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Zarzycki M, Vilchinsky N, Bei E, Ferraris G, Seddon D, Morrison V. Cross-country variations in the caregiver role: evidence from the ENTWINE-iCohort study. BMC Public Health 2024; 24:898. [PMID: 38532418 DOI: 10.1186/s12889-024-18302-6] [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: 07/20/2023] [Accepted: 03/07/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Globally, economically developed countries face similar ageing demographics and the challenge of a 'care gap', yet they vary due to different care and formal support systems, and different cultural and societal norms around illness and care. The aim of this exploratory study was to examine cross-country variations in caregiver motivations, willingness, values, meaning in life, illness beliefs, and experiences of wellbeing, gain, health-related quality of life, burden and depression, across 6 European countries and Israel. Cross-country differences in the above-mentioned informal caregiver experiences are rarely described. METHODS An online survey (ENTWINE-iCohort) was conducted using validated measures wherever possible. This paper utilises data from 879 caregivers and seven countries (Greece, Italy, the Netherlands, Poland, Sweden, the UK, and Israel). RESULTS No consistent finding supporting the concurrent relationship between caregiver support policies/country culture and caregiver motivations/willingness was found. Caregivers in countries typically characterised by individualist cultures reported lower familism, higher self-enhancement values, and greater perceived illness threat compared to more collectivist countries. Search for meaning was higher in poorer countries than in wealthier countries. Higher negative caregiver experiences (e.g., burden) and lower positive experiences (e.g., wellbeing) were generally observed in countries with underdeveloped caregiver support as compared to countries with more developed formal support systems. CONCLUSIONS Cross-country variations can be explained to varying degrees by national policies around care (or their absence) and country cultural contexts. The results emphasise the importance of formal support services for achieving positive caregiver experiences, and help inform the development of policies and measures to support caregivers in Europe and Israel.
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Affiliation(s)
- Mikołaj Zarzycki
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom.
- School of Psychology and Sports Sciences, Bangor University, Bangor, Wales, United Kingdom.
| | - Noa Vilchinsky
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Eva Bei
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
- Department of Political and Social Sciences, University of Bologna, Bologna, Italy
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Diane Seddon
- School of Medical and Health Sciences, Bangor University, Bangor, Wales, United Kingdom
| | - Val Morrison
- School of Psychology and Sports Sciences, Bangor University, Bangor, Wales, United Kingdom
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Casafont C, González-García MJ, Casadamon-Munarriz I, Piazuelo M, Cobo-Sánchez JL, Bravo M, Frías CE, Zabalegui A. Impact of Hospitalization of People With Dementia or Cognitive Impairment on Family Caregivers. Res Gerontol Nurs 2023; 16:283-290. [PMID: 37616481 DOI: 10.3928/19404921-20230817-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/26/2023]
Abstract
People with dementia (PWD) have a higher risk of hospitalization than people without dementia. Hospitalizations are stressful events for PWD and their caregivers, representing a considerable change to their routines. The current descriptive longitudinal study aimed to identify the positive and negative reactions, experiences related to health and social integrated care, resource use, and work status of family caregivers of PWD or cognitive impairment admitted to the hospital with a proximal femur fracture undergoing surgery. Findings indicated that family caregivers (N = 174) are fully committed to providing assistance in activities of daily living and supervision, showing positive attitudes on self-esteem and negative attitudes toward lack of family support and impact on finances, schedule, and health. Overall caregiver experiences with integrated health and social care improved after hospitalization but decreased after discharge. One month after hospitalization, family caregivers maintained the same work hours but used fewer health care resources. Hospitalization represents a good opportunity to approach family caregivers and determine their needs to provide them with interventions to minimize their burden and improve their well-being. [Research in Gerontological Nursing, 16(6), 283-290.].
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Lauritzen J, Nielsen LM, Kvande ME, Brammer Damsgaard J, Gregersen R. Carers' experience of everyday life impacted by people with dementia who attended a cognitive stimulation therapy (CST) group intervention: a qualitative systematic review. Aging Ment Health 2023; 27:343-349. [PMID: 35232308 DOI: 10.1080/13607863.2022.2046699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
ObjectivesTo explore carers' experiences of everyday life impacted by people with dementia who attended a seven-week cognitive stimulation therapy (CST) group intervention.MethodsA systematic review of qualitative studies and qualitative mixed method studies was conducted. Eight databases were searched. The selected studies were screened and assessed for methodological quality using the Rayyan Qatar Computing Research Institute (QCRI) and Critical Appraisal Skills Programme Qualitative Checklist (CASP-QC). Three studies were included following an inductive content analysis.ResultsTwo themes were identified: 'Enrichment by enhanced communication' and 'Growth through positive emotional interaction'.ConclusionQualitative research on the impact of the CST group intervention on carers' everyday life with a person with dementia is scarce. Carers experienced feelings of enrichment due to improvement and equality in communication and a possible source of happiness. There was a sense of togetherness and reconnection through music and singing together as well as a sense of mutual growth, increased positive interaction, increased ability to socialize, and feelings of fondness when experiencing glimpses of the previous personality of the person with dementia. Nevertheless, knowledge about the impact of the CST group intervention on carers' personal everyday life is lacking and requires further research.
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Affiliation(s)
- Jette Lauritzen
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark.,Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
| | - Louise Møldrup Nielsen
- Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
| | | | | | - Rikke Gregersen
- Research Centre for Health and Welfare Technology, the Dementia Program, VIA University College, Aarhus, Denmark
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Environmental and Caregivers-Related Factors Influencing the Psychosocial Well-Being of Older Adults with Dementia: A Systematic Review. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09512-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Im EO, Kim HJ, Kim SY, Yau YC, Brewster GS, Chee W. Attitudes toward Alzheimer's disease and dementia caregiving and health outcomes: Racial and ethnic differences. Geriatr Nurs 2022; 48:296-302. [PMID: 36335856 PMCID: PMC9899498 DOI: 10.1016/j.gerinurse.2022.10.018] [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: 09/10/2022] [Revised: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
This study aimed to explore racial/ethnic differences in the attitudes toward Alzheimer's Disease (AD) and dementia caregiving among midlife women who were family caregivers of persons living with AD (MWPLAD) in the U.S. and examine the associations of the attitudes to their health outcomes. This was a cross-sectional online survey study among 172 MWPLAD. The instruments included: the Attitude toward AD and Related Dementias Scale, the Questions on Attitudes toward AD Caregiving, the Social Readjustment Rating Scale, the EQ-5D-5L and the Midlife Women's Symptom Index. Multiple linear regression analyses were conducted. There were significant racial/ethnic differences in caregivers' attitudes toward dementia caregiving, health-related quality of life, and total severity scores of symptoms (p < .01). Controlling for covariates including race/ethnicity, caregivers' positive attitudes toward dementia caregiving were significantly associated with their health outcomes (p ≤ .05). Interventions for MWPLAD need to consider racial/ethnical differences in their attitudes toward dementia caregiving.
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Affiliation(s)
- Eun-Ok Im
- Nell Hodgson Woodruff School of Nursing, Emory University.
| | - Hee Jung Kim
- Nell Hodgson Woodruff School of Nursing, Emory University; College of Nursing, Yonsei University
| | - Seo-Yun Kim
- Nell Hodgson Woodruff School of Nursing, Emory University
| | - Yun Chan Yau
- Nell Hodgson Woodruff School of Nursing, Emory University
| | | | - Wonshik Chee
- Nell Hodgson Woodruff School of Nursing, Emory University
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Anderson S, Parmar J, L’Heureux T, Dobbs B, Charles L, Tian PGJ. Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:8636. [PMID: 35886490 PMCID: PMC9317413 DOI: 10.3390/ijerph19148636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022]
Abstract
Family caregiving is a public health issue because of caregivers' significant contribution to the health and social care systems, as well as the substantial impact that giving and receiving care has on the health and quality of life of care receivers and caregivers. While there have been many studies that associate caregivers' care work, financial difficulty, navigation, and other caregiving factors with family caregivers' psychological distress, we were interested not only in the factors related to family caregiver anxiety but also in hypothesizing how those effects occur. In this study, we used Andrew Hayes' PROCESS moderation analysis to explore the link between caregiver frailty, weekly care hours, and perceptions of financial difficulty, social support, and anxiety. In this analysis, we included 474 caregivers with relatively complete data on all of the variables. In regression analysis after controlling for gender and age, social loneliness (β = 0.245), frailty (β = 0.199), financial difficulty (β = 0.196), care time (β = 0.143), and navigation confidence (β = 0.131) were all significant. We then used PROCESS Model 6 to determine the significance of the direct, indirect, and total effects through the serial mediation model. The model pathway from frailty to care time to financial difficulty to social loneliness to anxiety was significant. The proportions of family caregivers who were moderately frail, anxious, and experiencing social loneliness after eighteen months of the COVID-19 pandemic found in this survey should be of concern to policymakers and healthcare providers.
