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Reblin M, Ambrose N, Pastore N, Nowak S. Perceived helpfulness of caregiver support resources: Results from a state-wide poll. PEC INNOVATION 2024; 4:100295. [PMID: 38855072 PMCID: PMC11157270 DOI: 10.1016/j.pecinn.2024.100295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 05/20/2024] [Accepted: 05/24/2024] [Indexed: 06/11/2024]
Abstract
Objective Our goal was to identify specific types of services desired by caregivers and determine subgroups most interested in each service type. Methods Caregiving questions were added to a state-wide poll conducted in a majority-rural state. Those who identified as caregivers (n = 428) were asked to report on the helpfulness of 6 domains of services. Descriptive analysis and logistic regressions were conducted. Results Top resources caregivers identified as potentially helpful included hands-on services (33.9%), help coordinating care from multiple providers (21.5%), help with finances (18.9%), and help managing emotional stress (17.8%). Only 15% indicated no caregiver resources would be helpful. Younger caregivers endorsed several service domains as more helpful than older caregivers; caregivers reporting higher stress were more likely to endorse most domains as helpful. Conclusion Data reinforces the overwhelming need to offer caregiver services. Navigation and integrated and tailored service models may be beneficial to help caregivers identify and access appropriate services within healthcare systems. Innovation This study uses an innovative approach to identifying needs of caregivers, who are often invisible within the healthcare system. Our findings suggest a paradigm shift is needed to broaden the scope and depth of services offered to caregivers.
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Affiliation(s)
- Maija Reblin
- Vermont Conversation Lab, Department of Family Medicine, University of Vermont, Burlington, VT, USA
| | - Natalie Ambrose
- Vermont Conversation Lab, Department of Family Medicine, University of Vermont, Burlington, VT, USA
| | - Nina Pastore
- Vermont Conversation Lab, Department of Family Medicine, University of Vermont, Burlington, VT, USA
| | - Sarah Nowak
- Department of Pathology and Laboratory Medicine, University of Vermont, Burlington, VT, USA
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Xu S, Lou VWQ, Chi I, Ng WC, Zhou J, Huang LK, Hok Ka Ma C, Jagasia M. Validating interRAI Chinese self-reported carer needs (SCaN) assessment and predicting caregiving distress among informal Chinese caregivers of older adults. BMC Geriatr 2024; 24:409. [PMID: 38720258 PMCID: PMC11080141 DOI: 10.1186/s12877-024-05014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 04/25/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aims to (1) determine the reliability and validity of the interRAI Chinese Self-reported Carer Needs (SCaN) assessment among informal Chinese caregivers of older adults, (2) identify predictors of caregiving distress in Asian regions with long-standing Confucian values of filial piety and family responsibility. METHODS This cross-sectional study recruited 531 informal Chinese caregivers of older adults in Hong Kong, Shanghai, Taiwan, and Singapore. The scale reliability was examined using Cronbach's alphas (α) and McDonald's omega coefficient (ω). The concurrent validity and discriminant validity were assessed using Spearman rank correlations (rho). To examine the predictors of caregiving distress among informal caregivers of older adults, we employed hierarchical linear regression analyses informed by the Model of Carer Stress and Burden and categorized the predictors into six domains. RESULTS Results revealed good internal consistency reliability (α = 0.83-0.96) and concurrent validity (rho = 0.45-0.74) of the interRAI Chinese SCaN assessment. Hierarchical linear regression analysis revealed that entering the background factors, primary stressors, secondary stressors, appraisal, and exacerbating factors all significantly enhanced the model's predictability, indicating that the source of caregiving distress is multidimensional. In the full model, caregivers with longer informal care time, lack of support from family and friends, have unmet needs, experience role overload, have sleep problems, and low IADL functioning are at a higher risk of caregiving distress. CONCLUSIONS The interRAI Chinese SCaN Assessment was found to be a reliable and valid tool among the Chinese informal caregivers of older adults. It would be useful for determining family caregivers' strengths, needs, and challenges, and tailoring interventions that address the potentially modifiable factors associated with caregiving distress and maximize support. Healthcare providers working in home and community settings should be aware of the early identification of caregiving distress and routine assessment of their needs and empower them to continue taking care of their needs and providing adequate care to the care recipient.
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Affiliation(s)
- Shicheng Xu
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China.
- Department of Social Work & Social Administration, The University of Hong Kong, Hong Kong, China.
| | - Iris Chi
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, China
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, USA
| | | | - Jing Zhou
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, University of Eastern Finland, Joensuu, Finland
- Department of Social Sciences, Faculty of Social Sciences and Business Studies, Shanghai Lixin University of Accounting and Finance, Shanghai, China
| | - Lung-Kuan Huang
- St. Camillus Long-term Care Center, Yi-lan County, Taiwan
- Fo Guang University, Yi-lan County, Taiwan
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Theotokatos G, Escorpizo R, Angelopoulos TJ, Chrysagis NK, Venieri A, Bickenbach J, Karteroliotis K, Grammatopoulou E, Skordilis E. The Sociodemographic Factors Related to Disability of Applicants of Welfare Benefits in Greece: A Cross-Sectional Survey Based on the World Health Organization Disability Assessment Schedule (WHODAS) 2.0. Cureus 2024; 16:e55614. [PMID: 38586637 PMCID: PMC10995654 DOI: 10.7759/cureus.55614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2024] [Indexed: 04/09/2024] Open
Abstract
INTRODUCTION The aim of the present study was to report on the prevalence of disability and its association with sociodemographic factors among welfare benefit applicants in Greece. The study also compared the disability scores between different health conditions using the WHODAS 2.0 (12-item version), a biopsychosocial-model-based measure. METHODS The Greek WHODAS 2.0, 12-item version, was administered by interview. A three-member medical committee assessed the medical records of the applicants and assigned a disability percentage based on the biomedical measure of disability percentage determination (Barema scale). RESULTS The majority of the participants were female (56.65%). Certain health conditions were presented more frequently among welfare benefit applicants (mental health disorders and neoplasms). The domains with the highest rate of difficulty were the "participation" and "life activities" domains. Significant differences were found between WHODAS 2.0 and Barema scores for all eight different health condition categories. The factorial ANOVA (8x2) showed a significant interaction effect between health condition category and gender with respect to the WHODAS 2.0 score (F = 19.033, p <.001, η2 = 0.13). The WHODAS 2.0 score was negatively correlated to gender, years of studies, and marital status and positively correlated to age, working status, and the Barema score. The results revealed that male participants with a partner who were younger, had more studies, were actively working, and had a lower Barema score would have lower WHODAS scores. CONCLUSION Sociodemographic characteristics of welfare benefit applicants are associated with disability levels based on WHODAS 2.0. Certain health conditions, like mental health or neuromusculoskeletal conditions, are associated with higher disability scores. There are differences between the biopsychosocial and the biomedical approaches to disability assessment. The implementation of WHODAS 2.0 may contribute to a better understanding of the lived experience of patients and is a feasible and efficient tool. Combining biomedical and biopsychosocial approaches may enhance the procedures of disability assessment and help in the development of policies that support people with disabilities.
