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Nolan A, Aaltonen K, Danielsbacka M. The Effect of Informal Caregiving on Depression: An Asymmetric Panel Fixed-Effects Analysis of In-Home and Out-Of-Home Caregivers Across Europe. J Aging Soc Policy 2024:1-19. [PMID: 38704670 DOI: 10.1080/08959420.2024.2348968] [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: 06/23/2023] [Accepted: 02/20/2024] [Indexed: 05/06/2024]
Abstract
Previous research has shown that providing intensive informal care can have a negative effect on an individual's mental health. However, few studies have been able to draw a precise comparison between the experiences of in-home and out-of-home caregivers. This study used data from 16 countries collected from 2011-2019 as part of the Survey of Health, Ageing and Retirement in Europe (SHARE) to conduct asymmetric panel fixed-effects models that examined within-person variation in depression scores after a respondent started providing daily or almost daily personal care either inside or outside of their home. The results substantiated previous findings that in-home caregivers experience more pronounced increases to their reported depressive symptoms after starting to provide daily personal care than do out-of-home caregivers. In addition, in-home caregivers in countries with greater governmental responsibility for long-term care provision (The Northern and Central Clusters) reported fewer increases to their depressive symptoms after starting to provide care than caregivers in countries where long-term care responsibility predominantly rests on families (The Southern and Eastern Cluster). Further, Northern Cluster countries most successfully shrank the pool of out-of-home care providers. Together, these findings underscore the context-specific nature of caregiver wellbeing.
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Affiliation(s)
- Andreas Nolan
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
| | - Katri Aaltonen
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
- Kela Research, The Social Insurance Institution of Finland, Helsinki, Finland
| | - Mirkka Danielsbacka
- INVEST Research Flagship Centre, University of Turku, Turku, Finland
- Population Research Institute, Väestöliitto, Helsinki, Finland
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Cardwell K, Awadia Z, McKenna O, Venasse M, Hume T, Ludgate J, Freedman M, Finlayson M, Latimer-Cheung A, Pilutti LA, Fakolade A. Physical activity together for MS (PAT-MS): Secondary outcomes of a randomized controlled feasibility trial. Mult Scler Relat Disord 2024; 82:105399. [PMID: 38184911 DOI: 10.1016/j.msard.2023.105399] [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] [Received: 08/10/2023] [Revised: 12/04/2023] [Accepted: 12/21/2023] [Indexed: 01/09/2024]
Abstract
BACKGROUND Care partners provide essential care to those with multiple sclerosis (MS). Dyadic interventions promoting health behaviours have wide-reaching benefits for individuals with MS and their care partners. However, behavioural interventions to promote physical activity in patient-caregiver dyads have yet to be explored in an MS-specific context. This study examined the secondary outcomes of the "Physical Activity Together for Multiple Sclerosis (PAT-MS)" intervention, including dyadic adjustment, caregiving tasks, caregiver quality of life, coping, and MS impact in MS dyads. METHODS A randomized controlled feasibility trial of the 12-week behavioural PAT-MS intervention. The Dyadic Adjustment Scale, Caregiving Tasks in MS Scale, Caregiver Quality of Life in MS Scale, Coping with MS Caregiving Inventory, and MS Impact Scale measured secondary outcomes of interest. Mixed-model ANOVAs were used to test changes in variables between groups (PAT-MS vs wait-list control) over time. RESULTS 20 participants, including 10 people with MS (51.4 ± 10.1 years old; median patient-determined disease steps (PDDS) score= 4, IQR= 1.25) and 10 care partners (48.5 ± 12.1 years old) were recruited and randomized. There was no statistically significant effect of the intervention on any of the secondary outcomes (p= 0.67-1.00). However, large effect sizes and condition-by-time interaction effects indicated improvement in dyadic adjustment (d= 1.03, ηp2= 0.45), the criticism-coercion coping subscale (d= -0.93, ηp2= 0.49), and caregiving tasks (d= 1.05, ηp2= 0.52), specifically within psycho-emotional (d= 1.47, ηp2= 0.38) and socio-practical (d= 1.10, ηp2 =0.37) sub-domains of caregiving tasks after the PAT-MS intervention compared to the wait-list condition. CONCLUSION While this pilot feasibility study was not powered based on the secondary outcomes herein, our findings indicate improvement in dyadic adjustment and emotional and social caregiving tasks, with reduced reliance on criticism-coercion coping in the PAT-MS group compared to controls following the intervention. Findings indicate that PAT-MS may improve dyadic psychosocial well-being of people with moderate-to-severe MS and their care partners, and this should be examined next in a fully-powered study.
