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Quach HL, Visaria A, Iversen MM, Malhotra R. Depressive Symptoms Among Caregivers of Older Adults With Both Diabetes and Functional Limitations and Moderation by Caregiver Expressive Social Support. Sci Diabetes Self Manag Care 2024:26350106241263521. [PMID: 39058245 DOI: 10.1177/26350106241263521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/28/2024]
Abstract
PURPOSE The purpose of the study was to explore how caring for older adults with both diabetes and functional limitations impacts caregiver depressive symptoms and whether this impact is moderated by caregivers' expressive social support and psychological resilience. METHOD Cross-sectional data of 278 dyads, each comprising an older adult with functional limitations and his/her primary family caregiver were analyzed. Older adult diabetes status (yes/no) was based on ever-diagnosis of diabetes. Caregiver depressive symptoms, expressive social support, and psychological resilience were measured using standard scales. Multivariable linear regression was used to assess the association of interest and its moderation by caregiver expressive social support and psychological resilience. RESULTS Caregivers of older adults with both diabetes and functional limitations had a higher depressive symptoms score compared to caregivers of older adults with only functional limitations. This association was inversely moderated by caregiver expressive social support. As caregiver expressive social support increased, the difference in depressive symptoms between caregivers of older adults with diabetes and functional limitations and caregivers of older adults with only functional limitations reduced. CONCLUSION Family caregivers of older adults with functional limitations and diabetes have a higher depressive symptoms score. However, enhancing caregiver expressive social support could mitigate this risk. Service providers should prioritize support for caregivers in such vulnerable situations and strive to enhance their expressive social support.
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Affiliation(s)
- Ha-Linh Quach
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - Abhijit Visaria
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | | | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
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Sung P, Lim-Soh J, Malhotra R. Informal Caregiver Social Network Types and Mental Health: The Mediating Role of Psychological Resilience. J Aging Soc Policy 2024; 36:693-708. [PMID: 38424034 DOI: 10.1080/08959420.2024.2319535] [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: 12/26/2022] [Accepted: 11/13/2023] [Indexed: 03/02/2024]
Abstract
Little is known about whether and why social networks protect mental health among informal caregivers. This study examined the association between informal caregiver social network types and depressive symptoms and the mediatory mechanism of psychological resilience. Latent class analysis, applied to cross-sectional data on 278 Singaporean caregivers, identified four social network types: restricted (42%), friend (16%), family (21%), and diverse (21%). Path analysis showed that the diverse social network type, compared to the restricted social network type, was associated with a lower level of depressive symptoms, and psychological resilience fully mediated this association. Interventions should help caregivers to maintain social networks with their family and friends.
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Affiliation(s)
- Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong, China
| | - Jeremy Lim-Soh
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore
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3
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Kim H, Mahmood A, Kedia S, Ogunsanmi DO, Sharma S, Wyant DK. Impact of Residential Segregation on Healthcare Utilization and Perceived Quality of Care Among Informal Caregivers in the United States. J Racial Ethn Health Disparities 2024:10.1007/s40615-024-02018-9. [PMID: 38758399 DOI: 10.1007/s40615-024-02018-9] [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: 02/01/2024] [Revised: 04/10/2024] [Accepted: 05/06/2024] [Indexed: 05/18/2024]
Abstract
This study aimed to investigate the impact of racial residential segregation on healthcare utilization and perceived quality of care among informal caregivers in the US. It further assessed potential variations in the estimated impact across caregivers' race and socioeconomic status. We used data from the Health Information National Trends Survey Data Linkage Project (fielded in 2020) for a sample of 583 self-identified informal caregivers in the US. Fitting a series of regression models with the maximum likelihood estimation, we computed the beta coefficients (β) of interest and their associated Wald 95% confidence limits (CI). Caregivers who resided in areas with higher segregation, compared to those living in lower segregated areas, were less likely to visit a healthcare professional [β = - 2.08; Wald 95%CI - 2.093, - 2.067] (moderate); [β = - 2.53; Wald 95%CI - 2.549, - 2.523] (high)]. Further, caregivers residing in moderate [β = - 0.766; Wald 95%CI - 0.770, - 0.761] and high [β = - 0.936; Wald 95%CI - 0.941, - 0.932] segregation regions were less likely to perceive a better quality of care compared to those located in low segregation areas. Moreover, as segregation level increased, Black caregivers were less likely to see a health professional, less frequently used healthcare services, and had poorer perceived healthcare quality when compared to Whites. Our findings indicate that higher residential segregation is associated with lower healthcare utilization, such as visiting a healthcare professional, and poorer perceived healthcare quality among informal caregivers. Given the essential role of informal caregivers in the current healthcare system, it is vital to investigate and address challenges associated with access to and quality of essential healthcare services to improve caregivers' health and well-being, specifically for caregivers of minority backgrounds.
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Affiliation(s)
- Hyunmin Kim
- College of Nursing and Health Professions, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Asos Mahmood
- Center for Health System Improvement, College of Medicine, University of Tennessee Health Science Center, 956 Court Ave Avenue, Ste D222A, Memphis, TN, 38103, USA.
- Department of Medicine-General Internal Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
| | - Satish Kedia
- Division of Social and Behavioral Sciences, School of Public Health, The University of Memphis, Memphis, TN, USA
| | - Deborah O Ogunsanmi
- Tennessee Population Health Consortium and Institute for Health Outcomes and Policy Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Sadikshya Sharma
- College of Nursing and Health Professions, School of Health Professions, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - David K Wyant
- Jack C. Massey College of Business, Frist College of Medicine, Belmont University, Nashville, TN, USA
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Elayan S, Angelini V, Buskens E, de Boer A. The Economic Costs of Informal Care: Estimates from a National Cross-Sectional Survey in The Netherlands. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2024:10.1007/s10198-023-01666-8. [PMID: 38294595 DOI: 10.1007/s10198-023-01666-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
Faced with an unprecedented demand for long-term care, European health care systems are moving towards mixed care models, where the welfare state and informal caregivers share care responsibilities. While informal care is often viewed as a means of alleviating pressure on public care, it comes with significant economic costs for caregivers, their employers, and society at large. This study uses nationally representative data to estimate the total direct (informal care time and out-of-pocket costs) and indirect (productivity) economic costs of informal care in the Netherlands in 2019. Informal care time costs are estimated using the opportunity cost and the proxy good methods. Indirect costs are estimated using the human capital and friction cost approaches. Our results reveal the considerable annual societal cost of informal care in the Netherlands, ranging between €17.5 billion and €30.1 billion, depending on the valuation approach. These costs are equivalent to 2.15% and 3.71% of Dutch GDP in 2019, comparable to the public expenditure on long-term care in that year. Female caregivers account for slightly more than half (53%-57%) of the total costs. Around 57%-88% of these costs are in the form of informal care time. The main driver of indirect costs is the temporary cessation of work, which comprises 12%-17% of the total costs. Findings corroborate that substantial resources, yet thus far largely disregarded, are spent on informal care even in a country with a relatively generous public long-term care system.
