD or brain health among US-based Latino adults who were not cognitively impaired and were not caregivers or healthcare providers. Results were synthesized narratively. RESULTS A total of 5528 unique records were identified. Following de-duplication and screening, 24 articles met the inclusion criteria for this review. Overall, knowledge about brain health and ADRD among Latinos is quite mixed. A consistent finding was that participants recognized memory loss as a symptom of cognitive impairment, but demonstrated limited recognition of other signs of impairment. The studies also highlighted variable knowledge of protective factors for maintaining brain health. CONCLUSIONS Opportunities exist to increase knowledge of ADRD signs and symptoms, and awareness of risk and protective factors. Given the heterogeneity of Latinos in the USA, more research is warranted to better elucidate nuances in conceptualizations of brain health and aging among diverse Latino subgroups.
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Affiliation(s)
- Sophia W. Light
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Francesca Tomasino
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Annie Wescott
- Galter Health Sciences Library & Learning Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Alissa Bernstein Sideman
- Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, CA, USA
- Global Brain Health Institute, University of California, San Francisco and Trinity College Dublin, San Francisco, CA, USA
- Department of Humanities and Social Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Alyssa Vela
- Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Katherine L. Possin
- Global Brain Health Institute, University of California, San Francisco and Trinity College Dublin, San Francisco, CA, USA
- Weill Institute for Neurosciences, Memory and Aging Center, University of California San Francisco, San Francisco, CA, USA
| | - Frank J. Penedo
- Departments of Psychology and Medicine, University of Miami, Coral Gables, FL, USA
| | - Michael S. Wolf
- Center for Applied Health Research on Aging and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Fink RM, Valenti KG, Kline DM, Fischer SM. Reality of Family Caregiving for Hispanics With Alzheimer's Disease and Related Dementias: A Qualitative Analysis. J Palliat Med 2023; 26:1618-1626. [PMID: 37311202 PMCID: PMC10714113 DOI: 10.1089/jpm.2023.0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2023] [Indexed: 06/15/2023] Open
Abstract
Background: Underserved Hispanic patients often experience unmet palliative care (PC) needs, particularly those with noncancer diagnoses such as Alzheimer's disease and related dementias. Most caregivers for Hispanic patients are family relatives who are less likely to use health care and community resources and experience high caregiver burden. We adapted a culturally tailored patient navigator (PN) intervention to provide support and improve PC outcomes for Hispanics with Alzheimer's disease and related dementias and their family caregivers (FCGs). Objectives: To explore Hispanic FCGs' experiences and perceptions of caregiving for a loved one, and how our PN intervention impacted their needs. Design: Qualitative descriptive. Setting/Subjects: FCG participants (n = 10) from our randomized control trial's intervention group were recruited from academic and safety net hospitals and community-based clinics across urban and rural Colorado in the United States. Measurements: Data obtained from individual, semistructured, 30-minute telephone interviews were recorded, transcribed, translated, and analyzed using NVivo and qualitative thematic analyses. Results: Four major themes emerged: Methods of Support, Cultural Expectations and Varying Family Contributions, Lack of Self-Care, and Awareness. Subthemes highlighted differing definitions of "contributing," role resentment, and interpersonal issues. Varying familial expectations underscore FCG strain when the burden of caregiving is not shared. Participants used various coping strategies as necessary support and gained awareness through education, guidance, and referrals to resources. Conclusions: PNs helped FCGs and patients beyond the intervention's scope. Providing support and awareness to FCGs, and incorporating cultural beliefs, may improve PC access to disparate populations and guide future interventions. Clinical Trial Registration Number NCT03181750.
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Affiliation(s)
- Regina M. Fink
- School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Korijna G. Valenti
- School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Danielle M. Kline
- School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Stacy M. Fischer
- School of Medicine and College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
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Sáenz R, Montes-de-Oca Zavala V, Angel JL. Resilience of Older Latinos and Mexicans Before and During the Pandemic. J Aging Health 2023; 35:763-766. [PMID: 37300390 DOI: 10.1177/08982643231182544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This article introduces the special issue on Aging and Resilience in the Americas: Mexico and the United States. The article overviews the role that the annual International Conference on Aging in the Americas (ICAA) has played in the development of scholarship on aging of Latinos in the United States and older persons in Latin America and the Caribbean. A brief overview of the aging literature reveals a growing interest on the resiliency of older Latino and Latin American populations in the United States and more broadly the Americas. The article provides a short description of each of the five articles included in this special issue.
