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Adebayo K, Omobowale M, Akinyemi A, Usman R, Olujimi A, Omodara F. "I am the one taking care of her and donating blood": lived experiences of role-routines of hospital-based informal caregiving in Nigeria. Int J Qual Stud Health Well-being 2024; 19:2356928. [PMID: 38773959 PMCID: PMC11123441 DOI: 10.1080/17482631.2024.2356928] [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: 10/10/2023] [Accepted: 05/14/2024] [Indexed: 05/24/2024] Open
Abstract
PURPOSE Informal caregivers (ICs) in Africa perform a long list of tasks to support hospitalization care. However, available studies are weak in accounting for the experiences of everyday role-routines of hospital-based informal caregiving (HIC) in under-resourced settings. This article explored the experiences of role-routines among informal caregivers in a Nigerian tertiary health facility. METHODS The ethnographic exploratory study relied on primary data collected from 75 participants, including 21 ICs, 15 inpatients, 36 hospital staff, and 3 ad-hoc/paid carers in a tertiary health facility in Southwestern Nigeria. RESULTS ICs perform several essential roles for hospitalized relatives, with each role characterized by a range of tasks. An integrative narrative of everyday routines of HIC as experienced by ICs showed critical complexities and complications involved in seemingly simple tasks of assisting hospitalized relatives with hygiene maintenance, medical investigations, blood donation, resource mobilization, errand-running, patient- and self-care and others. The role-routines are burdensome and ICs' experiences of them revealed the undercurrents of how health systems dysfunctions condition family members to support hospitalization care in Nigeria. CONCLUSION The intensity and repetitive nature of role-routines is suggestive of "routinization of suffering". We recommend the closing of gaps driving hospital-based informal caregiving in Africa's under-resourced settings.
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Affiliation(s)
- Kudus Adebayo
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
- School of Public Health, University of The Witwatersrand, Johannesburg, South Africa
| | - Mofeyisara Omobowale
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Rukayat Usman
- Institute of African Studies, University of Ibadan, Ibadan, Nigeria
| | - Atinuke Olujimi
- Department of Sociology, University of Ibadan, Ibadan, Nigeria
| | - Funmilayo Omodara
- Institute of Child Health, College of Medicine, University of Ibadan, Ibadan, Nigeria
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Petrova I, Pipere A. Caregivers' experience of caring for family members with complex health needs in Latvia. Health Promot Int 2024; 39:daae070. [PMID: 38934478 DOI: 10.1093/heapro/daae070] [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] [Indexed: 06/28/2024] Open
Abstract
The article examines the experiences of family caregivers engaged in the provision of long-term care for their relatives with complex health needs within the Latvian context. Semi-structured interviews were conducted with seven caregivers who provide care in cases of dementia, depression, schizophrenia, opioid use, Down syndrome and mild cognitive impairment. A thematic analysis of interview transcripts revealed common themes, such as the initial experiences when encountering a family member's disorder and the subsequent reactions, as well as the quest for support and resources. Variations mainly centered around differences in formal aspects and childhood experiences of care. Caregivers reported risk factors such as guilt, lack of support from family and friends, financial difficulties, deficiency of professional care and ignoring the caregiver's own needs. Awareness of personal resources, values and limits, coping with personal stigma and improved overall quality of life were identified as protective factors. The findings underscore several preventive measures that social and mental health services could implement to mitigate the adverse effects of caregiving on caregivers' lives.
