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Domeisen Benedetti F, Hechinger M, Fringer A. Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review. Healthcare (Basel) 2024; 12:1016. [PMID: 38786426 PMCID: PMC11120749 DOI: 10.3390/healthcare12101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/21/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.
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Affiliation(s)
- Franzisca Domeisen Benedetti
- School of Health Professions, Institute of Nursing, ZHAW—Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401 Winterthur, Switzerland (A.F.)
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Lee MMS, Yeoh EK, Wang K, Wong ELY. Caregiver Employees' Mental Well-Being in Hong Kong. Healthcare (Basel) 2024; 12:1013. [PMID: 38786422 PMCID: PMC11121220 DOI: 10.3390/healthcare12101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. METHOD Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick -Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. FINDINGS The mean score of the Short Warwick-Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (-0.050, p < 0.001) and Short Warwick-Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick-Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. CONCLUSIONS Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population.
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Affiliation(s)
| | | | | | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Avenue, Hong Kong, China; (M.M.-S.L.); (E.-K.Y.); (K.W.)
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Zhang J, Sun X, Yan Z. Blessing or curse: the role of authoritarian filial piety and self-efficacy in caregiver gains among Chinese family caregivers caring for physically impaired older adults. BMC Geriatr 2024; 24:163. [PMID: 38365573 PMCID: PMC10870663 DOI: 10.1186/s12877-024-04768-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] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 02/01/2024] [Indexed: 02/18/2024] Open
Abstract
BACKGROUND This study investigated the effects of authoritarian filial piety (AFP) and caregiver self-efficacy on the caregiving experience of adult children of physically impaired older adults. Socio-cultural stress and coping model was applied to test the influence of AFP on caregiver gains. METHODS A total of 601 Chinese adult children caregivers and care-recipient dyads participated in this cross-sectional study in 2021. Four instruments were used to collect data: the 4-item Zarit Burden Interview, Positive Aspects of Caregiving Scale, Caregiver Task Inventory Scale, and Authoritarian Filial Piety Scale. All mediation and moderated mediation effects were estimated using SPSS 26.0. RESULTS Caregiver self-efficacy was found to not only mediate but also help family caregivers convert their burden into positive gains. AFP moderates the association between caregiver burden and self-efficacy, as well as between caregiver burden and caregiver gains. CONCLUSIONS This study provides valuable insights into filial piety, elucidating AFP's comprehensive impact on cognitive appraisals of caregiving. Culturally sensitive psychoeducational therapy, addressing AFP expectations and boosting caregiver self-efficacy, is recommended to enhance positive caregiving outcomes.
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Affiliation(s)
- Jiyuan Zhang
- School of Public Administration, East China Normal University, Shanghai, 200062, China
| | - Xin Sun
- School of Social Development and Public Policy, Fudan University, Shanghai, 200433, China
| | - Zi Yan
- Waseda Institute for Advanced Studies, Waseda University, Tokyo, 169-8050, Japan.
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Qiu D, Li Y, Wu Q, An Y, Tang Z, Xiao S. Patient's disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia: mediation effects of potentially harmful behavior, affiliate stigma, and social support. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:83. [PMID: 38040711 PMCID: PMC10692118 DOI: 10.1038/s41537-023-00418-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 11/20/2023] [Indexed: 12/03/2023]
Abstract
Evidence on the associations between patient's disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia is lacking. This study aimed at explore the underlying mechanisms between patient's disability and caregiver burden among Chinese family caregivers of individual living with schizophrenia. A cross-sectional study was carried out in four Chinese cities (Wuhan, Changsha, Guangzhou, and Shenzhen), between April, 2021 and March, 2022. A total of 493 patients and their family caregivers were invited to report related data. The Zarit burden interview, WHODAS 2.0, the Potentially harmful behavior scale, the Affiliate Stigma Scale, and the Multidimensional Scale of perceived social support were used to collect data. Linear regression analysis and bootstrapping analysis were conducted. The adjusted regression results showed that patients' disability (B = 0.616; 95% CI: 0.479-0.753), potentially harmful behavior on caregivers (B = 0.474; 95% CI: 0.232-0.716), and caregiver's low social support (B = -0.079; 95% CI: -0.158- -0.002), high level of affiliate stigma (B = 13.045; 95% CI: 10.227-15.864) were associated with higher level of caregiver burden (p < 0.05). In the mediation model, the direct path from patient's disability to caregiver burden (B = 0.428, β = 0.371, p < 0.001) was significant and positive. Patient's disability was indirectly associated with caregiver burden through patient's potentially harmful behavior, caregiver's affiliate stigma, and social support, the standardized regression coefficients ranged from 0.026-0.049 (p < 0.05). Patient's potentially harmful behavior, caregiver's affiliate stigma, and social support mediated the relationship between patients' disability and caregiver burden. Future intervention studies designed to target these three factors may be beneficial for family caregivers of persons living with schizophrenia.
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Affiliation(s)
- Dan Qiu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yilu Li
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Qiuyan Wu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Yanni An
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Zixuan Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, Hunan, China.
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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5
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Hu H, Hu X, Xu Y. Caring load and family caregivers' burden in China: the mediating effects of social support and social exclusion. Front Public Health 2023; 11:1194774. [PMID: 37809000 PMCID: PMC10556706 DOI: 10.3389/fpubh.2023.1194774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objective Caring for older adults with disabilities is a source of stress for family caregivers, and the lack of social support and the pressure of social exclusion might aggravate family caregiver burden. This study aimed to examine the association between caring load and family caregivers' burden, as well as the mediating effects of social support and social exclusion. Methods Data used in this study was derived from the nationally representative database of the aged population in China, and 3,125 households with disabled old adults and their home-bound caregivers were eventually selected for this analysis. Regression methods and mediation analysis methods were employed in this study. Results The results indicated that there was a significant positive association between caring load and the caregiver burden, and specifically, social support intensity (rather than social support breadth) and passive social exclusion (rather than active social exclusion) played partial mediating effects. Furthermore, the contributions of mediating effects of social support intensity and passive social exclusion were 13-15 and 27-29%, respectively, and the total contribution of mediating effects was about 35-38%. Conclusion Family caregivers' burden should be paid more attention to in the large population with rapidly aging speed like China, and more guidance services as well as support should be provided to family caregivers. In addition, it is crucial to focus on the community's social support and social exclusion in public policy innovation.