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Affiliation(s)
- Rogelio Sáenz
- Department of Demography, University of Texas at San Antonio, San Antonio, TX, USA
| | - Verónica Montes-de-Oca Zavala
- Instituto de Investigaciones Sociales, Universidad Nacional Autónoma de México, Ciudad Universitaria, México, México
| | - Jacqueline L Angel
- LBJ School of Public Affairs, University of Texas at Austin, Austin, TX, USA
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Gutiérrez-Sánchez B, Orgeta V, López-Martínez C, del-Pino-Casado R. Association between Social Support and Depressive Symptoms in Informal Caregivers of Adult and Older Dependents: A Systematic Review and Meta-Analysis. J Clin Med 2023; 12:6468. [PMID: 37892607 PMCID: PMC10607501 DOI: 10.3390/jcm12206468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 10/08/2023] [Indexed: 10/29/2023] Open
Abstract
Social support is an important determinant of a carer's mental health. In recent decades, despite many studies reporting on the relationship between social support and depressive symptoms in informal caregivers of adult and older dependents, there are no systematic reviews synthesizing the available evidence. The purpose of the present study was to perform a systematic review and meta-analysis on the relationship between social support and depressive symptoms in informal caregivers of adults and older dependent people. We searched PubMed, CINAHL (EBSCO), PsycINFO (ProQuest), and Scopus, up to 15 January 2023 for studies. We applied no date or language limits to our search. A random-effects model was used to pool effect estimates. The included studies were also independently assessed for quality. Publication bias was evaluated by funnel plots, Egger's regression test, and the Trim and Fill method. Ninety-three studies were included in the review, reporting on a total of 15,431 informal caregivers. We found a moderate negative association between perceived social support and caregiver depressive symptoms (78 studies; r = -0.35, 95% CI = -0.39, -0.31; low heterogeneity and low risk of publications bias) and a small negative association between received social support and caregiver self-reported depressive symptoms (12 studies; r = -0.14, 95% CI = -0.20, -0.07; low heterogeneity and low risk of publications bias). Our results indicate that social support is a clinically relevant construct for carer well-being and an important protective factor for depressive symptoms in informal caregivers of adult and older dependents.
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Affiliation(s)
- Belén Gutiérrez-Sánchez
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, London W1T 7BN, UK;
| | - Catalina López-Martínez
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
| | - Rafael del-Pino-Casado
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23700 Jaén, Spain; (B.G.-S.); (R.d.-P.-C.)
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Jaldin MA, Balbim GM, Colin SJ, Marques IG, Mejia J, Magallanes M, Rocha JS, Marquez DX. The influence of Latino cultural values on the perceived caregiver role of family members with Alzheimer's disease and related dementias. ETHNICITY & HEALTH 2023; 28:619-633. [PMID: 36036081 DOI: 10.1080/13557858.2022.2115018] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVES We explored how Latino cultural values play a role in perceived caregiving experiences. DESIGN We conducted a qualitative study that used individual, in-depth, semi-structured interviews with middle-aged and older Latinos who were primary caregivers of family members with Alzheimer's disease and related dementias (ADRD). The interview guide consisted of questions about participants' perceptions of family caregiving and interrelationships between the caregiver and care recipient. The interviews were recorded, translated, and transcribed verbatim. We performed direct content analysis. RESULTS Participants were caregivers, 50-75 years old (n = 16), and the majority were female. We identified four cultural values that were salient to participants' caregiving experiences: (a) familismo, (b) fatalismo (c) marianismo, and (d) machismo. CONCLUSION Latino cultural values influenced the role of caregiving and caregiving roles of family members with ADRD. Future research should consider these values as they affect different familial and health dynamics.
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Affiliation(s)
- Michelle A Jaldin
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Guilherme M Balbim
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Stephanie J Colin
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Isabela G Marques
- Division of Rheumatology, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
| | - Jasmine Mejia
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Judith S Rocha
- Social Work Program, College of Arts and Sciences, Northeastern Illinois University, Chicago, IL, USA
| | - David X Marquez
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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Parker LJ, Marx KA, Nkimbeng M, Johnson E, Koeuth S, Gaugler JE, Gitlin LN. It's More Than Language: Cultural Adaptation of a Proven Dementia Care Intervention for Hispanic/Latino Caregivers. THE GERONTOLOGIST 2023; 63:558-567. [PMID: 35951488 PMCID: PMC10028233 DOI: 10.1093/geront/gnac120] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Indexed: 11/12/2022] Open
Abstract
Although Hispanic/Latino older adults are at disproportionate and increased risk for Alzheimer's disease and related dementias, few evidence-based supportive care interventions are specifically developed for or adapted for this population. Adapting a supportive care intervention requires more than Spanish language translation; it necessitates an understanding of cultural nuances and care preferences of Hispanic/Latino families and staff who implement the intervention. This article describes the cultural adaptation of the Adult Day Service Plus intervention for delivery by staff to Hispanic/Latino caregivers, which was guided by the cultural adaptation process model. Also, using the Framework for Reporting Adaptations and Modifications-Enhanced, we discuss (a) when modifications were made, (b) who determined the modifications needed, (c) what aspects of the intervention were modified, (d) the relationship to fidelity and how fidelity was maintained, and (e) reasons for modifications. Modifications to the delivery and content were changed to reflect the values and norms of both the Hispanic/Latino staff and the caregivers they serve. As supportive interventions for caregivers are developed and implemented into real-world settings, inclusion of cultural elements may enhance research participation among Hispanic/Latino provider sites, people living with dementia, and their caregivers. Cultural adaptation is an essential consideration when developing, adapting, and implementing previously tested evidence-based interventions. Cultural adaptation offers an important lens by which to identify contextual factors that influence successful adoption to assure equity in the reach of evidence-based programs.