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Affiliation(s)
- Saif Elayan
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands.
| | - Viola Angelini
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Nettelbosje 2, 9747 AE, Groningen, The Netherlands
| | - Erik Buskens
- Department of Epidemiology, University Medical Centre Groningen, University of Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands
| | - Alice de Boer
- Faculty of Social Sciences, Vrije Universiteit Amsterdam, 1081 HV, Amsterdam, The Netherlands
- The Netherlands Institute for Social Research (SCP), 2500 BD, The Hague, The Netherlands
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A'Azman S, Sung P, Malhotra R. Engagement in Physical Activity and Quality of Life Among Informal Caregivers of Older Adults. J Aging Health 2023:8982643231209086. [PMID: 37936406 DOI: 10.1177/08982643231209086] [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: 11/09/2023]
Abstract
OBJECTIVES This study examined (1) the association of caregiver engagement in physical activity (PA) with their quality of life (QoL) and (2) the moderating effect of caregiver engagement in PA on the relationship between several caregiving stressors and their QoL, among informal caregivers of older adults. METHODS Multivariable regression was applied to data from 278 adult caregivers, aged 23-90 years, in Singapore. RESULTS Engagement in PA by caregivers was positively associated with psychological, social relationships, and environment domains of their QoL. Caregiver engagement in PA also mitigated the negative association between care-recipient mood impairment and QoL of caregivers in the physical health and social relationships domains. DISCUSSION QoL of caregivers may be improved or protected by their regular engagement in PA, especially when their care-recipients have mood impairment. Policymakers and practitioners should encourage caregivers to engage in PA and provide them with the necessary support to do so.
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Affiliation(s)
| | - Pildoo Sung
- Department of Sociology, Hong Kong Baptist University, Hong Kong
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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Barbosa F, Simões Dias S, Voss G, Delerue Matos A. The Longitudinal Association between Co-Residential Care Provision and Healthcare Use among the Portuguese Population Aged 50 and Over: A SHARE Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3975. [PMID: 36900986 PMCID: PMC10001838 DOI: 10.3390/ijerph20053975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 02/01/2023] [Accepted: 02/21/2023] [Indexed: 06/18/2023]
Abstract
Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers' healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers.
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Affiliation(s)
- Fátima Barbosa
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
| | - Sara Simões Dias
- Center for Innovative Care and Health Technology (CiTechCare), School of Health Sciences, Polytechnic of Leiria, 2410-541 Leiria, Portugal
| | - Gina Voss
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
| | - Alice Delerue Matos
- Communication and Society Research Centre, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
- Department of Sociology, Institute of Social Sciences, University of Minho, 4710-057 Braga, Portugal
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Barriers to and Facilitators of Adherence to Prescribed Home Exercise in Older Adults at Risk of Falling in Singapore: A Qualitative Study. J Aging Phys Act 2023; 31:48-58. [PMID: 35649516 DOI: 10.1123/japa.2021-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 03/18/2022] [Accepted: 04/08/2022] [Indexed: 02/03/2023]
Abstract
Adherence to prescribed exercise poses significant challenges for older adults despite proven benefits. The aim of this exploratory descriptive qualitative study was to explore the perceived barriers to and facilitators of prescribed home exercise adherence in community-dwelling adults 65 years and older. Three focus groups with 17 older adults (Mage ± SD = 77 ± 5.12) living in Singapore were conducted. Inductive thematic analysis revealed that "the level of motivation" of individuals constantly influenced their exercise adherence (core theme). The level of motivation appeared to be a fluid concept and changed due to interactions with two subthemes: (a) individual factors (exercise needs to be tailored to the individual) and (b) environmental factors (i.e., support is essential). Hence, these factors must be considered when designing strategies to enhance exercise adherence in this vulnerable population. Strategies must be informed by the culturally unique context, in this case, a developed country with a multiethnic urban Asian population.
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Factors associated with depressive symptoms among workers employed in Japanese eldercare institutions: a cross-sectional study based on the Job Demand–Control–Support Model. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03971-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Chan EY, Wu LT, Ng EJY, Glass GF, Tan RHT. Applying the RE-AIM framework to evaluate a holistic caregiver-centric hospital-to-home programme: a feasibility study on Carer Matters. BMC Health Serv Res 2022; 22:933. [PMID: 35854296 PMCID: PMC9296119 DOI: 10.1186/s12913-022-08317-3] [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: 03/22/2022] [Accepted: 06/28/2022] [Indexed: 11/10/2022] Open
Abstract
Background Prolonged caregiving of an older adult can cause family caregivers to be overwhelmed, potentially affecting the well-being of both the caregivers and their care-recipients. Carer Matters is a holistic hospital-to-home programme, centred on caregivers’ needs as their care-recipients transit from hospital to home. The programme was piloted to support caregivers through caregivers needs assessment, tailored resources, tele-support, training courses, and community support network. This study aimed to examine the feasibility of Carer Matters in a tertiary hospital in Singapore. Methods This feasibility study was conducted on the pilot implementation from January to December 2021, during the Covid-19 pandemic. It adopted the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework. The study highlighted quantitative data collected from key process indicators, such as number of caregivers screened, assessed on their needs and provided with assistance. Additionally, qualitative data was collected from in-depth interviews with 51 stakeholders involved in the implementation to examine their perspectives and experiences. These included family caregivers, clinician caregiver support nurses, hospital leaders and community partners. Results During the pilot, 550 caregivers were enrolled. All caregivers received educational resources when they completed the needs assessment, while 69 of them who reported high burden were given tele-support and 252 attended our caregiver training courses. Despite initial recruitment challenges and obstacles to adoption, stakeholders interviewed found Carer Matters to be effective in providing caregivers with emotional support, knowledge and skills that improved their caregiving abilities, and reduced their sense of isolation and caregiving stress. Among caregivers, the training courses were effective with majority of caregivers agreeing that the courses addressed their needs (99%) and improved their knowledge of the relevant disease conditions (97%). Programme maintenance considered among stakeholders included strategies such as multipronged approach in recruiting caregivers and inviting caregiver advocates to share their experiences. Conclusion This feasibility study highlights that Carer Matters is a valuable component to the ecosystem of support for family caregivers and their care recipients. Carer Matters extends the current patient-centric care model to a more holistic post-discharge continuity of care for both caregivers and their care-recipients, improving and maintaining their overall well-being to better allow transition from hospital-to home. Trial registration Feasibility Study of Project Carer Matters for Family Caregivers of Persons with Dementia (NCT number: NCT05205135). Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08317-3.
