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Turró-Garriga O, Viñas-Díez V, Zacarias-Pons L, Conde-Sala JL, Garre-Olmo J. Longitudinal effect of dementia carers' sense of coherence on burden. Int J Geriatr Psychiatry 2022; 37. [PMID: 35932155 DOI: 10.1002/gps.5784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/11/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND A sense of coherence (SOC) could help us better understand why there are individuals who cope better than others in similar situations. The study aimed to assess the effect of SOC on the course of burden reports in relatives of persons with dementia. METHODS This was a prospective cohort study of 156 dementia carers. The SOC was assessed by the Orientation to Life Questionnaire (OLQ-13), burden by Burden Interview, and personal and contextual characteristics were collected via ad hoc questions. The main dementia symptoms, including functional difficulties (Disability Assessment for Dementia), neuropsychiatric symptoms (Neuropsychiatric Inventory), and cognitive impairment (Mini-Mental State Examination), were also assessed. A general linear model was adjusted to determine the effect of SOC and other covariates on burden throughout the follow-up. Burden differences between baseline and 12 and 24 months were analysed, and the baseline OLQ-13 score was grouped by quartiles. RESULTS The global burden reported increased after 24 months (F = 9.98; df = 2; p < 0.001), but not equally for all carers; daughters reported the greatest increase. SOC, functional disability, and neuropsychiatric disorders showed a significant effect on burden, but time did not. Carers with higher SOC at baseline tend to remain with lower burden levels, whereas carers with low SOC reported higher burden at each visit. CONCLUSIONS This study reports evidence of the effect of SOC on burden at baseline, 12 and 24 months of follow-up. Burden scores differ by carers' SOC; those with higher SOC showed lower burden levels, whereas the low-SOC group reported a greater burden at each visit.
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Affiliation(s)
- Oriol Turró-Garriga
- Research Institute, Fundació Salut Empordà, Figueres, Catalonia
- 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
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
| | - Lluís Zacarias-Pons
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, 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
| | - 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
- Serra Hunter Fellow, Department of Nursing, University of Girona, Girona, Catalonia
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Cartwright AV, Pione RD, Stoner CR, Spector A. Validation of the multidimensional scale of perceived social support (MSPSS) for family caregivers of people with dementia. Aging Ment Health 2022; 26:286-293. [PMID: 33300365 DOI: 10.1080/13607863.2020.1857699] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND OBJECTIVES The Multidimensional Scale of Perceived Social Support (MSPSS) is a measure of perceived adequacy of social support. Whilst this is an important area of research for family caregivers of people with dementia, it is not clear whether the MSPSS retains its psychometric properties when used with this population. The aim was to conduct an in-depth psychometric analysis of the MSPSS to ensure that it remains a psychometrically robust measure for this population. RESEARCH DESIGN AND METHODS Participants completed measures online using a self-complete procedure. A subsample completed the MSPSS twice, within a 4-week period. Properties assessed were internal consistency, floor and ceiling effects, test-retest reliability, convergent validity and factor structure. RESULTS 270 participants completed the study and 58 comprised the test-retest sample. Internal consistency was excellent for the total score (α = 0.92) and three subscales (α = 0.92-0.94). Significant correlations were observed in the expected directions with depression (r = -.48, p < .001) and mental (r = 0.32, p<.001) and physical (r = 0.17, p=.003) health-related quality of life. Test re-test reliability was excellent for the total score (ICC = 0.90 95%CI = 0.84, 0.94) and subscale scores (ICC = 0.84-0.89). Confirmatory factor analysis indicated acceptable fit indices for the three-factor solution. DISCUSSION AND IMPLICATIONS The MSPSS has robust psychometric properties when used with caregivers of people with dementia and may be recommended for use with this population. Further research is required to establish responsiveness and determine cross-cultural validity.
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Affiliation(s)
- Anna V Cartwright
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Richard D Pione
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Charlotte R Stoner
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
| | - Aimee Spector
- Research Department of Clinical, Educational and Health Psychology, University College London (UCL), London, UK
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3
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Alcañiz-Garrán M, García-Sanjuán S, Ramos-Pichardo JD, Sanjuán-Quiles A, Montejano-Lozoya R. The experiences of older individuals providing care to older dependents: A phenomenological study in Spain. PLoS One 2021; 16:e0255600. [PMID: 34351991 PMCID: PMC8341577 DOI: 10.1371/journal.pone.0255600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 07/19/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Non-professional care provided in domestic settings by a family member or someone from the close environment and without a connection to a professional care service, is increasingly assumed by older people, mainly the spouses of those requiring care. The aim of this study was to describe the experience of older people providing care at home to older dependents. Methods A qualitative study was carried out to describe and explore the experience of older people, caregivers of dependent older people in the home. Results Four themes emerged as a result of the analysis: interpersonal relationships established in the caregivers’ immediate environment; the need and request for public and private resources; consequences of providing care during old age; and adaptation to the circumstance of being a caregiver during old age. Older people who provide home-based care, experience their situation as stressful, feel that it limits their daily life, deprives them of their freedom, and affects their interpersonal relationships and social activities. Discussion Older caregivers learn quickly and can manage the skills issues. The volume of work is their challenge. Interpersonal relationships are altered depending on the length of time spent together and the demand for care. Public services and benefits are not adapted to the demands of caregivers or dependent persons.