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Affiliation(s)
- Indra Petrova
- Daugavpils University, Institute of Humanities and Social Sciences, Vienības iela 13, Daugavpils, LV 5400, Latvia
| | - Anita Pipere
- Daugavpils University, Institute of Humanities and Social Sciences, Vienības iela 13, Daugavpils, LV 5400, Latvia
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Matthews M, McKeaveney C, Noble H, Reid J. Exploring the unmet needs and experiences of informal caregivers of patients with end-stage kidney disease (ESKD) receiving haemodialysis - a qualitative study. PLoS One 2024; 19:e0302525. [PMID: 38722989 PMCID: PMC11081335 DOI: 10.1371/journal.pone.0302525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 04/07/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Patients with end stage kidney disease (ESKD) receiving haemodialysis experience multiple symptoms, which can present physical and emotional challenges for both patients and their informal caregivers. Caregivers can experience anxiety, depression, and social isolation negatively impacting their overall wellbeing and resulting in caregiver burden. The needs of this group of caregivers have been largely neglected, with little emphasis placed on supportive interventions that might assist and support them in their caring role. AIM The aim of this study Is to explore the unmet needs and experiences of caregivers of patients with ESKD receiving haemodialysis, and to determine the components of a supportive intervention. DESIGN A qualitative study using semi-structured interviews (n = 24) with informal caregivers. An interpretive qualitative framework was employed to generate a rich understanding of the unmet needs and experiences of caregivers. Data was analysed using thematic analysis. Interviews were transcribed verbatim and data management was assisted through NVIVO version 11. SETTING/PARTICIPANTS Twenty-four informal caregivers were purposively recruited from two haemodialysis settings within Northern Ireland. RESULTS Three themes were identified: (1) The negative impact of distress, anxiety, and isolation on caregivers due to their caregiving responsibilities (2) Inadequate information and knowledge about the complexities of renal care (3) The benefits of spiritual beliefs, stress management and peer support in relieving the caregiving burden. CONCLUSIONS Caregivers of patients with ESKD receiving haemodialysis are at increased risk of physical and psychological distress and burden arising from their caregiving role. The unpredictable nature of ESKD and haemodialysis treatment negatively impacts the caregiver experience and adds to the challenges of the role. The information needs of caregivers are not always adequately met and they subsequently lack appropriate knowledge, skills, and guidance to assist them in their caregiving role. Supportive interventions are essential for caregivers to enhance their capability to deliver effective care and improve their quality of life.
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Affiliation(s)
- Michael Matthews
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Clare McKeaveney
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Helen Noble
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
| | - Joanne Reid
- School of Nursing and Midwifery, Queen’s University Belfast, Belfast, United Kingdom
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Powathil GG, Kr A. The Experience of Living with a Chronic Illness: A Qualitative Study among End-Stage Renal Disease Patients. JOURNAL OF SOCIAL WORK IN END-OF-LIFE & PALLIATIVE CARE 2023; 19:190-208. [PMID: 37433003 DOI: 10.1080/15524256.2023.2229034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
The prevalence of End-Stage Renal Disease (ESRD) has been rising over time and substantially affects morbidity and mortality. ESRD requires lifelong treatment, and as a result, patients experience multiple physical and psychosocial stressors. ESRD patients struggle to retain their jobs, social lives, financial flexibility, and diet restrictions of liquids and solid foods. The present study aims to understand the experiences of ESRD patients undergoing hemodialysis. The study was conducted at Eldho Mor Baselious Dialysis Center in Perumbavoor, Kerala, in the hemodialysis outpatient unit. The Biopsychosocial model was used as the theoretical framework of the study. As the goal of the study was to investigate the inner experiences of ESRD patients, a qualitative research approach was employed. Twelve respondents were selected for the study using purposive sampling, and the data were organized and analyzed using Colaizzi's descriptive phenomenological method. Four theme categories emerged from data analysis: decline in physical function, psychosocial distress, economic hardships, and impact on the support system. The study shows that ESRD patients experience significant psychosocial and health-related issues. The role of the clinical social worker is vital as there is a need for social work interventions to resolve the psychosocial issues of patients with ESRD.
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Affiliation(s)
- Ginu George Powathil
- Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Kalamassery, Kerala, India
| | - Anish Kr
- Department of Social Work, Rajagiri College of Social Sciences (Autonomous), Kalamassery, Kerala, India
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McAndrew NS, Erickson J, Hetland B, Guttormson J, Patel J, Wallace L, Visotcky A, Banerjee A, Applebaum AJ. A Mixed-Methods Feasibility Study: Eliciting ICU Experiences and Measuring Outcomes of Family Caregivers of Patients Who Have Undergone Hematopoietic Stem Cell Transplantation. JOURNAL OF FAMILY NURSING 2023:10748407231166945. [PMID: 37191306 PMCID: PMC10330518 DOI: 10.1177/10748407231166945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
The impact of an intensive care unit (ICU) admission on family caregivers of patients who have undergone hematopoietic stem cell transplantation (HSCT) has not been well described. Aims of this study were to determine the feasibility of conducting research with family caregivers of HSCT patients during an ICU admission and generate preliminary data about their experiences and engagement in care. Using a mixed-methods, repeated measures design, we collected data from family caregivers after 48 hr in the ICU (T1) and at 48 hr after transferring out of ICU (T2). Enrolling HSCT caregivers in research while in the ICU was feasible (10/13 consented; 9/10 completed data collection at T1); however, data collection at T2 was not possible for most caregivers. Caregiver distress levels were high, and engagement in care was moderate. The three themes that emerged from interviews (n = 5) highlighted that although HSCT family caregivers faced many challenges and received limited support during their ICU experience, they were able to access their own personal resources and demonstrated resilience.