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Affiliation(s)
- Hongwei Hu
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Xinyi Hu
- School of Public Administration and Policy, Renmin University of China, Beijing, China
| | - Yang Xu
- School of Sociology, Beijing Normal University, Beijing, China
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Teo I, Ng S, Bundoc FG, Malhotra C, Ozdemir S, Steel JL, Finkelstein EA. A prospective study of psychological distress among patients with advanced cancer and their caregivers. Cancer Med 2023; 12:9956-9965. [PMID: 36934452 PMCID: PMC10166955 DOI: 10.1002/cam4.5713] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 02/07/2023] [Accepted: 02/08/2023] [Indexed: 03/20/2023] Open
Abstract
BACKGROUND Cancer can impact the psychological well-being of both patients and their informal caregivers. We investigated the joint trajectories of psychological distress among Singaporean advanced cancer patients-caregiver dyads. We also examined predictors of trajectory group membership. METHODS This study utilised data from 299 patients with advanced solid cancer and their caregivers over 33 months (12 times points). Group-based trajectory modelling was used to examine the joint trajectories of patient anxiety, patient depression, caregiver anxiety and caregiver depression scores using the Hospital Anxiety and Depression Scale. RESULTS Four joint trajectory groups were found: (1) Patient-caregiver low distress (27%), (2) patient-caregiver increasing distress (28.5%), (3) patient low- caregiver borderline distress (25%), (4) patient-caregiver high distress (19.5%). Dyads where the patient is below 50 years of age were more likely to be in Group 4. Dyads where caregiver-patient emotional closeness was low were more likely to be in Groups 2 or 4 where dyads reported increasing/high distress. Dyads that reported financial inadequacy were more likely to be in Groups 2, 3 and 4, while dyads with caregivers who were employed were more likely to be in group 3. CONCLUSIONS A substantial proportion of patients and caregivers reported anxiety and/or depression that lasted or increased throughout the study duration. We found significant heterogeneity in how dyads experienced psychological distress, suggesting that efforts should consider dyadic differences when providing psychological support. Particular focus should be placed on identifying dyads that are at risk and who require additional support.
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Affiliation(s)
- Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,National Cancer Centre Singapore, Singapore, Singapore
| | - Sean Ng
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | | | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
| | - Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Jennifer L Steel
- Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.,Signature Programme in Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
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Amini S, Jalali A, Jalali R. Perceived social support and family members of patients with mental disorders: A mixed method study. Front Public Health 2023; 11:1093282. [PMID: 36815153 PMCID: PMC9939439 DOI: 10.3389/fpubh.2023.1093282] [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: 11/08/2022] [Accepted: 01/12/2023] [Indexed: 02/08/2023] Open
Abstract
Introduction Family members are the caregivers to patients with mental disorders at home, and the mental and spiritual pressures caused by this responsibility necessitate physical, mental, and perceived social support for these families. The present mixed method study is an attempt to elaborate on the perceived social support by Iranian families of patients with chronic mental disorders. Materials and methods Using a sequential mixed method explanatory study (quantitative and qualitative), 200 family members of patients with chronic mental disorders were selected through convenient sampling (quantitative phase). Data gathering was started using a demographics form and Stewart and Sherburne's perceived social support scale. The qualitative phase included 10 participants who obtained low scores in the quantitative phase and took part in private, face-to-face, in-depth, and semi-structured interviews. The data obtained in the quantitative phase were analyzed using statistical tests, and the interviews were analyzed using qualitative content analysis. Findings The perceived social support by the participants was at a moderate level in different fields of tangible support, information and emotional support, kindness, and positive social interactions. The results of the qualitative phase revealed social support status in 15 subcategories, 6 categories, and 2 themes of support and acceptance by family, relatives, and friends, with support and being understood by society. The results of the qualitative and quantitative sections emphasized the needs of the patient's family members (who acted as caregivers for patients) for support in family, social, and emotional areas. Conclusion The family members of patients with chronic mental disorders have different needs in the area of perceived social support. Such needs are more tangible in family members such as children with mentally ill parents or parents with mentally ill children. The results of this study can be used for educational and supportive planning for caregivers of patients, most of whom are family members.
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Affiliation(s)
- Shabnam Amini
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Jalali
- Substance Abuse Prevention Research Center, Research Institute for Health, Kermanshah University of Medical Sciences, Kermanshah, Iran,*Correspondence: Amir Jalali ✉
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Han M, Diwan S, Cole T, Hay K, Paturzo M. Service Utilization, Self-Efficacy, Positive Attitude and Well-Being Among Asian American Family Caregivers of Persons with Serious Mental Illnesses. Community Ment Health J 2022; 58:1038-1048. [PMID: 35064855 DOI: 10.1007/s10597-021-00912-8] [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] [Received: 07/18/2021] [Accepted: 10/30/2021] [Indexed: 11/03/2022]
Abstract
The well-being of the family caregivers of people with serious mental illnesses (SMIs) is a crucial success factor in the recovery of the afflicted family member. This cross-sectional quantitative study examined the associations between the use of formal mental health services, self-efficacy, and positive attitudes and their effects on the well-being of Asian American family caregivers of people with SMIs. Using convenience and snowball sampling, 116 Asian American family caregivers of people with SMIs in Northern California were recruited for this study. We found that formal mental health service utilization predicted an enhanced sense of self-efficacy. Higher levels of self-efficacy were related to attitudes being more positive, and these positive attitudes contributed to enhanced overall well-being. These findings suggest that mental health professionals should develop culturally competent and tailored services for Asian American family caregivers to support self-efficacy, which is fundamental to maintaining positive attitudes and promoting wellness.
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Affiliation(s)
- Meekyung Han
- School of Social Work, San José State University, One Washington Square, San Jose, CA, 95192-0124, USA.
| | - Sadhna Diwan
- School of Social Work, San José State University, One Washington Square, San Jose, CA, 95192-0124, USA
| | - Tomasine Cole
- School of Social Work, San José State University, One Washington Square, San Jose, CA, 95192-0124, USA
| | - Kristen Hay
- School of Social Work, San José State University, One Washington Square, San Jose, CA, 95192-0124, USA
| | - Marisa Paturzo
- School of Social Work, San José State University, One Washington Square, San Jose, CA, 95192-0124, USA
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Brooks BL, Kumari J, Virani S. Family Burden in Adolescents With Refractory Postconcussion Symptoms. J Head Trauma Rehabil 2022; 37:230-239. [PMID: 34320550 DOI: 10.1097/htr.0000000000000717] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE A significant minority of adolescents will have persistent postconcussion symptoms after an injury, potentially having a negative impact on family functioning. However, the reasons for a family's negative impact are not clearly understood. The objective of this study was to determine whether preinjury/demographic factors, injury characteristics, and/or worse postinjury symptoms are associated with higher levels of family stress in youth with refractory postconcussion symptoms. SETTING Pediatric refractory concussion clinic in a tertiary care center. PARTICIPANTS A total of 121 adolescents (13-18 years old) who were 1 to 12 months postconcussion. MEASURES Primary outcome was the mean stress rating on the Family Burden of Injury Interview (FBII), a 27-item questionnaire rating the impact on a family as a result of an injury. Preinjury/demographic and injury details were collected. Youth and their parents also completed measures of postconcussion symptoms, depression, anxiety, and behavioral problems. RESULTS Participants had a mean age of 16.0 years (SD = 1.3), of which, 65% identified as female, and were on an average 5.2 months (SD = 2.4) postconcussion. FBII ratings were not significantly correlated with demographics, preinjury functioning, injury severity, duration of persistent postconcussion problems (ie, time since injury), or self-reported postconcussion symptoms. Greater family burden (higher FBII ratings) significantly correlated with worse parent-reported postconcussion symptoms, worse psychological functioning (self-reported depression, parent-reported anxiety, and depression), and worse behavioral functioning (parent-reported conduct problems and peer problems). A multiple linear regression model revealed that parent-perceived postconcussion cognitive symptoms (β = .292, t = 2.56, P = .012) and parent-perceived peer problems (β = .263, t = 2.59, P = .011) were significantly associated with family burden ( F8,105 = 6.53; P < .001; R2 = 0.35). CONCLUSION Families of youth with refractory postconcussion symptoms can experience a negative impact. The severity of reported family burden in those with slow recovery from concussion was significantly associated with parents' perception of their child's cognitive symptoms and peer problems. These results could provide support for family-based interventions in this population.