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Affiliation(s)
| | - S. García-Sanjuán
- Health Sciences Faculty, Nursing Department, University of Alicante, Alicante, Spain
- * E-mail:
| | | | - A. Sanjuán-Quiles
- Health Sciences Faculty, Nursing Department, University of Alicante, Alicante, Spain
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4
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Shamsikhani S, Ahmadi F, Kazemnejad A, Vaismoradi M. Typology of Family Support in Home Care for Iranian Older People: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126361. [PMID: 34208269 PMCID: PMC8296177 DOI: 10.3390/ijerph18126361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 01/20/2023]
Abstract
The world population is rapidly aging. In older people, age-related biological decline in most body systems causes functional decline, an increase in dependence, and an increased need for support, especially by their family members. The aim of this study was to explore the main aspects of family support for older parents in home care. This qualitative study was conducted using a deductive qualitative content analysis approach. Participants were 21 older parents living in their own homes, as well as four family members of some participants. Data were collected using semi-structured interviews and then were analyzed using the primary matrix developed based on the existing literature. The main aspects of family support for older parents were grouped into five predetermined categories and one new category: "instrumental support", "financial support", "psycho-emotional support", "healthcare-related support", "informational-technological support", and "social preference support ". Family support for older people in home care is a multi-dimensional phenomenon. Family members can identify the needs of their older parents and provide them with appropriate support in collaboration with healthcare professionals to enhance their quality of life, autonomy, and satisfaction with life.
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Affiliation(s)
- Soheila Shamsikhani
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran; (S.S.); (A.K.)
| | - Fazlollah Ahmadi
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran; (S.S.); (A.K.)
- Correspondence: ; Tel.: +98-21-8288-3590
| | - Anoshirvan Kazemnejad
- Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran; (S.S.); (A.K.)
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
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5
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Li J, Gao G, Zeng Y, Wu Y, Zhu X, Xu H. Perceived social support in Chinese family caregivers of patients with dementia. Int J Nurs Pract 2021; 28:e12945. [PMID: 33870622 DOI: 10.1111/ijn.12945] [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: 01/06/2020] [Revised: 03/01/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. BACKGROUND Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. METHODS This was a cross-sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. RESULTS Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. CONCLUSION Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. SUMMARY STATEMENT What is already known about this topic? Social support is important for family caregivers of patients with dementia. Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented. What this paper adds? Caregivers' subjective support and support utilization were significantly lower than the normal Chinese population; caregivers' total social support was significantly higher than the normal Chinese population. The best predictors of caregivers' social support were the monthly household income, educational level and place of residence of the caregivers. The implications of this paper: Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. Future research is needed to create effective nursing regimes, paying attention to caregivers with a lower educational level and caregivers who lived in the suburban area.
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Affiliation(s)
- Jufang Li
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Gexin Gao
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yawei Zeng
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yuping Wu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Xiaoling Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
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6
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Mirsoleymani S, Matbouei M, Vasli P, Marzaleh MA, Rohani C. The Role of Family Caregiver's Sense of Coherence and Family Adaptation Determinants in Predicting Distress and Caregiver Burden in Families of Cancer Patients. Indian J Palliat Care 2021; 27:47-53. [PMID: 34035617 PMCID: PMC8121216 DOI: 10.4103/ijpc.ijpc_112_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 05/14/2020] [Indexed: 11/18/2022] Open
Abstract
Background: Most cancer patients' families suffer from maladaptation which increases family distress and caregiving burden. This study was conducted to explore the relationship between these maladaptation indicators, and the sense of coherence (SOC) of family caregivers alongside other family resilience determines among family caregivers of cancer patients. Methods: A total of 104 family caregivers of cancer patients were included in this cross-sectional study. They answered three questionnaires to assess family resilience factors: Family Inventory of Resources for Management (FIRM), Family Crisis Oriented Personal Evaluation Scales (F-COPES), and SOC scale. In addition, family maladaptation factors were determined by two instruments, including Family Distress Index (FDI) and Caregiver Burden Inventory (CBI). Results: The results of this study showed that the FIRM and the SOC together were responsible for 35% and 43% of the variances in FDI and CBI scores, respectively (P < 0.001). “Reframing”, the subscale of the F-COPES, significantly predicted the variances of FDI (β = −0.26, P = 0.01) and CBI scores (β = −0.21, P = 0.04). Moreover, “Mastery and health”, the subscale of the FIRM, significantly predicted the variances of FDI (β = −0.38, P < 0.01) and CBI scores (β = −0.21, P = 0.02). Conclusions: Family caregiver's SOC alongside other family resilience determinants plays a significant role in alleviating family distress and caregiver burden. It is suggested that palliative care providers consider family caregivers' SOC in developing a psychological intervention plan to improve family resilience in families of cancer patients.
