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Askaryzadeh Mahani M, Ghasemi M, Arab M, Baniasadi Z, Omidi A, Irani PS. The correlation between caregiver burden with depression and quality of life among informal caregivers of hemodialysis and thalassemia patients during the COVID-19 pandemic: a cross-sectional study. BMC Nurs 2023; 22:183. [PMID: 37246222 DOI: 10.1186/s12912-023-01351-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Lifelong provision of care to chronically ill patients increase the risk of physical and mental diseases in informal caregivers and adversely affects their quality of life. The present study examined the correlation between caregiver burden, depression, and quality of life among the informal caregivers of thalassemia and hemodialysis patients during the COVID-19 pandemic in southeastern Iran. METHODS This cross-sectional correlational study used convenience sampling to select 200 informal caregivers involved in providing direct care for patients undergoing hemodialysis (n = 70) and patients with thalassemia (130) for at least 6 months. A demographic questionnaire, Beck's Depression Inventory (BDI), the Quality-Of-Life Questionnaire (SF-36), and the Zarit Burden Interview were used to collect data in 2021. The data were analyzed with SPSS software (version 19) using frequency, percentage, independent samples t-test, ANOVA, and multivariate regression analysis. RESULTS Most of the informal caregivers of the thalassemia and hemodialysis patients (58% and 43%) reported moderate levels of caregiver burden. There were significant correlations between the caregiver burden and depression (P < 0.0001) and between the caregiver burden and the quality of life (P < 0.009). The level of depression in informal caregivers of patients undergoing hemodialysis was higher than that of the informal caregivers of patients with thalassemia, but the quality of life in the informal caregivers of the patient's undergoing hemodialysis was higher than that of the informal caregivers of the patients with thalassemia. CONCLUSION Considering the significant correlations between caregiver burden, depression, and quality of life in this study, healthcare providers are recommended to develop educational and supportive interventions to meet informal caregivers' needs, mitigate their emotional distress, fears, and concerns, and prevent caregiver burden in times of greater uncertainty.
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Affiliation(s)
- Maryam Askaryzadeh Mahani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
| | | | | | | | - Ali Omidi
- School of Nursing ad Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parichehr Sabaghzadeh Irani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Sevenoaks T, Fouche JP, Mtukushe B, Phillips N, Heany S, Myer L, Zar HJ, Stein DJ, Hoare J. A longitudinal and qualitative analysis of caregiver depression and quality of life in the Cape Town adolescent antiretroviral cohort. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Song Y, Wang H, Yin Y, Nie A, Yang H, Liu Y, Tao L, Zhong H, Zhang L, Chen H. Caregiver Burden Among Informal Caregivers of Persons Living with HIV/AIDS in Liangshan Prefecture, China. Patient Prefer Adherence 2022; 16:1027-1035. [PMID: 35444411 PMCID: PMC9013673 DOI: 10.2147/ppa.s357580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/27/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Previous studies revealed that informal caregivers for persons living with HIV/AIDS (PLWHA) experience perceived caregiver burden. Although Liangshan prefecture is one of the areas with the fastest growing HIV/AIDS epidemics in China, little is known about burden of informal caregivers for PLWHA. This study aimed to evaluate caregiver burden and these predictors among informal caregivers of PLWHA in Liangshan prefecture, China. METHODS This was a cross-sectional study conducted from August to December 2017. We used convenience sampling to recruit informal caregivers of PLWHA. A total of 222 participants completed questionnaires including demographic information, caregiving-related information, and caregiver burden (measured by Zarit Burden Interview, ZBI). SPSS software was used to analyze the data. Independent student's t-test, one-way analysis of variance (one-way ANOVA), Spearman rank correlation, and multiple linear regression analysis were performed. RESULTS The mean ZBI score was 40.61 (SD = 14.47), and 199 (89.6%) informal caregivers had a mild or above caregiver burden. Multiple linear regression analysis revealed that older age (P=0.003), caregivers with poor health (P=0.002), parent-caregivers (P=0.001), poorer ability in 'balancing caregiving needs and their own needs' (P<0.001), and 'managing emotional needs' (P=0.014) were significantly associated with higher level of caregiver burden. CONCLUSION The majority of informal caregivers had perceived caregiver burden in Liangshan prefecture of China. Findings emphasize that health-care providers, medical institutions and government should develop educational programs and policy to improve caregiver's ability to cope with caregiving for PLWHA, and take more attention to caregivers with health problem, at older age, parent-caregivers. These may contribute to reducing caregiver burden among informal caregivers of PLWHA.
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Affiliation(s)
- Yuqing Song
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Huan Wang
- Department of Nursing, the Third Hospital of Mianyang, Sichuan Mental Health Centre, Mianyang, Sichuan Province, 621000, People's Republic of China
| | - Yao Yin
- Department of Neurology/Evidence-Based Nursing Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Anliu Nie
- Emergency Department, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, 510120, People's Republic of China
| | - Hui Yang
- Nursing Department, the First Affiliated Hospital of Harbin Medical University, Harbin, 150001, Heilongjiang, People's Republic of China
| | - Ying Liu
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Lin Tao
- Department of Breast Surgery, West China Hospital /West China School of Nursing, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Hua Zhong
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Liao Zhang
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
| | - Hong Chen
- West China School of Nursing/West China Hospital, Sichuan University, Chengdu, Sichuan Province, 610041, People's Republic of China
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Mental Health Problems of Female Spouses of Men Living With HIV in Sichuan, China: A Qualitative Study. J Assoc Nurses AIDS Care 2021; 31:526-534. [PMID: 31261287 DOI: 10.1097/jnc.0000000000000104] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
HIV disclosure to spouses can promote HIV prevention and facilitate support from those spouses; it can also cause mental health challenges for the spouses. We conducted a qualitative study of the mental health status and potential contributing factors of mental health challenges of spouses of men living with HIV in Sichuan, China. We interviewed 31 spouses whose husbands were living with HIV. Qualitative data were analyzed using content and thematic analyses. We found that mental health challenges were common among the spouses; leading challenges were themed as hopelessness, depression, and anxiety. Greater HIV knowledge, close relationship with husband, and psychological support may protect spouses from mental health challenges, whereas HIV-related stigma, heavy caregiving burden, and an unsupportive environment might be detrimental to mental health. Spouses of men living with HIV need mental health services, which should take into account a wide spectrum of contributors at individual, couple, and social levels.