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Affiliation(s)
- Brian L Brooks
- Neurosciences Program, Alberta Children's Hospital, Calgary, Alberta, Canada (Dr Brooks); Departments of Paediatrics (Dr Brooks), Clinical Neurosciences (Dr Brooks), and Psychology (Dr Brooks), Alberta Children's Hospital Research Institute (Dr Brooks and Mr Virani), Hotchkiss Brain Institute (Dr Brooks), Faculty of Nursing (Ms Kumari), and Faculty of Kinesiology (Mr Virani), University of Calgary, Calgary, Alberta, Canada
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Knopp K, Wrape ER, McInnis R, Khalifian CE, Rashkovsky K, Glynn SM, Morland LA. Posttraumatic stress disorder and relationship functioning: Examining gender differences in treatment-seeking veteran couples. J Trauma Stress 2022; 35:484-495. [PMID: 34800061 DOI: 10.1002/jts.22761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/28/2021] [Accepted: 08/25/2021] [Indexed: 11/08/2022]
Abstract
Posttraumatic stress disorder (PTSD) symptoms are robustly associated with intimate relationship dysfunction among veterans, but most existing research has focused on male veterans and their female partners. Links between PTSD and relationship functioning may differ between female-veteran couples and male-veteran couples. The current study used actor-partner interdependence models (APIMs) to test the associations between PTSD symptoms (i.e., veteran self-report or significant others' collateral-report) and each partner's reports of six domains of relationship functioning, as well as whether these links were moderated by the gender composition of the couple. Data were from 197 mixed-gender couples (N = 394 individuals) who completed baseline assessments for a larger randomized controlled trial of a couple-based PTSD treatment. Significant others' collateral PTSD reports were associated with their own ratings of relationship satisfaction, negotiation, psychological aggression, sexual pleasure, and sexual desire frequency, |β|s = .19-.67, and with veterans' ratings of negotiation and sexual desire frequency, |β|s = .20-.48. In contrast, veterans' self-reported PTSD symptoms were only associated with their own ratings of psychological aggression, β = .16. Gender moderated the associations between significant others' collateral PTSD reports and five of the six outcome variables; findings from exploratory subgroup analyses suggested links between reported PTSD symptoms and relationship functioning were generally more maladaptive for male-veteran couples, whereas female veterans showed more neutral or even helpful impacts of higher partner-perceived PTSD symptoms. These findings have implications for clinicians treating relational impacts of PTSD and emphasize the need for further research with female-veteran couples.
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Affiliation(s)
- Kayla Knopp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Elizabeth R Wrape
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Rachel McInnis
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Chandra E Khalifian
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Katerine Rashkovsky
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Shirley M Glynn
- Research Service, Veterans Affairs Greater Los Angeles Healthcare System at West LA, Los Angeles, California, USA.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute of Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, USA
| | - Leslie A Morland
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California San Diego, La Jolla, USA.,National Center for PTSD, Pacific Islands Division, Honolulu, Hawaii, USA
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High-Intensity Post-Stroke Rehabilitation Is Associated with Lower Risk of Pressure Ulcer Development in Patients with Stroke: Real-World Evidence from a Nationwide, Population-Based Cohort Study. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58030402. [PMID: 35334578 PMCID: PMC8955381 DOI: 10.3390/medicina58030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 11/21/2022]
Abstract
Background and Objectives: Multiple factors are associated with pressure ulcer (PU) development, including limited mobility following stroke. We performed a nationwide cohort study to investigate the impact of rehabilitation intensity on the incidence of post-stroke PU. Materials and Methods: Data of patients diagnosed with stroke between 2000 and 2012 were collected from the 2000 Longitudinal Health Insurance Database (Taiwan). Based on the number of rehabilitation sessions attended within 90 days of discharge, the rehabilitation intensity was classified as low, medium, or high. After adjusting for sociodemographic factors and comorbidities, the Cox proportional hazards model evaluated the risk of PU development during the 12-year follow-up period. Kaplan−Meier curves were used to estimate the cumulative incidence of PUs. Results: Our study included 18,971 patients who had their first episode of stroke. Of these, 9829 (51.8%) underwent rehabilitation therapy after discharge. Female patients and patients with a National Institutes of Health Stroke Scale (NIHSS) score >13 points, who commenced high-intensity post-stroke rehabilitation after discharge had a significantly lower risk of PU development than those who underwent low-intensity post-stroke rehabilitation after discharge. Cumulative survival analysis showed a significantly lower cumulative incidence of PU during the 12-year follow-up period in the high-intensity rehabilitation group. Conclusion: Compared with low-intensity post-stroke rehabilitation, high-intensity post-stroke rehabilitation after discharge from hospital is associated with a lower risk of post-stroke PU development, especially in female stroke patients and patients with a NIHSS score >13 points. High-intensity rehabilitation is also associated with a significantly lower cumulative incidence of PU events during the 12-year follow-up period.
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Dijkxhoorn MA, Padmakar A, Bunders JFG, Regeer BJ. Stigma, lost opportunities, and growth: Understanding experiences of caregivers of persons with mental illness in Tamil Nadu, India. Transcult Psychiatry 2022; 60:255-271. [PMID: 35171067 PMCID: PMC10149884 DOI: 10.1177/13634615211059692] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to address gaps in understanding of the lived experiences of caregivers of persons with mental illness in low-income countries. It was conducted among caregivers of persons with mental illness making use of a free non-governmental clinic in and around Chennai, India. The study adopted a qualitative methodology, with semi-structured interviews and life history exercises (n = 29) and six focus group discussions with caregivers (n = 21) and mental health professionals and community-based workers (n = 39). The experiences of caregivers were analyzed in the framework of "The Banyan model of caregiving," which identifies six phases. Major themes in caregivers' experience were: embarrassment and losing honor; fear; awareness; stigma and social exclusion; and reduced social interaction and loneliness. Posttraumatic growth considered as the result of caregiver experiences was found to consist mainly of personal growth and focusing on positive life experiences. Lost opportunities particular to the context of Tamil Nadu were described as the inability to get married, obtaining less education than desired, and loss of employment. Siblings faced lower levels of burden, while elderly mothers experienced especially high levels of burden and lack of happiness in life. Caregiver gains were identified as greater compassion for other people with disabilities, resulting in a desire to help others, as well as increased personal strength and confidence. Understanding the nuances of the caregiving experiences over time can provide a framework to devise more fine-tuned support structures that aim to prevent reductions in social interaction and lost opportunities, and improve a sense of meaning, in order to assist caregivers to continue providing care for their relatives with mental illness in a context with scarce mental health resources.