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Affiliation(s)
- Seyedreza Mirsoleymani
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Mahsa Matbouei
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran.,Department of Student Research Committee, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran
| | - Milad Ahmadi Marzaleh
- Research Center for Health Management of Mass Gathering, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.,Research Center for Emergency and Disaster Resilience, Red Crescent Society of the Islamic Republic of Iran, Tehran, Iran.,Student Research Committee, Department of Health in Disasters and Emergencies, Health Human Resources Research Center, School of Management and Medical Informatics, Shiraz University of Medical Sciences, Shiraz, Iran.,Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Fars, Iran
| | - Camelia Rohani
- Department of Community Health Nursing, Shahid Beheshti University of Medical Sciences, School of Nursing and Midwifery, Tehran, Iran.,Ersta Sköndal Bräcke University College, Campus Ersta, Stockholm, Sweden
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7
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Sołtys A, Bidzan M, Tyburski E. The Moderating Effects of Personal Resources on Caregiver Burden in Carers of Alzheimer's Patients. Front Psychiatry 2021; 12:772050. [PMID: 34916974 PMCID: PMC8669799 DOI: 10.3389/fpsyt.2021.772050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 10/27/2021] [Indexed: 11/13/2022] Open
Abstract
Caring for persons with Alzheimer's disease can be an extremely difficult experience. To date, there has been a lack of research into the role of intermediary variables in the relationship between caregiver personality and psychosocial functioning. The growing numbers of dementia patients worldwide mean that more people are involved in their care, making research into this area a pressing concern. Both a caregiver's personality and personal resources play a key role in their capacity to cope with stressful situations. In order to determine how personal resources moderate the relationship between personality and burden of care, a total of 100 caregivers of Alzheimer's patients (78 women and 22 men) were asked to complete a set of questionnaires to assess personality, personal resources (sense of coherence, generalized self-efficacy, and perceived social support), as well as their levels of stress, depression, and commitment to care. Structural equation modeling and latent growth analysis suggest that personal resources explain the mechanisms underlying burden of care and moderate its relationship with personality. Our findings indicate that personal resources are a critical predictor of burden of care. Therefore, caregivers must be provided with appropriate support, taking into account their resources and personality profiles.
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Affiliation(s)
- Anna Sołtys
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Mariola Bidzan
- Institute of Psychology, University of Gdansk, Gdansk, Poland
| | - Ernest Tyburski
- Department of Health Psychology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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8
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Turró-Garriga O, Conde-Sala JL, Viñas V, Turon-Estrada A, Cullell-Juncà M, Calvó-Perxas L, Juvinyà-Canal D, Mioshi E, Garre-Olmo J. Antonovsky's sense of coherence and resistance resources reduce perception of burden in family carers of people with Alzheimer's disease. Aging Ment Health 2020; 24:1717-1725. [PMID: 31559837 DOI: 10.1080/13607863.2019.1667297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Taking care of people with dementia (PWD) has been associated with some degree of burden. The variability of the carer's burden can be partially explained by their personal characteristics. Antonovsky's model of health defined the resistance resources (RRs) as essential mechanisms to cope with stressors, and to shape the personal sense of coherence (SOC). This study identifies the RRs related with carer's SOC, and their implications in the perception of burden in family dementia carers.Methods: A sample of 308 participants from the 'SOC & DEM study' (154 carers and 154 PWD) was recruited from two memory clinics. Carer's personal characteristics of burden, SOC, self-efficacy, coping strategies, perceived social support, and depression were evaluated using standardized instruments. PWD's degree of dependence and behaviour and psychological symptoms of dementia (BPSD) were assessed too. A path analysis was used to test the relationship between caregiver burden and SOC including the personal RRs of the carers and clinical data of PWD.Results: The path model identified SOC as a major factor related to carer's burden perception (r = -.327). Self-efficacy (r = .285), two coping strategies, 'use instrumental support' (r = -.235) and 'behavioural disengagement' (r = -.219), and social support perceived (r = .304) were the main carer's personal characteristics directly related with SOC. Caring experience (r = -.281) was the main carer factor related with burden while dependence (r = .156) and BPSD (r = .157) were the dementia factors.Conclusion: The SOC has previously related with carer's burden. The results contributed to identify relevant and modifiable personal characteristics as RRs that could reduce this burden.