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Affiliation(s)
- Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
| | - Tanya L’Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
| | - Bonnie Dobbs
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Peter George J. Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
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Caregiver-oncologist prognostic concordance, caregiving esteem, and caregiver outcomes. J Geriatr Oncol 2022; 13:828-833. [DOI: 10.1016/j.jgo.2022.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 02/17/2022] [Accepted: 02/26/2022] [Indexed: 11/19/2022]
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Neubert L, Gottschalk S, König HH, Brettschneider C. Dementia care-giving from a family network perspective in Germany: A typology. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:579-591. [PMID: 32939908 DOI: 10.1111/hsc.13161] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 07/06/2020] [Accepted: 08/12/2020] [Indexed: 06/11/2023]
Abstract
Sustaining informal care-giving for people living with dementia (PWD) is a common objective of societies worldwide. Families can contribute substantially to the support of care-giving relatives. However, a deeper understanding of the impact of informal care-giving for PWD on family life is needed. Interviewing of multiple family network members-in addition to the primary carer-provides more insight into familial contexts of care-giving. This pilot study aims to explore how informal carers reconcile dementia care-giving and family life from a family network perspective. Therefore, we conducted 14 narrative interviews with family carers from seven care-giving networks in Germany, which we interpreted using the documentary method. The yielded relational typology describes five types of family carers of PWD. These types reflect the way the families deal with dementia care-giving based on the interrelation between relationship quality and the distribution of care-giving tasks within the family. Depending on the constellation of this interrelationship, family carers either experience care as a joint project, as co-operation with external support or within the family, as disappointment or as a predicament without alternatives. Finally, if the care-giving tasks are not shared, or if the distribution is perceived as unequal, relationship break downs can occur, especially in family ties that are already strained. However, joint care-giving and strong ties can also bring the family closer together and enhance care experiences. Care professionals and social workers should be aware of the family network of dementia carers and support the development of a sense of family unity. This can contribute to positive care experiences among family carers and thus increase the maintenance of informal dementia care.
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Affiliation(s)
- Lydia Neubert
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sophie Gottschalk
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christian Brettschneider
- Department of Health Economics and Health Services Research, Hamburg Center for Health Economics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lauritzen J, Sørensen EE, Pedersen PU, Bjerrum MB. Needs of carers participating in support groups and caring for a person with dementia: A focused ethnographic study. DEMENTIA 2022; 21:1219-1232. [DOI: 10.1177/14713012211072928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aims The aim is to explore and understand how support group participation meets carers’ perceived needs for information and social and emotional support when caring for a person with dementia who lives at home. Design Focused ethnographic design. Methods Participant observations and semi-structured interviews with 25 carers were conducted. An inductive content analysis of the data was performed. Findings Two themes were identified: “Strengthening the sense of self” and “Managing uncertain benefits.” Conclusion Carers’ level of information about dementia was partly met, thereby strengthening their sense of self and joy. Maintaining shared decision-making in financial matters was viewed as an expression of respect and reciprocity. Getting acquainted with peers and dementia coordinators was viewed as emotional and social support but was also used strategically to gain easier access to health care services. By fulfilling their needs, support group meetings became meaningful, which motivated carers to continue providing care.
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Affiliation(s)
- Jette Lauritzen
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark; and Department of Nursing, Aarhus, Faculty of Health Sciences, VIA University College, Aarhus, Denmark
| | - Erik E Sørensen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark; and Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Preben U Pedersen
- Danish Center of Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Merete B Bjerrum
- Department of Public Health, Health, Aarhus University, Aarhus, Denmark
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Al Ghassani A, Rababa M. Factors Associated with Home Care Outcomes among Community-Dwelling Older Adult Patients with Dementia. Dement Geriatr Cogn Dis Extra 2021; 11:99-109. [PMID: 34178013 PMCID: PMC8215980 DOI: 10.1159/000516086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/19/2022] Open
Abstract
Background With the increase in the proportion of people with dementia (PWD), it is necessary to address dementia-related issues among older adults who live at home; however, there is no integrative review on this issue. Objectives To describe and analyze quantitative and qualitative studies from primary sources in order to identify the factors which impact home care outcomes among PWD. Methods A computer search of PsycINFO, MEDLINE (PubMed), and the Cumulative Index of Nursing and Allied Health Literature (CINAHL) was performed. This study was guided by Whittemore and Knafl's integrative review method. Results This review of the literature identified 3 main factors related to home care outcomes among PWD. These factors are environmental factors, caregiver-related factors, and social network factors. Conclusions Further research is required to investigate the impacts of multiple social and environmental factors on home care outcomes among PWD; which can eventually be used by nurses and family caregivers when providing care for older adult PWD.
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Affiliation(s)
- Amal Al Ghassani
- Department of Community and Mental Health, Oman College of Health Sciences, Muscat, Oman
| | - Mohammad Rababa
- Department of Adult Health Nursing, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
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Lucijanić J, Baždarić K, Librenjak D, Lucijanić M, Hanževački M, Jureša V. A validation of the Croatian version of Zarit Burden Interview and clinical predictors of caregiver burden in informal caregivers of patients with dementia: a cross-sectional study. Croat Med J 2021. [PMID: 33410300 PMCID: PMC7821365 DOI: 10.3325/cmj.2020.61.527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
AIM To validate the Croatian version of the Zarit Burden Interview (ZBI) and to investigate the predictors of perceived burden. METHODS This cross-sectional study involved 131 dyads of one informal caregiver family member and one patient with dementia visiting primary care practices (Health Care Center Zagreb-West; 10/2017-9/2018). Patient-related data were collected with the Mini-Mental-State-Examination, Barthel-index, and Neuropsychiatric-Inventory-Questionnaire (NPI-Q); caregiver-related data with the ZBI, and general information on caregivers and patients with a structured questionnaire. Principal-axis-factoring with varimax-rotation was used for factor analysis. RESULTS The caregivers' mean age was 62.1±13 years. They were mostly women (67.9%) and patients' children (51.1%). Four dimensions of ZBI corresponding to personal strain, frustration, embarrassment, and guilt were assessed and explained 56% variance of burden. Internal consistency of ZBI (α=0.87) and its dimensions (α1=0.88, α2=0.83, α3=0.72, α4=0.75) was good. Stronger cognitive and functional impairment of patients was associated only with personal strain, whereas more pronounced neuropsychiatric symptoms and the need for daily care were associated with more dimensions. Longer caregiver education suppressed embarrassment and promoted guilt. Guilt was higher in younger caregivers, caregivers of female patients, patients' children, and non-retired caregivers. In multivariate analysis significant predictors of higher overall burden were male sex of the patient, higher NPI-Q, the need for daily-care services, shorter duration of caregiving, non-spouse relationship, higher number of hours caring per-week, and anxious-depressive symptoms in a caregiver. CONCLUSION The Croatian version of ZBI is reliable and valid. Our data confirm that ZBI is a multidimensional construct. Caregivers may benefit from individually tailored interventions.
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Affiliation(s)
- Jelena Lucijanić
- Jelena Lucijanić, Health Care Center Zagreb-West, Prilaz baruna Filipovića 11, 10000, Zagreb, Croatia,
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Nguyen KH, Comans T. Making the Invisible Companion of People with Dementia Visible in Economic Studies: What Can We Learn from Social Science? Healthcare (Basel) 2021; 9:healthcare9010044. [PMID: 33466492 PMCID: PMC7824847 DOI: 10.3390/healthcare9010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022] Open
Abstract
The dyadic perspective is important to understand the mutual influence and interdependence of both the person living with dementia and their care partner. This perspective is routinely adopted in social research programs for dementia and many dyadic interventions have been developed. However, economic evaluation and modelling to date has often failed to incorporate caregivers’ perspectives, and their respective costs and outcomes while giving care for the person with dementia. On the occasions that this has been done, caregivers were represented as “informal costs” associated with dementia. This limited perspective cannot incorporate two-way interactions of the dyad in economic evaluations of dementia programs. This paper provides an overview of the possible interactions between people living with dementia and care partners as discovered in social science literature in the past 20 years. We demonstrate the strength of the relationships and discuss strategies for incorporating the dyadic perspective in economic evaluations of dementia programs in the future.
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Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy. BMC Health Serv Res 2020; 20:1114. [PMID: 33267856 PMCID: PMC7709414 DOI: 10.1186/s12913-020-05964-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.
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Bressan V, Visintini C, Palese A. What do family caregivers of people with dementia need? A mixed-method systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:1942-1960. [PMID: 32542963 DOI: 10.1111/hsc.13048] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 05/10/2020] [Accepted: 05/13/2020] [Indexed: 06/11/2023]
Abstract
Caring for people with dementia is a major challenge for relatives and society worldwide. Understanding the family caregivers' needs is crucial to promote their care-giving role during the disease trajectory. The aim of this mixed-method systematic review was to identify and synthetise the existing literature on the needs of family caregivers of people with dementia at home. PubMed, CINAHL, Cochrane Database of Systematic Reviews and PsycINFO databases were systematically explored to find quantitative, qualitative and mixed-method studies published between 2009 and 2019. A total of 1,196 citations were retrieved and 34 studies were included in the review. The variety of interrelated needs emerged from studies has been summarised in four themes: (a) Being supported, (b) Receiving accessible and personalised information, (c) Being trained and educated to care for their beloved with dementia and (d) Finding a balance. Care-giving for individuals with dementia is an ever-changing process characterised by continuous adjustments to their needs. The majority of a family caregivers' needs are oriented towards receiving support, help in offering daily care and finding a balance between the care-giving role and their own personal needs. For family caregivers, receiving information is a priority to improve their knowledge and to develop coping abilities, care skills and strategies aimed at promoting a balance between care assistance duties and their own needs. They also need social, psychological and emotional support and access to flexible, tailored and timely formal care. Further studies are recommended to detect changes in family caregivers' needs throughout the disease progression in order to tailor formal care offered by social and healthcare services.
