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Heymann J, Raub A, Waisath W, Earle A, Stek P, Sprague A. Paid Leave to Meet the Health Needs of Aging Family Members in 193 Countries. J Aging Soc Policy 2024; 36:508-531. [PMID: 36007142 DOI: 10.1080/08959420.2022.2110804] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 05/04/2022] [Indexed: 10/15/2022]
Abstract
Women and workers over 50 disproportionately provide care for aging family members worldwide, including the 101 million who are care-dependent. Paid leave for adult health needs, which temporarily replaces employment income for workers providing care, can critically support both caregivers' economic outcomes and care recipients' wellbeing. We created quantitatively comparable data on paid leave policies that can be used to meet adult family members' health needs in all United Nations member states. Globally, 112 countries fail to provide any paid leave that can be used to meet the serious health needs of an aging parent, spouse, or adult child. These gaps have profound consequences for older workers providing care as well as care access by aging, ill, and disabled adults.
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Affiliation(s)
- Jody Heymann
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Amy Raub
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Willetta Waisath
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Alison Earle
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Pamela Stek
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Aleta Sprague
- WORLD Policy Analysis Center, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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Zeides Taubin D, Maeir A. "I wish it wasn't all on me": women's experiences living with a partner with ADHD. Disabil Rehabil 2024; 46:3017-3025. [PMID: 37496495 DOI: 10.1080/09638288.2023.2239158] [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: 03/13/2023] [Revised: 07/13/2023] [Accepted: 07/15/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Grounded in the socio-ecological model of health, this study aims to understand the broader impact of adult attention deficit hyperactivity disorder (ADHD) on the family system. With a notable gap in knowledge concerning the impact of adult ADHD on spouses' well-being, this research explores the lived experiences of women in relationships with partners diagnosed with ADHD. MATERIAL AND METHODS Using a descriptive qualitative phenomenological approach, we conducted semi-structured interviews with thirteen women without ADHD, to gain insights into their experiences. RESULTS Three main themes were identified- ADHD in Everyday Life, Burden Experience, and Women's Coping Strategies for managing ADHD within relationships. The findings suggest that partners' ADHD symptoms involve a burden on women. In response, women developed coping strategies such as learning about ADHD, setting limits, and cultivating partnership by creating bridges to compensate for ADHD-related barriers. CONCLUSIONS This study highlights the substantial burden experienced by women in a relationship with partners diagnosed with ADHD, suggesting they should be recognized as caregivers and a potentially vulnerable group at risk. However, the homogeneous nature of our sample, focusing on white, heterosexual women, underlines the need for further research to better understand the impact of adult ADHD on diverse partners' functioning and health, as well as pathways to support them.
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Affiliation(s)
| | - Adina Maeir
- School of Occupational Therapy, Hebrew University, Jerusalem, Israel
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McGee JS, Polson EC, Myers DR, McClellan AM, Ke W, Zhao HC, Meraz R. Gratitude Predicts Meaning in Life in Family Caregivers of Persons with Alzheimer's Disease. Geriatrics (Basel) 2024; 9:72. [PMID: 38920428 PMCID: PMC11202586 DOI: 10.3390/geriatrics9030072] [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: 03/21/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 06/27/2024] Open
Abstract
Gratitude is a well-known and researched internal positive psychological resource. Empirical data, however, on the association between gratitude, meaning in life, and burden in family caregivers of persons with Alzheimer's disease is scant. The aims of this study were to (1) investigate the relationships among these variables in a sample of family caregivers of persons with Alzheimer's; and (2) determine if gratitude mediates the effects of perceived burden on meaning in life in this population. One-hundred and twenty-six adult family caregivers, most of whom were an intimate partner or adult child of a person with Alzheimer's, completed the Gratitude Questionnaire-Six Item, the Meaning in Life Questionnaire, the Zarit Burden Inventory, and other relevant measures. A series of OLS regression models, guided by the caregiver stress process model, were conducted. These analyses demonstrated that gratitude was a predictor of the presence of meaning in life among the caregivers in this study even when other key variables were considered. Furthermore, analyses revealed that gratitude fully mediated the effects of caregiver burden on the presence of meaning in life in this sample. Thus, clinicians should consider gratitude as an important internal resource for cultivating meaning in life in this population, especially when caregiver burden is present. Gratitude-bolstering clinical interventions should be further developed and tested as both stand-alone and complimentary additions to empirically supported psychoeducational approaches for supporting health and well-being in this population.
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Affiliation(s)
- Jocelyn Shealy McGee
- Diana R. Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.M.)
| | - Edward C. Polson
- Diana R. Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.M.)
| | - Dennis R. Myers
- Diana R. Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.M.)
| | - Angela M. McClellan
- Diana R. Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.M.)
| | - Weiming Ke
- Louise Herrington School of Nursing, Baylor University, Dallas, TX 75246, USA; (W.K.); (R.M.)
| | | | - Rebecca Meraz
- Louise Herrington School of Nursing, Baylor University, Dallas, TX 75246, USA; (W.K.); (R.M.)
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Jiang B, Yao Q, Yuan X, Liu G, Lu P. Burden of blindness and vision loss in China over the past 30 years: findings and predictions based on the Global Burden of Disease Study 2019. Br J Ophthalmol 2024; 108:889-896. [PMID: 37474257 DOI: 10.1136/bjo-2023-323527] [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: 03/04/2023] [Accepted: 07/07/2023] [Indexed: 07/22/2023]
Abstract
AIMS To investigate the burden of blindness and vision loss (BVL) in China over the past 30 years according to year, age and sex, and to estimate future predictions. METHODS We analysed the years lived with disability (YLDs), number of cases, age-standardised YLD rates (ASYRs) and age-standardised prevalence rates (ASPRs) of BVL in China from 1990 to 2019. We focused on changes over time using estimated annual percentage changes (EAPCs). Additionally, we used the Bayesian age-period-cohort model to predict the BVL burden from 2020 to 2030. RESULTS The number of YLDs and prevalent cases due to BVL increased from 2.57 (95% uncertainty interval (UI) 1.74 to 3.72) and 90.76 million (95% UI 72.21 to 111.92) in 1990 to 5.42 (95% UI 3.61 to 8.02) and 211.67 million (95% UI 168.21 to 259.66) in 2019, respectively. The BVL ASYRs and ASPRs showed a decreasing trend, with EAPCs of -0.13 (95% CI -0.28 to 0.02) and -0.11 (95% CI -0.19 to -0.04), respectively. The elderly and female populations had a higher BVL burden. The numbers of YLDs and cases due to BVL are projected to continue rising to 7.74 and 279.49 million in 2030, respectively. The ASYRs and ASPRs also showed increasing trends. CONCLUSION While rates of BVL in China have decreased, there has been a notable increase in the number of YLDs and new cases over the past 30 years. Projections suggest that the burden of BVL will continue to rise over the next 11 years. To address this challenge, appropriate policies must be implemented.
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Affiliation(s)
- Bo Jiang
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qingying Yao
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Xianbin Yuan
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Gaoqin Liu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Peirong Lu
- Department of Ophthalmology, The First Affiliated Hospital of Soochow University, Suzhou, China
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Chen H, Liu W, Xu X, Xiao M, Yin Y. The Effects of a Nonpharmacological Intervention Practice for Older Adults with Mild Cognitive Impairment and Their Family Caregivers in China. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-20. [PMID: 38762891 DOI: 10.1080/01634372.2024.2355152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 05/10/2024] [Indexed: 05/21/2024]
Abstract
Mild cognitive impairment (MCI) marks a critical phase in the progression to dementia. In our study, social workers utilized the Multicomponent Nonpharmacological Intervention Approach (MCNIA) to aid MCI participants (N = 52) and their caregivers, dividing into intervention and control groups. The intervention group underwent an additional regimen of non-pharmacological therapies besides pharmacological treatment. Our findings highlighted that: 1) MCNIA significantly enhanced cognitive and daily living abilities in the intervention group; 2) Caregivers experienced reduced burdens and improved social support; 3) Correlation analyses involving biomarkers indicated that MCNIA was particularly effective in alleviating depression in those with slightly more severe cognitive impairment.
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Affiliation(s)
- Honglin Chen
- Department of Social Sciences, Faculty of Social Science and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Wenrui Liu
- Department of Social Work, School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Xian Xu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
- NHC Key Laboratory of Clinical Nephrology, Sun Yat-Sen University and Guangdong Provincial Key Laboratory of Nephrology, Guangzhou, China
| | - Meng Xiao
- Department of social work, Tianjin Normal University, Tianjin, China
| | - You Yin
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), Shanghai, China
- Department of Neurology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China
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Lee MMS, Yeoh EK, Wang K, Wong ELY. Caregiver Employees' Mental Well-Being in Hong Kong. Healthcare (Basel) 2024; 12:1013. [PMID: 38786422 PMCID: PMC11121220 DOI: 10.3390/healthcare12101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. METHOD Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick -Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. FINDINGS The mean score of the Short Warwick-Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (-0.050, p < 0.001) and Short Warwick-Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick-Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. CONCLUSIONS Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population.
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Affiliation(s)
| | | | | | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Avenue, Hong Kong, China; (M.M.-S.L.); (E.-K.Y.); (K.W.)
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McGee JS, Polson EC, Myers DR, McClellan A, Meraz R, Ke W, Zhao HC. Hope Mediates Stress to Reduce Burden in Family Caregivers of Persons with Alzheimer's Disease. Geriatrics (Basel) 2024; 9:38. [PMID: 38525755 PMCID: PMC10961813 DOI: 10.3390/geriatrics9020038] [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: 12/27/2023] [Revised: 03/03/2024] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
The experience of burden among family caregivers of persons with Alzheimer's disease and other forms of dementia may be deleterious for their health and well-being. Little is known, however, about the degree to which internal positive psychological resources, such as hope, influence burden perceptions in this population. The current study is novel in that it examined how multiple dimensions of hope, hope-agency and hope-pathway, influenced burden in a sample of one-hundred and fifty-five family caregivers of persons with Alzheimer's disease. The stress process model was used as the theoretical framework for variable specification in this study. Hope was conceptualized using Snyder and colleagues' hope theory. Supporting our first hypothesis, we found that burden was negatively associated with hope-agency, r = -0.33, p < 0.001 and hope-pathway, r = -0.24, p < 0.01. Multiple regression was used to determine if hope-agency and hope-pathway independently contributed to burden. Analysis revealed that hope-agency but not hope-pathway influenced burden when other key variables were taken into consideration. Findings from mediation analysis affirmed that hope-agency had a small but significant mediation effect between stress and burden in this sample. This study provides evidence for the relevance of assessing multiple dimensions of hope when working with caregivers of persons with Alzheimer's. Although replication studies are warranted, the current study confirms a need for further development and refinement of hope-bolstering behavioral interventions which may mediate stress and burden in this population. These interventions should be systematically assessed for efficacy and effectiveness via implementation studies in real-world settings.