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Lourenço TMG, Abreu-Figueiredo RMS, Sá LOD. Review of nursing diagnosis validation studies: caregiver role strain. ACTA ACUST UNITED AC 2020; 41:e20190370. [PMID: 33237220 DOI: 10.1590/1983-1447.2020.20190370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/28/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the nursing diagnosis NANDA-I - Caregiver Role Strain validation studies. METHODS Integrative literature review. Research of studies carried out between 2000 and 2018 with the descriptors: caregivers, nursing diagnosis and validation study in the following databases: Web of Science, EBESCOhost, Scielo Brasil and Portugal, LILACS, RCAAP, CAPES, NANDA-I website, and in the bibliographic references of the articles. Articles in Portuguese, English or Spanish were included. RESULTS The sample consisted of seven validation studies, with heterogeneity in the methodologies used. The populations where the diagnosis was clinically validated focused on caregivers for the elderly and people with chronic illness. The most prevalent defining characteristics were Stress and Apprehension related to the future. CONCLUSIONS This diagnosis requires further validation studies among different populations in search of greater accuracy and a reduction in the number of defining characteristics, facilitating the use of taxonomy.
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Affiliation(s)
- Tânia Marlene Gonçalves Lourenço
- Escola Superior de Enfermagem São José de Cluny. Funchal, Portugal.,Center for Health Technology and Services Research (CINTESIS), NursID - Innovation & Development in Nursing Research Group. Porto, Portugal
| | | | - Luís Octávio de Sá
- Universidade Católica Portuguesa (UCP), Instituto de Ciências da Saúde, Centro de Investigação Interdisciplinar em Saúde (CIIS). Porto, Portugal
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Putera AM, Irwanto, Maramis MM. Quality-of-Life (QoL) of Indonesian Children Living with HIV: The Role of Caregiver Stigma, Burden of Care, and Coping. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:573-581. [PMID: 33116919 PMCID: PMC7569035 DOI: 10.2147/hiv.s269629] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 09/03/2020] [Indexed: 12/27/2022]
Abstract
Background Treatment of children with HIV infection has increased rapidly by increasing the life span of HIV patients from baby to adult. Improving the quality-of-life (QoL) in children living with HIV is a priority of HIV management in children and caregivers of children living with HIV have important roles. Caregiver stigma, caregiver burden, and caregiver coping affect caregivers in treating children living with HIV. Objective Analyzing the association of caregiver stigma, caregiver burden, and caregiver coping on QoL of Indonesian children living with HIV. Methods Participants in this study were caregivers of Indonesian children living with HIV. Participants were measured for caregiver stigma, caregiver burden, caregiver coping, and QoL of Indonesian children living with HIV. The instrument used in measuring caregiver stigma was people living with HIV/AIDS and caregiver questionnaire, caregiver burden used Zarit Burden questionnaire, caregiver coping used F-COPES questionnaire, and QoL used PedsQL for children aged 2-18 years old. Measurement data were analyzed using logistic regression and independent t tests with P<0.05. Results Indonesian children living with HIV in this study had an average age of 7.7±3.68 years and average participant age of 40.2±11.26 years. All participants stated that Indonesian children living with HIV tend to keep their health status confidential. Most QoL of Indonesian children living with HIV was good (71.7%), caregiver stigma value was 21.7±2.06, and caregiver burden level was moderate, of 50.9%. However, there was no significant association between caregiver stigma (β=0.064; P=0.548) and burden level (β=0.058; P=0.593) on QoL. On the other hand, caregiver coping value was 77.2±7.30, and there was a significant association of caregiver coping on QoL (β=-0.196; P=0.049). Conclusion There is an association of caregiver coping on QoL of Indonesian children living with HIV, in which the higher the caregiver coping, the lower the QoL. Meanwhile, there is no significant association of caregiver stigma and burden on QoL of Indonesian children living with HIV.
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Affiliation(s)
- Azwin Mengindra Putera
- Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Irwanto
- Department of Child Health, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
| | - Margarita Maria Maramis
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga - Dr. Soetomo General Academic Hospital, Surabaya, Indonesia
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Relationship Between Mothers’ Concerns and Nursing Support of Children Admitted to Baqiyatallah Al-Azam Hospital of Ali Abad Katoul, Golestan Province, Iran, in 2018. ACTA ACUST UNITED AC 2019. [DOI: 10.5812/modernc.92471] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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8
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Hawkins SK. Impact of HIV and AIDS on rural elderly caregivers in Chiang Mai Province, Thailand. AIDS Care 2019; 31:1494-1499. [PMID: 30894008 DOI: 10.1080/09540121.2019.1595520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The UN General Special Assembly on HIV/AIDS reported that Thailand's elderly are living on the edge of poverty. Those who become caregivers for the children who have been orphaned by AIDS incur even greater challenges. The 2007 Survey of Older Persons of Thailand (SOPT) concluded that there is a range of financial and social safety nets provided by the government, nongovernmental (NGO), and faith-based organizations (FBOs) to help the elderly caregivers and their families. The research offered limited studies on Thailand's elderly caring for these children. The purpose of this phenomenological study was to explore the social, religious and familial experiences of this population. In-depth interviews were conducted with 14 elderly caregivers participating in the Grandma Cares Program (GCP) located in the province of Chiang Mai. They were asked about their caregiving experiences, cultural and Buddhist beliefs, and programs that help them. Data were verified through member checking with a translator. The details of the caregivers' experiences and environments were transcribed and analyzed with Creswell's 6-step process to identify textural and structural themes and patterns. Results of this study indicated that caregivers gained comfort and strength from Buddha's teachings and cultural beliefs, but they would like more support.
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Affiliation(s)
- Sarah-Kate Hawkins
- Public Policy and Administration, Walden University , Minneapolis , MN , USA
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9
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Bagheri Z, Taheri M, Motazedian N. The impacts of depression and anxiety on quality of life among patients with HIV/AIDS and their spouses: testing dyadic dynamics using the actor-partner interdependence model. AIDS Care 2019; 31:1500-1508. [PMID: 30884955 DOI: 10.1080/09540121.2019.1595676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
HIV/AIDS not only affects the patients, but also their entire family. This study aimed to assess the impacts of the patients' and their spouses' anxiety and depression on their quality of life (QoL) at the dyadic level. A total of 120 serodiscordant husband-wife dyads from the voluntary counselling and testing center in Shiraz, Iran, were involved in this study from February to June 2015. The WHOQOL-BREEF, CESD-10, and Beck Anxiety Inventory instruments were used, respectively, to assess the QoL, depression, and anxiety scores of the participants. The actor-partner interdependence model (APIM) was used to estimate the effects of depression and anxiety of both the people living with HIV/AIDS (PLWHA) and their spouses on their own QoL (actor effect) as well as their partners' (partner effect). The APIM analysis revealed that both PLWHAs' and their spouses' depression and anxiety showed actor effects on their own QoL. Furthermore, spouses' depression showed a significant partner effect on PLWHAs' QoL and PLWHAs' anxiety had significant partner effects on spouses' QoL. Accordingly, this data can be used to develop targeted interventions aimed at guidance and assistance of PLWHAs and their spouses to find coping strategies that improve their own QoL as well as their partners'.