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Frias CE, Risco E, Zabalegui A. Psychoeducational intervention on burden and emotional well-being addressed to informal caregivers of people with dementia. Psychogeriatrics 2020; 20:900-909. [PMID: 33015927 DOI: 10.1111/psyg.12616] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 08/24/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND In dementia it is necessary that a family member become an informal caregiver. This labour has social, physical and emotional repercussions on the caregiver's health. The objective was to assesses the impact of the INFOSA-DEM intervention on burden and emotional well-being among caregivers of people with dementia, evaluating the effects at 3 and 6 months. METHOD We adopted an experimental, non-randomised design with an intervention group and a control group. The intervention group received the intervention and the control group received usual care. The study was carried out in the catchment areas of three centres specialising in the care of people with cognitive impairment in the province of Barcelona. RESULTS At 3 months, there was an improvement with respect to burden in the intervention group with a significant worsening (P < 0.012) in the control group. Similarly, a positive effect on emotional well-being was observed in the intervention group compared with a small negative effect among controls. CONCLUSIONS Programs addressed to informal caregivers based on psychoeducational and cognitive-behavioural therapies are effective in improving quality of life and emotional well-being, and in reducing burden, with a positive effect on the quality of care provided at home.
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Affiliation(s)
- Cindy E Frias
- Department of Nursing, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ester Risco
- Hospital Pere I Virgili of Barcelona, Barcelona, Spain
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Frias CE, Cabrera E, Zabalegui A. Informal Caregivers' Roles in Dementia: The Impact on Their Quality of Life. Life (Basel) 2020; 10:life10110251. [PMID: 33113995 PMCID: PMC7690694 DOI: 10.3390/life10110251] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 10/20/2020] [Accepted: 10/21/2020] [Indexed: 12/18/2022] Open
Abstract
The constantly changing process of caring for a person with dementia affects the informal caregivers’ role due to its psychosocial impact. This cross-sectional study aimed to analyze the impact of the Person with Dementia informal caregiver’s role caregiver to a person with dementia on the self-perceived quality of life (QoL) of the caregiver. In total, 160 informal caregivers were recruited between January and December 2019. Informal caregivers’ quality of life was assessed using the European Quality of Life 5-Dimension scale, burden with the Zarit Burden Scale, emotional wellbeing using the General Health Questionnaire, and caregiver reactions using Caregiver Reaction Aspects. Patients’ cognitive impairment was assessed with the Mini-Mental State Examination, their quality of life using Quality of Life in Alzheimer’s Disease, and neuropsychiatric symptoms using the Neuropsychiatric Inventory. Outcomes were studied using the Pearson correlation coefficient and ANOVA test. Most informal caregivers’ outcomes were significantly associated with their quality of life. Male informal caregivers have a slightly better quality of life than female caregivers (p < 0.001). Caregiver burden (p < 0.001), psychological wellbeing (p < 0.001) and negative aspects of caregiving on health (p < 0.001) correlated moderately with informal caregivers’ quality of life. Factors associated with dementia, including the course of the illness and its severity with the presence of neuropsychiatric symptoms can negatively affect the informal caregiver’s role and produce a low self-perception of quality of life; thus, social and professional support for informal caregivers is essential.
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Affiliation(s)
- Cindy E. Frias
- Mental Health Nurse, Hospital Clinic, 08036 Barcelona, Spain;
- School of Health Sciences, University of Barcelona, 08036 Barcelona, Spain
| | - Esther Cabrera
- School of Health Sciences, TecnoCampus Universitat, Pompeu Fabra, 08301 Mataró, Spain;
- Department of Care Management and Social Work, Sechenov University, Moscow 101000, Russia
| | - Adelaida Zabalegui
- School of Health Sciences, University of Barcelona, 08036 Barcelona, Spain
- Department of Nursing, Hospital Clínic de Barcelona, 08001 Barcelona, Spain
- Correspondence:
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Kes D, Aydin Yildirim T. The relationship of religious coping strategies and family harmony with caregiver burden for family members of patients with stroke. Brain Inj 2020; 34:1461-1466. [PMID: 32811207 DOI: 10.1080/02699052.2020.1810317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
AIM Patients with stroke experience various challenges such as motor and cognitive and sensory problems, which can increase the caregiver burden of family members in long-term care. Understanding the factors related to caregiver burden is important to develop strategies to support informal caregivers. Therefore, this study aimed to examine the relationship of religious coping strategies and family harmony to caregiver burden for family members of patients with stroke. METHOD The sample of this descriptive, cross-sectional study consisted of 181 family caregivers who completed the Religious Coping Scale, Burden Interview Scale, and Family Harmony Scale - Short Form. Multiple linear regression and Pearson's correlation were performed. RESULTS Pearson's correlation analysis indicated a significant positive relationship between caregiver burden and negative religious coping. A significant negative relationship was found of caregiver burden and family harmony with positive religious coping. Multiple regression analysis indicated that family harmony, amount of time spent on caregiving, and negative and positive religious coping were predictors of caregiver burden. Given the significant relationship of caregiver burden and family harmony to positive religious coping, future research should integrate religious coping strategies into multidisciplinary caregiver intervention programs to reduce caregiver burden.
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Affiliation(s)
- Duygu Kes
- Nursing Department, Faculty of Health Sciences, Karabuk University , Karabuk, Turkey
| | - Tugba Aydin Yildirim
- Nursing Department, Faculty of Health Sciences, Karabuk University , Karabuk, Turkey
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Krevers B, Ekdahl A, Jaarsma T, Eckerblad J, Milberg A. Factors associated with health-related quality of life and burden on relatives of older people with multi-morbidity: a dyadic data study. BMC Geriatr 2020; 20:224. [PMID: 32586359 PMCID: PMC7318431 DOI: 10.1186/s12877-020-01604-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 06/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to identify factors associated with health-related quality of life (HRQoL) and the burden on the relatives of older people with multi-morbidity. METHODS A secondary analysis of baseline data from 296 dyads, including older patients with multimorbidity and their relatives, which were previously collected in a randomized study. The analysis was conducted to select correlated independent variables to enter a final linear regression analysis of two models with different endpoints: the relatives' HRQoL (EQ5D index) and burden (COPE index: Negative impact scale). RESULTS Sixteen variables correlated with the relatives' HRQoL, and 15 with the relatives' burden. Both the HRQoL and burden correlated with both patient and relative variables. A high HRQoL was associated with relatives' working/studying. A high burden was associated with caring for an older person with changed behaviour. A low burden was associated with the relatives' high scores on positive values of caring, quality of support and HRQoL. CONCLUSION Older persons and their relatives should be considered as a unit in the development of support of older people in order to increase the health and quality of life of both groups. To support and protect relatives from a high burden, potential measures could include improving the relative's HRQoL and strengthening their ability to find positive values in care and strengthening reliable and good support from others. The relatives' HRQoL explained the variation in the burden. However, the burden did not explain the variation in the HRQoL, which suggests that the relatives' HRQoL is not so readily affected by their burden, whereas the relatives' HRQoL can influence their burden. The variables used in the regression analyses where chosen to reflect important aspects of the relatives' and older persons' situations. The final models explained 38% of the variation in the relatives' burden but only 10% of the variation in their HRQoL. This could be important to consider when choosing outcome assessments in future studies.
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Affiliation(s)
- Barbro Krevers
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
| | - Anne Ekdahl
- Department of Clinical Sciences Lund/Clinical Sciences Helsingborg, Lund University, Lund, Sweden
| | - Tiny Jaarsma
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Jeanette Eckerblad
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Anna Milberg
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Quinn C, Toms G. Influence of Positive Aspects of Dementia Caregiving on Caregivers' Well-Being: A Systematic Review. THE GERONTOLOGIST 2020; 59:e584-e596. [PMID: 30597058 DOI: 10.1093/geront/gny168] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES There is a growing evidence base that informal caregivers can identify positive aspects of providing care and that this may have a beneficial influence on their well-being. The aim of this systematic review was to explore how positive aspects of caregiving (PAC) affects the well-being of caregivers of people with dementia. RESEARCH DESIGN AND METHODS We searched electronic databases for quantitative studies exploring the association between PAC and caregiver well-being. Studies were included if they involved informal (unpaid) caregivers of people with dementia, at least 75% of whom had to be residing in the community. A narrative synthesis was used to explore patterns within the data. RESULTS Fifty-three studies were included in the narrative synthesis. Most studies utilized a cross-sectional design. The majority of samples consisted primarily of spouses and female caregivers. Twenty different PAC measures were employed and studies referred to a variety of constructs, such as satisfactions, gains, meaning, and rewards. PAC was associated with lower depressive symptoms and burden. Conversely, PAC was associated with better mental health, quality of life, satisfaction with life, and competence/self-efficacy. PAC was not associated with self-rated health or personal strain/stress. DISCUSSION AND IMPLICATIONS The findings suggest that identifying PAC is associated with better caregiver well-being, although further longitudinal studies are required to explore how this relationship changes over time. Interventions that enable caregivers to gain a more positive experience of caregiving could be beneficial for their well-being.
