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Lasanthika C, Janlöv AC, Amarasekara T, Larsson H. Caring burden and coping with haemodialysis: a qualitative study with family caregivers in Sri Lanka. BMJ Open 2024; 14:e080775. [PMID: 38580374 PMCID: PMC11002432 DOI: 10.1136/bmjopen-2023-080775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 03/25/2024] [Indexed: 04/07/2024] Open
Abstract
OBJECTIVE The number of patients with end-stage kidney disease (ESKD) requiring renal replacement therapy in Sri Lanka is significantly rising. Most of these patients depend on haemodialysis, carrying a significant burden on their family caregivers. To develop care and support for both the patient and their family caregiver, it is crucial to understand how caregivers experience their caregiving situation. Therefore, this study aimed to explore family caregivers' experiences of burden and coping when caring for a family member receiving haemodialysis in the Sri Lankan context. DESIGN Qualitative study with an exploratory design. SETTING Family caregivers were recruited at a haemodialysis unit of a main government sector hospital in Sri Lanka between October and November 2021. PARTICIPANTS A purposive sampling of 11 family caregivers who cared for a family member receiving haemodialysis in a main government teaching hospital in Sri Lanka for at least 3 consecutive months. Data were collected through individual semistructured telephone interviews and analysed using qualitative content analysis. RESULTS The results showed an overarching theme, 'striving to hold on and not let go', with four categories: (1) feeling exhausted by the care burden, (2) feeling burdened as failing the care responsibility, (3) striving to cope and find meaning in caregiving, and (4) coping with caregiving through others' support. CONCLUSION The results show that the family caregivers have a multifaceted burden. They continued caring for their family member receiving haemodialysis while making adjustments to the burdensome caregiving situation despite many constraints and suffering. Psychosocial support and financial assistance, including family counselling, are needed by family caregivers, through a community support system, to ensure endurance during their family members' illness trajectory. Advance care planning is vital to alleviate care uncertainty and to meet the care needs of patients with ESKD, particularly in resource-constrained settings.
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Affiliation(s)
- Chalani Lasanthika
- Department of Nursing and Midwifery, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Ann-Christin Janlöv
- Department of Nursing and Integrated Health Sciences, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
| | - Thamara Amarasekara
- Department of Nursing and Midwifery, Faculty of Allied Health Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Helena Larsson
- Department of Nursing and Integrated Health Sciences, Faculty of Health Science, Kristianstad University, Kristianstad, Sweden
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Lotfalipoor R, Jafaraghaee F, Kazemnejad Leyli E, Ghorbani Vajargah P, Karkhah S, Javadi-Pashaki N. Effect of family-centered care on the anxiety levels among family members of patients undergoing cardiac surgery: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:1370-1375. [PMID: 38463075 PMCID: PMC10923300 DOI: 10.1097/ms9.0000000000001576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 11/22/2023] [Indexed: 03/12/2024] Open
Abstract
Background The present study aims to determine the effect of family-centered care on anxiety levels among family members of patients undergoing cardiac surgery. Materials and methods This study was a randomized clinical trial study that was conducted on the families of Iranian cardiac surgery patients. In the intervention group, family-centered care was implemented, and the content of the intervention included providing informational and emotional support to the family member and the family member's participation in patient care according to the set framework. Results A total of 144 family members of patients undergoing cardiac surgery were included in this study. Among the 144 family members, 71 were in the intervention group, and 73 were in the control group. The changes in the state anxiety score before and after the intervention were significant between the two groups, and the changes were higher in the control group (P=0.043). Also, there was no significant difference in the changes in trait anxiety before and after the intervention between the two groups (P>0.05). Conclusion In general, the high prevalence of anxiety in patients' families has negative functional consequences on both patients and their families. To reduce the level of anxiety, special attention should be paid to knowing the effective factors and appropriate coping methods. Nevertheless, it is important to note that additional research is warranted to delve deeper into this matter in future studies.