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Affiliation(s)
- Zahra Bagheri
- Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Marjan Taheri
- Department of Biostatistics, Faculty of Medicine, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Nasrin Motazedian
- Shiraz Transplant Research Center, Shiraz University of Medical Sciences , Shiraz , Iran.,Shiraz HIV/AIDS Research Center, Shiraz University of Medical Sciences , Shiraz , Iran
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Punta P, Somrongthong R, Kumar R. Factors influencing quality of life (QOL) amongst elderly caregivers of people living with HIV/AIDS in Phayao province, Thailand: a cross-sectional study. F1000Res 2019; 8:39. [PMID: 31016012 PMCID: PMC6456834 DOI: 10.12688/f1000research.16892.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/28/2018] [Indexed: 11/20/2022] Open
Abstract
Background: There are many impacts on quality of life among elderly people living with HIV patients. This study aimed to assess factors influencing quality of life among elderly people living with HIV/AIDS in a northern province of Thailand. Methods: This cross-sectional study was conducted in Phayao province, Thailand. A systematic sampling technique was employed to select study participants. 152 elderly participants aged 60 years and older with a family member living with HIV/AIDS were recruited to the study. They were interviewed using the World Health Organization Quality of Life-Older Adults Module (WHOQOL-OLD) questionnaire. Stepwise multiple regression analysis was performed to determine the factors influencing quality of life among elderly people affected by family member living with HIV/AIDS. Results: The results of the study showed the mean age of elderly participants was 67.20 + 52 years, most of which were female (97 persons, 63.8%). The mean time taking care of HIV/AIDS patients was 6.61 + 4.96 years. In term of health status among the elderly participants, the majority did not have chronic diseases (61.4%), amongst those with chronic diseases (38.6%), hypertension and diabetes were the most common. The average quality of life score was at a fair level. The time taking care of HIV/AIDS patients and health status were significant predictors of quality of life among participants 8.1 % ( R 2 =.081; p < .05). Conclusion: In order to improve quality of life among elderly caregivers to family member living with HIV/AIDS, time taking care of HIV/AIDS patients and health status should be focused on, amongst other factors. Help and support from the government, community, health organizations, academic research, and family members can help improve quality of life amongst the elderly.
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Affiliation(s)
- Pitakpong Punta
- College of Public Health Sciences,, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ratana Somrongthong
- College of Public Health Sciences,, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Ramesh Kumar
- Department of Public Health, Health Services Academy, Islamabad, 44000, Pakistan
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Tanyi PL, Pelser A, Okeibunor J. HIV/AIDS and older adults in Cameroon: Emerging issues and implications for caregiving and policy-making. SAHARA J 2018; 15:7-19. [PMID: 29409392 PMCID: PMC5804678 DOI: 10.1080/17290376.2018.1433059] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
The burden of human immunodeficiency virus (HIV) infection and acquired immune deficiency syndrome (AIDS) on the elderly population in three divisions within the Northwest Region of Cameroon was examined. Data for this paper were extracted from a larger study which had been conducted concerning the burden of HIV infection and AIDS on the older adults in the Northwest Region of Cameroon. Using in-depth interviews (IDIs) and focus group discussions (FGDs), data were collected from 36 participants who were purposively selected from the three divisions which had been chosen randomly. 6 FGD sessions were held with 30 women aged 60 years and above and who were affected by HIV infection and AIDS, while IDIs sessions were held with 6 male community leaders. The results revealed that HIV infection and AIDS has added another dimension to the role of older persons. HIV infection and AIDS affects older people in diverse ways, as they have to look after themselves, their sick children and are often also left to look after their grandchildren orphaned by HIV infection and AIDS. These emerging issues in their lives make them vulnerable to health, social, economic and psychological challenges, and place a burden on them as caregivers instead of being cared for in their old age. Apart from increased direct expenditures, taking care of victims of HIV infection and AIDS requires older people to stay away from social, religious and community activities. The results showed that the loss of a child to HIV infection and AIDS affects the economic/financial well-being, participation in social/religious interactions as well as the community activities of older people participants. The implications of these findings for caregiving and social policy are discussed.
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Affiliation(s)
- Perpetua Lum Tanyi
- a PhD, is a postdoctoral research fellow at the Department of Sociology , University of the Free State , Bloemfontein , South Africa
| | - André Pelser
- b MA (Sociology) and PhD (Sociology), is a Professor at the Department of Sociology , University of the Free State , Bloemfontein , South Africa
| | - Joseph Okeibunor
- c Msc (Sociology) and PhD (Medical Sociology), is a Professor at the Department of Sociology , University of Nigeria Nsukka , Enugu , Nigeria
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Hsieh J, Li L, Lin C, Luo S, Ji G. Spousal role and caregiver burden in HIV affected families in Anhui Province, China. AIDS Care 2017; 29:1270-1274. [PMID: 28276252 DOI: 10.1080/09540121.2017.1300631] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined the burden experienced by various roles of family caregivers of people living with HIV (PLH), in particular spouses vs. non-spouses. A total of 475 family members of PLH were recruited from Anhui Province, China. Participants responded to a survey using the Computer Assisted Personal Interview method. The assessment collected data on demographic characteristics and their perceived caregiver burden, which was compared between spouses and non-spouses. Multiple regression models were built to identify factors associated with caregiver burden. About 64.4% of our study participants were female and the mean age was 42.1 years. Among various relationships to PLH, almost half reported being a spouse. Spouses reported significantly higher caregiver burden than non-spouses. In addition, older age and lower family income were significantly associated with higher level of caregiver burden. Among the subsample of spouses, significantly higher level of caregiver burden was identified among wives. Future studies should give special consideration to address the needs of female spouses in order to reduce their caregiver burden.