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Affiliation(s)
- Natalie S McAndrew
- University of Wisconsin-Milwaukee, USA
- Froedtert & the Medical College of Wisconsin, Milwaukee, USA
| | | | - Breanna Hetland
- University of Nebraska Medical Center, Omaha, USA
- Nebraska Medicine, Omaha, USA
| | | | | | | | | | | | - Allison J Applebaum
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
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Chironda G, Jarvis MA, Brysiewicz P. Family-Focused Nursing Research in WHO Afro-Region Member States: A Scoping Review. JOURNAL OF FAMILY NURSING 2023; 29:136-154. [PMID: 36433834 PMCID: PMC10160405 DOI: 10.1177/10748407221132018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Although family nursing research has become an important focus for over the past 20 years, the evolution and extent of family nursing research in the World Health Organization (WHO) Afro-regions is less explored. The purpose of this scoping review was to map the evidence of family-focused nursing research using the Joanna Briggs Institute Scoping Review methodology. A systematic electronic search of articles was carried out for the period January 1, 2000 to December 31, 2020. The review process culminated in 85 articles, evidencing an increase in publications particularly in 2019 (n = 12). Eighteen countries were involved, with the Southern African region contributing 52% of the studies. Family members were predominantly described as parents, siblings, and children, with the most focused area of study being family experiences (n = 52). The majority of studies (n = 59) used qualitative methodologies. Despite the recent increase in family-focused nursing research in the WHO Afro-regions, further qualitative research, including more complex methodologies and interventions are still required to build contextualized evidence-based family-focused nursing.
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Vovlianou S, Koutlas V, Ikonomou M, Vassilikopoulos T, Papoulidou F, Dounousi E. Quality of life of caregivers of end-stage kidney disease patients: Caregivers or care recipients? J Ren Care 2023; 49:56-72. [PMID: 34706151 DOI: 10.1111/jorc.12403] [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] [Received: 03/24/2021] [Revised: 09/26/2021] [Accepted: 10/01/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND End-stage kidney disease (ESKD) patients require specific and continuous care, which affects caregivers' quality of life (QOL). It is necessary to define the basic problems and restrictions upon family caregivers of renal patients affecting their physical and psychological status. OBJECTIVES The main objectives of this narrative review were to examine the literature over the past 10 years, to describe factors associated with QOL of caregivers of patients with ESKD, and to identify the level of subjective burden reported by caregivers. METHODS A literature search was carried out using the following electronic databases: PubMed, Medscape, Science Direct, Scopus, PsychINFO and other scientific sources. Keywords included 'quality of life', 'caregivers', 'end stage kidney or renal disease patients', 'burden' and a combination of these terms. Only studies from January 2010 to December 2020 were included in this study. RESULTS The results found that there was significant burden and distress experienced by caregivers that affected their QOL. Patients' QOL is associated with caregivers' QOL. The hours of caring per day and the long-term replacement therapy are associated with great burden. CONCLUSIONS More awareness to caregivers' QOL is required to meet their needs, reduce anxiety and to improve patients' QOL. Caregiver support could empower and prepare them for initiation of replacement therapy. This can potentially enhance their diseased family members' QOL and could also restrict the use of health care system resources. Given how difficult it is to conceptualize QOL, a holistic approach to patients and caregivers require QOL assessment in each stage of the kidney disease.