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Affiliation(s)
- Jocelyn Shealy McGee
- Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.)
| | - Edward C. Polson
- Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.)
| | - Dennis R. Myers
- Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.)
| | - Angela McClellan
- Garland School of Social Work, Baylor University, Waco, TX 76701, USA; (E.C.P.); (D.R.M.); (A.M.)
| | - Rebecca Meraz
- Louise Herrington School of Nursing, Baylor University, Dallas, TX 75246, USA; (R.M.); (W.K.)
| | - Weiming Ke
- Louise Herrington School of Nursing, Baylor University, Dallas, TX 75246, USA; (R.M.); (W.K.)
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Miskovic-Wheatley J, Schlage J, Pehlivan MJ, Simone R, Koreshe E, Hunt C, Maguire S. Skills-based online self-help program for carers of people with an eating disorder (SupportED): A case series evaluation. Int J Eat Disord 2024; 57:423-436. [PMID: 38149436 DOI: 10.1002/eat.24112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
OBJECTIVE To investigate the acceptability, feasibility, and preliminary effectiveness of "SupportED," a novel, online, self-paced skills-based program for carers/support people of those with lived and/or living experience of an eating disorder (ED). METHOD Carers of a loved one with an ED were invited to undertake a five-module skills-based (one core module, four optional modules) online program at their own pace. Modules cover general information about EDs, communication, practical skills, treatment engagement, and recovery. Participants completed demographics and were assessed using EDSIS, CASK, and DASS-21 for caregiver burden, skills, and distress, respectively, at program completion and 3-month follow-up. Feedback on the program and modules was also collected. RESULTS Most carers (65%; 82/126) completed the core module of the program, which is on par with other online learning programs. Nearly half of program completers responded to the 3-month follow-up (n = 39). On average, carers rated the program as relevant and useful and found the information validating and easy to understand, albeit a few carers found the program time-consuming and technically challenging. Intent-to-treat (ITT) linear mixed models demonstrated the preliminary effectiveness of the program for improving carer burden and skills, although the change in carer distress was non-significant. CONCLUSIONS Results of this case series evaluation suggest SupportED is an acceptable and feasible program for carers and may improve burden and support skill development. Although the online, self-paced format was highly rated, small improvements to improve acceptability were suggested. Reasons for a lack of impact on carer distress are discussed. PUBLIC SIGNIFICANCE This article describes a case series evaluation of "SupportED," an online skills-based support program for families, carers, and supporters of people with lived experience of an eating disorder. This is the first online carer support program that is designed to be inclusive of all carer types (e.g., partners, siblings) for all eating disorder presentations. Findings suggest the program's suitability and helpfulness for reducing carers' load and bolstering skills and knowledge.
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Affiliation(s)
- Jane Miskovic-Wheatley
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Jasmin Schlage
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Melissa J Pehlivan
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Rachel Simone
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Eyza Koreshe
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
| | - Caroline Hunt
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, New South Wales, Australia
| | - Sarah Maguire
- InsideOut Institute of Eating Disorders, Faculty of Medicine and Health, The University of Sydney, and Sydney Local Health District, Sydney, New South Wales, Australia
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LaManna JB, Loerzel V, Conner NE. Lived experiences of older male caregivers: "That was the Worst!". Geriatr Nurs 2024; 55:277-285. [PMID: 38104439 DOI: 10.1016/j.gerinurse.2023.12.006] [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: 10/23/2023] [Revised: 12/05/2023] [Accepted: 12/07/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION Although caregiving is a traditional female role, older men represent an increasing proportion of family caregivers. This study's aim was to describe lived experiences of men who engaged in later-life caregiving. METHOD Streubert's phenomenological method, inclusive of unstructured interviews and respondent validation of a single formalized description, was applied to explore lived experiences of eight older male caregivers. RESULTS Three overarching themes characterized older male caregiving: 1) role and life changes, 2) "taking care of business," and 3) getting over "the worst". All caregivers spent extensive time in anticipatory planning for potential problems and were dissatisfied with existing resources and services. Each man described a profound, mentally-challenging caregiving crisis that triggered important caregiving decisions. DISCUSSION Study findings support an urgent need for research to clarify the mental health needs of older male caregivers and to test interventions that better meet the unique needs of this growing caregiver demographic.
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Affiliation(s)
| | - Victoria Loerzel
- University of Central Florida College of Nursing, Orlando, FL, United States
| | - Norma E Conner
- University of Central Florida College of Nursing, Orlando, FL, United States
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Chiu WY, Yeh TC, Yang CC. Factors Associated With Emergency Department Visits Among Patients Receiving Publicly-Funded Homecare Services: A Retrospective Chart Review From Southern Taiwan Regional Hospital. Int J Health Policy Manag 2023; 12:7377. [PMID: 38618794 PMCID: PMC10699816 DOI: 10.34172/ijhpm.2023.7377] [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: 06/13/2022] [Accepted: 09/25/2023] [Indexed: 04/16/2024] Open
Abstract
BACKGROUND The public health strategy of increasing access to comprehensive home or community-based healthcare services and emergency home visits is intent on reducing the overcrowding of emergency departments. However, scientific evidence regarding the association between home-based healthcare services and emergency department uses is surprisingly insufficient and controversial so far. The present retrospective study identified the risk factors for emergency department visits among patients receiving publicly-funded homecare services. METHODS The personal demographic and medical information, caregiver characteristics, and behaviours related to homecare services and emergency department visits from the medical records and structured questionnaires of 108 patients who were recipients of integrated homecare services in a regional hospital in southern Taiwan between January 1, 2020, and December 31, 2020, were collected. After screening the potential predictor variables using the preliminary univariate analyses, the multivariate logistic regression with best subset selection approach was conducted to identify best combination of determinants to predict unplanned emergency department utilizations. RESULTS Best subset selection regression analysis showed Charlson Comorbidity Index (odds ratio (OR)=1.33, 95% CI=1.05 to 1.70), male caregiver (OR=0.18, 95% CI=0.05 to 0.66), duration of introducing homecare services (OR=0.97, 95% CI=0.95 to 1.00), working experience of dedicated nurses (OR=0.89, 95% CI=0.79 to 0.99) and number of emergency department utilizations within previous past year before enrollment (OR=1.54, 95% CI=1.14 to 2.10) as significant determinants for unplanned emergency department visits. CONCLUSIONS The present evidence may help government agencies propose supportive policies to improve access to integrated homecare resources and promote appropriate care recommendations to reduce unplanned or nonurgent emergency department visits among patients receiving homecare services.
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Affiliation(s)
- Wen-Yi Chiu
- Department of Family Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan
- The Master Program of Long-Term Care in Aging, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ta-Chuan Yeh
- Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Chia-Chi Yang
- The Master Program of Long-Term Care in Aging, College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
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11
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Stokes JE, Patterson SE. Caregiving and Self-Esteem in Mid and Later Life: Is There Variation by Age, Parental Status, and Gender? Int J Aging Hum Dev 2023; 97:306-326. [PMID: 36189474 PMCID: PMC10067533 DOI: 10.1177/00914150221128976] [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: 11/15/2022]
Abstract
Caregiving may prove either beneficial or harmful for caregiver well-being, depending on the circumstances surrounding care provision. Using data from the two most recent waves of the National Survey of Midlife Development in the United States (MIDUS, 2004-2014; N = 1,100), we examine whether providing care for an adult at both time points (i.e., 8-10 years apart) is associated with changes to self-esteem over the ten-year period, in comparison with providing care at only one time point, or not at all. We also examine moderation by caregivers' age, parental status, and gender. Findings indicated (1) caregiving at both waves was associated with decreases in self-esteem among younger and midlife adults, but this effect weakened and even reversed with age; and (2) caregiving at both waves was associated with increased self-esteem among participants without children, but not among those with children. We discuss implications for identifying caregivers at greatest risk of diminished well-being.
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Affiliation(s)
- Jeffrey E. Stokes
- Department of Gerontology, McCormack Graduate School of Policy & Global Studies, University of Massachusetts Boston, Boston, Massachusetts, USA
| | - Sarah E. Patterson
- Population Studies Center, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Min A, Miller WR, Rocha LM, Börner K, Correia RB, Shih PC. Understanding Contexts and Challenges of Information Management for Epilepsy Care. PROCEEDINGS OF THE SIGCHI CONFERENCE ON HUMAN FACTORS IN COMPUTING SYSTEMS. CHI CONFERENCE 2023; 2023:328. [PMID: 37786774 PMCID: PMC10544776 DOI: 10.1145/3544548.3580949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Epilepsy is a common chronic neurological disease. People with epilepsy (PWE) and their caregivers face several challenges related to their epilepsy management, including quality of care, care coordination, side effects, and stigma management. The sociotechnical issues of the information management contexts and challenges for epilepsy care may be mitigated through effective information management. We conducted 4 focus groups with 5 PWE and 7 caregivers to explore how they manage epilepsy-related information and the challenges they encountered. Primary issues include challenges of finding the right information, complexities of tracking and monitoring data, and limited information sharing. We provide a framework that encompasses three attributes - individual epilepsy symptoms and health conditions, information complexity, and circumstantial constraints. We suggest future design implications to mitigate these challenges and improve epilepsy information management and care coordination.