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Affiliation(s)
- Julie Hsieh
- a Semel Institute for Neuroscience and Human Behavior, Center for Community Health , University of California , Los Angeles , USA
| | - Li Li
- a Semel Institute for Neuroscience and Human Behavior, Center for Community Health , University of California , Los Angeles , USA
| | - Chunqing Lin
- a Semel Institute for Neuroscience and Human Behavior, Center for Community Health , University of California , Los Angeles , USA
| | - Sitong Luo
- a Semel Institute for Neuroscience and Human Behavior, Center for Community Health , University of California , Los Angeles , USA
| | - Guoping Ji
- b Anhui Provincial Center for Woman and Child Health , Hefei , China
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Chen L, Chi P, Li X, Zilioli S, Zhao J, Zhao G, Lin D. The effects of trait and state affect on diurnal cortisol slope among children affected by parental HIV/AIDS in rural China. AIDS Care 2016; 29:1034-1040. [PMID: 28030969 DOI: 10.1080/09540121.2016.1274015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Affect is believed to be one of the most prominent proximal psychological pathway through which more distal psychosocial factors influence physiology and ultimately health. The current study examines the relative contributions of trait affect and state affect to the hypothalamic-pituitary-adrenal axis activity, with particular focus on cortisol slope, in children affected by parental HIV/AIDS. A sample of 645 children (8-15 years old) affected by parental HIV/AIDS in rural China completed a multiple-day naturalistic salivary cortisol protocol. Trait and state affect, demographics, and psychosocial covariates were assessed via self-report. Hierarchical linear modeling was used for estimating the effects of trait affect and state affect on cortisol slope. Confidence intervals for indirect effects were estimated using the Monte Carlo method. Our results indicated that both trait and state negative affect (NA) predicted flatter (less "healthy") diurnal cortisol slopes. Subsequent analyses revealed that children's state NA mediated the effect of their trait NA on diurnal cortisol slope. The same relationships did not emerge for trait and state positive affect. These findings provide a rationale for future interventions that target NA as a modifiable antecedent of compromised health-related endocrine processes among children affected by parental HIV/AIDS.
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Affiliation(s)
- Lihua Chen
- a Institute of Developmental Psychology, Beijing Normal University , Beijing , People's Republic of China
| | - Peilian Chi
- b Department of Psychology, Faculty of Social Sciences , University of Macau , Macau SAR, People's Republic of China
| | - Xiaoming Li
- c Department of Health Promotion, Education, and Behavior , University of South Carolina , Columbia , SC , USA
| | - Samuele Zilioli
- d Department of Psychology , Wayne State University , Detroit , MI , USA.,e Department of Family Medicine and Public Health Science , Wayne State University , Detroit , MI , USA
| | - Junfeng Zhao
- f Department of Psychology , Institute of Behavior and Psychology, Henan University , Kaifeng , People's Republic of China
| | - Guoxiang Zhao
- f Department of Psychology , Institute of Behavior and Psychology, Henan University , Kaifeng , People's Republic of China
| | - Danhua Lin
- a Institute of Developmental Psychology, Beijing Normal University , Beijing , People's Republic of China.,g School of Psychology, Beijing Normal University , Beijing , People's Republic of China
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Asadullah M, Kamath R, Pattanshetty S, Andrews T, Nair NS. Psychological impact on caregivers of HIV-infected children in Udupi district, Karnataka. AIDS Care 2016; 29:787-792. [PMID: 27915488 DOI: 10.1080/09540121.2016.1263720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Caregivers of children living with HIV/AIDS (CLWHA) face unique challenges due to disease-related stigma and discrimination, isolation from society, financial constraints, grief and mortality of loved one. A descriptive cross-sectional study was conducted at Udupi ART centre to assess the caregiver burden, psychological distress and their associated factors among the caregivers of CLWHA in Udupi District. The convenience sampling technique was used to collect the data from 171 caregivers and analysed with the help of SPSS version 15.0. Majority of caregivers were female (64.9%) with mean age of 38.1 ± 9.6 years. About 64.3% caregivers were HIV-positive and 63.2% were biological parents of CLWHA. Mild-to-severe caregiver burden on Zarit Burden Inventory (ZBI) was reported among 84.8% of caregivers, and mild-to-severe psychological distress on General Health Questionnaire (GHQ-12) was reported among 49.7% caregivers. Relationship with child was found to be a significant predictor of caregiver burden as compared to other relatives/foster (P < 0.001). Relationship with child (P 0.004), Alcohol use (P 0.008) and Schooling of children (P 0.049) were reported as significant predictors of psychological distress. Study concludes that caregiver burden and psychological distress were high among caregivers of CLWHA. Psychological problems of caregivers need to be addressed and integrated along with the clinical care of HIV-infected children at ART centres.
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Affiliation(s)
- Md Asadullah
- a Department of Public Health , Manipal University , Manipal , India
| | | | | | - Teddy Andrews
- a Department of Public Health , Manipal University , Manipal , India
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Yu NX, Chan CLW, Zhang J. Dyadic Effects of Stigma and Discrimination on Distress in Chinese HIV Discordant Couples. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2016; 28:277-286. [PMID: 27427923 DOI: 10.1521/aeap.2016.28.4.277] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The present study investigated the dyadic effects of stigma and discrimination on distress in Chinese couples affected by HIV. Chinese people living with HIV (PLHIV) and their seronegative spouses (N = 119 couples) participated in this study. The PLHIV completed measures on stigma beliefs about being better off dead and dignity-related distress. The spouses completed measures on perceived discrimination and exclusion and caregiver distress. The results showed that there was no significant correlation between the PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion. The couples showed significant associations in their dignity-related distress and caregiver distress. Analyses using the actor-partner interdependence model showed that PLHIV's stigma beliefs and the spouses' perceived discrimination and exclusion both had significant actor and partner effects on distress within the dyad. Psychosocial interventions aiming for distress reduction in the context of HIV should tackle stigma and discrimination and target the couples rather than solely the patient or spouse.
