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Domeisen Benedetti F, Hechinger M, Fringer A. Self-Assessment Instruments for Supporting Family Caregivers: An Integrative Review. Healthcare (Basel) 2024; 12:1016. [PMID: 38786426 PMCID: PMC11120749 DOI: 10.3390/healthcare12101016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/21/2024] [Accepted: 04/30/2024] [Indexed: 05/25/2024] Open
Abstract
Family caregivers take on a variety of tasks when caring for relatives in need of care. Depending on the situation and the intensity of care, they may experience multidimensional burdens, such as physical, psychological, social, or financial stress. The aim of the present study was to identify and appraise self-assessment instruments (SAIs) that capture the dimensions of family caregivers' burdens and that support family caregivers in easily identifying their caregiving role, activities, burden, and needs. We performed an integrative review with a broad-based strategy. A literature search was conducted on PubMed, Google Scholar, Google, and mobile app stores in March 2020. After screening the records based on the eligibility criteria, we appraised the tools we found for their usefulness for family care and nursing practice. From a total of 2654 hits, 45 suitable SAIs from 274 records were identified and analyzed in this way. Finally, nine SAIs were identified and analyzed in detail based on further criteria such as their psychometric properties, advantages, and disadvantages. They are presented in multi-page vignettes with additional information for healthcare professionals. These SAIs have proven useful in assessing the dimensions of caregiver burden and can be recommended for application in family care and nursing practice.
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Affiliation(s)
- Franzisca Domeisen Benedetti
- School of Health Professions, Institute of Nursing, ZHAW—Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401 Winterthur, Switzerland (A.F.)
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Chien SC, Chang YH, Yen CM, Onthoni DD, Wu IC, Hsu CC, Chiou HY, Chung RH. Exploring concepts and trends in informal caregiver burden: systematic review using citation network and content analysis. Aging Clin Exp Res 2023; 35:2873-2885. [PMID: 37907665 DOI: 10.1007/s40520-023-02582-w] [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: 05/02/2023] [Accepted: 09/26/2023] [Indexed: 11/02/2023]
Abstract
BACKGROUND With the increase in the aging population, informal caregivers have become an essential pillar for the long-term care of older individuals. However, providing care can have a negative impact and increase the burden on caregivers, which is a cause for concern. OBJECTIVE This study aimed to comprehensively depict the concept of "informal caregiver burden" through bibliometric and content analyses. METHODS We searched the Web of Science (WoS) database to obtain bibliometric data and included only papers published between 2013 and 2022. We used content analysis to extract and identify the core concepts within the text systematically. RESULTS Altogether, 934 papers were included in the bibliometric analysis, from which we selected 19 highly impactful papers for content analysis. The results indicate that researchers have focused on exploring the factors that impact informal caregiver burden. Meanwhile, there has been a widespread discussion regarding the caregiver burden among those caring for recipients with specific illnesses, such as dementia, Alzheimer's disease, and cancer, as these illnesses can contribute to varying levels of burden on informal caregivers. In addition, questionnaires and interviews emerged as the predominant methods for data collection in the realm of informal caregiver research. Furthermore, we identified 26 distinct assessment tools specifically tailored for evaluating burden, such as caregiver strain index (CSI). CONCLUSION For future studies, we suggest considering the intersectionality of factors contributing to the burden on informal caregivers. This approach could enhance the well-being of both caregivers and older care recipients.
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Affiliation(s)
- Shuo-Chen Chien
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Yu-Hung Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chia-Ming Yen
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Djeane Debora Onthoni
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - I-Chien Wu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin County, 632, Taiwan
| | - Hung-Yi Chiou
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Ren-Hua Chung
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, 350, Taiwan.
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Fredriksen-Goldsen K, Shuman A, Jen S, Jung HH. Stress and Resilience among Sexual and Gender Diverse Caregivers. Res Aging 2023; 45:654-665. [PMID: 36772866 PMCID: PMC10415531 DOI: 10.1177/01640275231156191] [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: 02/12/2023]
Abstract
Little is known about caregiving outcomes of sexual and gender diverse, including LGBT, caregivers. Informed by the Health Equity Promotion Model (HEPM) and Pearlin's Stress Process Model, we utilized data from Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS), to examine perceived stress among a sample of 754 sexual and gender diverse caregivers using regressions on background and caregiving characteristics and risk and protective factors. Among caregivers, 38% were providing care to a spouse or partner and about one-third to a friend (29%). Higher stress was associated with younger age, lower income, higher education, partner/spouse care, personal care provision, longer caregiving hours, and caregiver cognitive impairment. After including the risk and protective factors from HEPM, victimization, social support, and community engagement significantly predicted perceived stress. Findings contribute to emergent research on caregiving in diverse populations.
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Affiliation(s)
| | - Abandon Shuman
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Sarah Jen
- School of Social Welfare, University of Kansas, Lawrence, KS, USA
| | - Hailey H Jung
- School of Social Work, University of Washington, Seattle, WA, USA
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Ikanga J, Reyes A, Zhao L, Hill-Jarrett TG, Hammers D, Epenge E, Esambo H, Kavugho I, Esselakoy C, Gikelekele G, Tshengele N, Alonso A, Robinson-Lane SG. Exploring factors contributing to caregiver burden in family caregivers of congolese adults with suspected dementia. Int J Geriatr Psychiatry 2023; 38:e6004. [PMID: 37712695 PMCID: PMC10901182 DOI: 10.1002/gps.6004] [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: 07/12/2022] [Accepted: 09/05/2023] [Indexed: 09/16/2023]
Abstract
INTRODUCTION Predicting caregiver burden in individuals with suspected dementia - is critical due to the debilitating nature of these disorders and need for caregiver support. While some examination of the factors affecting burden has been undertaken in Sub-Saharan Africa, each country presents with its own unique challenges and obstacles. This pilot study investigates predictors of caregiver burden in family caregivers of individuals with suspected dementia living in the Democratic Republic of the Congo (DRC). METHODS Linear and multiple regression analyses were conducted to explore factors associated with caregiver burden in 30 patient-caregiver dyads with the Zarit Burden Interview (ZBI) for caregiver burden evaluation. Cognitive impairments of patients were assessed using the Community Screening Instrument for Dementia, Alzheimer's Questionnaire (AQ), the African Neuropsychology Battery, and the Neuropsychiatric Symptoms Inventory (NPI). RESULTS Average caregiver burden on the ZBI was 36.1 (SD = 14.6; range = 12-58). Greater impairments in patient cognition (orientation, visuospatial, memory, executive functioning), fragility, and neuropsychiatric symptoms (delirium, agitation, depression) were predictive of caregiver burden. After controlling for AQ scores and caregiver gender, greater symptoms of depression, and worse performances on verbal memory and problem solving were associated with greater caregiver burden. CONCLUSION Worsening patient fragility, cognition, functioning, and neuropsychiatric symptoms influenced caregiver burden in caregivers of individuals with suspected cognitive impairment in the DRC. These findings are consistent with the prior literature. Future studies may wish to explore supportive factors and caregiver specific characteristics that buffer against perceived burden.