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Affiliation(s)
| | | | | | | | - Samad Karkhah
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery
| | - Nazila Javadi-Pashaki
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery
- Social Determinants of Health Research Center (SDHRC), Guilan University of Medical Sciences, Rasht, Iran
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Setyawati MB, Parsons AJ, Laing B, Lynch A, Habiburahman IL, Izza FN. The family caregiving; A Rogerian concept analysis of Muslim perspective & Islamic sources. Heliyon 2024; 10:e25415. [PMID: 38356493 PMCID: PMC10865263 DOI: 10.1016/j.heliyon.2024.e25415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 12/21/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024] Open
Abstract
Despite the numerous concepts of caregiving discussed in the literature, there is still no agreed definition and concept of family caregiving from the perspective of Islam. This study aims to comprehensively define family caregiving from Islamic religious and Muslim cultural perspectives. Rodger's evolutionary model was used to generate content by analyzing and redefining concepts. A thorough examination of the relevant literature using Scopus, PubMed, Medline, and CINAHL databases also trusted sources offered a total of 52 articles and 8 books to be reviewed. Our study reveals that family caregiving is viewed as God's gift as important as an essential religious and cultural obligation in Islam, where humans are expected to deliver care for their families although they are unprepared. This can be motivated by aspirations for respect, love, responsibility, and a desire to recompense parents, as well as the belief that by doing so they will be rewarded in the hereafter. The provision of family caregiving leads to positive consequences such as living with hope, gaining rewards and achievement, but at the same time, it also causes devastated life. This research contributes to a new discourse on family caregiving based on Islamic literature which helps in the comprehension of the practices of Muslim communities worldwide.
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Affiliation(s)
- Martyarini Budi Setyawati
- School of Nursing, Faculty of Health Sciences, Harapan Bangsa University, Banyumas, Central Java, Indonesia
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - A.P John Parsons
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Bobbi Laing
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Andrew Lynch
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | | | - Farah Nuril Izza
- Faculty of Ushuluddin, Adab, and Humanities UIN Prof. K.H. Saifuddin Zuhri Purwokerto Central Java, Indonesia
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Coexisting with the Life of Patients with Hemodialysis: Qualitative Meta-Synthesis Study of Life of Caregivers of Patients with Hemodialysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042163. [PMID: 35206351 PMCID: PMC8871738 DOI: 10.3390/ijerph19042163] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 02/04/2023]
Abstract
As the number of patients with hemodialysis (HD) continues to increase, so too does the number of people depending on caregivers. There is need to pay attention to the lives of caregivers of patients with HD, where sacrifices are forced. This study systematically reviewed and synthesized qualitative studies that explored the experiences of caregivers caring for patients with HD using the meta-synthesis method. We searched literature using four databases (i.e., PubMed, Excerpta Medica dataBASE, Cumulated Index to Nursing and Allied Health Literature, and Web of Science), and finally ten publications were selected. Four themes and nine subtopics were derived from analyzing and synthesizing the research results. The synthesized themes were: “bearing the burden of life as a caregiver,” “reconstructing life to maintain hemodialysis”, “the fading of caregiver’s own life,” and “effort to relieve the burden.” The results of this study can contribute to the development of interventional studies to improve the quality of life of HD patients. These studies provide an integrated and in-depth perspective on the experiences of caregivers who care for HD patients.
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The Role of Beliefs and Psychological Factors in Caring of Patients With Cancer: The Lived Experiences of Informal Caregivers. Holist Nurs Pract 2021; 35:248-256. [PMID: 34407022 DOI: 10.1097/hnp.0000000000000468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cancer affects not only the patient but also family members as informal caregivers. In order for family caregivers to achieve balance and improve their caregiving roles, it is essential to identify the beliefs and psychological aspects affecting them. The present study was carried out qualitatively with a descriptive phenomenological design in 2020. The main participants in this study were selected from one of the major referral centers for cancer patients in West Azerbaijan Province, located in northwestern, Iran. Twenty-two family caregivers were selected through a purposive sampling method. Data analysis showed that the 3 main themes of "emotional and religious preconceptions," "feeling committed to caring for beloveds," and "resilience" played a prominent role in family caregivers. These factors led to caregivers' commitment to and responsibility for care. Holistic care necessitates consideration of all aspects of human life. The results of this study led to an understanding of the complex tendencies and feelings of family caregivers. Based on the results, it was found that care is influenced by beliefs, religious preconceptions, sociocultural, and psychological factors. Identifying these variables helps medical staff share planning, interventions, and counseling with family caregivers and address issues that affect them.
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Marín-Maicas P, Corchón S, Ambrosio L, Portillo MC. Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7294. [PMID: 34299745 PMCID: PMC8305191 DOI: 10.3390/ijerph18147294] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/05/2021] [Accepted: 07/06/2021] [Indexed: 12/20/2022]
Abstract
(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family's needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand "the process of living with LTCs" from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.
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Affiliation(s)
| | - Silvia Corchón
- Faculty of Nursing and Chiropody, University of Valencia, 46010 Valencia, Spain
| | - Leire Ambrosio
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
| | - Mari Carmen Portillo
- NIHR ARC Wessex, School of Health Sciences, University of Southampton, Southampton SO17 1BJ, UK; (L.A.); (M.C.P.)