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Affiliation(s)
- Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Zain Awadia
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Myriam Venasse
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Taylor Hume
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Julia Ludgate
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Mark Freedman
- Faculty of Medicine, University of Ottawa, Ottawa, Canada; The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6, Canada
| | - Amy Latimer-Cheung
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | - Lara A Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada; Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen's University, Louise D. Acton Building, 31 George Street, Kingston, Ontario K7L 3N6, Canada.
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Veillard D, Baumstarck K, Hamonic S, Ousmen A, Hamidou Z, Edan G, Auquier P. Dyadic coping strategies and quality of care experience: An original study of patients living with multiple sclerosis and their caregivers. Rev Neurol (Paris) 2023; 179:1118-1127. [PMID: 37718212 DOI: 10.1016/j.neurol.2023.02.072] [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] [Received: 10/27/2022] [Revised: 02/12/2023] [Accepted: 02/17/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND AND OBJECTIVE Multiple sclerosis has a major impact on the lives of patients and their caregivers. Measuring their experience is essential for improving the quality of care. Based on a sample of patient-informal caregiver dyads we examine whether coping strategies they implemented influenced their self-experience of quality of care. METHODS One hundred and eighty three dyads were involved in this cross-sectional study. Self reported data included experience with the quality of care (Musicare) and coping strategies (Brief Cope) for patients and their caregivers. An actor-partner interdependence model (APIM) analysis was performed to assess the dyadic effects of coping strategies on experience of quality of care. RESULTS Positive coping strategies were the most used by patients and caregivers alike. They were associated with a better experience of relationships with healthcare professionals, information about the disease and patient reception at the sites providing care. APIM analyses confirmed most of these results and identified one "partner" effect. CONCLUSION The experience of the quality of the care of patients living with MS is related to the use of positive coping strategies.
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Affiliation(s)
- D Veillard
- Public Health and Epidemiology Department, Rennes University Hospital, Rennes, France; Public Health: Quality of Life and Chronic Diseases EA3279, Aix-Marseille University, Marseille, France.
| | - K Baumstarck
- Public Health: Quality of Life and Chronic Diseases EA3279, Aix-Marseille University, Marseille, France
| | - S Hamonic
- Public Health and Epidemiology Department, Rennes University Hospital, Rennes, France
| | - A Ousmen
- Public Health and Epidemiology Department, Rennes University Hospital, Rennes, France
| | - Z Hamidou
- Public Health: Quality of Life and Chronic Diseases EA3279, Aix-Marseille University, Marseille, France
| | - G Edan
- Clinical Neuroscience Centre, CIC-P 1414 INSERM, Rennes University Hospital, Rennes, France
| | - P Auquier
- Public Health: Quality of Life and Chronic Diseases EA3279, Aix-Marseille University, Marseille, France
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Cardwell KL, Hume TA, McKenna OJ, Pilutti LA, Fakolade A. Symptom Management Among Multiple Sclerosis Care Partners in Canada. Int J MS Care 2023; 25:281-287. [PMID: 37969913 PMCID: PMC10634598 DOI: 10.7224/1537-2073.2022-113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Managing the heterogeneity and unpredictability of multiple sclerosis (MS) symptoms can be difficult for MS care partners. This study aimed to characterize the symptoms managed by MS care partners, recognize relationships between symptom management difficulty and other aspects of the caregiving role, and identify supplemental sources of care-giving support used by care partners. METHODS A Canadian cohort of MS care partners completed an online survey capturing care-partner characteristics, care-recipient symptoms, care-partner difficulty with managing symptoms, and sources of caregiving assistance. Descriptive analysis, analysis of variance, and χ2 tests were used to compare differences in care-partner characteristics by symptom management difficulty groups, defined as low (<4 symptoms), medium (5-7 symptoms), and high difficulty (>7 symptoms). RESULTS Care partners to individuals with MS (N = 475) reported a median of 8 symptoms (IQR = 4) experienced by their care-recipients. The most frequent symptoms reported were fatigue (89.1%), weakness (87.2%), and depression (81.9%). Care partners reported a median of 6 (IQR = 5) symptoms being somewhat or very difficult to manage. Balance or mobility impairments (20.3%), depression (14.3%), and vision difficulties (13.1%) were most frequently reported as very difficult to manage. Assisting with activities of daily living (P < .001) and time spent caregiving (P = .035) varied significantly between symptom management difficulty groups. Additional help available was reported by 77.5%, 17.8%, and 41.6% of care partners reporting low, medium, and high symptom management difficulty, respectively (P < .001). CONCLUSIONS Care partners of individuals with MS report difficulty in managing multiple, variable symptoms and often have no additional help. These findings suggest that MS care partners experience difficulty managing many diverse symptoms and may benefit from additional support.