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Affiliation(s)
- Ee Yuee Chan
- Nursing Research Unit, Tan Tock Seng Hospital, Singapore, Singapore. .,Alice Lee Centre of Nursing Studies, Yong Lin School of Medicine, National University of Singapore, Singapore, Singapore. .,Geriatric Education and Research Institute, Singapore, Singapore.
| | - Ling Ting Wu
- Nursing Research Unit, Tan Tock Seng Hospital, Singapore, Singapore
| | | | | | - Robyn Hwee Teng Tan
- Geriatric Education and Research Institute, Singapore, Singapore.,Singapore Social Service Research Centre, National University of Singapore, Singapore, Singapore
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Ee J, Lim JM, Stenfert Kroese B, Rose J. Family carers' experiences of providing care for their adult relative with intellectual disabilities and mental health problems in Singapore. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 126:104241. [PMID: 35504125 DOI: 10.1016/j.ridd.2022.104241] [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: 06/21/2021] [Revised: 03/22/2022] [Accepted: 04/18/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Families in Singapore are primarily involved in the care of their relatives with intellectual disabilities and the study aimed to explore their experiences taking care of their relatives with intellectual disabilities and mental health problems. METHOD Nine unpaid family carers were interviewed. The interviews were analysed using Interpretative Phenomenological Analysis. RESULTS Analysis revealed four themes 1) Making sense of behaviours; 2) Staff are the experts; 3) Public reaction and 4) Worries and hopes for the future. CONCLUSIONS Family carers found it difficult to identify and manage the mental health symptoms of their relatives and sought help from specialist mental health professionals. They were satisfied with the specialist services and found psychotropic medication helpful to reduce the symptoms. Family carers expressed worries about their relative not being accepted by the public and did not make future care plans. More resources are needed to increase accessibility of specialist mental health services for people with intellectual disabilities. It is recommended for service providers to collaborate with family carers and provide them with resources and skills to empower them to care for their relatives with intellectual disabilities.
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Affiliation(s)
| | | | | | - John Rose
- University of Birmingham, United Kingdom
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11
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Mortality, Morbidity and Health-Related Outcomes in Informal Caregivers Compared to Non-Caregivers: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105864. [PMID: 35627399 PMCID: PMC9141545 DOI: 10.3390/ijerph19105864] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 11/25/2022]
Abstract
A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers.
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Ma J, Yang H, Hu W, Khan HTA. Spousal Care Intensity, Socioeconomic Status, and Depression among the Older Caregivers in China: A Study on 2011–2018 CHARLS Panel Data. Healthcare (Basel) 2022; 10:healthcare10020239. [PMID: 35206854 PMCID: PMC8872002 DOI: 10.3390/healthcare10020239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 01/21/2022] [Accepted: 01/23/2022] [Indexed: 02/04/2023] Open
Abstract
Using the stress process model and data from the 2011–2018 China Health and Retirement Longitudinal Study (CHARLS), this study examined the effect of spousal caregiving intensity on the depression level of older caregivers in China. The moderating role that socioeconomic status plays in the relationship between spouses was explored by constructing multilevel growth models (MGMs). The care intensity for a spouse was found to relate to significantly increased depression levels in older caregivers, while the degree of disability of the spouse being cared for (B = 0.200, p < 0.001) having a greater effect on depression than the duration of care (B = 0.007, p < 0.01). There was a threshold effect where the provision of more than 10 h of care per week for a spouse (B = 0.931, p < 0.001; B = 0.970; p < 0.01) or caring for a disabled spouse with limited ADLs (B = 0.709, p < 0.01; B = 1.326; p < 0.001; B = 1.469, p < 0.01) increased depression in older caregivers. There were moderating influences, including higher professional prestige before retirement (B = −0.006, p < 0.05) and higher annual family income (B = −0.037, p < 0.10), that increased depression related to the spouse’s degree of disability. It was considered that active familism measures should be formulated for older spousal caregivers, especially those with lower socioeconomic status.
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Affiliation(s)
- Jun Ma
- Center for Social Security Studies, Wuhan University, Wuhan 430072, China;
| | - Hongyan Yang
- Center for Social Security Studies, Wuhan University, Wuhan 430072, China;
- Correspondence:
| | - Wenxiu Hu
- Center for Population and Development Policy Studies, Fudan University, Shanghai 200433, China;
- Postdoctoral Research Workstation, China Everbright Group, Beijing 100033, China
| | - Hafiz T. A. Khan
- Public Health Group, College of Nursing, Midwifery and Healthcare, University of West London, Brentford, London TW8 9GB, UK;
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Heng WAM, Lin YP, Chua WL, Chan EY. The early stages of caregiving: A qualitative study into the caregiving experiences of Asian family caregivers of persons with newly-diagnosed dementia. Geriatr Nurs 2021; 42:1517-1524. [PMID: 34735998 DOI: 10.1016/j.gerinurse.2021.10.015] [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: 08/11/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
In Asian societies, the responsibility of caring for persons with dementia often falls upon an immediate family member. However, little attention has been paid to the early stages of caregiving, as well as their transition into a more experienced caregiver. Thus, a qualitative descriptive study involving a purposive sample of 11 main family caregivers of a person with newly diagnosed dementia was recruited from a tertiary hospital in Singapore. Three themes emerged from the data analysis: (1) Suspicions to seeking confirmation of dementia, (2) Grappling with dementia diagnosis, and (3) Making adjustments for the future. Areas of needs and support identified during the early caregiving journey suggest the need for caregivers to be prepared for the practical and emotional challenges. Unique to the Asian culture, our findings put forth the advocacy of engaging persons with dementia in the discussions of their long-term care and options.