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Affiliation(s)
- Aehong Min
- Indiana University Bloomington, Bloomington, Indiana, USA
| | | | - Luis M Rocha
- Binghamton University, Binghamton, New York, USA
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Katy Börner
- Indiana University Bloomington, Bloomington, Indiana, USA
| | - Rion Brattig Correia
- Instituto Gulbenkian de Ciência, Oeiras, Portugal
- Binghamton University, Binghamton, New York, USA
| | - Patrick C Shih
- Indiana University Bloomington, Bloomington, Indiana, USA
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Rurka MM, Suitor JJ, Gilligan M, Frase RT. How Do Own and Siblings' Genders Shape Caregivers' Risk of Perceiving Care-Related Criticism From Siblings? J Gerontol B Psychol Sci Soc Sci 2023; 78:520-531. [PMID: 36469600 PMCID: PMC9985314 DOI: 10.1093/geronb/gbac188] [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: 04/25/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Caring for a parent takes a greater psychological toll on daughters than sons. To minimize the psychological burden of parent care, it is important to understand what contributes to this gender disparity. Inspired by the caregiver stress process model and gender-as-relational perspective, we investigate how caregivers' gender, and the genders of their siblings, shape their risk of perceiving care-related criticism from siblings, a secondary stressor of caregiving with negative implications for psychological well-being. METHODS Using data from 408 adult child caregivers nested within 231 families collected as part of the Within-Family Differences Study, we employ multilevel modeling to examine how caregivers' gender, as well as the gender composition of their sibship, interact to shape caregivers' probability of perceiving criticism from siblings regarding the care that they provide their mother. Qualitative data from the same caregivers are then analyzed to illuminate processes underlying these statistical associations. RESULTS Quantitative analyses reveal that daughters in predominantly-son sibships have a lower risk of perceiving care-related criticism than daughters in sibships with higher proportions of daughters. Qualitative analyses elucidate these findings. Daughters in predominantly-son sibships report that their siblings defer to them regarding their mother's care. Conversely, daughters in higher proportion-daughter sibships perceive care-related criticism because they and their sibling(s) hold conflicting views regarding care, and there is less consensus regarding who best understands their mother's care needs and preferences. DISCUSSION Findings demonstrate how characteristics of caregivers and their sibships interact to affect caregivers' risk of perceiving criticism regarding their care to their mothers.
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Affiliation(s)
- Marissa M Rurka
- Center for Health and Research Transformation, University of Michigan, Ann Arbor, MI, USA
| | - J Jill Suitor
- Department of Sociology, Purdue University, West Lafayette, IN, USA
| | - Megan Gilligan
- Department of Human Development and Family Studies, Iowa State University, 2222 Osborn Dr., Ames, IA, 50011, USA
| | - Robert T Frase
- Department of Sociology, Purdue University, West Lafayette, IN, USA
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14
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Wang F, Nguyen AW. Correlates of Physical and Emotional Strain Among Older Adult Caregivers. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:221-238. [PMID: 35791671 PMCID: PMC9816348 DOI: 10.1080/01634372.2022.2097755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 06/15/2023]
Abstract
Caregiving can be physically challenging and emotionally draining for older caregivers. The existing research on physical and emotional strain mainly focuses on the general caregiver population. Using the Stress Process Model, this study aims to expand on existing caregiving literature by identifying correlates of physical and emotional strain among older caregivers. Hierarchical OLS regressions were performed on data selected from the 2015 Caregiving in the U.S. Survey (N = 701). Several risk factors for physical strain and emotional strain were identified: Assistance with ADLs and IADLs, the number of health problems of the care recipient, and the receipt of formal support were positively associated with physical and emotional strain. Moreover, providing care to parents/parents-in-law was associated with higher levels of emotional strain than providing care to non-relatives. The number of care recipients was positively associated with emotional strain. Older African Americans experienced lower levels of physical strain than their white counterparts. The findings uncover the individual differences among older caregivers and provide insights into how these differences uniquely influence caregiving strain. Moreover, the study identifies a risk and protective profile of caregiving strain, which can help practitioners direct services and resources to older caregivers who are particularly at risk for caregiving strain.
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Affiliation(s)
- Fei Wang
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
| | - Ann W Nguyen
- Jack, Joseph and Morton Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH, USA
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15
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Hengelaar AH, Wittenberg Y, Kwekkeboom R, Van Hartingsveldt M, Verdonk P. Intersectionality in informal care research: a scoping review. Scand J Public Health 2023; 51:106-124. [PMID: 34232094 PMCID: PMC9903248 DOI: 10.1177/14034948211027816] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: Informal caregivers share common experiences in providing care to someone with health and/or social needs, but at the same time their experiences differ across diverse backgrounds such as gender, age, culture, as these aspects of diversity co-shape these experiences. This scoping review aims to explore how aspects of diversity, across their intersections, are currently incorporated in informal care research and discusses how an intersectional perspective can further develop our understanding of informal care. Methods: A scoping review was performed to map relevant caregiving literature from an intersectionality perspective. Key terms 'informal care' and 'intersectionality' were used for a search in four databases resulting in the inclusion of 28 articles. All 28 studies were analysed based on a scoping review created intersectionality informed coding scheme. Results: Aspects of diversity are largely understudied in informal care research, in particular across their intersections and from a critical perspective. This intersectional informed analysis revealed that when studying diverse caregiving experiences the use of intersections of dimensions of diversity provides a nuanced understanding of these experiences. Conclusions: Adopting an intersectional perspective ensures that not only different categories or social identities of caregivers are included in future studies, but the mutual relationships between these categories embedded in their specific context are actually studied.
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Affiliation(s)
- Aldiene H. Hengelaar
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands,Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands,Aldiene H Hengelaar, Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557/1000, 1081 Amsterdam, HV, The Netherlands. E-mail:
| | - Yvette Wittenberg
- Faculty of Social and Behavioral Sciences, University of Amsterdam, The Netherlands,Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Rick Kwekkeboom
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Margo Van Hartingsveldt
- Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands
| | - Petra Verdonk
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands
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16
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Thorsen K, Johannessen A. How gender matters in demanding caring for a spouse with young-onset dementia. A narrative study. J Women Aging 2023; 35:81-97. [PMID: 35722752 DOI: 10.1080/08952841.2022.2087455] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND The gendered aspects of extraordinary demanding spousal caring for people with young-onset dementia have been scarcely researched. AIM To analyze spouses' experiences of the meaning, content, and effort of intensive caring for spouses/partners with young-onset frontotemporal dementia (YO-FTD), concentrating on a female perspective. METHOD A qualitative Norwegian study using narrative interviews with 10 wives and 6 husbands were conducted in 2014 and 2015. FINDINGS The analysis resulted in four gendered main themes: Different caregiving periods, Distancing: experiencing a transformed spouse and relationship, Social isolation, and Needing assistance and relief. A case analysis of wives' and men's stories was applied, especially focusing on a wife's story, to examine the detailed interrelationships between life situation, caring demands, experiences, and reactions. Spousal care is influenced by gendered caring norms and roles. The study finds marked differences between wives and husbands in the meaning, content and sustainability of care, and needs for support vary. Wives endured more stress longer than husbands, with a greater emotional impact and negative health consequences, and their needs are more easily neglected. Husbands presented their needs more efficiently and obtained public relief earlier. CONCLUSION Women may need more support earlier during different stages of caring for a spouse with YO-FTD. They need gender sensitive person-centered support to live their own lives and preserve their selves.
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Affiliation(s)
- Kirsten Thorsen
- Vestfold Hospital Trust, The Norwegian National Centre for Ageing and Health, Tønsberg, Norway.,Oslo Metropolitan University, Oslo, Norway
| | - Aud Johannessen
- Vestfold Hospital Trust, The Norwegian National Centre for Ageing and Health, Tønsberg, Norway.,Faculty of Health and Social Sciences, Department of Health, Social and Welfare Studies, University of South-Eastern Norway, Kongsberg, Norway
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17
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Stites SD, Cao H, James R, Harkins K, Coykendall C, Flatt JD. A systematic review of measures of gender and biological sex: Exploring candidates for Alzheimer's disease and related dementias (AD/ADRD) research. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12359. [PMID: 36845632 PMCID: PMC9943901 DOI: 10.1002/dad2.12359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/19/2022] [Accepted: 08/23/2022] [Indexed: 02/24/2023]
Abstract
Background Gender and biological sex are social and structural determinants of health and umbrella concepts encompassing many distinct attributes. This systematic review summarizes measures of gender and biological sex published in the biomedical literature. The goal was to identify measures that may be useful to researchers studying Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD). Methods A search of PubMed, Embase, and PsycINFO (ProQuest platform) databases from 2000 to 2021 identified 1454 articles, which were then screened by five independent reviewers. Measures of gender and biological sex are summarized according to theoretical commitments and psychometric properties. Results Twenty-nine measures were identified that assessed gender-related constructs, and 4 were identified that assessed biological factors. Self-report instruments characterized aspects of gender, such as gender stereotypes, norms, and ideologies. One measure was developed with a focus on older adults (65+ years). Discussion We offer recommendations to guide measurement of gender in AD/ADRD research, including how the use of specific existing measures may help advance AD/ADRD research. The lack of gender measures for older adults limits AD/ADRD research. New measures may be needed to address lifespan and generational differences in gender factors. Highlights A review of articles identifies 29 measures of gender in biomedical research.Gender is captured using multidimensional, self-reported concepts.One measure was developed with a focus on older adults (65+).
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Affiliation(s)
- Shana D. Stites
- Department of PsychiatryPerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Hannah Cao
- School of Social Policy and PracticeUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Richard James
- University of Pennsylvania LibrariesPhiladelphiaPennsylvaniaUSA
| | - Kristin Harkins
- Division of Geriatric MedicineDepartment of MedicinePerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Cameron Coykendall
- Division of Geriatric MedicineDepartment of MedicinePerelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Jason D. Flatt
- Department of Social and Behavioral HealthSchool of Public HealthUniversity of NevadaLas VegasNevadaUSA
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18
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Parker LJ, Fabius C. Who's Helping Whom? Examination of Care Arrangements for Racially and Ethnically Diverse People Living With Dementia in the Community. J Appl Gerontol 2022; 41:2589-2593. [PMID: 35960528 PMCID: PMC10348595 DOI: 10.1177/07334648221120247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective: To address notions around care arrangements for Black and Hispanic people living with dementia (PLwD), the study examined if racial and ethnic differences exist for community-dwelling PLwD. Methods: Using cross-sectional data from the 2015 National Health and Aging Trends Study, we used Pearson's chi-square and mean comparison to examine differences among a sample of n = 863 community-dwelling White, Black, and Hispanic older PLwD. Results: Black PLwD were less likely than White PLwD to use paid help (26.8% vs. 32.6%), but Hispanic PLwD were most likely to use paid help (46.2%, p < 0.05). Black and Hispanic older adults were more often receiving help from a child (65.8% and 72.2%, respectively; p = 0.01) or other family member (40.3% and 31.0%, respectively; p < 0.01). Discussion: Our findings highlight the important role of familial support in care provision for Black and Hispanic communities. Caregiving supports should be intentional in centering services on the family, not a sole caregiver.