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Affiliation(s)
- Katherine L. Cardwell
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Taylor A. Hume
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Odessa J. McKenna
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada (AF)
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Cardwell KL, Koch L, McKenna OJ, Pilutti LA, Fakolade A. Mapping Resilience: Structural Equation Modeling of Psychological Resilience in Multiple Sclerosis Care Partners. Int J MS Care 2023; 25:245-251. [PMID: 37969910 PMCID: PMC10634600 DOI: 10.7224/1537-2073.2023-078] [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: 11/17/2023]
Abstract
BACKGROUND Care partners are essential supports to individuals with multiple sclerosis (MS). Both negative and positive outcomes associated with the caregiving role have been reported. Psychological resilience may be an important factor influencing the MS caregiving experience, but an MS-specific model of care partner resilience has yet to be established. This study sought to explore an explicit model of MS care partner resilience. METHODS Cross-sectional data from 471 Canadian MS care partners were collected via an online survey. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) were used to test measures within a hypothesized model of resilience. Resilience was measured using the 25-item Connor-Davidson Resilience Scale. RESULTS Following CFA, the hypothesized model was simplified due to the poor fit of several variables. The final model yielded a moderate SEM fit (χ2 = 6030.95, P < .01). Being a woman was associated with greater caregiving tasks (β = 0.53, P < .001) and poorer spiritual health (β = -0.35, P < .001). Spiritual health, but not caregiving tasks, had a positive impact on both positive (β = 0.48, P < .01) and negative coping (β = 0.49, P = .01). Quality of life and resilience did not have relationships with other variables in the model. However, quality of life had a positive, unidirectional influence on resilience (β = 0.83, P < .01). CONCLUSIONS Our findings indicate that spiritual health is an important predictor of coping and should be further explored in MS care partners. Quality of life may act as a precursor to resilience within MS care partners. Further research and exploration into MS care partner resilience is warranted to confirm this exploratory model.