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Affiliation(s)
- Mirjam A Dijkxhoorn
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Archana Padmakar
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Joske F G Bunders
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
| | - Barbara J Regeer
- The Banyan Academy of Leadership in Mental Health, Vrije Universiteit Amsterdam
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13
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Fernández-Medina IM, Ruíz-Fernández MD, Gálvez-Ramírez F, Martínez-Mengíbar E, Ruíz-García ME, Jiménez-Lasserrotte MDM, Ortega-Galán ÁM, Hernández-Padilla JM. The Experiences of Home Care Nurses in Regard to the Care of Vulnerable Populations: A Qualitative Study. Healthcare (Basel) 2021; 10:21. [PMID: 35052185 PMCID: PMC8774707 DOI: 10.3390/healthcare10010021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022] Open
Abstract
Home care nurses have become the main references in home care for vulnerable patients. In patients' homes they offer comprehensive and continuous care to both the vulnerable population and their families. The aim of this qualitative study was to explore experiences and perspectives of home care nurses regarding the care of vulnerable patients in Spain. We conducted in-depth semi-structured interviews with 15 home care nurses working with a vulnerable population. From a data analysis, two themes and four subthemes emerged: (1) "barriers to providing home care to vulnerable populations", with the following subthemes: "the particularities of the patient and their home caregivers" and "perceived barriers for the involvement of home care nurses in the care"; and (2) "the emotional cost of home care" with the subthemes "home care is draining for caregivers" and "the impact of home care on the home care nurses". These findings show us that nurses face a number of difficulties in home care for vulnerable patients. The training of nurses in certain competencies and skills by the social health services would enhance the quality of care offered to these patients.
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Affiliation(s)
| | - María Dolores Ruíz-Fernández
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almeria, Spain
- Facultad Ciencias de la Salud, Universidad Autónoma de Chile, Temuco 7500000, Chile
| | - Felisa Gálvez-Ramírez
- Basic Health Zone Puerto de la Torre, Sanitary Distric Málaga-Guadalhorce, Andalusian Health System, 29009 Malaga, Spain
| | | | | | | | | | - José Manuel Hernández-Padilla
- Department of Nursing, Physiotherapy and Medicine, University of Almería, 04120 Almeria, Spain
- Department of Adult, Child and Midwifery, School of Health and Education, Middlesex University, London NW4 4BT, UK
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14
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Factors associated with caregiver burden for mothers of children undergoing Acute Lymphocytic Leukemia (ALL) treatment. Palliat Support Care 2021; 18:405-412. [PMID: 31727187 DOI: 10.1017/s1478951519000853] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The present study examined the extent to which social support (SS) availability and satisfaction could predict the extent of caregiver burden (CB) among mothers of children with Acute Lymphocytic Leukemia (ALL). METHOD The study was a cross-sectional, descriptive-correlative study. It was conducted on a sample of 117 mothers whose children were undergoing treatment in a public hospital in Bam, Iran. The Norbeck Social Support Scale and the Caregiver Burden Scale were used to measuring study variables. The data were analyzed using Pearson's correlations, t-tests, ANOVAs, and linear regressions. RESULTS Significant correlations were observed between CB and SS availability (r = -0.499, p < 0.001), SS satisfaction (r = -0.543, p < 0.001), the age of the child with cancer (r = -0.22, p = 0.01), and duration of treatment (r = 0.336, p < 0.001). Married mothers experienced less CB than those that were widowed or divorced. Within the regression equation, SS satisfaction, SS availability, marital status, and duration of treatment were the predictors of CB. SIGNIFICANCE OF RESULTS Based on the results of the current study, mothers who have less SS, especially those who are single mothers, with younger children, and who have taken care of their child for an extended duration should be given special attention. Furthermore, it appears that there are distinct cultural variations amongst Iranian mothers which suggest that culture may impact upon SS availability. Results also suggest a need for interventions that enhance nurses' ability to provide support to caregivers and the broader family unit as a whole. Nurses in cancer care need to have psychological competencies to help family members of cancer patients especially mothers and more so those that are single mothers. As integral members of the patient care experience, nurses may be uniquely positioned to provide this needed psychosocial support.
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15
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Ozdemir S, Ng S, Malhotra C, Teo I, Finkelstein EA. Patient-Caregiver Treatment Preference Discordance and Its Association With Caregiving Burden and Esteem. Innov Aging 2021; 5:igab020. [PMID: 34316519 PMCID: PMC8306724 DOI: 10.1093/geroni/igab020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Indexed: 11/14/2022] Open
Abstract
Background and Objectives Many patient–caregiver dyads report conflicting treatment decisions regarding preferences for life extension treatments and symptom management. It is possible that this discordance will lead to negative psychological outcomes including lowered caregiving esteem and increased caregiver burden. However, the relationships between treatment discordance among dyads and caregiver psychological outcomes are not well studied among advanced cancer patients—a gap this study aims to fill. Research Design and Methods Outcome variables included caregiver burden and caregiving esteem, measured via a modified 4-domain Caregiver Reaction Assessment Scale. The main independent variable was patient–caregiver treatment preference discordance, examined using questions adapted from an existing protocol. Analyses were conducted using multivariable regressions. Results A convenience sample of 285 patient–caregiver dyads were recruited from outpatient clinics at 2 tertiary hospitals in Singapore. The majority (60%) of patient–caregiver dyads reported discordant treatment preferences. Discordance in this study arose because caregivers wanted a balance between life extension and symptom management while patients preferred life-extending treatment. In multivariable analyses, discordance predicted caregiver burden arising from impact on caregiver schedule and health (β = 0.16, p = .07) and lack of family support (β = 0.13, p = .04). Discussion and Implications Theoretically, this study provided a more nuanced understanding of how dyad discordance may worsen the burdens felt by caregivers, and which aspects of their lives (i.e., burden due to impact of caregiver schedule and health and lack of family support) are most affected. Our findings can aid in establishing therapeutic interventions targeted toward improving communication skills and encouraging end-of-life discussions among patients, caregivers, and their health care providers. The importance of establishing and improving therapy programs specifically targeted toward caregivers was also underlined.