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Affiliation(s)
- Nancy Xiaonan Yu
- Department of Applied Social Sciences, City University of Hong Kong, Hong Kong, China
| | - Cecilia L W Chan
- Department of Social Work and Social Administration and Center on Behavioral Health, The University of Hong Kong, Hong Kong, China
| | - Jianxin Zhang
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Challinor JM, Galassi AL, Al-Ruzzieh MA, Bigirimana JB, Buswell L, So WK, Steinberg AB, Williams M. Nursing's Potential to Address the Growing Cancer Burden in Low- and Middle-Income Countries. J Glob Oncol 2016; 2:154-163. [PMID: 28717695 PMCID: PMC5495453 DOI: 10.1200/jgo.2015.001974] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Affiliation(s)
- Julia M. Challinor
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Annette L. Galassi
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Majeda A. Al-Ruzzieh
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Jean Bosco Bigirimana
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Lori Buswell
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Winnie K.W. So
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Allison Burg Steinberg
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
| | - Makeda Williams
- Julia M. Challinor, International Network for Cancer Treatment and Research, Brussels, Belgium; Annette L. Galassi and Makeda Williams, National Cancer Institute, Bethesda, MD; Majeda A. Al-Ruzzieh, King Hussein Cancer Center, Amman, Jordan; Jean Bosco Bigirimana, Inshuti Mu Buzima, Rwinkwavu, Rwanda; Lori Buswell, Partners in Health, Boston, MA; Winnie K. W. So, The Chinese University of Hong Kong, Hong Kong, Special Administrative Region, People’s Republic of China; and Allison Burg Steinberg, Johns Hopkins Sidney Kimmel Comprehensive Cancer Center at Sibley Memorial Hospital, Washington, DC
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Ashraf M, Sitwat A. Personality dimensions, positive emotions and coping strategies in the caregivers of people living with HIV in Lahore, Pakistan. Int J Nurs Pract 2016; 22:364-74. [PMID: 27166621 DOI: 10.1111/ijn.12444] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 01/27/2016] [Accepted: 03/21/2016] [Indexed: 11/28/2022]
Abstract
The aim of this research was to study the relationship between personality dimensions, positive emotions and coping mechanisms of caregivers of patients living with HIV. This study used a cross-sectional research design. A sample comprising 56 caregivers was recruited from HIV/AIDS clinics in three teaching hospitals in Lahore, Pakistan. Data were collected between February and July 2010. Most caregivers were men, and of low socio-economic status. Individuals with both high and low extraversion used problem-focused coping, self-control and accepting responsibility, but those with low extraversion used more escape-avoidance coping, and they had also high levels of negative emotions. Those high in neuroticism used more tension-reduction coping than problem-focused coping, and experienced fewer positive emotions. Regression analysis findings revealed neuroticism as a significant predictor of negative emotions as well as emotion-focused coping, and only extraversion significantly predicted negative emotions. This research could help in devising psychological management plans for caregivers of patients living with HIV in order to assist them in coping with the burden of care.
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Affiliation(s)
- Mujeeba Ashraf
- Department of Applied Psychology, University of Punjab, Lahore, Pakistan
| | - Aisha Sitwat
- Centre for Clinical Psychology, University of Punjab, Lahore, Pakistan
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Chandran V, Madi D, Chowta N, Ramapuram J, Bhaskaran U, Achappa B, Jose H. Caregiver Burden among Adults Caring for People Living with HIV/AIDS (PLWHA) in Southern India. J Clin Diagn Res 2016; 10:OC41-3. [PMID: 27437270 DOI: 10.7860/jcdr/2016/20076.7865] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 04/21/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION In India, family caregivers provide bulk of care to People Living With HIV/AIDS (PLWHA). Caregiver burden refers to the physical, emotional and financial hardships associated with providing care to a diseased individual. Attending to the needs of PLWHA can place a significant burden on family members. This may adversely affect their Quality of Life (QOL). AIM The main aim of our study was to assess the caregiver burden and QOL among the family members of PLWHA in Southern India. We also determined the impact of caregiver burden on QOL. MATERIALS AND METHODS This facility based cross-sectional study was carried out at Kasturba Medical College (KMC) Mangalore. The study was conducted over a period of 18 months starting from October 2013. A total of 360 caregivers participated in our study. The data were collected by face-to-face interview. Caregiver burden was assessed using the Zarit Burden scale & WHOQOL-BREF scale was used to assess the QOL of caregivers. The collected data was entered and analysed using SPSS version 11.5. A p-value of less than 0.05 was considered statistically significant. RESULTS The mean age of caregivers was 36.09± 10.18 years. Most of the caregivers were females 279 (77.5%). Majority of caregivers 184 (51.1%) belonged to Middle/Lower Middle socioeconomic class (Kuppuswamy class III). Majority of PLWHA 155 (43.1%) had Stage 2 disease. Mean CD4 count of the patients was 405.2± 240 cells/μL. In our study 88(24.4%) caregivers had moderate to severe burden and 36(10%) had very severe burden. Physical domain of QOL showed maximum score of 60.28±13.08, while a minimum score of 51.88 ± 14.20 was seen in social domain. With increase in caregiver burden, the mean QOL scores decreased which was statistically significant. CONCLUSION Our study highlights the need to counsel the caregivers on how to deal with PLWHA in the family. Family care plays a major role in the general wellbeing of PLWHA. Majority of national HIV programmes all over the world focus mainly on PLWHA. National programmes should immediately address the mental health issues of caregivers thereby reducing caregiver burden. More studies on this topic have to be conducted in developing countries.
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Affiliation(s)
- Vishnu Chandran
- Junior Resident, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - Deepak Madi
- Associate Professor, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - Nithyananda Chowta
- Additional Professor, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - John Ramapuram
- Professor, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - Unnikrishnan Bhaskaran
- Professor, Department of Community Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - Basavaprabhu Achappa
- Associate Professor, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
| | - Hyma Jose
- Junior Resident, Department of Medicine, KMC Mangalore, Manipal University , Karnataka, India
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Chauhan RC, Rai SK, Kant S, Lodha R, Kumar N, Singh N. Burden Among Caregivers of Children Living with Human Immunodeficiency Virus in North India. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:129-33. [PMID: 27114969 PMCID: PMC4821091 DOI: 10.4103/1947-2714.179117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background: Due to wider access to and free antiretroviral therapy (ART) program, the number of children dying due to acquired immune deficiency syndrome (AIDS)-related causes has declined and the nature and duration of human immunodeficiency virus (HIV)/AIDS caregiving has also dramatically altered. The care of children living with HIV/AIDS (CLHA) places a significant additional burden on the caregivers. Aims: This study was conducted to assess the perceived burden among caregivers of children living with HIV in North India. Materials and Methods: A hospital-based cross-sectional study among 156 CLHA-caregiver dyads in North India was conducted from June 2010 to May 2011. Data were collected by using a pretested structured interview schedule. The caregiver burden was measured with a 36-item scale adapted from Burden Assessment Schedule of Schizophrenia Research Foundation (BASS). Child characteristics, caregiver characteristics, caregiving burden, the knowledge of caregivers, and issues related to health care, nutrition, education, and psychological aspects were studied. Results: Caregivers had a mean age of 35.9 ± 10.2 years. Women accounted for over three-fourth (76.9%) of the caregivers. Nearly two-third of them (65.4%) reported as living with HIV. The mean caregiver burden score was 68.7 ± 2.9. A majority of the caregivers reported either low or moderate burden. Standardized percentage score was high in the domains of physical and mental health, external support, patients’ behavior, and caregivers’ strategy and seemed to be comparatively less in the other domains such as support of the patient and taking responsibility. Conclusions: Caring of children is a universal practice but there is a need of special care for children living with HIV. The majority of caregivers who were usually the mothers perceived the burden and need to be assisted in caring for the child. Stigma and discrimination with HIV infection further increased the burden as caregivers did not disclose the HIV status to any near and dear one.
