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Marchetti D, Sawrikar V. Parents' illness representations of their child with anorexia nervosa: A systematic review of qualitative studies using the common-sense model. Int J Eat Disord 2024; 57:1049-1068. [PMID: 37916901 DOI: 10.1002/eat.24081] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVE Research indicates that parents experience distress while caring for a child with anorexia nervosa. Applying the Common Sense Model of Self-Regulation (CSM), a framework to describe responses to illness may help to understand the antecedents of parental distress, which could inform how to support parents in treatment. The aim of this systematic review was to synthesize outcomes from qualitative research in relation to parents' experiences of caring for a child with anorexia nervosa using the CSM. METHOD Systematic search of four electronic databases (psychINFO, MEDLINE, EMBASE, ProQuest Dissertation, and Theses Database) alongside a two-way screening process was used to identify eligible studies. Qualitative themes were synthesized using a "best fit" framework analysis and reported according to CSM dimensions of cognitive and emotional illness representations. RESULTS A total of 32 studies published between 1970 and 2023 were eligible for inclusion for review. Parents perceived their child's anorexia nervosa as a major health threat observable by illness representations that anorexia nervosa was uncontrollable, incomprehensible, chronic, and associated with negative consequences. The themes also suggested parents take responsibility for causing anorexia nervosa. These illness representations were linked with emotional representations of fear, anxiety, shame, guilt, loneliness, and depression. CONCLUSIONS The findings provide evidence of the utility of using the CSM to understand the antecedents of parents' distress and negative impacts of caring for a child with anorexia nervosa. Recommendations for future research and clinical practice are discussed emphasizing the need to understand parents' perceptions of their child's illness to putatively maximize treatment benefits for families. PUBLIC SIGNIFICANCE This review emphasizes the salience of understanding parents distress while caring for a child with anorexia nervosa. The findings present opportunities to best support parents in treatment, with a focus on addressing their cognitive and emotional representations of their child's illness. A multicomponent treatment regimen may be required to support parents if they present with illness representations that negatively affect their well-being and ability to cope with distress.
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Affiliation(s)
- Doriana Marchetti
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
- Department of Clinical Psychology, NHS Grampian, UK
| | - Vilas Sawrikar
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
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2
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Wang H, Cui H, Wang M, Yang C. What You Believe Can Affect How You Feel: Anger Among Caregivers of Elderly People With Dementia. Front Psychiatry 2021; 12:633730. [PMID: 33897493 PMCID: PMC8058189 DOI: 10.3389/fpsyt.2021.633730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 03/08/2021] [Indexed: 11/24/2022] Open
Abstract
Background and Purpose: Anger has been recognized as a commonly experienced emotion among caregivers of elderly people with dementia. While several cognitive behavioral therapy (CBT)-based intervening methods have been developed, limited research has systematically examined the associations between dementia-related cognition and caregiving anger. Currently, we focused on three representative and well-studied cognitive constructs, person-centered attitude (PCA), dementia representation (DR), and empathy, exploring how they related to caregiving anger. Methods & Results: In total, 327 caregivers (239 female) participated in the study and finished online questionnaires. Multi-variable regression analyzes showed that PCA (βPCA = -0.22**) and empathy (βempathy = -0.18**) could negatively predict caregiving anger. However, all DR dimensions had no influence on caregiving anger except coherence (βcoherence = -0.24**) in the current study. Conclusion: Generally, lower caregiving anger was associated with: (1) being more empathic; (2) having a person-centered attitude; and (3) having a comprehensive understanding of dementia. The results of this study provide detailed suggestions for the development of anger management programs for caregivers of people with dementia.