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Affiliation(s)
- Semra Ozdemir
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Signature Programme in Health Services and System Research, Duke-NUS Medical School, Singapore
| | - Sean Ng
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Signature Programme in Health Services and System Research, Duke-NUS Medical School, Singapore
| | - Chetna Malhotra
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Signature Programme in Health Services and System Research, Duke-NUS Medical School, Singapore
| | - Irene Teo
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,National Cancer Centre Singapore, Singapore
| | - Eric A Finkelstein
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore.,Signature Programme in Health Services and System Research, Duke-NUS Medical School, Singapore
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16
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Sit HF, Huang L, Chang K, Chau WI, Hall BJ. Caregiving burden among informal caregivers of people with disability. Br J Health Psychol 2020; 25:790-813. [PMID: 32472979 DOI: 10.1111/bjhp.12434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 05/04/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Chinese informal caregivers experience burden due to their caregiving responsibilities that violate their belief of reciprocal parent-child relationship, but little is known about this burden and coping processes among Chinese. It is believed that internal coping (i.e., self-reliance) and external coping (i.e., seeking help from others) better captured cultural characteristics of coping styles observed among Chinese. Thus, the aim of this study was to estimate the prevalence of mental ill health, identify correlates, investigate the impact of caregiving burden on mental health, and explore the potentially moderating role of two coping strategies. DESIGN A purposive sample of 234 informal caregivers of family with intellectual or mental disability in Macao (SAR), China, from August to September 2018 was investigated. METHODS DASS-21, Caregiving Burden Inventory (CBI), Perceived Difficulty Scale (PD), and a modified Chinese Coping Scale were used. Multiple regression analyses were conducted. RESULTS CBI and PD were associated with depression, anxiety, and stress. Whereas internal coping buffered the effect of PD on depression and anxiety, external coping exacerbated the effect of PD on anxiety and the effect of CBI on depression and anxiety. CONCLUSION Poor mental health among caregivers is associated with greater caregiving challenges and burdens. Internal coping helped to buffer but external coping worsened the effect of burdens on mental health outcomes. Interventions that improve internal coping and mental health might be helpful for ageing informal caregivers.
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Affiliation(s)
- Hao Fong Sit
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Lei Huang
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Kay Chang
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China
| | - Wai I Chau
- Fuhong Society of Macau, Macao (SAR), China
| | - Brian J Hall
- Global and Community Mental Health Research Group, Department of Psychology, University of Macau, Macao (SAR), China.,Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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17
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Hielscher E, Diminic S, Kealton J, Harris M, Lee YY, Whiteford H. Hours of Care and Caring Tasks Performed by Australian Carers of Adults with Mental Illness: Results from an Online Survey. Community Ment Health J 2019; 55:279-295. [PMID: 29476284 DOI: 10.1007/s10597-018-0244-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 02/03/2018] [Indexed: 11/30/2022]
Abstract
The aim of this study was to provide a detailed profile of the hours of care Australian mental health carers provide for different types of caring tasks. The UQ Carer Survey 2016 was administered online to 105 adults caring for someone aged 16 years or older whose main condition is mental illness. Mental health carers reported providing on average 37.2 h of care per week to their main care recipient. Carers spent most of their active caring time providing emotional support, and the least of their time assisting with activities of daily living. Carers highlighted that this care time fluctuates with the undulating nature of mental illness, and many noted additional hours devoted to being 'on call' in case of emergency. Carers provide large amounts of support on a long-term and often unpredictable basis. Government services need to match the undulating nature of the illness by providing more flexible support options for mental health carers.
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Affiliation(s)
- Emily Hielscher
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia. .,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia. .,Centre for Clinical Research, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Sandra Diminic
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Jan Kealton
- Carer consultant, Gold Coast, QLD, Australia
| | - Meredith Harris
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Yong Yi Lee
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Harvey Whiteford
- Policy and Epidemiology Group, Queensland Centre for Mental Health Research (QCMHR), The Park Centre for Mental Health, Brisbane, QLD, Australia.,School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.,Institute of Health Metrics and Evaluation, University of Washington, Seattle, USA
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18
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Dijkxhoorn MA, Padmakar A, Jude N, Bunders J, Regeer B. Understanding caregiver burden from a long-term perspective: The Banyan model of caregiver experiences. Perspect Psychiatr Care 2019; 55:61-71. [PMID: 29862525 DOI: 10.1111/ppc.12299] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 04/26/2018] [Accepted: 05/13/2018] [Indexed: 01/14/2023] Open
Abstract
PURPOSE A multiphase model for experiences of family members of persons with mental illness that considers both positive and negative aspects is proposed. DESIGN AND METHODS Mixed methods (semistructured interviews, life history timelines, focus group discussions, and the Experience of Caregiving Inventory) were used with caregivers accessing outpatient services of a nongovernmental organization in urban and rural locations around Chennai, India. FINDINGS Based on our results, we constructed a multiphase model, which we named The Banyan model of caregiver experiences. The phases are (1) manifestation of symptoms, (2) seeking help, (3) helplessness and attribution, (4) relative control and insight, (5) loss and worries, and (6) finding new meaning. PRACTICAL IMPLICATIONS Our multiphase model allows us to identify in more detail the needs of caregivers at various stages.
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Affiliation(s)
- Mirjam Anne Dijkxhoorn
- The Banyan Academy of Leadership in Mental Health, Chennai, Tamil Nadu, India.,Athena Institute, VU University, Amsterdam, North-Holland, The Netherlands
| | - Archana Padmakar
- The Banyan Academy of Leadership in Mental Health, Chennai, Tamil Nadu, India.,The Banyan, Chennai, Tamil Nadu, India.,Athena Institute, VU University, Amsterdam, North-Holland, The Netherlands
| | | | - Joske Bunders
- Athena Institute, VU University, Amsterdam, North-Holland, The Netherlands
| | - Barbara Regeer
- Athena Institute, VU University, Amsterdam, North-Holland, The Netherlands
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19
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Bui QNN, Han M, Diwan S, Dao T. Vietnamese-American family caregivers of persons with mental illness: Exploring caregiving experience in cultural context. Transcult Psychiatry 2018; 55:846-865. [PMID: 30088804 DOI: 10.1177/1363461518793185] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
While involvement of family caregivers can play an important role in the recovery process of persons with serious mental illness (SMI), family caregivers often endure poor health and mental health issues due to caregiving-related distress. These challenges may be exacerbated for Vietnamese American families due to cultural values (e.g., familism and stigma). This qualitative exploratory study examined how Vietnamese American family caregivers of persons with SMI describe their caregiving experience. Using convenience and snowball sampling, the study recruited 21 participants who took part in two Vietnamese-language focus groups. Key findings of the study addressed three themes: (1) the influence of cultural and religious values on caregiving and mental health; (2) the negative impact of caregiving on caregivers' wellbeing; and (3) the stigma attached to mental illness. The study offers useful insights to assist mental health practitioners in tailoring culturally appropriate and effective services for Vietnamese caregivers.
