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Krause EG, Christensen U, Svendsen MN. Curating 'the good story': Care as representative performance in Danish veteran rehabilitation. SOCIOLOGY OF HEALTH & ILLNESS 2024. [PMID: 39023821 DOI: 10.1111/1467-9566.13822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 06/25/2024] [Indexed: 07/20/2024]
Abstract
In this article, we explore the intricacies of veteran care and show how care practices come to incorporate veterans' 'self-performances' to raise political attention and funding for future rehabilitation activities. By bringing into dialogue theories of care and theories of performance and representation, we illustrate how a seemingly classic form of care-veteran rehabilitation-takes the form of representative performance. Drawing on ethnographic fieldwork and interviews with the Danish Invictus Games team, we demonstrate how politics, research and TV documentaries are integrated into veteran care practices. Through this integration, mentally wounded veterans, while performing 'themselves' for shifting audiences with shifting agendas, come to assume the roles of both caregivers and care receivers. Crucially, we highlight that wounded veterans, while undertaking their personal rehabilitation journey, are curated into and (un)willingly positioned as representatives of others. By showing how caring for wounded veterans goes hand in hand with caring for fictive, future wounded veterans and for political, research and media agendas, this article offers new ways of thinking of and with care.
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Affiliation(s)
- Eva Graae Krause
- Department of Occupational Therapy and Physiotherapy, Copenhagen University Hospital, Kobenhavn, Denmark
- Department of Public Health, Centre for Medical Science and Technology Studies, University of Copenhagen, Kobenhavn, Denmark
| | - Ulla Christensen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Mette N Svendsen
- Department of Public Health, Centre for Medical Science and Technology Studies, University of Copenhagen, Kobenhavn, Denmark
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Hansen L, Chang MF, Hiatt S, Dieckmann NF, Lee CS. Informal Family Care Partner Well-Being Is Diminished in End-Stage Liver Disease. Nurs Res 2024; 73:E202-E211. [PMID: 38526959 PMCID: PMC11192616 DOI: 10.1097/nnr.0000000000000740] [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: 03/27/2024]
Abstract
BACKGROUND Chronic liver disease is a significant global neglected public health problem. End-stage liver disease is associated with substantial symptom complexity, disability, and care needs that require assistance from informal family care partners. Research on these care partners' caregiver burden or strain, symptoms, and quality of life is sparse and has not focused on these variables as co-occurring or in the context of the quality of the relationship care partners have with the patients. OBJECTIVES The purpose of this study was to provide a collective presentation of patterns and determinants of well-being as measured by caregiver strain, depression, sleep, and quality of life in a cohort of informal family care partners for adult outpatients with end-stage liver disease. METHODS Care partners (aged >18 years) were recruited from two liver clinics within two tertiary healthcare systems and invited to complete a cross-sectional survey. They completed the Multidimensional Caregiver Strain Index, Patient Health Questionnaire, Pittsburgh Sleep Quality Index, Short Form Health Survey, and Mutuality Scale. Descriptive statistics and latent class mixture modeling were used to analyze these data. RESULTS The sample was predominantly female and White. The well-being of care partners was diminished. Three distinct classes of well-being were identified: mildly diminished (53.2%), moderately diminished (39.0%), and severely diminished (7.8%). Those at a greater risk of worse well-being were younger and spouses and had poorer relationship quality with the patients. DISCUSSION To improve the well-being of care partners in moderately and severely diminished classes, assessing and addressing caregiver strain and co-occurring symptoms is essential. Addressing the strain and symptoms has the potential to maintain or optimize care partners' ability to provide care to patients. Future researchers should include longitudinal and dyadic studies to examine how patients' disease progression and symptoms may affect family care partners' well-being and vice versa.
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Elliott J, Francetic I, Meacock R, Sutton M. Do Informal Care Recipients Internalise Carer Burden? Examining the Impact of Informal Care Receipt on Health Behaviours. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2024; 22:209-225. [PMID: 38198104 PMCID: PMC10864417 DOI: 10.1007/s40258-023-00843-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Providing informal care has a negative effect on the caregiver's health and well-being, but little is known about how individuals respond to receiving informal care. Care recipients may improve their health behaviours to minimise the onerousness of caregiving and the stress faced by their carer from seeing a loved one in ill-health. OBJECTIVE We aimed to examine whether informal care recipients internalise the potential for carer spillovers through changes in health behaviours. METHODS We used data from 3250 older adults with care needs who took part in the UK Household Longitudinal Study between 2017 and 2019. We examined the response to informal care receipt in terms of the probability of engaging in four health behaviours: healthy diet, physical activity, smoking and alcohol consumption. We estimated average treatment effects using regression adjustment with inverse probability treatment weights, comparing individuals that received informal care to those receiving either formal or no care. RESULTS We found that informal care receipt increased the probability of refraining from negative health behaviours (smoking and alcohol consumption) but reduced the probability of engaging in positive health behaviours (eating fruits and/or vegetables and physical activity). CONCLUSIONS The asymmetric effects detected suggest that the underlying mechanisms are different, and care recipients may be engaging in risk and effort compensation between negative and positive health behaviours. Failure to account for the behavioural responses from informal care recipients may lead to under-estimation or over-estimation of the extent of caregiving burden and the effectiveness of interventions impacting informal carers.
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Affiliation(s)
- Jack Elliott
- Health Organisation, Policy and Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Services, The University of Manchester, Williamson building, 176 Oxford Road, Manchester, M13 9QQ, UK.
| | - Igor Francetic
- Health Organisation, Policy and Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Services, The University of Manchester, Williamson building, 176 Oxford Road, Manchester, M13 9QQ, UK
| | - Rachel Meacock
- Health Organisation, Policy and Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Services, The University of Manchester, Williamson building, 176 Oxford Road, Manchester, M13 9QQ, UK
| | - Matt Sutton
- Health Organisation, Policy and Economics, Division of Population Health, Health Services Research and Primary Care, Faculty of Biology, Medicine and Health, School of Health Services, The University of Manchester, Williamson building, 176 Oxford Road, Manchester, M13 9QQ, UK
- Melbourne Institute, Applied Economic and Social Research, University of Melbourne, Melbourne, VIC, Australia
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Wawrziczny E, Flinois B, Constant E, Brugallé E, Sokolowski C, Manceau C, Baille G, Defebvre L, Dujardin K, Antoine P. Dealing with the diagnosis of Parkinson's disease and its implications for couple functioning in the early stage: An interpretative phenomenological analysis. PLoS One 2024; 19:e0294240. [PMID: 38381728 PMCID: PMC10880977 DOI: 10.1371/journal.pone.0294240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/27/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND For couples facing Parkinson's disease, marital relationships are significantly impacted, even at the early stages of the disease. However, very few studies have explicitly explored the functioning of the couple and how both partners deal with Parkinson's disease. The aim of this study was to explore the experiences and strategies of couples facing Parkinson's disease in the early stage using dyadic interpretative phenomenological analysis. METHODS Fifteen couples agreed to participate in the study. Semistructured interviews were conducted with each partner separately regarding his or her individual experience with Parkinson's disease, the couple's history, the impact of the diagnosis on the functioning of the couple, and his or her projections for the future. RESULTS Three higher-order themes emerged from the analyses. The first theme, "Being tested by the diagnosis", highlights 4 dyadic configurations according to the individual's and the couple's capacity for adjustment following the diagnosis: "noncongruent", "collapsed", "relieved" and "avoidant". The second theme, "Talking about everything except the disease", underlines that communication about the disease is often avoided both within the couple and with relatives to protect the persons with Parkinson's disease or respect their wishes. The third theme, "Supporting each other", describes the different levels of harmony between the two partners in the management of daily life and symptoms and their relational impacts. CONCLUSION These results allow us to better understand the experiences of both partners and to highlight the importance of promoting better acceptance of the diagnosis by persons with Parkinson's disease to allow better communication between partners and with relatives. Such support prevents disease-specific distress and facilitates better adjustment in the later stages of the disease.
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Affiliation(s)
- Emilie Wawrziczny
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Emilie Constant
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Elodie Brugallé
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Céline Sokolowski
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | - Charlotte Manceau
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
| | | | - Luc Defebvre
- Regional and University Hospital Centre of Lille, Lille, France
| | - Kathy Dujardin
- Regional and University Hospital Centre of Lille, Lille, France
| | - Pascal Antoine
- University of Lille, CNRS, UMR 9193 – SCALab – Sciences Cognitives et Sciences Affectives, Lille, France
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Shao M, Wang X, Zhang M, Ding Y, Ma B, Yang Y, Yu L, Chen C, Wang T. Caregiver burden, mutuality, and family resilience in colorectal cancer caring: A mediating model analysis. Eur J Oncol Nurs 2024; 68:102480. [PMID: 38101244 DOI: 10.1016/j.ejon.2023.102480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Revised: 11/15/2023] [Accepted: 11/18/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE This study investigates the interaction between caregiver burden, mutuality, and family resilience in colorectal cancer management, and determines whether mutuality affects the effect of caregiver burden on family resilience. METHOD In this cross-sectional study, 295 family caregivers of colorectal cancer patients from two major public hospitals (Henan Province, China) were analyzed. Caregiver burden, mutuality, and family resilience were assessed through Chinese versions of the Zarit Burden Interview (ZBI-C), the mutuality Scale (MS-C), and the Family Resilience Questionnaire (FaREQ-C). The structural equation model and multiple mediating effect test were applied to explore the interaction between caregiver burden, mutuality, and family resilience. RESULTS Total and subscale scores of caregiver burden were negatively correlated with both mutuality (r = -0.54 to -0.32, P < 0.01) and family resilience (r = -0.60 to -0.26, P < 0.01). Family resilience and its four dimensions were positively correlated with mutuality (r = 0.17 to 0.51, P < 0.01). Mutuality served as a partial mediator between caregiver burden and family resilience. Caregiver burden had an indirect effect on family resilience through mutuality (β = -0.157, 95%CI: -0.316, -0.046, P = 0.009). CONCLUSIONS This study examined the interaction between caregiver burden, mutuality, and family resilience for colorectal cancer caring and confirmed the mediating role of mutuality in caregiver burden and family resilience. Therefore, we suggested that clinicians should develop strategies to improve the relationship between patients and caregivers so that both parties can actively manage stress and trauma experiences for improved colorectal cancer management.