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Affiliation(s)
- Jean Ikanga
- Emory University School of Medicine, Department of Rehabilitation Medicine, Georgia, 1441 Clifton Rd NE, Atlanta, GA, 30322, USA
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Anny Reyes
- Emory University School of Medicine, Department of Rehabilitation Medicine, Georgia, 1441 Clifton Rd NE, Atlanta, GA, 30322, USA
| | - Liping Zhao
- Emory University, Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, 1518 Clifton Rd NE, Atlanta GA 30322, USA
| | - Tanisha G. Hill-Jarrett
- University of South Florida, Department of Neurosurgery and Brain Repair, Tampa, Florida, 33613, USA
- University of California, Global Brain Health Institute, San Francisco, California, 94158, USA
| | - Dustin Hammers
- Indiana university, department of neurology, Indiana, Indianapolis, IN 46202, USA
| | - Emmanuel Epenge
- University of Kinshasa, department of neurology, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Herve Esambo
- University of Kinshasa, department of neurology, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Immaculée Kavugho
- Memory Clinic of Kinshasa, BP 7463 Kinshasa, Democratic Republic of Congo
| | - Christian Esselakoy
- University of Montreal, Department of psychology, PO BOX 6128 Centre-ville STN Montreal QC H3C 3J, CANADA
| | - Guy Gikelekele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Nathan Tshengele
- University of Kinshasa and Catholic University of Congo, School of Medicine, Department of Psychiatry, Kinshasa, B.P. 7463 Kinshasa, Democratic Republic of Congo
| | - Alvaro Alonso
- Emory University, School of Public Health, department of epidemiology, Georgia, Atlanta, GA, 30307, USA
| | - Sheria G. Robinson-Lane
- University of Michigan, School of Nursing, Department of Systems, Populations, and Leadership, Ann Arbor, Michigan, 48109, USA
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Maximiano-Barreto MA, Alves LCDS, Monteiro DQ, Gratão ACM, Pavarini SCI, Luchesi BM, Chagas MHN. Cultural factors associated with burden in unpaid caregivers of older adults: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3629-e3642. [PMID: 36069278 DOI: 10.1111/hsc.14003] [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: 01/25/2022] [Revised: 07/21/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
The aim of the present systematic review was to investigate cultural factors associated with burden in unpaid caregivers of older adults. Searches were conducted in the Pubmed, Web of Science, PsycInfo, Scopus, Embase, LILACs and SciELO databases for relevant articles published in English, Portuguese and Spanish using the search terms 'Caregiver AND Culture AND (Burnout OR Caregiver Burden) AND Aged'. No restriction was imposed regarding year of publication. A total of 1234 articles were identified, 34 of which were selected for the present review. The following sociodemographic characteristics were associated with burden: being female, married, White caregivers, young and the spouse of the care recipient; having no siblings; having low schooling and low economic status. Cultural factors associated with burden were living with the care recipient, not professing a religion or having little spirituality, familism (i.e. less reciprocity) and an absence of social support. The present findings underscore the importance of developing intervention strategies that consider cultural factors to minimise the negative impacts of care on unpaid caregivers of older adults.
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Affiliation(s)
| | | | | | - Aline Cristina Martins Gratão
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Sofia Cristina Iost Pavarini
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bruna Moretti Luchesi
- Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marcos Hortes Nisihara Chagas
- Psychology Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Bairral Institute of Psychiatry, Itapira, SP, Brazil
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Cerquera Córdoba AM, Dugarte Peña E, Tiga Loza DC, Plata Osma LJ, Castellanos Suárez L, Álvarez Anaya WA. Factores que influyen en la sobrecarga de cuidadores informales de pacientes con Trastorno Neurocognitivo debido a enfermedad de Alzheimer. UNIVERSITAS PSYCHOLOGICA 2022. [DOI: 10.11144/javeriana.upsy20.fisc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
La sobrecarga es uno de los fenómenos presentados en los cuidadores de pacientes con Alzheimer. El objetivo de esta investigación fue identificar los factores que influyen en la sobrecarga de cuidadores informales de pacientes con Alzheimer, partícipes de un programa de intervención en Bucaramanga, Santander, Colombia. El estudio fue transversal anidado en un ensayo controlado aleatorizado con 3 grupos en paralelo, y con una muestra a conveniencia de 58 cuidadores. Adicionalmente, se aplicó la escala de carga del cuidador de Zarit y una entrevista estructurada, al igual que se utilizó un modelo de efectos mixtos con varianza no estructurada. Se encontró que la edad media fue de 55.6 años (79.3 %), mujeres e hijos (70.7 %), un bajo uso de redes de apoyo (8.6 %) y una mediana de dedicación al cuidado de 24 horas/día. Como factores asociados a la sobrecarga, por cada año del cuidador, la sobrecarga disminuye 0.5 puntos (p = 0.005), así como se encuentra con más sobrecarga a los cuidadores cuyos pacientes tienen una mayor afectación del comportamiento (p = 0.003), los cuidadores que tienen otro empleo (p = 0.025) y la falta de apoyo brindado por otros familiares (p = 0.014). Estos resultados permiten caracterizar a familiares cuidadores en quienes se requiere una intervención multidisciplinaria.
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Spatuzzi R, Vespa A, Fabbietti P, Ricciuti M, Rosati G, Guariniello L, Verrastro MAF, Attademo L, Giulietti MV. Elderly Helping Other Elderly: A Comparative Study of Family Caregiver Burden Between Patients With Dementia or Cancer at the End of Life. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2022; 18:96-108. [PMID: 35245165 DOI: 10.1080/15524256.2022.2042459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
A new reality is being observed around the world as the population ages: family caregivers, who are themselves older adults helping their ill older relatives. The aim of this study is to assess the burden of the older family caregiver assisting older patients in his or her end-of-life who are suffering from dementia or cancer. In this context, the elderly person is involved in the dual role of patient and caregiver. In this comparative study, a total of 87 older family caregivers (age ≥ 65 years) completed the Caregiver Burden Inventory (CBI) measurement. The sample was divided into 2 subgroups based on the individuals' advanced disease: Alzheimer's disease (AD) or cancer. Compared to cancer caregivers, the AD subgroup reported significantly higher scores in the CBI-emotional subscale (P = 0.006), confirmed by the evaluation of the generalized linear model (multivariate). There were no significant differences in the other CBI subscales and overall scores. According to the findings of this study, elderly who help elderly with AD are at a higher risk of experiencing an emotional burden than cancer caregivers. This data could be considered in designing interventions to reduce the caregiver burden of older family caregivers as they provide informal end-of-life care.
