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Norinder M, Årestedt K, Axelsson L, Grande G, Ewing G, Alvariza A. Increased preparedness for caregiving among family caregivers in specialized home care by using the Carer Support Needs Assessment Tool Intervention. Palliat Support Care 2024; 22:236-242. [PMID: 37278216 DOI: 10.1017/s1478951523000639] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Family caregivers often feel insufficiently prepared for a caregiving role, experiencing challenges and demands related to care at home that may negatively affect their own quality of life. Supportive interventions have been shown to influence negative effects, but more studies are needed. Therefore, this study aims to explore potential effects of the Carer Support Needs Assessment Tool Intervention on preparedness, caregiver burden, and quality of life among Swedish family caregivers in specialized home care. METHODS The study had a pre-post intervention design and was conducted at 6 specialized home care services in Sweden. Family caregivers who received the intervention completed a questionnaire, including the Preparedness for caregiving scale, Caregiver Burden Scale, and Quality of Life in Life-Threatening Illness - Family carer version, at 2 time points, baseline and follow up, about 5 weeks later. Data were analyzed using descriptive statistics and Wilcoxon signed-rank test. RESULTS Altogether, 33 family caregivers completed the baseline and follow-up assessment. A majority were retired (n = 26, 81%) and women (n = 19, 58%) and two-fifths had a university degree (n = 13, 41%). The family caregivers had significantly increased their preparedness for caregiving between the baseline and follow-up assessment (Mdn = 18 vs. 20, p = 0.002). No significant changes were found on caregiver burden or quality of life. SIGNIFICANCE OF RESULTS The results add to knowledge regarding the Carer Support Needs Assessment Tool Intervention's potential to improve family caregiver outcomes. Findings suggest that the intervention may be used to improve the preparedness for caregiving and support among family caregivers in specialized home care.
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Affiliation(s)
- Maria Norinder
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Capio Palliative Care, Dalen Hospital, Stockholm, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Research, Region Kalmar County, Kalmar, Sweden
| | - Lena Axelsson
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
| | - Gunn Grande
- Division of Nursing, Midwifery & Social Care, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - Gail Ewing
- Centre for Family Research, University of Cambridge, Cambridge, UK
| | - Anette Alvariza
- Department of Health Care Sciences, Palliative Research Centre, Marie Cederschiöld University, Stockholm, Sweden
- Research and Development Unit/Palliative Care, Stockholms Sjukhem, Stockholm, Sweden
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2
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Parker D, Reymond L, Cooper K, Tieman J, Ivynian S. An evaluation of an online education programme to improve nurses' ability to support carers to use subcutaneous medicines. Int J Palliat Nurs 2023; 29:538-546. [PMID: 38039121 DOI: 10.12968/ijpn.2023.29.11.538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND Most Australians say they wish to die at home, but many are admitted to inpatient facilities for symptom management. Caring@home resources can be used to support informal carers to manage breakthrough symptoms safely using subcutaneous medicines. Nurses require education about how to teach informal carers to use these resources. AIM To evaluate the effectiveness and relevance of an online education programme for registered nurses (RNs) about using the caring@home resources. METHODS Nurses must complete an online survey prior to the commencement of the online education programme and again upon completion to assess their change in skills, knowledge, confidence and attitudes of the RNs. T-tests were conducted to compare average pre- and post-education scores. FINDINGS The knowledge, skills and confidence of RNs to teach carers improved significantly following the completion of an education programme. There was a significant change in attitude, meaning that the perceived benefit of teaching informal carers to give subcutaneous medicines improved. All reported they would use the resources in their clinical practice. CONCLUSION The online education programme is an effective and cost-efficient strategy to educate nurses to support informal carers to help manage breakthrough symptoms using subcutaneous medicines.