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Affiliation(s)
| | | | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ee-Yuee Chan
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Johnson SS, Sowa M, McCann R, Cohen SA, Nash CC, Greaney ML, Alexander RA, Kasten J, Martin MP, McEntee ML, Suri Y, Roman C, Bane S, Opthof E. Knowing Well, Being Well: well-being born of understanding: The Science of Teamwork. Am J Health Promot 2021; 35:1028-1047. [PMID: 34351249 DOI: 10.1177/08901171211030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Cohen SA, Nash CC, Greaney ML. Informal Caregiving During the COVID-19 Pandemic in the US: Background, Challenges, and Opportunities. Am J Health Promot 2021; 35:1032-1036. [PMID: 34351245 DOI: 10.1177/08901171211030142c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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16
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Eyaloba C, De Brauwer I, Cès S, Benoit F, Gillain S, Pesch L, Rouvière H, De Breucker S. Profile and needs of primary informal caregivers of older patients in Belgian geriatric day hospitals: a multicentric cross-sectional study. BMC Geriatr 2021; 21:315. [PMID: 34001018 PMCID: PMC8130294 DOI: 10.1186/s12877-021-02255-1] [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: 12/01/2020] [Accepted: 04/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background With the improvement of life expectancy, the world faces increasing demands for care of older persons. In this manuscript, we define the characteristics of primary informal caregivers (PIC) of patients aged 75 years and older admitted to geriatric day hospitals (GDH) in Belgium. A PIC is defined as the person who most often provides care and assistance to persons who need to be cared for. We describe PIC socio-demographic characteristics, satisfaction, burden and wishes about caring; the type of assistance provided and received, their self-rated health, socio-demographic and medical characteristics of proxies, in particular the presence of behavioural disorders. Methods We conducted a cross-sectional study in 25 GDH. Participants Four hundred seventy-five PIC of patients ≥75 years and their proxies. PIC completed a questionnaire at the GDH assessing burden by Zarit Burden Index-12 (ZBI-12), self-rated health, social restriction due to caregiving and financial participation. We compared the characteristics of PIC with high and low burden, and the characteristics of spouses and adult children PIC. We also analyzed factors associated with a high burden in a multivariable logistic regression model. Results PIC were mainly women (72%), adult children (53.8%) and spouses (30.6%). The mean age was 64 ± 14 years for PIC and 84 ± 5 years for care recipients. PIC helped for most of Activities in Daily Living (ADL) and Instrumental ADL (iADL). The median ZBI-12 score was 10 [IQR 5–18]. In multivariable regression analysis, a high burden was positively associated in the total group with living with the relative (p = 0.045), the difficulty to take leisure time or vacation (p < 0.001), behavioral and mood disorders (p < 0.001;p = 0.005), and was negatively associated with bathing the relative (p = 0.017) and a better subjective health status estimation (p < 0.001). Conclusion Primary informal caregivers, who were predominantly women, were involved in care for ADL and iADL. A high burden was associated with living with the relative, the difficulty to take leisure time or vacation and the relative’s behavioral and mood disorders. Bathing the relative and a subjective health status estimated as good as or better than people the same age, were protective factors against a high burden. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02255-1.
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Affiliation(s)
- C Eyaloba
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - I De Brauwer
- IRSS, Institute of Health and Society, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - S Cès
- IRSS, Institute of Health and Society, Université Catholique de Louvain, Ottignies-Louvain-la-Neuve, Belgium
| | - F Benoit
- Department of Geriatric Medicine, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium
| | - S Gillain
- Department of Geriatric Medicine, University Hospital of Liège, Université de Liège, Liège, Belgium
| | - L Pesch
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - H Rouvière
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium
| | - S De Breucker
- Department of Geriatric Medicine, Erasme Hospital, Université Libre de Bruxelles, 808 Lennikstreet, 1070, Brussels, Belgium.
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Orawiec RB, Nowak SB, Tomaszewski P. Postural stability in Parkinson's disease patients' wives and in elderly women leading different lifestyles. Health Care Women Int 2019; 40:1070-1083. [PMID: 30742568 DOI: 10.1080/07399332.2018.1531865] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 09/30/2018] [Accepted: 09/30/2018] [Indexed: 10/27/2022]
Abstract
The study aimed to determine postural stability of Parkinson's disease (PD) patients' wives in comparison with women differing in their lifestyle. (PD) patients' wives (n = 44), homemakers (n = 41), and female students of the University of the Third Age (n = 43) performed balance tests on a stabilometric platform. The PD patients' wives were characterized by significantly (p < 0.001) higher values of mean velocity sway than the homemakers and students (approximately 3.5 and 5 mm/s, respectively) and performed worst in displacement velocity and sway range in both sagittal and frontal plane. The results indicate that the wives of PD patients need support in the area of health training targeted at improving their standing stability.
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Affiliation(s)
- Renata B Orawiec
- Department of Physiotherapy, Kazimierz Pulaski University of Technology and Humanities , Radom , Poland
| | - Stanisław B Nowak
- Department of Physical Education, Kazimierz Pulaski University of Technology and Humanities , Radom , Poland
| | - Paweł Tomaszewski
- Department of Biometry, The Jozef Pilsudski University of Physical Education , Warsaw , Poland
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18
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Fushimi M. Depressive symptoms and related factors among workers in care institutions for older persons in Japan: a cross-sectional study. Eur Geriatr Med 2019; 10:957-964. [DOI: 10.1007/s41999-019-00241-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 09/10/2019] [Indexed: 11/28/2022]
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19
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Rahman A, Anjum R, Sahakian Y. Impact of Caregiving for Dementia Patients on Healthcare Utilization of Caregivers. PHARMACY 2019; 7:E138. [PMID: 31554156 PMCID: PMC6958358 DOI: 10.3390/pharmacy7040138] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Revised: 09/03/2019] [Accepted: 09/12/2019] [Indexed: 12/24/2022] Open
Abstract
The elderly, whom are vulnerable to the physical, mental and chronic diseases of aging, are the fastest growing segment of the US population. Dementia is of particular concern in this population, and caregivers of people with dementia are subjected to psychological, physical, emotional and functional stress. The purpose of this study was to investigate the impact of caregiving for dementia patients on health care services utilization of caregivers and to examine if caregivers utilize more healthcare services than the control group. The study recruited a total of 143 people in control and non-control groups through non-probability convenience sampling. The control group (non-caregivers) comprised of 71 people, whereas the experimental group (caregivers) consisted of 72 participants. The focus of the study was the health care utilization questionnaire, asking the caregiver about the frequency of specific health care services utilization-including medication use in the last six months, on the scale from 0 to 10. Results were statistically significant for each of the healthcare service utilization when comparing caregivers to the control group. By providing adequate support and assistance in form of support groups, we can alleviate caregivers' burden and more effectively address the needs of caregivers-thereby reducing the utilization of healthcare services.
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Affiliation(s)
- Ateequr Rahman
- College of Pharmacy, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
| | | | - Yelena Sahakian
- College of Pharmacy, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, USA.