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Affiliation(s)
- Stavroula Vovlianou
- Department of Nephrology, Faculty of Medicine, University of Ioannina, Ioannina, Greece.,Department of Nephrology, General Hospital of Kavala, Kavala, Greece
| | - Vasilios Koutlas
- Department of Nephrology, Faculty of Medicine, University of Ioannina, Ioannina, Greece.,Department of Nephrology, University General Hospital of Ioannina, Ioannina, Greece
| | - Margarita Ikonomou
- Department of Nephrology, University General Hospital of Ioannina, Ioannina, Greece
| | - Theodore Vassilikopoulos
- Department of Nephrology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Fani Papoulidou
- Department of Nephrology, General Hospital of Kavala, Kavala, Greece
| | - Evangelia Dounousi
- Department of Nephrology, Faculty of Medicine, University of Ioannina, Ioannina, Greece.,Department of Nephrology, University General Hospital of Ioannina, Ioannina, Greece
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Burden, depression and anxiety effects on family caregivers of patients with chronic kidney disease in Greece: a comparative study between dialysis modalities and kidney transplantation. Int Urol Nephrol 2023; 55:1619-1628. [PMID: 36720745 DOI: 10.1007/s11255-023-03482-8] [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: 01/05/2023] [Accepted: 01/21/2023] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Burden of caregivers is a status that was identified as a consequence of daily care. Anxiety and depression are probably related to complex tasks interwined with the care of a family member suffering from chronic kidney disease (CKD). PURPOSE To examine the experienced burden, anxiety and depression of Greek caregivers of patients with End-Stage CKD on dialysis as well as kidney transplant recipients (TX) in relation to their demographic profile and to compare among the groups. METHODS A total of 396 participants (198 couples of patients and caregivers) were recruited. Structured interviews and self-completed questionnaires were obtained from patients undergoing dialysis modalities as well as TX (28 peritoneal dialysis patients, 137 hemodialysis patients, 33 TX) and their caregivers. Zarit Burden Interview, Beck Depression Inventory and the Generalized Anxiety Disorder-2 scales were used as screening tools. RESULTS The majority of caregivers were females (67.2%), with a median age of 58 years. Total burden was indicated as mild to moderate (Mdn = 36 (24-51)). Caregivers of haemodialysis (HD) patients showed the highest burden (Mdn = 40 (26-53)) followed by peritoneal dialysis(PD) (Mdn = 29 (25-51)) and TX group (Mdn = 28 (21-43)) (p = 0.022). Caregivers' depression and anxiety were related to the type of patients' treatment, as well. Caregivers of HD and PD patients reported significantly higher depression (Mdn = 11 (5-18)) and anxiety scores (Mdn = 3 (2-5)) in comparison to TX caregivers (Mdn = 6 (2-13) and Mdn = 2 (2-4)) (p = 0.045 and p = 0.04, respectively). CONCLUSION Caregivers of TX patients appeared to have less burden, depression and anxiety levels compared with caregivers of patients on dialysis modalities. Caregivers' burden is significantly associated with anxiety, depressive symptoms, gender, duration of caregiving, educational level, financial status and caregivers' age.
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Ibrahim N, Chu SY, Siau CS, Amit N, Ismail R, Abdul Gafor AH. The effects of psychosocial and economic factors on the quality of life of patients with end-stage renal disease and their caregivers in Klang Valley, Malaysia: protocol for a mixed-methods study. BMJ Open 2022; 12:e059305. [PMID: 36691236 PMCID: PMC9171257 DOI: 10.1136/bmjopen-2021-059305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 05/12/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION The number of patients in Malaysia requiring dialysis is expected to rise substantially in the future due to the ageing population and increasing prevalence of diabetes mellitus and hypertension. Hence, more individuals will be expected to adopt the role of caregivers in the future. The upward trend of end-stage renal disease (ESRD) and caregiving for dialysis patients has detrimental consequences for both patients and caregivers in terms of their psychological well-being and quality of life. Despite the current circumstances, there are very few studies in Malaysia that have explored the psychosocial factors, specifically on the economic impact of the management of ESRD. METHODS AND ANALYSIS This two-phase sequential explanatory mixed-methods design, incorporating a quantitative design (phase I) and a qualitative study (phase II), is to be conducted in 4 government hospitals and 10 other non-governmental organisations or private dialysis centres within Klang Valley, Malaysia. A cross-sectional survey (phase I) will include 236 patient-caregiver dyads, while focus group discussions (phase II) will include 30 participants. The participants for both phases will be recruited purposively. Descriptive statistics, independent sample t-tests and multiple regression analysis will be used for analyses in phase I, and thematic analysis will be used in phase II. ETHICS AND DISSEMINATION Approval for the study has been obtained from the National Medical Research and Ethics Committee (MREC) (NMRR-21-1012-59714) and the Research Ethics Committee of Hospital Canselor Tuanku Muhriz UKM (UKM PPI/111/8/JEP-2021-078) and University of Malaya Medical Centre (MREC ID NO: 2 02 178-10346). Informed consent of the participants will be obtained beforehand, and no personal identifiers will be obtained from the participants to protect their anonymity. The findings will be published in peer-reviewed scientific journals and presented at national or international conferences with minimal anonymised data.