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Affiliation(s)
- Georgios Theotokatos
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, GRC
| | - Reuben Escorpizo
- Employment and Participation Unit, Swiss Paraplegic Research, Nottwil, CHE
- Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, USA
| | - Theodore J Angelopoulos
- Rehabilitation and Movement Science, College of Nursing and Health Sciences, University of Vermont, Burlington, USA
| | - Nikolaos K Chrysagis
- Laboratory of Advanced Physiotherapy (LAdPhys) Physiotherapy, School of Health and Care Sciences, University of West Attica (UNIWA), Athens, GRC
| | - Aikaterini Venieri
- Sports Excellence, 1st Orthopedics Department, School of Health Sciences, National and Kapodistrian University of Athens, Athens, GRC
| | - Jerome Bickenbach
- Schweizer Paraplegiker Forschung (SPF), Swiss Paraplegic Research, Nottwil, CHE
- University of Lucerne, Faculty of Health Sciences and Medicine, Lucerne, CHE
| | | | - Eirini Grammatopoulou
- Laboratory of Advanced Physiotherapy (LAdPhys) Physiotherapy, School of Health and Care Sciences, University of West Attica (UNIWA), Athens, GRC
| | - Emmanouil Skordilis
- School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, GRC
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Subramaniam A, Mehta KK. Exploring the Lived Experiences of Caregiving for Older Family Members by Young Caregivers in Singapore: Transition, Trials, and Tribulations. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:182. [PMID: 38397673 PMCID: PMC10888348 DOI: 10.3390/ijerph21020182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 01/22/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024]
Abstract
Amidst population ageing trends and epidemiological transitions, there has been a growing emergence of young family caregivers, about whom most studies have been conducted in Western countries. Their subjective experiences and perceptions toward caregiving remain underexplored in Asia. This qualitative study explored the lived experiences of caregiving for older family members by young caregivers in Singapore. Interpretative phenomenological analysis was employed to collect and analyse data from semi-structured, in-depth interviews with six young adult caregivers aged between 23 and 29. Interviews were supplemented with photo-elicitation techniques to deepen interview discussions and uncover experiential significance. Findings illustrated transitions into caregiving, challenges across role conflicts and expectations amidst developmental tasks and transitions, and navigation of intergenerational conflicts and ambivalence. Although no definitive conclusions can be reached from this small-scale study, the findings offer important insights into the convergence and intensity of young caregivers' experiences. Given that caregiving challenges are likely to continue amidst Singapore's rapidly ageing population, these necessitate further in-depth research efforts. Implications for policy and practice across multiple stakeholders interfacing with youth and older adults are presented. A whole-of-society approach is called for to enable young caregivers to realise their full potential while contributing to their ageing families and nation.
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Affiliation(s)
- Araviinthansai Subramaniam
- S R Nathan School of Human Development, Singapore University of Social Sciences, Singapore 599494, Singapore;
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Howe RJ, Bell JF, Agnoli A, Sullivan JL, Bidwell JT. Home alone or connected: Caregiver communication and training from health providers. J Am Geriatr Soc 2024; 72:361-368. [PMID: 38006285 DOI: 10.1111/jgs.18686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/23/2023] [Accepted: 10/25/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND As care shifts from institutional to community settings, family caregivers are providing increasing support to older adults, including complex medical/nursing care. In the mid-late pandemic, technology advancements such as use of online patient portals present opportunities for communication and care delivery. This study aims to assess the association between caregiver medical/nursing tasks or patient portal use with contact, communication, and training of caregivers by healthcare providers. METHODS We conducted a cross-sectional analysis of caregiver data from the 2021 National Study of Caregiving (NSOC), linked to the National Health and Aging Trends Study (NHATS). NHATS is nationally-representative, annual survey of Medicare enrollees; NSOC surveys family/unpaid caregivers of NHATS participants. Logistic regression tested association between whether the caregiver does medical/nursing tasks or uses an online patient portal to contact the medical team (independent variables), and communication with or training by the medical team (dependent variables). RESULTS Participants were 1590 caregivers of living, community-dwelling older adults. More than half (54%) reported no contact with the care recipient's medical team in the past year. Caregivers who did medical/nursing tasks (OR = 3.10; 95% CI: 2.16, 4.46) or who used patient portals (OR = 3.28; 95% CI: 1.96, 5.51) had higher odds of contacting the older adult's medical team. Thirty percent of caregivers stated communication was either not at all or just a little helpful. Sixty-seven percent reported that providers rarely asked if they needed help managing the older adult's treatments. Just 6% of caregivers reported receiving any caregiver training in the last year. CONCLUSIONS Both medical/nursing tasks and online patient portal use were independently associated with contact with health providers. Overall contact, communication, and training were limited or of variable value. Despite recent policy changes and technology advancement, there is still a need for improved integration of caregivers into health teams with ongoing assessment of their needs.
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Affiliation(s)
- Rebecca J Howe
- University of California, Davis, Sacramento, California, USA
| | - Janice F Bell
- University of California, Davis, Sacramento, California, USA
| | - Alicia Agnoli
- University of California, Davis, Sacramento, California, USA
| | - Jennifer L Sullivan
- VA Providence Healthcare System and Brown University School of Public Health, Providence, Rhode Island, USA
| | - Julie T Bidwell
- University of California, Davis, Sacramento, California, USA
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Burgess-Flowers J, de Saxe Zerden L, Yokovich K. The social determinants of health, social work, and dental patients: a case study. SOCIAL WORK IN HEALTH CARE 2024; 63:117-130. [PMID: 38111138 DOI: 10.1080/00981389.2023.2292546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/16/2023] [Indexed: 12/20/2023]
Abstract
Oral health has been largely overlooked in conceptualizing health, and the workforce responsible for addressing the Social Determinants of Health (SDOH) within oral health settings has received little attention. While the role for social work in oral health has remained limited, there has been recent growth articulating its role in dental education. This paper presents a case study of how social work has been implemented into one school of dentistry in the U.S. to address SDOH and offers a roadmap for integration of social work into dental education, including opportunities for interprofessional health care experiences related to SDOH.
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Affiliation(s)
- Jamie Burgess-Flowers
- Workman School of Dental Medicine, High Point University, High Point, North Carolina, USA
| | - Lisa de Saxe Zerden
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kelsey Yokovich
- Foundation for Health Leadership and Innovation, Cary, North Carolina, USA
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Saragosa M, Hahn-Goldberg S, Lunsky Y, Cameron JI, Caven I, Bookey-Bassett S, Newman K, Okrainec K. Young carers' perspectives on navigating the healthcare system and co-designing support for their caring roles: a mixed-methods qualitative study. BMJ Open 2023; 13:e075804. [PMID: 38072468 PMCID: PMC10729167 DOI: 10.1136/bmjopen-2023-075804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVES Despite young carers (YCs) providing regular and significant care that exceeds what would normally be associated with an adult caregiver, we need to learn more about their experience interacting with the healthcare system. The primary study aims were to (1) describe YC experiences in interacting with the healthcare system and (2) identify types of support YC recognise as potentially helpful to their caring role. DESIGN AND SETTING A mixed-methods qualitative study was conducted between March 2022 and August 2022, comprising two phases of (1) semi-structured interviews and focus groups with YCs living in the community to confirm and expand earlier research findings, and (2) a co-design workshop informed by a generative research approach. We used findings from the interviews and focus groups to inform the brainstorming process for identifying potential solutions. RESULTS Eight YCs completed either a focus group or an interview, and four continued the study and participated in the co-design activity with 12 participants. Phase 1 resulted in three overarching themes: (1) navigating the YC role within the healthcare system; (2) being kept out of the loop; and (3) normalising the transition into caregiving. Phase 2 identified two categories: (1) YC-focused supports and (2) raising awareness and building capacity in the healthcare system. CONCLUSION Study findings revealed the critical role that YCs play when supporting their families during pivotal interactions in the healthcare system. Like their older caregiver counterparts, YCs struggle to navigate, coordinate and advocate for their family members while juggling their needs as they transition from adolescence to adulthood. This study provides important preliminary insights into YCs encountering professionals, which can be used to design and implement national support structures.