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Affiliation(s)
- Roberta Spatuzzi
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | - Anna Vespa
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | - Paolo Fabbietti
- Biostatistical Center, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
| | | | - Gerardo Rosati
- Medical Oncology Unit, "San Carlo" Hospital, Potenza, Italy
| | - Lorella Guariniello
- UOSD CSM Vulture-Melfese, Department of Mental Health, ASP Basilicata, Potenza, Italy
| | | | - Luigi Attademo
- Department of Mental Health, Hospital Psychiatric Service of Diagnosis and Care at "San Carlo" Hospital, ASP Basilicata, Italian NHS, Italy
| | - Maria Velia Giulietti
- Clinic of Internal Medicine and Geriatrics, Scientific and Technological Area, INRCA-IRCCS National Institute of Health and Science on Aging, Ancona, Italy
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Rojas-Ocaña MJ, Araujo-Hernández M, Romero-Castillo R, García Navarro EB. Educational interventions by nurses in caregivers with their elderly patients at home. Prim Health Care Res Dev 2021; 22:e26. [PMID: 34092277 PMCID: PMC8220347 DOI: 10.1017/s1463423621000086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 12/10/2020] [Accepted: 01/25/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION The home is the natural setting for the development of informal care. The work that nurses are required to develop in this context (the carer/the elderly dependent/the home) focuses on training and educational activities to assist these two groups, such as demonstrating care activities to help dependent seniors, instruction in self-care techniques and teaching strategies for the use of human and material resources. AIMS This article analyzes care education interventions performed by nurses, and the factors that facilitate, or limit, health care training. METHODOLOGICAL APPROACH This is a qualitative, descriptive study designed to be flexible and openly analytical in its approach to the research problem and the dynamic nature of the home environment. Triangulation of the methodological techniques and study subjects was applied. RESULTS Nursing interventions related to professional attitudes, such as encouraging communication and facilitating teaching; communication interventions in health education and counseling; and technical interventions aimed at improving access to health information and support for the informal carer. Lack of will, the advanced age of the carer, emotional state and work overload are factors that undermine care instruction, which if reversed, would become learning facilitators. The lack of time and resources in the home are the major limiting factors on care teaching, according to nurses. Evidence from our study suggests that care in the home is considered a key primary health care strategy, one in which nurses play a significant role.
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Becoming an older caregiver: A study of gender differences in family caregiving at the end of life. Palliat Support Care 2021; 20:38-44. [PMID: 33736742 DOI: 10.1017/s1478951521000274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Older people are not traditionally expected to become caregivers. For this reason, the experience of caregiving in older persons has not been explored adequately in the research on gender differences. The objective of this study was to assess the caregiver burden among older family members who care for cancer patients facing the end of their lives, in order to compare their differences according to gender (male vs. female). METHODS This is a cross-sectional study. A total of 102 older caregivers (aged ≥65 years) of hospice patients were interviewed through the Caregiver Burden Inventory (CBI). The sample group was divided into two gender subgroups. RESULTS Compared with male caregivers, the older female group reported significantly higher scores in the CBI-physical subscale (P = 0.028), and in the CBI, the overall score (P = 0.0399) confirmed by the generalized linear model (multivariate) evaluation that included possible predictors in the model. There were no significant differences in the other CBI subscale scores (time-dependent, developmental, social, and emotional). SIGNIFICANCE OF RESULTS Older female caregivers are at higher risk of experiencing burden and worse physical health compared with men. Further research is needed in modern palliative care to assess the role of gender differences in the experience of caregiving when the caregiver is an older person.
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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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Santini S, Socci M, D’Amen B, Di Rosa M, Casu G, Hlebec V, Lewis F, Leu A, Hoefman R, Brolin R, Magnusson L, Hanson E. Positive and Negative Impacts of Caring among Adolescents Caring for Grandparents. Results from an Online Survey in Six European Countries and Implications for Future Research, Policy and Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E6593. [PMID: 32927827 PMCID: PMC7559354 DOI: 10.3390/ijerph17186593] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/28/2020] [Accepted: 09/08/2020] [Indexed: 01/03/2023]
Abstract
Although up to 8% of European youngsters carry out high-intensity care for a family member, adolescent young carers (AYCs), especially those caring for their grandparents (GrPs), remain an under-researched group. This study aimed at addressing the current knowledge gap by carrying out an online survey in Italy, the Netherlands, Slovenia, Sweden, Switzerland, and the United Kingdom. The analysis included a final sample of 817 AYCs aged 15-17 years old. AYCs of grandparents (GrPs) were compared to AYCs of other care recipients (OCRs), in order to identify any difference in positive and negative caregiving outcomes and exposure factors between the two groups. Linear or logistic regression models were built, and multivariate analyses were repeated, including a fixed effect on the country variable. AYCs of GrPs experienced more positive caregiving outcomes than AYCs of OCRs across all six countries. Being female or non-binary, and having a migration background, were associated with more negative outcomes, regardless of the relationship with the care recipient. Further research on intergenerational caregiving outcomes is recommended for shaping measures and policies, which preserve the intergenerational emotional bonds, whilst protecting AYCs from inappropriate responsibilities, undermining their mental health and well-being.
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Affiliation(s)
- Sara Santini
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (B.D.)
| | - Marco Socci
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (B.D.)
| | - Barbara D’Amen
- Centre for Socio-Economic Research on Aging, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy; (S.S.); (B.D.)
| | - Mirko Di Rosa
- Unit of Geriatric Pharmacoepidemiology and Biostatistics, IRCCS INRCA-National Institute of Health and Science on Aging, Via Santa Margherita 5, 60124 Ancona, Italy;
| | - Giulia Casu
- Department of Psychology, University of Bologna, viale Berti Pichat 5, 40127 Bologna, Italy;
| | - Valentina Hlebec
- Faculty of Social Sciences, University of Ljubljana, Kardeljeva pl. 5, 1000 Ljubljana, Slovenia;
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena pot. 5, 1000 Ljubljana, Slovenia
| | - Feylyn Lewis
- School of Education and Social Work, University of Sussex, Essex House 121, Brighton BN1 9QQ, UK;
| | - Agnes Leu
- Careum School of Health, University of Applied Sciences, Pestalozzistrasse 3, 8032 Zürich, Switzerland;
- Medical Faculty, Institute of Biomedical Ethics, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Renske Hoefman
- The Netherlands Institute for Social Research (SCP), Postbus 16164, 2500 BD De Hague, The Netherlands;
| | - Rosita Brolin
- Department Health and Caring Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (R.B.); (L.M.); (E.H.)
- The Swedish Family Care Competence Centre, Strömgatan 13, SE-39232 Kalmar, Sweden
| | - Lennart Magnusson
- Department Health and Caring Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (R.B.); (L.M.); (E.H.)
- The Swedish Family Care Competence Centre, Strömgatan 13, SE-39232 Kalmar, Sweden
| | - Elizabeth Hanson
- Department Health and Caring Sciences, Linnaeus University, SE-39182 Kalmar, Sweden; (R.B.); (L.M.); (E.H.)
- The Swedish Family Care Competence Centre, Strömgatan 13, SE-39232 Kalmar, Sweden
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Pérez-Cruz M, Parra-Anguita L, López-Martínez C, Moreno-Cámara S, Del-Pino-Casado R. Burden and Anxiety in Family Caregivers in the Hospital That Debut in Caregiving. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203977. [PMID: 31635233 PMCID: PMC6843602 DOI: 10.3390/ijerph16203977] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 10/04/2019] [Accepted: 10/16/2019] [Indexed: 11/22/2022]
Abstract
This cross-sectional study aims to determine the level of subjective burden and anxiety of caregivers of dependent older relatives that start providing care in the hospital and to analyse the relationship between objective burden, subjective burden and anxiety in these caregivers. Seventy-two caregivers of dependent older relatives were recruited in a medium–long stay hospital. Sociodemographic variables, number of basic activities of daily living (ADLs) attended, hours of surveillance, burden, and anxiety were collected from caregivers. A trajectory analysis was used to analyse the relationship between variables. Of the caregivers, 36.1% had subjective burden and 14.9% had anxiety. Subjective burden was positively associated with the number of basic ADLs attended, the hours of surveillance, and the cognitive impairment of the care recipient. Anxiety was also positively associated with subjective burden. Subjective burden mediated the effects of the number of basic ADLs attended, hours of surveillance and the cognitive impairment of the care recipient on anxiety. The levels of subjective burden and anxiety in caregivers debuting in hospital care are elevated, showing the need for these caregivers to be cared for. Subjective burden is a possible risk factor for anxiety, independent of the objective burden; it may buffer the effects of objective burden on anxiety.