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Affiliation(s)
- Mengwei Shao
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Xin Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China.
| | - Menghan Zhang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Yangqing Ding
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China
| | - Bin Ma
- School of Medical, Molecular and Forensic Sciences, Murdoch University, 6149, Australia
| | - Yi Yang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Lulu Yu
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China
| | - Changying Chen
- The First Affiliated Hospital of Zhengzhou University, Zhengzhou, 450052, China.
| | - Tao Wang
- The College of Nursing and Health of Zhengzhou University, Zhengzhou, 450001, China; Telethon Kids Institute, Perth, WA, 6872, Australia; Medical School, University of Western Australia, Perth, WA, 6872, Australia; People' s Hospital of Hebi, Hebi, 458010, China.
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6
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Mroz EL, Monin JK, Gaugler JE, Matta-Singh TD, Fried TR. Rewriting the Story of Mid- and Late-Life Family Caregiving: Applying a Narrative Identity Framework. THE GERONTOLOGIST 2024; 64:gnad040. [PMID: 37018754 PMCID: PMC10809219 DOI: 10.1093/geront/gnad040] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Indexed: 04/07/2023] Open
Abstract
Family caregivers of older people with health needs often provide long-term, intensive support. Caregivers are, in turn, shaped by these caregiving experiences. According to the narrative identity framework, self-narratives from lived experiences influence self-beliefs and behaviors. We assert that family caregiving experiences, filtered through individuals' memory systems as self-narratives, provide substantial scaffolding for navigating novel challenges in late life. Self-narratives from caregiving can guide positive self-beliefs and behaviors, leading to constructive health-focused outcomes, but they also have the potential to guide negative self-beliefs or behaviors, causing adverse consequences for navigating late-life health. We advocate for incorporating the narrative identity framework into existing caregiving stress models and for new programs of research that examine central mechanisms by which caregiving self-narratives guide self-beliefs and behavioral outcomes. To provide a foundation for this research, we outline 3 domains in which caregiving self-narratives may substantially influence health-related outcomes. This article concludes with recommendations for supporting family caregivers moving forward, highlighting narrative therapy interventions as innovative options for reducing the negative consequences of maladaptive caregiving self-narratives.
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Affiliation(s)
- Emily L Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Joan K Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Joseph E Gaugler
- Center for Healthy Aging and Innovation, School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
- School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA
| | | | - Terri R Fried
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
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Shalev A, Ringel JB, Riegel B, Vellone E, Stawnychy MA, Safford M, Goyal P, Tsui E, Franzosa E, Reckrey J, Sterling M. Does Connectedness Matter? The Association Between Mutuality and Job Satisfaction Among Home Health Aides Caring for Adults With Heart Failure. J Appl Gerontol 2023; 42:747-757. [PMID: 36541188 PMCID: PMC9992152 DOI: 10.1177/07334648221146772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Home health aides (HHAs) provide care to many adults with heart failure (HF) in the home. As the demand for HHAs increases, there is a need to promote HHAs' job satisfaction and retention. In this cross-sectional community-partnered study, we examined whether mutuality (e.g., quality of the HHA-patient relationship), is associated with job satisfaction among HHAs caring for adults with HF. Mutuality was assessed with the Mutuality Scale, which measures overall mutuality and its four domains (reciprocity, love and affection, shared pleasurable activities, and shared values). Our final sample of 200 HHAs was primarily female. The mean overall mutuality score was 2.92 out of 4 (SD 0.79). In our final model, overall mutuality and each of the four domains were associated with increased job satisfaction; however, only the shared pleasurable activities domain was significant (aPR: 1.15 [1.03-1.32]). Overall, mutuality may play a role in promoting job satisfaction among HHAs.
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Affiliation(s)
- Ariel Shalev
- 12295Weill Cornell Medical College, New York, NY, USA
| | | | - Barbara Riegel
- 16142University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| | - Ercole Vellone
- University of Rome Tor Vergata, Italy; Wroclaw Medical University, Poland
| | | | | | - Parag Goyal
- 12295Weill Cornell Medical College, New York, NY, USA
| | - Emma Tsui
- CUNY Graduate School of Public Health & Health Policy, New York, NY, USA
| | - Emily Franzosa
- 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
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8
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Zhu S, Yang C, Mei W, Kang L, Li T, Li J, Li L. Caregiver burden for informal caregivers of patients after surgical treatment of early-stage lung cancer. J Clin Nurs 2023; 32:859-871. [PMID: 35869414 DOI: 10.1111/jocn.16424] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/20/2022] [Accepted: 06/01/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Caregivers of lung cancer patients frequently experience psychological distress and high caregiver burden. Previous studies have focused on caregiver burden for patients with advanced lung cancer, while few studies focused on the caregiver burden among informal caregivers of postoperative patients with early-stage non-small cell lung cancer (NSCLC). OBJECTIVES This study aimed to (a) examine caregiver burden for caregivers of patients with early-stage NSCLC after surgical treatment and (b) identify predictive factors related to caregiver burden of patients with early-stage NSCLC. METHODS A cross-sectional study was conducted in a university-affiliated hospital in Changsha, China. A total of 385 patients with early-stage NSCLC and postsurgical treatment and their caregivers were included in this study. Caregiver burden was evaluated using the Zarit caregiver burden interview (ZBI). A set of questionnaires was used to assess psychosocial characteristics of participants, including simplified coping style questionnaire, social support rate scale, and hospital anxiety and depression scale. Hierarchical regression analysis was applied to identify factors associated with caregiver burden. We followed STROBE checklist for reporting the study. RESULTS The average ZBI score was 29.1 ± 11.4. Most caregivers (62.6%) demonstrated mild to moderate caregiving burden. The duration of caregiving (β = 0.18, p < .001), passive coping of caregiver (β = 0.17, p = .001) and anxiety (β = 0.13, p = .007) were significant predictors of caregiving burden. A variance of 17.6% in caregiving burden was explained by these identified factors. CONCLUSIONS Caregivers of early-stage NSCLC patients experience a mild to moderate level of caregiver burden. The duration of caregiving, passive coping and anxiety are factors associated with caregiver burden. RELEVANCE TO CLINICAL PRACTICE Clinicians should provide early care to support new roles of family members as caregivers.
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Affiliation(s)
- Song Zhu
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Wei Mei
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lu Kang
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Tong Li
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jina Li
- Clinic Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China.,Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lezhi Li
- Xiangya Nursing School, Central South University, Changsha, China
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McKenna O, Fakolade A, Cardwell K, Pilutti LA. A continuum of languishing to flourishing: exploring experiences of psychological resilience in multiple sclerosis family caregivers. Int J Qual Stud Health Well-being 2022; 17:2135480. [PMID: 36333904 PMCID: PMC9645274 DOI: 10.1080/17482631.2022.2135480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Purpose Resilience research in family caregiving in chronic neurological conditions is growing, but multiple sclerosis (MS) caregivers are noticeably absent from this body of work. MS caregivers represent a unique population due to the disease’s early onset, prolonged life expectancy, and heterogeneity. As such, this study aimed to explore MS caregivers’ conceptualizations of resilience, examine MS caregivers’ experiences of resilience development, and determine which assets and resources influence resilience in this role. Methods Twenty-four Canadian MS caregivers were recruited. Semi-structured in-depth interviews were conducted with questions derived from an ecological resilience framework. Data were analysed using reflexive thematic analysis. Results Themes constructed a cyclical resilience model, beginning with encounters with hardship and extending to thriving adjustment. Subthemes included reports of additive challenges, impactful individual and community resources, and multi-level adaptive pathways. Within this cycle, the achievement of healthy adjustment exerted a positive feedback function and informed future responses to lifelong challenges. Conclusions Despite the salience of resilience processes within caregiver testimonies, inadequate resources at societal levels were evident. These findings afford researchers and decision-makers relevant information for designing and implementing resilience-building interventions for MS caregivers that attend to contextual factors and current systemic support deficiencies.
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Affiliation(s)
- Odessa McKenna
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada
| | - Katherine Cardwell
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
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Carleton-Eagleton K, Walker I, Gibson D, Freene N, Semple S. Testing the validation and reliability of the Caregiver-Patient Activation Measure (CG-PAM). PEC INNOVATION 2022; 1:100098. [PMID: 37213753 PMCID: PMC10194270 DOI: 10.1016/j.pecinn.2022.100098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 10/06/2022] [Accepted: 11/07/2022] [Indexed: 05/23/2023]
Abstract
Objective The objective of this study was to test the reliability and validity of the Caregiver-Patient Activation Measure (CG-PAM). Methods Based on the psychometric testing of the original Patient Activation Measure (PAM), three assessments of reliability and validity were completed on the CG-PAM. Test-retest reliability was assessed across two weeks (n = 23). Criterion validity was assessed by interviewing participants from the test-retest cohort (n = 10), with transcripts assessed by subject matter experts (n = 3) to classify activation levels of the interviewee. Construct validity was assessed through a survey (n = 179) consisting of demographic questions, the CG-PAM and concepts hypothesised to be related to caregiver activation. Results There was strong test-retest reliability (r = 0.893), but poor criterion validity. Assessment o;f construct validity demonstrated significant relationships found between caregiver activation and weekly hours of care provided (p < 0.001), relationship satisfaction (p < 0.001), and dyad typology (p < 0.001), but not with perceived levels of stress or social support. Conclusion The CG-PAM was found to have strong reliability, but there were inconsistent results across the validation tests conducted. Innovation Future research must consider the dynamic nature of caring and the importance of the relationship between the caregiver/recipient when defining activation levels within the CG-PAM.
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Affiliation(s)
- Katherine Carleton-Eagleton
- Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
- Corresponding author at: Faculty of Health, 11 Kirinari Street, Bruce, ACT 2617, Australia
| | - Iain Walker
- School of Psychological Sciences, University of Melbourne, Level 7, Redmond Barry Building, The University of Melbourne, Victoria, 3010, Australia
| | - Diane Gibson
- Health Research Institute, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
| | - Nicole Freene
- Health Research Institute, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
| | - Stuart Semple
- Health Research Institute and Research Institute for Sport & Exercise, Faculty of Health, University of Canberra, 11 Kirinari Street, Bruce, ACT 2617, Australia
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Shrestha S, Richey S, Lipovac-Dew M, Kunik ME, Stanley MA, Ramsey D, Amspoker AB. An Examination of Positive and Negative Dementia Caregiving Experiences. Clin Gerontol 2022; 45:1263-1272. [PMID: 33357171 PMCID: PMC8236064 DOI: 10.1080/07317115.2020.1868033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES We examined associations among three measures of caregiver experiences (i.e., positive aspects of caring [PAC], caregiver burden, and mutuality) in 228 dyads involving persons with dementia (PWD) and their informal caregivers. The associations between predisposing, enabling, and need factors and each of these three measures of caregiver experiences were also examined. METHODS We used baseline data from a randomized controlled trial of a psychosocial intervention aimed at preventing aggression in PWD. Associations among PAC, caregiver burden, and mutuality were examined. The Behavioral Model of Health Services Utilization guided the selection of predisposing, enabling, and need components. RESULTS Enabling characteristics (e.g., race/ethnicity, caregiver education and employment and PWD education) and most predisposing characteristics (e.g., caregiver age, PWD age, relationship type) were not associated with any caregiving experience measures. Need characteristics (e.g., levels of memory and functional impairment, behavioral problems, depression, pleasant events) were associated with the caregiving experience. CONCLUSIONS Bivariate correlations between PAC, caregiver burden, and mutuality were between -0.20 and -0.58. Predisposing, enabling, and need factors were differentially associated with outcomes, with need characteristics being most frequently associated with various aspects of caregiving. CLINICAL IMPLICATIONS Assessment of both positive and negative aspects of caregiving is important. Particular attention to depression and interventions that improve depressive symptoms may increase PAC and mutuality and reduce caregiver burden.