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Affiliation(s)
- Marianne Saragosa
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Science of Care Institute, Sinai Health, Toronto, Ontario, Canada
| | - Shoshana Hahn-Goldberg
- OpenLab, University Hospital Network, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada
| | - Yona Lunsky
- Azrieli Adult Neurodevelopmental Centre, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Deptartment of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Isabelle Caven
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
| | - Susan Bookey-Bassett
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Kristine Newman
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Karen Okrainec
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- OpenLab, University Hospital Network, Toronto, Ontario, Canada
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Hu FY, Wang Y, Abbas M, Bollens-Lund E, Reich AJ, Lipsitz SR, Gray TF, Kim D, Ritchie C, Kelley AS, Cooper Z. Prevalence of unpaid caregiving, pain, and depression in older seriously ill patients undergoing elective surgery. J Am Geriatr Soc 2023; 71:2151-2162. [PMID: 36914427 PMCID: PMC10363213 DOI: 10.1111/jgs.18316] [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: 09/25/2022] [Revised: 01/22/2023] [Accepted: 02/07/2023] [Indexed: 03/14/2023]
Abstract
INTRODUCTION Serious illness is a life-limiting condition negatively impacting daily function, quality of life, or excessively straining caregivers. Over 1 million older seriously ill adults undergo major surgery annually, and national guidelines recommend that palliative care be available to all seriously ill patients. However, the palliative care needs of elective surgical patients are incompletely described. Understanding baseline caregiving needs and symptom burden among seriously ill older surgical patients could inform interventions to improve outcomes. METHODS Using Health and Retirement Study data (2008-2018) linked to Medicare claims, we identified patients ≥66 years who met an established serious illness definition from administrative data and underwent major elective surgery using Agency for Healthcare Research and Quality (AHRQ) criteria. Descriptive analyses were performed for preoperative patient characteristics, including: unpaid caregiving (no or yes); pain (none/mild or moderate/severe); and depression (no, CES-D < 3, or yes, CES-D ≥ 3). Multivariable regression was performed to examine the association between unpaid caregiving, pain, depression, and in-hospital outcomes, including hospital days (days admitted between discharge date and one-year post-discharge), in-hospital complications (no or yes), and discharge destination (home or non-home). RESULTS Of the 1343 patients, 55.0% were female and 81.6% were non-Hispanic White. Mean age was 78.0 (SD 6.8); 86.9% had ≥2 comorbidities. Before admission, 27.3% of patients received unpaid caregiving. Pre-admission pain and depression were 42.6% and 32.8%, respectively. Baseline depression was significantly associated with non-home discharge (OR 1.6, 95% CI 1.2-2.1, p = 0.003), while baseline pain and unpaid caregiving needs were not associated with in-hospital or post-acute outcomes in multivariable analysis. CONCLUSIONS Prior to elective surgery, older adults with serious illnesses have high unpaid caregiving needs and a prevalence of pain and depression. Baseline depression alone was associated with discharge destinations. These findings highlight opportunities for targeted palliative care interventions throughout the surgical encounter.
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Affiliation(s)
- Frances Y Hu
- Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
| | - Yihan Wang
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Muhammad Abbas
- Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, Massachusetts, USA
| | - Evan Bollens-Lund
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amanda J Reich
- Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, Massachusetts, USA
| | - Stuart R Lipsitz
- Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, Massachusetts, USA
| | - Tamryn F Gray
- Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute, Boston, Massachusetts, USA
- Department of Medicine, Brigham and Woman's Hospital, Boston, Massachusetts, USA
| | - Dae Kim
- Department of Medicine, Brigham and Woman's Hospital, Boston, Massachusetts, USA
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Christine Ritchie
- Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Amy S Kelley
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Zara Cooper
- Center for Surgery and Public Health, Brigham and Woman's Hospital, Boston, Massachusetts, USA
- Department of Surgery, Brigham and Woman's Hospital, Boston, Massachusetts, USA
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Tyagi S, Luo N, Tan CS, Tan KB, Tan BY, Menon E, Venketasubramanian N, Loh WC, Fan SH, Yang KLT, Swee Ling Chan A, Farwin A, Lukman ZB, Koh GCH. Qualitative study exploring heterogeneity in caregiving experiences post-stroke in Singapore. BMJ Open 2023; 13:e055988. [PMID: 36921949 PMCID: PMC10030476 DOI: 10.1136/bmjopen-2021-055988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Abstract
OBJECTIVE Stroke, a common illness in older adults, accounts for up to 4% of direct medical costs in developed nations. Informal caregiving contributing a significant proportion of economic burden post-stroke warrants a deeper understanding of the caregiving context to sustain caregiving arrangement. While literature exists describing differences in motivation and preferences of caregivers, limited literature explores differences in caregiving experiences of different types of caregivers (ie, spouse, adult-child, sibling or others). Addressing this gap, our study aimed to explore the caregiving experience of stroke survivors and their family caregivers across different caregiver identities in an Asian setting. DESIGN Qualitative descriptive study. SETTING Community setting. PARTICIPANTS We conducted semi-structured interviews with 26 stroke survivors and 35 caregivers purposively sampled from an outpatient rehabilitation setting, an outpatient clinic and a support organisation. Data were analysed using thematic analysis. OUTCOME MEASURES Themes including caregiving experience of stroke survivors and their family caregivers across different caregiver identities. RESULTS Following five themes were reported: caregiver reserve, coping strategies, caregiver burden, competing commitments and role of foreign domestic worker (FDW) in family caregiving. Spouse caregivers were less willing to ask for help, commonly adopted faith-based, and spacing or recharging types of coping, reported emotional strain and shared limited accounts of FDWs. Adult-child caregivers were more willing to ask for help, engaged in alternative care arrangements involving FDWs, commonly adopted action-focussed coping and reported multidimensional caregiver burden. CONCLUSION Our findings illustrated the heterogeneity in factors affecting caregiving experience across spouse and adult-child caregivers. Practical implications include conducting a needs assessment for caregiver-stroke survivor dyads and providing tailored support, training and information to help caregivers cope better.
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Affiliation(s)
- Shilpa Tyagi
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Kelvin Bryan Tan
- Policy Research & Evaluation Division, Ministry of Health Singapore, Singapore
| | | | - Edward Menon
- Medical Services, St. Andrew's Community Hospital, Singapore
| | | | - Wei Chin Loh
- Rehabilitation, St. Andrew's Community Hospital, Singapore
| | - Shu Hui Fan
- Rehabilitation, St. Andrew's Community Hospital, Singapore
| | | | | | - Aysha Farwin
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Zabeen S, Phua D, Mohammadi L, Lawn S. Family involvement to support cardiovascular self-management care for people with severe mental illness: a systematic review. J Ment Health 2023; 32:290-306. [PMID: 32924668 DOI: 10.1080/09638237.2020.1818194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Family members play a pivotal role in supporting cardiovascular self-management-based care of community-living adults with severe mental illness (SMI). However, little is known about what strategies caregivers employ as part of their caring roles. AIM This paper aims to explore what caregiving strategies work (or not), why and how by collating and synthesising existing evidence on this issue. METHODS A systematic search of peer-reviewed qualitative and mixed-method studies published between 2000 and 2019 was employed. This comprehensive process generated only nine papers for subsequent meta-synthesis of qualitative data. RESULTS Findings suggested that caregivers have a complex yet comprehensive role to play in initiating and perpetuating self-management-based cardiovascular care. The elements of recovery such as promoting hope, normality, autonomy and identity were flagged as critical underpinning factors that motivated the person with SMI to adopt a healthy lifestyle. However, it was evident that caregivers needed to walk alongside the person, at times, to help them reach their maximum potential in sustaining improved self-management behaviours. CONCLUSION Caregivers sit in a favourable bridging position between healthcare systems and community-living individuals with SMI, to support their cardiovascular health. However, this powerful but invisible 'workforce' clearly needs further support involving finance, skill-development and acknowledgement.