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Affiliation(s)
- Deborah Parker
- Professor of Nursing Aged Care (Dementia); Co-Director of the Ageing Research Collaborative, University of Technology Sydney
| | - Liz Reymond
- Director of Queensland Voluntary Assisted Dying Support and Pharmacy Service; Co-director of the Statewide Office of Advance Care Planning and of the Queensland-wide PallConsult service; Brisbane South Palliative Care Collaborative; Griffith University School of Medicine, Gold Coast Campus
| | - Karen Cooper
- Project Manager; Brisbane South Palliative Care Collaborative
| | - Jennifer Tieman
- Matthew Flinders Fellow; Director of the Research Centre in Palliative Care, Death and Dying (RePaDD), Director of CareSearch Research Centre for Palliative Care, Death and Dying, Flinders University
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3
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Mehus G, Giæver A. Om uformell omsorg: en kvalitativ studie fra sjøsamiske kystsamfunn i Finnmark. TIDSSKRIFT FOR OMSORGSFORSKNING 2022. [DOI: 10.18261/tfo.8.3.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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4
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Zhao W, Wu MLW, Petsky H, Moyle W. Family carers' expectations regarding dementia care services and support in China: A qualitative study. DEMENTIA 2022; 21:2004-2019. [PMID: 35701898 DOI: 10.1177/14713012221106817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION In China, approximately 85% of people with dementia are cared for by family carers. However, limited research has been conducted to examine family carers' expectations regarding what they perceive is required for optimal care. Therefore, this study aimed to explore family carers' expectations regarding dementia care support and services in China. METHODS A qualitative study employing semi-structured interviews, with data collected from three public tertiary hospitals where the primary family carers of people with dementia (N = 21) were recruited from May to December 2019. Purposive maximum variation sampling was used to recruit participants. Data was interpreted both inductively and deductively using thematic analysis. FINDINGS Four themes were identified. The family carers reported minimal support regarding dementia care, and they held little hope of receiving support. However, most carers expressed their limited expectations, such as financial support from the government and respite care services from the community. Carers believed that care was their duty, and some of them were unwilling to move their relative with dementia into a nursing home. CONCLUSION Health and the three-tier long-term care systems in China are inadequately prepared for the challenges of dementia care, suggesting the need to develop health and social services and improve support for family carers to enable improved care for people with dementia.
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Affiliation(s)
- Wenhong Zhao
- School of Nursing and Midwifery, 5723Griffith University, Nathan, QLD, Australia
| | - Min-Lin Winnie Wu
- Menzies Health Institute Queensland, 5723Griffith University, Brisbane, QLD, Australia
| | - Helen Petsky
- School of Nursing and Midwifery, 5723Griffith University, Nathan, QLD, Australia
| | - Wendy Moyle
- Menzies Health Institute Queensland, 5723Griffith University, Brisbane, QLD, Australia
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5
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Racine L, Ford H, Johnson L, Fowler-Kerry S. An integrative review of Indigenous informal caregiving in the context of dementia care. J Adv Nurs 2021; 78:895-917. [PMID: 34806198 DOI: 10.1111/jan.15102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 09/24/2021] [Accepted: 11/05/2021] [Indexed: 11/29/2022]
Abstract
AIMS To appraise the empirical literature on the needs of Indigenous informal caregivers caring for people living with dementia in Indigenous communities. DESIGN Whittemore and Knafl's updated approach to integrative reviews, PRISMA guidelines, and CASP checklists for narrative analysis were followed. DATA SOURCES A systematic search of published empirical literature from January 2010 to August 2020 was undertaken in six databases. REVIEW METHODS Fifty-one studies met the research question and the inclusion criteria. RESULTS Five themes describe the findings: Decolonizing Western perspectives on dementia, the centrality of cultural safety, caregivers' experiences, pre-dementia community education and family and community-centred care emerged from the thematic analysis. Most of the studies used quantitative methodologies, and few studies were conducted using community-based approaches. CONCLUSION This review shows that Indigenous caregiving represents an emerging field in nursing and health sciences in a context of a global crisis. Researchers need to focus on Indigenous values and voices to adapt care and support informal caregivers. Our review emphasizes that working with Indigenous communities will likely translate into new care delivery models, policies and practices to support Indigenous informal caregivers and address the specific social determinants impacting caregivers' roles and tasks. IMPACT This review highlights the necessity of having community and family-based discussions on enhancing the delivery of dementia care for Indigenous peoples in Canada and worldwide. Decolonizing Western perspectives of dementia translate into culturally safe approaches that aim to integrate Indigenous cultural perspectives of holism, reciprocity, wisdom, respect of older people and relationality into nursing practice. The support of Indigenous informal caregivers requires future studies to address the stigmatizing Western views of dementia.