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20
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Aloweni F, Doshi K, Fook-Chong S, Malhotra R, Østbye T. The types of caregiving reactions experienced by the older spouse caregivers. J Clin Nurs 2019; 28:4538-4548. [PMID: 31466133 DOI: 10.1111/jocn.15044] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 07/30/2019] [Accepted: 08/18/2019] [Indexed: 01/07/2023]
Abstract
AIMS To examine factors associated with the four types of caregiver reactions according to the modified Caregiver Reaction Assessment (mCRA) and assess the differences in the narrative assessment from spouse caregivers between the high-positive and high-negative caregiver reactions. BACKGROUND There is a limited understanding of the factors contributing to positive and negative reactions among older spouse caregivers with chronic illnesses. Narrative assessment from spouse caregivers has not been studied before. DESIGN The study design was a paired-sample, mixed-method survey design. Data were collected from spouse caregivers (≥55 years old) and care-recipients in one medical institute from February 2017-December 2017. This manuscript used STROBE checklist to ensure complete reporting. METHODS Demographic, socioeconomic, Frailty Index, perceived stress, and quality of life data were gathered from caregiver dyads. mCRA, relationship, and life satisfaction data were collected from caregivers. mCRA identified the four types of caregiver reactions: (a) high-positive, low-negative; (b) high-positive, high-negative; (c) low-positive, high-negative; and (d) low-positive, low-negative. A qualitative interview was conducted to understand the differences in the narrative and choice of words used to describe caregiving experience. RESULTS Seventy-five caregiver dyads were recruited. Total perceived stress was found to be negatively associated with high-positive, low-negative caregiver reaction (baseline category: low-positive, high-negative) by multinomial logistic regression. Content analyses showed that low-positive and high-negative caregivers used words that implied a lack of volition. Caregivers with positive experience viewed caregiving as a responsibility; the opposite viewed it as having 'no choice'. CONCLUSIONS Perceived stress is an important indicator of caregiver reactions. Words used when describing caregiving experiences can potentially depict the spouse caregivers' current state of being as a caregiver. RELEVANCE TO CLINICAL PRACTICE Spouse caregiver's narrative of their caregiving experience may provide easy and quick insights if interventions are needed. Early identification of negative reactions will allow for prompt interventions in mitigating caregivers' stress.
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Affiliation(s)
- Fazila Aloweni
- Division of Nursing, Singapore General Hospital, Singapore, Singapore
| | - Kinjal Doshi
- Department of Psychology, Singapore General Hospital, Singapore, Singapore
| | | | - Rahul Malhotra
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Truls Østbye
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Community and Family Medicine, Duke University, Durham, NC, USA
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21
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Lane AP, Wong CH, Močnik Š, Song S, Yuen B. Association of Neighborhood Social Capital With Quality of Life Among Older People in Singapore. J Aging Health 2019; 32:841-850. [PMID: 31216922 DOI: 10.1177/0898264319857990] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To examine how neighborhood-based cognitive and structural social capital are associated with individual quality of life among a sample of community-dwelling older adults in Singapore. Method: Using survey data from 981 older adults (aged 55 years and above) in nine residential neighborhoods, multilevel models simultaneously estimated the effects of independent variables at the individual and neighborhood levels on quality of life (CASP-12). Results: Social cohesion (β = 1.39, p < .01) and associational membership (β = 19.16, p < .01) were associated with higher quality of life in models adjusted for neighborhood facilities and individual sociodemographics, social networks, functional limitations, global cognitive status, and medical conditions. Discussion: The results suggest that place-based or neighborhood social capital may be important for older person's well-being. It identifies the contribution of structural (associational membership) and cognitive (social cohesion) social capital to the well-being of community-dwelling older adults in Singapore.
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Affiliation(s)
- Anna P Lane
- Singapore University of Technology and Design, Singapore
| | | | - Špela Močnik
- Singapore University of Technology and Design, Singapore
| | - Siqi Song
- Singapore University of Technology and Design, Singapore
| | - Belinda Yuen
- Singapore University of Technology and Design, Singapore
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22
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Shaffer KM, Nightingale CL. Comparison of Healthcare Utilization Between Informal Caregivers and Non-Caregivers: An Analysis of the Health Information National Trends Survey. J Aging Health 2019; 32:453-461. [PMID: 30793639 DOI: 10.1177/0898264319830262] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The demands of providing unpaid care for someone with a disabling health condition (i.e., informal caregiving) can limit attention to one's own health needs. Using a nationally representative survey, this study examines whether caregivers report different healthcare utilization relative to non-caregivers. Method: Participants in the Health Information National Trends Survey 5, Cycle 1 reported whether they provided unpaid care and healthcare utilization outcomes. Logistic regressions and chi-square tests with jackknife variance estimation were used. Results: Caregivers (N = 391) did not differ from non-caregivers (N = 2,894) in time since routine checkup or number of healthcare appointments in the past year (p values > .25). Among caregivers, number of healthcare appointments differed according to caregivers' relationship to the care recipient (p = .04). Discussion: Findings suggest that informal caregivers access routine healthcare at a frequency similar to non-caregivers. Further research should determine whether this utilization is optimal, or whether increased utilization during caregiving might help attenuate caregivers' longer term morbidity.
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Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
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23
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Chan EY, Lim ZX, Ding YY, Chan YH, Lim WS. Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults. J Nutr Health Aging 2019; 23:578-585. [PMID: 31233081 PMCID: PMC6586909 DOI: 10.1007/s12603-019-1197-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/14/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Caregivers of hospitalized older adults experience elevated levels of stress and are at risk of poor health outcomes. There is a lack of screening tools based on self-reported caregiver variables incorporating both protective and risk factors, for early identification of at-risk caregivers. This study reports the development of a caregiver-centric screening tool to identify risk of depression at admission and predicts 3-month risk of depression and quality of life amongst caregivers of older adults with an unplanned admission. DESIGN, SETTING AND PARTICIPANTS This prospective cohort study was conducted in the medical wards of a tertiary-care hospital from July 2015 to May 2017. We recruited family caregivers of patients aged 65 years and above who fulfilled the following criteria: a) unplanned admission, b) not residing in nursing homes; and c) requiring assistance in activities of daily living. MEASUREMENTS We examined 11 candidate caregiver variables (mastery, burden and nine demographic variables). Risk of depression (score ≥8 on Hospital Anxiety and Depression Scale (HADS-D) depression subscale) was the primary outcome, and was assessed during the index admission. Logistic regression models were used to identify risk factors and risk scores (weights). The total risk scores were then stratified into three risk levels. Predictive validity of the screening tool was assessed using 3-months post-discharge risk of depression and health-related quality of life (HRQoL). RESULTS The study included 274 caregiver-patient dyads. The mean (SD) age of the caregivers was 59 (10) years with 33.6% caregivers screening positive for risk of depression. The final model comprised three caregiver variables: mastery, burden and education. The total risk scores ranged from 0 to 6 and showed good discrimination (AUC:0.82, 95% CI: 0.77 to 0.87). Caregivers were classified into low-risk (0-1 points), intermediate-risk (2-4 points), and high-risk (5-6 points) groups, with corresponding rates of risk of depression (HADS-D≥8) of 10.7%, 44.6% and 73.3%, during admission. Relative risk rates of the intermediate- and high- risk group using the low-risk group as reference were 4.16 and 6.84 respectively. At 3-months post-discharge, the rates of caregivers at risk of depression or having poor HRQoL also increased corresponding to the three risk levels as per baseline, supporting the predictive validity of the tool. CONCLUSIONS/IMPLICATIONS The caregiver-centric tool is a novel, practical, self-administered, relatively brief caregiver-centric instrument that can be used for rapid screening and stratification of caregivers at risk of depression. Uniquely, the tool comprised of assessment of protective factor (mastery) in addition to risk factors to provide a holistic assessment of the caregiver. It can be incorporated as part of older adults' admission evaluation so that prompt intervention can be rendered to their at-risk caregivers.