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Affiliation(s)
| | - Laura Parra-Anguita
- Department of Nursing, School of Health Sciences, University of Jaén, 23071 Jaén, Spain.
| | | | - Sara Moreno-Cámara
- Department of Nursing, School of Health Sciences, University of Jaén, 23071 Jaén, Spain.
| | - Rafael Del-Pino-Casado
- Department of Nursing, School of Health Sciences, University of Jaén, 23071 Jaén, Spain.
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Physical Strength Perception of Older Caregivers in Rural Areas. ACTA ACUST UNITED AC 2019; 55:medicina55100692. [PMID: 31623256 PMCID: PMC6843900 DOI: 10.3390/medicina55100692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 10/02/2019] [Accepted: 10/14/2019] [Indexed: 01/19/2023]
Abstract
Background and objective: In an aging population, it is increasingly common for older adults to take care of other older adults. Caregiving tasks may be conditioned by the aging process. This study aims to analyze the perceived physical strength of older caregivers and its impact on the functional capacity to engage in caregiving activities. Methods: A discretionary sampling of caregivers (N = 107), ≥65 years old, in the rural health area of Badajoz (Spain) participated in this cross-sectional study. Measurements included questions about the caregiver’s role (experience, years, hours, difficulties, demands) and their perceived physical strength, ability to perform activities of daily living (ADL), need for help or difficulty for caring. Results: Older caregivers from rural areas perceived a lack of physical strength (71%). These caregivers need more help, have more difficulties, and show less ability to perform ADL. Furthermore, around 80% of the people who had a lack of strength were caring for people with severe or total dependence. There is a direct correlation between the perceived lack of physical strength and the ability to perform basic (r = 0.382, p < 0.01) and instrumental (r = 0.370, p < 0.01) activities. Conclusions: Therefore, the perception of strength and the characteristics of the cared for person may be crucial variables to successfully conduct caregiving tasks.
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14
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López-Martínez C, Serrano-Ortega N, Moreno-Cámara S, Del-Pino-Casado R. Association between Sense of Coherence Associated with Mental Health in Caregivers of Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203800. [PMID: 31601018 PMCID: PMC6843852 DOI: 10.3390/ijerph16203800] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 09/30/2019] [Accepted: 10/04/2019] [Indexed: 12/14/2022]
Abstract
The purpose of this study was to analyze association between sense of coherence and perceived burden, anxiety, depression, and quality of life in caregivers of older adults. A cross-sectional study was carried out with a probabilistic sample of 132 caregivers of older relatives from the regions of Jaén, Spain. The measures assessed were sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index of Robinson), anxiety and depression (Goldberg Scale), and quality of life (Health Questionnaire SF-12). The main analyses included bivariate analysis using Pearson’s correlation coefficient and multivariate analysis through canonical correlation analysis. Our findings show that the sense of coherence explained 50.8% of the variance shared between subjective burden, anxiety, depression, and quality of life. We highlighted manageability as the variable within the dimensions of the sense of coherence with the greatest participation in the model. The sense of coherence may be an important protective factor for the mental health of the caregiver of dependent elderly relatives.
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Affiliation(s)
| | | | - Sara Moreno-Cámara
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jáen, Spain.
| | - Rafael Del-Pino-Casado
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jáen, Spain.
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15
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Crist JD, Liu J, Shea KD, Peterson RL, Martin-Plank L, Lacasse CL, May JT, Wyles CL, Williams DK, Slebodnik M, Heasley BJ, Phillips LR. "Tipping point" concept analysis in the family caregiving context. Nurs Forum 2019; 54:582-592. [PMID: 31373002 DOI: 10.1111/nuf.12373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
AIM Analyze the concept "tipping point" in the older adult family caregiving context to further knowledge about caregiving families, enhancing transdisciplinary theory, research, and practice. BACKGROUND While used commonly in some disciplines, how "tipping point" has been used in health care, generally, and in relation to caregiving families, specifically, is less clear. This project was conducted to offer conceptual clarity to tipping point. DESIGN Walker and Avant's framework. DATA SOURCE Searches of scholarly literature in PsycINFO, CINAHL, and PubMed using the search term "tipping point" in either title or abstract. REVIEW METHODS Definitions used were extracted; instances when the concept was implied but the actual term "tipping point" was not used and contexts where the term was used or implied were identified. RESULTS The composite definition of a caregiving tipping point is a seemingly abrupt, severe, and absolute change event involving either the older adult or caregiver(s), or both that indicates a breakdown in the status quo of the caregiving system. CONCLUSIONS Transdisciplinary research, care, and policy should treat caregiving families as complex systems, use longitudinal assessments, and include colloquial communication. Early detection of impending tipping points will provide family-centered decisional support and enhance families' quality of life and safety.
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Affiliation(s)
- Janice D Crist
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Jian Liu
- Department of Systems and Industrial Engineering, The University of Arizona, Tucson, Arizona
| | - Kim D Shea
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Rachel L Peterson
- College of Medicine, University of Arizona Center on Aging, The University of Arizona, Tucson, Arizona
| | - Lori Martin-Plank
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Cheryl L Lacasse
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Jennifer T May
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Christina L Wyles
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Deborah K Williams
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Maribeth Slebodnik
- Arizona Health Sciences Library, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Beverly J Heasley
- Community and Systems Health Science Division, College of Nursing, The University of Arizona, Tucson, Arizona
| | - Linda R Phillips
- College of Medicine, University of Arizona Center on Aging, The University of Arizona, Tucson, Arizona
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16
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Blanco V, Guisande MA, Sánchez MT, Otero P, López L, Vázquez FL. [Caregiver burden and associated factors in family caregivers in the Community of Galicia, Spain]. Rev Esp Geriatr Gerontol 2019; 54:19-26. [PMID: 30646994 DOI: 10.1016/j.regg.2018.03.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 01/12/2018] [Accepted: 03/09/2018] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Most of existing work on burden among family caregivers has methodological sample constraints. Moreover, there is contradictory information regarding sociodemographic variables, especially those related to care, clinical variables, and burden. Few studies have analysed the self-esteem and personality characteristics as correlates of burden. In this study, an analysis is performed on the prevalence of burden among family caregivers and the relationship with their sociodemographic, care-related, and clinical characteristics. MATERIALS AND METHODS The study consisted of a randomly selected sample of 294 family caregivers (mean age 55.3years, 89.8% women) from the Autonomous Region of Galicia, Spain. Trained psychologists assessed the presence of burden via the Zarit Caregiver Burden Interview (CBI). Information was also collected on sociodemographic, care-related variables, social support, personality characteristics, and self-esteem. RESULTS More than half (55.4%) of the surveyed caregivers exhibited burden (CBI>24), with mean score of 27.3 (SD=13.3). Not being employed outside the home and having higher scores in neuroticism were associated with a greater probability of presenting with burden, while being older and having higher social support were associated with a lower risk. CONCLUSIONS A significant number of caregivers suffered from burden in the current study. Psychotherapeutic interventions need to be developed for those who are already suffering from burden, as well as prevention strategies for those who have not yet developed it.