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Affiliation(s)
- Catherine Quinn
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School and College of Life and Environmental Sciences, UK.,Centre of Applied Dementia Studies, University of Bradford, Faculty of Health Studies, West Yorkshire, UK
| | - Gill Toms
- Wales School for Social Care Research: School of Health Sciences, Bangor University, Gwynedd, UK
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Gerłowska J, Furtak-Niczyporuk M, Rejdak K. Robotic assistance for people with dementia: a viable option for the future? Expert Rev Med Devices 2020; 17:507-518. [PMID: 32511027 DOI: 10.1080/17434440.2020.1770592] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Demographic changes in society and fewer personnel working in healthcare services have resulted in an increase in the speed of development of safe, reliable robotic assistance technologies for patients with neurological diseases. This paper aims to advocate for the frailty of patients in light of the economic need for robotic assistance, discuss potential hazards, and outline related factors that influence positive outcomes. AREAS COVERED This article reviews the state of the art and perspectives regarding the use of robotics in older adults with dementia. We focus on current trends in the development of robotic technologies for these patients and discuss the potential hazards associated with the implementation of such cutting-edge technology in daily practice. EXPERT OPINION We envisage a gradual increase in the usage of robot-based devices for the management and support of patients with cognitive deficits. In particular, the introduction of artificial intelligence will enhance the functionality of these technologies, but also increase potential hazards resulting from human-robot interactions. The development of such technology must consider whether neurological syndromes are static or progressive. Progressive syndromes pose the biggest challenge since the functionality of robotic devices must adapt to patients changing cognitive and motor performance profiles.
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Affiliation(s)
| | | | - Konrad Rejdak
- Department of Neurology, Medical University of Lublin , Lublin, Poland
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Zauszniewski JA, Burant CJ. Resourcefulness as a Mediator of the Effects of Dementia Symptoms and Caregiver Reactions on Caregiver Mental Health. Issues Ment Health Nurs 2020; 41:486-493. [PMID: 32255406 PMCID: PMC7314645 DOI: 10.1080/01612840.2019.1693670] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In this secondary analysis of 138 community-dwelling women caregivers of persons with dementia, we examined whether caregiver resourcefulness mediated the effects of both the frequency of and reactions to their care recipients' memory-related, depressive, and disruptive symptoms of dementia on caregiver depressive symptoms. Caregiver resourcefulness mediated the effects of care recipient depressive symptoms on caregiver depressive symptoms, and the effects of caregiver actions to depressive and disruptive symptoms on caregiver depressive symptoms. The findings suggest the potential benefit of teaching resourcefulness skills to reduce depressive symptoms of caregivers whose care recipients frequently exhibited depressive or disruptive symptoms associated with dementia.
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Affiliation(s)
- Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Christopher J Burant
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Parrotta I, De Mauleon A, Abdeljalil AB, De Souto Barreto P, Lethin C, Veerbek H, Stephan A, Saks K, Zabalegui A, Soto Martin ME. Depression in People With Dementia and Caregiver Outcomes: Results From the European Right Time Place Care Study. J Am Med Dir Assoc 2020; 21:872-878.e1. [PMID: 32307275 DOI: 10.1016/j.jamda.2020.02.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/24/2020] [Accepted: 02/28/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate the cross-sectional associations between depression in people with dementia and both caregiver burden and quality of life in 8 European countries, and to test these associations compared with the presence of other neuropsychiatric symptoms. DESIGN Cross-sectional study. SETTING AND PARTICIPANTS In total, 1223 dyads comprised of informal caregivers and people with dementia living in a community-dwelling setting, recruited from the Right Time Place Care study, a cohort survey from 8 European countries. MEASURES To test the associations between depression (according to the Cornell Scale for Depression in Dementia) and informal caregiver burden (defined by the Zarit scale and hours of supervision in terms of Resource Utilization in Dementia), distress (defined by the Neuropsychiatric Inventory Questionnaire distress score), and quality of life (according to the visual analogue scale and 12-item General Health Questionnaire). RESULTS Linear regressions showed an association between depression and main outcomes (Zarit scale: β 3.7; P = .001; hours of supervision: β 1.7; P = .004; Neuropsychiatric Inventory Questionnaire distress score: β 1.2; P = .002). A similar association was found concerning psychological and overall well-being (12-item General Health Questionnaire: β 1.8; P < .001; Euroqol Visual Analogue Scale: β -4.1; P = .003). Both associations remained significant despite the presence of other NPS and after adjusting for confounders. CONCLUSIONS AND IMPLICATIONS Further studies are needed to assess whether providing tailored strategies for optimizing diagnosis and managing of depression in people with dementia might improve caregiver quality of life and reduce their burden in the community-dwelling setting.
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Affiliation(s)
- Ilaria Parrotta
- Department of Geriatric and Internal Medicine, La Sapienza University of Rome, Rome, Italy; Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
| | | | | | | | - Connie Lethin
- Faculty of Medicine, Department of Health Science, Lund University, Lund, Sweden
| | - Hilde Veerbek
- Department of Health Service Research, Maastricht University, Maastricht, Netherlands
| | - Astrid Stephan
- Wissenschaftliche Mitarbeiterin Martin-Luther-Universität Halle-Wittenberg Medizinische Fakultät Institut für Gesundheits- und Pflegewissenschaft, Wittenberg, Germany
| | - Kay Saks
- University of Tartu, Tartu, Estonia
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Action Research as a Method to Find Solutions for the Burden of Caregiving at Hospital Discharge. SYSTEMIC PRACTICE AND ACTION RESEARCH 2020. [DOI: 10.1007/s11213-019-09486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Söderberg M, Ståhl A, Melin Emilsson U. Dignity as a guiding principle for family care partners in the care of an old relative with dementia. Scand J Caring Sci 2020; 34:87-95. [DOI: 10.1111/scs.12708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 04/10/2019] [Indexed: 11/28/2022]
Affiliation(s)
| | - Agneta Ståhl
- Faculty of Engineering Department of Technology and Society Lund University Lund Sweden
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25
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Frias CE, Garcia-Pascual M, Montoro M, Ribas N, Risco E, Zabalegui A. Effectiveness of a psychoeducational intervention for caregivers of People With Dementia with regard to burden, anxiety and depression: A systematic review. J Adv Nurs 2020; 76:787-802. [PMID: 31808211 DOI: 10.1111/jan.14286] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 11/07/2019] [Accepted: 11/27/2019] [Indexed: 11/28/2022]
Abstract
AIM To assess the effectiveness of psychoeducational interventions with respect to burden, anxiety and depression in family caregivers of People With Dementia living at home. BACKGROUND In dementia, the family assumes the role of main caregiver, maintaining the patient in a good state of health. Nevertheless, burden, anxiety and depression may have negative repercussions in caregivers. Therefore, professional supports through psychoeducational programmes are recommended as interventions for improving caregivers' health. DESIGN A quantitative systematic review. DATA SOURCES Electronic searches were performed in CINAHL/AMED/CENTRAL/Web of Science/LILACS/PUBMED from January 2005-August 2018. REVIEW METHODS The review was conducted using the JADAD scale to assess bias risk and the quality of the randomized controlled trials (RCTs) and the CONSORT instrument to assess study quality report. The extracted data were reviewed by independent reviewer pairs. The review was reported using PRISMA. RESULTS A total of 18 RCTs met inclusion criteria. Seven were classified as Technology-based Interventions and 11 as Group-based Interventions. CONCLUSION Psychoeducational interventions for caregivers allow them to increase their knowledge of the illness, develop problem-solving skills and facilitate social support. Technology-based Interventions significantly affect burden while Group-based Interventions affect anxiety, depression, insomnia and burden and quality of life and self-efficacy. IMPACT Research findings can be used to classify caregivers in future interventions according to illness stage to obtain more precise results.
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Affiliation(s)
| | | | | | - Nuria Ribas
- Hospital Clinic of Barcelona, Barcelona, Spain
| | - Ester Risco
- Hospital Clinic of Barcelona, Barcelona, Spain
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26
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The Relationship Between Caregiver Reactions and Psychological Distress in Family Caregivers of Patients With Heart Failure. J Cardiovasc Nurs 2020; 35:234-242. [PMID: 31904686 DOI: 10.1097/jcn.0000000000000636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Providing care often causes negative reactions and psychological distress in family caregivers of patients with heart failure. How these 2 constructs are related has not been fully explored. OBJECTIVE The aims of this study were to describe caregiver reactions to caregiving and psychological distress and to determine the associations between caregiver reactions to caregiving and psychological distress in family caregivers of patients with heart failure. METHODS In this secondary analysis of a cross-sectional study, the sample included 231 patients and their family caregivers. The Chinese version of the Hospital Anxiety and Depression Scale was used to assess psychological distress (ie, symptoms of anxiety and depression), and the Caregiver Reaction Assessment was used to measure both negative and positive caregiver reactions to caregiving, including financial problems, impact on schedule, health problems, lack of family support, and self-esteem. RESULTS Of the participants, 15.2% and 25.5% of caregivers reported symptoms of depression and anxiety, respectively. Impact on schedule was the most common caregiver reaction, followed by financial problems. Impact on schedule was related to both the caregivers' symptoms of depression (odds ratio [OR], 1.705; P = .001) and anxiety (OR, 1.306; P = .035), whereas financial problems were only related to symptoms of anxiety (OR, 1.273; P = .011). CONCLUSIONS The findings suggest that interventions for reducing the negative impact on schedule of caregiving and helping to solve the caregivers' financial concerns might help to relieve their symptoms of depression and anxiety.