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Affiliation(s)
- Louise Racine
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Harris Ford
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Letitia Johnson
- College of Arts and Science, Department of History, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan Fowler-Kerry
- College of Nursing, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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6
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Singh GK, Ivynian SE, Davidson PM, Ferguson C, Hickman LD. Elements of Integrated Palliative Care in Chronic Heart Failure Across the Care Continuum: A Scoping Review. Heart Lung Circ 2021; 31:32-41. [PMID: 34593316 DOI: 10.1016/j.hlc.2021.08.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 05/09/2021] [Accepted: 08/01/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Individuals with chronic heart failure experience high symptom burden, reduced quality of life and high health care utilisation. Although there is growing evidence that a palliative approach, provided concurrently with usual treatment improves outcomes, the method of integrating palliative care for individuals living with chronic heart failure across the care continuum remains elusive. AIM To examine the key elements of integrated palliative care recommended for individuals living with chronic heart failure across the care continuum. DESIGN Scoping review. DATA SOURCES Databases searched were CINAHL, Ovid MEDLINE, Scopus and OpenGrey. Studies written in English and containing key strategic elements specific to chronic heart failure were included. Search terms relating to palliative care and chronic heart failure and the Joanna Briggs Institute methodology for scoping reviews was used. RESULTS Seventy-nine (79) articles were selected that described key elements to integrate palliative care for individuals with chronic heart failure. This review identifies four levels of key strategic elements: 1) clinical; 2) professional; 3) organisational and 4) system-level integration. Implementing strategies across these elements facilitates integrated palliative care for individuals with chronic heart failure. CONCLUSIONS Inter-sectorial collaborations across systems and the intersection of health and social services are essential to delivering integrated, person-centred palliative care. Further research focussing on patient and family needs at a system-level is needed. Research with strong theoretical underpinnings utilising implementation science methods are required to achieve and sustain complex behaviour change to translate key elements.
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Affiliation(s)
- Gursharan K Singh
- Centre for Healthcare Transformation, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Qld, Australia; Cancer and Palliative Care Outcomes Centre, School of Nursing, Queensland University of Technology (QUT), Brisbane, Qld, Australia.
| | - Serra E Ivynian
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Patricia M Davidson
- School of Nursing, Johns Hopkins University, Baltimore, MD, USA & Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Caleb Ferguson
- School of Nursing & Midwifery, Western Sydney University, Penrith, NSW, Australia; Western Sydney Local Health District, Blacktown Hospital, Sydney, NSW, Australia
| | - Louise D Hickman
- Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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Stefánsdóttir OÁ, Munkejord MC, Sveinbjarnardóttir EK. Maintaining or letting go of couplehood: Perspectives of older male spousal dementia caregivers. Scand J Caring Sci 2021; 36:742-751. [PMID: 34569074 DOI: 10.1111/scs.13035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/01/2021] [Accepted: 09/12/2021] [Indexed: 11/30/2022]
Abstract
Despite the negative implications for their own health, spouses continue to support each other and maintain their couplehood for as long as possible, including when one of them develops a severe illness. However, with some exceptions, the experiences of older male spousal caregivers have been largely overlooked, and our knowledge of the relational aspects of spousal dementia care is scarce. To respond to this knowledge gap, this article explores the following research questions: How do older male spousal caregivers of wives with dementia talk about changes in their couplehood? What transitions or phases in the relationship can be identified as the caring process evolves and the wife's health continues to deteriorate? To answer these questions, we analyse in-depth interviews with eight purposefully selected men aged 67-92 years old from Iceland and Norway. Our findings reveal that the participants felt that they were gradually losing their couplehood in the sense that they lost their shared everyday life routines, intimacy, joint activities, meaningful communication, and dreams and hopes for the future. Four phases of the dementia caring process were identified: the denial phase, the battle phase, the new reality phase and the redefinition phase. We hope that our findings spur more research on relational challenges as experienced by spouses caring for partners with cognitive decline. In conclusion, we argue that interdisciplinary clinical guidelines for a couple-centred approach in elder care should be developed to urge professional care providers to pay attention to the various changes and challenges that dementia couples undergo to meet not only the health and care needs of dementia patients but also those of their spouses.