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Affiliation(s)
- Lauren J Parker
- Department of Health, Behavior, and Society, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Chanee Fabius
- Department of Health, Policy, and Management, 25802Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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19
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Li W, Manuel DG, Isenberg SR, Tanuseputro P. Caring for older men and women: whose caregivers are more distressed? A population-based retrospective cohort study. BMC Geriatr 2022; 22:890. [PMID: 36418977 PMCID: PMC9682689 DOI: 10.1186/s12877-022-03583-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 04/12/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND To our knowledge, no population-based studies have examined whether family or friend caregivers of men and women differ in their experience of distress over time. Thus, we aimed to describe, on a population-level and longitudinally, how older men and women care-receivers differed in their health and care needs, compare their caregivers' distress trajectories, and identify factors that contribute to the observed differences. METHODS This is a population-based, retrospective cohort study using routinely collected data. We examined longitudinally 485,407 community-dwelling Ontario residents, aged over 50 years, who have received at least one Residential Assessment Instrument-Home Care (RAI-HC) assessment between April 2008 and June 2015. Descriptive analyses were performed on the demographic characteristics, health profiles, and care needs of men and women. We also compared their caregivers' baseline and one-year change in distress status. Logistic regressions were performed to examine if the effect of gender on caregiver distress is reduced after controlling for care-receiver's health and functional status as well as their caregiver's kinship and co-residence status. RESULTS Men (39.5% of our cohort) were frailer, required more care, were mostly cared for by their spouses (52%), and mostly lived with their caregiver (66%). In contrast, women (60.5%) were more likely cared for by their child/child-in-law (60%), less likely to live with caregivers (47%), and received less care. Caregivers of men were more likely to be distressed at baseline (27.7% versus 20.4% of women caregivers) and remain distressed (74.6% versus 69.5%) or become distressed (19.3% versus 14.3%) throughout the year. In logistic regression modelling, the effect of care-receiver's gender on caregiver distress is reduced from an unadjusted odds ratio of 1.49 (95% CI: 1.47-1.51) to 1.17 (95% CI: 1.15-1.19) when care-receiver's health and caregiving factors are controlled for. CONCLUSION Older men and women differed in health and care needs. Caregivers, especially those caring for men, were often distressed and remained so through time. These results highlight the need for policies that account for the differential care needs and caregiver profiles of men and women in order to offer targetted and appropriate support.
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Affiliation(s)
- Wenshan Li
- grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, ON Canada ,ICES uOttawa, Ottawa, ON Canada
| | - Douglas G. Manuel
- ICES uOttawa, Ottawa, ON Canada ,grid.412687.e0000 0000 9606 5108Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada
| | - Sarina R. Isenberg
- grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Canada
| | - Peter Tanuseputro
- grid.28046.380000 0001 2182 2255School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON Canada ,grid.418792.10000 0000 9064 3333Bruyère Research Institute, Ottawa, ON Canada ,ICES uOttawa, Ottawa, ON Canada ,grid.412687.e0000 0000 9606 5108Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON Canada ,grid.28046.380000 0001 2182 2255Division of Palliative Care, Department of Medicine, University of Ottawa, Ottawa, Canada
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20
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Radu M, Ciucă A, Crișan CA, Pintea S, Predescu E, Șipos R, Moldovan R, Băban A. The impact of psychiatric disorders on caregivers: An integrative predictive model of burden, stigma, and well-being. Perspect Psychiatr Care 2022; 58:2372-2382. [PMID: 35347717 PMCID: PMC9790354 DOI: 10.1111/ppc.13071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 02/17/2022] [Accepted: 02/24/2022] [Indexed: 12/30/2022] Open
Abstract
PURPOSE The study investigates the predictors of caregivers' experienced burden, stigma, and well-being, when looking after family members diagnosed with a psychiatric disorder. DESIGN AND METHODS This cross-sectional study included 168 caregivers; perceived burden, stigma, well-being, knowledge, illness perception, and medical variables were assessed. FINDINGS A number of correlates of burden, stigma, and well-being have been identified and are being discussed. The integrative predictive model showed that the caregiver's emotional representation of illness best predicts burden (β = 0.38, p < 0.001), stigma (β = 0.53, p < 0.001) and well-being (β = -0.36, p < 0.001). PRACTICE IMPLICATIONS Our results can enable health professionals to tailor psychosocial interventions addressed to family members of individuals living with a psychiatric condition.
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Affiliation(s)
- Mădălina Radu
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Andrada Ciucă
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Cătălina-Angela Crișan
- Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Sebastian Pintea
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Elena Predescu
- Department of Neuroscience, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Roxana Șipos
- Department of Neuroscience, Discipline of Psychiatry and Pediatric Psychiatry, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Ramona Moldovan
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania.,Division of Evolution and Genomic Sciences, School of Biological Science, University of Manchester, Manchester, UK.,Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Adriana Băban
- Department of Psychology, Babeș-Bolyai University, Cluj-Napoca, Romania
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21
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Jiménez S, Bueno B, Navarro AB. Do the caregiving spouses of people with dementia in Spain perceive the same barriers for taking part in interventions as caregiving offspring? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e2385-e2394. [PMID: 34890481 DOI: 10.1111/hsc.13678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 11/10/2021] [Accepted: 11/23/2021] [Indexed: 06/13/2023]
Abstract
The aim of this qualitative research is to examine the difficulties perceived by caregivers for taking part in an offered intervention, exploring whether there are differences depending on caregiver's degree of kinship. Forty-two family caregivers from Salamanca (Spain) were interviewed after declining an invitation to take part in an intervention programme. All the telephone conversations were transcribed verbatim. The transcriptions were subject to a thematic content analysis using QDA MINER software. The barriers identified were (1) difficulties adapting to the intervention's schedule due to a lack of time, or incompatibility with its dates or timetables, (2) belief among the caregivers that they do not need or are not interested in the support the intervention provides, (3) impossibility to separate from the family member to attend due to the absence of relief or a feeling of guilt, (4) caregiver's health issues, (5) difficulties with accessibility, and (6) belief that the therapies serve no useful purpose. Certain differences were identified depending on the caregiver's kinship. Understanding the difficulties caregivers face for taking part in the interventions will enable steps to be taken to remove and/or reduce such barriers, whereby more caregivers will benefit from interventions.
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Affiliation(s)
- Sara Jiménez
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Salamanca, Salamanca, Spain
| | - Belén Bueno
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Salamanca, Salamanca, Spain
| | - Ana B Navarro
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología, Universidad de Salamanca, Salamanca, Spain
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22
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Drummond M, Johnston B, Quinn TJ. Cutting through the intersections to care for caregivers: Secondary data analysis of a carers support service in Glasgow, Scotland. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1334-1343. [PMID: 34060160 DOI: 10.1111/hsc.13463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 01/06/2021] [Accepted: 05/05/2021] [Indexed: 06/12/2023]
Abstract
As the number of people living longer with life-limiting conditions grows, so too does the number of caregivers and the complexity of the caring role. To understand more about the role and how caregivers can be supported, local and national registers have been created that collect data on caregivers. Our objective was to undertake comparative analysis of female and male adult caregiver assessments from a caregiver database created from a carers support service running in Glasgow, Scotland. Assessments were carried out over a 12-month period (01/04/17-29/03/18). We aimed to identify the prevalence of negative consequences of caring through descriptive statistical, comparative analysis. Seven hundred and eighty-three assessments were eligible for inclusion. In our dataset, 69% were female (n = 552), and 29% were male (n = 231). Female caregivers were more likely to be of working age but unemployed (p = 0.03) and experiencing mental ill-health (p = 0.011). Male caregivers were more likely to be retired (p < 0.001), caring for a parent (p = 0.017) and living with heart disease (p = 0.0004), addiction issues (p = 0.013) or diabetes (p = 0.042) than female caregivers. For caregivers using this support service, female and male caregivers experienced, recognised or reported negative impacts from caring on their personal identity, social life, ability to self-care and relationships similarly. Furthermore, a caregiver whose relationships had been negatively impacted was 13.8 times more likely (p > 0.00) to report a reduction in psychological well-being. Sex disaggregated data are an important consideration for caregiver research due to socio-political influences that impact caring roles and expectations. Disaggregating data by sex allow researchers to understand how the caring role differs between subsets and allow for the development of more targeted, sensitive support.
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Affiliation(s)
- Maria Drummond
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Bridget Johnston
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
| | - Terence J Quinn
- School of Medicine, Dentistry & Nursing, College of Medical, Veterinary & Life Sciences, University of Glasgow, Glasgow, UK
- NHS Greater Glasgow and Clyde, Glasgow, UK
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23
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Hicks NM, Sellers SL, Zhang J, Sun N, Harris K. "What Matters Most? Intersectional Correlates of Caregiver Burdens". J Appl Gerontol 2022; 41:2013-2021. [PMID: 35576162 DOI: 10.1177/07334648221100227] [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] Open
Abstract
Increasing numbers of older adults require caregiver support from unpaid caregivers. Yet, there is limited research on caregiver burden type and interactions across race, gender, and other sociodemographic characteristics. This quantitative study uses an intersectional framework to examine associations between caregiving burden and sociodemographic factors. Using survey data from the National Survey of Caregiving the sample included unpaid caregivers (N = 1304) of older adult (65+) Medicare beneficiaries. Binary logistic regression analysis revealed that over 40% of the respondents reported emotional difficulties. Correlates to emotional difficulties included race, gender, age, and income with an age by income interaction. For physical difficulties, gender, age, work, and education mattered most, with an age by education interaction. Age and income predicted financial difficulties without interactions. Findings suggest that policymakers target emotional and physical difficulties, attend to age and socioeconomic status, and address the unique challenges faced in midlife by caregivers.