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Affiliation(s)
- Vanessa Blanco
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España.
| | - María Adelina Guisande
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - María Teresa Sánchez
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Patricia Otero
- Departamento de Psicología, Universidad de A Coruña, A Coruña, España
| | - Lara López
- Departamento de Psicología Clínica y Psicobiología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
| | - Fernando Lino Vázquez
- Departamento de Psicología Clínica y Psicobiología, Universidad de Santiago de Compostela, Santiago de Compostela, A Coruña, España
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17
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del-Pino-Casado R, López-Martínez C, Serrano-Ortega N, Pastor-Bravo MDM, Parra-Anguita L. Obligation and negative consequences in primary caregivers of dependent older relatives. PLoS One 2018; 13:e0203790. [PMID: 30192898 PMCID: PMC6128659 DOI: 10.1371/journal.pone.0203790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 08/27/2018] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to analyse the multidimensional nature of obligation and the relations between each dimension of obligation and both anxiety and depression. A secondary analysis of data from two cross-sectional studies of primary home caregivers (N = 400; probabilistic sample) of older adult relatives in Spain was conducted. Data regarding obligation (four categories basing on beliefs of obligation and social pressure: low pressure and low beliefs, low pressure and high beliefs, high pressure and low beliefs and high pressure and high beliefs), stressors, anxiety and depression were collected by interview in 2013. The combination of high pressure and low beliefs had the highest levels of anxiety and depression, and the combination of low pressure and high beliefs had the lowest levels of anxiety and depression. When the relation of behavioural problems with anxiety and depression stratified by the previous four categories of obligation was analysed, behavioural problems were associated with anxiety and depression in the subgroups with low beliefs of obligation, whereas this association disappeared in the subgroups with high beliefs of obligation.
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Affiliation(s)
| | | | | | - Maria del Mar Pastor-Bravo
- School of Nursing, Department of Nursing, University of Murcia, Cartagena, Spain
- IMIB-Arrixaca, Murcia, Spain
- * E-mail:
| | - Laura Parra-Anguita
- School of Health Sciences, Department of Nursing, University of Jaén, Jaén, Spain
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18
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Behm L, Björkman E, Ahlström G. Mental health and reactions to caregiving among next of kin of older people (65+) with multi-morbidity discharged home after hospitalization. Scand J Caring Sci 2018; 32:1458-1467. [PMID: 30092125 DOI: 10.1111/scs.12592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 05/29/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Older people with multi-morbidity are major users of healthcare and are often discharged from hospital with ongoing care needs. This care is frequently provided by informal caregivers and the time immediately after discharge is challenging for caregivers with new and/or additional tasks, resulting in anxiety and stress. AIM This study aimed to describe mental health, with particular reference to anxiety and depression and reactions to caregiving, and to investigate any associations between the two, in next of kin of older people with multi-morbidity after hospitalisation. It also aimed to explore the association between the demographic characteristics of the study group and mental health and reactions to caregiving. METHODS This was a cross-sectional questionnaire study using the Hospital Anxiety and Depression Scale and the Caregiver Reaction Assessment. The study group consisted of 345 next of kin of older people (65+) with multi-morbidity discharged home from 13 medical wards in Sweden. Data were analysed using descriptive and analytical statistics. To identify whether reactions to caregiving and next of kin characteristics were associated with anxiety and depression, a univariate logistic regression analysis was performed. RESULTS More than one quarter of respondents showed severe anxiety and nearly one in 10 had severe depressive symptoms. The frequencies of anxiety and depression increased significantly with increased negative reactions to caregiving and decreased significantly with positive reactions to caregiving. Regarding caregiving reactions, the scores were highest for the positive domain Caregiver esteem, followed by the negative domain Impact on health. Women scored significantly higher than men on Impact on health and spouses scored highest for Impact on schedule and Caregiver esteem. CONCLUSIONS Nurses and other healthcare professionals may need to provide additional support to informal caregivers before and after discharging older people with significant care needs from hospital. This might include person-centred information, education and training.
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Affiliation(s)
- Lina Behm
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Eva Björkman
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Gerd Ahlström
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
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19
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López-Cerdá E, Carmona-Torres JM, Rodríguez-Borrego MA. Social support for elderly people over 65 years in Spain. Int Nurs Rev 2018; 66:104-111. [PMID: 30010194 DOI: 10.1111/inr.12468] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
AIMS To determine what social support is available in Spain to people over 65 who also dedicate hours of their time to the care of others who are older. BACKGROUND Demographic and social changes are leading to growth of the population. The social support available to older people in the final stage of life affects their health. METHODS A cross-sectional study was conducted involving the records of older, non-institutionalized individuals residing in Spain, obtained from the European Health Survey of 2014. The method of collecting information used in the European Survey was personal interviews assisted by a computer. RESULTS The records of 6520 older people were studied; 40.1% of the participants studied had expressed the possibility of having three to five people available in case of a serious problem, and 83.6% reported that the rest of the people around them were very interested in what happens to them. With respect to care, only 7% of the older people studied mentioned performing care tasks. CONCLUSIONS Social support is beneficial to older people, regardless of whether they perform care tasks, because it acts as a protective factor against problems such as loneliness, stress and depression. The profile of a primary caregiver in this age range is a married, middle-class woman with primary schooling who is caring for a first-degree relative. IMPLICATIONS FOR NURSING AND HEALTH POLICY These data suggest that it is necessary for nurses to know about the needs of older people to implement societal measures of health promotion, prevention and education that favour social cohort. In addition, health policymakers should establish programmes that improve the social support of non-institutionalized older people.
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Affiliation(s)
- E López-Cerdá
- Universidad de Córdoba (UCO).,Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC).,Hospital Universitario Reina Sofía de Córdoba (HURS)
| | - J M Carmona-Torres
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC).,Universidad de Castilla la Mancha (UCLM), E.U. Enfermería y Fisioterapia de Toledo
| | - M A Rodríguez-Borrego
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC).,Hospital Universitario Reina Sofía de Córdoba (HURS).,Facultad de Medicina y Enfermería, Universidad de Córdoba (UCO)
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20
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Juntunen K, Salminen AL, Törmäkangas T, Tillman P, Leinonen K, Nikander R. Perceived burden among spouse, adult child, and parent caregivers. J Adv Nurs 2018; 74:2340-2350. [PMID: 29869807 DOI: 10.1111/jan.13733] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/22/2018] [Accepted: 03/26/2018] [Indexed: 01/14/2023]
Abstract
AIMS To identify what factors are associated with the caregiver burden of spouse caregivers, adult child caregivers, and parent caregivers. BACKGROUND Caregivers often feel stressed and perceive caregiving as a burden. The caregiver burden has been little studied from the perspective of the personal relationship between caregiver and care recipient. DESIGN Cross-sectional study. METHODS A random sample of 4,000 caregivers in Finland was drawn in 2014 and those who remained either spouse, adult child, or parent caregivers at data collection were included in the analysis (N = 1,062). Data collection included recipients' characteristics. Caregivers' perceived burden was measured using the Caregivers of Older People in Europe index. General linear models were used to explain perceived caregiver burden. RESULTS Care recipients' low level of cognitive function was associated with greater perceived burden. Higher quality of support was associated with lower perceived burden among female and male spouse caregivers, daughter caregivers, and mother caregivers. Low cognitive function explained 3-6% and high quality of support 2-5% of the total variation in the burden explained by the models, which ranged between 45-55%. CONCLUSION Because cognitive challenges of care recipient are associated with greater perceived burden and high quality of support with lower burden among most of the caregiver groups, high-quality tailored nursing interventions will be needed especially for the caregivers of the most frail care recipients.