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Affiliation(s)
- Haoran Wang
- Dalian Seventh People's Hospital, Dalian, China
| | - Hongmei Cui
- Qindao Mental Health Center, Qingdao University, Qingdao, China
| | - Meng Wang
- Qindao Mental Health Center, Qingdao University, Qingdao, China
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3
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Villaseñor T, Perrin PB, Donovan EK, McKee GB, Henry RS, Dzierzewski JM, Lageman SK. Parkinson's family dynamics and caregiver sense of coherence: A family-systems approach to coping in Mexico and the United States. Aging Med (Milton) 2020; 3:252-259. [PMID: 33392431 PMCID: PMC7771559 DOI: 10.1002/agm2.12130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 09/22/2020] [Accepted: 09/23/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE The population of individuals with Parkinson's disease (PD) is growing in Mexico and the United States, and there is an increasing need for family members to provide caregiving. This study examined the connections between family dynamics and coping, or sense of coherence, among PD caregivers in Mexico (n = 148) and the United States (n = 105). METHODS Caregivers completed measures of family dynamics and sense of coherence across indices of comprehensibility, manageability, and meaningfulness. RESULTS Although caregivers in Mexico and the United States had similar levels of sense of coherence and family dynamics reflecting strengths/adaptability and being overwhelmed with difficulties, caregivers in Mexico had worse disrupted communication. Family dynamics explained: 24.2% of the variance in caregiver comprehensibility in the United States and 17.5% in Mexico; 34.1% in manageability in the United States and 23.5% in Mexico; and 22.6% in meaningfulness in the United States and 22.7% in Mexico (all Ps < 0.001). In both Mexico and the United States, family strengths/adaptability uniquely predicted caregiver comprehensibility, manageability, and meaningfulness. Being overwhelmed with difficulties uniquely predicted comprehensibility in Mexico and manageability and meaningfulness in the United States. CONCLUSION The development of family-systems interventions for PD caregivers to improve family strengths/adaptability and help families deal with difficulties may increase caregiver coping.
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Affiliation(s)
- Teresita Villaseñor
- Hospital Civil Fray Antonio AlcaldeGuadalajaraJaliscoMexico
- Neurosciences DepartmentUniversity of GuadalajaraGuadalajaraJaliscoMexico
| | - Paul B. Perrin
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUnited States
- Department of Physical Medicine and RehabilitationVirginia Commonwealth UniversityRichmondVirginiaUnited States
| | - Emily K. Donovan
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUnited States
| | - Grace B. McKee
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUnited States
- Hunter Holmes McGuire Veterans Affairs Medical CenterMid‐Atlantic Mental Illness Research Education and Clinical CenterCentral Virginia VA Health Care SystemRichmondVirginiaUnited States
| | - Richard S. Henry
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUnited States
| | - Joseph M. Dzierzewski
- Department of PsychologyVirginia Commonwealth UniversityRichmondVirginiaUnited States
| | - Sarah K. Lageman
- Department of NeurologyParkinson’s & Movement Disorders CenterVirginia Commonwealth UniversityRichmondVirginiaUnited States
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Turró-Garriga O, Viñas-Díez V, Conde-Sala JL, Calvó-Perxas L, Cullell-Juncà M, Mas-Vall-Llosera G, Flaqué M, Turon-Estrada A, Juvinyà-Canal D, Mioshi E, Garre-Olmo J. Caregivers' Sense of Coherence: Implications on Direct and Indirect Costs of Dementia Care. J Alzheimers Dis 2020; 78:117-126. [PMID: 32925037 DOI: 10.3233/jad-200350] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dementia care is associated with physical, emotional, and monetary impact on the informal carers providing unpaid care. Differences in the personal characteristics of caregivers may help explain the variations in the costs of dementia care. OBJECTIVE The aim of this study was to analyze the effect of caregivers' sense of coherence (SOC) on direct and indirect costs in dementia care. METHODS A cross-sectional study was conducted in community dwelling caregivers of patients with Alzheimer's disease. Data of healthcare services were obtained from clinical registries, and information was collected from caregivers regarding their use of social care resources and time spent caregiving. The transformation of all costs into Euros was made assigning a fixed cost of 10.29 € /h and 16.24 € /h for assisting in instrumental and basic activities of daily living, respectively. Caregivers' SOC was assessed using the Orientation to Life Questionnaire (OLQ-13). Adjusted regression models were developed, with different types of costs as dependent variables. RESULTS A sample of 147 caregivers was recruited. The mean OLQ-13 score was 73.3 points (SD = 11.6). The regression models showed a small association between caregivers' SOC and direct costs, mainly linked to the use of social care resources (r2 = 0.429; β= -15.6 € /month), and a greater association between SOC and indirect costs (r2 = 0.562; β= -222.3 € /month). CONCLUSION Increasing caregivers' SOC could reduce dementia care costs by decreasing the use of social care resources and caregiving time.