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Affiliation(s)
- Srijana Shrestha
- Wheaton College, Norton, MA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Sheila Richey
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
| | - Martha Lipovac-Dew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Mark E. Kunik
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
| | - Melinda A. Stanley
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - David Ramsey
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
| | - Amber B. Amspoker
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
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Johansson MF, McKee KJ, Dahlberg L, Summer Meranius M, Williams CL, Marmstål Hammar L. Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons with Dementia in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031788. [PMID: 35162811 PMCID: PMC8835239 DOI: 10.3390/ijerph19031788] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/04/2022]
Abstract
(1) Background: Spouse carers of persons with dementia (PwD) are particularly vulnerable to negative outcomes of care, yet research rarely focuses on their caregiving situation. This study explores factors associated with the positive value and negative impact of caregiving in spouse carers of PwD in Sweden. (2) Methods: The study was a cross-sectional questionnaire-based survey, with a convenience sample of spouse carers of PwD (n = 163). The questionnaire addressed: care situation, carer stress, health and social well-being, relationship quality and quality of support, and contained measures of positive value and negative impact of caregiving. (3) Results: Hierarchical regression models explained 63.4% variance in positive value and 63.2% variance in negative impact of caregiving. Three variables were significant in the model of positive value: mutuality, change in emotional closeness following dementia and quality of support. Six variables were significant in the model of negative impact: years in relationship, years as carer, behavioural stress, self-rated health, emotional loneliness and change in physical intimacy following dementia. (4) Conclusions: Support to spouse carers of PwD should address the carer–care-recipient relationship quality, although different aspects of the relationship should be addressed if both the positive value of caregiving is to be enhanced and the negative impact reduced.
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Affiliation(s)
- Marcus F. Johansson
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- Correspondence:
| | - Kevin J. McKee
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- Aging Research Center, Karolinska Institutet & Stockholm University, Tomtebodavägen 18A, 171 65 Solna, Sweden
| | | | - Christine L. Williams
- Christine E Lynn College of Nursing, Florida Atlantic University Boca Raton, FL 334 31, USA;
| | - Lena Marmstål Hammar
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (K.J.M.); (L.D.); (L.M.H.)
- School of Health, Care and Social Welfare, Mälardalen University, 721 23 Västerås, Sweden;
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, 141 52 Huddinge, Sweden
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13
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Cranley LA, Lam SC, Brennenstuhl S, Kabir ZN, Boström AM, Leung AYM, Konradsen H. Nurses' Attitudes Toward the Importance of Families in Nursing Care: A Multinational Comparative Study. JOURNAL OF FAMILY NURSING 2022; 28:69-82. [PMID: 34493109 PMCID: PMC8814953 DOI: 10.1177/10748407211042338] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The aim of this study was to examine nurses' attitudes about the importance of family in nursing care from an international perspective. We used a cross-sectional design. Data were collected online using the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) questionnaire from a convenience sample of 740 registered nurses across health care sectors from Sweden, Ontario, Canada, and Hong Kong, China. Mean levels of attitudes were compared across countries using analysis of variance (ANOVA). Multiple regression was used to identify factors associated with nurses' attitudes and to test for interactions by country. Factors associated with nurse attitudes included country, age, gender, and several practice areas. On average, nurses working in Hong Kong had less positive attitudes compared with Canada and Sweden. The effects of predictors on nurses' attitudes did not vary by country. Knowledge of nurses' attitudes could lead to the development of tailored interventions that facilitate nurse-family partnerships in care.
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Affiliation(s)
| | | | | | | | - Anne-Marie Boström
- Karolinska Institutet, Stockholm, Sweden
- Karolinska University Hospital, Stockholm, Sweden
- Stockholms Sjukhem, Sweden
- University of Alberta, Edmonton, Canada
| | | | - Hanne Konradsen
- Karolinska Institutet, Stockholm, Sweden
- University of Copenhagen, Denmark
- Herlev and Gentofte Hospital, Denmark
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14
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The Influence of Preparedness, Mutuality, and Self-efficacy on Home Care Workers' Contribution to Self-care in Heart Failure: A Structural Equation Modeling Analysis. J Cardiovasc Nurs 2022; 37:146-157. [PMID: 33315614 PMCID: PMC8196074 DOI: 10.1097/jcn.0000000000000768] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Home care workers (HCWs) are increasingly caring for patients with heart failure (HF). Previous studies have shown that they contribute to HF patients' care, but how their preparedness and their relationship with patients (mutuality) influence caregiving is unknown, as well as the role of HCWs' self-efficacy. OBJECTIVE Guided by the Situation-Specific Theory of Caregiver Contribution to HF Self-Care, we investigated the influence of HCWs' preparedness and mutuality on HCWs' contribution to HF self-care and the mediating effect of HCWs' self-efficacy in the process. METHODS We conducted a cross-sectional survey of HCWs who cared for patients with HF. The survey included the Caregiver Preparedness Scale, Mutuality Scale, Caregiver Contribution to Self-Care of HF Index, and Caregiver Self-Efficacy in Contributing to Self-Care Scale. We performed structural equation modeling and a mediation analysis. RESULTS A total of 317 HCWs employed by 22 unique home care agencies across New York, NY, completed the survey. They had a median age of 50 years, 94% were women, and 44% were non-Hispanic Black. Results demonstrated that mutuality had a direct influence on HCW contribution to self-care and preparedness influenced their contribution to self-care, but only through the mediation of self-efficacy. CONCLUSION Home care workers' preparedness, mutuality, and self-efficacy have important roles in influencing their contribution to HF self-care. As a workforce increasingly involved in the care of patients with HF, knowing the mechanisms underpinning HCWs' contribution to self-care may illuminate future interventions aimed at improving their contributions and HF patient outcomes.
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15
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Ris I, Volken T, Schnepp W, Mahrer-Imhof R. Exploring Factors Associated With Family Caregivers' Preparedness to Care for an Older Family Member Together With Home Care Nurses: An Analysis in a Swiss Urban Area. J Prim Care Community Health 2022; 13:21501319221103961. [PMID: 35670066 PMCID: PMC9178975 DOI: 10.1177/21501319221103961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction: Home-dwelling older people with chronic diseases often need the support of informal and formal caregivers in order to continue living at home. Family members, however, need to be willing and prepared for caregiving together with home care nurses. Objectives: The purpose of this study was to explore factors associated with family caregivers’ preparedness to care for older home-dwelling adults who also receive home care nursing services. Methods: For this cross-sectional correlational study, a structured questionnaire was sent to family caregivers of adults aged 65 years or older receiving services from a community care agency. A total of 243 participants returned the questionnaire, of which 199 could be analyzed. Results: The stepwise backward regression model explained 29.1% of the variance of family caregivers’ preparedness. Mutuality was the most strongly associated factor with family caregivers’ preparedness whereas professional involvement of family caregiver in care process was important as well. Care intensity showed no significant impact. Conclusion: Nurses should support the whole family emotionally, and appreciate, admire, reinforce, and respect the caregivers’ situation. Home care nurses need to invest in helping families to find solutions, to strengthen their relationships between family members and the older person dwelling at home.
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Affiliation(s)
- Irène Ris
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland.,Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
| | - Thomas Volken
- ZHAW Zürcher Hochschule für Angewandte Wissenschaften, Winterthur Schweiz, Switzerland
| | - Wilfried Schnepp
- Universität Witten/Herdecke, Fakultät für Gesundheit, Witten, Deutschland
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16
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Dellafiore F, Chung ML, Alvaro R, Zeffiro V, Ercole V, Pucciarelli G. Influence of mutuality on quality of life in heart failure patient with inadequate self-care and caregiver dyads: an actor-partner interdependence model analysis. Eur J Cardiovasc Nurs 2021; 21:366-373. [PMID: 34661635 DOI: 10.1093/eurjcn/zvab089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 05/31/2021] [Accepted: 08/16/2021] [Indexed: 12/28/2022]
Abstract
AIMS Mutuality, a positive quality of the relationship between patients and their informal caregivers characterized by love and affection, shared pleasurable activities, shared values, and reciprocity, influences several patient-caregiver outcomes in chronic-condition cases, but it remains unknown whether it influences the heart failure (HF) patient-caregiver dyad quality of life (QOL). The aim of this study was to evaluate the influence of mutuality and its four dimensions (love and affection, shared pleasurable activities, shared values, and reciprocity) on QOL in HF patient-caregiver dyads. METHODS AND RESULTS Cross-sectional study: Using the actor-partner interdependence model, we examined how an individual's mutuality influenced his/her own QOL (actor effect) and his/her partner's QOL (partner effect). Mutuality and physical and mental QOL were measured with the Mutuality Scale and Short Form 12, respectively. A total of 494 HF patient-caregiver dyads were enrolled in the study. Mutuality showed strong evidence of caregiver partner effects on the HF patients' physical QOL (total score B = 2.503, P = 0.001; shared pleasurable activities B = 2.265, P < 0.001; shared values B = 1.174, P = 0.420 and reciprocity B = 1.888, P = 0.001). For the mental QOL, mutuality and its four subscales had actor effects only on the patients' mental health (total mutuality B = 2.646, P = 0.003; love and affection B = 1.599, P = 0.360; shared pleasurable activities B = 2.599, P = 0.001; shared values B = 1.564, P = 0.001 and reciprocity B = 1.739, P = 0.020). In caregivers, mutuality had an actor effects on mental QOL (total score B = 1.548, P = 0.041 and reciprocity B = 1.526, P = 0.009). CONCLUSION Our results confirm the important role of mutuality in determining the physical and mental QOL in HF patient-caregiver dyads. Interventions aimed at improving the relationships within HF patient-caregiver dyads may have an impact on HF patients' and caregivers' QOL.