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Affiliation(s)
- Kristiina Juntunen
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Field of Social Services and Health Care, JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | - Timo Törmäkangas
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Tillman
- Social Insurance Institution of Finland, Helsinki, Finland
| | | | - Riku Nikander
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
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21
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Six S, Musomi S, Deschepper R. Are the Elderly Perceived as a Burden to Society? The Perspective of Family Caregivers in Belgium and Kenya: A Comparative Study. J Transcult Nurs 2018; 30:124-131. [DOI: 10.1177/1043659618784358] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: It is estimated that 70% to 80% of informal care for frail and disabled elders is provided by family caregivers (FCGs). Aim: To better understand how caregiving for the elderly has affected FCGs lives and to compare the perspective of these caregivers in Belgium and Kenya. Method: Semistructured interviews were undertaken with 15 FCGs in Kenya and 15 FCGs in Belgium. Interpretative phenomenological analysis was used to identify themes. Results: Themes discovered in the experience of family caregiving included profile of the care receiver, impact of caregiving on the FCG, cultural values and norms, challenges in caregiving, coping strategies and caregiver well-being. Discussion: FCGs in both Kenya and Belgium identified experiencing serious concerns. In Kenya, the lack of resources and formal structures play a more important role than in Belgium. Despite this difference, culture-specific views and norms are paramount to explaining the FCG experience in the two countries.
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Affiliation(s)
- Stefaan Six
- Vrije Universiteit Brussel, Brussels, Belgium
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22
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del-Pino-Casado R, Frías-Osuna A, Palomino-Moral PA, Ruzafa-Martínez M, Ramos-Morcillo AJ. Social support and subjective burden in caregivers of adults and older adults: A meta-analysis. PLoS One 2018; 13:e0189874. [PMID: 29293522 PMCID: PMC5749735 DOI: 10.1371/journal.pone.0189874] [Citation(s) in RCA: 122] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 12/04/2017] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Despite the generally accepted belief that social support improves caregiver adjustment in general and subjective burden in particular, the literature shows mixed findings, and a recent review concluded that the predictive strength of caregiver social support in determining caregiver burden is less evident, due to the conceptual diversity of this determinant. OBJECTIVE The purpose of this review is to analyse the relationship of perceived and received social support with subjective burden among informal caregivers of an adult or older adult. METHODS A systematic search was carried out up to September 2017 in the following databases: MEDLINE (PubMed), CINAHL, EMBASE, PsycINFO), Scopus and ISI Proceedings, and a meta-analysis was performed with the results of the selected and included studies. RESULTS Fifty-six studies were included in the meta-analysis, which provided 46 independent comparisons for perceived support and 16 for received support. Most of these studies were cross-sectional. There was a moderate, negative association of perceived social support on subjective burden (r = -0.36; CI 95% = -0.40, -0.32) and a very small, negative association of received support on subjective burden (r = -0.05; CI 95% = -0.095, -0.001). CONCLUSIONS 1) perceived and received support are not redundant constructs, 2) the relationships between social support and subjective burden depend on whether the social support is measured as perceived or received, 3) the relationship of perceived social support with subjective burden has a bigger effect size than that of received social support, the relation between received support and subjective burden being clinically irrelevant, 4) perceived social support may be a good predictor of subjective burden. IMPLICATIONS OF KEY FINDINGS Our findings broadly support interventions promoting social support in caregivers to prevent or alleviate subjective burden, and specifically, to intervene on the promotion of perceived social support more than on the promotion of received social support when preventing or alleviating burden.
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Affiliation(s)
| | - Antonio Frías-Osuna
- Department of Nursing, Faculty of Health Sciences, University of Jaén, Jaén, Spain
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23
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López-Martínez C, Frías-Osuna A, Del-Pino-Casado R. [Sense of coherence and subjective overload, anxiety and depression in caregivers of elderly relatives]. GACETA SANITARIA 2017; 33:185-190. [PMID: 29174275 DOI: 10.1016/j.gaceta.2017.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 07/07/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze the relationship between the sense of coherence and subjective overload, anxiety and depression in caregivers of dependent elderly relatives. METHOD Cross-sectional study in an area of the province of Jaén (Andalusia, Spain) with a probabilistic sample of 132 caregivers of dependent elderly. MAIN MEASURES sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index), anxiety and depression (Goldberg Scale), objective burden (Dedication to Care Scale), sex and kinship. Main analyses: bivariate analysis using the Pearson correlation coefficient and multivariate analysis using multiple linear regression. RESULTS Most of the caregivers studied were women (86.4%), daughter or son of the care recipient (74.2%) and shared home with the latter (69.7%). When controlling for objective burden, sex and kinship, we found that the sense of coherence was inversely related to subjective burden (β = -0.46; p <0.001), anxiety (β = -0.57; p = 0.001) and depression (β = -0.66; p <0.001). CONCLUSIONS The sense of coherence might be an important protective factor of subjective burden, anxiety and depression in caregivers of dependent elderly relatives.
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Del-Pino-Casado R, Palomino-Moral PA, Pastor-Bravo MDM, Frías-Osuna A. Determinants of depression in primary caregivers of disabled older relatives: a path analysis. BMC Geriatr 2017; 17:274. [PMID: 29169326 PMCID: PMC5701372 DOI: 10.1186/s12877-017-0667-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 11/15/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Despite the large literature analysing factors related to depression, several factors such as caregiving obligation and the interrelationships among the different variables relating to depression have been little studied. The current study aimed to analyse the effect of caregiving obligation (beliefs regarding obligation and social pressure) on depression, and the mediating effects of perceived burden on the relationship between stressors and depression, in primary caregivers of older relatives. METHODS Cross-sectional study design. A probabilistic sample of caregivers from Spain (N = 200) was used. The data collection was conducted in 2013 through structured interviews in the caregivers' homes. The measures included sense of obligation for caregiving, perceived burden, stressors and depression. RESULTS Depression had a direct and positive association with perceived burden, behavioural problems, and social pressure, and it was indirectly related through perceived burden to behavioural problems, independence for the activities of daily living and beliefs of obligation. CONCLUSIONS Our results support the multidimensional concept of obligation, suggesting the existence of both an external obligation (social pressure) and an internal obligation (beliefs of obligation); (b) our findings support the hypothesis that external obligation is related to negative caregiving consequences, while internal obligation protects from these consequences; and (c) our findings support the partial mediation of stressors on depression by perceived burden. The relevance of the research to clinical practice includes the importance of understanding the perceived obligation of caregiving related to both internal and external sources of obligation.