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Affiliation(s)
- Lauren J Parker
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Katherine A Marx
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
| | - Manka Nkimbeng
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Elma Johnson
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Sokha Koeuth
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Laura N Gitlin
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, Maryland, USA
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA
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McCarthy MJ, Garcia YE, Remiker M, Hustead MLR, Bacon R, Williamson HJ, Dunn DJ, Baldwin JA. Diverse rural caregivers for individuals with Alzheimer's disease or related dementias: analysis of health factors at the individual, interpersonal, and community level. Aging Ment Health 2023; 27:94-100. [PMID: 35098811 PMCID: PMC9339023 DOI: 10.1080/13607863.2022.2026880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Objectives: Approximately 6.2 million Americans aged 65 or older have Alzheimer's disease or related dementias (ADRD). Unpaid family members and friends provide the bulk of caregiving for these individuals. Caregiving in rural areas adds unique challenges, particularly for ethnically/racially diverse caregivers. This study provides a profile of diverse, rural ADRD caregivers with an emphasis on multi-level factors that influence physical and mental health.Methods: A cross-sectional survey was conducted with 156 diverse rural ADRD caregivers.Results: 65% of participants identified as White/Non-Hispanic (WNH; n = 101) and 35% identified as ethnically/racially diverse (ERD; n = 55). The majority of participants reported economic deprivation. More ERD caregivers were uninsured and had at least one chronic health condition. Higher proportions of ERD caregivers smoked cigarettes, consumed alcohol regularly, and had not seen or talked to a doctor in the previous year. There were no ethnic/racial group differences in stress, anxiety, depressive symptoms, subjective health, or sleep quality.Conclusion: Rural caregivers, regardless of ethnicity/race, may benefit from extra supports in order to maintain optimal health. Further research is needed to disentangle the complex relationship between culture, caregiving, and health.
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Affiliation(s)
| | - Y. Evie Garcia
- Department of Educational Psychology, Northern Arizona University, Flagstaff, AZ
| | - Mark Remiker
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ
| | | | - Rachel Bacon
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ
| | | | - Dorothy J. Dunn
- School of Nursing, Northern Arizona University, Flagstaff, AZ
| | - Julie A. Baldwin
- Center for Health Equity Research, Northern Arizona University, Flagstaff, AZ
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Castro FG, Berkel C, Epstein DR. Cultural adaptations and cultural factors in EBI implementation with Latinx communities. Front Public Health 2023; 11:1007328. [PMID: 37026135 PMCID: PMC10070745 DOI: 10.3389/fpubh.2023.1007328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 02/06/2023] [Indexed: 04/08/2023] Open
Abstract
Introduction Cultural factors are constructs that capture important life experiences of Latinx/Hispanic individuals, families, and communities. Despite their importance for Latinx communities, Latinx cultural factors have yet to be fully incorporated into the literature of many social, behavioral science, and health service fields, including implementation science. This significant gap in the literature has limited in-depth assessments and a more complete understanding of the cultural life experiences of diverse Latinx community residents. This gap has also stifled the cultural adaptation, dissemination, and implementation of evidence based interventions (EBIs). Addressing this gap can inform the design, dissemination, adoption, implementation, and sustainability of EBIs developed to serve Latinx and other ethnocultural groups. Methods Based on a prior Framework Synthesis systematic review of Latinx stress-coping research for the years 2000-2020, our research team conducted a thematic analysis to identify salient Latinx cultural factors in this research field. This thematic analysis examined the Discussion sections of 60 quality empirical journal articles previously included into this prior Framework Synthesis literature review. In Part 1, our team conducted an exploratory analysis of potential Latinx cultural factors mentioned in these Discussion sections. In Part 2 we conducted a confirmatory analysis using NVivo 12 for a rigorous confirmatory thematic analysis. Results This procedure identified 13 salient Latinx cultural factors mentioned frequently in quality empirical research within the field of Latinx stress-coping research during the years 2000-2020. Discussion We defined and examined how these salient Latinx cultural factors can be incorporated into intervention implementation strategies and can be expanded to facilitate EBI implementation within diverse Latinx community settings.