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Affiliation(s)
- Norhayati Ibrahim
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
- Institute of Islam Hadhari, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Sin Yee Chu
- Centre for Health Aging and Wellness (H-Care), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Ching Sin Siau
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Noh Amit
- Centre for Community Health Studies (ReaCH), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Federal Territory of Kuala Lumpur, Malaysia
| | - Rozmi Ismail
- Centre for Research in Psychology and Human Well-being (PsiTra), Faculty of Social Sciences and Humanities, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
| | - Abdul Halim Abdul Gafor
- Department of Medicine, Hospital Canselor Tuanku Muhriz UKM, Cheras, Federal Territory of Kuala Lumpur, Malaysia
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Hogan U, Bingley A, Morbey H, Walshe C. The experience of informal caregivers in providing patient care in hospitals in low- and middle-income countries: A qualitative meta-synthesis. J Health Serv Res Policy 2022; 27:321-329. [PMID: 35592881 PMCID: PMC9548935 DOI: 10.1177/13558196221101968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE In low- and middle-income countries, informal caregivers frequently stay in hospitals and perform patient care tasks typically performed by nurses in other contexts. This article reviews qualitative research on these informal caregivers, to gain insight and understanding of their experiences. METHODS We undertook a qualitative meta-synthesis. Relevant literature was identified through searches of electronic databases in 2021. Thematic analysis was conducted to facilitate the identification of conceptual relationships to formulate synthesised findings. RESULTS Twenty-four studies met the inclusion criteria - 13 from Sub-Saharan Africa, five from Bangladesh, two from India, two from Iran, one from Brazil and one from Peru. Three themes were generated from the meta-synthesis: (1) The unwelcome but tolerated guest, (2) Enduring personal sacrifice and (3) Fulfilling familial obligations. These themes emphasised the significant burden associated with the hospital caregiving experience and highlighted the implicit reliance on informal caregivers in low- and middle-income countries. CONCLUSIONS Informal caregivers perform an essential caregiving role, yet occupy a peripheral and voluntary space in hospitals. There is a clear need to support informal caregivers so that they can safely perform their tasks.
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Affiliation(s)
- Unarose Hogan
- Division of Health Research, Faculty of Health and Medicine, 151268Lancaster University, Bailrigg, UK
| | - Amanda Bingley
- Division of Health Research, Faculty of Health and Medicine, 151268Lancaster University, Bailrigg, UK
| | - Hazel Morbey
- Division of Health Research, Faculty of Health and Medicine, 151268Lancaster University, Bailrigg, UK
| | - Catherine Walshe
- Division of Health Research, Faculty of Health and Medicine, 151268Lancaster University, Bailrigg, UK
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Mbeje PN, Mtshali N. Perceived predictors of quality of life in patients with end-stage renal disease on dialysis. Curationis 2021; 44:e1-e11. [PMID: 34636621 PMCID: PMC8517801 DOI: 10.4102/curationis.v44i1.2251] [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: 04/23/2021] [Revised: 07/04/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Reduced quality of life (QOL) is associated with shorter survival, and is more marked in patients with end-stage renal disease (ESRD). Predictors of health, which include policymaking, social factors, health services, individual behaviour, biology and genetics, have an impact on the QOL of patients with ESRD. Patients with ESRD in South Africa are cared for in public and private hospitals, with public health institutions characterised by several challenges. OBJECTIVE To explore and analyse the perceived predictors of QOL in patients with ESRD in the three district hospitals that provide renal services in KwaZulu-Natal. METHODS An exploratory, descriptive qualitative research approach based on grounded theory research design was used and three focus group discussions (FGDs) were conducted. The researcher recruited 18 participants, 6 in each focus group. Three phases of data analysis were followed: open coding, axial coding, and selective coding. RESULTS Predictors of QOL that emerged were the geographic location of the patients, accessibility of haemodialysis centres, patients' adaptation and acceptance of the condition, self-management, support by family members and caregivers and availability of adequately trained nurses. CONCLUSION Predictors of QOL in patients with ESRD are associated with an increased risk of morbidity and mortality resulting from dialysis. The broad range of dimensions of life is negatively affected and requires intervention by the renal team and policymakers to improve the QOL of patients.
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Affiliation(s)
- Pretty N Mbeje
- Department of Nursing, Faculty of Health Sciences, University of KwaZulu-Natal, Durban.
