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Campbell-Enns HJ, Bornstein S, Hutchings VMM, Janzen M, Kampen M, O'Brien K, Rieger KL, Stewart T, Zendel BR, Doupe MB. The experiences and needs of unpaid family caregivers for persons living with dementia in rural settings: A qualitative systematic review. PLoS One 2023; 18:e0286548. [PMID: 37315078 DOI: 10.1371/journal.pone.0286548] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 05/18/2023] [Indexed: 06/16/2023] Open
Abstract
PURPOSE Unpaid family caregivers provide extensive support for community-dwelling persons living with dementia, impacting family caregivers' health and wellbeing. Further, unpaid family caregiving in rural settings has additional challenges because of lower access to services. This systematic review examines qualitative evidence to summarize the experiences and needs of rural unpaid family caregivers of persons living with dementia. METHODS CINAHL, SCOPUS, EMBASE, Web of Science, PsychINFO, ProQuest, and Medline were searched for articles investigating the experience and needs of rural family caregivers of persons living with dementia. Eligibility criteria were: 1) original qualitative research; 2) written in the English language; 3) focused on the perspectives of caregivers of community-dwelling persons with dementia; 4) focused on rural settings. Study findings were extracted from each article and a meta-aggregate process was used to synthesize the findings. FINDINGS Of the 510 articles screened, 36 studies were included in this review. Studies were of moderate to high quality and produced 245 findings that were analyzed to produce three synthesized findings: 1) the challenge of dementia care; 2) rural limitations; 3) rural opportunities. CONCLUSIONS Rurality is perceived as a limitation for family caregivers in relation to the scope of services provided but can be perceived as a benefit when caregivers experience trustworthy and helpful social networks in rural settings. Implications for practice include establishing and empowering community groups to partner in the provision of care. Further research must be conducted to better understand the strengths and limitations of rurality on caregiving.
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Affiliation(s)
| | - Stephen Bornstein
- Department of Political Science, Memorial University, St. John's, Newfoundland, Canada
- Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
| | - Veronica M M Hutchings
- Aging Research Centre-NL, Grenfell Campus, Memorial University, Corner Brook, Newfoundland and Labrador, St. John's, Canada
| | - Maya Janzen
- School of Public Policy and Administration, Carleton University, Ottawa, Ontario, Canada
| | - Melanie Kampen
- Centre for Transnational Mennonite Studies, University of Winnipeg, Winnipeg, Manitoba, Canada
| | - Kelli O'Brien
- St. Joseph's Care Group, Thunder Bay, Ontario, Canada
- Western Health, Corner Brook, Newfoundland and Labrador, Canada
| | - Kendra L Rieger
- School of Nursing, Trinity Western University, Langley, British Columbia, Canada
| | - Tara Stewart
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Benjamin Rich Zendel
- Faculty of Medicine, Memorial University, St. John's, Newfoundland, Canada
- Aging Research Centre-NL, Grenfell Campus, Memorial University, Corner Brook, Newfoundland and Labrador, St. John's, Canada
| | - Malcolm B Doupe
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Abebe A, Arba A, Paulos K, Abera W, Sidamo T, Shiferaw S, Abraham Z, Baza D, Nega B, Woldeyohannes S. The Lived Experience of Primary Family Caregivers of Patients on Hemodialysis Treatment in Southern Ethiopia: A Phenomenological Study. Int J Nephrol Renovasc Dis 2022; 15:41-52. [PMID: 35237064 PMCID: PMC8882975 DOI: 10.2147/ijnrd.s353191] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 02/16/2022] [Indexed: 11/23/2022] Open
Abstract
Background Primary family caregivers of hemodialysis patients are the “hidden patients” who shoulder extraordinary care burdens. However, there is a dearth of studies in Ethiopia. The purpose of this study was to explore the lived experience of primary family caregivers of hemodialysis patients in Southern Ethiopia. Methods Qualitative phenomenological study design was employed in February 2021. A homogeneous purposive sampling technique was applied to select study participants. An in-depth interview using an interview guide and field notes were used to collect the required data. All interviews were recorded using a digital audio recorder. Data coding was assisted by Open code software version 4.03. Inductive thematic analysis was used to develop the emerged themes and sub-themes using Colaizzi’s 1978 seven-step phenomenological analysis method. The themes and sub-themes are described in detail in the respective heading and sub-headings. Results A total of twelve participants were involved in the present study. Bio-psychological experience, socio-economic impact, and healthcare provider-primary family caregiver relationships are the major themes that emerged from the data. The emotional responses, coping mechanisms, consequences on the family caregivers’ health, care fatigue, lifestyle change, economic burden, impact on social responsibility, social support, the role of the primary family caregiver, and trust and confidence in the service providers are the sub-themes defining primary family caregivers caring experience. Conclusion In this study, emotional instabilities and reactions, care fatigue, distortion of caregiver’s health, multiple economic and social damages are the major challenges faced by primary family caregivers.