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Affiliation(s)
| | - Mai Camilla Munkejord
- Dept of Business Administration, Western Norway University of Applied Sciences, Bergen, Norway.,NORCE, Bergen, Norway.,Centre for Care Research West, Western Norway of Applied Sciences, Bergen, Norway
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Tarter R, Mates EA, Lindauer A, Hassouneh D. Relationship, Choice, Health, and Typologies of Unpaid Care Labor for Older Adults. West J Nurs Res 2021; 44:436-445. [PMID: 33882771 DOI: 10.1177/01939459211001429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Providing unpaid care labor to older adult friends and relatives is associated with deleterious health outcomes, especially among persons who feel they have no choice when taking on care responsibilities. We used hierarchical cluster analysis and structural equation modeling of data from the National Alliance for Caregiving's Caregiving in the U.S. 2015 Survey to explore choice-outcome relationships. We identified three distinct care typologies, hands-on, household, and managerial care. Perceived lack of choice predicted emotional stress directly and indirectly through household and managerial care; predicted physical strain directly and indirectly through all care typologies; but only predicted negative health impact indirectly through mediation. Lack of choice had greater direct effects on emotional stress and negative health impact for adult-descendants compared to participants with other relationships with recipients, for whom the effects of lack of choice on outcomes were mediated through household and managerial care.
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Affiliation(s)
- Robin Tarter
- Oregon Health & Science University (OHSU) School of Nursing, Portland, OR, USA
| | - Exu Anton Mates
- University of Washington Department of Psychology, Seattle, WA, USA
| | - Allison Lindauer
- Oregon Health & Science University (OHSU) Department of Neurology, Portland, OR, USA
| | - Dena Hassouneh
- Oregon Health & Science University (OHSU) School of Nursing, Portland, OR, USA
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9
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Fetherstonhaugh D, Rayner JA, Solly K, McAuliffe L. 'You become their advocate': The experiences of family carers as advocates for older people with dementia living in residential aged care. J Clin Nurs 2021; 30:676-686. [PMID: 33295051 DOI: 10.1111/jocn.15589] [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: 09/29/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 12/27/2022]
Abstract
AIMS The aim of this study was to identify features of well-performing residential aged care services (RACS) as experienced by family carers. BACKGROUND Family carers can have an integral role in residential aged care providing social support and are well-placed to engage with staff and monitor care. DESIGN A qualitative descriptive design was used. Semi-structured face-to-face and telephone interviews were conducted with family carers of current or past residents of Australian RACS between November 2018 and January 2019. Interview transcripts were analysed thematically. RESULTS Rather than reporting features of well-performing RACS, participants shared stories of sub-standard care, dysfunctional management and poor resident-staff-family interactions. An overarching theme emerged of 'having to be an advocate' for residents' needs, which covered four major categories: organisational accountability (including transparency and individualised care), good communication, connection and trust. Combined, these constitute what carers perceive are the necessary conditions for determining the features of a well-performing RACS. CONCLUSION Family carers need to feel confident and trust RACS staff when they hand over the role of carer for their relative with dementia. RELEVANCE TO CLINICAL PRACTICE This study provides insight into the needs and challenges of family carers when they relinquish the care of an older relative with dementia. Strategies to build confidence and trust between RACS and family carers are essential. Aged care nurses can play a pivotal role to support this through the development of open communication and relational connections with residents and their families.