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Affiliation(s)
- E-Y Chan
- Ee-Yuee Chan, 11 Jalan Tan Tock Seng, Nursing Service, Annex 1, Tan Tock Seng Hospital, Singapore 308433, Email address: , Telephone number: (65)63573185, Fax number: (65)63578515
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24
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Eom K, Penkunas MJ, Chan AWM. Effect of caregiving relationship and formal long-term care service use on caregiver well-being. Geriatr Gerontol Int 2017; 17:1714-1721. [PMID: 28276179 DOI: 10.1111/ggi.12958] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/13/2016] [Accepted: 09/20/2016] [Indexed: 11/29/2022]
Abstract
AIM Despite efforts to revise the traditional long-term care (LTC) model, informal caregivers continue to provide a substantial amount of support to older adults as front-line care providers. The present study aimed to understand the effect of informal caregiving on caregivers' well-being in Singapore with respect to different types of patient-caregiver relationships. Second, this study examined the association between formal LTC service use and caregivers' well-being. METHODS Two waves of data for 781 dyads of patients with LTC needs and their caregivers from a longitudinal study were analyzed. Multilevel regression models were used to examine the association between caregivers' well-being (self-rated general health, stress level and quality of life) and LTC service use among different patient-caregiver relationships. RESULTS Spousal caregivers reported significantly lower quality of life compared with adult children caregivers. Non-immediate family caregivers showed better overall well-being compared with spouse and adult children caregivers. Caregivers of patients referred to nursing homes reported higher levels of stress and poorer self-rated general health compared with caregivers of patients referred to community-based services. Spouse and non-immediate family caregivers of patients who utilized nursing home or home-based services presented poorer self-rated general health than caregivers of the patients who did not use any formal services. CONCLUSIONS Developing a better understanding of the associations between well-being and formal LTC service use for different types of patient-caregiver relationships is critical for policy makers and healthcare providers who aim to create holistic systems of care. Geriatr Gerontol Int 2017; 17: 1714-1721.
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Affiliation(s)
- Kirsten Eom
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Michael J Penkunas
- Center for Aging Research and Education, Duke-NUS Medical School, Singapore
| | - Angelique W M Chan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.,Center for Aging Research and Education, Duke-NUS Medical School, Singapore.,Department of Sociology, National University of Singapore, Singapore
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25
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Ajay S, Østbye T, Malhotra R. Caregiving-related needs of family caregivers of older Singaporeans. Australas J Ageing 2017; 36:E8-E13. [PMID: 28191735 DOI: 10.1111/ajag.12370] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the extent and correlates of caregiving-related needs among family caregivers of Singaporeans aged 75+ with ≥1 activity of daily living limitations (care-recipients). METHODS National survey data of 1181 care-recipient/caregiver dyads were used. Caregiver's report (yes/no) of 16 needs was assessed. Care-recipient and caregiver correlates of each need were determined through logistic regression analysis. RESULTS Caregiving-related needs were expressed by 42.3% caregivers. The most commonly reported need was keeping care-recipient safe at home (24.5%). Needs concerned with caring for care-recipients were more frequent than those concerned with the caregiver's own needs. The most frequent correlate was care-recipient's extent of mood impairment (associated with 13 needs). CONCLUSION Caregivers should not neglect themselves when engaging in care provision. Families and service providers should explore whether reported lack of needs reflects limited awareness and/or under-reporting.
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Affiliation(s)
- Shweta Ajay
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore
| | - Truls Østbye
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore.,Duke Global Health Institute, Duke University, Durham, North Carolina, USA
| | - Rahul Malhotra
- Centre for Ageing Research and Education, Duke-NUS Medical School, Singapore, Singapore.,Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
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26
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Caregivers for older adults: Prevalence, characteristics, and health care utilization and expenditures. Geriatr Nurs 2017; 38:9-16. [DOI: 10.1016/j.gerinurse.2016.06.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 06/21/2016] [Accepted: 06/27/2016] [Indexed: 11/24/2022]
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27
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Yiengprugsawan V, Leach L, Berecki-Gisolf J, Kendig H, Harley D, Seubsman SA, Sleigh AC. Caregiving and mental health among workers: Longitudinal evidence from a large cohort of adults in Thailand. SSM Popul Health 2016; 2:149-154. [PMID: 28004031 PMCID: PMC5165045 DOI: 10.1016/j.ssmph.2016.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 01/22/2016] [Accepted: 01/25/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND As people in middle and lower income countries live longer, more people become sick, disabled, and frail and the demand for family caregiving grows. Thailand faces such challenges. This study investigates the relationship between caregiving and mental health among workers drawn from a large longitudinal cohort of Thai adults. METHODS Participants were drawn from the Thai Health-Risk Transition Study, a cohort study since 2005 of distance-learning adult Open University students residing nationwide. Caregiving status and binary psychological distress outcome (score 19-30 on Kessler 6) were recorded in 2009 and 2013 among cohort members who were paid workers at both years (n=33,972). Multivariate logistic regression was used to estimate the relationship between four-year longitudinal caregiving status and psychological distress in 2013, adjusting for potential covariates. RESULTS Longitudinal analyses revealed the transitional nature of care with 25% exiting and 10% entering the caring role during the four-year follow-up. Based on multivariate logistic regression, 2009-2013 caregiving status was significantly associated with psychological distress. Cohort members transitioning into caregiving and those who were caregivers in both 2009 and 2013 had a higher risk for psychological distress than non-caregivers (Adjusted Odds Ratios 1.40 [1.02-1.96] and 1.64 [1.16-2.33], respectively). CONCLUSION Our findings provide evidence on caregiving and associated risk for psychological distress among working Thais. This adds to the limited existing literature in middle-income countries and highlights the potential pressure among caregivers in balancing work and care while preserving their own mental health.