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Affiliation(s)
- Katherine L. Cardwell
- From the Interdisciplinary School of Health Sciences (KLC, LAP), the Faculty of Medicine (OJM), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Laura Koch
- Temerty School of Medicine, University of Toronto, Toronto, ON, Canada (LK)
| | - Odessa J. McKenna
- From the Interdisciplinary School of Health Sciences (KLC, LAP), the Faculty of Medicine (OJM), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- From the Interdisciplinary School of Health Sciences (KLC, LAP), the Faculty of Medicine (OJM), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada (AF)
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Benini S, Pellegrini E, Descovich C, Lugaresi A. Burden and resources in caregivers of people with multiple sclerosis: A qualitative study. PLoS One 2023; 18:e0265297. [PMID: 37068110 PMCID: PMC10109507 DOI: 10.1371/journal.pone.0265297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/27/2023] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Caregivers of people with Multiple Sclerosis are required to provide ongoing assistance especially during the advanced stages of the disease. They have to manage interventions and assume responsibilities which significantly impact both their personal quality of life and family's dynamics. OBJECTIVE A qualitative phenomenological study was carried out to understand the experience of burden in caregivers and their resources to manage it. The study also explores how healthcare services involved in the Multiple Sclerosis Clinical Pathway respond to the needs of well-being of patients and family members. METHODS 17 caregivers were involved in focus groups and in semi-structured individual interviews. RESULTS Fatigue is experienced by all respondents and it starts when physical disabilities increase or when people become aware of them. Many caregivers declare that they refer to intrinsic (love towards their relatives, patience and dedication) or extrinsic (family members, hobbies) resources to cope with the burden of assistance. Patient associations and the Multiple Sclerosis Clinical Pathway play a significant role in supporting caregivers. CONCLUSIONS Fatigue, loneliness, and isolation are experienced by caregivers and strongly affect their quality of life and health status. The study highlights caregivers' need to reconcile working times with care times, to give more space to self-care and to have moments to share their experiences with someone else. These needs should be at the core of health policies in order to avoid physical and emotional breakdowns which could lead to the rupture of the relational balance on which home care is based.
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Affiliation(s)
| | | | | | - Alessandra Lugaresi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
- Dipartimento di Scienze Biomediche e Neuromotorie, Università di Bologna, Bologna, Italia
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Rajachandrakumar R, Finlayson M. Multiple sclerosis caregiving: A systematic scoping review to map current state of knowledge. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e874-e897. [PMID: 34935217 DOI: 10.1111/hsc.13687] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 11/07/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
Unpaid caregivers, typically family and friends, provide significant amounts of support to people with multiple sclerosis (MS). Understanding their experiences, needs and challenges is necessary to ensure that caregivers receive the support that they require to continue in their role. Our aim was to map the current state of knowledge about unpaid caregivers of people with MS and identify gaps in knowledge to guide future research and practice. We used scoping review methodology with three major health-related databases (MEDLINE, CINAHL, APA Psychinfo), searching in September 2019, April and October 2020 and October 2021. We selected peer-reviewed scientific articles reporting on primary studies of unpaid caregivers of people with MS, regardless of topic or research design. We extracted information on study aim, participant characteristics, measures used and key findings to generate major themes and identify knowledge gaps. We identified 108 published studies between 1992 and 2021 that met our criteria. Studies of spousal caregivers were most common. Studies focused primarily on measurement of caregiver burden or other negative consequences of caregiving. Thirteen studies addressed positive consequences of caregiving. Sixteen studies reported actual tasks performed by caregivers and seven reported outcomes of caregiver support interventions. Attention to diversity issues that may influence caregiving experiences and outcomes was rare. Overall, knowledge of MS caregiving is limited, particularly with respect to tasks performed by caregivers that may contribute to negative outcomes, diversity issues and effective approaches to remediate caregiver burden. Without this knowledge, finding ways to better support MS caregivers will be difficult.
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Affiliation(s)
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada
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Luca M, Ortega-Castro N, Patti F. Paediatric Multiple Sclerosis: A Scoping Review of Patients' and Parents' Perspectives. CHILDREN (BASEL, SWITZERLAND) 2021; 9:11. [PMID: 35053636 PMCID: PMC8773986 DOI: 10.3390/children9010011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/13/2021] [Accepted: 12/20/2021] [Indexed: 11/17/2022]
Abstract
Dealing with paediatric-onset multiple sclerosis is particularly challenging for the young patients and their families, due to its unpredictable symptoms and uncertain outcome. This review aimed at synthesising the qualitative evidence regarding the perspectives about paediatric-onset multiple sclerosis, as expressed by the patients and/or their parents. A literature search was conducted on PubMed and CINAHL. The advanced multi-field search allowed to perform an abstract/title search in both databases, using keywords, combined through Boolean operators. Additional search strategies were adopted: searching the reference list of the selected papers; searching for key authors in the field. All the relevant papers were thoroughly revised using The Joanna Briggs Institute's data extraction form for qualitative evidence as a guidance. Eight papers were selected. The analysis of these papers allowed to identify some common issues pertaining paediatric-onset multiple sclerosis: (1) onset of symptoms, (2) diagnostic process, (3) reaction to the diagnosis, (4) management and acceptance of multiple sclerosis. The burden of multiple sclerosis was confirmed. However, the young patients and their parents can adjust to the disease. Both the community and the health care professionals must strive to prevent the families dealing with multiple sclerosis from experiencing solitude and rejection.