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Affiliation(s)
- Federica Dellafiore
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Forlanini, 2 - 27100 Pavia, Italy
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA & Yonsei University, Seoul, Korea
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Vellone Ercole
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
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17
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A pilot randomized clinical trial of a teamwork intervention for heart failure care dyads. Heart Lung 2021; 50:877-884. [PMID: 34407481 DOI: 10.1016/j.hrtlng.2021.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/24/2021] [Accepted: 07/26/2021] [Indexed: 01/31/2023]
Abstract
BACKGROUND Dyadic heart failure (HF) management can improve outcomes for patients and caregivers and can be enhanced through eHealth interventions. OBJECTIVE To evaluate the feasibility, acceptability, and preliminary efficacy of an eHealth dyadic teamwork intervention, compared to an attention control condition. METHODS We recruited 29 HF patient-caregiver dyads from inpatient units and randomized dyads to an intervention or a control group. We calculated enrollment and retention rates, described acceptability using interview and questionnaire data, and computed intervention effect sizes. RESULTS 37% of eligible dyads agreed to participate and 93% of randomized participants completed follow-up questionnaires. Participants found both study conditions to be acceptable. Between-group effect sizes suggested that the intervention led to improvements in relationship quality, self-efficacy, and quality of life for patients and caregivers. CONCLUSIONS Dyadic recruitment from acute care settings is challenging. Findings provide initial evidence that our intervention can contribute to better health outcomes for HF dyads.
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18
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Abstract
There are more than 43 million family caregivers in the United States. In studies of family caregivers and receivers, evidence suggests that family caregiver-receiver mutuality is linked to health. Lack of a clear definition of family caregiver-receiver mutuality is an obstacle that prevents scientific progress and effective operationalization of the concept. To address this issue, the authors applied Walker and Avant's method for concept analysis and clarified the concept of family caregiver-receiver mutuality. A standardized definition of caregiver-receiver mutuality is presented along with antecedents, consequences, defining attributes, empirical referents, and case illustrations.
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19
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La IS, Johantgen M, Storr CL, Zhu S, Cagle JG, Ross A. Caregiver burden and related factors during active cancer treatment: A latent growth curve analysis. Eur J Oncol Nurs 2021; 52:101962. [PMID: 33962232 DOI: 10.1016/j.ejon.2021.101962] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/06/2021] [Accepted: 04/11/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE Caregiver burden is frequently studied cross-sectionally, but longitudinal studies on family caregiver burden during active cancer treatment are lacking. The goals of this study were to characterize trajectories of caregivers' burden during a 6-month active treatment period, and to examine which predictors are associated with their burden. METHOD This study was a secondary analysis of data from a prospective study. A sample of 112 family caregivers of patients receiving cancer treatment were assessed at three time points (the initiation of new treatment regimen, 3-, and 6-month follow-up). Caregivers completed measures: Caregiver Reaction Assessment and Mutuality Scale of the Family Care Inventory. Data were analyzed using latent growth curve modeling. RESULTS The two highest burdens were subdomains related to disrupted schedule and financial problems. Models showed a decline in schedule burden over time, yet total burden and other subscales (financial problems, health problems, and lack of family support and self-esteem) remained relatively stable. In multivariate analysis, mutuality, the relationship quality between patients and caregivers was inversely related to burden at baseline. Being a spouse, a sole caregiver and lower income were related to higher burden over time. CONCLUSIONS Our findings confirmed significant determinants of caregiver burden over the course of active treatment. It is important for health care providers to be attentive to vulnerable caregivers who are at higher risk of elevated burden over time. Considering the multidimensional nature of caregiver burden, early assessment and tailored support programs may be effective by focusing on patient-caregiver relationships, caregiving roles, and income.
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Affiliation(s)
- In Seo La
- College of Nursing Science, Kyung Hee University, Seoul, South Korea; University of Maryland School of Nursing, Baltimore, MD, USA.
| | - Meg Johantgen
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Carla L Storr
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - Shijun Zhu
- University of Maryland School of Nursing, Baltimore, MD, USA
| | - John G Cagle
- University of Maryland School of Social Work, Baltimore, MD, USA
| | - Alyson Ross
- National Institutes of Health, Clinical Center, Bethesda, MD, USA
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20
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Peng Y, Wang J, Sun G, Liu S. Family Hardiness in Patients with Heart Failure: Exploring Protective Factors and Identifying the Mediator. Psychol Res Behav Manag 2021; 14:355-364. [PMID: 33790667 PMCID: PMC8007564 DOI: 10.2147/prbm.s301765] [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: 01/13/2021] [Accepted: 03/11/2021] [Indexed: 01/12/2023] Open
Abstract
Background Struggling with heart failure (HF) may be a distressful experience for the entire family. As a key variable contributing to positive family functioning, family hardiness can protect against HF-related harm. Thus, recognizing factors associated with family hardiness could promote strategies that enable successful adaptation to HF. This study aimed to explore protective factors linked to family hardiness among HF patients. Patients and Methods A cross-sectional study was undertaken in 2020 among 167 HF patients in Nanjing, China. The study measures comprised a self-designed general information questionnaire, the Family Hardiness Index, the Mutuality Scale, the Positive and Negative Affect Scale, and the Simplified Coping Style Questionnaire. The data analysis was performed using IBM SPSS, version 25 and comprised Pearson’s correlation analysis, a multiple linear regression model, and an analysis of mediating effects. Results The average Family Hardiness Index score for the 167 HF patients was 57.95 ± 11.41. The multiple linear regression analysis revealed that mutuality, active coping style, and positive emotions of HF patients positively predicted family hardiness (β = 0.359, 0.308, and 0.215, respectively; all P ˂ 0.05). Mutuality between patients and family members had partial mediating effects between active coping style, positive emotions, and family hardiness. Conclusion Our results revealed that patients’ active coping styles, positive emotions, and mutuality were protective factors associated with family hardiness. In light of our findings, we suggest that active coping strategies, positive emotions, and, especially, closer relationships within families should be encouraged during the rehabilitation and follow-up care of HF patients.
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Affiliation(s)
- Yuanyuan Peng
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Jie Wang
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guozhen Sun
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China.,Department of Cardiology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Shenxinyu Liu
- School of Nursing, Nanjing Medical University, Nanjing, People's Republic of China
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21
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Abstract
ABSTRACT BACKGROUND: Mutuality, a positive relationship between caregiver and care receiver that affects patient's health and caregiver's burden, stress, and well-being, has never been investigated in motor neuron disease. METHOD: We conducted a mixed-method study with convergent parallel design. Quantitative data were collected with the Mutuality Scale, and qualitative data were collected using deep interviews. The sample was composed of 30 people with motor neuron diseases and 24 family caregivers. RESULTS: Deductive, qualitative content analysis of the interviews confirmed the presence of mutuality and its 4 dimensions. The average score of patients' Mutuality Scale was 3.07 (SD, 0.79; range, 1.3-4), and that of the caregivers was 3.16 (SD, 0.53; range, 2.2-3.9). The dimensions "love" and "shared values" had the highest scores, whereas the dimension "shared pleasurable activities" had the lowest score. Patients' and caregivers' answers correlated. CONCLUSION: Mutuality concept and its 4 dimensions had content validity in motor neuron disease people. Nurses should consider the level of mutuality and adopt strategies to increase and preserve it.
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22
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Guillaume C, Roche J. [Video calls to disoriented elderly persons during the COVID-19 health crisis]. SOINS. GÉRONTOLOGIE 2021; 26:20-23. [PMID: 34083010 DOI: 10.1016/j.sger.2021.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Maintaining an exchange between the disoriented elderly patient and his family circle is essential to help reduce patient anxiety. When visits are not possible, the implementation of video calls with highly disoriented individuals shows a benefit of these virtual exchanges. The introduction of new technologies, if accompanied, does not disturb the patient and does not alter the quality of the relationship.
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Affiliation(s)
- Cécile Guillaume
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France.
| | - Jean Roche
- Service de psychogériatrie, hôpital Fontan 2, 1 rue André-Verhaeghe, 59037 Lille cedex, France
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23
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Association between Mutuality and Health-Related Quality of Life in Patient-Caregiver Dyads Living with Schizophrenia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052438. [PMID: 33801391 PMCID: PMC7967568 DOI: 10.3390/ijerph18052438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Revised: 02/14/2021] [Accepted: 02/20/2021] [Indexed: 01/02/2023]
Abstract
Background: Although caregivers are a crucial support in the recovery of patients with schizophrenia, little is known about how mutuality is related to health-related quality of life within the dyadic (patient and caregiver) context. This study aimed to investigate the dyadic relationship between mutuality and health-related quality of life in patients with schizophrenia and caregivers. Methods: A cross-sectional, correlational study was conducted with a sample of 133 dyads of patients with schizophrenia and caregivers. Structured questionnaires were used to collect data. Data were analyzed using descriptive statistics, paired sample t-tests, Pearson’s product-moment correlations, and the Actor–Partner Interdependence Model. Results: Mutuality of patients was significantly higher than that of caregivers. Compared with caregivers, patients had significantly lower total scores for health-related quality of life. Patients’ and caregivers’ mutuality was related to their own health-related quality of life (actor effect) and their partners’ health-related quality of life (partner effect). Conclusion: Mutuality plays a critical role in health-related quality of life in dyads of patients with schizophrenia and caregivers. Viewing a dyad as a unit of nursing care reveals a promising approach for developing recovery-oriented modalities targeted at stimulating mutuality that may enhance health-related quality of life for both patients and caregivers.
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24
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Bristol AA, Mata AC, Mickens M, Dassel KB, Ellington L, Scammon D, Thompson A, Towsley GL, Utz RL, Terrill AL. "You Feel Very Isolated": Effects of COVID-19 Pandemic on Caregiver Social Connections. Gerontol Geriatr Med 2021; 7:23337214211060166. [PMID: 34993276 PMCID: PMC8724994 DOI: 10.1177/23337214211060166] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 10/08/2021] [Accepted: 10/28/2021] [Indexed: 12/02/2022] Open
Abstract
One in five individuals in the United States provides care and support to ill, disabled, and aging family members in the home, leading to feelings of burden, stress, and poor health and well-being. Social support represents an important buffer for family caregivers that allows them to feel less isolated and more positive about their caregiving role. This sequential mixed-methods study aimed to examine the effect of the COVID-19 pandemic on family caregivers' social connections. Eighty-two caregivers completed a web-based survey which comprised of fixed-choice and open-ended questions. Survey data showed that the majority of caregivers (83%) reported an increase in stress and feeling lonely (77%) during the pandemic. Qualitative interviews with a subsample of caregivers (n=27) further explored social connections during the pandemic. Three themes echoed the quantitative findings and centered around defining boundaries, intentionality in social interactions, and loss of social resources. Although caregivers were often strained by new or increased caregiving demands, many experienced positive changes such as feeling a deeper connection with the care-recipient. Findings from this study highlight the need for further consideration of the impact of social isolation on the well-being of caregivers.