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Affiliation(s)
- Sara Zabeen
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Delphine Phua
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Leila Mohammadi
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
| | - Sharon Lawn
- College of Medicine and Public Health, Flinders University, Bedford Park, Australia
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Shoults CC, Rutherford MW, Kemp AS, Addicott MA, Brown A, Greene CJ, Hayes CJ, Gan JM, Larson-Prior LJ, Bona JP. Analysis of Caregiver Burden Expressed in Social Media Discussions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1933. [PMID: 36767297 PMCID: PMC9915402 DOI: 10.3390/ijerph20031933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
Almost 40% of US adults provide informal caregiving, yet research gaps remain around what burdens affect informal caregivers. This study uses a novel social media site, Reddit, to mine and better understand what online communities focus on as their caregiving burdens. These forums were accessed using an application programming interface, a machine learning classifier was developed to remove low information posts, and topic modeling was applied to the corpus. An expert panel summarized the forums' themes into ten categories. The largest theme extracted from Reddit's forums discussed the personal emotional toll of being a caregiver. This was followed by logistic issues while caregiving and caring for parents who have cancer. Smaller themes included approaches to end-of-life care, physical equipment needs when caregiving, and the use of wearables or technology to help monitor care recipients. The platform often discusses caregiving for parents which may reflect the age of Reddit's users. This study confirms that Reddit forums are used for caregivers to discuss the burdens associated with their role and the types of stress that can result from informal caregiving.
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Affiliation(s)
- Catherine C. Shoults
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Michael W. Rutherford
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Aaron S. Kemp
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Merideth A. Addicott
- Department of Physiology and Pharmacology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Aliza Brown
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Carolyn J. Greene
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Corey J. Hayes
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- VA HSR&D COIN Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System, Little Rock, AR 72205, USA
| | - Jennifer M. Gan
- Department of Medical Humanities and Bioethics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Linda J. Larson-Prior
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Department of Neurobiology and Developmental Sciences, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Jonathan P. Bona
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
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12
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Downer B, Li CY, Snih SA. Hospitalizations and Emergency Room Admissions by Mexican American Older Adults with and without Dementia and Caregiver Mental Health. J Alzheimers Dis 2023; 91:1185-1195. [PMID: 36565125 PMCID: PMC9946698 DOI: 10.3233/jad-220997] [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] [Indexed: 12/24/2022]
Abstract
BACKGROUND Evidence from predominately non-Hispanic White populations indicates that emergency room (ER) admissions and hospitalizations by older adults with and without dementia are associated with caregiver stress and depressive symptoms. These results may not generalize to Hispanic populations because of cultural differences in caregiving roles, responsibilities, and perspectives about care burden. OBJECTIVE Investigate the association between ER admissions and hospitalizations by Mexican American older adults with and without dementia and symptoms of depression and stress among family caregivers. METHODS Data came from the 2010/11 wave of the Hispanic Established Populations for the Epidemiologic Study of the Elderly and Medicare claims files. The final sample included 326 older adults and their caregivers. Negative binomial regression was used to model the association between hospitalizations and ER admissions by older adults in the previous two years and caregivers' depressive symptoms and stress in 2010/11. RESULTS The number of older adult ER admissions and hospitalizations was not associated with caregiver depressive symptoms. Two or more ER admissions (incident rate ratio [IRR] = 1.26, 95% CI = 1.05-1.51) and two or more hospitalizations (IRR = 1.32, 95% CI = 1.07-1.61) were associated with significantly higher caregiver stress. Additionally, ER admissions and hospitalizations for a circulatory disease or injury and poisoning were associated with significantly higher caregiver stress. These associations were not modified by the care recipient's dementia status. CONCLUSION Hospitalizations and ER admissions by older Mexican Americans were associated with greater caregiver stress but not depressive symptoms. These associations were similar for caregivers to older adults with and without dementia.
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Affiliation(s)
- Brian Downer
- Department of Population Health & Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Chih-Ying Li
- Department of Occupational Therapy, School of Health Professions, University of Texas Medical Branch, Galveston, TX, USA
| | - Soham Al Snih
- Department of Population Health & Health Disparities, School of Public and Population Health, University of Texas Medical Branch, Galveston, TX, USA
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
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13
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Leech AA, Lin PJ, D'Cruz B, Parsons SK, Lavelle TA. Family Spillover Effects: Are Economic Evaluations Misrepresenting the Value of Healthcare Interventions to Society? APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2023; 21:5-10. [PMID: 35997896 PMCID: PMC9839569 DOI: 10.1007/s40258-022-00755-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/03/2022] [Indexed: 06/15/2023]
Abstract
The societal impacts of health interventions are seldom incorporated into health economic evaluations, including the impact that illness can have on informal or unpaid caregivers and other family members (i.e., "family spillover effects"). Previous research has demonstrated that by excluding family spillover effects, the value of health interventions may be underestimated on average. In this commentary, we discuss how the inclusion of spillover effects influences how we value interventions and, given the extent to which caregiver/family effects are largely not captured or known, propose ways in which these data could be more systematically collected or estimated and used by researchers. These recommendations include prioritizing data collection alongside clinical trials and patient registries, engaging expert opinion panels, and developing mapping algorithms for estimating caregiver/family utility values from non-preference-based caregiver health-related quality-of-life measures and/or from patient preference-based measures.
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Affiliation(s)
- Ashley A Leech
- Department of Health Policy, Vanderbilt University School of Medicine, 2525 West End Avenue, Suite 1275-F, Nashville, TN, 37203, USA.
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
| | - Pei-Jung Lin
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Brittany D'Cruz
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Susan K Parsons
- Center for Health Solutions, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
- Division of Hematology/Oncology, Tufts Medical Center, Boston, MA, USA
| | - Tara A Lavelle
- Center for the Evaluation of Value and Risk in Health, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
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14
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Size and characteristics of family caregiving for people with serious illness: A population-based survey. Palliat Support Care 2022:1-10. [PMID: 35942630 DOI: 10.1017/s1478951522001079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Family caregivers play a vital role in care for people with serious illness. Reliable population-level information on family caregiving is scarce. We describe the socio-demographic and family caregiving characteristics and experiences of family caregivers of people with serious illness in the adult population. METHOD We performed a secondary analysis of the cross-sectional population-based 19th Social-Cultural Changes survey. A random sample of 2,581 Dutch-speaking people aged 18-95, living in Flanders or Brussels, were contacted for participation in the survey between March and July 2014 using a stratified two-step sample. Differences between groups are described using Pearson chi-square tests and analysis of variance. RESULTS Response rate was 58.7% (1,515/2,581). Over a 12-month period, 7.6% of respondents provided family care for someone with a serious illness (n = 114). They were most often aged 55-74 (36.0%), women (57.9%), worked full-time (42.3%); 31.8% provided at least 10 h of family care each week. Family caregivers of people with serious illness, compared with family caregivers of people with other conditions, provided more medical and nursing care (33.3% vs. 22.5%, p = 0.027), and experienced a higher burden of family caregiving (p = 0.038) but a similarly high meaningfulness of family caregiving. SIGNIFICANCE OF RESULTS A considerable part of the adult working population provides family care for someone with serious illness. While family caregiving for someone with serious illness shows similarities with family caregiving for people with other conditions in terms of caregiver characteristics and the impact of caregiving on work-life balance and the meaning derived from it, it is also associated with increased burden.