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Affiliation(s)
- Oriol Turró-Garriga
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain
| | - Josep Lluís Conde-Sala
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Faculty of Psychology, University of Barcelona, Barcelona, Catalonia, Spain
| | - Vanesa Viñas
- Faculty of Psychology, University of Barcelona, Barcelona, Catalonia, Spain
| | - Antoni Turon-Estrada
- Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain
| | | | - Laia Calvó-Perxas
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain
| | | | - Eneida Mioshi
- School of Health Sciences, University of East Anglia, Norwich, United Kingdom
| | - Josep Garre-Olmo
- Aging, Disability and Health Research Group, Girona's Biomedical Research Institute (IdIBGI), Salt, Catalonia, Spain.,Registry of Dementias of Girona, Catalan Health System, Girona, Catalonia, Spain.,Department of Medical Sciences, University of Girona, Girona, Catalonia, Spain
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9
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Duke S, Campling N, May CR, Lund S, Lunt N, Richardson A. Co-construction of the family-focused support conversation: a participatory learning and action research study to implement support for family members whose relatives are being discharged for end-of-life care at home or in a nursing home. BMC Palliat Care 2020; 19:146. [PMID: 32957952 PMCID: PMC7507823 DOI: 10.1186/s12904-020-00647-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 09/04/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Many people move in and out of hospital in the last few weeks of life. These care transitions can be distressing for family members because they signify the deterioration and impending death of their ill relative and forthcoming family bereavement. Whilst there is evidence about psychosocial support for family members providing end-of-life care at home, there is limited evidence about how this can be provided in acute hospitals during care transitions. Consequently, family members report a lack of support from hospital-based healthcare professionals. METHODS The aim of the study was to implement research evidence for family support at the end-of-life in acute hospital care. Informed by Participatory Learning and Action Research and Normalization Process Theory (NPT) we co-designed a context-specific intervention, the Family-Focused Support Conversation, from a detailed review of research evidence. We undertook a pilot implementation in three acute hospital Trusts in England to assess the potential for the intervention to be used in clinical practice. Pilot implementation was undertaken during a three-month period by seven clinical co-researchers - nurses and occupational therapists in hospital specialist palliative care services. Implementation was evaluated through data comprised of reflective records of intervention delivery (n = 22), in-depth records of telephone implementation support meetings between research team members and co-researchers (n = 3), and in-depth evaluation meetings (n = 2). Data were qualitatively analysed using an NPT framework designed for intervention evaluation. RESULTS Clinical co-researchers readily incorporated the Family-Focused Support Conversation into their everyday work. The intervention changed family support from being solely patient-focused, providing information about patient needs, to family-focused, identifying family concerns about the significance and implications of discharge and facilitating family-focused care. Co-researchers reported an increase in family members' involvement in discharge decisions and end-of-life care planning. CONCLUSION The Family-Focused Support Conversation is a novel, evidenced-based and context specific intervention. Pilot implementation demonstrated the potential for the intervention to be used in acute hospitals to support family members during end-of-life care transitions. This subsequently informed a larger scale implementation study. TRIAL REGISTRATION n/a.
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Affiliation(s)
- Sue Duke
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England.
| | - Natasha Campling
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Carl R May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, 15-17 Tavistock Place, London, WC1H 9SH, England
| | - Susi Lund
- School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
| | - Neil Lunt
- Department of Social Policy and Social Work, University of York, Heslington, York, YO10 5DD, England
| | - Alison Richardson
- University Hospitals Southampton and School of Health Sciences, University of Southampton, Highfield, Southampton, SO17 1BJ, England
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10
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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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Tulek Z, Baykal D, Erturk S, Bilgic B, Hanagasi H, Gurvit IH. Caregiver Burden, Quality of Life and Related Factors in Family Caregivers of Dementia Patients in Turkey. Issues Ment Health Nurs 2020; 41:741-749. [PMID: 32286096 DOI: 10.1080/01612840.2019.1705945] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
This study aimed to evaluate caregiver burden and quality of life (QoL) and their predictors in family caregivers of dementia patients. A descriptive cross-sectional survey was carried out with a sample of 102 patients and their family caregivers. The Caregiver Burden Inventory (CBI) and Short Form-12 (SF-12) were used to collect data. CBI mean score was 37.97 ± 21.30. Mean scores of SF-12 sub-domains varied between 36.02 and 77.94 and were significantly lower as compared to normative means of the general population, excluding only the physical health subdomain. Among several patient and caregiver-related correlations, the number of medications and worse cognitive function of the patient, caregiver's age and having limited space at home were found as predictors of burden, whereas caregiver's chronic disease and having a limited space were predictors of QoL. Also, the burden and QoL were correlated. This study demonstrated a high burden and low QoL in dementia caregivers. In societies where caregivers are mostly informal such as that in Turkey, supportive systems should be established.
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Affiliation(s)
- Zeliha Tulek
- Department of Medical Nursing, Istanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, Istanbul, Turkey
| | - Dilek Baykal
- Department of Medical Nursing, Halic University School of Health Sciences, Istanbul, Turkey
| | - Sumeyye Erturk
- Istanbul University-Cerrahpasa Institute of Graduate Studies, Istanbul, Turkey
| | - Basar Bilgic
- Istanbul University Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, Turkey
| | - Hasmet Hanagasi
- Istanbul University Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, Turkey
| | - I Hakan Gurvit
- Istanbul University Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, Turkey
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Intention to use respite services among informal care-givers of frail older adults in China: the role of care needs change. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20000628] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractPopulation ageing in China calls for evidence-based solutions, especially in terms of fulfilling long-term care needs among frail older adults. Respite services are identified as effective resources for alleviating care-giver burden and promoting the wellbeing of both older adults and their family care-givers. However, respite care is often under-used in China. This research aimed to examine factors associated with intention to use respite services among informal care-givers in Shanghai, mainland China. This study was part of the Longitudinal Study on Family Caregivers for Frail Older Adults in Shanghai. Pairs of older adults and their care-givers (N = 583) who successfully completed the 2013 and 2016 waves were included in the data analysis. Two logistic regression models were conducted, one with time-invariant and one with time-variant factors. The model with time-variant factors had greater explanatory power than the original Andersen model with time-invariant factors influencing intention to use respite services among care-givers. Care-givers had higher odds of intending to use respite services if they had higher care-giving burden, were caring elderly people who experienced care-giver transitions, or were caring for elderly people with increased function of ambulation or decreased function of feeding. The findings imply that change in functional health was a significant determinant of intention to use respite care. Relevant policy and service implications will be discussed.