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Vieira IFDO, Garcia ACM, Brito TRP, Lima RS, Nogueira DA, Rezende EG, Fava SMCL. Burden and social support in informal caregivers of people undergoing kidney dialysis: a mixed study. Rev Bras Enferm 2021; 74:e20201266. [PMID: 34431939 DOI: 10.1590/0034-7167-2020-1266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/11/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the burden and the social support of the informal caregivers of people undergoing kidney dialysis. METHODS mixed study, based on the Theory of Stress and Overload, using instruments of sociodemographic characterization, the Social Support Survey from the Medical Outcomes Study, Zarit's Burden Scale, and guiding questions. Analysis of data used statistical and thematic inferences. RESULTS 55 caregivers were evaluated, most were women, from 31 to 50 years old, married, and having worked in care for more than three years. A high level of affective and material support was observed, with a light overload on the caregiver. The central theme of the discourses was: "Experiences of the caregiver: between the burden of responsibility and the search for meaning". CONCLUSIONS a small overload was found in the participants, with a high median in the dimensions of affective and emotional support, in the relations between positive social interactions and the burden of the caregivers, in addition to the duality or responsibility and the meaning of care.
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Afolabi OA, Nkhoma K, Maddocks M, Harding R. What constitutes a palliative care need in people with serious illnesses across Africa? A mixed-methods systematic review of the concept and evidence. Palliat Med 2021; 35:1052-1070. [PMID: 33860715 PMCID: PMC8371282 DOI: 10.1177/02692163211008784] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Clarity on what constitutes a palliative care need is essential to ensure that health systems and clinical services deliver an appropriate response within Universal Health Coverage. AIM To synthesise primary evidence from Africa for palliative care needs among patients and families with serious illness. DESIGN We conducted a mixed methods systematic review with sequential synthesis design. The protocol was registered with PROSPERO (CRD42019136606) and included studies were quality assessed using Mixed Method Appraisal Tool. DATA SOURCES Six global literature databases and Three Africa-specific databases were searched up to October 2020 for terms related to palliative care, serious illnesses and Africa. Palliative care need was defined as multidimensional problems, symptoms, distress and concerns which can benefit from palliative care. RESULTS Of 7810 papers screened, 159 papers met eligibility criteria. Palliative care needs were mostly described amongst patients with HIV/AIDS (n = 99 studies) or cancer (n = 59), from East (n = 72) and Southern (n = 89) Africa. Context-specific palliative care needs included managing pregnancy and breastfeeding, preventing infection transmission (physical); health literacy needs, worry about medical bills (psychological); isolation and stigma, overwhelmed families needing a break, struggling to pay children's school fees and selling assets (social and practical needs); and rites associated with cultural and religious beliefs (spiritual). CONCLUSIONS Palliative care assessment and care must reflect the context-driven specific needs of patients and families in Africa, in line with the novel framework. Health literacy is a crucial need in this context that must be met to ensure that the benefits of palliative care can be achieved at the patient-level.
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Affiliation(s)
- Oladayo A Afolabi
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK.,Department of Nursing Science, University of Maiduguri, Maiduguri, Nigeria
| | - Kennedy Nkhoma
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Matthew Maddocks
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Richard Harding
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
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Nkuranyabahizi M, Rajeswaran L, Ngendahayo F, Umuhire L, Shyaka JC, Dushimiyimana V, Chironda G. Caring experiences and support needs among family caregivers of patients with End Stage Renal Disease (ESRD) in Rwanda: A descriptive qualitative study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100384] [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] Open
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Adejumo OA, Iyawe IO, Akinbodewa AA, Abolarin OS, Alli EO. Burden, psychological well-being and quality of life of caregivers of end stage renal disease patients. Ghana Med J 2019; 53:190-196. [PMID: 31741490 PMCID: PMC6842729 DOI: 10.4314/gmj.v53i3.2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Caregivers of chronic kidney disease (CKD) patients play an important role in the management of the patients. Their psychological needs are often overlooked and unmet by the managing team. This study assessed the psychosocial well-being and quality of life (QoL) of caregivers of CKD patients in two hospitals in Southern Nigeria. Methods Burden of caregiving, QoL, depression, and anxiety were assessed using standardized instruments; modified Zarit questionnaire, modified SF-12 questionnaire and Hospital Anxiety and Depression Scale (HADS) respectively among caregivers of CKD patients on maintenance haemodialysis and controls. Results Fifty-seven caregivers of CKD patients and aged and sex-matched controls participated in the study. Anxiety was significantly higher in caregivers compared to control (31.6% vs 5.3%, p = 0.004). Also, depression was significantly higher in caregivers (31.6% vs 3.5%, p= <0.001). Twenty-eight (49.1%) of the caregivers had mild to moderate burden and 19 (33.3%) had a high burden. The mean Zarit burden score was higher in female caregivers compared to male caregivers (18.30±8.11 vs 14.83±6.70, p = 0.09). The mean depression score was higher in female caregivers compared to male caregivers (8.58±3.83 vs 6.75±3.80, p= 0.08). There was significant positive correlation between Zarit burden and hospital anxiety score (r = 0.539, p= < 0.001) and depression score (r = 0.472, p = 0.005). Conclusion Depression, anxiety and burden were common among caregivers of CKD patients especially females compared to controls. Supportive interventions for these caregivers should be included in treatment guidelines in order to improve overall patients' outcome. Funding Self-funded