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Nkuranyabahizi M, Rajeswaran L, Ngendahayo F, Umuhire L, Shyaka JC, Dushimiyimana V, Chironda G. Caring experiences and support needs among family caregivers of patients with End Stage Renal Disease (ESRD) in Rwanda: A descriptive qualitative study. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Jafarpoor H, Vasli P, Manoochehri H. How is family involved in clinical care and decision-making in intensive care units? A qualitative study. Contemp Nurse 2020; 56:215-229. [PMID: 32715979 DOI: 10.1080/10376178.2020.1801350] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Involving family members in patient care is considered as a significant dimension of family-centered care in intensive care units (ICUs). Aims: To describe family members' perceptions and experiences regarding involvement in clinical care delivery and decision-making in ICUs in Iran. Design: A qualitative research method using conventional content analysis. Methods: A total number of 24 participants were selected through purposive sampling method between 2018 and 2019. Each interview also lasted between 30 and 60 min and the inductive data analysis was used. Results: The findings revealed that non-agreed involvement in clinical care delivery and family involvement in decision-making is being implemented on a continuum of paternalistic views. Conclusion: Healthcare providers, particularly nurses, and policy makers can thus exploit these findings to strengthen family involvement in this regard and consequently improve quality of care. Impact statement: A non-agreed approach and paternalistic views along with some barriers can affect family members' involvement in providing clinical care and making decisions in ICUs in Iran.
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Affiliation(s)
- Hasanali Jafarpoor
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Houman Manoochehri
- School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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The Experience of Primary Caregivers of Undocumented Immigrants with End-Stage Kidney Disease that Rely on Emergency-Only Hemodialysis. J Gen Intern Med 2020; 35:2389-2397. [PMID: 32076974 PMCID: PMC7403248 DOI: 10.1007/s11606-020-05696-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 01/31/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND Undocumented immigrants with end-stage kidney disease (ESKD) who rely on emergency-only hemodialysis (dialysis only after an emergency department evaluation) face psychosocial distress. Emergency-only hemodialysis (EOHD) is likely burdensome for primary caregivers as well. OBJECTIVE To understand the experience of primary caregivers of undocumented immigrants with ESKD who rely on emergency-only hemodialysis. DESIGN, SETTING, AND PARTICIPANTS A qualitative, semi-structured interview study to assess the experiences of primary caregivers of undocumented immigrants with ESKD at a safety-net hospital in Denver, Colorado from June 28 to November 15, 2018. Applied thematic analysis was used to analyze interviews. MAIN OUTCOMES AND MEASURES Themes and subthemes. RESULTS Twenty primary caregiver participants had a mean (SD) age of 46 (17), 13 (65%) were female, 7 (35%) were in an adult child caregiver role, and 13 (65%) were spouses. Five themes and 17 subthemes (in parentheses) were identified: (1) Caregiver role (providing emotional, physical, and economic support, advocacy and care navigation), (2) Caregiver burden (anxiety related to patient and personal death, emotional exhaustion and personal illness, struggle with finances, self-care and redefining relationship), (3) Unpredictable EOHD (acute episodes of illness that trigger emergency, stress when patient is denied dialysis, impact on work and sleep, and emotional relief after a session of EOHD), (4) Effect on children (dropping out or missing school, psychosocial distress, children assuming caregiver responsibilities, and juggling multi-generational caregiving of children), (5) Faith and appreciation (comfort in God and appreciation of healthcare). CONCLUSIONS AND RELEVANCE Caregivers of undocumented immigrants with ESKD who rely upon EOHD experience caregiver burden and distress. The impact of EOHD on caregivers should be considered when assessing the consequences of excluding undocumented immigrants from public insurance programs.