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Affiliation(s)
- Felipe González Castro
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, United States
- *Correspondence: Felipe González Castro
| | - Cady Berkel
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
| | - Dana R. Epstein
- College of Health Solutions, Arizona State University, Phoenix, AZ, United States
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Roberto KA, Savla J, McCann BR, Blieszner R, Knight AL. Dementia Family Caregiving in Rural Appalachia: A Sociocultural Model of Care Decisions and Service Use. J Gerontol B Psychol Sci Soc Sci 2022; 77:1094-1104. [PMID: 34951643 PMCID: PMC9159069 DOI: 10.1093/geronb/gbab236] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES Examinations of cultural variations in caregiving experiences and practices tend to focus on racially and ethnically diverse family caregivers. We extended this research by exploring the role of place-based cultural constructs on care decisions of family caregivers for persons living with dementia in rural Appalachia whose experiences and backgrounds dwell outside the lines of dominant culture. METHODS Guided by our sociocultural conceptual model of service use and a descriptive qualitative study design, we conducted in-depth interviews with 30 caregivers for persons living with dementia to understand how predisposing and enabling factors influence caregiving decisions, including the use of services to care for persons living with dementia. RESULTS Three predisposing factors reflecting the culture of rural Appalachian counties in Virginia (reasons for becoming a caregiver, previous caregiving experience, and deference to the person living with dementia) shaped decisions about caregiving responsibilities and service use. Three place-based enabling factors (a personal sense of belonging, knowledge of services, and family support for service use) played an important role in facilitating access to services. DISCUSSION Findings revealed subtle variation across caregivers in this study and in comparison, to caregivers' experiences more generally. We interpret these variations in light of culturally influenced attitudes, family norms, and sources of information about formal services. Place-based cultural experience influenced dementia family caregivers' behaviors and choices regarding formal service use, suggesting that investigators should pay more attention to cultural influences in future caregiving research.
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Affiliation(s)
- Karen A Roberto
- Center for Gerontology, Virginia Tech, Blacksburg, Virginia, USA
- Institute for Society, Culture, and Environment, Virginia Tech, Blacksburg, Virginia, USA
| | - Jyoti Savla
- Center for Gerontology, Virginia Tech, Blacksburg, Virginia, USA
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
| | | | | | - Aubrey L Knight
- Department of Internal Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Department of Family and Community Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
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Martinez IL, Acosta Gonzalez E. Care v. Caring: Obligation, Duty, and Love Among Latino Alzheimer's Family Caregivers. J Appl Gerontol 2022; 41:1744-1751. [PMID: 35484911 DOI: 10.1177/07334648221084998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The number of Latinos living with Alzheimer's disease is projected to grow. Latinos currently make one-fifth of U.S. family caregivers. In this paper, we explore the cultural scripts and gendered practice of care in Latino families in relation to the underutilization of services to persons with Alzheimer's disease and related dementias. We conducted interviews with 24 Latino caregivers in Miami-Dade, Florida representing six Latin American countries of origin. Interviews were analyzed using a grounded theory approach. We critically examined the concept of familism in order to better understand in-depth experiences of diverse Latino caregivers and concluded that an ethics of care model better elucidates the complexities of the care experience. Our analysis illustrates the ambivalence, contradictions, and changes in the beliefs and practice of care. These findings can help advance understanding among researchers and providers to develop a formal support system that is responsive to Latino caregiver needs.
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Affiliation(s)
- Iveris L Martinez
- Center for Successful Aging, 14668California State University Long Beach, Long Beach, CA, USA
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11
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Arévalo‐Flechas LC, Flores B“P, Wang H, Liang H, Li Y, Gelfond J, Espinoza S, Lewis SL, Musi N, Yeh C. Stress‐Busting Program for Family Caregivers: Validation of the Spanish version using biomarkers and quality‐of‐life measures. Res Nurs Health 2022; 45:205-217. [DOI: 10.1002/nur.22216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 12/22/2021] [Accepted: 01/23/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Lyda C. Arévalo‐Flechas
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
- Division of Geriatrics, Gerontology and Palliative Medicine The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Bertha “Penny” Flores
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
- School of Nursing The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Hanzhou Wang
- Department of Comprehensive Dentistry The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Hanyu Liang
- Barshop Institute for Longevity and Aging Studies The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Yan Li
- Barshop Institute for Longevity and Aging Studies The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Jonathan Gelfond
- Department of Population Health Sciences, Long School of Medicine The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Sara Espinoza
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
- Division of Geriatrics, Gerontology and Palliative Medicine The University of Texas Health Science Center at San Antonio San Antonio Texas USA
- Barshop Institute for Longevity and Aging Studies The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Sharon L. Lewis
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
| | - Nicolas Musi
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
- Barshop Institute for Longevity and Aging Studies The University of Texas Health Science Center at San Antonio San Antonio Texas USA
| | - Chih‐Ko Yeh
- Geriatric Research, Education & Clinical Center, Audie L. Murphy Division South Texas Veterans Health Care System San Antonio Texas USA
- Department of Comprehensive Dentistry The University of Texas Health Science Center at San Antonio San Antonio Texas USA
- Barshop Institute for Longevity and Aging Studies The University of Texas Health Science Center at San Antonio San Antonio Texas USA
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Faletar Tanacković S, Petr Balog K, Erdelez S. How can libraries support dementia friendly communities? The study into perceptions and experiences of Croatian public librarians. EDUCATION FOR INFORMATION 2021. [DOI: 10.3233/efi-211560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Alzheimer’s Disease (AD), the most common cause of dementia, is an incurable neurological disease with an unknown cause. Since AD is not only social and health challenge but also an economic and fiscal burden and its prevalence is expected to grow exponentially as world population gets older, in 2012 the World Health Organization (WHO) and Alzheimer’s Disease International (ADI) recognized dementia as a global public health priority. Although librarians have not generally been recognized as professionals caring for persons with dementia, recent research indicates that public libraries can contribute to the development of dementia friendly communities by supporting social inclusion, self-efficacy and capacity building of persons with AD, and by providing support to their informal caregivers (CGs). The research reported in this paper aims to examine the role of Croatian public libraries in building a dementia friendly communities, in a country where information, health and social care systems for D patients and their CGs are not sufficiently developed (Rušac, 2016; Petr Balog et al., 2020). With the help of quantitative (online survey) methodology authors explore how Croatian public libraries tailor their spaces, collections, programs and services in order to enhance the everyday experience of persons with AD and their CGs.