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Affiliation(s)
- Oriol Turró-Garriga
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia.,Registry of Dementia of Girona (ReDeGi), Institut d'Assistència Sanitària, Salt, Catalonia
| | - Vanesa Viñas-Díez
- Faculty of Psychology, University of Barcelona, Barcelona, Catalonia
| | - Josep Lluís Conde-Sala
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia.,Faculty of Psychology, University of Barcelona, Barcelona, Catalonia
| | - Laia Calvó-Perxas
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
| | - Marta Cullell-Juncà
- Centre Socio Sanitari Bernat Jaume, Fundació Salut Empordà, Figueres, Catalonia
| | | | - Margarida Flaqué
- Centre Socio Sanitari Palamós Gent Gran, Serveis Sanitaris Integrats del Baix Empordà, Palamós, Catalonia
| | - Antoni Turon-Estrada
- Registry of Dementia of Girona (ReDeGi), Institut d'Assistència Sanitària, Salt, Catalonia
| | | | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Josep Garre-Olmo
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia.,Registry of Dementia of Girona (ReDeGi), Institut d'Assistència Sanitària, Salt, Catalonia.,Department of Medical Sciences, University of Girona, Girona, Catalonia
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Kampanellou E, Wilberforce M, Worden A, Giebel C, Challis D, Bhui K. The Barts Explanatory Model Inventory for Dementia: An item reduction approach based on responses from South Asian communities. Int J Geriatr Psychiatry 2020; 35:916-925. [PMID: 32337760 DOI: 10.1002/gps.5313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 03/26/2020] [Accepted: 04/09/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Cultural differences in how the symptoms, causes, consequences, and treatments of dementia are understood and interpreted by South Asian people are a commonly expressed reason for late- or nonuse of mental health and care services. However, systematic collection of information on South Asian perceptions of dementia is hindered by a lack of appropriate instrumentation. OBJECTIVES To produce a shortened version of the Barts Explanatory Model Inventory for Dementia (BEMI-D) schedule. METHODS A two stage item reduction approach was employed first using multidimensional scaling categorizing items as core, intermediate, or outlier. Then, item review was undertaken using three criteria: literature importance, clinical face validity, and sub-group prevalence. The analysis followed a nonmetric multidimensional scaling method based on a two-way proximity matrix. RESULTS The original BEMI-D had 197 items allocated to four checklists: symptoms, causes, consequences, and treatments. The two stage item reduction approach resulted in the removal of 75 items. These reductions were achieved across all four checklists in relatively equal proportions. There was no evidence of substantive content loss in the revised schedule. The reduced version of the schedule comprises 122 items. CONCLUSIONS A condensed version of the BEMI-D is more efficient as an assessment schedule that captures the culturally diverse perceptions of memory problems for South Asians offering a balanced trade-off between feasibility of use and content validity.