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15
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Crowley R, Atiq O, Hilden D. Long-Term Services and Supports for Older Adults: A Position Paper From the American College of Physicians. Ann Intern Med 2022; 175:1172-1174. [PMID: 35816710 DOI: 10.7326/m22-0864] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The number of Americans aged 65 years or older is expected to increase in the coming decades. Because the risk for disability increases with age, more persons will need long-term services and supports (LTSS) to help with bathing, eating, dressing, and other everyday tasks. Long-term services and supports are delivered in nursing homes, assisted living facilities, the person's home, and other settings. However, the LTSS sector faces several challenges, including keeping patients and staff safe during the COVID-19 pandemic, workforce shortages, quality problems, and fragmented coverage options. In this position paper, the American College of Physicians offers policy recommendations on LTSS coverage, financing, workforce, safety and quality, and emergency preparedness and calls on policymakers and other stakeholders to reform and improve the LTSS sector so that care is high quality, accessible, equitable, and affordable.
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Affiliation(s)
- Ryan Crowley
- American College of Physicians, Washington, DC (R.C.)
| | - Omar Atiq
- University of Arkansas for Medical Sciences, Little Rock, Arkansas (O.A.)
| | - David Hilden
- Hennepin Healthcare, Minneapolis, Minnesota (D.H.)
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16
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Aging in Place: Interprofessional Approaches to Empower Informal Caregivers. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.07.020] [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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17
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Feliciano A, Feliciano E, Palompon D, Gonzales F. Acceptance Theory of Family Caregiving. BELITUNG NURSING JOURNAL 2022; 8:86-92. [PMID: 37521897 PMCID: PMC10386812 DOI: 10.33546/bnj.2004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/20/2022] [Accepted: 02/12/2022] [Indexed: 08/01/2023] Open
Abstract
Acceptance of roles in the care of older adults by a family caregiver depends on factors emanating from commitment to familial relationships, widespread cultural expectation, and debt of gratitude. This study aims to develop a theory that explains the acceptance of the role of caregiving of the older adults by the family caregiver necessary to predict behavioral adaptation and control caring phenomenon that favors successful meeting of caring expectation across trajectory phases and transitions. A deductive axiomatic approach to theory generation was utilized, resulting in four axioms that served as bases for four propositions. Acceptance Theory of Family Caregiving implies that older adults who expect their children to take care of them as they age have cultural influence and that the acceptance of the role will determine the caregiver's acceptance of consequences in the form of physical, economical, psychological, and spiritual aspects. In terms of preparedness, family members who accept the possibility of the decline of their older adults are more likely to be assume caregiving roles efficaciously. In the process that family members face in this so-called trajectory caregiving process, resources play a significant role. The developed theory suggests that the care of the older adult in the family caregiving process is determined by the acceptance of role assumption by the family caregiver across trajectory phases. This study highlights the vital implication of acceptance of role assumption to the outcomes of the caregiving process with respect to older adult care, prevention of family caregiver burden, and establishment of strong familial and social relationships.
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Affiliation(s)
- Alfredo Feliciano
- College of Nursing, Angeles University Foundation, Angeles City, 2009, Philippines
- College of Nursing, Cebu Normal University, Cebu City, 6000, Philippines
| | - Evelyn Feliciano
- College of Nursing, Angeles University Foundation, Angeles City, 2009, Philippines
- College of Nursing, Cebu Normal University, Cebu City, 6000, Philippines
| | - Daisy Palompon
- College of Nursing, Cebu Normal University, Cebu City, 6000, Philippines
| | - Ferdinand Gonzales
- Medical-Surgical and Pediatric Nursing Department, College of Nursing, University of Hail, Saudi Arabia
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18
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Young HM, Bell JF, Tonkikh O, Kilaberia TR, Whitney RL, Mongoven JM, Link BM, Kelly K. Implementation of a state-wide online caregiver resource information system (CareNavTM): A mixed-methods study (Preprint). JMIR Form Res 2022; 6:e38735. [PMID: 35830234 PMCID: PMC9330201 DOI: 10.2196/38735] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 12/04/2022] Open
Abstract
Background With the aging population, family caregivers provide increasingly complex and intense care for older adults and persons with disabilities. There is growing interest in developing community-based services to support family caregivers. Caregiving occurs around the clock, and caregivers face challenges in accessing community-based services at convenient times owing to the demands of care. Web-based resources hold promise for accessible real-time support. CareNav (TM), a caregiver resource information system, is a web-based platform designed to support real-time universal caregiver assessment, a record of client encounters, development of a care plan, tailored information and resource content, access to web-based caregiver resources, the capacity to track service authorization and contracts, and secure communications. The assessment includes needs and health conditions of both the care recipient and caregiver; current resources; and priorities for support, information, and referral. In 2019, the California Department of Health Care Services funded the 11 nonprofit California Caregiver Resource Centers (CRCs) to expand and improve family caregiver services and enhance CRC information technology services. Deployment of a statewide information system offered a unique opportunity to examine structures and processes facilitating implementation, providing feedback to the sites as well as lessons learned for similar projects in the future. Objective The aim of this paper was to describe the statewide implementation of the comprehensive CareNav system using the Consolidated Framework for Implementation Research as an organizing structure for synthesizing the evaluation. Methods This mixed methods study used two major approaches to evaluate the implementation process: a survey of all staff who completed training (n=82) and in-depth qualitative interviews with 11 CRC teams and 3 key informants (n=35). We initially analyzed interview transcripts using qualitative descriptive methods and then identified subthemes and relationships among ideas, mapping the findings to the Consolidated Framework for Implementation Research. Results We present findings on the outer setting, inner setting, characteristics of the intervention, characteristics of the staff, and the implementation process. The critical elements for success were leadership, communication, harmonization of processes across sites, and motivation to serve clients in more accessible and convenient ways. Conclusions These findings have implications for technology deployment in diverse community-based agencies that aspire to enhance web-based services.
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Affiliation(s)
- Heather M Young
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Janice F Bell
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Orly Tonkikh
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Tina R Kilaberia
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Robin L Whitney
- The Valley Foundation School of Nursing, San Jose State University, San Jose, CA, United States
| | - Jennifer M Mongoven
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Benjamin M Link
- Family Caregiving Institute, Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, United States
| | - Kathleen Kelly
- Family Caregiver Alliance, San Francisco, CA, United States
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Danish Kirmani M. Socio-Environmental Considerations and Organic Food Consumption: An Empirical Investigation of the Attitude of Indian Consumers. Food Qual Prefer 2022. [DOI: 10.1016/j.foodqual.2022.104604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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20
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Parmar JK, L'Heureux T, Anderson S, Duggleby W, Pollard C, Poole L, Charles L, Sonnenberg LK, Leslie M, McGhan G, Huhn A, Sereda S, Marion C, Tarnowski G, Mah J, Melenberg D, Weir C, Pooler C, MacLachlan N, Bremault-Phillips S, Tian PGJ, Sacrey LAR. Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce. BMC Health Serv Res 2022; 22:364. [PMID: 35303870 PMCID: PMC8932680 DOI: 10.1186/s12913-022-07689-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Background While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory. Objective This paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce. Methods This foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers’ learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3). Results Participants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = − 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners’ knowledge and confidence. Conclusion Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-07689-w.