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Affiliation(s)
- Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health and Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia; Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Liana Leach
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
| | | | - Hal Kendig
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
| | - David Harley
- National Centre for Epidemiology and Population Health and Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
| | - Sam-Ang Seubsman
- National Centre for Epidemiology and Population Health and Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia; School of Human Ecology, Sukhothai Thammathirat Open University, Nonthaburi, Thailand
| | - Adrian C Sleigh
- National Centre for Epidemiology and Population Health and Department of Global Health, Research School of Population Health, The Australian National University, Canberra, Australia
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Mittal R, Young M, Tan CS, Chen C, Tham WY, Seong LPS, Tan TL, Koh GCH. Trends of Patients’ Characteristics Admitted Into a Multi-Professional Home Medical Care Service From 2000 to 2009 in Singapore. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822316662196] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The main aim of this study is to present the socio-demographic, clinical, and functional characteristics of home medical care patients admitted into one of the oldest home care service over a 10-year period. Data were manually retrospectively extracted from the non-computerized medical records of all patients admitted into Code 4 Home Medical Service from January 1, 2000, to December 31, 2009. Records of 1,069 patients were examined. Over the 10-year period, there was an increasing proportion of patients older than 70 years ( B [95% CI], 1.08 [0.43, 1.73]) and dependency on foreign domestic workers as primary caregivers ( B [95% CI], 4.65 [3.71, 5.58]). Cognitive impairment and functional dependency of the patients increased over the years, as assessed using Abbreviated Mental Test score < 7 ( B [95% CI], 1.73 [0.71-2.76]) and Barthel Index = 0 ( B [95% CI], 4.32 [2.74-5.91]). Knowledge about these trends may be helpful to project future demands for home medical care in Singapore.
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Affiliation(s)
- Rakhi Mittal
- National University of Singapore, Singapore
- National University Health System, Singapore
| | | | - C. S. Tan
- National University of Singapore, Singapore
- National University Health System, Singapore
| | - C. Chen
- National University of Singapore, Singapore
- National University Health System, Singapore
| | | | - Lydia P. S. Seong
- Adjunct Associate Professor, Saw Swee Hock School of Public Health, Singapore
| | | | - G. Choon-Huat Koh
- National University of Singapore, Singapore
- National University Health System, Singapore
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29
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Borman P, Gökçe-Kutsal Y, Terzioğlu F, Okumuş M, Ceceli E, Karahan S, Şenel K, Gökkaya KO, Doğan A, Eskiyurt N, Günaydin R, Eyigör S, Şahin N, Şahin M. A Multicenter Pilot Study of Burden Among Caregivers of Geriatric Rehabilitation Patients With Neuromusculoskeletal Diseases. Rehabil Nurs 2016; 42:199-209. [PMID: 27080048 DOI: 10.1002/rnj.272] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE In this study, we aimed to describe the sociodemographic characteristics of caregivers of patients in a geriatric unit and to clarify the relationship between caregiver burden and specific clinical variables in the patients and the characteristics of the caregivers. DESIGN Cross-sectional multicenter study. METHODS One hundred twenty-three patients and 123 caregiver dyads, with mean ages of 72.5 ± 7.7 years and 51 ± 14.7 years, respectively, were included. The functional, psychological, and cognitive statuses of the patients were determined, and the sociodemographic characteristics of the caregivers as well as the type and duration of caregiving were recorded. Caregivers completed the Caregiver Burden Inventory (CBI) to measure the perceived burden of care. Most patients were female and generally lived with their family. FINDINGS Most of the caregivers were family members (90%), female (73.2%), primary school graduates (52.8%), and first-degree relatives (73.1%). The average CBI score was 33, and the highest CBI subscores were for time, developmental, and physical burdens. Caregiver burden correlated with the patient's ambulatory, psychological, and cognitive status and with the caregiver's age, gender, income level, and duration of caregiving. CONCLUSIONS We have highlighted the relationship between caregiver and patient characteristics in a cohort of elderly Turkish patients with neurological and musculoskeletal disorders. In particular, we have highlighted the heavy caregiver burden in a developing country. CLINICAL RELEVANCE Our results may guide the nurses to understand the requirements of caregivers and to help them find suitable resources that would meet their needs to cope with their burden.
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Affiliation(s)
- Pinar Borman
- 1 Department of Physical Medicine and Rehabilitation, Medical Faculty, Hacettepe University, Ankara, Turkey2 Faculty of Nursing, Hacettepe University, Ankara, Turkey3 Department of Physical Medicine and Rehabilitation, Medical Faculty, Kirikkale University, Kirikkale, Turkey4 Department of Bio-Statistics, Medical Faculty, Hacettepe University, Ankara, Turkey5 Department of Physical Medicine and Rehabilitation, Medical Faculty, Erzurum University, Erzurum, Turkey6 Clinic of Physical Medicine and Rehabilitation, Ankara Rehabilitation Training and Research Hospital, Ankara, Turkey7 Department of Physical Medicine and Rehabilitation, Medical Faculty, Istanbul University, Istanbul, Turkey8 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ordu University, Ordu, Turkey9 Department of Physical Medicine and Rehabilitation, Medical Faculty, Ege University, Izmir, Turkey10 Department of Physical Medicine and Rehabilitation, Medical Faculty, Balikesir University, Balikesir, Turkey
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Chang S, Zhang Y, Jeyagurunathan A, Lau YW, Sagayadevan V, Chong SA, Subramaniam M. Providing care to relatives with mental illness: reactions and distress among primary informal caregivers. BMC Psychiatry 2016; 16:80. [PMID: 27016185 PMCID: PMC4807582 DOI: 10.1186/s12888-016-0786-9] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 03/18/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The responsibility of caring for relatives with mental illness often falls on the family members. It has been reported that the reactions to or consequences of providing care are what rendered the role of a caregiver challenging and hence a source of distress. This present study thus aimed to identify socio-demographic correlates of caregiving experiences using the Caregiver Reaction Assessment (CRA) and to examine the associations between reactions to caregiving and psychological distress. METHODS A total of 350 caregivers with relatives seeking outpatient care at a tertiary psychiatric hospital were recruited for this study. Distress among caregivers was assessed using the Patient Health Questionnaire (PHQ-9). The CRA was administered to measure reactions from caregiving in four domains including impact on schedule and health (ISH), impact on finance (IF), lack of family support (LFS) and caregiver esteem (CE). Participants also completed a questionnaire that asked for their socio-demographic information. Multivariable linear regression analysis was first used with domains of CRA as outcome variables and socio-demographic variables as predictors in the models. The next set of multivariable linear regression analysis tested for the association between CRA domains and distress with CRA domain scores as outcome variables and PHQ-9 score as predictor, controlling for socio-demographic variables. RESULTS Socio-demographic correlates of CRA domains identified were age, education, employment, income and ethnicity. Domain scores of CRA were significantly associated with PHQ-9 score even after controlling for socio-demographic variables. A higher distress score was associated with greater impact felt in the domain of ISH (β = 0.080, P < 0.001), IF (β = 0.064, P < 0.001), and LFS (β = 0.057, P < 0.001), and was associated with lower CE domain scores (β = -0.021, P < 0.05). CONCLUSION This study identified several socio-demographic correlates of caregiving reaction in the different domains. Each of these domains was found to be significantly associated with caregiver distress. Higher distress was associated with stronger impact on the negative domains and a lower impact in the positive domain of caregiving reaction. Interventions such as educational programs at the caregiver level, and also promoting wider social care support in these domains may help to address caregiver distress.