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Affiliation(s)
| | | | - Angela Worden
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Clarissa Giebel
- Institute of Population Health Sciences, University of Liverpool, Liverpool, UK.,NIHR ARC NWC, Liverpool, UK
| | - David Challis
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Kamaldeep Bhui
- Centre for Psychiatry, Queen Mary University of London, London, UK
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Quinn C, Jones IR, Martyr A, Nelis SM, Morris RG, Clare L. Caregivers’ beliefs about dementia: findings from the IDEAL study. Psychol Health 2019; 34:1214-1230. [DOI: 10.1080/08870446.2019.1597098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Catherine Quinn
- Centre of Applied Dementia Research, Faculty of Health Studies, University of Bradford, Bradford, West Yorkshire, UK
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, St Luke’s Campus, Exeter, UK
| | - Ian Rees Jones
- Wales Institute for Social and Economic Research, Data and Methods, Cardiff University, Cardiff, UK
| | - Anthony Martyr
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, St Luke’s Campus, Exeter, UK
| | - Sharon M. Nelis
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, St Luke’s Campus, Exeter, UK
| | - Robin G. Morris
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter, St Luke’s Campus, Exeter, UK
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Abstract
As the number of persons with dementia grows, an increasing number of families, professionals, and laypersons will come into contact with persons with cognitive deterioration. Assessing dementia illness representations (IRs) among these groups may have great importance for understanding their responses to dementia. The purpose of this study was to summarize and critically review the literature on dementia IRs. A total of 25 articles that satisfied the inclusion criteria were identified. The review revealed that conceptually, research attention on dementia IRs has increased over the past several years as a result of changes in the notion of IRs and in the dementia discourse. Regardless of the population examined, dementia was mostly described as a chronic condition, presenting more cognitive than behavioral symptoms, and as being caused mainly by age, heredity, and abnormal brain changes. Methodologically, the area of dementia IRs is characterized by design, sample, and data collection weaknesses. Findings suggest that although the literature in the area of dementia and IRs is increasing, several conceptual and methodological limitations still have to be resolved in order to advance knowledge in the area. The research and clinical implications of these findings stress the importance of IRs in the area of dementia.
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Affiliation(s)
- Shiri Shinan-Altman
- The Louis and Gabi Weisfeld School of Social Work, Faculty of Social Sciences, Bar Ilan University, Ramat Gan, Israel,
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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8
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Del-Pino-Casado R, Espinosa-Medina A, López-Martínez C, Orgeta V. Sense of coherence, burden and mental health in caregiving: A systematic review and meta-analysis. J Affect Disord 2019; 242:14-21. [PMID: 30170234 DOI: 10.1016/j.jad.2018.08.002] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Revised: 05/17/2018] [Accepted: 08/01/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Informal caregiving is associated with a number of negative effects on carers' physical and psychological well-being. The salutogenic theory argues that sense of coherence (SOC) is an important factor in psychological adjustment to stress. The main aim of this study was to systematically review current evidence on the association between SOC, burden and mental health outcomes in informal carers. METHOD A systematic search was carried out up to September 2017 in the following databases: PubMed, CINAHL (EBSCO), PsychInfo (OVID) and Scopus. Studies were included if they evaluated the relationship between sense of coherence and subjective caregiver burden and/or mental health outcomes, specifically symptoms of depression and anxiety. Meta-analyses were performed and subgroup analyses were carried out to explore if methodological factors influenced findings. RESULTS Thirty-five studies were included in the meta-analysis, which provided 40 independent samples with 22 independent comparisons for subjective caregiver burden, 26 for symptoms of depression and 7 for symptoms of anxiety. Higher levels of SOC were associated with lower levels of subjective caregiver burden and better mental health outcomes. Publication bias did not change the estimate of the effect. LIMITATIONS Most of the studies included in this review were cross-sectional. CONCLUSIONS Findings suggest that SOC is an important determinant of carer well-being and may protect carers from high levels of psychological distress and caregiver burden.