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Affiliation(s)
- Jasneet K Parmar
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada.,Home Living and Transitions, Alberta Health Services - Edmonton Zone Continuing Care, Strathcona Health Centre, 2 Brower Drive, Baseline Road, Sherwood Park, AB, T8H1V4, Canada
| | - Tanya L'Heureux
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada
| | - Sharon Anderson
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada. .,Department of Human Ecology, University of Alberta, 335 Human Ecology Building, 8905 - 116 St NW, Edmonton, Alberta, T6G 2N1, Canada.
| | - Wendy Duggleby
- Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, T6G 1C9, Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, RI 508, 3737 Wascana Parkway, Regina, Saskatchewan, S4S 0A2, Canada
| | - Lisa Poole
- Dementia Advocacy Canada, Calgary Dementia Network Strategic Council, Glencoe Club Dementia Advisory Group, Calgary, Canada
| | - Lesley Charles
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada.,Care of the Elderly, Glenrose Rehabilitation Hospital-East, 10230 111 Ave NW, Edmonton, AB, T5G 0B7, Canada
| | - Lyn K Sonnenberg
- Department of Family Medicine, Faculty of Medicine and Dentistry, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada.,Faculty of Rehabilitation Medicine, University of Alberta, 3-14 Corbett Hall, Edmonton, AB, T6G 2G4, Canada
| | - Myles Leslie
- School of Public Policy, University of Calgary, Calgary, 906 8th Avenue S.W. 5th Floor, Alberta, T2P 1H9, Canada.,Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, 3D10, 3280 Hospital Drive NW, Alberta, T2N 4Z6 , Canada
| | - Gwen McGhan
- Faculty of Nursing, University of Calgary, PF 3204, 2500 University Drive NW, Calgary, AB, T2N 1N4, Canada
| | - Arlene Huhn
- Client Services & Programs, Alzheimer Society of Alberta and Northwest Territories, Suite 306, 10430-61 Avenue, Edmonton, AB, T6H 2J3, Canada
| | - Sandy Sereda
- Caregivers Alberta, 12122 68 St NW, Edmonton, Alberta, T5B 1R1, Canada
| | - Cecilia Marion
- Youville Home, Covenant Health, 9A St Vital Ave, St. Albert, Alberta, T8N 1K1, Canada
| | - Glenda Tarnowski
- College of Licensed Practical Nurses of Alberta, St. Albert Trail Place, 13163-146 Street, Edmonton, AB, T5L 4S8, Canada
| | - Jennifer Mah
- Faculty of Health and Community Studies, Norquest College, Edmonton, Canada
| | - Denise Melenberg
- Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada
| | - Carolyn Weir
- Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada.,Mother Rosalie Health Service Centre, 16930 87 Ave, Edmonton, AB, T5R4H5, Canada
| | - Charlotte Pooler
- Faculty of Nursing, University of Alberta, 3-141 Edmonton Clinic Health Academy (ECHA), Edmonton, Alberta, T6G 1C9, Canada.,Palliative Care Programs/Education and Practice Development/Community Programs, Alberta Health Services, Edmonton, Canada
| | - Nora MacLachlan
- Health and Community Studies, Bow Valley College, Calgary, North Campus, Seventh Floor, 345 - 6 Avenue SE., Alberta, AB T2G 4S6, Canada
| | - Suzette Bremault-Phillips
- Faculty of Rehabilitation Medicine, University of Alberta, 3-14 Corbett Hall, Edmonton, AB, T6G 2G4, Canada
| | - Peter George J Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, 6-40 University Terrace, 8303 112 St NW, Edmonton, AB, T6G 2T4, Canada
| | - Lori-Ann R Sacrey
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Avenue, Edmonton, Alberta, T6G 1C9, Canada.,Autism Research Centre (E209), Glenrose Rehabilitation Hospital, 10230 - 111 Avenue, Edmonton, AB, T5G 0B7, Canada
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Carbery M, Schwartz S, Werner N, Fields B. Education and skills training for care partners of hospitalised older adults: A scoping review. HEALTH EDUCATION JOURNAL 2021; 80:921-933. [PMID: 37131526 PMCID: PMC10150946 DOI: 10.1177/00178969211034192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Background The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners' needs and begin at, or even before, the hospital admission of older adult patients.
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Affiliation(s)
- Madeline Carbery
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
| | - Samantha Schwartz
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
| | - Nicole Werner
- Department of Industrial and Systems Engineering, University of Wisconsin–Madison, WI, Madison, USA
| | - Beth Fields
- Department of Kinesiology, University of Wisconsin–Madison, Madison, WI, USA
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Tyagi S, Luo N, Tan CS, Tan KB, Tan BY, Menon E, Venketasubramanian N, Loh WC, Fan SH, Yang KLT, Chan ASL, Farwin A, Lukman ZB, Koh GCH. Seeking healthcare services post-stroke: a qualitative descriptive study exploring family caregiver and stroke survivor perspectives in an asian setting. BMC Neurol 2021; 21:429. [PMID: 34740323 PMCID: PMC8569985 DOI: 10.1186/s12883-021-02463-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 10/22/2021] [Indexed: 11/10/2022] Open
Abstract
Aim Exploration of the healthcare journey post-stroke is incomplete without acknowledging the crucial role of family caregivers. With limited literature documenting the role of caregivers in the healthcare journey post-stroke, we aimed to describe the healthcare experiences of family caregivers and stroke survivors across different caregiver identities in Singapore. Methods We conducted a qualitative descriptive study involving semi-structured interviews with transcripts analysed using thematic analysis. 26 stroke survivors and 35 family caregivers purposively sampled from multiple settings. Results Findings were summarized into seeking care and experience of healthcare encounters. Seeking care comprised of the following themes: factors influencing seeking care, decision to seek care and role of caregiver in seeking care. Experience of healthcare encounters comprised of the following themes: service around the patient, service with care and role of caregiver in healthcare encounters. Conclusion Multi-dimensional role of caregivers in healthcare experience emerged as a major finding. Unique to our Asian context, as per the participants’ accounts, family caregivers seemed to be central in healthcare decision-making for stroke survivors, with adult-child caregivers commonly reported being engaged in collaborative decision-making. While spousal caregivers preferred a relational healthcare experience, adult-child caregivers preferred a transactional one. Practical implications include equipping caregivers with skillset to make healthcare decisions, provision of supportive decision-making environment for caregivers and reinforcing communication aspects in the medical, nursing and allied healthcare curriculum to improve healthcare experience. Supplementary Information The online version contains supplementary material available at 10.1186/s12883-021-02463-7.
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Affiliation(s)
- Shilpa Tyagi
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Nan Luo
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Kelvin Bryan Tan
- Policy Research & Economics Office, Ministry of Health, Singapore, Singapore
| | | | - Edward Menon
- St. Andrew's Community Hospital, Singapore, Singapore
| | - N Venketasubramanian
- Raffles Neuroscience Centre, Raffles Hospital, Singapore, Singapore.,Singapore National Stroke Association, Singapore, Singapore
| | - Wei Chin Loh
- St. Andrew's Community Hospital, Singapore, Singapore
| | - Shu Hui Fan
- St. Andrew's Community Hospital, Singapore, Singapore
| | | | - Audrey Swee Ling Chan
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Aysha Farwin
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Zunairah Binti Lukman
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore
| | - Gerald Choon-Huat Koh
- Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore, Singapore.