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Affiliation(s)
- Deirdre Fetherstonhaugh
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Jo-Anne Rayner
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Kane Solly
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
| | - Linda McAuliffe
- Australian Centre for Evidence Based Aged Care, La Trobe University, Melbourne, Vic., Australia
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Vermorgen M, Vandenbogaerde I, Van Audenhove C, Hudson P, Deliens L, Cohen J, De Vleminck A. Are family carers part of the care team providing end-of-life care? A qualitative interview study on the collaboration between family and professional carers. Palliat Med 2021; 35:109-119. [PMID: 32928056 DOI: 10.1177/0269216320954342] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The attention of healthcare professionals is directed mainly towards the recipients of care and often insufficiently towards family carers. However, an effective collaboration between professionals and family carers is vital to provide quality palliative and end-of-life care. Such collaboration is under-studied in a palliative care context. AIM This study aimed to investigate how family carers of people who live at home with a life-limiting chronic illness experience and perceive collaboration with different healthcare professionals in the last phase of life. DESIGN Face-to-face semi-structured interviews were conducted with the primary family carers of people with a life-limiting chronic illness. Interpretative phenomenological analysis was used to analyse the data. SETTING/PARTICIPANTS A heterogeneous sample of 30 family carers of people with cancer, heart failure or dementia was recruited through a variety of care providers and services, in order to reflect the heterogeneity of caregiving in serious illness. RESULTS Five main themes emerged from interpretative phenomenological analysis that describe the quality of the collaboration between family carers and professionals: respecting family carers both as someone with care needs and as a member of the care team; the continuous availability and accessibility of healthcare professionals; the provision of information and communication including family carer issues; the coordination of care between all parties and contextual factors. The dominant experience by family carers was one of missed opportunities across these themes. CONCLUSIONS This qualitative study about the experiences and perceptions of family carers of people with a chronic life-limiting illness living at home regarding the collaboration with different healthcare providers in the last phase life, showed that family carers experience a lot of possibilities, but perceive missed opportunities as well, for healthcare professionals to effectively collaborate with them for palliative care.
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Affiliation(s)
- Maarten Vermorgen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Isabel Vandenbogaerde
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | | | - Peter Hudson
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.,Centre for Palliative Care, St Vincent's Hospital Melbourne and University of Melbourne, Melbourne, Australia
| | - Luc Deliens
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium.,Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Joachim Cohen
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
| | - Aline De Vleminck
- End-of-life Care Research Group, Vrije Universiteit Brussel (VUB) & Ghent University, Brussels, Belgium
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Petersen JJ, Østergaard B, Svavarsdóttir EK, Rosenstock SJ, Brødsgaard A. A challenging journey: The experience of elderly patients and their close family members after major emergency abdominal surgery. Scand J Caring Sci 2020; 35:901-910. [PMID: 32857474 DOI: 10.1111/scs.12907] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/19/2020] [Accepted: 08/02/2020] [Indexed: 12/16/2022]
Abstract
RATIONALE Knowledge of how elderly patients undergoing major emergency abdominal surgery and their close family members experience the course of illness is limited. Little is known about how such surgery and hospitalisation affect elderly patients' daily life after discharge. It is well known that such patients have an increased risk of mortality and that their physical functional level often decreases during hospitalisation, which can make them dependent on family or homecare services. Critical illness and caregiving for a close relative can be a stressful experience for families, which are at risk of developing stress-related symptoms. AIM To explore how elderly patients and their families experience the course of illness during hospitalisation and the first month at home after discharge. METHOD A phenomenological study was conducted to gain in-depth descriptions through 15 family interviews with 15 patients who had undergone major emergency abdominal surgery and 20 of their close adult family members. Data were analysed using a phenomenological approach inspired by Giorgi. FINDINGS The essence of the phenomenon is captured in three themes: (1) Being emotionally overwhelmed, (2) Wanting to be cared for and (3) Finding a way back to life. CONCLUSION Patients and their close family members experienced the course of illness as a challenging journey where they longed for life to become as it was before illness. They experienced illness as a sudden life-threatening incidence. In this situation, it was crucial to be met with empathy from healthcare professionals. The patients' experience of fatigue and powerlessness remained intense one month after discharge and affected their and their close family members' lives.