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Affiliation(s)
- Ramesh Chand Chauhan
- Department of Community Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - Sanjay Kumar Rai
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shashi Kant
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Nand Kumar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Neelima Singh
- Department of Obstetrics and Gynaecology, Pondicherry Institute of Medical Sciences, Puducherry, India
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20
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Lundberg PC, Doan TTK, Dinh TTX, Oach NK, Le PH. Caregiving to persons living with HIV/AIDS: experiences of Vietnamese family members. J Clin Nurs 2016; 25:788-98. [PMID: 26778364 DOI: 10.1111/jocn.13099] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2015] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To examine the experiences of caregiving among Vietnamese family members of persons living with HIV/AIDS. BACKGROUND As the number of persons living with HIV/AIDS increases, the need of family caregivers who can take responsibility for the home care of these persons increases. Vietnam has one of the fastest growing HIV epidemics in Asia. DESIGN A descriptive cross-sectional study with quantitative and qualitative methods was used. METHODS A purposive sample of 104 family caregivers, both male and female, participated voluntarily by answering a questionnaire of caregiver burden, and 20 of them participated in in-depth interview. RESULTS Female caregivers were mainly mothers and wives while male caregivers were mainly husbands, fathers and siblings. The largest group of family caregivers reported moderate to severe burden. There was no difference between genders in total caregiver burden, but there were several differences between older and younger caregivers in some items of caregiver burden. Five categories of experiences emerged: Different types of caregiving to persons living with HIV/AIDS, cultural and religious issues associated with caregiving, keeping secret to avoid stigma and discrimination, lack of knowledge about disease and provision of care, and fear, anxiety and frustration. CONCLUSIONS Stigma and discrimination should be decreased by providing knowledge to the general public about HIV/AIDS, in particular about ways of transmission and protection. Special knowledge should be given to family caregivers to enable them to give care to persons living with HIV/AIDS at home. This could be done through culturally appropriate training/intervention programmes in which coping methods should be included. Support group interventions should also be carried through. The results obtained can be used as baseline information. RELEVANCE TO CLINICAL PRACTICE Health care providers should consider gender, age and culture of family members of persons living with HIV/AIDS. Knowledge about HIV/AIDS, provision of care at home and in hospital, and support groups should be developed and implemented.
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Affiliation(s)
- Pranee C Lundberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Thoa Thi Kim Doan
- Department of Nursing, Faculty of Nursing and Medical Technology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | - Nhung Kim Oach
- Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Phong Hoang Le
- Medicine and Pharmacy University Hospital, Ho Chi Minh City, Vietnam
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21
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Effendy C, Vernooij-Dassen M, Setiyarini S, Kristanti MS, Tejawinata S, Vissers K, Engels Y. Family caregivers' involvement in caring for a hospitalized patient with cancer and their quality of life in a country with strong family bonds. Psychooncology 2014; 24:585-91. [DOI: 10.1002/pon.3701] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2014] [Revised: 09/10/2014] [Accepted: 09/11/2014] [Indexed: 12/11/2022]
Affiliation(s)
- Christantie Effendy
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
| | - Myrra Vernooij-Dassen
- Scientific Institute for Quality of Healthcare; Radboudumc; Nijmegen the Netherlands
- Kalorama Foundation; Beek-Ubbergen the Netherlands
| | - Sri Setiyarini
- School of Nursing, Medical Faculty; Universitas Gadjah Mada; Yogyakarta Indonesia
| | | | - Sunaryadi Tejawinata
- Center of Development for Palliative and Pain Relief; Dr. Soetomo Hospital; Surabaya Indonesia
| | - Kris Vissers
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
| | - Yvonne Engels
- Department of Anesthesiology, Pain and Palliative Medicine; Radboudumc; Nijmegen the Netherlands
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22
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Lee SJ, Li L, Lin C, Tuan LA. Challenges facing HIV-positive persons who use drugs and their families in Vietnam. AIDS Care 2014; 27:283-7. [PMID: 25285396 DOI: 10.1080/09540121.2014.963015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
It is hypothesized that persons who use drugs (PWUD) in Vietnam who are also HIV-positive may face additional challenges in psychosocial outcomes, and these challenges may extend to their family members. In this study, we examined depressive symptoms, stigma, social support, and caregiver burden of HIV-positive PWUD and their family members, compared to the outcomes of HIV-negative PWUD and their family members. Baseline, 3-month, and 6-month assessment data were gathered from 83 PWUD and 83 family members recruited from four communes in Phú Thọ Province, Vietnam. For PWUD, although we observed a general decline in overall stigma over time for both groups, HIV-positive PWUD consistently reported significantly higher overall stigma for all three periods. Depressive symptoms among family members in both groups declined over time; however, family members of HIV-positive PWUD reported higher depressive symptoms across all three periods. In addition, family members of HIV-positive PWUD reported lower levels of tangible support across all three periods. Caregiver burden among family members of HIV-positive PWUD increased significantly over time, whereas the reported burden among family members of HIV-negative PWUD remained relatively unchanged. The findings highlight the need for future interventions for PWUD and family members, with targeted and culturally specific strategies to focus on the importance of addressing additional stigma experienced by PWUD who are HIV-positive. Such challenges may have direct negative impact on their family members' depressive symptoms, tangible support, and caregiver burden.