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Affiliation(s)
- Oluseyi A Adejumo
- Department of Internal Medicine, Kidney Care Centre, University of Medical Sciences Ondo, Ondo State, Nigeria
| | - Ikponmwosa O Iyawe
- Department of Internal Medicine, University of Benin, Benin City, Edo State, Nigeria
| | - Ayodeji A Akinbodewa
- Department of Internal Medicine, Kidney Care Centre, University of Medical Sciences Ondo, Ondo State, Nigeria
| | - Olatunji S Abolarin
- Department of Internal Medicine, Kidney Care Centre, University of Medical Sciences Ondo, Ondo State, Nigeria
| | - Emmanuel O Alli
- Department of Internal Medicine, Kidney Care Centre, University of Medical Sciences Ondo, Ondo State, Nigeria
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García-Sanjuán S, Lillo-Crespo M, Cabañero-Martínez MJ, Richart-Martínez M, Sanjuan-Quiles Á. Experiencing the care of a family member with Crohn's disease: a qualitative study. BMJ Open 2019; 9:e030625. [PMID: 31641000 PMCID: PMC6830586 DOI: 10.1136/bmjopen-2019-030625] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES To explore the experiences of caregivers living with relatives affected by Crohn's disease (CD) in a context in which the family provides social support. DESIGN A qualitative study based on a phenomenological approach was conducted through in-depth interviews. SETTING Participants living in Alicante (Spain) were recruited PARTICIPANTS: Eleven family caregivers of people with CD were interviewed. METHODS The in-depth interviews took place in the participants' homes and were audio recorded and then transcribed for a qualitative thematic analysis. RESULTS Five themes and accompanying subthemes were identified: (1) adaptation to the caring experience, (2) dichotomy 'with or without me', (3) unending burden, (4) need for knowledge and control of the disease, and (5) getting used to CD and normalising life. CONCLUSION The findings contribute to an increase in the knowledge and comprehension of the experience of being the caregiver of a relative with CD, which could be useful for professionals towards improving the quality of the CD caring process. Due to the temporal dimension of CD with frequent bouts of exacerbation and remission, family caregivers must adapt and acquire skills during chronic illness evolution. Moreover, the lack of family caregivers' inclusion and follow-up within the Spanish health system makes them feel invisible and useless, which may contribute to caregivers' burdens.
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Affiliation(s)
- Sofía García-Sanjuán
- Faculty of Health Sciences, Department of Nursing, University of Alicante, Alicante, España
| | - Manuel Lillo-Crespo
- Faculty of Health Sciences, Department of Nursing, University of Alicante, Alicante, España
| | | | | | - Ángela Sanjuan-Quiles
- Faculty of Health Sciences, Department of Nursing, University of Alicante, Alicante, España
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Abstract
Rationale & Objective Understanding whether family members’ experiences with patients’ treatment for end-stage kidney disease (ESKD) were expected could guide the development of family-centered interventions that enhance the preparedness of patients and their care partners for kidney replacement therapies. We explored unexpected negative experiences with ESKD treatments among family members of dialysis and posttransplantation patients to identify meaningful directions for family-centered research and clinical care. Study Design Qualitative study. Setting & Participants 8 focus groups comprising 49 family members of dialysis patients and living donor kidney transplant recipients undergoing medical care in Baltimore, MD. Analytical Approach Focus groups were stratified by patients’ treatment (in-center hemodialysis, home hemodialysis, peritoneal dialysis, or living donor kidney transplantation) and family members’ self-reported race (African American vs non–African American), resulting in 2 groups per treatment experience. Inductive thematic analysis was used to identify themes in focus group transcripts. Themes shared across different treatment groups were highlighted to provide insight into common experiences. Results We identified 4 themes that described family members’ unexpected negative treatment experiences: becoming a care partner (unanticipated responsibilities and sleep disruptions), adverse psychological treatment responses in patients (eg, depression) and family members (eg, anxiety), treatment delivery and logistics (insufficient information, medication regimen, and logistical inconveniences), and patient morbidity (dialysis-related health problems and fatigue). All themes were relevant to discussions in the in-center hemodialysis, peritoneal dialysis, and transplantation groups, whereas psychological responses and morbidity themes did not reflect discussions in home hemodialysis groups. Limitations Data collection occurred from 2008 to 2009; family members were recruited through patients undergoing care in 1 geographic area; 1 family member participant per patient. Conclusions Family members described a broad range of unexpected negative experiences with ESKD treatments. Efforts to prepare families for ESKD treatments through more family-centered care, early and tailored education, and interventions targeting care partner preparedness, health provider–family member communication, and relationship dynamics in family member–patient dyads are needed.