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Affiliation(s)
- Nytasia M Hicks
- Elizabeth Dole Center on Excellence for Veteran and Caregiver Research, South Texas Veterans Health Care System, Audie L. Murphy Division, San Antonio, TX, USA
| | - Sherrill L Sellers
- Department of Family Science and Social Work, 6403Miami University, Oxford, OH, USA
| | - Jinghua Zhang
- OMS Analytics, Georgia Institution of Technology, Atlanta, GA, USA
| | - Na Sun
- Department of Sociology and Gerontology, 124575Miami University, Oxford, OH, USA
| | - Karleah Harris
- Department of Human Sciences, University of Arkansas at Pine Bluff, USA
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24
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Shafeek Amin N, Driver N. Health care utilization among Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States: an application of Andersen's behavioral model. ETHNICITY & HEALTH 2022; 27:858-876. [PMID: 33054364 DOI: 10.1080/13557858.2020.1830034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 09/24/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES To examine whether Andersen's model explains health care utilization among Middle Eastern immigrants and to examine gender and ethnic differences in health care utilization of Middle Eastern, Hispanic/Latino, and Asian immigrants in the United States. METHOD Using data from the 2000-2017 National Health Interview Surveys (NHIS), this study compares patterns of health care utilization among Middle Eastern (ME) immigrants to those among Hispanic/Latino and Asian immigrants in the U.S. Specifically, we use Andersen's Behavioral Model of Health Care Utilization to model the likelihood of seeing a doctor in the past 12 months for these three immigrant groups. Additionally, the current study emphasizes the predisposing factor of gender and its differences across and within these groups. RESULTS Andersen's behavioral framework is partially suited to predict the likelihood of seeing a doctor in the past 12 months among ME immigrants. Immigrant women, regardless of their ethnicity, are significantly more likely than men to report seeing a doctor in the past 12 months. Moreover, the effects of the predisposing, need, and enabling characteristics for Hispanics and Asians are significantly different from those for ME immigrants. Additionally, although Asians are significantly less likely to utilize the health care system than ME immigrants, there are no significant differences comparing Hispanics/Latinos to ME immigrants. Furthermore, Andersen's behavioral framework explains ethnicity and gender differences particularly when comparing Asian men to ME men and Asian women to ME women. CONCLUSIONS This study highlights the importance of considering ethnicity and gender differences when examining health outcomes of immigrants.
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Affiliation(s)
- Neveen Shafeek Amin
- Department of Sociology and Anthropology, University of Arkansas at Little Rock, Little Rock, AR, USA
| | - Nichola Driver
- Clinton School of Public Service, University of Arkansas, Little Rock, AR 72201, USA
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25
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Gender differences in the association between unmet support service needs and mental health among American cancer caregivers. Support Care Cancer 2022; 30:5469-5480. [PMID: 35304632 DOI: 10.1007/s00520-022-06966-y] [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: 10/26/2021] [Accepted: 03/07/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE Cancer caregiving can be distressing, and many caregivers have support service needs. Given the role gender has played in shaping norms around caring, gender may influence caregiving experiences. Using Behavioral Risk Factor Surveillance System data, 2015-2018, we aimed to examine gender as an effect modifier of the unmet support service needs and mental health association among cancer caregivers. METHODS Our n = 5814 sample represented approximately 4.8 million caregivers. Mental health was operationalized as number of mentally unhealthy days over the past 30 (MUDs) and Frequent Mental Distress (FMD, MUDs ± 14 days). Unmet supportive care needs included endorsement of needing but not receiving caregiving classes, help accessing services, support groups, counseling, and respite care. We conducted zero-inflated negative binomial (ZINB) and logistic regression analyses to examine the associations between unmet needs with MUDs and FMD and then tested gender as an effect modifier. RESULTS Cancer caregivers reported an average of 6 MUDs. Approximately 20% of caregivers reported FMD, and 17% reported having any unmet needs. Gender moderated the unmet needs and FMD association. Among female caregivers, those with unmet needs were more likely to report FMD (aOR: 2.167; 95%CI: 1.447, 3.243); among male caregivers, no association was found (aOR: 0.970; 95%CI: 0.471, 2.001). In the ZINB model of MUDs, no significant moderation effect of gender was found. CONCLUSION Though distress does not appear to vary by gender, having unmet support needs may negatively affect mental health in female cancer caregivers. Studies on gendered experiences can inform strategies to meet caregiver needs.
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Dementia care-sharing and migration: An intersectional exploration of family carers' experiences. J Aging Stud 2022; 60:100996. [DOI: 10.1016/j.jaging.2021.100996] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 12/07/2021] [Accepted: 12/13/2021] [Indexed: 11/20/2022]
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Helgeson VS, Zajdel M, Tracy EL, Allen NA, Kent de Grey RG, Litchman ML, Berg CA. Observed dyadic collaboration among couples coping with type 1 diabetes. JOURNAL OF FAMILY PSYCHOLOGY : JFP : JOURNAL OF THE DIVISION OF FAMILY PSYCHOLOGY OF THE AMERICAN PSYCHOLOGICAL ASSOCIATION (DIVISION 43) 2022; 36:147-152. [PMID: 33793274 PMCID: PMC8484364 DOI: 10.1037/fam0000763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Previous research linking collaboration to relationship and health outcomes has relied almost exclusively on individual self-report and failed to take into consideration the dyadic nature of collaboration. We enrolled couples (n = 193) in which one person had Type 1 diabetes (52% female; 91% non-Hispanic white) into the study and asked them to discuss a diabetes-related issue of high concern for 8 min. These videotaped interactions were coded for dyadic collaboration. Mood was measured before and after the discussion. After the discussion, patients and partners reported support provided and received during the discussion. Results showed that observed dyadic collaboration was related to improvements in mood and greater support exchanges for both patients and partners when self-reported collaboration was statistically controlled. Gender moderated the effects on partners, such that benefits of dyadic collaboration were stronger for women than men. Future research may benefit from including collaborative elements into couple-focused interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Subramanian I, Mathur S, Oosterbaan A, Flanagan R, Keener AM, Moro E. Unmet Needs of Women Living with Parkinson's Disease: Gaps and Controversies. Mov Disord 2022; 37:444-455. [DOI: 10.1002/mds.28921] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 12/10/2021] [Accepted: 12/15/2021] [Indexed: 12/21/2022] Open
Affiliation(s)
- Indu Subramanian
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | | | - Annelien Oosterbaan
- Department of Neurology Radboud University Medical Center Nijmegen The Netherlands
| | | | - Adrienne M. Keener
- Department of Neurology David Geffen School of Medicine, University of California Los Angeles Los Angeles California USA
- Parkinson's Disease Research, Education, and Clinical Center, Greater Los Angeles Veterans Affairs Medical Center Los Angeles California USA
| | - Elena Moro
- Grenoble Alpes University, Faculty of Medicine, Division of Neurology CHUGA, Grenoble Institute of Neurosciences Grenoble France
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Abstract
OBJECTIVES This pilot study aimed to describe the phenomenon of suicidal ideation among caregivers who were aged 60 and over and who provided care for a person with dementia. METHODS A qualitative study was conducted, using a descriptive method. Semi-structured interviews were administered to caregivers who had or were having suicidal thoughts whilst caring for a relative with dementia. RESULTS Six caregivers were interviewed. Four caregivers reported experiencing active suicidal ideation whilst caregiving. Two subjects mentioned wishing for the death of their care recipient. While saturation criteria were not all met themes regarding suicidal ideation types and developmental contexts emerged. Findings suggest that family conflicts, placement difficulties, exhaustion, feelings of injustice, and loneliness contributed to the development of suicidal ideation. CONCLUSIONS Suicidal distress can emerge from the dementia caregiving context and these findings highlight a complex phenomenon among caregivers. The understanding of caregivers' suicidal distress is of great importance to guide screening and intervention efforts. Research is needed to keep the implication and well-being of older caregivers. CLINICAL IMPLICATIONS Screening efforts should consider the caregiving context as a conducive environment for suicidal distress and clinicians could use this knowledge to provide specific interventions to distressed carers.
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Affiliation(s)
- Audrée Teasdale-Dubé
- Département de Psychologie, Université Du Québec À Trois-Rivières, Québec, Canada
- Quebec Network for Research on Aging, Montreal, Canada
| | - Charles Viau-Quesnel
- Quebec Network for Research on Aging, Montreal, Canada
- Département de Psychoéducation, Université Du Québec À Trois-Rivières, Québec, Canada
- Laboratoire Interdisciplinaire de Recherche En Gérontologie, Université Du Québec À Trois-Rivières, Trois-Rivières, Canada
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Smith G, Rodham K. Supporting and sustaining care at home: Experiences of adult daughters who support a parent with dementia to remain in their own home. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:81-90. [PMID: 33825265 DOI: 10.1111/hsc.13373] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 02/22/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Supporting a parent with dementia living in their own home is a challenging care issue which has potential for negative physical, emotional and psychosocial impacts. This research explores the experiences of adult daughters who sustain this arrangement as well as managing the competing demands of their lives. Using a qualitative approach, semistructured interviews were conducted between March and October 2017. Eight adult females in the United Kingdom who were supporting a parent with dementia to remain living in their home were interviewed. Photo-elicitation was used as an aid to data collection and complemented the use of Thematic Analysis (TA) to analyse verbatim transcripts. Four themes were identified: (a) Impact on identity: impact of the participants' experience on their sense of identity; (b) Continuity and change: relationship redefinition and duality of roles; (c) Stepping up to the challenge: adjustment to and coping with competing demands and ethical dilemmas; and (d) Finding help: 'It is just a minefield': experiences of help-seeking and service provision. This study highlights the experiences and challenges for adult daughters who support a parent with dementia. Ethical dilemmas regarding autonomy and safeguarding concerns figure large along with the competing demands of multiple roles. Service providers should aim to be more proactive in offering timely practical and psychosocial support and guidance to avoid compassion fatigue and acknowledge the valuable unpaid service provided by these 'women in the middle'.
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Affiliation(s)
- Gillian Smith
- Staffordshire Centre for Psychological Research, Department of Psychology, School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, UK
| | - Karen Rodham
- Staffordshire Centre for Psychological Research, Department of Psychology, School of Life Sciences and Education, Staffordshire University, Stoke-on-Trent, UK
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Prato L, Abley C, Adamson J. Exploring online identity construction for the caregivers of adults living with dementia and the value of interactions with health and social care professionals. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:295-306. [PMID: 33894073 DOI: 10.1111/hsc.13403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/05/2021] [Accepted: 03/21/2021] [Indexed: 06/12/2023]
Abstract
Becoming an informal caregiver for an adult living with dementia has been shown to have a significant impact upon the conception of identity. This study aimed to identify how identity is constructed online amongst caregivers of individuals living with dementia and how healthcare interactions can influence identity development through the analysis of online web blogs. Sixteen online blogs (172 entries) were selected through purposive and snowball sampling, and discourse analysis was used to analyse online identity construction for informal caregivers of adults living with dementia. Six areas of online identity construction were identified: changing family role; powerful expert social campaigner; being an advocate; guardian of their relative's selfhood; sustaining creative and spiritual individuality and wider community member in online and real life. Further to this, the importance of health and social care service interactions in the development of caregiver identity revealed that professionals must ensure person-centred service contacts for caregivers. This is a challenging task in the pandemic climate where interactions between health and social care professionals and caregivers are limited due to isolation measures. It is evident that the blog format can provide a forum through which the identity of the caregiver of an adult living with dementia can evolve. The six areas of identity construction reveal the multifaceted nature of identity for the caregiver and the value of belonging to an online community both in relation to identity construction and support. This finding is especially applicable in the current pandemic when accessing a face-to-face community is challenging for caregivers who may be shielding or living in isolation. The findings of this research can aid health and social care professionals in understanding the development of caregiver identity and in providing appropriate support during service interactions, on accessing virtual and face to face community support.