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Varik M, Medar M, Saks K. Informal caregivers' experiences of caring for persons with dementia in Estonia: A narrative study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:448-455. [PMID: 31637794 DOI: 10.1111/hsc.12877] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 09/10/2019] [Accepted: 09/24/2019] [Indexed: 06/10/2023]
Abstract
This paper presents the results of a qualitative study aimed at exploring the experiences and needs of informal caregivers of persons with dementia and identifying caregiver expectations for support. The research was based on phenomenological and social constructionist approaches; it also took experience-centred and culturally oriented approaches to narratives. It was conducted in Estonia in 2017 by means of unstructured in-depth interviews with 16 informal caregivers who had relatives with dementia. The narrative approach used in this study proved to be an appropriate and valuable method to understand the situations of the caregivers of the people with dementia, in identifying their needs and expectations, and in developing social understanding for caregivers. The results are divided under four thematic headings: awareness of dementia; process of caregiving and different caregiving roles; influence of caregiving on personal life; and expectations of empowerment. We found that it is necessary to raise public awareness of dementia and develop person-centred support services for the people living with dementia.
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Affiliation(s)
- Merle Varik
- School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
- Tartu Health Care College, Tartu, Estonia
| | - Marju Medar
- School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Kai Saks
- University of Tartu, Tartu, Estonia
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Cao Y, Yang F. Objective and Subjective Dementia Caregiving Burden: The Moderating Role of Immanent Justice Reasoning and Social Support. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020455. [PMID: 31936738 PMCID: PMC7014207 DOI: 10.3390/ijerph17020455] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 11/22/2022]
Abstract
Caregiving burden significantly effects the physical and mental health of family dementia caregivers. While the association between objective caregiving burden (OCB) and subjective caregiving burden (SCB) of family dementia caregivers is well documented, little is known as with how the association is moderated by the configuration of intrapersonal resource (e.g., immanent justice reasoning) and interpersonal resource (e.g., social support). The present study collected cross-sectional data on 157 major family caregivers of non-institutionalized persons with dementia in an urbanizing region of Western China’s Sichuan Province. They responded to questions on daily time spent on caregiving, the short version of Zarit Burden Interview (ZBI), a sub-scale of a caregiver meaning scale, Social Support Rating Scale (SSRS), and demographic questions. Controlling for the demographic variables of the caregivers, this study found that the objective and subjective dementia caregiving burden were significantly associated (p < 0.001), and immanent justice reasoning was positively correlated with subjective burden (p < 0.01). Moreover, the association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both high (p < 0.001), but neutral when social support was high and immanent justice reasoning was low. The association between OCB and SCB was significantly positive when social support and immanent justice reasoning were both low (p < 0.05), but neutral when social support was low and immanent justice reasoning was high. This research suggests the importance of developing intervention programs that consider the configuration of the external supporting resources and internal meaning-making of caregiving of the family dementia caregivers.
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Affiliation(s)
- Yanchun Cao
- Faculty of Economics and Management, East China Normal University, Shanghai 200062, China;
| | - Fan Yang
- School of International and Public Affairs, China Institute for Urban Governance, Shanghai Jiao Tong University, Shanghai 200030, China
- Correspondence:
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Solli H, Hvalvik S. Nurses striving to provide caregiver with excellent support and care at a distance: a qualitative study. BMC Health Serv Res 2019; 19:893. [PMID: 31771566 PMCID: PMC6880571 DOI: 10.1186/s12913-019-4740-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 11/13/2019] [Indexed: 12/26/2022] Open
Abstract
Background In Norway, changes in life expectancy have led to increased attention to older people who are ageing at home, by means of home care services, adapted technology and informal caregivers. The caring situation has become difficult for many caregivers. The use of telecare has now offered them the possibility to receive support at home. The purpose of this study was to explore how nurses provide support and care at a distance, using a web camera and a web forum in a closed telecare network for caregivers to persons suffering from stroke and dementia. Methods The study had an explorative design with a qualitative approach. The data sources consisted of interviews with nurses and excerpts from posts in a closed telecare network. Content analysis was used to analyse the text from the interviews and the text from the web forum. Results The main theme, “Balancing asymmetric and symmetric relationships” described nurses’ relationship with caregiver. Two categories, “Balancing personal and professional qualities” and “Balancing caregivers’ dependence versus independence” were identified. The first describing the tension in their dialogue, the second describing how nurses provided the caregivers with a sense of security as well as strengthening them to master their daily lives. Conclusions The nurses provided long distance support and care for the caregivers, by using computer-meditated communication. This communication was characterized by closeness as well as empathy. To strengthen the caregivers’ competence and independence, the nurses were easy accessible and provided virtual supervision and support. This study increases the knowledge about online dialogues and relationship between nurses and caregivers. It contributes to knowledge about balancing in the relationship, as well as knowledge about bridging the gap between technologies and nursing care as potential conflicting dimensions. Maintenance of ethical principles are therefore critical to be aware of.