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Roberti J, Cummings A, Myall M, Harvey J, Lippiett K, Hunt K, Cicora F, Alonso JP, May CR. Work of being an adult patient with chronic kidney disease: a systematic review of qualitative studies. BMJ Open 2018; 8:e023507. [PMID: 30181188 PMCID: PMC6129107 DOI: 10.1136/bmjopen-2018-023507] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/28/2018] [Accepted: 08/08/2018] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) requires patients and caregivers to invest in self-care and self-management of their disease. We aimed to describe the work for adult patients that follows from these investments and develop an understanding of burden of treatment (BoT). METHODS Systematic review of qualitative primary studies that builds on EXPERTS1 Protocol, PROSPERO registration number: CRD42014014547. We included research published in English, Spanish and Portuguese, from 2000 to present, describing experience of illness and healthcare of people with CKD and caregivers. Searches were conducted in MEDLINE, Embase, CINAHL Plus, PsycINFO, Scopus, Scientific Electronic Library Online and Red de Revistas Científicas de América Latina y el Caribe, España y Portugal. Content was analysed with theoretical framework using middle-range theories. RESULTS Searches resulted in 260 studies from 30 countries (5115 patients and 1071 carers). Socioeconomic status was central to the experience of CKD, especially in its advanced stages when renal replacement treatment is necessary. Unfunded healthcare was fragmented and of indeterminate duration, with patients often depending on emergency care. Treatment could lead to unemployment, and in turn, to uninsurance or underinsurance. Patients feared catastrophic events because of diminished financial capacity and made strenuous efforts to prevent them. Transportation to and from haemodialysis centre, with variable availability and cost, was a common problem, aggravated for patients in non-urban areas, or with young children, and low resources. Additional work for those uninsured or underinsured included fund-raising. Transplanted patients needed to manage finances and responsibilities in an uncertain context. Information on the disease, treatment options and immunosuppressants side effects was a widespread problem. CONCLUSIONS Being a person with end-stage kidney disease always implied high burden, time-consuming, invasive and exhausting tasks, impacting on all aspects of patients' and caregivers' lives. Further research on BoT could inform healthcare professionals and policy makers about factors that shape patients' trajectories and contribute towards a better illness experience for those living with CKD. PROSPERO REGISTRATION NUMBER CRD42014014547.
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Affiliation(s)
- Javier Roberti
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Amanda Cummings
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Michelle Myall
- Faculty of Health Sciences, University of Southampton, Southampton, UK
- NIHR CLAHRC Wessex, University of Southampton, Southampton, UK
| | - Jonathan Harvey
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Kate Lippiett
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Federico Cicora
- FINAER, Foundation for Research and Assistance of Kidney Disease, Buenos Aires, Argentina
| | - Juan Pedro Alonso
- Faculty of Social Sciences, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Carl R May
- London School of Hygiene and Tropical Medicine, Faculty of Epidemiology and Population Health, London, UK
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Sou'ub RM, Masa'Deh R, AbuRuz ME, Alhalaiqa F. Parental psychological stress: Children on hemodialysis. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: https://doi.org/10.1016/j.ijans.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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Sou'ub RM, Masa'Deh R, AbuRuz ME, Alhalaiqa F. Parental psychological stress: Children on hemodialysis. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: 10.1016/j.ijans.2018.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Sou'ub RM, Masa'Deh R, AbuRuz ME, Alhalaiqa F. Parental psychological stress: Children on hemodialysis. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2018. [DOI: https:/doi.org/10.1016/j.ijans.2018.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
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