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Affiliation(s)
- Alycia A. Bristol
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- Gerontology Interdisciplinary Program, University of Utah, Salt Lake City, UT, USA
| | - Aaron C. Mata
- College of Social & Behavioral Sciences, University of Utah, Salt Lake City, UT, USA
| | - Melody Mickens
- Division of Rehabilitative Medicine, School of Medicine, University of Utah, Salt Lake City, UT, USA
| | - Kara B. Dassel
- Gerontology Interdisciplinary Program, University of Utah, Salt Lake City, UT, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Debra Scammon
- Department of Marketing, School of Business, University of Utah, Salt Lake City, UT, USA
| | - Amber Thompson
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Gail L. Towsley
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- Gerontology Interdisciplinary Program, University of Utah, Salt Lake City, UT, USA
| | - Rebecca L. Utz
- Department of Sociology, University of Utah, Salt Lake City, UT, USA
| | - Alexandra L. Terrill
- Department of Occupational & Recreational Therapy, College of Health, University of Utah, Salt Lake City, UT, USA
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25
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Chinh K, Secinti E, Johns SA, Hirsh AT, Miller KD, Schneider B, Storniolo AM, Mina L, Newton EV, Champion VL, Mosher CE. Relations of Mindfulness and Illness Acceptance With Psychosocial Functioning in Patients With Metastatic Breast Cancer and Caregivers. Oncol Nurs Forum 2020; 47:739-752. [PMID: 33063774 DOI: 10.1188/20.onf.739-752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To examine relationships in mindfulness and illness acceptance and psychosocial functioning in patients with metastatic breast cancer and their family caregivers. SAMPLE & SETTING 33 dyads from an academic cancer center in the United States. METHODS & VARIABLES Participants completed questionnaires on mindfulness, illness acceptance, relationship quality, anxiety, and depressive symptoms. Dyadic, cross-sectional data were analyzed using actor-partner interdependence models. RESULTS Greater nonjudging, acting with awareness, and illness acceptance among caregivers were associated with patients' and caregivers' perceptions of better relationship quality. Higher levels of these processes were associated with reduced anxiety and depressive symptoms in patients and caregivers. IMPLICATIONS FOR NURSING Aspects of mindfulness and illness acceptance in dyads confer benefits that are primarily intrapersonal in nature. Nurses may consider introducing mindfulness and acceptance-based interventions to patients and caregivers with adjustment difficulties.
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Affiliation(s)
- Kelly Chinh
- Indiana University-Purdue University Indianapolis
| | - Ekin Secinti
- Indiana University-Purdue University Indianapolis
| | | | - Adam T Hirsh
- Indiana University-Purdue University Indianapolis
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26
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Hsiao CY, Lu HL, Tsai YF. Psychiatric morbidity and its correlates among primary family caregivers of individuals diagnosed with schizophrenia in Taiwan. J Ment Health 2020; 31:487-495. [PMID: 32930016 DOI: 10.1080/09638237.2020.1818703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Caregiving for patients with schizophrenia is often challenging and may increase the risk of psychiatric morbidity among primary family caregivers. However, the associated factors of psychiatric morbidity among caregivers have not been fully investigated. AIMS This study aimed to screen psychiatric morbidity and its correlates among primary family caregivers of persons with schizophrenia receiving inpatient psychiatric rehabilitation services. METHODS A cross-sectional, correlational design was used. A total of 184 Taiwanese primary family caregivers in inpatient psychiatric rehabilitation units participated in the study. Descriptive statistics, Chi-square tests, independent t-tests, and a stepwise binary logistic regression analysis were performed to examine the association among primary family caregivers' psychiatric morbidity and primary family caregivers' sociodemographic characteristics and mutuality and patients' sociodemographic and clinical characteristics. RESULTS The prevalence of psychiatric morbidity among primary family caregivers was 48.4%. Unemployment, lower mutuality, additional dependents in need of care, and caring for patients with more psychiatric hospitalizations were the most significant factors for psychiatric morbidity among primary family caregivers. CONCLUSION Mental healthcare professionals should recognize patients and their primary family caregivers as a unit of care. Primary family caregivers must receive increased assistance, including supportive resources and therapeutic interventions, to reduce psychiatric morbidity.
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Affiliation(s)
- Chiu-Yueh Hsiao
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.,Department of Psychiatry, Chang Gung Memorial Hospital, Tao-Yuan City, Taiwan, Republic of China
| | - Huei-Lan Lu
- Department of Nursing, Jianan Psychiatric Center, Ministry of Health and Welfare, Tainan, Taiwan, Republic of China
| | - Yun-Fang Tsai
- School of Nursing, College of Medicine, Chang Gung University, Taoyuan, Taiwan, Republic of China.,Department of Nursing, Chang Gung University of Science and Technology, Tao-Yuan City, Taiwan, Republic of China.,Department of Psychiatry, Chang Gung Memorial Hospital in Keelung, Keelung City, Taiwan, Republic of China
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Experiences of caregiving and quality of healthcare among caregivers of patients with complex chronic processes: A qualitative study. Appl Nurs Res 2020; 56:151344. [PMID: 32907769 DOI: 10.1016/j.apnr.2020.151344] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 07/12/2020] [Accepted: 08/22/2020] [Indexed: 11/20/2022]
Abstract
Aim To explore the perceptions of main caregivers regarding caring for chronic complex patients in two different regions of Spain. BACKGROUND Spain is a country with an ageing population and a high number of people with chronic diseases. It is well known that the role of the caregiver is important to ensure quality of life and appropriate care. METHODS Qualitative design using focus groups. Five focus groups, from two different regions, were conducted with 22 caregivers of people with chronic complex diseases to explore their personal experience, examine the quality of care received by the patient and their family and to develop strategies for the improvement of the quality of health care. The focus groups were audio and video recorded. The transcriptions of the focus group sessions were exported to qualitative software analysis MAXQDA 2018.2. The qualitative content analysis was based on different analytical cycles. RESULTS In general terms, caregivers would refer to accepting the care of their family members, but they highlight many negative aspects such as tiredness, lack of help and overload of care. They indicated general satisfaction with the health system but indicated that help was insufficient and that strategies to better address the situations of the complex chronic patient should be improved. The main categories observed were: Conclusions. Complex chronic illnesses are increasingly common at present, generating important consequences on the lives of patients and that of their caregivers. The design of any health strategy for facing the dilemma of chronic illnesses, must necessarily include the vision of the caregivers.
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Moderator Role of Mutuality on the Association Between Depression and Quality of Life in Stroke Survivor-Caregiver Dyads. J Cardiovasc Nurs 2020; 36:245-253. [PMID: 32740226 DOI: 10.1097/jcn.0000000000000728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Authors of previous research have not yet analyzed the role of potential moderators in the relationship between depressive symptoms and quality of life (QOL). AIMS The aim of this study was to examine the moderating effect of mutuality between depressive symptoms and QOL in stroke survivor and caregiver dyads. METHODS This study used a longitudinal design with 222 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed for 12 months. We examined survivor and caregiver QOL dimensions (physical, psychological, social, and environmental), depression, and mutuality at baseline and every 3 months. Hierarchical linear modeling was used to test 4 longitudinal dyadic moderation models (1 for each QOL domain). RESULTS Survivors (50% male) and caregivers (65% female) were 70.8 (SD, 11.9) and 52.5 (SD, 13.1) years old, respectively. We observed no significant moderating effects of mutuality for survivors across the 4 dimensions of QOL over time. However, higher survivor mutuality was significantly associated with higher survivor psychological and social QOL at baseline. Regarding caregivers, caregiver mutuality significantly moderated the association between caregiver depressive symptoms and caregiver physical (B = 0.63, P < .05), psychological (B = 0.63, P < .01), and social (B = 0.95, P < .001) QOL at baseline, but not in environmental QOL. Higher caregiver mutuality was significantly associated with less improvement in caregiver physical QOL over time. CONCLUSIONS Mutuality is a positive variable on the association between depression and QOL for both members of the dyad at discharge but may lead to declines in physical health for caregivers over time. Further work is needed to understand the role of mutuality on long-term outcomes and associations with increased care strain.
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Caregiver burden and health-related quality of life among primary family caregivers of individuals with schizophrenia: a cross-sectional study. Qual Life Res 2020; 29:2745-2757. [PMID: 32394137 DOI: 10.1007/s11136-020-02518-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE This study aimed to examine correlates of caregiver burden and health-related quality of life (HRQoL) among primary family caregivers of individuals with schizophrenia in inpatient psychiatric rehabilitation facilities. METHODS A cross-sectional study was conducted with 157 Taiwanese primary family caregivers of individuals with schizophrenia residing in inpatient psychiatric facilities. Measures included socio-demographic questionnaires and clinical information, Mutuality Scale, Family Crisis-Oriented Personal Evaluation Scales, Zarit Burden Interview, and World Health Organization Quality of Life-brief version. To describe the degree of caregiver burden and domains of HRQoL, descriptive statistics were computed. Independent sample t test, one-way analysis of variance, and Pearson's correlation analysis followed by multiple regression analyses were performed to determine correlations and relationships between characteristics of patients and primary family caregivers with caregiver burden and domains of HRQoL. RESULTS Primary family caregivers experienced mild to moderate caregiver burden and poor HRQoL. Primary family caregivers who were older and unemployed, caring for patient's severe psychiatric symptoms, and had low monthly incomes, decreased mutuality, and fewer family coping strategies were associated with greater caregiver burden and poor HRQoL. Greater mutuality and family coping strategies of reframing and seeking spiritual support were the most significant factors in improving caregiver burden and all domains of HRQoL, respectively. CONCLUSION Family-focused interventions for caregivers of institutionalized persons with schizophrenia that include psychological support and peer support groups are recommended to enhance mutuality and family coping strategies, reduce caregiver burden, and improve HRQoL.