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Affiliation(s)
| | | | - Maria Del Mar Pastor-Bravo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, ON, M5T 1P8, Canada.
| | - Antonio Frías-Osuna
- School of Health Sciences, Department of Nursing, University of Jaén, Jaén, Spain
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25
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Dios-Guerra C, Carmona-Torres JM, Ruíz-Gándara Á, Muñoz-Alonso A, Rodríguez-Borrego MA. Programmed home visits by nursing professionals to older adults: prevention or treatment? Rev Lat Am Enfermagem 2017; 23:535-42. [PMID: 26312638 PMCID: PMC4547078 DOI: 10.1590/0104-1169.0338.2585] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 02/23/2015] [Indexed: 11/21/2022] Open
Abstract
OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en
enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad. MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo
aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de
la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas
de tendencia central, dispersión, posición, tabulación, frecuencias relativas,
absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney. RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la
edad media de quien recibe visita es de 81,99 años; estos presentan mayor número
de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto
presentan más institucionalización que los controles; el 50% no tiene identificado
el Cuidador Principal; es mayor el número de visitas de las enfermeras a los
pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan
de cuidados, con relación significativa (p < 0,001). No existen diferencias
significativas en tiempo de vida entre los casos y los controles. CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la
morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de
salud, no hay datos de prevención.
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Affiliation(s)
- Caridad Dios-Guerra
- Departamento de Enfermería, Facultad de Medicina y Enfermería, Universidad de Córdoba, Córdoba, Andalucía, ES
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Alshammari SA, Alzahrani AA, Alabduljabbar KA, Aldaghri AA, Alhusainy YA, Khan MA, Alshuwaier RA, Kariz IN. The burden perceived by informal caregivers of the elderly in Saudi Arabia. J Family Community Med 2017; 24:145-150. [PMID: 28932158 PMCID: PMC5596626 DOI: 10.4103/jfcm.jfcm_117_16] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES: The objective of this study was to discover the characteristics of informal caregivers of elderly patients; to determine the socioeconomic, psychological, and physical consequences facing informal caregivers; and to measure their burdens and needs. MATERIALS AND METHODS: This study was a cross-sectional survey of informal caregivers of elderly patients. Participants were recruited from different hospitals and primary care clinics in Riyadh, Saudi Arabia. For an intended sample size of 384 caregivers, a multistage sampling was used. A self-administered questionnaire was used to collect data. Data analysis included student's t-test and ANOVA to test for statistical significance. RESULTS: The study included 315 caregivers of elderly patients. Over half of the elderly patients were female (55.9%) and over 70 years old (65.7%); about 31% had chronic diseases or disabilities, which represented the majority of health problems reported by the elderly population. Most of the caregivers were family members (87.9%), young (43.8%), female (52.7%), unemployed (54.6%), and unmarried (58.1%). Most caregivers suffered from musculoskeletal problems (78.1%). The mean Zarit Burden Interview score was 31.3, which indicated a moderate burden. More than half of caregivers requested blood pressure (55.6%) and blood sugar measuring devices (53%). Three quarters (74.9%) of the caregivers wanted educational training to cope with emergencies. Most caregivers expressed a need for frequent healthcare for themselves (58.4%) and a home health visit service (72.9%) to support them in the care of their elderly. CONCLUSIONS AND RECOMMENDATIONS: Mobilization of resources in locations where these carers of the elderly live are greatly needed. In addition, health authorities should provide devices and essential training to manage the common problems and emergencies that informal caregivers have to deal with. Moreover, caregivers need follow-up supervision by a home visit team. Further studies are required to guide the implementation of the above advice.
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Affiliation(s)
- Sulaiman A Alshammari
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah A Alzahrani
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khaled A Alabduljabbar
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdulaziz A Aldaghri
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Yazeed A Alhusainy
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed A Khan
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rakan A Alshuwaier
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ismail N Kariz
- Research Chair of Health Education and Health Promotion, Department of Family Community Medicine, King Saud University, Riyadh, Saudi Arabia
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Casado-Mejía R, Ruiz-Arias E. Influence of Gender and Care Strategy in Family Caregivers´ Strain: A Cross-Sectional Study. J Nurs Scholarsh 2016; 48:587-597. [DOI: 10.1111/jnu.12256] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Rosa Casado-Mejía
- Professor, Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry; University of Seville; Seville Spain
| | - Esperanza Ruiz-Arias
- Professor, Nursing Department, Faculty of Nursing; Physiotherapy and Podiatry, University of Seville; Seville Spain
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Borman P, Gökçe-Kutsal Y, Terzioğlu F, Okumuş M, Ceceli E, Karahan S, Şenel K, Gökkaya KO, Doğan A, Eskiyurt N, Günaydin R, Eyigör S, Şahin N, Şahin M. A Multicenter Pilot Study of Burden Among Caregivers of Geriatric Rehabilitation Patients With Neuromusculoskeletal Diseases. Rehabil Nurs 2016; 42:199-209. [PMID: 27080048 DOI: 10.1002/rnj.272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. DESIGN Cross-sectional multicenter study. METHODS One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 ± 7.7 years and 51 ± 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. FINDINGS Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient's ambulatory, psychological, and cognitive status and with the caregiver's age, gender, income level, and duration of caregiving. CONCLUSIONS We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. CLINICAL RELEVANCE Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden.
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Affiliation(s)
- Pinar Borman
- 1 Department of Physical Medicine and Rehabilitation, Medical Faculty, Hacettepe University, Ankara, Turkey2 Faculty of Nursing, Hacettepe University, Ankara, Turkey3 Department of Physical Medicine and Rehabilitation, Medical Faculty, Kirikkale University, Kirikkale, Turkey4 Department of Bio-Statistics, Medical Faculty, Hacettepe University, Ankara, Turkey5 Department of Physical Medicine and Rehabilitation, Medical Faculty, Erzurum University, Erzurum, Turkey6 Clinic of Physical Medicine and Rehabilitation, Ankara Rehabilitation Training and Research Hospital, Ankara, Turkey7 Department of Physical Medicine and Rehabilitation, Medical Faculty, Istanbul University, Istanbul, Turkey8 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ordu University, Ordu, Turkey9 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ege University, Izmir, Turkey10 Department of Physical Medicine and Rehabilitation, Medical Faculty, Balikesir University, Balikesir, Turkey
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Álvarez-Tello M, Casado-Mejía R, Praena-Fernández JM, Ortega-Calvo M. [Developing a predictive model for the caregiver strain index]. Rev Esp Geriatr Gerontol 2016; 52:15-19. [PMID: 26857085 DOI: 10.1016/j.regg.2015.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 09/27/2015] [Accepted: 12/09/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND Patient homecare with multiple morbidities is an increasingly common occurrence. The caregiver strain index is tool in the form of questionnaire that is designed to measure the perceived burden of those who care for their families. The aim of this study is to construct a diagnostic nomogram of informal caregiver burden using data from a predictive model. METHODS The model was drawn up using binary logistic regression and the questionnaire items as dichotomous factors. The dependent variable was the final score obtained with the questionnaire but categorised in accordance with that in the literature. Scores between 0 and 6 were labelled as "no" (no caregiver stress) and at or greater than 7 as "yes". The version 3.1.1R statistical software was used. To construct confidence intervals for the ROC curve 2000 boot strap replicates were used. RESULTS A sample of 67 caregivers was obtained. A diagnosing nomogram was made up with its calibration graph (Brier scaled = 0.686, Nagelkerke R2=0.791), and the corresponding ROC curve (area under the curve=0.962). FINDINGS The predictive model generated using binary logistic regression and the nomogram contain four items (1, 4, 5 and 9) of the questionnaire. R plotting functions allow a very good solution for validating a model like this. The area under the ROC curve (0.96; 95% CI: 0.994-0.941) achieves a high discriminative value. Calibration also shows high goodness of fit values, suggesting that it may be clinically useful in community nursing and geriatric establishments.