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Affiliation(s)
- Maria Luca
- Centre for Addiction, Via Pò 2, 95031 Adrano, Italy
| | | | - Francesco Patti
- Department “GF Ingrassia”, Section of Neurosciences, University of Catania, 95125 Catania, Italy;
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Ninfa A, Crispiatico V, Pizzorni N, Bassi M, Casazza G, Schindler A, Delle Fave A. The care needs of persons with oropharyngeal dysphagia and their informal caregivers: A scoping review. PLoS One 2021; 16:e0257683. [PMID: 34555044 PMCID: PMC8460009 DOI: 10.1371/journal.pone.0257683] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 09/07/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Besides affecting physical health, Oropharyngeal Dysphagia (OD) entails limitations in daily activities and social participation for both patients and their informal caregivers. The identification of OD-related needs is crucial for designing appropriate person-centered interventions. AIMS To explore and map the literature investigating the care needs related to OD management of adult persons with OD and their informal caregivers during the last 20 years. METHODS A scoping review was conducted and reported following PRISMA guidelines. Five electronic databases and reference lists of eligible publications were searched for original works in English or Italian, published between January 2000 and February 2021. Two independent raters assessed studies' eligibility and extracted data; a third rater resolved disagreements. Extracted care needs were analyzed using a Best fit framework synthesis approach. RESULTS Out of 2,534 records preliminarily identified, 15 studies were included in the review and 266 care needs were extracted. All studies were conducted in Western countries. Research methods primarily consisted of qualitative interviews and focus groups (14 studies, 93.3%); head and neck cancer was the most frequent cause of patients' dysphagia (8 studies, 53.3%); caregivers' perspective was seldom investigated (5 studies, 33.3%). Both patients and caregivers primarily reported social (N = 77; 28.9%) and practical (N = 67; 25.2%) needs, followed by informational (N = 55; 20.7%) and psychological (N = 54; 20.3%) ones. Only patients reported physical needs (N = 13; 4.9%), while spiritual needs were not cited. CONCLUSIONS The recurrence of personal and social needs besides physical ones highlighted the manifold impact of OD on patients' and caregivers' lives. Larger and more focused studies are required in order to design tools and interventions tailored to patients' and caregivers' needs.
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Affiliation(s)
- Aurora Ninfa
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Valeria Crispiatico
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
| | - Nicole Pizzorni
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Marta Bassi
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Giovanni Casazza
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Antonio Schindler
- Department of Biomedical and Clinical Sciences “Luigi Sacco”, Università degli Studi di Milano, Milan, Italy
| | - Antonella Delle Fave
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy
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Effectivenes of Acceptance-Commitment Therapy on the Resillience and Psycological Well-being of Female Patients with Multiple Sclerosis in Hamadan, Iran. AVICENNA JOURNAL OF CLINICAL MEDICINE 2021. [DOI: 10.52547/ajcm.28.2.126] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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11
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Douglas SL, Plow M, Packer T, Lipson AR, Lehman MJ. Psychoeducational Interventions for Caregivers of Persons With Multiple Sclerosis: Protocol for a Randomized Trial. JMIR Res Protoc 2021; 10:e30617. [PMID: 34435971 PMCID: PMC8430872 DOI: 10.2196/30617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 06/28/2021] [Accepted: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
Background Of the approximately 1 million people living with multiple sclerosis in the United States, more than half receive informal, unpaid care or support from family or friends (caregivers). These caregivers report high levels of stress, anxiety, and negative emotions. Few researchers have conducted psychoeducational interventions for these caregivers. Objective This paper presents a protocol for a randomized clinical trial that aims to test the efficacy of two interventions for improving stress, anxiety, depression, and negative emotions for caregivers of persons with multiple sclerosis. Methods Participants included any self-identified family or friend caregiver of a person with multiple sclerosis. Data collection began in April 2021 and is expected to continue until November 2021. Participants