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Affiliation(s)
| | | | | | - Vasiliki Orgeta
- Division of Psychiatry, University College London, United Kingdom
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9
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Rayment G, Swainston K, Wilson G. Using photo-elicitation to explore the lived experience of informal caregivers of individuals living with dementia. Br J Health Psychol 2018; 24:102-122. [PMID: 30294928 DOI: 10.1111/bjhp.12342] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 08/28/2018] [Indexed: 12/24/2022]
Abstract
OBJECTIVES This study aims to explore the subjective lived experience of informal caregivers supporting an individual with dementia. DESIGN This study uses the interpretive phenomenological approach utilizing the method of photo-elicitation and in-depth semi-structured interviews. METHODS Six individuals were given a disposable camera to capture photographs which they felt illustrated their own lived experiences of being a caregiver of an individual living with dementia. Photographs were printed and used to form discussion within an in-depth semi-structured interview. The photographs provided an innovative way of capturing the lived experiences of formal dementia caregivers and allowed the interview data to be grounded in their daily living, centring around their own lived experiences. RESULTS Three themes emerged from data analysis: 'conceptualising the role of informal caregiver', 'support for the informal caregiver', and 'the caregivers own needs'. CONCLUSIONS Findings demonstrated the complexity of the relationship between the caregiver and the person living with dementia, and the shift in this relationship specifically due to the role of carer, with notable differences between spousal caregivers and adult-child caregivers. The importance of social, emotional, and practical support for caregivers was highlighted, as well as significance of the caregiver's individual needs. Statement of contribution What is already known on this subject? Informal caregivers of individuals living with dementia cover much of the associated health care costs. Informal caregiving of individuals living with dementia can lead to negative health outcomes of the carer. Health outcomes of informal caregivers living with dementia are grounded in culture and are influenced by multiple factors. What does this study add? The complexity of the transition from family member to informal caregiver has both a physical and emotional impact on caregivers. The transition, and experiences of informal caregiving, is dependent on the relationship to the individual living with dementia. Caregiver support and recognizing the caregiver's individual needs were imperative to caregiver well-being.
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Affiliation(s)
- Georgie Rayment
- West Lothian Psychological Approach Team for Dementia (WeLPAT), St John's hospital, NHS Lothian, Edinburgh, UK
| | - Katherine Swainston
- School of Social Sciences, Business and Law, Teesside University, Middlesbrough, UK
| | - Gemma Wilson
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle-upon-Tyne, UK
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10
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López-Martínez C, Frías-Osuna A, Del-Pino-Casado R. [Sense of coherence and subjective overload, anxiety and depression in caregivers of elderly relatives]. GACETA SANITARIA 2017; 33:185-190. [PMID: 29174275 DOI: 10.1016/j.gaceta.2017.09.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Revised: 07/07/2017] [Accepted: 09/22/2017] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To analyze the relationship between the sense of coherence and subjective overload, anxiety and depression in caregivers of dependent elderly relatives. METHOD Cross-sectional study in an area of the province of Jaén (Andalusia, Spain) with a probabilistic sample of 132 caregivers of dependent elderly. MAIN MEASURES sense of coherence (Life Orientation Questionnaire), subjective burden (Caregiver Strain Index), anxiety and depression (Goldberg Scale), objective burden (Dedication to Care Scale), sex and kinship. Main analyses: bivariate analysis using the Pearson correlation coefficient and multivariate analysis using multiple linear regression. RESULTS Most of the caregivers studied were women (86.4%), daughter or son of the care recipient (74.2%) and shared home with the latter (69.7%). When controlling for objective burden, sex and kinship, we found that the sense of coherence was inversely related to subjective burden (β = -0.46; p <0.001), anxiety (β = -0.57; p = 0.001) and depression (β = -0.66; p <0.001). CONCLUSIONS The sense of coherence might be an important protective factor of subjective burden, anxiety and depression in caregivers of dependent elderly relatives.