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Cruz-Oliver DM, Abshire M, Budhathoki C, deCardi Hladek M, Volandes A, Jorgensen L, Oliver DP. Comparison of Traditional Videos With Telenovelas for Hospice Family Caregivers Education. Am J Hosp Palliat Care 2021; 38:1230-1237. [PMID: 33550835 PMCID: PMC9058977 DOI: 10.1177/1049909121991524] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND While research has shown that hospice family caregivers (HFCG) seek additional information related to patient care, pain and symptom management, and self-care, it is unknown how the use of telenovela videos for education in hospice would be received by HFCG. OBJECTIVE To explore HFCG perceived benefits and challenges with the use of telenovelas as compared to traditional educational videos during online support group. METHODS A mixed methods study with a concurrent triangulated design that analyzed qualitative interviews and YouTube analytics report to identify how viewers responded (number of views and their feedback) to telenovela videos as compared to traditional educational videos. RESULTS Among 39 (n = 39) HFCGs, most participants were female (80%) of White/Caucasian race, with more than high school education (85%) and they were adult children of hospice cancer patient (49%). Comparing HFCG that viewed traditional videos with HFCG that viewed telenovela videos, the telenovela video was watched more (12% longer viewing duration) and caregivers reported better content recall with informative benefits, more follow up actions and reflection about their own hospice experience. CONCLUSION Caregiver feedback indicated that watching the telenovela was engaging, acceptable and produced more conversations about patient care, than watching a non-telenovela format video. Further research is needed to test telenovela efficacy in enhancing HFCG outcomes.
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Affiliation(s)
- Dulce M. Cruz-Oliver
- Internal Medicine, Palliative Medicine Program, Johns Hopkins Hospital, Baltimore, MD, USA
| | - Martha Abshire
- Johns Hopkins University School of Nursing, Baltimore, MD, USA
| | | | | | - Angelo Volandes
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lucas Jorgensen
- Division of Palliative Medicine, Washington University, St. Louis, MO, USA
| | - Debra Parker Oliver
- Division of Palliative Medicine, Washington University, St. Louis, MO, USA
- Goldfarb School of Nursing, Barnes Jewish Hospital, Columbia, MO, USA
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Xu J, Liu PJ, Beach S. Multiple Caregivers, Many Minds: Family Discord and Caregiver Outcomes. THE GERONTOLOGIST 2021; 61:661-669. [PMID: 32539097 DOI: 10.1093/geront/gnaa067] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Family caregivers often have other family members helping to provide care. The purpose of our study was to examine relationships between care coordination quality among family members and the following caregiver outcomes: caregiver mental health (depressive symptoms, anxiety), social activity restrictions, and caregiver burden. RESEARCH DESIGN AND METHODS Secondary analysis was conducted using data from the 2017 Pittsburgh Regional Caregivers' Survey. Six hundred and fifty-five caregivers who had other family members helping with care reported discordance in care coordination, depressive symptoms, anxiety, social activity restrictions, caregiving burden, and covariates such as demographics and known risk factors for negative caregiver outcomes. We used multiple logistic regression and negative binominal expansion models in the analysis. RESULTS Discordant care coordination was associated with higher levels of caregiver depressive symptoms (p < .001), anxiety (p < .01), social activity restriction (p < .001), and caregiver burden (p < .001) after controlling for known risk factors. DISCUSSION AND IMPLICATIONS We found that lower quality of family care coordination was associated with negative caregiver outcomes. Future research should further investigate the dynamics of family care coordination and impacts on both caregivers and care recipients. The results suggest that caregiver interventions attempting to understand and decrease care coordination discord should be a priority.
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Affiliation(s)
- Jiayun Xu
- School of Nursing and Center on Aging and the Life Course, Purdue University, West Lafayette, Indiana
| | - Pi-Ju Liu
- Center for Families, Purdue University, West Lafayette, Indiana
| | - Scott Beach
- University Center for Social & Urban Research, University of Pittsburgh, Pennsylvania
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25
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The Development and Content Validation of the Care Partner Hospital Assessment Tool. NURSING REPORTS 2021; 11:522-529. [PMID: 34968327 PMCID: PMC8608130 DOI: 10.3390/nursrep11030049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 06/18/2021] [Accepted: 07/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background/Objectives: When aging adults are hospitalized due to a major health event, they often turn to care partners (‘family members or friends’) for support. Assessment of care partners’ needs during hospital care may be important to inform and target information and skills training that will equip them to fulfill caregiving tasks for the aging adults. The objectives of this study were to develop and complete content validation of the Care Partner Hospital Assessment Tool (CHAT). Methods: Based on standard instrumentation methodology and an assessment framework recommended by the National Center on Caregiving at the Family Caregiving Alliance, three steps were followed to develop and validate CHAT: (1) generation of a 24-item tool grouped into three content domains (background, plans and preferences, skills and supports), and a survey by a multidisciplinary team, (2) administration of an online survey of care partners and experts, and (3) assessment of item and scale-content validity indices (I-CVI and S-CVI). Results: A total of four care partners that provide unpaid care to a family member or friend age 65 years or older with a chronic illness or disability either before or after a hospitalization, and 19 leading experts in gerontology, caregiving, and health services completed an online survey in English. Twenty-two items were accepted by having an I-CVI at or above the acceptable 78% cut point; the S-CVI for the tool was 85%. Most revisions to the tool were associated with modifying or clarifying language within each item. For example, participants shared the following open-ended suggestions for revising CHAT: (1) change the “do you prefer” sentence stem to “do you want” (n = 12), define “training” (n = 6), and (2) allow care partners to provide an unsure response (n = 5). Conclusion: CHAT may be a promising way to increase health care practitioner’s understanding of care partners’ backgrounds, preferences and plans, and potential information or training needs during a patient’s hospital stay. Initial evaluation of CHAT reveals strong conceptual development and content validity.
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Foley KT, Luz CC. Retooling the Health Care Workforce for an Aging America: A Current Perspective. THE GERONTOLOGIST 2021; 61:487-496. [PMID: 33095881 DOI: 10.1093/geront/gnaa163] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Indexed: 11/14/2022] Open
Abstract
A 2008 Institute of Medicine (IoM) report outlined a vision for health care and a workforce capable of addressing health and extended care needs of our aging population. It highlighted dramatic shortages necessitating bold action and outlined recommendations aimed at building a sizable and qualified workforce. This study updates report findings and progress made on its recommendations. Through review of publicly accessible, internet-based literature and government and professional organization websites, current workforce data and recent policy changes are compared to the report's statistics and recommendations. Direct comparisons are limited by changing definitions, context, and data collection and analyses methods. Future workforce-need projections are estimated using reports from various sources. Inability to forecast medical advances, socioeconomic changes, and world events affects the accuracy of these projections. Nonetheless, clear conclusions emerge despite such limitations. Progress toward fulfilling the IoM goals is variable and insufficient. The current and projected numbers for all geriatric health providers remain inadequate compared to estimated 2030 demand. Challenges in meeting estimated needs persist essentially unchanged. The 2008 IoM framework and recommendations remain relevant and constitute an important roadmap to complete unfinished goals. Initial findings from this update provide a platform for developing practice and policy reforms.