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Irani E, Niyomyart A, Hickman RL. Systematic Review of Technology-Based Interventions Targeting Chronically Ill Adults and Their Caregivers. West J Nurs Res 2020; 42:974-992. [PMID: 31941418 DOI: 10.1177/0193945919897011] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of this systematic review is to synthesize the study design features as well as the attributes and outcomes of technology-based health interventions targeting chronically ill adults and their family caregivers. Twenty papers representing 19 studies met the inclusion criteria. Various theoretical foundations or approaches guided the interventions in 11 studies. Interventions either aimed to support patient self-management and improve patient outcomes or enhance shared illness management and improve patient and caregiver outcomes. The interventions included educational, behavioral, and support components and were delivered using various technologies ranging from text messaging to using the Internet. Overall, patients and caregivers expressed improvements in self-management outcomes (or support) and quality of life. Interventions with a dyadic focus reported on interpersonal outcomes, with improvements noted mostly in patients. This review captures an emerging area of science, and findings should be interpreted in light of the methodological limitations of the included studies.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Atsadaporn Niyomyart
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Ronald L Hickman
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
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Gibbons SW, Ross A, Wehrlen L, Klagholz S, Bevans M. Enhancing the cancer caregiving experience: Building resilience through role adjustment and mutuality. Eur J Oncol Nurs 2019; 43:101663. [PMID: 31606005 DOI: 10.1016/j.ejon.2019.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE The purpose of this study was to explore the dyadic experience of caring for a family member with cancer. Particular attention was given to examine the relationship between dyadic perceptions of role adjustment and mutuality as facilitators in resilience for posttreatment cancer patients and family caregivers. METHOD For this convergent parallel, mixed-methods study using grounded theory methodologies, 12 dyads were recruited from the National Institutes of Health Clinical Center in Bethesda, Maryland, USA. Qualitative data collection focused on social interactions between cancer patients and their family caregivers to better understand and describe how post-treatment patients and caregivers create mutuality in their relationships, how they describe the processes of role-adjustment, and how these processes facilitate dyadic resiliency. Quantitative data collected through electronic survey included the Family Caregiving Inventory (FCI) for Mutuality Scale, Neuro QoL Ability to Participate in Social Roles and Activities, and Satisfaction with Social Roles and Activities-Short Forms, and Mental Health Continuum-Short Form (MHC). RESULTS Eleven participants were spouses. Twenty-two self-reported as Caucasian. The sample ranged from 35 to 71 years of age (Caregiver M = 53.7, Patient M = 54.3). Most of the caregivers were female (n = 8; 66.7%) and most of the patients were male (n = 9; 75%). Qualitative interview data illuminated two primary psychosocial processes relating to resilience, role adjustment and mutuality, as key facilitators for transformation and growth within dyadic partnerships coping with the challenges of cancer treatment and cancer caregiving. The FCI-mutuality score for patients (M = 3.65 ± 0.47) and caregivers (M = 3.45 ± 0.42) reflected an average level of relationship quality. Relative to participation in, and satisfaction with social roles and activities, patients (M = 50.66 ± 7.70, M = 48.81 ± 6.64, respectively) and caregivers (M = 50.69 ± 8.6, M = 51.9 ± 8.75, respectively) reported scores that were similar to the US General Population (M = 50 ± 10). CONCLUSIONS New patterns of role adjustment and mutuality can assist with making meaning and finding benefit, and these patterns contribute to dyadic resilience when moving through a cancer experience. There are few interventions that target the function of the dyad, yet the emergent model identified in this paper provides a direction for future dyadic research. By developing interventions at a dyadic level, providers have the potential to encourage dyadic resilience and sustain partnerships from cancer treatment into survivorship.
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Affiliation(s)
- Susanne W Gibbons
- Uniformed Services University of the Health Sciences, Bethesda, MD, 20815, USA.
| | - Alyson Ross
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Leslie Wehrlen
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Stephen Klagholz
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
| | - Margaret Bevans
- National Institutes of Health, Clinical Center, Bethesda, MD, 20815, USA.
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Pan Y, Chen R, Yang D. The Role of Mutuality and Coping in a Nurse-Led Cognitive Behavioral Intervention on Depressive Symptoms Among Dementia Caregivers. Res Gerontol Nurs 2019; 12:44-55. [PMID: 30653651 DOI: 10.3928/19404921-20181212-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/09/2018] [Indexed: 11/20/2022]
Abstract
The current study explored whether mutuality and coping predicted and/or mediated the effect of a nurse-led cognitive behavioral intervention (NLCBI) on depressive symptoms of caregivers of persons with dementia. The intervention group (n = 56) received five monthly in-home nurse-led cognitive behavioral sessions and consultation calls after each session. The control group (n = 56) received five monthly short general conversations with the nurse interventionist. Questionnaires on study variables and demographics were collected at baseline, end of intervention, and 2-month follow up. Improved mutuality (β = -0.75, p = 0.049) and active coping (β = -2.06, p = 0.0001) and decreased passive coping (β = 1.43, p = 0.001) were found to predict the reduction of depressive symptoms among caregivers in the NLCBI. However, none of these variables mediated the interventional effect. Regular mental health nursing interventions are suggested to focus on enhancing mutuality and active coping and decreasing passive coping to maintain caregivers' mental health. TARGETS Caregivers of persons with dementia. INTERVENTION DESCRIPTION Nurse-led cognitive behavioral sessions and subsequent consultation calls. MECHANISMS OF ACTION Impacted caregivers' reappraisals, thus improving their active coping skills and mutuality and decreasing their passive coping, which directly reduced their depressive symptoms. OUTCOMES Mutuality, active coping, and passive coping played a predicting, but not mediating, role in the effect of the NLCBI. [Res Gerontol Nurs. 2019; 12(1):44-55.].
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Kayser K, Acquati C. The influence of relational mutuality on dyadic coping among couples facing breast cancer. J Psychosoc Oncol 2019; 37:194-212. [PMID: 30822220 DOI: 10.1080/07347332.2019.1566809] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The study examined how a couple's capacity for mutuality as conceptualized by the Relational-Cultural Theory plays a role in their managing the stresses accompanying breast cancer. METHODS Eighty-six women treated for a primary, non-metastatic breast cancer and their partners completed measures of quality of life, relational mutuality, and dyadic coping. Demographic and clinical factors were self-reported. The relationship between mutuality and dyadic coping was evaluated using the Actor-Partner Interdependence Model (APIM). RESULTS Relational mutuality was positively associated with both the patients' and the caregivers' scores on common and positive dyadic coping. Similarly, relational mutuality was associated with both patients' and caregivers' reduced scores on avoidance of dyadic coping. CONCLUSIONS Relational mutuality emerges as a significant factor in our understanding about dyadic coping in the context of cancer and this study highlights the role it plays in dyadic coping behaviors. IMPLICATIONS The promotion of relational mutuality in couples coping with cancer-related stress should be a major focus in couple-based interventions.
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Affiliation(s)
- Karen Kayser
- a Kent School of Social Work , University of Louisville , Louisville , Kentucky , USA
| | - Chiara Acquati
- b Graduate College of Social Work , University of Houston , Houston , Texas , USA
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Magasi S, Buono S, Yancy CW, Ramirez RD, Grady KL. Preparedness and Mutuality Affect Quality of Life for Patients With Mechanical Circulatory Support and Their Caregivers. Circ Cardiovasc Qual Outcomes 2019; 12:e004414. [DOI: 10.1161/circoutcomes.117.004414] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Susan Magasi
- Department of Occupational Therapy and Department of Disability Studies, University of Illinois at Chicago (S.M.)
| | - Sarah Buono
- Department of Medical Social Sciences (S.B.), Northwestern University, Chicago, IL
| | - Clyde W. Yancy
- Division of Cardiology, Department of Medicine and Department of Medical Social Sciences (C.W.Y.), Northwestern University, Chicago, IL
| | - Ricardo D. Ramirez
- Department of Occupational Therapy, University of Illinois at Chicago (R.D.R.)
| | - Kathleen L. Grady
- Division of Cardiac Surgery, Department of Surgery and Department of Medicine, Feinberg School of Medicine (K.L.G.), Northwestern University, Chicago, IL
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Dellafiore F, Buck HG, Pucciarelli G, Barbaranelli C, Paturzo M, Alvaro R, Vellone E. Psychometric characteristics of the mutuality scale in heart failure patients and caregivers. Heart Lung 2018; 47:553-561. [DOI: 10.1016/j.hrtlng.2018.05.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 05/23/2018] [Indexed: 12/28/2022]
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Blundell Jones J, Walsh S, Isaac C. The Relational Impact of Multiple Sclerosis: An Integrative Review of the Literature Using a Cognitive Analytic Framework. J Clin Psychol Med Settings 2018; 24:316-340. [PMID: 28756504 PMCID: PMC5705738 DOI: 10.1007/s10880-017-9506-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This integrative literature review uses cognitive analytic therapy (CAT) theory to examine the impact of a chronic illness, multiple sclerosis (MS), on relationships and mental health. Electronic searches were conducted in six medical and social science databases. Thirty-eight articles met inclusion criteria, and also satisfied quality criteria. Articles revealed that MS-related demands change care needs and alter relationships. Using a CAT framework, the MS literature was analysed, and five key patterns of relating to oneself and to others were identified. A diagrammatic formulation is proposed that interconnects these patterns with wellbeing and suggests potential “exits” to improve mental health, for example, assisting families to minimise overprotection. Application of CAT analysis to the literature clarifies relational processes that may affect mental health among individuals with MS, which hopefully will inform how services assist in reducing unhelpful patterns and improve coping. Further investigation of the identified patterns is needed.
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Affiliation(s)
- Joanna Blundell Jones
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, S10 2TN UK
| | - Sue Walsh
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, S10 2TN UK
| | - Claire Isaac
- Russell Cairns Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU UK
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Mediating Effect of Mutuality on Health-Related Quality of Life in Patients with Parkinson's Disease. PARKINSONS DISEASE 2018; 2018:9548681. [PMID: 30305888 PMCID: PMC6164202 DOI: 10.1155/2018/9548681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 08/05/2018] [Indexed: 11/18/2022]
Abstract
The relationship quality, mutuality, has been identified as a protective factor in family care situations, but its role in mediating health-related quality of life (HRQoL) in patients having Parkinson's disease (PD) is not known. Data on patients' and partners' mutuality (MS), motor signs (UPDRS III), non-motor symptoms (NMSQuest), impaired cognition (IQCODE), dependency in activities of daily life (ADL), and HRQoL (PDQ8) were collected from 51 dyads. Structural equation model with manifest variables was applied to explore if the MS score mediated the effect of UPDRS III, NMSQuest, IQCODE, and dependency in ADL on PDQ8. The results suggest that increasing severity of motor and non-motor symptoms decreases patients' mutuality which leads to worse HRQoL. Partners' mutuality mediated the effect of impaired cognition which in turn decreased patients' mutuality. The findings enhance our understanding of how various symptoms may influence PD patients' HRQoL. This may help clinicians to personalize interventions to provide more effective interventions to improve the lives of patients with PD.