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Affiliation(s)
- Hilde Solli
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway. .,, Kongsberg, Norway.
| | - Sigrun Hvalvik
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University of South-Eastern Norway, Porsgrunn, Norway.,, Kongsberg, Norway
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Band-Winterstein T, Avieli H. Women Coping With a Partner's Dementia-Related Violence: A Qualitative Study. J Nurs Scholarsh 2019; 51:368-379. [PMID: 31173457 DOI: 10.1111/jnu.12485] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE The aim of the present study was to differentiate between the lived experience of two groups of women caregiving for a partner with dementia. One group was coping with lifelong intimate partner violence (IPV) and dementia-related violence (Group 1); the other group was coping with dementia-related violence only (Group 2). DESIGN An interpretive phenomenological analysis perspective was used. Data collection was performed through in-depth, semistructured interviews with eight female spouses of men with dementia from each of the two above-mentioned groups, followed by a content analysis. FINDINGS Comparing the narratives of the aging women revealed their different experiences over several dimensions: (a) the identification of violence as a symptom of dementia; (b) the use of past couplehood memories; (c) feelings over time; (d) willingness to care for the partner with dementia; and (e) a prospective view of life. CONCLUSIONS The complexities of being old and having to cope with caregiving responsibilities for a spouse with dementia, accompanied by violent behaviors, emphasize the significance of the couple's past relationship. This notion should be taken into account in practical interventions. CLINICAL RELEVANCE As part of the aging process, there is an increase in people who are engaged in dementia-related violence. Nurses' education and practice should focus on the dynamics of dyads coping with violence and identify the particular needs of the caregiver spouse in this context.
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Affiliation(s)
- Tova Band-Winterstein
- Associate Professor, Department of Gerontology, University of Haifa, Mt. Carmel, Haifa, Israel
| | - Hila Avieli
- Lecturer, Department of Criminology, Ariel University, Ariel, Israel
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17
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Marques MJ, Woods B, Hopper L, Jelley H, Irving K, Kerpershoek L, Meyer G, Bieber A, Stephan A, Sköldunger A, Sjölund BM, Selbaek G, Rosvik J, Zanetti O, Portolani E, de Vugt M, Verhey F, Gonçalves-Pereira M. Relationship quality and sense of coherence in dementia: Results of a European cohort study. Int J Geriatr Psychiatry 2019; 34:745-755. [PMID: 30729572 DOI: 10.1002/gps.5082] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 02/03/2019] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives. METHODS Cross-sectional data were used from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC). RESULTS Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress, and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia, and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and discrepancies was carer stress (negative feelings subscore). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two. CONCLUSIONS In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
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Affiliation(s)
- Maria J Marques
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Bob Woods
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Hannah Jelley
- Dementia Services Development Centre (DSDC) Wales, Bangor University, Bangor, UK
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Liselot Kerpershoek
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Anders Sköldunger
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Britt-Marie Sjölund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway.,Centre for Old Age Psychiatric Research, Innlandet Hospital Trust, Ottestad, Norway
| | - Janne Rosvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Elisa Portolani
- IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Marjolein de Vugt
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Manuel Gonçalves-Pereira
- CEDOC, NOVA Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
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Boztepe H, Çınar S, Ay A, Kerimoğlu Yıldız G, Kılıç C. Predictors of caregiver burden in mothers of children with leukemia and cerebral palsy. J Psychosoc Oncol 2018; 37:69-78. [PMID: 30422097 DOI: 10.1080/07347332.2018.1489441] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Caring for a sick child can lead to considerable burden in the caregiver. Comparative studies of burden in mothers of children with different types of disorders are rare. METHODS We assessed levels of and risk factors for burden in mothers of children with leukemia (n: 70) or with cerebral palsy (CP) (n: 69). Subjects were recruited from two hospitals in Ankara. RESULTS Levels of burden or depression were not different between groups. Burden was predicted by the presence of depression in the mother and severity of illness in both groups. In the leukemia group, mothers reported higher burden if the child was male or younger; no such relationship was observed in the CP group. CONCLUSION Our results show that type of illness has an effect on levels of burden. Mothers of children with leukemia should receive more attention, especially if their child is male or younger, to take preventive measures against burden.