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Hansen BR, Hodgson NA, Budhathoki C, Gitlin LN. Caregiver Reactions to Aggressive Behaviors in Persons With Dementia in a Diverse, Community-Dwelling Sample. J Appl Gerontol 2020; 39:50-61. [PMID: 29457520 PMCID: PMC5824433 DOI: 10.1177/0733464818756999] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Purpose: To describe caregiver challenges with and confidence managing three aggressive behavior types in persons with dementia: verbal aggression, destroying property, and threatening to hurt others. Design and Method: Secondary analysis of baseline data from the 2001-2004 Resources for Enhancing Alzheimer's Caregiver Health II (REACH II) initiative. Results: One or more aggressive behaviors within 1 week were reported by more than a third of caregivers, with most expressing upset but fewer expressing confidence managing the behaviors. Caregiver distress and confidence differed by race/ethnicity in response to verbal aggression, with more White/Caucasian caregivers expressing upset than Hispanic/Latinos or Black/African Americans. Fewer Hispanic/Latinos expressed confidence managing verbal aggression, compared with White/Caucasians or Black/African Americans. Discussion: Aggressive behaviors challenge caregivers, with reactions varying by behavior type and race/ethnicity. Cultural and contextual factors suggest the need to tailor interventions, especially skill-building interventions that increase confidence managing aggressive behaviors while decreasing upset.
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Affiliation(s)
- Bryan R. Hansen
- Assistant Professor, Johns Hopkins School of Nursing, 525 North Wolfe Street, Baltimore, Maryland 21205, Office: 410-614-4820
| | - Nancy A. Hodgson
- Associate Professor, University of Pennsylvania School of Nursing
| | | | - Laura N. Gitlin
- Distinguished Professor, Director, Center for Innovative Care in Aging, Johns Hopkins School of Nursing
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Evelyn Malone H, Coyne I. Decision-tables for choosing commonly applied inferential statistical tests in comparative and correlation studies. Nurse Res 2019; 27:29-35. [PMID: 31621211 DOI: 10.7748/nr.2019.e1636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Nurse researchers are increasingly using a wide variety of inferential statistical tests. However, novice researchers might find choosing tests for their studies difficult, as a result of this variety. AIM To present structured decision-tables to help choose which statistical tests to use in comparative and correlation studies. DISCUSSION The wide spectrum of statistical techniques the authors identified in nursing research helped them to construct overview tables that researchers could use as a simple tool to help choose appropriate statistical tests for their studies. CONCLUSION The decision-tables provided in this paper are unique in that they are composed of commonly applied statistical techniques identified in nursing studies and structured to simplify the pathway to statistical test decision-making for a broad spectrum of study designs. IMPLICATIONS FOR PRACTICE Novice nurse researchers can use the decision-tables presented in this paper as a starting point to explore with research colleagues or supervisors the appropriate choice of statistical techniques.
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Affiliation(s)
- Helen Evelyn Malone
- University of Dublin Trinity College, School of Nursing and Midwifery, Dublin, Republic of Ireland
| | - Imelda Coyne
- University of Dublin Trinity College, Dublin, Republic of Ireland
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Costs and Burden Associated With Loss of Labor Productivity in Informal Caregivers of People With Dementia: Results From Spain. J Occup Environ Med 2019; 60:449-456. [PMID: 29135840 DOI: 10.1097/jom.0000000000001229] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS We analyzed indirect costs related to loss of labor productivity (LLP) in informal caregivers (ICs) of people with dementia (PwD) and the associated caregiver burden and patients' clinical variables. METHODS Multicenter cohort study of PwD and their ICs (n = 287) focused on two groups: (1) home care and (2) institutional long-term care. The costs of LLP were assessed using the Resource Utilization Dementia instrument and a human capital approach. RESULTS The cost for LLP was 378&OV0556;/month or 4.536&OV0556;/year. Greater disease severity increased the likelihood of reducing working hours and missing a working day. There was a significant association between partial absenteeism and burden in employed informal caregiver in both the home and institutional setting. CONCLUSION Cognitive impairment contributes to the cost of LLP in IC especially in home-care. LLP has a negative impact on IC burden.
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Lauritzen J, Bjerrum MB, Pedersen PU, Sørensen EE. Support groups for carers of a person with dementia who lives at home: A focused ethnographic study. J Adv Nurs 2019; 75:2934-2942. [DOI: 10.1111/jan.14151] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 05/17/2019] [Accepted: 07/02/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Jette Lauritzen
- Department of Public Health Health, Aarhus University Aarhus Denmark
- Department of Nursing, Aarhus, Faculty of Health Sciences VIA University College Aarhus Denmark
| | - Merete B. Bjerrum
- Department of Public Health Health, Aarhus University Aarhus Denmark
| | - Preben U. Pedersen
- Danish Center of Clinical Guidelines, Department of Health Science and Technology Aalborg University Aalborg Denmark
| | - Erik E. Sørensen
- Clinical Nursing Research Unit Aalborg University Hospital Aalborg Denmark
- Department of Clinical Medicine Aalborg University Aalborg Denmark
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31
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Quinn C, Nelis SM, Martyr A, Victor C, Morris RG, Clare L. Influence of Positive and Negative Dimensions of Dementia Caregiving on Caregiver Well-Being and Satisfaction With Life: Findings From the IDEAL Study. Am J Geriatr Psychiatry 2019; 27:838-848. [PMID: 30917903 DOI: 10.1016/j.jagp.2019.02.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/04/2019] [Accepted: 02/06/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The aim of this study was to identify the potential impact of positive and negative dimensions of caregiving on caregiver well-being and satisfaction with life (SwL). METHODS This study used time-point one data from the Improving the experience of Dementia and Enhancing Active Life (also known as IDEAL)cohort study that involved 1,283 informal caregivers of people in the mild-to-moderate stages of dementia recruited from 29 sites within Great Britain. Multivariate linear regression modeling was used to investigate the associations between positive dimensions of caregiving (measured by caregiving competence and perceptions of positive aspects of caregiving), negative dimensions of caregiving (measured by caregiving stress and role captivity), and caregiver well-being and SwL. RESULTS Lower well-being was associated with low caregiving competence (-13.77; 95% confidence interval [CI]:-16.67, -10.87), perceiving fewer positive aspects of caregiving (-7.67; 95% CI:-10.26, -5.07), high caregiving stress (-24.45; 95% CI:-26.94, -21.96), and high role captivity (-15.61; 95% CI:-18.33, -12.89). Lower SwL was associated with low caregiving competence (-4.61; 95% CI:-5.57, -3.66), perceiving fewer positive aspects of caregiving (-3.09; 95% CI:-3.94, -2.25), high caregiving stress (-7.88; 95% CI:-8.71, -7.06), and high role captivity (-6.41; 95% CI:-7.27, -5.54). When these four measures were combined within the same model, only positive aspects of caregiving and caregiving stress retained independent associations with well-being and SwL. CONCLUSION Both positive and negative dimensions of caregiving were associated with caregiver well-being and SwL. Psychological therapies and interventions need to consider not only the negative aspects of caregiving but also positive caregiving experiences and their implications for caregiver well-being and SwL.
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Affiliation(s)
- Catherine Quinn
- Centre of Applied Dementia Studies (CQ), University of Bradford, Faculty of Health Studies, Bradford, United Kingdom; Centre for Research in Ageing and Cognitive Health (REACH) (CQ, SMN, AM, LC), University of Exeter Medical School and College of Life and Environmental Sciences, St Luke's Campus, Exeter, United Kingdom.