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Affiliation(s)
- Sanjica Faletar Tanacković
- Department of Information Sciences, Faculty of Humanities and Social Sciences, University of Osijek, Croatia
| | - Kornelija Petr Balog
- Department of Information Sciences, Faculty of Humanities and Social Sciences, University of Osijek, Croatia
| | - Sanda Erdelez
- Simmons University School of Library and Information Science, Boston, MA, USA
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13
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Martinez IL, Acosta Gonzalez E, Quintero C, Vania MJ. The Experience of Alzheimer's Disease Family Caregivers in a Latino Community: Expectations and incongruences in support services. J Gerontol B Psychol Sci Soc Sci 2021; 77:1083-1093. [PMID: 34543386 DOI: 10.1093/geronb/gbab170] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Current theoretical constructs on the utilization of formal support for Latino caregivers focus on familism and exclude the cultural values represented in the service system. The purpose of this paper is to highlight the experience of care for Latino family caregivers to persons with Alzheimer's disease and related dementias (ADRD). We also examine the cultural congruence between provider perspectives with the expectations of Latino ADRD caregivers. METHOD We conducted extended interviews with 24 Latino ADRD caregivers and 10 service providers. Interview transcripts were coded and analyzed using a grounded theory approach. RESULTS Our study provides a deeper understanding of Latino caregiving experiences and highlights some of the structural and systematic issues in current systems of caregiver support. While Latino families have very specific notions of care, by upholding notions of familism, there is a tendency to not look deeper into how they may be better supported in caregiving and fall into the "culture trap." The assumption that family should be the natural support network for older adults may lead to health and social systems of care to ignore the specific needs of the Latino population. DISCUSSION Services are being provided under a model that was established four decades ago and may not reflect current realities. The concept of "an ethics of care" allows us to move beyond familism and explain that underutilization of services may also be due in part to the cultural incongruence between what service providers offer and the perceived needs of Latino caregivers.
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Morgenstern LB, Hollenhorst CN, Gallo LC, Hsu CW, Kim S, Gibbs R, Case E, Lisabeth LD. Ethnic Differences in Informal Caregiving After Stroke. Stroke 2021; 52:3938-3943. [PMID: 34455820 DOI: 10.1161/strokeaha.120.032740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Informal (unpaid) caregiving usually provided by family is important poststroke. We studied whether the prevalence of informal caregiving after stroke differs between Mexican Americans (MAs) and non-Hispanic Whites (NHWs). METHODS Between October 2014 and December 2018, participants in the BASIC (Brain Attack Surveillance in Corpus Christi) project in Nueces County, Texas, were interviewed 90 days after stroke to determine which activities of daily living they required help with and whether family provided informal caregiving. Ethnic differences between MAs and NHWs were determined by logistic regression. The logistic models were stratified by formal (paid) care status. Odds ratios (95% CIs) are reported with NHW as the referent group. Fisher exact tests were used to assess the association of ethnicity with relationship of caregiver and with individual activities of daily living. RESULTS Eight hundred thirty-one patients answered the caregiving questions. Of these, 242 (29%) received family caregiving (33% of MAs and 23% of NHWs), and 142 (17%) received paid caregiving (21% of MAs and 10% of NHWs). There were no ethnic differences in stroke severity. In logistic regression analyses, among those without formal, paid care, MAs were more likely to have informal caregiving (odds ratio, 1.75 [95% CI, 1.12-2.73]) adjusted for age, National Institutes of Health Stroke Scale, prestroke modified Rankin Scale, and insurance. No ethnic differences in informal care were found among those who had formal care. There were no differences between ethnic groups in which family members provided the informal care. MAs were more likely to require help compared with NHWs for walking (P<0.0001), bathing (P<0.0001), hygiene (P=0.0012), eating (P=0.0004), dressing (P<0.0001), ambulating (P=0.0304), and toileting (P=0.0003). CONCLUSIONS MAs required more help poststroke than NHWs for assistance with activities of daily living. MAs received more help for activities of daily living through informal, unpaid caregiving than NHWs if they were not also receiving formal, paid care. Efforts to help minority and low-resource populations provide stroke care are needed.