will be randomized to receive either a website-only or a website-coaching intervention delivered for 6 weeks. Data will be collected at baseline, 6 weeks after baseline (after delivery of intervention), and 6 weeks later. Results The protocol was approved by the institutional review board of the Case Western Reserve University on January 21, 2021 (protocol 20201484). As of May 2021, 66 participants were enrolled. Conclusions Our findings will have implications for identifying the efficacy of two types of interventions developed for caregivers of persons with multiple sclerosis to reduce negative psychological outcomes associated with caregiving. Trial Registration ClinicalTrials.gov NCT04662008; http://clinicaltrials.gov/ct2/show/NCT04662008 International Registered Report Identifier (IRRID) DERR1-10.2196/30617
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Affiliation(s)
- Sara L Douglas
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Matthew Plow
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Tanya Packer
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada.,School of Health Administration, Dalhousie University, Halifax, NS, Canada
| | - Amy R Lipson
- School of Nursing, Case Western Reserve University, Cleveland, OH, United States
| | - Michelle J Lehman
- School of Occupational Therapy, Dalhousie University, Halifax, NS, Canada
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Abstract
Purpose of Review In spite of recent advances in treatment, many people with multiple sclerosis (MS) require ongoing care and support. Informal caregivers can experience burden as a result of their role, with possible implications for quality of life (QOL). We review recent research examining MS caregiver experience to (1) understand current risk factors for caregiver burden and (2) identify possible strategies for increasing carer well-being. Recent Findings MS caregiver experience is highly variable and can be predicted by a variety of care recipient, caregiver and contextual factors. Burden is not the only characteristic associated with care, with positive consequences also reported. Emerging research suggests a number of ways in which carers can be better supported. Summary Identifying and meeting the needs of MS caregivers offers the best way of delivering tailored support. Future research should focus on the development of psychosocial supports, while acknowledging the needs of those caring for different MS patient populations.
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Affiliation(s)
- Rebecca Maguire
- Department of Psychology, Maynooth University, Maynooth, Co. Kildare, Ireland.
| | - Phil Maguire
- Department of Computer Science, Maynooth University, Maynooth, Co. Kildare, Ireland
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13
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Italian validation of the caregiving tasks in multiple sclerosis scale (CTiMSS). Neurol Sci 2020; 41:1881-1889. [PMID: 32095946 DOI: 10.1007/s10072-020-04302-y] [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: 12/18/2019] [Accepted: 02/14/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Informal caregivers provide fundamental help to persons with multiple sclerosis through a variety of tasks ranging from practical assistance to psychological support. Caregiving Tasks in Multiple Sclerosis Scale (CTiMSS) is a reliable and valid measure assessing the complex structure of caregiving tasks within the context of multiple sclerosis. The present study was aimed to test the validity and reliability of the Italian translation of CTiMSS in a sample of informal caregivers of persons with multiple sclerosis. METHODS A total of 580 caregivers (51.4% women, aged 18-81, M = 46.47, SD = 12.8) together with their care recipients (63.1% women, aged 19-60, M = 40.08, SD = 9.9) were involved in this study. Exploratory and confirmatory factor analyses with a split-sample approach were employed to evaluate construct validity. Convergent and discriminant validity were assessed using correlation indices with scales from Short Form Health Survey-36 and Positive and Negative Affect Schedule. Cronbach's alphas were used as a measure of reliability. RESULTS Compared with the original CTiMSS 4-factor structure, a more stable and valid solution with 3 first-order factor loading on a single second-order factor was evaluated and confirmed; convergent and discriminant validity were also supported, and Cronbach's alpha values highlighted good-to-excellent reliability levels. CONCLUSION Results supported the validity and reliability of the Italian CTiMSS. Thanks to its ability to assess specific caregiving tasks, the measure can be a useful instrument for tailoring intervention focused on the promotion of both caregivers' and care recipients' quality of life.
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