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Affiliation(s)
- Sung-Jae Lee
- a Semel Institute for Neuroscience and Human Behavior, Center for Community Health , University of California , Los Angeles , CA , USA
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23
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Kidman R, Thurman TR. Caregiver burden among adults caring for orphaned children in rural South Africa. VULNERABLE CHILDREN AND YOUTH STUDIES 2014; 9:234-246. [PMID: 24999368 PMCID: PMC4066884 DOI: 10.1080/17450128.2013.871379] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Accepted: 11/28/2013] [Indexed: 06/01/2023]
Abstract
The AIDS epidemic has created an unprecedented number of orphans. While largely absorbed by extended family, this additional responsibility can weigh heavily on their caregivers. The concept of caregiver burden captures multiple dimensions of well-being (e.g., physical, social and psychological). Measuring the extent and determinants of caregiving burden can inform the design of programmes to ease the negative consequences of caregiving. This study uses the baseline data from a study assessing interventions for orphans and vulnerable adolescents in the Eastern Cape, South Africa. Orphan caregivers (n = 726) completed an adapted version of the 12-item Zarit Burden Interview. In addition to basic caregiver and household demographics, the survey also collected information on AIDS-related illness and recent deaths. Descriptive data are presented, followed by multivariate Poisson regression models to explore factors associated with caregiver burden. Approximately 40% of caregivers reported high levels of orphan caregiving burden. Feelings of stress and inadequacy concerning their care responsibilities as well as anger towards the child were common. Household food insecurity was the most important predictor of orphan caregiving burden (marginal effect = 7.82; p < 0.001 for those reporting severe hunger); income was also a significant determinant. When other AIDS impacts were added to the model, only the AIDS-related illness of the caregiver was significantly associated with burden (marginal effect = 3.77; p < 0.001). This study suggests that caregivers with economic vulnerability and those struggling with their own AIDS-related illness feel most overburdened. These findings are particularly relevant to service providers who must identify caregivers in need of immediate assistance and allocate limited resources effectively. To alleviate caregiver burden, programmes must foster greater economic security (e.g., by facilitating access to social grants or directly providing cash transfers) and coordinate services with home-based care programmes serving the chronically ill.
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Affiliation(s)
- Rachel Kidman
- Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
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24
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Kuo C, Cluver L, Casale M, Lane T. Cumulative effects of HIV illness and caring for children orphaned by AIDS on anxiety symptoms among adults caring for children in HIV-endemic South Africa. AIDS Patient Care STDS 2014; 28:318-26. [PMID: 24901465 DOI: 10.1089/apc.2013.0225] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Adults caring for children in HIV-endemic communities are at risk for poor psychological outcomes. However, we still have a limited understanding of how various HIV impacts--including caregiver's own HIV illness, responsibilities of caring for a child orphaned by AIDS, or both--affect psychological outcomes among caregivers. Furthermore, few studies have explored the relationship between stigma, HIV, and psychological outcomes among caregivers of children in HIV-endemic communities. A cross-sectional survey conducted from 2009 to 2010 assessed anxiety among 2477 caregivers of children in HIV-endemic South Africa. Chi-square tested differences in anxiety among caregivers living with HIV, caregivers of a child orphaned by AIDS, and caregivers affected with both conditions. Multivariate logistic regressions identified whether the relationship between HIV impacts and anxiety remained after controlling for socio-demographic co-factors. Mediation analysis tested the relationship between stigma, HIV, and anxiety. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were two and a half times greater among caregivers living with HIV compared to nonaffected caregivers. The odds of meeting threshold criteria for clinically relevant anxiety symptoms were greatest among caregivers living with HIV and caring for a child orphaned by AIDS. Exposure to AIDS-related stigma partially mediated the relationship between HIV and anxiety. Interventions are needed to address caregiver psychological health, particularly among caregivers affected with both conditions of living with HIV and caring for a child orphaned by AIDS.
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Affiliation(s)
- Caroline Kuo
- Department of Behavioral and Social Sciences and Center for Alcohol and Addiction Studies, Brown University School of Public Health, Providence, Rhode Island
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Lucie Cluver
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
| | - Marisa Casale
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
- Department of Psychology, University of Cape Town, Cape Town, South Africa
| | - Tyler Lane
- Department of Social Policy and Intervention, University of Oxford, Oxford, United Kingdom
- Health Economics and HIV/AIDS Research Division, University of KwaZulu-Natal, South Africa
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Li L, Tuan NA, Liang LJ, Lin C, Farmer SC, Flore M. Mental health and family relations among people who inject drugs and their family members in Vietnam. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2013; 24:545-9. [PMID: 23910167 DOI: 10.1016/j.drugpo.2013.06.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 06/18/2013] [Accepted: 06/19/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND This article explores the association of people who inject drugs and their family members in terms of mental health and family relations. The objective was to understand the family context and its impact on people who inject drugs in a family-oriented culture in Vietnam. METHODS Cross-sectional assessment data were gathered from 83 people who inject drugs and 83 of their family members recruited from four communes in Phú Thọ province, Vietnam. Depressive symptoms and family relations were measured for both people who inject drugs and family members. Internalized shame and drug-using behavior were reported by people who inject drugs, and caregiver burden was reported by family members. RESULTS We found that higher level of drug using behavior of people who inject drugs was significantly associated with higher depressive symptoms and lower family relations reported by themselves as well as their family members. Family relations reported by people who inject drugs and their family members were positively correlated. CONCLUSION The findings highlight the need for interventions that address psychological distress and the related challenges faced by family members of people who inject drugs. The article has policy implication which concludes with an argument for developing strategies that enhance the role of families in supporting behavioral change among people who inject drugs.
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Affiliation(s)
- Li Li
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA.
| | - Nguyen Anh Tuan
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Li-Jung Liang
- Department of Medicine Statistics Core, University of California at Los Angeles, Los Angeles, CA, USA
| | - Chunqing Lin
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA
| | - Shu C Farmer
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California, Los Angeles, CA, USA
| | - Martin Flore
- Department of Medicine Statistics Core, University of California at Los Angeles, Los Angeles, CA, USA
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Greene MC, Zhang J, Li J, Desai M, Kershaw T. Mental health and social support among HIV-positive injection drug users and their caregivers in China. AIDS Behav 2013; 17:1775-84. [PMID: 23283579 DOI: 10.1007/s10461-012-0396-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The burden of HIV/AIDS in China is due to injection drug use. Non-clinical caregivers provide much of the care for HIV patients but are often not included in HIV care or research. The objective of this study is to examine the relationships between the caregiver context and mental health of HIV-positive injection drug users and their caregivers. We interviewed 96 patient-caregiver dyads using quantitative methods. A conceptual model was developed as a framework for multivariate linear regression modeling. The strongest predictor of poor patient mental health was lack of social support, which was largely determined by the caregiver's stigma towards HIV/AIDS and caregiver burden. Patient disability and caregiver burden were the primary predictors of poor caregiver mental health. The interrelated nature of caregiver and patient mental health supports the inclusion of caregiver health into the patient's HIV/AIDS treatment to maximize support provision and health for the patient and caregiver.