| | - Sharon M Nelis
- Centre for Research in Ageing and Cognitive Health (REACH) (CQ, SMN, AM, LC), University of Exeter Medical School and College of Life and Environmental Sciences, St Luke's Campus, Exeter, United Kingdom
| | - Anthony Martyr
- Centre for Research in Ageing and Cognitive Health (REACH) (CQ, SMN, AM, LC), University of Exeter Medical School and College of Life and Environmental Sciences, St Luke's Campus, Exeter, United Kingdom
| | - Christina Victor
- Department of Clinical Sciences (CV), College of Health and Life Sciences, Brunel University London, Uxbridge, United Kingdom
| | - Robin G Morris
- King's College London Institute of Psychiatry, Psychology and Neuroscience (RGM), London
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health (REACH) (CQ, SMN, AM, LC), University of Exeter Medical School and College of Life and Environmental Sciences, St Luke's Campus, Exeter, United Kingdom
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García-Valverde E, Badia M, Orgaz MB, Gónzalez-Ingelmo E. The influence of songwriting on quality of life of family caregivers of people with dementia: An exploratory study. NORDIC JOURNAL OF MUSIC THERAPY 2019. [DOI: 10.1080/08098131.2019.1630666] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Esther García-Valverde
- National Reference Centre for Alzheimer’s disease and Dementia Care of IMSERSO, Salamanca, Spain
| | - Marta Badia
- Department of Personality, Assessment and Psychological Treatment of University of Salamanca, Salamanca, Spain
| | - Mª Begoña Orgaz
- Department of Basic Psychology, Psychobiology, and Methodology of Behavioral Sciences of University of Salamanca, Salamanca, Spain
| | - Elena Gónzalez-Ingelmo
- National Reference Centre for Alzheimer’s disease and Dementia Care of IMSERSO, Salamanca, Spain
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Chacón Valera C, Bartolomé Regué M, Font Ritort S, Cabrera Torres E. How to Undertake Aging in a Healthy Way: Changes and Opportunities. AQUICHAN 2019. [DOI: 10.5294/aqui.2019.19.1.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To know the socio-demographic characteristics of the elderly adults (60-70 years), of the population of Mataró (Barcelona), and their relationship with the knowledge degree and training needs perceived to face a healthy aging. Materials and methods: Descriptive observational cross-sectional study in which a sample of 306 people was analysed. Socio-demographic data and variables related to leisure activities, health status, training, formative needs and predisposition to take a course on aging were evaluated. Results: About a 60 % of the respondents showed interest in receiving training about; healthy habits (59,1 %), proper diet (62,0 %), work out (59,6 %), future limitations (62,6 %), why we grow old (61,0 %), frequent illnesses in the elderly (62,5 %), use of medication (66,1 %), use of the health system (61,9 %), social resources (70,0 %), new technologies (64,0 %), care of sick people (60,5 %), and security aspects (61,6 %). Conclusions: There is a need to receive training among the elderly adult population in order to cope with aging in a healthier way. The main needs perceived by the elderly are: Healthy habits, possible future limitations due to the aging process, use of medication, functioning of the health system and access to social resources, new technologies and, finally, caring for sick relatives.
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Gillès de Pélichy E, Ebbing K, Matos Queiros A, Hanon C, von Gunten A, Sellah Z, Verloo H. Demographics, Clinical Characteristics, and Therapeutic Approaches among Older Adults Referred to Mobile Psychiatric Crisis Intervention Teams: A Retrospective Study. Dement Geriatr Cogn Dis Extra 2018; 8:402-413. [PMID: 30483306 PMCID: PMC6243965 DOI: 10.1159/000493525] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022] Open
Abstract
Background / Aims The advent of mobile old age psychiatry intervention teams supports policies maintaining older adults in their habitual living environments, even those who are very old and suffering from acute cognitive and psychiatric impairments. Analyzing sociodemographic data, clinical and health characteristics, reasons for crisis-oriented psychiatric consultations, and other therapeutic suggestions for supporting home- or nursing home-dwelling older adult patients suffering from an onset of a psychiatric crisis. Methods Reviews of the medical records and discharge letters of home- or nursing home-dwelling older adults who had undergone a consultation with the Lausanne region's Mobile Old Age Psychiatry Teams (MOAPTs), between May 2016 and December 2017. Results Of 570 older adult patients referred for consultation with MOAPTs, 333 had medical records and discharge letters eligible for retrospective analysis (59%). The majority of these older adult patients were women aged over 80 years suffering from dementia, mood disorders with and without a risk of suicide, and delirium. Challenging behaviors related to different stages of cognitive impairment were the most important clinical reason for crisis consultations. Nonpharmacological and pharmacological treatments were delivered concurrently in 68% of crisis consultations. Conclusion Appropriate responses by dual nurse-psychiatrist teams using crisis-oriented nonpharmacological and pharmacological interventions decreased hospitalization.
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Affiliation(s)
- Estelle Gillès de Pélichy
- Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland
- Administration of Health and Social Welfare, Service of Public Health, Lausanne, Switzerland
- *Estelle Gillès de Pélichy, MD, FRC-Psych, Department of Psychiatry, Lausanne University Hospital, CH-1197 Prangins (Switzerland), E-Mail , Karsten Ebbing, MD, FRC-Psych, Department of Psychiatry, Lausanne University Hospital, CH-1011 Lausanne (Switzerland), E-Mail
| | - Karsten Ebbing
- Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland
| | - Alcina Matos Queiros
- Administration of Health and Social Welfare, Service of Public Health, Lausanne, Switzerland
| | - Cécile Hanon
- Regional Resource Center of Old Age Psychiatry, Mobile Team for Old Age Psychiatric Subjects – EMPSA 92 South, Paris University Hospitals-West, Corentin-Celton Hospital, Issy-Les-Moulineaux, France
| | - Armin von Gunten
- Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland
| | - Zaia Sellah
- Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland
| | - Henk Verloo
- Service of Old Age Psychiatry (SUPAA), Lausanne University Hospital, Prilly / Prangins, Switzerland
- University of Applied Sciences Western Switzerland, Nursing Sciences, Sion, Switzerland
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The effects of a multidisciplinary education course on the burden, health literacy and needs of family caregivers. Appl Nurs Res 2018; 44:100-106. [PMID: 30389053 DOI: 10.1016/j.apnr.2018.10.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 09/04/2018] [Accepted: 10/14/2018] [Indexed: 12/13/2022]
Abstract
Chronic diseases are mostly managed by family caregivers that often face the "caregiver burden". This study aimed to understand whether a multidisciplinary theoretical-practical training course could influence the burden, health literacy and needs of caregivers. Seventy-six familial caregivers were asked to complete the Caregiver Burden Inventory-CBI, Caregiver Needs Assessment-CNA, and Health Literacy Questionnaire-HLQ, before and after the course. A significant decrease in CBI and an increase of CNA were observed. However, a significantly higher rate of CBI decrease and a lower increase of CNA were detected in the neurological compared to the oncological group (p = 0.001). Moreover, the ability of the participants to look for and find health information significantly improved. The course contrasted caregivers' burden, increased their search for health information, and revealed their requiring of training and emotional and social support. Caregiver education plays a pivotal role in the management of chronic patients, enhancing the quality of life of both patients and caregivers.
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Alves EVDC, Flesch LD, Cachioni M, Neri AL, Batistoni SST. The double vulnerability of elderly caregivers: multimorbidity and perceived burden and their associations with frailty. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.180050] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: To identify if multimorbidity and burden are associated with a greater likelihood of frailty in elderly caregivers of other elderly persons within the family context. Method: 148 elderly caregivers caring for other elderly persons [M=69.7 (±7.0) years old] were recruited using a criterion of convenience in public and private health services in the city of Campinas and surrounding areas. Information was gathered about socio-demographic context, context of care, physical health, care burden using the Zarit Burden Scale, and frailty, measured by subjective evaluation. Four groups of vulnerability were created based on the presence or absence of multimorbidities and high or low burden, in order to verify which group was most strongly associated with frailty. Data were analyzed using descriptive analysis, measurements of association and multivariate hierarchical logistic regression. Results: The prevalence of multimorbidity was 55.4%. The Zarit Burden Scale presented a median of 23 out of a total of 88 points. Of the sample, 35.1% were frail, 46.0% intermediate, and 18.9% robust. Elderly caregivers with multimorbidity and high burden had a greater probability of frailty (OR=3.6; CI 1.55-8.36), followed by those with multimorbidity and low burden (OR=2.8; CI 1.13-6.79). Conclusion: The sensation of burden among caregivers was reduced; those with double vulnerability were most prevalent among the four groups and had the greatest association with the occurrence of frailty; multimorbidity was associated with frailty. If combined with perceived burden, however, the odds ratios of the elderly caregivers being frail increased.
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Affiliation(s)
| | | | - Meire Cachioni
- Universidade Estadual de Campinas, Brazil; Universidade de São Paulo, Brazil
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Zauszniewski JA, Lekhak N, Musil CM. Caregiver Reactions to Dementia Symptoms: Effects on Coping Repertoire and Mental Health. Issues Ment Health Nurs 2018; 39:382-387. [PMID: 29451843 PMCID: PMC6260985 DOI: 10.1080/01612840.2018.1424974] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Currently, 15 million informal caregivers, most of whom are women, provide care for older adults with dementia (Alzheimer's Disease Association, 2016). Caregiving for these individuals often creates distress and may adversely affect female caregivers' psychosocial and spiritual well-being. Approximately 35% of dementia caregivers complain of health deterioration after initiating caregiving responsibilities as compared to 19% of caregivers of older adults who do not have dementia (Alzheimer's Disease Association, 2016). Persons with dementia exhibit symptoms and behaviors that often are challenging for their caregivers. The way that caregivers react to these symptoms and behaviors may affect their coping repertoire and their mental health. Adequate evaluation of caregiver reactions to symptoms of dementia will provide information useful for developing targeted interventions to promote optimal health of female dementia caregivers and to potentially postpone the need for nursing home or long-term placement of the care recipient.