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Fernandes CS, Angelo M, Martins MM. Giving Voice to Caregivers: a game for family caregivers of dependent individuals. Rev Esc Enferm USP 2018; 52:e03309. [PMID: 29947701 DOI: 10.1590/s1980-220x2017013903309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 11/16/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To construct and assess a board game created to promote the effective transition of family members into caregivers of dependent individuals. METHOD This was a qualitative exploratory and descriptive case study conducted with family caregivers of dependent individuals. RESULTS The study resulted in the conceptualization, construction, and assessment of the board game. The game proved to be an important family evaluation tool, enabling open communication and interventions in family dynamics. CONCLUSION The results showed that the game can help build new family narratives, providing an opportunity for open communication, expression of problems and sharing, representing an important family evaluation and intervention strategy.
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Affiliation(s)
| | - Margareth Angelo
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brasil
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Bidwell JT, Lyons KS, Mudd JO, Grady KL, Gelow JM, Hiatt SO, Chien CV, Lee CS. Patient and Caregiver Determinants of Patient Quality of Life and Caregiver Strain in Left Ventricular Assist Device Therapy. J Am Heart Assoc 2018; 7:e008080. [PMID: 29514804 PMCID: PMC5907562 DOI: 10.1161/jaha.117.008080] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 01/03/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Although current guidelines emphasize the importance of social support to the success of left ventricular assist device (LVAD) therapy, few studies examine the influence of the caregiver on patient outcomes or quantify the impact of LVAD caregiving on caregiver outcomes. The purpose of this analysis was to identify patient and caregiver determinants of patient quality of life (QOL) and caregiver strain in response to LVAD therapy. METHODS AND RESULTS Data on patients receiving LVAD therapy and their caregivers (n=50 dyads) were prospectively collected pre-implantation and 1, 3, and 6 months post-implantation. Growth curve modeling was used to describe change in patient QOL (Kansas City Cardiomyopathy Questionnaire) and caregiver strain (Multidimensional Caregiver Strain Index). Patient QOL improved most in the first month (β=23.22±3.76, P<0.001), followed by gradual gains over 6 months (β=1.90±0.64, P<0.01). Caregivers experienced worsening of strain in the first month (β=4.30±1.42, P<0.01), followed by gradual resolution to pre-implantation levels by 6 months (β=-0.71±0.23, P<0.01). Worse pre-implantation patient symptoms were associated with greater improvement in patient QOL (β=0.53±0.19, P<0.01) but worsening caregiver strain (β=0.15±0.07, P=0.04). Better relationship quality was associated with greater improvement in patient QOL (β=14.39±5.85, P=0.01) and less pre-implantation caregiver strain (β=-9.31±2.28, P<0.001). Nonspousal caregivers experienced less pre-implantation strain (β=-8.60±3.10, P=0.01), and patients with nonspousal caregivers had less improvement in QOL (β=-3.70±1.62, P=0.02). CONCLUSIONS A combination of patient and caregiver characteristics predicts patient and caregiver response to LVAD therapy. Including caregiver factors in future studies may be helpful in developing interventions that improve patient and caregiver outcomes, together.
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Affiliation(s)
- Julie T Bidwell
- Oregon Health and Science University School of Nursing, Portland, OR
| | - Karen S Lyons
- Oregon Health and Science University School of Nursing, Portland, OR
| | - James O Mudd
- Oregon Health and Science University Knight Cardiovascular Institute, Portland, OR
| | - Kathleen L Grady
- Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jill M Gelow
- Oregon Health and Science University Knight Cardiovascular Institute, Portland, OR
| | - Shirin O Hiatt
- Oregon Health and Science University School of Nursing, Portland, OR
| | | | - Christopher S Lee
- Oregon Health and Science University School of Nursing, Portland, OR
- Oregon Health and Science University Knight Cardiovascular Institute, Portland, OR
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Objective and Subjective Burden of Informal Caregivers 4 Years After a Severe Traumatic Brain Injury: Results From the PariS-TBI Study. J Head Trauma Rehabil 2018; 31:E59-67. [PMID: 24992640 DOI: 10.1097/htr.0000000000000079] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Prospective assessment of informal caregiver (IC) burden 4 years after the traumatic brain injury of a relative. SETTING Longitudinal cohort study (metropolitan Paris, France). PARTICIPANTS Home dwelling adults (N = 98) with initially severe traumatic brain injury and their primary ICs. MAIN OUTCOME MEASURES Informal caregiver objective burden (Resource Utilization in Dementia measuring Informal Care Time [ICT]), subjective burden (Zarit Burden Inventory), monetary self-valuation of ICT (Willingness-to-pay, Willingness-to-accept). RESULTS Informal caregivers were women (81%) assisting men (80%) of mean age of 37 years. Fifty-five ICs reported no objective burden (ICT = 0) and no/low subjective burden (average Zarit Burden Inventory = 12.1). Forty-three ICs reported a major objective burden (average ICT = 5.6 h/d) and a moderate/severe subjective burden (average Zarit Burden Inventory = 30.3). In multivariate analyses, higher objective burden was associated with poorer Glasgow Outcome Scale-Extended scores, with more severe cognitive disorders (Neurobehavioral Rating Scale-revised) and with no coresidency status; higher subjective burden was associated with poorer Glasgow Outcome Scale-Extended scores, more Neurobehavioral Rating Scale-revised disorders, drug-alcohol abuse, and involvement in litigation. Economic valuation showed that on average, ICs did not value their ICT as free and preferred to pay a mean Willingness-to-pay = &OV0556;17 per hour to be replaced instead of being paid for providing care themselves (Willingness-to-accept = &OV0556;12). CONCLUSION Four years after a severe traumatic brain injury, 44% of ICs experienced a heavy multidimensional burden.
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Vellone E, Dellafiore F, Chung ML, Alvaro R. Mutuality and self-care in heart failure patient and caregiver dyads. Eur J Cardiovasc Nurs 2017; 17:467-468. [DOI: 10.1177/1474515117740482] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | - Federica Dellafiore
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
| | | | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy
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Hooker SA, Schmiege SJ, Trivedi RB, Amoyal NR, Bekelman DB. Mutuality and heart failure self-care in patients and their informal caregivers. Eur J Cardiovasc Nurs 2017; 17:102-113. [PMID: 28868917 DOI: 10.1177/1474515117730184] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Heart failure is a progressive condition characterized by frequent hospitalizations for exacerbated symptoms. Informal family caregivers may help patients improve self-care, which may in turn reduce hospitalizations. However, little is known about how mutuality, defined as the quality of the patient-caregiver relationship, and caregiver burden affect self-care. OBJECTIVE This study examines the associations among mutuality, patient self-care confidence (beliefs in abilities to engage in self-care behaviors) and maintenance (behaviors such as medication adherence, activity, and low salt intake), caregiver confidence in and maintenance of patient care, and caregiver perceived burden. METHODS This study used cross-sectional baseline data from a multi-site randomized clinical trial of a symptom and psychosocial care intervention. Patient-caregiver dyads ( N=99) completed self-report surveys of mutuality and self-care confidence and maintenance, and caregivers completed a measure of caregiver burden. Path analysis, with actor (effects within a person) partner (effects across the dyad) interdependence model paths and regression models were used to examine the associations among mutuality, caregiver burden, and self-care. RESULTS The majority of patients ( M age=66, 21% female) and caregivers ( M age=57, 81% female) were spouses (60%). The path model demonstrated significant actor effects; patients and caregivers with better mutuality were more confident in patient self-care ( p<.05). Partner effects were not significant. Regression models indicated that caregivers with greater mutuality reported less perceived burden ( p<.01). CONCLUSIONS Mutuality in patient-caregiver dyads is associated with patient self-care and caregiver burden and may be an important intervention target to improve self-care and reduce hospitalizations.
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Affiliation(s)
- Stephanie A Hooker
- 1 Department of Psychology, University of Colorado Denver, USA.,2 Department of Family Medicine and Community Health, University of Minnesota, USA
| | - Sarah J Schmiege
- 3 Department of Biostatistics and Informatics, Colorado School of Public Health at the Anschutz Medical Campus, University of Colorado Denver, USA
| | - Ranak B Trivedi
- 4 Center for Innovation to Implementation, VA Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University, USA
| | - Nicole R Amoyal
- 5 Division of General Internal Medicine, University of Colorado School of Medicine, USA
| | - David B Bekelman
- 5 Division of General Internal Medicine, University of Colorado School of Medicine, USA.,6 Department of Veterans Affairs, Eastern Colorado Health Care System, USA
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Pan Y, Jones PS, Pothier P. The Relationship Between Mutuality and Health-Related Quality of Life in Adult Child Caregivers in China. JOURNAL OF FAMILY NURSING 2017; 23:366-391. [PMID: 28795855 DOI: 10.1177/1074840717718540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The strain inherent in caregiving relationships between adult children and aging parents is a prominent issue in contemporary China due to a combination of demographic and socioeconomic changes. The purpose of this study was to explore how mutuality, a positive quality of caregiving relationships, contributes to the physical health and mental health (health-related quality of life [HRQoL]) of adult child caregivers [ACCs] of parent stroke survivors. A cross-sectional correlational study was conducted on a nonproportional quota sample of 126 ACCs, using questionnaires of demographics, the 15-item Mutuality Scale, and the Second Version of the Standard 12-Item Health Survey (SF-12v2). Higher mutuality was found to be correlated with better caregiver physical health and mental health. However, after adjusting for the covariates, mutuality significantly explained 4.6% of the variance of caregiver physical health (β = .22, ΔR2 = .046, p < .01) but it did not significantly explain the variance of caregiver mental health. Although multiple factors correlate with Chinese family caregivers' HRQoL, this was the first study exploring the impact of caregiver-care receiver dyadic relationships on caregiver HRQoL in mainland China by using a mutuality scale with SF-12v2. Despite the fact that the Chinese tradition of filial piety can facilitate mutuality, socioeconomic changes and legislation that require adult children to care for aging parents appear to create high stress among family caregivers. Higher levels of mutuality contribute to better physical health in Chinese family caregivers. Therefore, culturally appropriate family nursing strategies and social policies in China could enhance caregiver mutuality and potentially promote their HRQoL, in particular physical health.