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Affiliation(s)
- Laura Prato
- Newcastle University, Newcastle Upon Tyne, UK
| | - Clare Abley
- Newcastle University, Newcastle Upon Tyne, UK
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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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Care-giver wellbeing: exploring gender, relationship-to-care-recipient and care-giving demands in the Canadian Longitudinal Study on Aging. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The three-way intersection of gender, relationship-to-care-recipient and care-giving demands has not, to our knowledge, been examined in relation to the wellbeing of family care-givers. We explore inequalities in depressive symptoms and life satisfaction, comparing wives, husbands, daughters and sons providing very-intensive care (36+ hours/week) with those providing less care and disparities between these groups in the factors related to disadvantage. Data from the Canadian Longitudinal Study on Aging (N = 5,994) support the existence of differences between the groups. Very-intensive care-giving wives report the most depressive symptoms and lowest life satisfaction; less-intensive care-giving sons report the fewest depressive symptoms, and less-intensive care-giving daughters report the highest life satisfaction. However, group differences in life satisfaction disappear among very-intensive care-givers. Drawing on Intersectionality and Stress Process theories, data from regression analyses reveal a non-significant gender–relationship–demand interaction term, but, health, socio-economic and social support resources play a strong mediating role between care demand and wellbeing. Analyses of the eight groups separately reveal diversity in the care-giving experience. Among less-intensive care-givers, the mediating role of resources remains strong even as differences are evident. Among very-intensive care-givers, the role of resources is less and differences in wellbeing between the groups are magnified. Policy implications emphasise the imperative to personalise services to meet the varied needs of care-givers.
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The relationship between filial piety and caregiver burden among adult children: A systematic review and meta-analysis. Geriatr Nurs 2021; 43:113-123. [PMID: 34864295 DOI: 10.1016/j.gerinurse.2021.10.024] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 10/20/2021] [Accepted: 10/22/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Filial piety is an important cultural value in aging societies. However, mixed findings were identified regarding its influence on caregiver burden. The purpose of this meta-analysis was to clarify the relationships between filial concepts and caregiver burden. METHOD Twelve databases on filial piety, filial obligation, and caregiver burden among adult children prior to January, 2020 were systematically cross-culturally reviewed. RESULTS Twelve studies were finalized for analysis. Fixed effect models indicated that stronger filial piety was significantly correlated (r = -.23) or associated with (β = -.27) less caregiver burden. However, no significant relationship between filial obligation and caregiver burden was revealed by random effect models. CONCLUSION Stronger filial piety may lessen caregiver burden. Therefore, filial piety should be assessed and supported in adult child caregivers, particularly in Eastern cultures. However, the concept of filial piety and its tools should be updated transculturally. PROSPERO Registration Number: CRD42020161969.
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Zhao Y, Inder B, Kim JS. Spousal bereavement and the cognitive health of older adults in the US: New insights on channels, single items, and subjective evidence. ECONOMICS AND HUMAN BIOLOGY 2021; 43:101055. [PMID: 34530393 DOI: 10.1016/j.ehb.2021.101055] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 07/13/2021] [Accepted: 08/16/2021] [Indexed: 06/13/2023]
Abstract
This study provides novel insights into older adults' cognitive functioning before and after widowhood onset and possible effect channels. It further examines gender heterogeneity in the adaptation to (anticipated or actual) spousal bereavement, comparing objective evidence with subjective evidence of cognitive abilities. We used longitudinal data of up to 26,584 participants of the Health and Retirement Study, aged over 50 at recruitment, assessed biennially between 1998 and 2016. Two-way fixed effects with dynamic treatment effects were estimated for various cognitive measures, including six aggregated indices and six single item scales. After adjusting for effect channels including depression, social vulnerability, and stress, there remained significant widowhood effects on older adults' cognitive health. Using single item scales, we established the adverse contemporaneous and adaptation effects on bereaved older females' short-term memory, semantic memory, and numeracy. For bereaved older males, working memory and focus-of-attention deteriorated after widowhood onset. Meanwhile, subjective memory rating remained intact, contrary to objective evidence. We conclude that cognitive transitions to and from widowhood can exhibit distinctive patterns across objective and subjective cognitive domains. With the effect channels in mind, cognitive intervention for widowed older adults should be tailored to the temporal distance to spousal loss, gender, and task.
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Affiliation(s)
- Yuejun Zhao
- Department of Economics, University of Gothenburg, Sweden.
| | - Brett Inder
- Department of Econometrics and Business Statistics, Monash University, Australia.
| | - Jun Sung Kim
- Department of Economics, College of Politics and Economics, Kyung Hee University, Korea.
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Clustering of Socioeconomic Data in Hong Kong for Planning Better Community Health Protection. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312617. [PMID: 34886341 PMCID: PMC8656856 DOI: 10.3390/ijerph182312617] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/11/2021] [Accepted: 11/27/2021] [Indexed: 11/17/2022]
Abstract
The concept of socioeconomic vulnerability has made a substantial contribution to the understanding and conceptualization of health risk. To assess the spatial distribution of multi-dimensional socioeconomic vulnerability in an urban context, a vulnerability assessment scheme was proposed to guide decision-making in disaster resilience and sustainable urban development to reduce health risk. A two-stage approach was applied in Hong Kong to identify subgroups among Tertiary Planning Units (TPU) (i.e., the local geographic areas) with similar characteristics. In stage 1, principal components analysis was used for dimension reduction and to de-noise the socioeconomic data for each TPU based on the variables selected, while in stage 2, Gaussian mixture modeling was used to partition all the TPUs into different subgroups based on the results of stage 1. This study summarized socioeconomic-vulnerability-related data into five principal components, including indigenous degree, family resilience, individual productivity, populous grassroots, and young-age. According to these five principal components, all TPUs were clustered into five subgroups/clusters. Socioeconomic vulnerability is a concept that could be used to help identify areas susceptible to health risk, and even identify susceptible groups in affluent areas. More attention should be paid to areas with high populous grassroots scores and low young-age score since they were associated with a higher mortality rate.
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Schaffler-Schaden D, Krutter S, Seymer A, Eßl-Maurer R, Flamm M, Osterbrink J. Caring for a Relative with Dementia: Determinants and Gender Differences of Caregiver Burden in the Rural Setting. Brain Sci 2021; 11:brainsci11111511. [PMID: 34827510 PMCID: PMC8615550 DOI: 10.3390/brainsci11111511] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022] Open
Abstract
Dementia is a progressive disease that puts substantial strain on caregivers. Many persons with dementia (PwDs) receive care from a relative. Since male and female caregivers experience different issues related to stress, it is important to meet their different needs to prevent the early nursing home placement of PwDs. This study investigated the multifactorial aspects of caregiver burden and explored gender differences in caregiver burden in a rural setting. This was a cross sectional study that administered anonymous questionnaires to family caregivers of PwDs. Caregiver burden was assessed using the Burden Scale for Family Caregivers-short version. A path model was used to determine the multivariate associations between the variables. To reflect the multifaceted aspects of caregiver burden, we used Pearlin's model with its four dimensions. A total of 113 family caregivers responded to our survey. The overall burden of caregivers was moderate. According to the path model, gender differences were predictors of caregiver burden. The behaviour of the person with dementia and cohabitation had direct effects on caregiver burden. Our results suggest that the experiences of men and women caring for a PwD are different and highlight the need for tailored support in dementia care.
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Affiliation(s)
- Dagmar Schaffler-Schaden
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
- Correspondence:
| | - Simon Krutter
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Alexander Seymer
- Department of Sociology, Paris Lodron University, 5020 Salzburg, Austria;
| | - Roland Eßl-Maurer
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
| | - Maria Flamm
- Institute of General Practice, Family Medicine and Preventive Medicine, Paracelsus Medical University, 5020 Salzburg, Austria;
| | - Jürgen Osterbrink
- Institute for Nursing Science and Practice, Paracelsus Medical University, 5020 Salzburg, Austria; (S.K.); (R.E.-M.); (J.O.)
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Aninye IO, Digre K, Hartnett ME, Baldonado K, Shriver EM, Periman LM, Grutzmacher J, Clayton JA. The roles of sex and gender in women's eye health disparities in the United States. Biol Sex Differ 2021; 12:57. [PMID: 34670620 PMCID: PMC8527306 DOI: 10.1186/s13293-021-00401-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 10/08/2021] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND In the United States, women are at a higher risk of developing vision impairment or a serious eye disease (such as age-related macular degeneration, thyroid eye disease, or chronic dry eye disease) than men. Disparities in eye diseases due to biology widen even further when considering factors such as social determinants of health; gaps in research data, literature, and policy; insufficient provider and patient education; and limitations in screening and treatment options. Sex and gender disparities in eye health are clinically under-addressed and burdensome on both patient quality of life and the health care and economic systems, resulting in a pressing population health issue that negatively impacts women. DESIGN The Society for Women's Health Research convened a working group of expert clinicians, researchers, and patient advocates to review the current state of science regarding sex and gender disparities in women's eye health, identify knowledge gaps and unmet needs, and explore better means to advance research, improve patient care, and raise awareness of key issues. DISCUSSION The SWHR Women's Eye Health Working Group identified priority areas in research, clinical care, and education to reduce disparities and improve patient care in women's eye health. The working group recommends using a systems approach that incorporates a comprehensive research framework with a sex and gender lens to guide future work and that increases health care provider and public education, as well as engagement by expanding partnerships among ophthalmologic providers, researchers, and non-vision stakeholders.