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Affiliation(s)
- Jaclene A Zauszniewski
- a Nursing , Kate Hanna Harvey Professor of Community Health Nursing and Case Western Reserve University , Cleveland , Ohio , USA
| | - Nirmala Lekhak
- b Nursing , University of Nevada , Las Vegas Las Vegas , Nevada , USA
| | - Carol M Musil
- c Nursing , Case Western Reserve University , Cleveland , Ohio , USA
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Copanitsanou P, Sourtzi P, Cano S, Cabrera E, Charalambous A, Katajisto J, Leino-Kilpi H, Papastavrou E, Valkeapää K, Zabalegui A, Lemonidou C. Empowering education of arthroplasty patients' significant others in three Southern European countries. Int J Older People Nurs 2018; 13:e12193. [DOI: 10.1111/opn.12193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 02/05/2018] [Indexed: 11/26/2022]
Affiliation(s)
| | | | - Sara Cano
- Universitat Jaume I; Castellón Spain
| | - Esther Cabrera
- School of Health Sciences TecnoCampus; University Pompeu Fabra; Mataró Barcelona Spain
| | - Andreas Charalambous
- Faculty of Nursing; Cyprus University of Technology; Limassol Cyprus
- University of Turku; Turku Finland
| | - Jouko Katajisto
- Department of Statistics; University of Turku; Turku Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science; University of Turku; Turku Finland
- Turku University Hospital; Turku Finland
| | | | - Kirsi Valkeapää
- Department of Nursing Science; University of Turku; Turku Finland
- Lahti University of Applied Sciences; Lahti Finland
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Yamazaki A, Kawahara T. The Structure of Family Practices in Multifunctional Long-Term Care in a Small Group Home in Japan. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2018. [DOI: 10.1177/1084822317734181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present research was to extract the structure of family practices in multifunctional long-term care in a small group home by focusing on practices offered to families that are not present in conventional in-home support services. Semistructured interviews were conducted with 18 care providers and four users’ family members. Four categories and 16 subcategories were extracted. In multifunctional long-term care in a small group home, staff engaged in the practices of becoming a part of family life, drawing out the nursing care capabilities of family members, and constantly speaking about the future with office staff and family members so that elderly users with dementia could live while being respected as people.
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Aravena JM, Albala C, Gitlin LN. Measuring change in perceived well-being of family caregivers: validation of the Spanish version of the Perceived Change Index (PCI-S) in Chilean dementia caregivers. Int J Geriatr Psychiatry 2018; 33:e120-e130. [PMID: 28509367 PMCID: PMC5800416 DOI: 10.1002/gps.4734] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 04/05/2017] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Few instruments evaluate family caregiver perceptions of challenges caring for persons with dementia and improvement or worsening in these areas. To address this measurement gap, we examine psychometric properties of a Spanish version of the 13-item Perceived Change Index (PCI-S), originally validated with English-speaking caregivers. METHODS Cross-sectional study with 94 caregivers of persons with mild to moderate dementia in Chile. Interviews included caregiver demographics, burden, health perception, distress with behaviours, dementia severity, behavioural symptoms and functionality. RESULTS Caregiver mean age was 55.9 (SD ± 14.14) years and mean years caregiving was 3 (SD ± 2.60). The scale had strong internal consistency (Cronbach α = 0.94), and inter-observer consistency (CCI = 0.99; 95% CI = 0.95-0.99). Two factors were identified: Management skills (α = 0.89), and somatic well-being and affects (α = 0.92), explaining 63% of scale variance. Significant associations supporting convergent validity were observed for PCI-S and subscales with caregiver burden (p < 0.01), health perceptions (p < 0.01), depressive symptoms (p < 0.01) and distress with behaviours (p < 0.01); and in persons with dementia, functionality (p < 0.05), dementia severity (p < 0.05) and behavioural symptoms (p < 0.01) in expected directions. In logistic regression models, perceived worsening (PCI-S and subscale scores) was associated with more behavioural symptoms (OR = 1.07; 95% CI = 1.03-1.15) and caregiver burden (OR = 1.48; 95% CI = 1.18-1.86); whereas perceived improvement was associated with higher physical functioning (OR = 0.95; 95% CI = 0.91-0.99) in persons with dementia. PCI-S scores were not associated with socio-demographic characteristics reflecting divergent validity. CONCLUSIONS Spanish version of the 13-item Perceived Change Index and its two-factor solution is a valid and reliable measure with clinical utility to detect improvement or worsening in caregivers concerning daily care challenges. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- José M Aravena
- Public Nutrition Unit, Nutrition and Food Technology Institute, INTA, University of Chile, Santiago, Chile
| | - Cecilia Albala
- Public Nutrition Unit, Nutrition and Food Technology Institute, INTA, University of Chile, Santiago, Chile
| | - Laura N Gitlin
- Department of Community Public Health, School of Nursing, Joint appointments, Department of Psychiatry, and Division of Geriatrics and Gerontology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
- Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA
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Sutcliffe C, Giebel C, Bleijlevens M, Lethin C, Stolt M, Saks K, Soto ME, Meyer G, Zabalegui A, Chester H, Challis D, Meyer G, Stephan A, Renom-Guiteras A, Sauerland D, Wübker A, Bremer P, Hamers JP, Afram B, Beerens HC, Bleijlevens MH, Verbeek H, Zwakhalen SM, Ruwaard D, Ambergen T, Hallberg IR, Emilsson UM, Karlsson S, Bökberg C, Lethin C, Challis D, Sutcliffe C, Jolley D, Tucker S, Bowns I, Roe B, Burns A, Leino-Kilpi H, Koskenniemi J, Suhonen R, Viitanen M, Arve S, Stolt M, Hupli M, Saks K, Tiit EM, Leibur J, Raamat K, Armolik A, Toivari TTM, Zabalegui A, Navarro M, Cabrera E, Risco E, Alvira C, Farre M, Miguel S, Soto M, Milhet A, Sourdet S, Gillette S, Vellas B. Caring for a Person With Dementia on the Margins of Long-Term Care: A Perspective on Burden From 8 European Countries. J Am Med Dir Assoc 2017; 18:967-973.e1. [DOI: 10.1016/j.jamda.2017.06.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2017] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 10/19/2022]
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Holopainen A, Siltanen H, Pohjanvuori A, Mäkisalo-Ropponen M, Okkonen E. Factors Associated with the Quality of Life of People with Dementia and with Quality of Life-Improving Interventions: Scoping Review. DEMENTIA 2017; 18:1507-1537. [DOI: 10.1177/1471301217716725] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objectives To synthesise current research exploring the factors and interventions associated with the quality of life of people with dementia. Background Dementia is a progressive condition affecting an estimated 40 million people worldwide. The illness has a significant impact on the lives of the persons affected and their loved ones, and may thus impair the quality of life of both. As it progresses, dementia weakens the patients’ ability to express their own views about their quality of life and the factors associated with it. Design Scoping review. Data sources Electronic database search of MEDLINE, CINAHL, PsycINFO, Joanna Briggs Institute Library, Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects (DARE), EMBASE, Medic published up to March 2016; and incremental hand search. Review method: Systematic or other kinds of reviews and single studies were included for the review if they met the inclusion criteria. Results: A total of 20 reviews and 7 primary studies were retained for synthesis. Key findings were abstracted and a themes matrix was generated to identify patterns of meaning. The factors associated with the quality of life of people with dementia were sociodemographic factors, factors related to dementia and social and caring environment. Interventions supporting quality of life focused on the activation of people with dementia. Conclusions: This scoping review identified a large body of knowledge exploring the factors and interventions associated with the quality of life of people with dementia. The interventions were heterogeneous and the sample sizes small, which is why more research is needed.
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Affiliation(s)
- Arja Holopainen
- Nursing Research Foundation, Helsinki, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland; The WHO Collaborating Centre for Nursing, Helsinki, Finland
| | - Hannele Siltanen
- Nursing Research Foundation, Helsinki, Finland; The Finnish Centre for Evidence-Based Health Care: A Joanna Briggs Institute Centre of Excellence, Helsinki, Finland
| | | | | | - Eila Okkonen
- The Alzheimer Society of Finland, Helsinki, Finland
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Ehrlich K, Emami A, Heikkilä K. The relationship between geographical and social space and approaches to care among rural and urban caregivers caring for a family member with Dementia: a qualitative study. Int J Qual Stud Health Well-being 2017; 12:1275107. [PMID: 28452593 PMCID: PMC7011969 DOI: 10.1080/17482631.2016.1275107] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Knowledge about family caregivers in rural areas remains sparse. No studies to date have addressed the sociocultural aspects in caregiving, thus neglecting potentially significant data. This study aimed to explore and better understand family caregivers’ experiences in rural and urban areas and the sociocultural spheres that these two areas represent. How do family caregivers approach their caregiving situation? A hermeneutical approach was chosen to uncover the underlying meanings of experiences. Open-ended in-depth interviews were conducted. The ontological and epistemological roots are based on hermeneutic philosophy, where a human being’s existence is viewed as socially constructed. The study followed a purposeful sampling. Semi-structured in-depth interviews were conducted with 12 rural and 11 urban family caregivers to persons with dementia. These were then analyzed in accordance with the hermeneutical process. The findings provide insight into the variations of family caregiver approaches to caregiving in rural and urban areas of Sweden. There seemed to be a prevalence of a more accepting and maintaining approach in the rural areas as compared to the urban areas, where caregiving was more often viewed as an obligation and something that limited one’s space. Differences in the construction of family identity seemed to influence the participants approach to family caregiving. Therefore, community-based caregiving for the elderly needs to become aware of how living within a family differs and how this affects their views on being a caregiver. Thus, support systems must be individually adjusted to each family’s lifestyles so that this is more in tune with their everyday lives.