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Affiliation(s)
| | | | | | - Tran Dao
- Santa Clara County Social Services Agency
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20
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Bai X, Liu C, Baladon L, Rubio-Valera M. Multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Aging Ment Health 2018; 22:980-989. [PMID: 28541777 DOI: 10.1080/13607863.2017.1330872] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objective of this study was to examine multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Based on a modified stress process model, this study explored how background and contextual factors (demographic characteristics and mental health status of caregivers, caregiving-related factors, and support and services), primary stressors (degree of care dependency and special care needs), and secondary stressors (self-efficacy and gender role conflict) might affect the caregiving burden among male caregivers. METHOD A questionnaire survey was completed by 204 male caregivers who considered themselves as primary caregivers for older family members with care needs aged 60 and over. Descriptive, bivariate, and multivariate analyses were conducted. RESULTS Being the son of the care receiver, the presence of depressive symptoms, a higher degree of gender role conflict, a lower degree of caregiving self-efficacy, and the use of support and services all predicted greater caregiving burden among male caregivers. CONCLUSION This study established a modified stress process model specifically for male caregivers. Gender role conflict and caregiving self-efficacy were introduced into the model as secondary stressors and found to be significantly associated with the degree of caregiving burden. The findings of this study could inform the development of services and interventions to reduce the caregiving burden among male caregivers.
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Affiliation(s)
- Xue Bai
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong.,b Personal Social Services Research Unit , London School of Economics and Political Science , UK
| | - Chang Liu
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong
| | - Luisa Baladon
- c Adults Mental Health Centre of Garraf , Parc Sanitari Sant Joan De Déu , Barcelona , Spain
| | - Maria Rubio-Valera
- d Research and Teaching Unit , Fundació Sant Joan de Déu , Spain.,e Centre For Biomedical Research in Epidemiology and Public Health, CIBERESP , Madrid , Spain.,f School of Pharmacy , Universitat de Barcelona , Barcelona , Spain
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21
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Lin LE, Lo SC, Liu CY, Chen SC, Wu WC, Liu WI. Effectiveness of Needs-oriented Hospital Discharge Planning for Caregivers of Patients With Schizophrenia. Arch Psychiatr Nurs 2018; 32:180-187. [PMID: 29579510 DOI: 10.1016/j.apnu.2017.10.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/13/2017] [Accepted: 10/14/2017] [Indexed: 11/26/2022]
Abstract
Hospital discharge planning for clients with schizophrenia reduces client rehospitalization rates and improves their medication adherence. The effectiveness of caregiver participation in hospital discharge planning has seldom been explored. The purpose of this study was to examine the effectiveness of caregiver participation in hospital discharge planning for clients with schizophrenia in reducing caregiver burden and improving health status. A quasi-experimental research design was adopted. The research location was in a psychiatric hospital in Northern Taiwan. The target population was caregivers of inpatients with schizophrenia. Nurses served as care coordinators and provided six-step hospital discharge planning services to caregivers. Structured questionnaires were employed to measure caregiver burden and health status. Intervention effect was tested using analysis of covariance in which outcome measure at pretest and selected demographic variables were treated as covariates. A total of 114 caregivers completed pretest and posttest evaluations, with 57 people in each group. A significant difference was found between the experimental and the control group regarding the caregiver burden and health status (P<0.001) The caregiver burden and health status of the experimental group improved more significantly compared with the control group. The caregiver-involved discharge planning process developed in this study effectively reduced the burden placed on caregivers and improved their health status. Mental health nurses can serve as the main care coordinators for assessment, planning, referral and provision of the required services. Caregiver-involved hospital discharge planning should become part of the routine care process.
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Affiliation(s)
- Li-En Lin
- Department of Nursing, Bali Psychiatric Center, No.33, Huafushan, Bali Dist., New Taipei City 249, Taiwan, ROC
| | - Su-Chen Lo
- Department of Nursing, Bali Psychiatric Center, No.33, Huafushan, Bali Dist., New Taipei City 249, Taiwan, ROC
| | - Chieh-Yu Liu
- National Taipei University of Nursing and Health Sciences
| | - Shing-Chia Chen
- School of Nursing, College of Medicine, National Taiwan University, Department of Nursing, National Taiwan University Hospital, No.1, Sec. 1, Ren Ai Rd., Zhongzheng Dist., Taipei City 10052, Taiwan, ROC
| | - Wen-Cheng Wu
- Tao Yuan General Hospital, Ministry of Health and Welfare; School of Law, Fu Jen Catholic University
| | - Wen-I Liu
- National Taipei University of Nursing and Health Sciences.
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22
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Dikeç G, Ergün G, Gumus F. Relation Among Anxiety and Family Burden in Primary First-Degree Caregivers of Outpatients with Mental Disorders in Turkey. Issues Ment Health Nurs 2018; 39:142-150. [PMID: 29193998 DOI: 10.1080/01612840.2017.1373174] [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: 10/18/2022]
Abstract
The aim of this study was to determine the relation among anxiety and family burden in primary first-degree relative caregivers of outpatients with mental disorders in Turkey. Data were collected with patients' primary first-degree relative caregivers via the Information Form, Beck Anxiety Inventory (BAI), and Perceived Family Burden Scale (PFBS). In all, 481 caregivers (325 women and 156 men) participated in this study. Based on this study's results, primary caregivers of patients with mental disorders had a moderate level anxiety, and as anxiety increased, family burden also increased. Those results suggest that mental health nurses should plan interventions not only for patients, but also for their family member or their caregivers to decrease anxiety level.
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Affiliation(s)
- Gül Dikeç
- a Department of Nursing , Faculty of Heath Sciences, Istinye University , Istanbul , Turkey
| | - Gül Ergün
- b Department of Emergency Aid and Disaster Management , Faculty of Heath Sciences, Mehmet Akif Ersoy University , Burdur , Turkey
| | - Funda Gumus
- c Department of Nursing , School of Health, Dicle University , Diyarbakır , Turkey
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23
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Gender differences in primary home caregivers of older relatives in a Mediterranean environment: A cross-sectional study. Arch Gerontol Geriatr 2017; 69:128-133. [DOI: 10.1016/j.archger.2016.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 10/19/2016] [Accepted: 11/15/2016] [Indexed: 11/21/2022]
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24
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Care Burden and Social Support Levels of Caregivers of Patients with Chronic Obstructive Pulmonary Disease. Holist Nurs Pract 2017; 30:227-35. [PMID: 27309411 DOI: 10.1097/hnp.0000000000000153] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This descriptive study was conducted to determine the care burden and social support levels of caregivers to patients with chronic obstructive pulmonary disease (COPD). The primary caregivers of 112 patients with COPD hospitalized in the chest diseases service of a university hospital were involved in the study. Data of the study were collected by using the Patient and Caregiver Information Form, which was prepared by reviewing the literature, Katz Index of Independence in Activities of Daily Living, Zarit Burden Interview, and Multidimensional Scale of Perceived Social Support. While the care burden mean score of caregivers of patients with COPD was 40.91 ± 20.58, the mean score of Multidimensional Scale of Perceived Social Support was 54.13 ± 18.84. In this study, it was determined that female caregivers, as well as individuals stating that their physical and psychological health was affected and those having difficulty giving care and needing help, had higher levels of care burden, whereas the spouses, as well as individuals with lower levels of income and those stating that their physical and psychological health was affected, had lower levels of social support.