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Affiliation(s)
- Kevin T Foley
- Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing
| | - Clare C Luz
- Department of Family and Community Medicine, College of Osteopathic Medicine, Michigan State University, East Lansing
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27
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Toles M, Colón-Emeric C, Hanson LC, Naylor M, Weinberger M, Covington J, Preisser JS. Transitional care from skilled nursing facilities to home: study protocol for a stepped wedge cluster randomized trial. Trials 2021; 22:120. [PMID: 33546737 PMCID: PMC7863858 DOI: 10.1186/s13063-021-05068-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/20/2021] [Indexed: 11/22/2022] Open
Abstract
Background Skilled nursing facility (SNF) patients are medically complex with multiple, advanced chronic conditions. They are dependent on caregivers and have experienced recent acute illnesses. Among SNF patients, the rate of mortality or acute care use is over 50% within 90 days of discharge, yet these patients and their caregivers often do not receive the quality of transitional care that prepares them to manage serious illnesses at home. Methods The study will test the efficacy of Connect-Home, a successfully piloted transitional care intervention targeting seriously ill SNF patients discharged to home and their caregivers. The study setting will be SNFs in North Carolina, USA, and, following discharge, in patients’ home. Using a stepped wedge cluster randomized trial design, six SNFs will transition at randomly assigned intervals from standard discharge planning to the Connect-Home intervention. The SNFs will contribute data for patients (N = 360) and their caregivers (N = 360), during both the standard discharge planning and Connect-Home time periods. Connect-Home is a two-step intervention: (a) SNF staff create an individualized Transition Plan of Care to manage the patient’s illness at home; and (b) a Connect-Home Activation RN visits the patient’s home to implement the written Transition Plan of Care. A key feature of the trial includes training of the SNF and Home Care Agency staff to complete the transition plan rather than using study interventionists. The primary outcomes will be patient preparedness for discharge and caregiver preparedness for caregiving role. With the proposed sample and using a two-sided test at the 5% significance level, we have 80% power to detect a 18% increase in the patient’s preparedness for discharge score. We will employ linear mixed models to compare observations between intervention and usual care periods to assess primary outcomes. Secondary outcomes include (a) patients’ quality of life, functional status, and days of acute care use and (b) caregivers’ burden and distress. Discussion Study results will determine the efficacy of an intervention using existing clinical staff to (a) improve transitional care for seriously ill SNF patients and their caregivers, (b) prevent avoidable days of acute care use in a population with persistent risks from chronic conditions, and (c) advance the science of transitional care within end-of-life and palliative care trajectories of SNF patients and their caregivers. While this study protocol was being implemented, the COVID-19 pandemic occurred and this protocol was revised to mitigate COVID-related risks of patients, their caregivers, SNF staff, and the study team. Thus, this paper includes additional material describing these modifications. Trial registration ClinicalTrials.gov NCT03810534. Registered on January 18, 2019.
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Affiliation(s)
- M Toles
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, USA.
| | - C Colón-Emeric
- School of Medicine and the Durham VA GRECC, Duke University, Durham, USA
| | - L C Hanson
- School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - M Naylor
- School of Nursing, University of Pennsylvania, Philadelphia, USA
| | - M Weinberger
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - J Covington
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - J S Preisser
- Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, USA
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Zhou Y, O'Hara A, Ishado E, Borson S, Sadak T. Developing a new behavioral framework for dementia care partner resilience (CP-R): A mixed research synthesis. THE GERONTOLOGIST 2020; 62:e265-e281. [PMID: 33367603 DOI: 10.1093/geront/gnaa218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caring for a person living with dementia requires resilience, the capacity to recover and grow from challenging situations. Despite the increasing interest in assessing and promoting resilience for dementia care partners, behaviors that indicate this attribute are not well known. The goal of this study is to synthesize the literature to identify resilience-related behaviors and develop a new framework for future validation and intervention research. RESEARCH DESIGN AND METHODS We searched English-language peer-reviewed articles (January 1991 - June 2019) reporting qualitative or quantitative descriptions of resilience-related behaviors among dementia care partners. Thematic analysis was used to categorize behaviors into domains, identify the relationships among them, and generate a thematic map. RESULTS Sixteen articles were identified according to predefined inclusion criteria. Four domains emerged: (1) problem-response behaviors (problem-solving, problem-distancing); (2) self-growth behaviors (self-care activities, spiritual-related activities, and developing and maintaining meaningful social relationships); (3) help-related behaviors (help-seeking and help-receiving), and (4) learning-related behaviors (learning from others and reflection). Definitions of each domain, identification of corresponding behaviors, and formulation of Care Partner Resilience (CP-R) behavioral framework were informed by this mixed research synthesis and other relevant literature. DISCUSSION AND IMPLICATIONS The CP-R framework emerged as a result of a new focus on identifying and cultivating strengths instead of evaluating strain and burden. It serves as a useful foundation for understanding the impact of specific behaviors on dementia care partner resilience. Once validated, this framework will inform the development of future measures, research, interventions, and policies for dementia care partners.
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Affiliation(s)
- Yuanjin Zhou
- School of Social Work, University of Washington, Seattle, Washington, USA
| | - Avery O'Hara
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Emily Ishado
- School of Nursing, University of Washington, Seattle, Washington, USA
| | - Soo Borson
- School of Medicine, University of Washington, Seattle, Washington, USA
| | - Tatiana Sadak
- School of Nursing, University of Washington, Seattle, Washington, USA
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Cruz-Oliver DM, Abshire M, Budhathoki C, Oliver DP, Volandes A, Smith TJ. Reflections of Hospice Staff Members About Educating Hospice Family Caregivers Through Telenovela. Am J Hosp Palliat Care 2020; 38:161-168. [PMID: 32638608 DOI: 10.1177/1049909120936169] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Hospice family caregivers are seeking additional information related to patient care, pain and symptom management, and self-care. This study interviewed hospice staff about the potential dissemination of bilingual telenovelas to address these caregiver needs. METHODS Qualitative structured phone interviews were conducted with 22 hospice professionals from 17 different hospice organizations in 3 different Midwest states. The interviews were conducted from October to December 2019. Hospice staff volunteers were recruited from conferences, then individual interviews were audio-recorded, transcribed, and thematic analysis was conducted to gain an in-depth understanding of how to best implement telenovela video education into hospice care. RESULTS Most participants were hospice nurses (36%) located primarily in Missouri (91%), with a mean of 9 years of experience. Three discrete themes emerged, the educational resources currently provided to patient/families, perceptions of the usefulness of telenovelas for education, and practical suggestions regarding the dissemination of telenovelas. The development of 4 telenovela videos covering different topics is described. CONCLUSION Hospice staff responded favorably to the concept of telenovelas and identified important keys for dissemination.
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Affiliation(s)
- Dulce M Cruz-Oliver
- Division of General Internal Medicine, Department of Medicine, Palliative Medicine Section, 1466Johns Hopkins Hospital, Baltimore, MD, USA
| | - Martha Abshire
- 15851Johns Hopkins School of Nursing, Baltimore, MD, USA
| | | | - Debra Parker Oliver
- Department of Family and Community Medicine, 14716University of Missouri, Medical Sciences Building, Columbia, MO, USA
| | - Angelo Volandes
- 273161Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Thomas J Smith
- Harry J. Duffey Family Professor of Palliative Medicine, JHMI, 1501Johns Hopkins Hospital, Baltimore, MD, USA
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30
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Spetz J, Periyakoil VS. Introduction to the Special Issue on the Workforce for Seriously Ill Older Adults in the Community. J Am Geriatr Soc 2020; 67:S390. [PMID: 31074848 DOI: 10.1111/jgs.15942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/01/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Joanne Spetz
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, California
| | - Vyjeyanthi S Periyakoil
- Department of Medicine/Primary Care and Population Health, Stanford University, Palo Alto, California
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31
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Gitlin LN. Whose Responsibility Is It? Balancing Individual, Family, and Societal Needs for Supporting Seriously Ill Older Adults. J Am Geriatr Soc 2019; 67:S457-S460. [PMID: 31074862 DOI: 10.1111/jgs.15819] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/23/2018] [Accepted: 01/13/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania
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