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27
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Pandit LV, Vishnuvardhan G. Impact of age and gender on the coping styles and psychiatric morbidity faced by informal primary caregivers of HIV-infected individuals living in India. J Int Assoc Provid AIDS Care 2013; 13:24-8. [PMID: 23612766 DOI: 10.1177/2325957412456742] [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: 11/15/2022] Open
Abstract
BACKGROUND Primary caregivers of HIV-infected patients face enormous burden, which if inappropriately coped, leads to psychiatric morbidity. Little is known of what role caregiver's age and gender play in this. PURPOSE To assess the socio-demographic profile and the influence of age and gender on coping strategies and psychiatric morbidity. PROCEDURE Sixty caregivers were assessed on a semistructured sociodemographic proforma, a coping checklist, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; [SCID-I]). MAIN FINDINGS Majority of the carers were young, equally from both genders, and used the same number of coping strategies which increased with age. "Avoidance" was preferred by males and older carers. Youngsters had maximum psychiatric morbidity, majority of the depressed were females, while 90% of nicotine dependants were males. CONCLUSION Gender, but not age, decided the style of coping and extent of psychiatric morbidity hence gender-specific interventions will improve the quality of life of the carers and their wards.
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The changing impact of the AIDS epidemic on older-age parents in the era of ART: evidence from Thailand. J Cross Cult Gerontol 2012; 27:1-15. [PMID: 22205427 DOI: 10.1007/s10823-011-9159-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Previous research makes clear that before antiretroviral therapy (ART), when HIV led to disabling illness and certain death, many older persons as parents of infected adults experienced adverse emotional, material and social consequences. The present study examines how widespread access to ART is transforming the situation in Thailand. Interviews with parents of adult ART recipients reveal that major improvements in the health of their adult children under treatment is associated with major reductions in parental caregiving and expenses associated with their HIV-infected child although parents continue to provide psychological support. Parents own worry about their child's health also declines. Most adult children on ART are able to continue or resume economic activity and many contribute to support of the parental household. ART appears to reduce negative community reaction. Nevertheless, given uncertainty surrounding how long ART can protect against fatal illnesses, whether the adverse impacts of the AIDS epidemic on parents are being eliminated or only postponed remains an open question.
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Li L, Ji G, Liang LJ, Ding Y, Tian J, Xiao Y. A multilevel intervention for HIV-affected families in China: Together for Empowerment Activities (TEA). Soc Sci Med 2011; 73:1214-21. [PMID: 21852030 PMCID: PMC3185109 DOI: 10.1016/j.socscimed.2011.07.013] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 05/04/2011] [Accepted: 07/07/2011] [Indexed: 11/19/2022]
Abstract
This article analyzes the efficacy of the Together for Empowerment Activities (TEA) intervention in decreasing depressive symptoms and improving social support for persons living with HIV (PLH) and their family members. A total of 79 families, consisting of 88 PLH and 79 family members, were recruited from Anhui province, China, and randomized to the TEA intervention (n = 38) or a control condition (n = 41). The intervention was delivered at three levels: 1) TEA Gathering (small group for PLH and family members); 2) TEA Time (home-based family activities with children that accompany each TEA Gathering); and 3) TEA Garden (community events that build social integration). Face-to-face interviews were administered at baseline, 3, and 6 months. Mixed-effects regression models and kernel density estimation were used for data analysis. PLH and their family members in the intervention reported significant improvements in depressive symptoms, social support, and family functioning at the 3-month and 6-month follow-up assessments compared to those in the control condition. Heterogeneous intervention effects on social support and family functioning were indicated at the 6-month follow-up. The intervention could have various effect patterns for different subgroups within the intervention condition. This study provides preliminary data to support the feasibility and efficacy of a multilevel intervention.
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Affiliation(s)
- Li Li
- Semel Institute for Neuroscience and Human Behavior, Center for Community Health, University of California at Los Angeles, 10920 Wilshire Blvd., Suite 350, Los Angeles, CA 90024, USA.
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Intergenerational relationships within families of HIV-infected adults under antiretroviral treatment in Northern Thailand. AGEING & SOCIETY 2011. [DOI: 10.1017/s0144686x11000389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTThailand has been severely affected by AIDS/HIV. The epidemic has undermined the health of the population of working age, placing stress on intergenerational relations and threatening the social fabric. Older people in families affected by the disease, although not the main victims, have experienced major changes in relationships with their adult children and grandchildren. However, the availability of antiretrovirals has transformed HIV infection from a lethal to a chronic disease. Intergenerational relationships are analysed with data from a quantitative survey of HIV-infected adults currently receiving antiretroviral treatment in Northern Thailand. The introduction of antiretroviral treatment has eased the pressure on families. Where HIV-infected adults are more dependent on their older parents, it is because they are single and childless or single parents. While ageing parents remain a source of support for their adult children, the introduction of antiretroviral treatment has radically changed the prospects for HIV-infected adults and their regained health allows them to work, take care of their family and fulfil their filial duties as expected in Thai society. If Thailand's original aim in introducing health policies in this area was to curtail the HIV epidemic, its positive impact on intergenerational relations is an additional benefit.
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Kelley SJ, Whitley DM, Campos PE. Grandmothers raising grandchildren: results of an intervention to improve health outcomes. J Nurs Scholarsh 2010; 42:379-86. [PMID: 21091620 DOI: 10.1111/j.1547-5069.2010.01371.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE To examine the impact of an intervention to improve the health of grandmothers raising grandchildren in parent-absent homes. DESIGN A longitudinal, pretest-posttest design. METHODS The sample was composed of 529 female caregivers with a mean age of 56.7 years (range 38-83) who were predominantly low-income African Americans. Data were collected prior to the intervention and again at 12 months when the intervention was complete. The intervention involved home visitation by registered nurses and social workers, as well as other support services. The Short Form-36 was used to assess physical and mental health, using eight multi-item scales. RESULTS A comparison of pre- and posttest mean scores on the SF-36 indicated significantly (p < .003) improved mean scores for vitality, physical effects on role functioning, emotional effects on role functioning, and mental health. No significant differences were found for other attributes. CONCLUSIONS These preliminary findings suggest that grandmothers raising grandchildren may benefit from a home-based intervention designed to improve health attributes. Implications for nursing practice, policy, and research are presented. CLINICAL RELEVANCE The health of grandmother caregivers is critical to their ability to parent grandchildren successfully. Nurses practicing in a variety of settings are in a unique position to identify and address the health challenges of grandmothers who are raising grandchildren.
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Affiliation(s)
- Susan J Kelley
- College of Health and HumanSciences, Georgia State University, Atlanta, GA 30302, USA.
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