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Affiliation(s)
- Margarita Álvarez-Tello
- Unidad de Gestión Clínica Polígono Sur-Las Letanías, Distrito Sanitario de Atención Primaria, Sevilla, España
| | - Rosa Casado-Mejía
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad de Sevilla, Sevilla, España
| | - Juan Manuel Praena-Fernández
- Unidad de Metodología y Evaluación de la Investigación, Fundación Pública Andaluza para la Gestión de la Investigación en Salud de Sevilla (FISEVI), Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Manuel Ortega-Calvo
- Centro de Salud Esperanza Macarena, Unidad de Investigación Distrito Sanitario de Atención Primaria, Sevilla, España; CIBER de la Fisiopatología de la Obesidad y de la Nutrición, Instituto de Salud Carlos III, Madrid, España.
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Serrano-Ortega N, Frías-Osuna A, Recio-Gómez JM, Del-Pino-Casado R. [Desing and validation of a scale to measure caregiving dedication in caregivers of dependent older people]. Aten Primaria 2015; 47:589-95. [PMID: 25962569 PMCID: PMC6983807 DOI: 10.1016/j.aprim.2014.11.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 09/22/2014] [Accepted: 11/11/2014] [Indexed: 11/19/2022] Open
Abstract
Objetivo El objetivo del presenta estudio es el desarrollo y validación de una escala para medir la dedicación al cuidado en personas cuidadoras de mayores dependientes, en la esfera de las actividades básicas de la vida diaria (ABVD). Diseño Estudio descriptivo transversal. Emplazamiento Atención primaria (comunidad autónoma de Andalucía, España). Participantes Muestra probabilística de 200 personas cuidadoras de familiares mayores dependientes de la comarca cordobesa del Alto Guadalquivir. Mediciones principales Validación de contenido por expertos, validez de constructo (mediante análisis factorial exploratorio), validez divergente y fiabilidad (consistencia interna, estabilidad y concordancia interobservadores). Resultados El valor del alfa de Cronbach fue 0,86. El coeficiente de correlación intraclase para la fiabilidad test-retest fue de 0,96 y para la concordancia interobservadores fue de 0,88. Al dividir la muestra en 2 grupos en función del nivel de sobrecarga (presencia y ausencia), la puntuación de la escala fue significativamente diferente en cada grupo (p = 0,001). El análisis factorial reveló la existencia de un único factor que explicaba el 64% de la varianza. Conclusiones La escala desarrollada permite una adecuada medición de la dedicación al cuidado en la esfera de las ABVD en personas cuidadoras de mayores dependientes, ya que es un instrumento de fácil y rápida administración, que es bien aceptado por las personas cuidadoras, presenta adecuados resultados psicométricos y se ajusta a la frecuencia de dedicación, al tipo de necesidad atendida y al nivel de dependencia de cada necesidad.
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Affiliation(s)
- Natalia Serrano-Ortega
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Jaén, Jaén, España
| | - Antonio Frías-Osuna
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Jaén, Jaén, España.
| | | | - Rafael Del-Pino-Casado
- Departamento de Enfermería, Facultad de Ciencias de la Salud, Universidad de Jaén, Jaén, España
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Crist JD, Pasvogel A, Hepworth JT, Koerner KM. The impact of a telenovela intervention on use of home health care services and Mexican American older adult and caregiver outcomes. Res Gerontol Nurs 2015; 8:62-76. [PMID: 25594360 DOI: 10.3928/19404921-20150105-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/14/2014] [Indexed: 11/20/2022]
Abstract
A two-group randomized controlled trial tested a telenovela intervention (i.e., a culturally congruent videotaped dramatization with guided dialogue) to increase Mexican American older adults' and family caregivers' awareness of and confidence in home health care services (HHCS), thereby increasing use of HHCS and improving older adult and caregiver outcomes. Both groups had significant increases in awareness of and confidence in HHCS. The intervention group used HHCS more than the control group (91.1% versus 71.2% of total visits authorized); however, this was not a statistically significant difference (p = 0.18). Use of HHCS was associated with increased older adult and caregiver mutuality (i.e., the quality of the older adult-caregiver relationship) and decreased caregiving burden and depression. The predictive role and measurement of awareness and ways to improve the intervention are discussed. Findings are especially important with today's focus on transitional care to keep older adults at home and prevent unnecessary readmissions.
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Alvira MC, Risco E, Cabrera E, Farré M, Rahm Hallberg I, Bleijlevens MHC, Meyer G, Koskenniemi J, Soto ME, Zabalegui A. The association between positive-negative reactions of informal caregivers of people with dementia and health outcomes in eight European countries: a cross-sectional study. J Adv Nurs 2014; 71:1417-34. [PMID: 25250659 DOI: 10.1111/jan.12528] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2014] [Indexed: 11/29/2022]
Abstract
AIM To describe the associations between positive and negative reactions of informal caregivers of people with dementia and health outcomes across eight European Countries. BACKGROUND Caring for someone with dementia may have implications for the caregiver's own health and for the care recipient. These consequences could be associated with caregivers' reactions to the process of care. DESIGN Association study based on cross-sectional data. METHODS Participants were people with dementia and their informal caregivers living at home or in long-term care institutions. Data were collected between November 2010-April 2012 using the Caregiver Reaction Assessment (with dimensions of self-esteem, lack of family support, financial problems, disrupted schedule and health problems) and associations were sought with informal caregiver burden, quality of life and psychological well-being and with dementia sufferers' neuropsychiatric symptoms, comorbidity and dependency in activities of daily living using correlation coefficients. RESULTS Data from 2014 participants were used. Variability across countries was noted, as well as differences between care at home and in long-term care institutions. In general, self-esteem and lack of family support correlated with caregiver burden and psychological well-being. Associations were also found between disrupted schedule and caregiver burden, psychological well-being and quality of life. Health problems were clearly associated with caregiver burden, psychological well-being and quality of life. CONCLUSION Study results support links between the reactions of informal caregivers of people with dementia and health outcomes. These may have implications in terms of how services are addressed.
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Affiliation(s)
| | | | - Esther Cabrera
- University Pompeu Fabra, School TecnoCampus, Mataró, Spain
| | - Marta Farré
- Department of Internal Medicine, Hospital Clínic de Barcelona, Spain
| | | | | | - Gabriele Meyer
- Martin-Luther-University Halle-Wittenberg, Institute of Health and Nursing Science, Germany
| | | | - Maria E Soto
- Department of Geriatrics, University Hospital of Toulouse, France
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