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Affiliation(s)
- Julie Jacoby Petersen
- Gastrounit, Surgical Division, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Graduate School of Health, University of Aarhus Graduate School of Health Sciences, Aarhus N, Denmark
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | | | - Steffen Jais Rosenstock
- Gastrounit, Surgical Division, Copenhagen University Hospital Amager Hvidovre, Hvidovre, Denmark.,Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark
| | - Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Denmark.,Section for Nursing, Department of Public Health, University of Aarhus, Aarhus, Denmark
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12
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Andersen HE, Hoeck B, Nielsen DS, Ryg J, Delmar C. A phenomenological-hermeneutic study exploring caring responsibility for a chronically ill, older parent with frailty. Nurs Open 2020; 7:951-960. [PMID: 32587713 PMCID: PMC7308672 DOI: 10.1002/nop2.467] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/17/2019] [Accepted: 02/16/2020] [Indexed: 11/07/2022] Open
Abstract
Aim To provide lifeworld insights into experiences of adult children with caring responsibility for an 80+-year-old chronically ill parent with frailty. Background Informal care is common in Nordic welfare countries; however, little is known about adult children's experience of caring responsibility in this setting. Design A phenomenological-hermeneutic study based on Reflective Lifeworld Research. Methods Diaries and semi-structured interviews with 12 adult children. Results Caring responsibility is identified as "a condition of life, filled with uncertainty." Three constituents contribute to this phenomenon: (a) balancing love, duty and reciprocity; (b) being the parent's advocate and manager; and (c) experiencing concerns and bodily strain. Conclusion Adult children work hard to provide care and enhance the well-being of their parent. Heidegger's concept 'Fürsorge' may help us understand how by showing how caring responsibility means balancing different roles vis-à-vis the parent, one's own life and the health and social systems. Caring responsibility changes the relationship between parent and child.
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Affiliation(s)
- Helle Elisabeth Andersen
- Department of Public Health NursingAarhus UniversityAarhusDenmark
- Health Sciences Research CentreUCLOdenseDenmark
| | - Bente Hoeck
- Department of Public HealthUniversity of Southern DenmarkOdenseDenmark
| | - Dorthe Susanne Nielsen
- Health Sciences Research CentreUCLOdenseDenmark
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
- Migrant Health ClinicOdense University HospitalOdenseDenmark
| | - Jesper Ryg
- Department of Clinical ResearchUniversity of Southern DenmarkOdenseDenmark
- Department of Geriatric MedicineOdense University HospitalOdenseDenmark
| | - Charlotte Delmar
- Department of Public Health NursingAarhus UniversityAarhusDenmark
- Institut for Helse‐ og omsorgsfagNorway's Artic UniversityTromsøNorway
- VIDHelsefagBergenOsloNorway
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13
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Jarling A, Rydström I, Ernsth-Bravell M, Nyström M, Dalheim-Englund AC. A responsibility that never rests - the life situation of a family caregiver to an older person. Scand J Caring Sci 2019; 34:44-51. [PMID: 31058334 DOI: 10.1111/scs.12703] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND When the ageing population increases, the burden and responsibility of close family members will likely increase. Those closely related who assume a great responsibility can be significantly affected in health, well-being and daily life. AIM This study aims to describe the life situation when family caregivers are imposed responsibility for an older person with complex care needs in their own home. METHODS In this Swedish qualitative study, ten family caregivers were strategically selected in order to achieve variations in the life situation. A reflective lifeworld research design based on phenomenological philosophy was used throughout the data collection with the lifeworld interviews and the analytic process. FINDINGS In terms of extensive responsibility, the life situation is complex and involves emotions that are difficult to manage. In essence, a paradoxical life situation is described which is experienced as both voluntarily and nonchosen at the same time. The responsibility never rests. The essential meaning is further illustrated with three constituents: loss of freedom, contradictory feelings and affected relationships. CONCLUSION A life situation with extensive responsibility for an older family member interferes with the whole life situation with an impact on health and relationships with other people. The findings are crucial for professional caregivers in order to capture the nature of family support in a way that enables a meaningful life for both the family caregiver and the older person being cared for. Knowledge of this will give professional caregivers an increased awareness of the life situation of family caregivers and provide a better understanding of the support they are longing for, and, in some countries, such as Sweden, also are entitled to by law.