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Affiliation(s)
- Kethy Ehrlich
- a Department of Neurobiology, Care Sciences and Society, Division of Nursing , Karolinska Institute , Huddinge , Sweden
| | - Azita Emami
- a Department of Neurobiology, Care Sciences and Society, Division of Nursing , Karolinska Institute , Huddinge , Sweden.,b Biobehavioral Nursing & Health Systems, School of Nursing , University of Washington , Seattle , WA , USA.,c Aging Research Center (ARC) , Karolinska Institute , Stockholm , Sweden
| | - Kristiina Heikkilä
- a Department of Neurobiology, Care Sciences and Society, Division of Nursing , Karolinska Institute , Huddinge , Sweden.,d Department of Health and Care Sciences, Faculty of Health and Life Sciences , Linneaus University , Kalmar , Sweden
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Older Adult Spouses with Multiple Chronic Conditions: Challenges, Rewards, and Coping Strategies. Can J Aging 2017; 36:209-222. [PMID: 28349856 DOI: 10.1017/s0714980817000095] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions. Unique findings relate to the challenges inherent in decision-making within the context of multiple chronic conditions. This article begins to address the gap in the literature regarding the caregiving experience within the context of multiple chronic conditions.
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Farina N, Page TE, Daley S, Brown A, Bowling A, Basset T, Livingston G, Knapp M, Murray J, Banerjee S. Factors associated with the quality of life of family carers of people with dementia: A systematic review. Alzheimers Dement 2017; 13:572-581. [DOI: 10.1016/j.jalz.2016.12.010] [Citation(s) in RCA: 143] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 12/03/2016] [Accepted: 12/21/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Nicolas Farina
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
| | | | - Stephanie Daley
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
| | - Anna Brown
- School of Psychology University of Kent Canterbury UK
| | - Ann Bowling
- Health Sciences University of Southampton Southampton UK
| | - Thurstine Basset
- Lived Experience Advisory Panel Sussex Partnership NHS Foundation Trust Hove UK
| | | | - Martin Knapp
- Department of Social Policy London School of Economics London UK
| | - Joanna Murray
- Institute of Psychiatry, Psychology & Neuroscience King's College London London UK
| | - Sube Banerjee
- Centre for Dementia Studies Brighton and Sussex Medical School Brighton UK
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Influence of personality on depression, burden, and health-related quality of life in family caregivers of persons with dementia. Int Psychogeriatr 2017; 29:227-237. [PMID: 27780493 DOI: 10.1017/s1041610216001770] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Personality may predispose family caregivers to experience caregiving differently in similar situations and influence the outcomes of caregiving. A limited body of research has examined the role of some personality traits for health-related quality of life (HRQoL) among family caregivers of persons with dementia (PWD) in relation to burden and depression. METHODS Data from a large clinic-based national study in South Korea, the Caregivers of Alzheimer's Disease Research (CARE), were analyzed (N = 476). Path analysis was performed to explore the association between family caregivers' personality traits and HRQoL. With depression and burden as mediating factors, direct and indirect associations between five personality traits and HRQoL of family caregivers were examined. RESULTS Results demonstrated the mediating role of caregiver burden and depression in linking two personality traits (neuroticism and extraversion) and HRQoL. Neuroticism and extraversion directly and indirectly influenced the mental HRQoL of caregivers. Neuroticism and extraversion only indirectly influenced their physical HRQoL. Neuroticism increased the caregiver's depression, whereas extraversion decreased it. Neuroticism only was mediated by burden to influence depression and mental and physical HRQoL. CONCLUSIONS Personality traits can influence caregiving outcomes and be viewed as an individual resource of the caregiver. A family caregiver's personality characteristics need to be assessed for tailoring support programs to get the optimal benefits from caregiver interventions.
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Naef R, Hediger H, Imhof L, Mahrer-Imhof R. Variances in family carers' quality of life based on selected relationship and caregiving indicators: A quantitative secondary analysis. Int J Older People Nurs 2016; 12. [PMID: 27863032 DOI: 10.1111/opn.12138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To determine subgroups of family carers based on family relational and caregiving variables and to explore group differences in relation to selected carer outcomes. BACKGROUND Family caregiving in later life holds a myriad of positive and negative outcomes for family members' well-being. However, factors that constitute family carers' experience and explain variances are less well understood. DESIGN A secondary data analysis using cross-sectional data from a controlled randomised trial with community-dwelling people 80 years or older and their families. METHODS A total of 277 paired data sets of older persons and their family carers were included into the analysis. Data were collected via mailed questionnaires and a geriatric nursing assessment. A two-step cluster analysis was performed to determine subgroups. To discern group differences, appropriate tests for differences with Bonferroni correction were used. RESULTS Two family carer groups were identified. The low-intensity caregiver group (57% of carers) reported high relationship quality and self-perceived ease of caregiving. In contrast, the high-intensity caregiver group (43% of carers) experienced significantly lower relationship quality, felt less prepared and appraised caregiving as more difficult, time intensive and burdensome. The latter cared for older, frailer and more dependent octogenarians and had significantly lower levels of quality of life and self-perceived health compared to the low-intensity caregiver group. CONCLUSIONS A combination of family relational and caregiving variables differentiates those at risk for adverse outcomes. Family carers of frailer older people tend to experience higher strain, lower relationship quality and ability to work together as a family. IMPLICATIONS FOR PRACTICE Nurses should explicitly assess family carer needs, in particular when older persons are frail. Family carer support interventions should address caregiving preparedness, demand and burden, as well as concerns situated in the relationship.
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Affiliation(s)
- Rahel Naef
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland.,Centre for Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Hannele Hediger
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Lorenz Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Romy Mahrer-Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
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Abajo M, Rodríguez-Sanz M, Malmusi D, Salvador M, Borrell C. Gender and socio-economic inequalities in health and living conditions among co-resident informal caregivers: a nationwide survey in Spain. J Adv Nurs 2016; 73:700-715. [PMID: 27683193 DOI: 10.1111/jan.13172] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 01/13/2023]
Abstract
AIMS To explore the associations between social determinants, caregiver's network support, burden of care and their consequences in health and living conditions of informal caregivers. BACKGROUND The socio-demographic trends regarding population ageing and changes in family models trigger an increased demand for care. DESIGN Cross-sectional study based on the 2008 edition of the National Disability, Independence and Dependency Situations Survey (DIDSS-2008) conducted by the National Statistics Institute in Spain. METHODS Analyses focused on persons identified as primary caregivers who co-reside with the dependent person. The associations between social determinants of caregivers, burden of care, support network and problems attributed to informal care (impaired health, depression, professional, economic and personal issues) were estimated by fitting robust Poisson regression models. Analyses were conducted separately for women and men. RESULTS The study sample included 6923 caregivers, 73% of women and 27% of men. Gender and socio-economic inequalities were found in assumption of responsibilities and burden of caring for dependents, which tend to fall more on women and persons of lower socio-economic level, who in turn have less access to formal support. These aspects translate into a higher prevalence of health, professional, economic and personal problems. CONCLUSIONS The study highlights gender and socio-economic inequalities in informal caregiving and its negative consequences. These findings may be useful in the design of policies and support programmes targeting the most affected groups of informal caregivers.
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Affiliation(s)
- María Abajo
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain
| | - Maica Rodríguez-Sanz
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Davide Malmusi
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - María Salvador
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain
| | - Carme Borrell
- Department of Health Information Systems, Public Health Agency of Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain.,Institute of Biomedical Research (IIB-Sant Pau), Barcelona, Spain.,Pompeu Fabra University, Barcelona, Spain
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Risco E, Cabrera E, Farré M, Alvira C, Miguel S, Zabalegui A. Perspectives About Health Care Provision in Dementia Care in Spain: A Qualitative Study Using Focus-Group Methodology. Am J Alzheimers Dis Other Demen 2016; 31:223-30. [PMID: 26340965 PMCID: PMC10852885 DOI: 10.1177/1533317515603818] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
BACKGROUND The aim of this study is to identify the barriers and facilitators in dementia care with respect to information provision, communication, and collaboration from the perspectives of the person with dementia, family caregivers, and health care professionals over the course of the illness. METHODS A qualitative study using Focus-Group methodology was carried out in people with dementia, family caregivers, and health care providers. RESULTS The categories that emerged from the analysis were insufficient information provided, specific dementia care needs, and acceptance of long-term care institutionalization from the people with dementia and caregivers' groups and insufficient communication between health care providers, differential information according to disease stage, and home care coordination from the health care providers' groups. CONCLUSION The family is a key element in successful care coordination during dementia care provision. New effective strategies including self-management and emergent roles, such as case managers, could bring great benefits to people with dementia, caregivers, and health care providers.
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Affiliation(s)
- Ester Risco
- Department of Nursing, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Esther Cabrera
- School of Health Sciences TecnoCampus, Pompeu Fabra University, Mataró, Spain
| | - Marta Farré
- Department of Nursing, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Carme Alvira
- Department of Nursing, Comte Borrell Primary Care, Comte Borrell, Barcelona, Spain
| | - Susana Miguel
- School of Health Sciences Gimbernat i Tomàs Cerdà, UAB. Av. de la Generalitat, Barcelona, Spain
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Kim M, Lim KC. Effects of Dongsasub Training for Family Caregivers of Patients with Dementia on their Burden, Depression, and Self-esteem. ACTA ACUST UNITED AC 2016. [DOI: 10.5953/jmjh.2016.23.1.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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