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Affiliation(s)
- Lewis B Morgenstern
- University of Michigan Medical School, Ann Arbor (L.B.M., C.N.H., L.D.L.).,University of Michigan School of Public Health, Ann Arbor (L.B.M., C.-W.H., R.G., E.C., L.D.L.)
| | | | | | - Chia-Wei Hsu
- University of Michigan School of Public Health, Ann Arbor (L.B.M., C.-W.H., R.G., E.C., L.D.L.)
| | - Sehee Kim
- Asian Medical Center, Seoul, South Korea (S.K.)
| | - River Gibbs
- University of Michigan School of Public Health, Ann Arbor (L.B.M., C.-W.H., R.G., E.C., L.D.L.)
| | - Erin Case
- University of Michigan School of Public Health, Ann Arbor (L.B.M., C.-W.H., R.G., E.C., L.D.L.)
| | - Lynda D Lisabeth
- University of Michigan Medical School, Ann Arbor (L.B.M., C.N.H., L.D.L.).,University of Michigan School of Public Health, Ann Arbor (L.B.M., C.-W.H., R.G., E.C., L.D.L.)
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McCarthy MJ, Lee-Regalado Hustead M, Bacon R, Garcia YE, Dunn DJ, Williamson HJ, Baldwin J. Development and Validation of a Community Assessment Survey for Diverse Rural Family Caregivers of People With Alzheimer Disease and Related Dementias. FAMILY & COMMUNITY HEALTH 2021; 44:126-135. [PMID: 33646980 PMCID: PMC8131205 DOI: 10.1097/fch.0000000000000297] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Many individuals with Alzheimer disease and related dementias receive care from family members and friends. Rurality adds increased complexity to care, especially for diverse caregivers. This study details the development and content validation process for a community assessment survey for rural white, Latinx, and American Indian/Alaska Native Alzheimer disease and related dementias caregivers. Foundational survey items were based upon instruments validated with diverse rural caregivers. A modified Delphi process (2 rounds) was used to refine items. The process concluded when 75%+ of experts agreed that the survey was (1) inclusive of different cultural groups; (2) respectful of cultural values and norms; (3) comprehensive with respect to needs, assets, and resources, and (4) relevant to the experiences of diverse rural caregivers. Round 1 of the process (N = 9 panelists) resulted in the elimination of 2 survey sections, a greater focus on issues including transportation and roles of extended family members, and the inclusion of open-ended questions. Round 2 (N = 6 panelists) resulted in further improvements, particularly to the sections about cultural customs, beliefs, and traditions and interactions with health care and other providers. Benefits of the process included raising awareness about rural caregiving issues and maximizing data quality. Challenges included honoring the diversity of respondents' opinions and balancing research rigor with community utility. This community assessment survey may help researchers better understand the needs and culturally-based strengths of diverse rural family caregivers.
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Affiliation(s)
- Michael J McCarthy
- Departments of Social Work, College of Social and Behavioral Sciences (Dr McCarthy), Educational Psychology, College of Education (Ms Lee-Regalado Hustead and Dr Garcia), and Occupational Therapy (Dr Williamson) and Health Sciences (Dr Baldwin), Center for Health Equity Research, Northern Arizona University, Flagstaff; Center for Health Equity Research (Dr Bacon), Northern Arizona University, Flagstaff; and School of Nursing, College of Health & Human Services (Dr Dunn), Northern Arizona University, Flagstaff
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Cabrera LY, Kelly P, Vega IE. Knowledge and Attitudes of two Latino Groups about Alzheimer Disease: a Qualitative Study. J Cross Cult Gerontol 2021; 36:265-284. [PMID: 34196838 PMCID: PMC8421275 DOI: 10.1007/s10823-021-09432-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/29/2022]
Abstract
Clustering Latinos under a single group in Alzheimer Disease (AD) research, neglects, among other things cultural and environmental differences. To address this, we examine knowledge and attitudes about AD among two Latino groups. We held 5 focus groups and 2 interviews all in Spanish with Mexicans and Puerto Ricans between 40 and 60 years old living in the Grand Rapids area in Michigan. Using content analysis of the discussions, we identified themes related to knowledge, attitudes and concerns about AD and caregiving. A total of 20 Mexicans and 9 Puerto Ricans participated. Improving knowledge and awareness, barriers and home-based family care were important themes in both Latino groups. Puerto Rican groups raised more concerns about the disease, whereas lack of knowledge was a key theme among Mexican participants. The exploratory study is a first step in promoting research that is attentive to the commonalities and differences of Latino groups and in continuing efforts to enhance health literacy among these groups.