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25
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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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26
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Rollero C. The Experience of Men Caring for a Partner With Multiple Sclerosis. J Nurs Scholarsh 2016; 48:482-9. [DOI: 10.1111/jnu.12231] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/21/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Chiara Rollero
- Assistant Professor; Faculty of Psychology; University eCampus; Italy
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27
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Batista CF, Bandeira M, Oliveira DR. [Factors associated with the overburden of male and female caregivers of psychiatric patients]. CIENCIA & SAUDE COLETIVA 2015; 20:2857-66. [PMID: 26331517 DOI: 10.1590/1413-81232015209.03522014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Various studies have investigated the factors associated with the overburden of family caregivers of psychiatric patients. This research sought to identify the factors associated with overburden in groups of male and female caregivers, analyzed separately. Fifty people of each sex participated in the study of family caregivers of psychiatric patients who filled out the Family Overburden Interview Schedule and a standardized sociodemographic data questionnaire. The results showed that different factors were associated with overburden in male and female groups. In the female group, the predictors of a greater degree of overburden were: no children at home, greater number of people living with the family, the patient not performing activities outside the home, the presence of comorbidity and greater incidence of patient problematic behavior. For men, the associated variables were: the family caregiver member not living with the patient, having income, reporting illness resulting from the caregiver role, number of children of the family caregiver, the patient not having a single room at home, patient's age, physical illness and quantity of drugs taken by the patient. These results point to the need for differentiated strategies in the family interventions developed by the mental health services.
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Affiliation(s)
- Cynthia Felicio Batista
- Laboratório de Pesquisa em Saúde Mental, Universidade Federal de São João del-Rei, São João del Rei, MG, BR,
| | - Marina Bandeira
- Laboratório de Pesquisa em Saúde Mental, Universidade Federal de São João del-Rei, São João del Rei, MG, BR,
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28
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Zhang Q, Chen H, Ju K, Niu X, Song L, Chui J. Cross-sectional evaluation of the adequacy of guardianship by family members of community-residing persons with mental disorders in Changning District, Shanghai. SHANGHAI ARCHIVES OF PSYCHIATRY 2015; 27:18-26. [PMID: 25852252 PMCID: PMC4372757 DOI: 10.11919/j.issn.1002-0829.214094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 01/29/2015] [Indexed: 11/17/2022]
Abstract
Background The disease burden associated with chronic psychiatric illnesses is high and is projected to grow rapidly. A community-based management system for persons with mental illness was established in Shanghai in 2012 based on the Shanghai Mental Health Regulations that were developed to conform with China’s new mental health law. Aim Evaluate the guardianship services provided by family members to persons with mental illnesses living in the Changning District of Shanghai. Methods The legal guardians of 4034 of the 4283 community-dwelling persons with psychiatric disorders living in Changning District who are registered in the Shanghai Information Management System of Mental Health were interviewed by local community health doctors and local neighborhood committee officials. The adequacy of guardianship was assessed based on standardized criteria (including the guardian’s regular attendance at mental health training sessions, and their level of assistance in the treatment, daily life, and rehabilitation of the patient) and the main reasons for inadequate guardianship were recorded. Results The majority of guardians (3331, 83.6%) adequately fulfilled their guardianship duties. Advanced age and ill-health of the guardian was the main contributing factor in 87% of the 703 cases in which the guardianship was classified as inadequate. Other factors associated with inadequate guardianship included the patient’s unstable clinical condition or failure to adhere to medication, and when the guardian did not live in the same household as the patient. The patient’s diagnosis, the guardian’s level of education, and the relationship between the guardian and patient were also associated with the adequacy of guardianship. Conclusions The guardianship-based community services for mentally ill individuals in urban China works reasonably well. But the rapid aging of China’s population may gradually decrease the ability of China’s families to continue to assume this heavy burden. Alternative models of providing high-quality, community-based services for persons with mental disorders need to be developed as part of the roll-out of China’s new mental health law.
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Affiliation(s)
| | - Hao Chen
- Changning District Mental Health Center, Shanghai, China
| | - Kang Ju
- Changning District Mental Health Center, Shanghai, China
| | - Xin Niu
- Changning District Mental Health Center, Shanghai, China
| | - Lanjun Song
- Changning District Mental Health Center, Shanghai, China
| | - Jia Chui
- Changning District Mental Health Center, Shanghai, China
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Yeh PM, Chang Y. Use of Zarit Burden Interview in analysis of family caregivers' perception among Taiwanese caring with hospitalized relatives. Int J Nurs Pract 2014; 21:622-34. [PMID: 25307788 DOI: 10.1111/ijn.12333] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study was conducted to examine the relationships between family caregivers' perception of caregiving and its influencing factors among Taiwanese with hospitalized relatives. The study used a cross-sectional and descriptive correlational design. A convenience sample of 200 primary caregivers of hospitalized patients diagnosed with cancer, stroke and chronic illness was recruited in a Taiwanese Medical Center; this focus was chosen because cancer, stroke and chronic illness generally require long term care. Data were collected by structured questionnaires. Pearson product-moment correlation and stepwise multiple regression analyses were used to analyse the results of this study. Family caregivers who lacked family support and whose patients' ADL (activities of daily living) dependency was increasing experienced a greater caregiving burden. Family caregivers who had better psychological well-being, better quality of relationship and more caregiving knowledge experienced a lower caregiving burden. Quality of relationship, lack of family support and patients' ADL dependency accounted for 43% of the Zarit Burden Interview variance. The results indicated that family caregivers' perception of caregiving included sacrifice, strain, embarrassment, anger and loss of control. It is vital for nurses to understand these caregiving perceptions and their related factors to provide a holistic care plan.
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Affiliation(s)
- Pi-Ming Yeh
- Department of Nursing, Missouri Western State University, St Joseph, Missouri, USA
| | - Yuanmay Chang
- Chairman Office, Shin Kong Memorial Hospital, Taipei, Taiwan.,Nursing, National Taipei University of Nursing and Health Science, Taipei, Taiwan
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Hsiao YC, Chiang YC, Lee HC, Han CY. Psychometric testing of the properties of the spiritual health scale short form. J Clin Nurs 2014; 22:2981-90. [PMID: 24118517 DOI: 10.1111/jocn.12410] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To further examine the psychometric properties of the spiritual health scale short form, including its reliability and validity. BACKGROUND Spirituality is one of the main factors associated with good health outcomes. A reliable and valid instrument to measure spirituality is essential to identify the spiritual needs of an individual and to evaluate the effect of spiritual care. DESIGN A cross-sectional study design was used. METHODS The study was conducted in six nursing schools in northern, central and southern Taiwan. The inclusion criterion for participants was nursing students with clinical practice experience. Initially, 1141 participants were recruited for the study, but 67 were absent and 48 did not complete the questionnaires. A total of 1026 participants were finally recruited, indicating a response rate of 89·9%. The psychometric testing of the spiritual health scale short form included construct validity with confirmatory factor analysis, known-group validity and internal consistency reliability. RESULTS The results of the confirmatory factor analysis supported the five-factor model as an acceptable model fit. In the known-group validity, the results indicated that people who are in the category of primary religious affiliation have better spiritual health than people in the category of secondary religious affiliation and atheism. The result also indicated that the 24-item spiritual health scale short form achieved an acceptable internal consistency coefficient. CONCLUSIONS The findings suggest that the spiritual health scale short form is a valid and reliable instrument for the appraisal of individual spiritual health. RELEVANCE TO CLINICAL PRACTICE The spiritual health scale short form could provide useful information to guide clinical practice in assessing and managing people's spiritual health in Taiwan.