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Affiliation(s)
- Irene O Aninye
- Society for Women's Health Research, 1025 Connecticut Avenue, NW, Suite 1104, Washington, DC, 20036, USA.
| | - Kathleen Digre
- Ophthalmology and Visual Sciences, University of Utah, Salt Lake City, UT, USA
| | | | | | - Erin M Shriver
- Ophthalmology and Visual Sciences, University of Iowa, Iowa City, IA, USA
| | | | | | - Janine A Clayton
- Office of Research on Women's Health, National Institute of Health, Bethesda, MD, USA
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Liu R, Chi I, Wu S. Caregiving Burden among Caregivers of People with Dementia through the Lens of Intersectionality. THE GERONTOLOGIST 2021; 62:650-661. [PMID: 34606599 DOI: 10.1093/geront/gnab146] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Caregivers may be at different risks of various types of burdens by virtue of their gender and racial/ethnic status. This paper explores the differences in caregiving burdens across the intersectionality of race and gender. RESEARCH DESIGN AND METHODS Using Round 5 (conducted in 2015) and Round 7 (conducted in 2017) of National Study of Caregiving and National Health and Aging Trends Study data, the study examined differences in caregiver burdens across and within different gender and racial/ethnic groups, within the realms of financial, emotional, and physical burdens. The sample consisted of 1,206 caregivers who provided services to Medicare beneficiaries. Logistic regressions were performed to assess the three types of burdens each subgroup was experiencing. RESULTS Results indicated that within the intersectionality framework, compared to White female caregivers, Black male caregivers were 3.3 times (95% CI 1.77-6.22) more likely to experience financial burden, and Black female caregivers were 54% less likely to experience physical burden. Surprisingly, compared to White female caregivers, all the other groups were 37% (95% CI 0.41-0.95) to 71% (95% CI 0.15-0.56) less likely to have emotional burden. DISCUSSION AND IMPLICATIONS The findings highlighted that Black male caregivers are experiencing financial burden and White female caregivers are experiencing emotional burden disproportionately. To develop effective interventions and programs for dementia caregivers, a special focus should be put on monitoring the differences in the types of burdens that the above-mentioned population subgroups experience.
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Affiliation(s)
- Ruotong Liu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, California, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA.,Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, California, USA
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Alshammari B, Noble H, McAneney H, Alshammari F, O’Halloran P. Factors Associated with Burden in Caregivers of Patients with End-Stage Kidney Disease (A Systematic Review). Healthcare (Basel) 2021; 9:healthcare9091212. [PMID: 34574986 PMCID: PMC8468425 DOI: 10.3390/healthcare9091212] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 09/07/2021] [Accepted: 09/07/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Caring for a patient with end-stage kidney disease (ESKD) is highly stressful and can impact negatively on the physical and psychological well-being of caregivers. To accurately assess caregiver burden (CB), health care providers (HCPs) need to identify characteristics associated with an increase in CB. AIM The aim of this review is to explore CB in caregivers of adult patients with ESKD and to identify characteristics associated with any increase in CB. METHOD A comprehensive literature search was completed using five electronic databases. Medline, Embase, CINHAL, PsycINFO, and Scopus. The Joanna Briggs Institute checklist (JBI) was used to quality appraise full text papers included in the review. No time limit for the date of publication of studies was employed, to enable the inclusion of more extensive literature. RESULTS A total of 38 relevant studies from 18 countries were identified and included in the review. A variety of patient and caregiver factors can impact positively or negatively on CB, including socio-demographic factors of patients and caregivers, disease-related factors, situational and relational factors, environmental factors, and psychological factors. CONCLUSION This review provides awareness to HCPs of the important factors associated with CB, when assessing or targeting interventions for caregivers experiencing burden.
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Affiliation(s)
- Bushra Alshammari
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
- College of Nursing, University of Hail, Hail 2440, Saudi Arabia
- Correspondence: or
| | - Helen Noble
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
| | - Helen McAneney
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery and Health Systems, University College Dublin, Dublin, Ireland;
| | - Farhan Alshammari
- Department of Pharmaceutics, College of Pharmacy, University of Hail, Hail 2440, Saudi Arabia;
| | - Peter O’Halloran
- Medical Biology Centre, School of Nursing and Midwifery, Queen’s University Belfast, 97 Lisburn Rd, Belfast BT9 7BL, UK; (H.N.); (P.O.)
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Martínez-Santos AE, Facal D, Vicho de la Fuente N, Vilanova-Trillo L, Gandoy-Crego M, Rodríguez-González R. Gender impact of caring on the health of caregivers of persons with dementia. PATIENT EDUCATION AND COUNSELING 2021; 104:2165-2169. [PMID: 33610335 DOI: 10.1016/j.pec.2021.02.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Dementia is a brain syndrome that affects a growing number of persons worldwide and generates a strong and progressive demand for care from a family caregiver, usually females. OBJECTIVE We aimed to describe the care provided by family caregivers of persons with dementia as well as the impact on their health and its interrelation with gender. PATIENT INVOLVEMENT This study was carried out in collaboration with the 13 associations of family caregivers of persons with dementia that are part of a Regional Federation. This partnership worked towards bettering patient care and proposing improvements to the public health system. METHODS A multi-institutional cross-sectional study. A total of 462 primary family caregivers of persons with dementia from north-west Spain were included. Data were collected between January and April 2019 with an anonymous self-administered validated questionnaire (ICUB-97) based on Virginia Henderson's nursing care model. RESULTS The most affected needs in family caregivers are those related to "recreational activities", "communication" and "rest and sleep". Statistically significant differences between male and female participants' pattern of care and health-related impacts were found, especially in issues related to work and family reconciliation. DISCUSSION Care plans should be developed taking gender perspective into account. From a nurse model point of view, more research is necessary to reduce health disparities. This study provides an assessment of gender differences in care and the impact on caregivers' health. PRACTICAL VALUE Regarding the specific health conditions of female caregivers and from a holistic point of view, these findings could provide novel and interesting data that might help to implement gender perspective in nursing care plans, generally invisible in routine clinical practice.
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Affiliation(s)
- Alba-Elena Martínez-Santos
- University of Santiago De Compostela, Faculty of Education Sciences, Department of Pedagogy and Didactics, Santiago de Compostela, Spain; University of Santiago De Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain
| | - David Facal
- University of Santiago De Compostela, Faculty of Psychology, Department of Developmental Psychology, Santiago de Compostela, Spain
| | | | | | - Manuel Gandoy-Crego
- University of Santiago De Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain
| | - Raquel Rodríguez-González
- University of Santiago De Compostela, Faculty of Nursing, Department of Psychiatry, Radiology, Public Health, Nursing and Medicine, Santiago de Compostela, Spain; Health Research Institute of Santiago De Compostela (IDIS), Santiago de Compostela, Spain.
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42
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Hodgdon BT, Wong JD. Family Caregivers' Psychosocial Well-being in the Context of the Great Recession. Int J Aging Hum Dev 2021; 94:478-495. [PMID: 34409878 DOI: 10.1177/00914150211037650] [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: 11/17/2022]
Abstract
The economic instability of the Great Recession contributed to a rise in multigenerational households as more individuals took on unanticipated care responsibilities for older family members while navigating financial uncertainties. Guided by the life course perspective, this study compared the psychological and social well-being of family caregivers and examined the moderating influences of financial challenges experienced during the Great Recession. Filial and sandwiched caregivers (N = 138; Mage = 52.80; SDage = 11.25) from the Refresher Cohort of the Midlife in the United States (MIDUS) survey provided information on demographics, caregiving, financial challenges, and well-being. Findings from regression analyses showed that sandwiched caregivers exhibited lower environmental mastery and positive relations with others than filial caregivers (p = .07). Moderation analyses showed that sandwiched caregivers with fewer than average financial challenges exhibited lower social actualization than the other family caregivers (p = .01). Study findings underscore the need to support family caregivers' psychosocial well-being as they navigate caregiving responsibilities and financial disruptions.
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Affiliation(s)
- Barbara T Hodgdon
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Jen D Wong
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
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43
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How to understand diversity in citizens’ care attitudes: an exploratory study in the Netherlands. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The aim of this study is to investigate Dutch citizens’ care attitudes by looking at care-giving norms and citizens’ welfare state orientation and to explore to what extent these attitudes can be explained by combinations of diversity characteristics. We combined two datasets (2016 and 2018, N = 5,293) containing citizens’ opinions regarding society and conducted multivariate linear and ordered probit regression analyses. An intersectional perspective was adopted to explore the influence of combinations of diversity characteristics. Results show that citizens’ care-giving norms are relatively strong, meaning they believe persons in need of care should receive help from their families or social networks. However, citizens consider the government responsible for care as well. Men, younger people, people in good health and people of non-Western origin have stronger care-giving norms than others, and younger people assign relatively more responsibility to the family than the government. Level of education and religiosity are also associated with care attitudes. Primary diversity dimensions are more related to care attitudes than secondary, circumstantial dimensions. Some of the secondary dimensions interact with primary dimensions. These insights offer policy makers, social workers and (allied) health professionals the opportunity to align with citizens’ care attitudes, as results show that people vary to a large extent in their care-giving norms and welfare state orientation.
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44
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Zygouri I, Cowdell F, Ploumis A, Gouva M, Mantzoukas S. Gendered experiences of providing informal care for older people: a systematic review and thematic synthesis. BMC Health Serv Res 2021; 21:730. [PMID: 34301248 PMCID: PMC8306003 DOI: 10.1186/s12913-021-06736-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/06/2021] [Indexed: 12/24/2022] Open
Abstract
Background and purpose The caregiving’s impact on informal carers’ quality of life and gender-based stereotypes make older individuals’ informal care a complex process for which our knowledge is still limited. The purpose of this review is to identify how gender relates to informal carers’ experiences of providing care for people aged 60 years and over with mental and physical health needs by synthesising the available empirical data published between 2000 to 2020. Design and methods The systematic method for reviewing and synthesising qualitative data was performed using the PRISMA checklist and ENTREQ statement. The CASP tool was used to examine the quality of the included papers. Thematic synthesis was used as the methodological framework. Results This review produced two analytical themes, the impact of gender on the caregivers’ labour and negotiating gender identity with self, society, and cultural norms. While informal caregivers share motivators, a linkage between traditional gender stereotypes impacts caregiving burden and coping strategies. Informal carers’ experiences entail a constant pursuit of self-agency after acquiring the caregiver role. Cultural values and their intersection with gender appear to influence caregivers’ healthy adjustment into their new caregiving identities. The flexibility to move beyond gender boundaries could mediate caregivers’ negotiations between self and society on developing their new caregiving identity. Providing intensive informal primary care to older people affects both men’s and women’s mental and physical health. Gender ideals of the feminine nurturing role further disadvantage women as they determine the caregiving arrangements, the strategies and resources to sustain the caring burden, and the adaptability to experience their new caregiving role positively. Men appear more flexible to debate their hegemonic masculinity and defend their existence in the caregiving role. Conclusion and implications Transgressing gender lines and expanding gender possibilities can ease the caregiving burden and strengthen caregivers coping potentials. Health professionals can empower informal careers to challenge gender binaries and expand gender possibilities by intentionally injecting the language of diversity in caring information and caring processes. The review findings outline a path for research on gender identity development in older people’s care. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06736-2.