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Affiliation(s)
- Handan Boztepe
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Sevil Çınar
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Ayşe Ay
- a Department of Pediatric Nursing, Faculty of Nursing , Hacettepe University , Ankara , Turkey
| | - Gizem Kerimoğlu Yıldız
- b Department of Pediatric Nursing, Florence Nightingale Nursing Faculty , Istanbul University , Istanbul, Turkey
| | - Cengiz Kılıç
- c Department of Psychiatry, Faculty of Medicine , Hacettepe University , Ankara , Turkey
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Jackson JDS, Cotton SE, Bruce Wirta S, Proenca CC, Zhang M, Lahoz R, Calado FJ. Burden of heart failure on caregivers in China: results from a cross-sectional survey. Drug Des Devel Ther 2018; 12:1669-1678. [PMID: 29922041 PMCID: PMC5996855 DOI: 10.2147/dddt.s148970] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
PURPOSE Family and friends play a pivotal role in caring for patients with heart failure (HF); however, evidence of the impact of caregiving is limited. The objectives of this study were to describe the burden of caregiving on informal caregivers of patients with chronic HF in China. MATERIALS AND METHODS A cross-sectional survey of cardiologists, their patients with HF, and those patients' caregivers was conducted. Patient record forms were completed by 150 cardiologists for 10 consecutive patients. Caregivers of these patients were invited to complete a questionnaire. RESULTS Overall, 458 caregivers completed a questionnaire (mean ± standard deviation age 60.1±10.6 years; 60% female; 77% spouses; 74% retired). Caregivers spent a mean of 24.5 (16.9) hours caregiving per week, and a third reported a reduction in their social activity, time for themselves, or time for family. Caregivers in employment took several days off work in the past 3 months owing to caregiving, sometimes resulting in reduced income. Up to 79% of caregivers reported an impact on their physical or emotional well-being, and 57% reported deterioration in their objective health status. Inconsistencies stemming from differences in the three-level five-dimension EuroQol questionnaire and HF Caregiver Questionnaire were observed for the impact of caregiving on caregivers' health-related quality of life. CONCLUSION Assisting patients with HF is associated with caregiver burden. Addressing the needs of caregivers may help to promote their continued support and improve patient outcomes.
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Affiliation(s)
- James DS Jackson
- Real World Research, Adelphi Real World, Bollington, Cheshire, UK
| | - Sarah E Cotton
- Real World Research, Adelphi Real World, Bollington, Cheshire, UK
| | - Sara Bruce Wirta
- Real World Evidence Center of Excellence, Novartis Sweden AB, Stockholm, Sweden
| | | | - Milun Zhang
- Health Economics and Outcomes Research & Access Strategy, Novartis Pharma China, Beijing, China
| | - Raquel Lahoz
- Real World Evidence Center of Excellence, Novartis Pharma AG, Basel, Switzerland
| | - Frederico J Calado
- Real World Evidence Center of Excellence, Novartis Pharma AG, Basel, Switzerland
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20
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Kazmer MM, Glueckauf RL, Schettini G, Ma J, Silva M. Qualitative Analysis of Faith Community Nurse-Led Cognitive-Behavioral and Spiritual Counseling for Dementia Caregivers. QUALITATIVE HEALTH RESEARCH 2018; 28:633-647. [PMID: 29169293 DOI: 10.1177/1049732317743238] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This article presents themes emerging from semistructured interviews with dementia family caregivers in rural communities who participated in an integrative, cognitive-behavioral and spiritual counseling intervention, and with faith community nurses (FCNs) who delivered the intervention. The primary objectives of the counseling intervention were to ameliorate dementia caregivers' depressive affect and the severity of their self-identified caregiving and self-care problems. The qualitative portion of the study was intended to elicit caregivers' and FCNs' perceptions of the benefits and drawbacks of the intervention. We conducted interviews with seven FCN/caregiver pairs 4 times during the 6-month counseling process, totaling 56 interviews. Themes emerging from the interviews included caregivers' perception of burden and care partners' problem behavior; formation of therapeutic alliance between FCNs and caregivers; problem-solving skills, tools, and resources; caregivers' use of problem-solving strategies; spirituality in caregiving and counseling processes; FCNs' prior professional experience; and caregiver and FCN time constraints.
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Affiliation(s)
| | | | | | - Jinxuan Ma
- 2 Emporia State University, Emporia, Kansas, USA
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21
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Carlsen B, Lundberg K. ‘If it weren't for me…’: perspectives of family carers of older people receiving professional care. Scand J Caring Sci 2017; 32:213-221. [DOI: 10.1111/scs.12450] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/22/2017] [Indexed: 11/26/2022]
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Le Galès C, Bungener M. The family accompaniment of persons with dementia seen through the lens of the capability approach. DEMENTIA 2016; 18:55-79. [PMID: 27390172 DOI: 10.1177/1471301216657476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Using the capability approach initially developed by A Sen as a theoretical framework, this paper analyses both what people with dementia and their families do in response to difficulties in their daily life brought about by the disease, and the reasons they give for acting as they do. Individual and collective interviews and ethnographic observations with 15 persons with dementia and one or more of their family members were conducted. Follow-up interviews were possible for nine families. Results highlight a great diversity in ways of doing things and in accompaniment by family members. Daily adjustments are often hidden or minimized, at least at the onset of the dementia. Later, they become more frequent, repetitive and indispensable but remain influenced by the social and gender roles that existed prior to the illness. The inventiveness of families, in a context marked by various kinds of constraints, is primarily motivated by their desire to maintain the apparently intact abilities of the person with dementia but especially to preserve forms of liberty and what counted for the person, what that person valued before the disease. There are some ways of living with dementia, even when accompanied, which may long remain preferable to others, which better answer to the past and present aspirations of persons with dementia and the purposes of the accompanying persons. It is thus essential that health professionals, as well as society in general, recognize and address this issue.