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Affiliation(s)
- Ya-Chu Hsiao
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan
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Bauer R, Döring A, Schmidt T, Spießl H. "Mad or bad?": burden on caregivers of patients with personality disorders. J Pers Disord 2012; 26:956-71. [PMID: 23281679 DOI: 10.1521/pedi.2012.26.6.956] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The burden on caregivers of patients with personality disorders is often greatly underestimated or completely disregarded. Possibilities for caregiver support have rarely been assessed. Thirty interviews were conducted with caregivers of such patients to assess illness-related burden. Responses were analyzed with a mixed method of qualitative and quantitative analysis in a sequential design. Patient and caregiver data, including sociodemographic and disease-related variables, were evaluated with regression analysis and regression trees. Caregiver statements (n = 404) were summarized into 44 global statements. The most frequent global statements were worries about the burden on other family members (70.0%), poor cooperation with clinical centers and other institutions (60.0%), financial burden (56.7%), worry about the patient's future (53.3%), and dissatisfaction with the patient's treatment and rehabilitation (53.3%). Linear regression and regression tree analysis identified predictors for more burdened caregivers. Caregivers of patients with personality disorders experience a variety of burdens, some disorder specific. Yet these caregivers often receive little attention or support.
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Affiliation(s)
- Rita Bauer
- Department of Psychiatry and Psychotherapy, University of Regensburg, Universitätsstraße 84, 93053 Regensburg, Germany.
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del-Pino-Casado R, Frías-Osuna A, Palomino-Moral PA, Ramón Martínez-Riera J. Gender differences regarding informal caregivers of older people. J Nurs Scholarsh 2012; 44:349-57. [PMID: 23121734 DOI: 10.1111/j.1547-5069.2012.01477.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE The aim of this study was to examine differences related to gender among informal caregivers serving older disabled individuals. DESIGN AND METHODS A secondary analysis of the most recent national cross-sectional survey, which was conducted in Spain on informal caregivers who served older individuals (65 years of age or older), was conducted in 2011 (N= 1,272, probability sample). The relationships between gender and intensity of care (amount and type of care provided), duration of caregiving, subjective burden, and satisfaction with caregiving were analyzed by bivariate and multivariate procedures. FINDINGS No statistically significant gender differences were found with regard to the intensity of care, duration of caregiving, or satisfaction; however, subjective burden was found to differ between men and women, and this difference was statistically significant (odds ratio = 1.98; p= .012). CONCLUSIONS Because this study was conducted in Spain, a country with strong patriarchal norms with regard to caregiving and familism, whereas gender differences in intensity of care have been reported in countries with low familism, we conclude that cultural diversity can influence the relationship between gender and intensity of care. On the other hand, our study increases the evidence in support of there being gender-based differences in subjective burden among family caregivers serving older people in Western industrial countries. Finally, the results of our study support the hypothesis that sources of satisfaction are more strongly related to the caregiver's personal context and characteristics than to his or her gender. CLINICAL RELEVANCE These findings support the following recommendations regarding nursing interventions: (a) nurses should take into account specific cultural patterns in caregiving to improve their understanding concerning the relationships between gender and intensity of care, and (b) gender should be taken into account in interventions that are tailored toward addressing subjective burden.
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Lee HS. [Caregiver burden in caring for elders before and after long-term care service in Korea]. J Korean Acad Nurs 2012; 42:236-47. [PMID: 22699173 DOI: 10.4040/jkan.2012.42.2.236] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE Purposes of this study were: evaluation of family burden of caring for elders who receive long term care services, and examination of differences in burden before and after the introduction of long term care service in Korea. METHODS Data were collected by questionnaires from 416 caregivers of elders who were registered with the Long Term Care Insurance Corporation in six cities. Data were collected in September, 2010 and analyzed using descriptive statistics, paired t-test, and ANOVA with the Scheffe test, and stepwise multiple regression. RESULTS Family burden decreased significantly after long-term care service was initiated. Subjective burden decreased from 2.93 to 2.69 (t=11.78, p<.001), and objective burden, from 3.40 to 3.10 (t=12.73, p<.001). Stepwise multiple regression analysis revealed that factors affecting subjective burden were family relations (F=13.60, p=.003), age (F=5.47, p=.019), job (F=6.98, p=.008), and education (F=4.59, p=.032), and that factors affecting objective burden were living together (F=17.66, p<.001), job (F=13.34, p=.003), monthly income (F=6.61, p=.010), and type of service (F=6.62, p=.010). CONCLUSION The results of this first study to investigate caregiver burden after the Korean Long-term Care Insurance System was begun provide positive information for the development of strategies to decrease family burden in long term care.
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Affiliation(s)
- Hung Sa Lee
- Department of Nursing, Daegu Haany University, Daegu, Korea.
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Yeh PM, Chang Y. Family carer reactions and their related factors among Taiwanese with hospitalized relatives. J Adv Nurs 2011; 68:2195-206. [PMID: 22128763 DOI: 10.1111/j.1365-2648.2011.05904.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM The purpose of this study was to examine the relationships among family carer reactions and their related factors among Taiwanese with hospitalized relatives. BACKGROUND In Taiwan, most hospitalized patients have relatives or foreign labourers with them 24 hours a day. Limited research has focused on the reactions of family members who provide care for hospitalized relatives. METHODS A cross-sectional, correlation design was used. A convenience sample of 200 primary carers of hospitalized patients diagnosed with cancer, stroke, and enduring illness was recruited between 2009 and 2010. Data were collected by structured questionnaires. RESULTS The findings indicate that participants with a moderate level of family support experienced a moderate impact on health and finances, but a high impact on schedule. Family carers' health status and work time were significantly different between, before and after serving as a carer. The multiple regression model variables accounted for 40.1% of the total family carer reaction variance. Three factors were found to predict significantly greater impact on a family carer: (1) lower scores of caregiving knowledge, (2) increasing patient's activities of daily living dependency and (3) lack of family support. CONCLUSION It is vital for nurses not only to assess patients' activities of daily living, but also to assess family carers' knowledge of caregiving and the patient's existing family support in developing a plan of care that reduces negative impact on family carers.
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Affiliation(s)
- Pi-Ming Yeh
- Department of Nursing, Missouri Western State University, St. Joseph, Missouri, USA.
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