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Affiliation(s)
- Amene Abebe
- Department of Public Health, Wolaita Sodo University, Wolaita Sodo, Ethiopia
- Correspondence: Amene Abebe, Email
| | - Aseb Arba
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Kebreab Paulos
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Wogayehu Abera
- Department of Anaesthesia, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Temesgen Sidamo
- Department of Pharmacy, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Shimelis Shiferaw
- Department of Medical Laboratory Science, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Zinabu Abraham
- Department of Surgery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Daniel Baza
- Department of Nursing, Wolaita Sodo University, Wolaita Sodo, Ethiopia
| | - Banchialem Nega
- Department of Midwifery, Wolaita Sodo University, Wolaita Sodo, Ethiopia
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Yakubu YAM, Schutte DW. Socio-economic determinants and environmental hygiene factors of female caregiver burden in two selected low-income communities in Cape Town, South Africa. Pan Afr Med J 2020; 34:80. [PMID: 31934223 PMCID: PMC6945377 DOI: 10.11604/pamj.2019.34.80.16719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 02/15/2019] [Indexed: 11/17/2022] Open
Abstract
Introduction Studies on female caregiver burden and its determinants in relation to physical environment and social support in low-income and middle-income countries are limited. This study evaluates the relationship between caregiving physical environment, social support and well-being of female caregivers and care recipients in Cape Town, South Africa. Methods One hundred (100) each of black African and coloured female caregivers from two different population settlements were randomly selected. Structured questionnaire was employed to gather information from caregivers. Description and correlation analyses were used to examine the association between health status of care recipients, environmental hygiene factors and female caregiver burden. Results About 49.5% of the female caregivers were between 50-59 years and worked full-time (≥40 hours per week). Better hygiene environment and working conditions are major determinants of caregiver burden and care recipient's physical health. Better hygiene conditions in the kitchen and toilet significantly increased care recipients' and caregivers’ physical health (P<0.05). Diarrhoea was found to be significantly associated with poorer environmental hygiene. Over 50% of the reported diarrhoea cases were among care recipients with poorer kitchen and toilet hygiene. Bad environmental hygiene increased the risk of diarrhoea among care recipients and caregivers. Physical health of the care recipients and social grants influenced the burden on the female caregiver. Conclusion Increase social grants and attention to environmental conditions of caregiving will improve the physical health and living standard of the care recipients and caregivers.