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Affiliation(s)
- Laura Y Cabrera
- Department of Engineering Science and Mechanics, Center for Neural Engineering, College of Engineering, Pennsylvania State University, W-316 Millennium Science Complex, University Park, PA, 16802, USA.
- Rock Ethics Institute and Huck Institute of Life Sciences, Pennsylvania State University, University Park, PA, USA.
| | - P Kelly
- College of Natural Science, Michigan State University, East Lansing, MI, USA
| | - I E Vega
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
- Department of Translational Neuroscience, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
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Benasi G, Fava GA, Rafanelli C. Kellner's Symptom Questionnaire, a Highly Sensitive Patient-Reported Outcome Measure: Systematic Review of Clinimetric Properties. PSYCHOTHERAPY AND PSYCHOSOMATICS 2021; 89:74-89. [PMID: 32050199 DOI: 10.1159/000506110] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/23/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Patient-reported outcomes (PROs) are of increasing importance in clinical medicine. However, their evaluation by classic psychometric methods carries considerable limitations. The clinimetric approach provides a viable framework for their assessment. OBJECTIVE The aim of this paper was to provide a systematic review of clinimetric properties of the Symptom Questionnaire (SQ), a simple, self-rated instrument for the assessment of psychological symptoms (depression, anxiety, hostility, and somatization) and well-being (contentment, relaxation, friendliness, and physical well-being). METHODS The PRISMA guidelines were used. Electronic databases were searched from inception up to March 2019. Only original research articles, published in English, reporting data about the clinimetric properties of the SQ, were included. RESULTS A total of 284 studies was selected. The SQ has been used in populations of adults, adolescents, and older individuals. The scale significantly discriminated between subgroups of subjects in both clinical and nonclinical settings, and differentiated medical and psychiatric patients from healthy controls. In longitudinal studies and in controlled pharmacological and psychotherapy trials, it was highly sensitive to symptoms and well-being changes and discriminated between the effects of psychotropic drugs and placebo. CONCLUSIONS The SQ is a highly sensitive clinimetric index. It may yield clinical information that similar scales would fail to provide and has a unique position among the PROs that are available. Its use in clinical trials is strongly recommended.
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Affiliation(s)
- Giada Benasi
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Giovanni A Fava
- Department of Psychiatry, University at Buffalo, State University of New York, Buffalo, New York, USA
| | - Chiara Rafanelli
- Department of Psychology, University of Bologna, Bologna, Italy,
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Balbim GM, Magallanes M, Marques IG, Ciruelas K, Aguiñaga S, Guzman J, Marquez DX. Sources of Caregiving Burden in Middle-Aged and Older Latino Caregivers. J Geriatr Psychiatry Neurol 2020; 33:185-194. [PMID: 31510848 DOI: 10.1177/0891988719874119] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We aimed to identify sources of caregiver burden in middle-aged and older Latino caregivers of people with Alzheimer disease and related dementia (ADRD). METHODS Participants were recruited through an agreement with the Rush Alzheimer's Disease Center Clinic Data Repository. We conducted semistructured interviews with 16 middle-aged and older Latinos who were the primary caregiver for a family member diagnosed with ADRD. The interview guide consisted of questions and probes to capture participants' perceptions of family caregiving. Direct content analysis was performed. RESULTS Participants were aged 50 to 75 years (n = 16) and a majority female (n = 12). The sources of burden identified were (1) caregiver responsibilities, (2) caregiving-related health decline, (3) lack of support, (4) financial status, (5) vigilance, and (6) concerns about the future. CONCLUSIONS The influence of gender roles seemed to play a role in caregivers' perceptions of sources of burden, especially on caregiver responsibilities and perceptions of lack of support. Latinos cultural values such as familismo and marianismo likely reinforced gender disparities in family caregiving.
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Affiliation(s)
- Guilherme Moraes Balbim
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
| | | | - Isabela Gouveia Marques
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, British Columbia, Canada
| | - Karen Ciruelas
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
| | - Susan Aguiñaga
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jacqueline Guzman
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - David Xavier Marquez
- Department of Kinesiology and Nutrition, College of Applied Health Sciences, University of Illinois at Chicago, IL, USA
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Latina/o and non-latina/o brain injury and dementia patients’ and caregivers’ health: An actor/partner interdependence model. BRAIN IMPAIR 2020. [DOI: 10.1017/brimp.2020.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:The interdependence between patient and caregivers’ health, which is when the patients’ and informal caregivers’ emotion, cognition and/or behavior affects that of the other person is well documented among dyads experiencing cancer and heart disease, but scant research has assessed interdependence among those with brain injuries or dementia and Latina/o populations. This study aimed to assess the interdependence of patient and caregiver depression, patient functional independence and caregiver burden among non-Latina/o and Latina/o and patients with brain injuries and dementia and their caregivers.Methods:Patients and caregiver dyads (n = 96) were recruited from a trauma hospital. Participants completed measures on patient and caregiver depression, patient functional independence and caregiver burden. Participants provided written informed consent. Patient inclusion criteria included: (1) diagnosis with a brain injury or dementia, (2) minimum age of 12, (3) community dwelling and (4) ability to verbally communicate and complete study measures. Caregivers were only included if they were informal, unpaid, family or a friend. Nonparametric Spearman’s Rho correlations were conducted to test the study hypotheses.Discussion:There was consistently a statistically significant positive relationship between caregiver depression and caregiver burden for all groups. For non-Latina/o patient and caregiver dementia dyads, there were associations between patient depression and caregiver depression. For non-Latina/o dementia dyads, functional ability was only associated with patient depression. For Latina/o patient and caregiver brain injury and dementia dyads, the only statistically significant relationship was between caregiver depression and caregiver burden. Health services should embrace family-focused mental health and respite interventions.