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Affiliation(s)
- Ioanna Zygouri
- Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10, Ioannina, Greece.
| | - Fiona Cowdell
- School of Nursing and Midwifery, Birmingham City University, Birmingham, UK
| | - Avraam Ploumis
- Department of Medicine, Faculty of Medicine, University of Ioannina, University Campus, P.O. Box: 1186, Zip: 451 10, Ioannina, Greece
| | - Mary Gouva
- Department of Nursing, University of Ioannina, Ioannina, Greece
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45
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Cohen SA, Mendez-Luck CA, Greaney ML, Azzoli AB, Cook SK, Sabik NJ. Differences in Caregiving Intensity Among Distinct Sociodemographic Subgroups of Informal Caregivers: Joint Effects of Race/Ethnicity, Gender, and Employment. J Gerontol Nurs 2021; 47:23-32. [PMID: 34191652 DOI: 10.3928/00989134-20210610-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
More than 40 million informal caregivers in the United States provide essential care to older adults. Recent research has identified substantial differences in caregiving intensity by gender, race/ethnicity, and employment status. Using intersectionality theory, the current study extends the existing literature by exploring the relationship between caregiving intensity and the unique experiences of individuals with different intersections of gender, ethnicity, and employment. We used generalized linear models to estimate multivariate associations between caregiving intensity assessed by three different measures (hours of caregiving per month and number of activities of daily living and instrumental activities of daily living [IADLs] assisted with) and the three sociodemographic factors of interest (race/ethnicity, gender, and employment status). Unemployed White males provided, on average, 77 fewer hours per month of care (p < 0.001) and assisted with 1.9 fewer IADLs (p = 0.004) than unemployed Black males. Employed White females provided 42.6 fewer hours per month of care (p = 0.002) than employed Black females and 49.2 fewer hours per month (p = 0.036) than employed females of other races. Study findings suggest that examining racial/ethnic or gender differences in isolation does not provide a true picture of differences in caregiving intensity. There is a critical need to understand how the intersections of race/ethnicity, gender, employment, and other sociodemographic factors shape the experiences of caregiver subgroups. [Journal of Gerontological Nursing, 47(7), 23-32.].
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46
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Kunicki ZJ, Gaudiano BA, Miller IW, Tremont G, Salloway S, Darling E, Broughton MK, Kraines MA, Hoopes R, Epstein-Lubow G. Differences in Burden Severity in Adult-Child Family Caregivers and Spousal Caregivers of Persons with Dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:518-532. [PMID: 33820479 DOI: 10.1080/01634372.2021.1912242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
Researchers are continuing to focus on the nature and sources of burden of family caregivers of persons living with dementia. Caregiving stress and burden are assessed and addressed by social workers, including at high-risk times such as hospitalization. This study tested whether adult-child family caregivers experience greater perceived burden than spousal caregivers, accounting for risks of acute stress which can accompany hospitalization for their care recipient, where social workers may be meeting with family caregivers for the first time. Family caregivers (N = 76; n = 42 adult-child; n = 34 spouse) were recruited during care-recipient clinical treatment. The settings of care included an outpatient memory care program and an inpatient geriatric psychiatry service. Results showed that adult-child caregivers reported greater burden as compared with spousal caregivers, but no differences regarding depressive symptoms, perceived stress, or grief. After controlling for demographics and location of care, being an adult-child caregiver remained a predictor of greater burden severity. Being an adult-child family caregiver may place an individual at increased risk for experiencing high burden. These findings suggest socials workers should consider how adult-child caregivers may benefit from strategies to address and reduce burden, beyond those typically offered to spousal caregivers.
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Affiliation(s)
- Zachary J Kunicki
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Brandon A Gaudiano
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Ivan W Miller
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Geoffrey Tremont
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Stephen Salloway
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Brown University, The Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Ellen Darling
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | | | - Morganne A Kraines
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Ryan Hoopes
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Gary Epstein-Lubow
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
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47
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Dalirirad H, Najafi T, Seyedfatemi N. Effect of an Educational Support Programme on Caregiver Burden Among the Family Members of Patients Undergoing Coronary Artery Bypass Graft Surgery. Sultan Qaboos Univ Med J 2021; 21:e266-e274. [PMID: 34221475 PMCID: PMC8219316 DOI: 10.18295/squmj.2021.21.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/26/2020] [Accepted: 08/19/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The family caregivers of patients undergoing coronary artery bypass graft (CABG) surgery experience considerable physical and emotional distress. This study aimed to investigate the effect of an educational support programme on caregiver burden among the family caregivers of patients undergoing CABG surgery in Iran. METHODS This non-randomised controlled clinical trial was conducted from January to April 2017 at a cardiovascular centre in Tehran, Iran. A total of 80 family caregivers of patients undergoing CABG surgery were sequentially selected and non-randomly assigned to intervention and control groups. The control group received routine care, whereas the intervention group received additional education sessions at baseline, prior to surgery, the day after surgery and before discharge. Caregiver burden was compared at baseline and six weeks post-discharge using the Persian-language versions of the Caregiver Burden Inventory (CBI) and Katz Index of Independence in Activities of Daily Living (IADL). RESULTS A significant difference was observed between family caregivers in the control and intervention groups with regards to pre-post differences in mean CBI scores (+1.67 ± 19.23 versus +17.45 ± 9.83; P <0.001), with an effect size of -1.14. In addition, there was a significant increase in mean post-discharge IADL scores among CABG patients in the intervention group compared to the control group (4.42 ± 1.05 versus 3.07 ± 1.09; P <0.001). CONCLUSION An educational support programme significantly reduced caregiver burden among the family members of patients undergoing CABG surgery in Iran. As such, in addition to routine care, healthcare providers should provide educational support to this population to help mitigate caregiver burden.
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Affiliation(s)
- Helen Dalirirad
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
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48
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Min A, Miller W, Rocha LM, Börner K, Correia RB, Shih PC. Just In Time: Challenges and Opportunities of First Aid Care Information Sharing for Supporting Epileptic Seizure Response. PROCEEDINGS OF THE ACM ON HUMAN-COMPUTER INTERACTION 2021; 5:113. [PMID: 34355131 PMCID: PMC8336724 DOI: 10.1145/3449187] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
There are over three million people living with epilepsy in the U.S. People with epilepsy experience multiple daily challenges such as seizures, social isolation, social stigma, experience of physical and emotional symptoms, medication side effects, cognitive and memory deficits, care coordination difficulties, and risks of sudden unexpected death. In this work, we report findings collected from 3 focus groups of 11 people with epilepsy and caregivers and 10 follow-up questionnaires. We found that these participants feel that most people do not know how to deal with seizures. To improve others' abilities to respond safely and appropriately to someone having seizures, people with epilepsy and caregivers would like to share and educate the public about their epilepsy conditions, reduce common misconceptions about seizures and prevent associated stigma, and get first aid help from the public when needed. Considering social stigma, we propose design implications of future technologies for effective delivery of appropriate first aid care information to bystanders around individuals with epilepsy when they experience a seizure.
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Affiliation(s)
| | - Wendy Miller
- Indiana University-Purdue University Indianapolis, USA
| | - Luis M Rocha
- Indiana University Bloomington, USA and Instituto Gulbenkian de Ciência, Portugal
| | | | - Rion Brattig Correia
- Instituto Gulbenkian de Ciência, Portugal, CAPES Foundation, Ministry of Education of Brazil, Brazil, and Indiana University Bloomington, USA
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49
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Samsuddin MF, Karim J, Salim AA. The Outcomes of Health Education Programme on Stress Level Among the Caregivers of Post Total Knee Replacement Surgery. Front Psychiatry 2021; 12:571027. [PMID: 33868035 PMCID: PMC8044915 DOI: 10.3389/fpsyt.2021.571027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 03/01/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Stress level among the caregivers is often related to caregivers' lack of knowledge and skill to care for the patients. A health education program to the caregivers is one of the important elements in increasing the knowledge and skills in managing patients at home. The specific objectives of this study were to determine caregiver's stress level in managing post total knee replacement (TKR) patients pre and post of a health education program. Materials and Methods: A clinical intervention trial design was conducted in Hospital Universiti Sains Malaysia (HUSM) with a sample size of 32 caregivers. A validated Zarit Burden Interview (ZBI) questionnaire was used to measure the stress level pre and post of the health education program on the management of patients post-TKR surgery which was adopted from Fresno Surgical Hospital in California. Results: The findings showed that there was a significant difference between pre and post level of stress (p ≤ 0.001). Conclusion: This study revealed the positive outcome of the health education program. It reduced the stress level among the caregivers in caring for their relatives with post-TKR surgery.
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Affiliation(s)
- Md Fadlisham Samsuddin
- Department of Nursing, Faculty of Medicine & Health Sciences, University Malaysia Sarawak, Kota Samarahan, Malaysia.,Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Jalina Karim
- Department of Nursing, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Azizul Akram Salim
- Department of Orthopaedics, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.,Hospital Universiti Sains Malaysia, Kota Bharu, Malaysia
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50
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Venters S, Jones CJ. The experiences of grandchildren who provide care for a grandparent with dementia: A systematic review. DEMENTIA 2020; 20:2205-2230. [PMID: 33372548 PMCID: PMC8369917 DOI: 10.1177/1471301220980243] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Much of the research exploring the experiences of family caregivers of people with dementia has focussed on spouses and adult children. It is hypothesised that other family members at different life stages and with different family roles may experience and perceive the caregiving role differently. The objective of the current review was to explore the experiences of grandchildren who provide care to a grandparent with dementia. A systematic search of four databases identified 12 studies which met the inclusion criteria. An assessment of quality was completed for each of the included studies. Grandchildren described dementia-related changes, changes to their role and relationship with their grandparent, multiple impacts of caregiving, influences of other family relationships on caregiving and positive aspects of caregiving. Many of the included studies met most of the quality criteria for the respective methodological design; however, there was some variation in quality and sample across included studies. The review indicates that assessments and interventions to incorporate grandchildren and the wider family system may help to support family carers to continue to provide care for grandparents with dementia. The research and clinical implications and limitations of the review are also considered.
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Affiliation(s)
- Sophie Venters
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Christina J Jones
- Department of Psychology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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