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11
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Characteristics and Correlates of Caregivers' Perceptions of Their Family Members' Memory Loss. Nurs Res 2017; 66:240-245. [PMID: 28448374 DOI: 10.1097/nnr.0000000000000220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Understanding caregiver's perceptions of their family member's memory loss is a necessary step in planning nursing interventions to detect and address caregiver burden. OBJECTIVE The purpose of this study was to characterize caregivers' perceptions of their family members' memory loss and identify potential correlates within Leventhal's common sense model (CSM). METHODS This secondary analysis used baseline data from a larger randomized controlled trial. Patients with memory loss and their caregivers (N = 83 dyads) from the community were included. The adapted Brief Illness Perception Questionnaire (BIPQ) assessed caregivers' illness perceptions. Eight additional instruments measured correlates within the CSM. Responses were described; multiple linear regression was used to predict BIPQ dimension scores, and logistic regression was used to predict dichotomized BIPQ scores. RESULTS Most caregivers were female, White, and spouses of the patients; they reported a range of perceptions on the nine BIPQ dimensions. Patients' cognitive function consistently emerged as a significant correlate of caregivers' illness perceptions, explaining the most variance in caregivers' perceived consequences, identity, and treatment control (p < .01). Caregivers' reactions to patients' behavioral symptoms and caregivers' trait anxiety were associated with perceived illness coherence (p < .01). Caregivers with higher severity of daily hassles and White caregivers perceived that their family members' memory loss would last longer (p < .001). DISCUSSION Caregivers' perceptions of family members' memory loss varied; distinct dimensions of caregivers' illness perception were associated with a range of clinical and psychosocial factors. This exploratory study demonstrates the complexity of applying the CSM to caregivers of persons with memory loss.
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Cañabate P, Martínez G, Rosende-Roca M, Moreno M, Preckler S, Valero S, Sotolongo O, Hernández I, Alegret M, Ortega G, Espinosa A, Mauleón A, Vargas L, Rodríguez O, Abdelnour C, Sánchez D, Martín E, Ruiz A, Tárraga L, Boada M. Social Representation of Dementia: An Analysis of 5,792 Consecutive Cases Evaluated in a Memory Clinic. J Alzheimers Dis 2017; 58:1099-1108. [PMID: 28527206 PMCID: PMC5523907 DOI: 10.3233/jad-161119] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Different interpretations of cognitive impairment and dementia due to differences in health structures, such as cultural differences could affect the diagnosis and treatment of the condition. it is reasonable to expect that the social and family impact of the disease and coping strategies will differ among societies. OBJECTIVE The general aim of this study is to understand the social representations of dementia, its associated practices, and the effects they imply. METHODS People diagnosed with clinical dementia and their families were assessed from 2005 to 2015 in the memory clinic of the Fundació ACE, Institut Català de Neurociències Aplicades in Barcelona, Spain. RESULTS 9,898 people were examined and 5,792 were diagnosed with dementia. For those with a caregiver (71%), the decision-making fell on the person with dementia in 16.2% of the cases; and for those without a caregiver, in 26.4% of the cases the family did not perceive the deficits as a disease, which led to multiple risk situations (74.6%). CONCLUSIONS The recognition of dementia as part of aging is common among families. Consequently, risk situations may arise and diagnosis and access to treatment may be delayed. The incorporation of a social appraisal to the diagnostic process is a necessity to evaluate these situations.
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Affiliation(s)
- Pilar Cañabate
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Gabriel Martínez
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
- Iberoamerican Cochrane Centre, Barcelona, Spain
- Faculty of Medicine and Dentistry, University of Antofagasta, Antofagasta, Chile
| | - Maitée Rosende-Roca
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Mariola Moreno
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Silvia Preckler
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Sergi Valero
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, CIBERSAM, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Oscar Sotolongo
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Isabel Hernández
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Montserrat Alegret
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Gemma Ortega
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Ana Espinosa
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Ana Mauleón
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Liliana Vargas
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Octavio Rodríguez
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Carla Abdelnour
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Domingo Sánchez
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Elvira Martín
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Agustín Ruiz
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Lluís Tárraga
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
| | - Mercè Boada
- Memory Clinic and Research Center of Fundació ACE. Institut Català de Neurociènces Aplicades, Barcelona, Spain
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