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Balbim GM, Marques IG, Cortez C, Magallanes M, Rocha J, Marquez DX. Coping Strategies Utilized by Middle-Aged and Older Latino Caregivers of Loved Ones with Alzheimer’s Disease and Related Dementia. J Cross Cult Gerontol 2019; 34:355-371. [DOI: 10.1007/s10823-019-09390-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Abstract
The Caregiver Advise, Record, Enable (CARE) Act has the potential to make a positive impact in the lives of Latino older adults and their caregivers. As Latino individuals are the fastest growing older adult population, the number of Latino families and caregivers is also expected to grow, particularly among those providing care for someone with Alzheimer's disease or other dementias. Caregiving has been considered a culturally embedded value among Latino individuals. Although few studies have focused on caregiving in this population, those that exist suggest that Latino caregivers struggle to find bilingual and bicultural support and information and show higher levels of distress and health disparities. The purpose of the CARE Act is to help and support family caregivers when older adults are admitted to the hospital and during care transitions. The current article examines the potential implications of this state law, specifically on Latino individuals, including recommendations for policy implementation. [Journal of Gerontological Nursing, 44(3), 9-14.].
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Piedra LM, Andrade FCD, Hernandez R, Boughton SW, Trejo L, Sarkisian CA. The Influence of Exercise on Cognitive Function in Older Hispanic/Latino Adults: Results From the "¡Caminemos!" Study. THE GERONTOLOGIST 2017; 57:1072-1083. [PMID: 28329844 PMCID: PMC5881662 DOI: 10.1093/geront/gnw256] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Accepted: 02/09/2017] [Indexed: 01/01/2023] Open
Abstract
Purpose of the Study We examined the prospective effect of an evidence-based exercise intervention (¡Caminemos!) on cognitive function among older Hispanic/Latino adults and the potential synergistic effects (if any) of an attribution-retraining intervention given to a random sample to counter negative ascriptions of the aging process. Design and Methods We analyzed baseline and follow-up (1- and 2-year) data collected from Hispanics/Latinos ≥60 years (N = 571) who participated in ¡Caminemos! across 27 senior centers. All participants were randomly assigned to either (a) the treatment group-a 1-hr attribution-retraining session plus a 1-hr exercise class or (b) the control group-health education plus a 1-hr exercise class. Mixed-effects linear regression was used to determine the effects of the exercise class and the attribution-retraining component on longitudinal changes in cognitive functioning, as measured by the Modified Mini-Mental State (3MS) examination. Results In analyses adjusted for age, sex, education, income, and medical comorbidities, participants in both trial arms displayed higher cognitive functioning scores at the 1-year (β = 1.76, p = .001) and 2-year (β = 1.37, p = .013) follow-ups when compared with original baseline scores. However, we found no significant difference in cognitive function between the treatment versus control conditions (β = 0.41, p = .582), nor were any differences found across groups over time. Implications The exercise intervention improved cognitive function in older Hispanics/Latinos, regardless of whether it was supplemented with the age-related attribution retraining. These findings suggest that limited access to exercise programs may be a greater obstacle in forestalling cognitive decline in older Hispanics/Latinos than the negative beliefs they might hold of the aging process.
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Affiliation(s)
| | - Flavia C D Andrade
- Kinesiology & Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign
| | | | | | - Laura Trejo
- City of Los Angeles Department of Aging, California
| | - Catherine A Sarkisian
- Department of Medicine, David Geffen School of Medicine at UCLA and VA Greater Los Angeles Geriatric Research Education and Clinical Center, Los Angeles, California
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Crist JD, Pasvogel A, Szalacha LA, Finley BA. Depression in Family Caregivers of Mexican Descent: Exacerbated by Stress and Mitigated by Mutuality. Res Gerontol Nurs 2017; 10:106-113. [DOI: 10.3928/19404921-20170412-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/27/2017] [Indexed: 11/20/2022]
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Research on Hispanics benefits the field of management. JOURNAL OF MANAGERIAL PSYCHOLOGY 2014. [DOI: 10.1108/jmp-02-2014-0067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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