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Affiliation(s)
- Yuqin Pan
- 1 Jinhua Polytechnic, Zhejiang Province, China
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Karlstedt M, Fereshtehnejad SM, Winnberg E, Aarsland D, Lökk J. Psychometric properties of the mutuality scale in Swedish dyads with Parkinson's disease. Acta Neurol Scand 2017; 136:122-128. [PMID: 27781261 DOI: 10.1111/ane.12706] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 01/17/2023]
Abstract
OBJECTIVES The 15-item mutuality scale (MS) has been used in several neurological conditions assessing the quality of relationship associations with negative effects of the caregiving situation. The aim of this study was to translate the original MS into Swedish and assess its psychometric properties in Parkinson's disease (PD). MATERIALS AND METHODS Following the forward-backward translation method, the scale was evaluated regarding linguistic correctness at a conceptual level and user-friendliness. The scale was filled out by a sample of 50 care dyads where one was having PD. Scale assumptions and scale structure were evaluated using floor/ceiling effect and principal component analyses (PCA) with promax rotation. Internal consistency was evaluated using Cronbach's alpha and mean inter-item correlation coefficients. RESULTS The Swedish MS was evaluated as user-friendly and relevant by the participants. The scale demonstrated no floor/ceiling effect and showed high internal consistency (α≥0.93) with a mean inter-item correlation coefficient of ≥0.5. Through the PCA, a two factor solution emerged, which accounted for 67% and 64% of the variance of the MS score by PD-partners and PD-patients, respectively. However, some variables were complex and discarded in the final solution. CONCLUSION Our findings provide initial support of the Swedish MS as a user-friendly and useful instrument with acceptable psychometric properties even though more research is needed to evaluate the existence of subscales.
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Affiliation(s)
- M. Karlstedt
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - S. M. Fereshtehnejad
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - E. Winnberg
- Department of Health Care Sciences; Ersta Sköndal University College; Stockholm Sweden
| | - D. Aarsland
- Division of Neurogeriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
| | - J. Lökk
- Division of Clinical Geriatrics; Department of Neurobiology, Care Sciences and Society; Karolinska Institutet; Huddinge Sweden
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Abstract
RÉSUMÉLa plupart des recherches concernant les impacts des accidents vasculaires cérébraux (AVC) sur les couples ont été centrées sur la transition vers le rôle de soignant ou de bénéficiaire de soins. Même s’il est bien établi que la source principale du soutien dans les cas de maladies chroniques soit le mariage, il n’existe que peu de données sur les effets de ces soins, après un AVC, sur la relation maritale. Afin de combler cette lacune, nous avons réalisé une étude qualitative fondée sur une théorie à base empirique impliquant 18 couples dans lesquels l’un des époux avait subi un AVC. Les résultats ont mis en évidence deux thèmes étroitement liés en ce qui concerne la dynamique de couple : organiser les soins, un thème qui implique la découverte des problèmes dans la vie de tous les jours et leur prise en charge ; et repenser le mariage, un aspect qui nécessite la détermination du sens rattaché à la relation de couple dans un nouveau contexte caractérisé par des soins et des incapacités. Trois types du mariage se sont ressortis à partir de ces processus : la « reconfirmation » du mariage tel qu’il existait avant l’AVC ; la recalibration » du mariage autour des nouveaux soins ; et la « relation parallèle » — considérée comme « son mariage » à chacun des deux prtenaires. Ces résultats mettent en évidence la nécessité de considérer les dynamiques des relations, en plus des connaissances associées à l’AVC et aux soins.
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Crist JD, Pasvogel A, Szalacha LA, Finley BA. Depression in Family Caregivers of Mexican Descent: Exacerbated by Stress and Mitigated by Mutuality. Res Gerontol Nurs 2017; 10:106-113. [DOI: 10.3928/19404921-20170412-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/27/2017] [Indexed: 11/20/2022]
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Winter L, Moriarty HJ. Quality of relationship between veterans with traumatic brain injury and their family members. Brain Inj 2017; 31:493-501. [PMID: 28340316 DOI: 10.1080/02699052.2017.1283534] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The quality of the relationship between patients with many illnesses and their family members has been shown to affect the well-being of both. Yet, relationship quality has not been studied in traumatic brain injury (TBI), and giving and receiving aspects have not been distinguished. The present study of veterans with TBI examined associations between relationship quality and caregiver burden, satisfaction with caregiving, and veterans' competence in interpersonal functioning, rated by veterans and family members. METHOD In this cross-sectional study, 83 veterans and their family members were interviewed at home. Measures of quality of relationship, veterans' interpersonal competence and sociodemographics were collected for both, caregiver burden and satisfaction for family members only. RESULTS As predicted, veteran-rated Qrel/Giving was associated with family-rated Qrel/Receiving, and veteran-rated Qrel/Receiving with family-rated Qrel/Giving. Lower caregiver burden and higher caregiving satisfaction were associated with higher Qrel/Receiving scores but not with Qrel/Giving scores. Veterans' interpersonal competence was associated with total Qrel as rated by either veterans or family members. CONCLUSIONS Relationship quality should be included in family research in TBI, and giving and receiving aspects should be differentiated. Findings suggest that lower caregiver burden and greater satisfaction should be more achievable by increasing caregivers' sense of benefits received from the relationship.
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Affiliation(s)
- Laraine Winter
- a Nursing Service, Corporal Michael J. Crescenz Veterans Affairs Medical Center , Philadelphia , PA , USA.,b Philadelphia Research and Education Foundation, Corporal Michael J. Crescenz Veterans Affairs Medical Center , Philadelphia , PA , USA
| | - Helene J Moriarty
- a Nursing Service, Corporal Michael J. Crescenz Veterans Affairs Medical Center , Philadelphia , PA , USA.,c Villanova University, College of Nursing , Villanova , PA , USA
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Fernandes CS, Angelo M. Family caregivers: what do they need? An integrative review. Rev Esc Enferm USP 2017; 50:675-682. [PMID: 27680055 DOI: 10.1590/s0080-623420160000500019] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/30/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE Aimed to identify the main needs expressed by family caregivers in caring for adependent person. METHOD An integrative review of the literature in the period between 2010 and 2015 using specific search engine tools in the EBSCO and SCOPUSdatabases. RESULTS 11 articles were selected, and the analysis of the scientific evidence obtained allowed for organizing the results into five thematic areas:transition into care, being responsible for everything, the importance of support, access to formal support, communication and informationprocesses. CONCLUSION The results showed that caregivers have many needs in different areas, which should be addressed in nursing interventions. OBJETIVO Este estudo teve como objetivo identificar quais as principais necessidades manifestadas pelo cuidador familiar no cuidado à pessoa dependente. MÉTODO Realizou-se uma revisão integrativa da literatura no período entre 2010 e 2015 com o recurso de instrumentos de busca específicos, nas bases de dados EBSCO e SCOPUS. RESULTADOS Foram selecionados 11 artigos A análise da evidência científica obtida permitiu organizar os resultados em cinco áreas temáticas: a transição para o cuidar, o ser responsável por tudo, a importância do suporte, o acesso aos apoios formais, a comunicação e a informação na tomada de decisão. CONCLUSÃO Os resultados demonstram que o cuidador apresenta inúmeras necessidades em áreas distintas,as quais devem ser abordadasnas intervenções de enfermagem.
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Affiliation(s)
| | - Margareth Angelo
- Universidade de São Paulo, Escola de Enfermagem, Departamento de Enfermagem Materno-Infantil e Psiquiátrica, São Paulo, SP, Brazil
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Determinants of Dyadic Relationship and Its Psychosocial Impact in Patients with Parkinson's Disease and Their Spouses. PARKINSONS DISEASE 2017; 2017:4697052. [PMID: 28286689 PMCID: PMC5329678 DOI: 10.1155/2017/4697052] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Revised: 01/08/2017] [Accepted: 01/17/2017] [Indexed: 11/17/2022]
Abstract
The caregiver-care receiver relationship (mutuality) in Parkinson's disease (PD) and its association with motor and non-motors symptoms, health-related quality of life (HRQoL), and caregiver burden have not fully been investigated. The aim of our study was to explore if (1) the level of mutuality perceived by PD-patients and PD-partners differs, (2) different factors are associated with perceived mutuality by PD-patients and PD-partners, and (3) mutuality is associated with PD-patients health-related quality of life (HRQoL) and caregiver burden. We collected data on motor signs (UPDRS III), non-motor manifestations (NMSQuest), PD-patients' cognition (IQCODE), mutuality scale (MS), PD-patients' HRQoL (PDQ8), and caregiver burden (CB) from 51 PD dyads. Predictors were identified using multivariate regression analyses. Overall, the dyads rated their own mutuality as high with no significant difference between the dyads except for the dimension of reciprocity. PD-patients' MS score (p = .001) and NMSQuest (p ≤ .001) were significant predictors of PDQ8. Strongest predictor of CB was PD-partners' MS score (<.001) and IQCODE (p = .050). In general, it seems that non-motor symptoms contribute to a larger extent to the mutual relationship in PD-affected dyads than motor disabilities.
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Naef R, Hediger H, Imhof L, Mahrer-Imhof R. Variances in family carers' quality of life based on selected relationship and caregiving indicators: A quantitative secondary analysis. Int J Older People Nurs 2016; 12. [PMID: 27863032 DOI: 10.1111/opn.12138] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 09/19/2016] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To determine subgroups of family carers based on family relational and caregiving variables and to explore group differences in relation to selected carer outcomes. BACKGROUND Family caregiving in later life holds a myriad of positive and negative outcomes for family members' well-being. However, factors that constitute family carers' experience and explain variances are less well understood. DESIGN A secondary data analysis using cross-sectional data from a controlled randomised trial with community-dwelling people 80 years or older and their families. METHODS A total of 277 paired data sets of older persons and their family carers were included into the analysis. Data were collected via mailed questionnaires and a geriatric nursing assessment. A two-step cluster analysis was performed to determine subgroups. To discern group differences, appropriate tests for differences with Bonferroni correction were used. RESULTS Two family carer groups were identified. The low-intensity caregiver group (57% of carers) reported high relationship quality and self-perceived ease of caregiving. In contrast, the high-intensity caregiver group (43% of carers) experienced significantly lower relationship quality, felt less prepared and appraised caregiving as more difficult, time intensive and burdensome. The latter cared for older, frailer and more dependent octogenarians and had significantly lower levels of quality of life and self-perceived health compared to the low-intensity caregiver group. CONCLUSIONS A combination of family relational and caregiving variables differentiates those at risk for adverse outcomes. Family carers of frailer older people tend to experience higher strain, lower relationship quality and ability to work together as a family. IMPLICATIONS FOR PRACTICE Nurses should explicitly assess family carer needs, in particular when older persons are frail. Family carer support interventions should address caregiving preparedness, demand and burden, as well as concerns situated in the relationship.
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Affiliation(s)
- Rahel Naef
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland.,Centre for Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Hannele Hediger
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Lorenz Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
| | - Romy Mahrer-Imhof
- Institute of Nursing, Zurich University of Applied Sciences, Winterthur, Zurich, Switzerland
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