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Affiliation(s)
- Catherine Le Galès
- CERMES3, INSERM U 988, CNRS UMR 8211, EHESS, Paris Descartes University, France
| | - Martine Bungener
- CERMES3, INSERM U 988, CNRS UMR 8211, EHESS, Paris Descartes University, France
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Wang LJ, Zhong WX, Ji XD, Chen J. Depression, caregiver burden and social support among caregivers of retinoblastoma patients in China. Int J Nurs Pract 2016; 22:478-485. [PMID: 27325472 DOI: 10.1111/ijn.12458] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 02/25/2016] [Accepted: 05/09/2016] [Indexed: 11/29/2022]
Abstract
The aim of this study is to examine the burden of family caregivers of patients with retinoblastoma in China and the relationships between depression, caregiver burden and social support. A descriptive and correlational survey was conducted with 117 Chinese family caregivers of outpatient patients with retinoblastoma from the Department of Ophthalmology of a tertiary hospital in Shanghai, China. Family caregivers of outpatient patients with retinoblastoma were asked to respond to four questionnaires including sociodemographic questionnaire, Becker Depression Inventory, Caregiver Burden Inventory and Social Support Rating Scale. The incidence of depression in this study was 51.3%; the average score for social support indicated moderate social support available to the caregivers, although their level of caregiver burden was heavy. Depression scores were significantly positively correlated with caregiver burden scores and significantly negatively correlated with the social support scores. Heavy caregiver burden was associated with lower monthly income, low subjective social support and less use of social support.
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Affiliation(s)
- Li-Juan Wang
- Department of Anesthesiology and Intensive Care Medicine, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Wen-Xiang Zhong
- Department of Neurosurgery, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xun-Da Ji
- Ophthalmology, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jiao Chen
- Department of Anesthesiology and Intensive Care Medicine, Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
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Lebrec J, Ascher-Svanum H, Chen YF, Reed C, Kahle-Wrobleski K, Hake AM, Raskin J, Naderali E, Schuster D, Heine RJ, Kendall DM. Effect of diabetes on caregiver burden in an observational study of individuals with Alzheimer's disease. BMC Geriatr 2016; 16:93. [PMID: 27142529 PMCID: PMC4855347 DOI: 10.1186/s12877-016-0264-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2015] [Accepted: 04/21/2016] [Indexed: 01/21/2023] Open
Abstract
Background The burden on caregivers of patients with Alzheimer’s disease (AD) is associated with the patient’s functional status and may also be influenced by chronic comorbid medical conditions, such as diabetes. This post-hoc exploratory analysis assessed whether comorbid diabetes in patients with AD affects caregiver burden, and whether caregivers with diabetes experience greater burden than caregivers without diabetes. Caregiver and patient healthcare resource use (HCRU) were also assessed. Methods Baseline data from the GERAS observational study of patients with AD and their caregivers (both n = 1495) in France, Germany and the UK were analyzed. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Caregiver time on activities of daily living (ADL: basic ADL; instrumental ADL, iADL) and supervision (hours/month), and caregiver and patient HCRU (outpatient visits, emergency room visits, nights hospitalized) were assessed using the Resource Utilization in Dementia instrument for the month before the baseline visit. Regression analyses were adjusted for relevant covariates. Time on supervision and basic ADL was analyzed using zero-inflated negative binomial regression. Results Caregivers of patients with diabetes (n = 188) were younger and more likely to be female (both p < 0.05), compared with caregivers of patients without diabetes (n = 1307). Analyses showed caregivers of patients with diabetes spent significantly more time on iADL (+16 %; p = 0.03; increases were also observed for basic ADL and total caregiver time but did not reach statistical significance) and had a trend towards increased ZBI score. Patients with diabetes had a 63 % increase in the odds of requiring supervision versus those without diabetes (p = 0.01). Caregiver and patient HCRU did not differ according to patient diabetes. Caregivers with diabetes (n = 127) did not differ from those without diabetes (n = 1367) regarding burden/time, but caregivers with diabetes had a 91 % increase in the odds of having outpatient visits (p = 0.01). Conclusions This cross-sectional analysis found caregiver time on iADL and supervision was higher for caregivers of patients with AD and diabetes versus without diabetes, while HCRU was unaffected by patient diabetes. Longitudinal analyses assessing change in caregiver burden over time by patient diabetes status may help clarify the cumulative impact of diabetes and AD dementia on caregiver burden.
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Affiliation(s)
| | | | | | - Catherine Reed
- Eli Lilly and Company Limited, Lilly Research Centre, Windlesham, Surrey, UK.
| | | | - Ann Marie Hake
- Eli Lilly and Company, Indianapolis, IN, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Ebrahim Naderali
- Eli Lilly and Company, Lilly House, Basingstoke, Hampshire, UK.,Faculty of Science, Liverpool Hope University, Liverpool, UK
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