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Kamali SH, Imanipour M, Emamzadeh Ghasemi HS, Razaghi Z. Effect of Programmed Family Presence in Coronary Care Units on Patients' and Families' Anxiety. J Caring Sci 2020; 9:104-112. [PMID: 32626673 PMCID: PMC7322404 DOI: 10.34172/jcs.2020.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 08/27/2019] [Indexed: 01/01/2023] Open
Abstract
Introduction: Hospitalization of patients in the intensive care units always has negative consequences such as anxiety and concern for patients and their families. This study aimed to investigate the effect of programmed family presence in intensive care units on patients’ and families’ anxiety. Methods: This was a quasi-experimental study conducted in Iran. The eligible patients and a member of their families were assigned into two groups (N = 80) through convenience sampling. The family members in the experimental group were allowed to attend twice a day for 15 minutes in a planned way beside the patient and contribute to their clinical primary care. In the control group, the family members had a strict limitation to visit their patients based on the usual policy. Anxiety in both groups at the beginning and on the third day of patient’s admission was measured, using Spielberger’s questionnaire. The data were analyzed with SPSS version13. Results: The mean score of anxiety in the control group did not show significant difference in patients and in families, however it had decreased significantly in the experimental group after the intervention for both patients and families. The results showed that mean differences between the two groups was statistically significant in patients and families. Conclusion: The planned presence of the family of patients in coronary care unit (CCU) played a crucial role in reducing the anxiety of patients and their family. Furthermore, it is recommended that strategies of visiting policy in intensive care units (ICUs) should be revised and the possibility be provided for the families’ planned presence and participation in the patient care.
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Affiliation(s)
- Seyyedeh Halimeh Kamali
- Department of Critical Care Nursing and Management, School of Nursing and Midwifery, Tehran University of Medical Sciences; Tehran, Iran
| | - Masoomeh Imanipour
- Department of Critical Care Nursing and Management, Nursing and Midwifery Care Research Center; Tehran University of Medical Sciences; Tehran; Iran
| | - Hormat Sadat Emamzadeh Ghasemi
- Department of Critical Care Nursing and Management; School of Nursing and Midwifery, Tehran University of Medical Sciences; Tehran; Iran
| | - Zahra Razaghi
- Laser Application in Medical Sciences Research Center; Shahid Beheshti University of Medical Sciences; Tehran; Iran
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Dalir Z, Heydari A, Kareshki H, Manzari ZS. Coping with Caregiving Stress in Families of Children with Congenital Heart Disease: A Qualitative Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2020; 8:127-139. [PMID: 32309454 PMCID: PMC7153423 DOI: 10.30476/ijcbnm.2020.83029.1113] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: The families of children with congenital heart disease experience significant stress as to the care of the child and need
to cope with stress. Accordingly, understanding of how families cope and use coping strategies is more important to help
them better cope with stressful situations caused by caregiving. This study aimed to explore coping strategies used by families in the face of caregiving stress. Methods: This qualitative study was conducted on 40 eligible participants from the families of children with congenital heart disease. They were
recruited through a purposive sampling method from those referred to hospitals in Mashhad, Iran. In-depth and semi-structured interviews
were used for data collection from November 2017 to December 2018. The data were analyzed using conventional content analysis,
and MAXQDA software (Ver.2010) was used to manage the data encoding process. Results: According to the results, effort to maintain well-being emerged as the main theme which included five categories:
“spirituality in caregiving”, “acceptance and adjustment”, “optimism and hopefulness”, “self-control and patience”, and “ management of psychological needs”. Conclusion: Families used various coping strategies including spirituality, acceptance, optimism, patience, and management of psychological
needs based on their beliefs, attitudes, abilities, and available resources for coping with caregiving stress. The results can help
the nurses and health care professionals to develop appropriate educational, supportive, and psychological interventions based
on the family’s needs to cope effectively with caregiving stress.
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Affiliation(s)
- Zahra Dalir
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abbas Heydari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hossein Kareshki
- Department of Counseling and Educational Psychology, School of Educational Sciences and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Zahra Sadat Manzari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Progressive exhaustion: A qualitative study on the experiences of Iranian family caregivers regarding patients undergoing hemodialysis. Int J Nurs Sci 2018; 5:193-200. [PMID: 31406824 PMCID: PMC6626230 DOI: 10.1016/j.ijnss.2018.01.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 10/29/2017] [Accepted: 01/11/2018] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of this study was to explore the burden of care for patients undergoing hemodialysis from the experiences of family caregivers. Methods In this qualitative study, a content analysis approach was used for data collection and analysis. Participants were 16 family caregivers selected through purposive sampling from four medical education centers affiliated with Ahvaz Jundishapur University of Medical Sciences, Iran. Semi-structured interviews were held to collect data. Results Four categories were developed as follows: ‘care challenges’, ‘psychological vulnerabilities’, ‘the chronic nature of care ’and “care in the shade”. The categories led to the development of the main theme of ‘progressive exhaustion’ experienced by the family caregivers during the provision of care to patients undergoing hemodialysis. Conclusion Family caregivers have a significant role in the process of patient care, and this role leads them to progressive exhaustion; therefore, the overall health of the caregivers should be taken into account and more attention should be paid to their quality of life, social welfare, and satisfaction level.
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