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Affiliation(s)
- Aleksandra Jarling
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Ingela Rydström
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Maria Nyström
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Eriksson E, Wejåker M, Danhard A, Nilsson A, Kristofferzon ML. Living with a spouse with chronic illness - the challenge of balancing demands and resources. BMC Public Health 2019; 19:422. [PMID: 31014309 PMCID: PMC6480606 DOI: 10.1186/s12889-019-6800-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/11/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The number of partners providing informal care for their chronically ill spouse is rising, and they describe their daily life as demanding. The aim of this paper was to describe the partners' experiences of living with a person with chronic illness and how they manage everyday life. METHODS A descriptive design with a qualitative approach was used. A purposive sample of 16 Swedish partners with a chronically ill spouse were interviewed. The interviews were recorded, transcribed, and analyzed using qualitative content analysis. RESULTS Four main themes were identified: 'Managing challenges in daily life,' 'Seeking support and use own capabilities to manage life,' 'Appreciating the good parts of life' and 'Adapting to constant changes and an uncertain future'. Their experiences of support from formal care providers varied; they expressed the need for more assistance from the health care sector. CONCLUSIONS The partners experienced many challenges in everyday life when providing informal care for their chronically ill spouse. This affected both their physical and psychological health, as they had limited time for themselves. The partners seemed to receive more support from their informal network than from formal care providers. In handling daily life, the partners balanced demands and resources to identify possibilities to move forward and find meaning in life. This is congruent with theories by Antonovsky, and Folkman and Lazarus that describes meaningfulness and how to handle challenges in everyday life.
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Affiliation(s)
- Elisabet Eriksson
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Maria Wejåker
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Anna Danhard
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
| | - Annika Nilsson
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Marja-Leena Kristofferzon
- Department of Health and Caring Sciences, University of Gävle, Kungsbäcksvägen 47, 801 76 Gävle, Sweden
- Department of Public Health and Caring Sciences, Section of Caring Sciences, Uppsala University, Uppsala, Sweden
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15
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Uysal N, Gürol Arslan G, Mete S. The feelings and experiences of hospitalized patients regarding informal caregivers: a qualitative study. SOCIAL WORK IN HEALTH CARE 2019; 58:166-181. [PMID: 30321130 DOI: 10.1080/00981389.2018.1531102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Revised: 09/21/2018] [Accepted: 09/28/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to understand the views of hospitalized patients regarding family/informal caregivers (ICs). In this study thematic content analysis was used, interviews were audio-recorded, transcribed verbatim, and coded. The 4 themes and 11 subthemes were determined. Themes: Identity of IC, expectations of IC, feelings about the presence or absence of an IC. Along with feeling positive emotions when ICs were present, patients also felt as though they were a burden on caregivers. Family caregivers are an important social support for patients and they may lead to more meaningful patient outcomes globally.
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Affiliation(s)
- Nurcan Uysal
- a Faculty of Health Science Nursing Department, Florya Halit Aydin Campus , Istanbul Aydin University , Küçükçekmece , Turkey
| | - Gülşah Gürol Arslan
- b Department of Fundamentals Nursing , Dokuz Eylül University Faculty of Nursing , Balçova, İzmir , Turkey
| | - Samiye Mete
- c Faculty of Health Sciences , University of Kyrenia , Girne, KKTC , Turkish Republic of Northern Cyprus
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16
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Søvde BE, Hovland G, Ullebust B, Råholm M. Struggling for a dignifying care: experiences of being next of kin to patients in home health care. Scand J Caring Sci 2019; 33:409-416. [DOI: 10.1111/scs.12638] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Accepted: 11/13/2018] [Indexed: 01/01/2023]
Affiliation(s)
- Bente Egge Søvde
- Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
| | - Gro Hovland
- Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
| | - Berit Ullebust
- Centre for Development of Institutional and Home Care Services (USHT) Førde Norway
| | - Maj‐Britt Råholm
- Faculty of Health and Social Sciences Western Norway University of Applied Sciences Bergen Norway
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