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Affiliation(s)
- Sherilyn Chang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747, Singapore.
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Anitha Jeyagurunathan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Ying Wen Lau
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Vathsala Sagayadevan
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, 10 Buangkok View, Singapore, 539747 Singapore
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Penkunas MJ, Chan AWM, Wong CH, de Korne DF, Tan SM, Wong SF. The Role of a Multicomponent Home-Health Intervention in Reducing Caregiver Stress in Singapore: A Qualitative Study. J Gerontol B Psychol Sci Soc Sci 2016; 73:314-325. [DOI: 10.1093/geronb/gbw008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 01/16/2016] [Indexed: 11/14/2022] Open
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Mahendran R, Tan JYS, Griva K, Lim HA, Ng HY, Chua J, Lim SE, Kua EH. A pilot, quasi-experimental, mixed methods investigation into the efficacy of a group psychotherapy intervention for caregivers of outpatients with cancer: the COPE study protocol. BMJ Open 2015; 5:e008527. [PMID: 26586322 PMCID: PMC4654340 DOI: 10.1136/bmjopen-2015-008527] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Despite the rising trend of cancer prevalence and increase in family caregiving, little attention has been paid to the efficacy of psychosocial interventions among Asian caregiver samples, particularly support groups, given the benefits that have been shown in studies on Western populations. This trial aims to evaluate the effectiveness of a pilot 4-week group psychotherapy for Singaporean family caregivers of patients receiving outpatient care. METHODS AND ANALYSIS Facilitated by a clinical psychologist, this intervention is primarily based on the brief integrative psychological therapy with a supportive-expressive intent. Participants will be recruited while they are accompanying their care recipients for outpatient consultations. Since this is a pilot study, a sample size of 120 participants is targeted on the basis of sample sizes of previous studies. The study adopts a quasi-experimental design, as participants are assigned the intervention or control arms based on their availability to attend the intervention. A mixed methods approach is used to evaluate the outcomes of the intervention. A self-administered battery of tests is completed at four time points: baseline, postintervention and follow-up at 1-month and 2-month postinterventions; semi-structured interviews are conducted at baseline and post-intervention. Primary outcomes are quality of life and anxious and depressive symptoms; secondary outcomes are stress and basic psychological needs. Analysis using analysis of covariance would be conducted to determine the effectiveness of the intervention. ETHICS AND DISSEMINATION This study protocol has ethics approval from the National Healthcare Group Domain Specific Review Board (NHG DSRB Ref: 2013/00662). Written informed consent is obtained from every participant. Results will be disseminated through journals and conferences, and will be particularly relevant for clinicians intending to implement similar support groups to address the psychosocial concerns of caregivers, as well as for researchers seeking to refine the structure and evaluate the effectiveness of such programmes. TRIAL REGISTRATION NUMBER Current Controlled Trials NCT02120183 (https://clinicaltrials.gov/show/NCT02120183).
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Affiliation(s)
- Rathi Mahendran
- Department of Psychological Medicine, National University Hospital, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Joyce Yi Siang Tan
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Konstadina Griva
- Department of Psychology, National University of Singapore, Singapore
| | - Haikel Asyraf Lim
- Department of Psychological Medicine, National University of Singapore, Singapore
- Duke-NUS Graduate Medical School, Singapore, Singapore
| | - Hui Ying Ng
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Joanne Chua
- Department of Psychological Medicine, National University Hospital, Singapore
| | - Siew Eng Lim
- National University Cancer Institute, Singapore, National University Health System, Singapore
| | - Ee Heok Kua
- Department of Psychological Medicine, National University Hospital, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore
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Bremer P, Cabrera E, Leino-Kilpi H, Lethin C, Saks K, Sutcliffe C, Soto M, Zwakhalen SM, Wübker A. Informal dementia care: Consequences for caregivers’ health and health care use in 8 European countries. Health Policy 2015; 119:1459-71. [DOI: 10.1016/j.healthpol.2015.09.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2014] [Revised: 09/23/2015] [Accepted: 09/30/2015] [Indexed: 11/29/2022]
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Berglund E, Lytsy P, Westerling R. Health and wellbeing in informal caregivers and non-caregivers: a comparative cross-sectional study of the Swedish general population. Health Qual Life Outcomes 2015. [PMID: 26216099 PMCID: PMC4517403 DOI: 10.1186/s12955-015-0309-2] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Background Informal caregiving by relatives is a great resource for individuals as well as for society, but the caregiving role is associated with health problems for the caregiver. This study aimed to compare caregivers’ self-rated health, number of recent days with poor health and psychological wellbeing with that of non-caregivers in a general Swedish population. Methods From 2004 to 2013, 90,845 Swedish people completed a postal questionnaire about their health, number of recent days with poor health during last month, psychological wellbeing and if they were performing caregiving or not. Descriptive statistics, chi-square analysis, ANOVA, logistic regressions and negative binomial regression models were used to investigate associations between being a caregiver or not and health and wellbeing. Negative binomial regression was used to assess the relation between caregiver status and recent days with poor health or functioning. Results Eleven percent reported having a caregiving role. Caregivers reported poorer self-rated health compered to non-caregivers, also in adjusted models; odds ratio (OR): 1.07 with a 95 % confidence interval (CI): 1.01-1.13. Caregivers also reported lower psychological wellbeing compared to non-caregivers; OR: 1.22, CI: 1.15-1.30. Caregiving status was associated with more recent days with poor physical health and more recent days with poor mental health. Conclusions This study suggests that caregivers have worse perceptions in self-rated health and psychological wellbeing compared with non-caregivers, indicating that the role of caregiver is adversely associated with health. This association also appears in terms of reporting days of poor health in the last month. The underlying mechanism of these associations, including the potential detrimental health effects of being a caregiver, needs to be investigated in longitudinal studies.
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Affiliation(s)
- Erik Berglund
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden.
| | - Per Lytsy
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
| | - Ragnar Westerling
- Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden
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Wee SL, Liu C, Goh SN, Chong WF, Aravindhan A, Chan A. Determinants of use of community-based long-term care services. J Am Geriatr Soc 2014; 62:1801-3. [PMID: 25243689 DOI: 10.1111/jgs.13003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Shiou-Liang Wee
- Geriatric Education and Research Institute, Alexandra Health System, Singapore; Duke-National University of Singapore Graduate Medical School, Singapore
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Liu G, Dupre ME. Health Trajectories of Women in China: The Role of Parental Caregiving. J Gerontol B Psychol Sci Soc Sci 2014; 71:320-31. [DOI: 10.1093/geronb/gbu144] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2013] [Accepted: 09/09/2014] [Indexed: 11/13/2022] Open
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