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Affiliation(s)
- Yakubu Almu-Min Yakubu
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
| | - De Wet Schutte
- Department of Environmental and Occupational Studies, Cape Peninsula University of Technology, Cape Town, South Africa
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Hayslip B, Knight RP, Page KS, Phillips C. Rural versus urban residence as an influence on grandparent caregivers’ needs for service. JOURNAL OF INTERGENERATIONAL RELATIONSHIPS 2018. [DOI: 10.1080/15350770.2018.1489327] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Bert Hayslip
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Rebekah P. Knight
- Department of Disability and Addiction Rehabilitation, University of North Texas, Denton, TX, USA
| | - Kyle S. Page
- Department of Psychology, University of North Texas, Denton, TX, USA
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Exploring caregiver burden experienced by family caregivers of patients with End-Stage Renal Disease in Nigeria. INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2017. [DOI: 10.1016/j.ijans.2017.11.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Applying the evidence to help caregivers torn in two. Nursing 2015; 45:30-7; quiz 37-8. [PMID: 25973758 DOI: 10.1097/01.nurse.0000464983.54444.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Branger C, O’Connell ME, Morgan DG. Factor Analysis of the 12-Item Zarit Burden Interview in Caregivers of Persons Diagnosed With Dementia. J Appl Gerontol 2014; 35:489-507. [PMID: 24652929 DOI: 10.1177/0733464813520222] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 12/15/2013] [Indexed: 11/15/2022] Open
Abstract
The Zarit Burden Interview (ZBI) is commonly used to measure dementia caregiver burden, but its factor structure is unclear. A two-factor structure for the 12-item ZBI, “personal strain” and “role strain,” has been shown, but recent data suggest that an additional factor of “guilt” is embedded in the “role strain” items. The 12-item ZBI administered to 194 informal rural and urban caregivers of persons diagnosed with dementia was analyzed using exploratory factor analysis. A two-factor structure, with item loadings consistent with previously conceptualized constructs of “personal strain” and “role strain,” was found. Moreover, this factor structure was invariant to caregiver subgroups. When the predictive value of these factors was explored, only “personal strain” was important in predicting caregiver psychological distress, measured with the Brief Symptom Inventory. However, “role strain,” which included the hypothesized “guilt” items, did not appear to be an important predictor of caregiver distress.
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Stewart NJ, Morgan DG, Karunanayake CP, Wickenhauser JP, Cammer A, Minish D, O’Connell ME, Hayduk LA. Rural Caregivers for a Family Member With Dementia. J Appl Gerontol 2014; 35:150-78. [DOI: 10.1177/0733464813517547] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2012] [Accepted: 11/24/2013] [Indexed: 11/17/2022] Open
Abstract
Forecasts of increasing prevalence of dementia in rural settings, coupled with reliance on family caregiver support, indicate that a greater understanding of caregiver distress in these contexts is necessary. The purpose of this study was to examine family caregiver burden and severity of distress on the day that a family member was diagnosed with dementia at a memory clinic that serves a rural population. Participants in this retrospective study were 231 primary family caregivers of a rural community-dwelling person with dementia. On the diagnostic day, women reported more burden and severity of distress than men and spouses reported more severity of distress than adult children. A structural equation model was not supported for the entire sample, but was supported for women caregivers only ( n = 161). Caregiver distress related to dementia-specific behaviors explained both global distress and burden. Patients’ functional decline was related to caregiver burden.
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O'Connell ME, Germaine N, Burton R, Stewart N, Morgan DG. Degree of rurality is not related to dementia caregiver distress, burden, and coping in a predominantly rural sample. J Appl Gerontol 2012; 32:1015-29. [PMID: 25474826 DOI: 10.1177/0733464812450071] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Earlier research suggests that geographic location matters for informal caregivers of persons with dementia: rural caregivers tend to rely on more informal supports and may report more psychological distress and burden than urban caregivers. Differential access to services may underlie these findings, but degree of rurality is typically measured with population size. In contrast, the current article measured degree of rurality with standardized scale of access to metropolitan centers. In a large sample we found nonsignificant and trivial associations between metropolitan access with self-reported caregiver distress, (N = 272; Brief Symptom Inventory), burden (N = 234; Zarit Burden Interview), and coping (n = 46; Jalowiec Coping Scale). The null findings were likely related to the use of a proxy variable for dementia-related caregiver supports (i.e., degree of access to metropolitan centers). In future research, direct measures of access to appropriate dementia related services should be used to study caregiver outcomes.
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