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Hernandez Chilatra JA, Patrician PA, Fazeli PL, Pickering CE. Neglect of older adults living with dementia in family caregiving: A dimensional concept analysis. Int J Psychiatry Med 2024:912174241272615. [PMID: 39129719 DOI: 10.1177/00912174241272615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
OBJECTIVE To present a concept analysis of neglect, specifically examining its occurrence and implications in the context of family caregiving for older adults living with dementia. METHODS A literature search was conducted in Medline, CINAHL, Scopus, and Embase databases in February 2023. Inclusion criteria targeted articles focusing on neglect in dementia family caregiving, leading to the identification of 11 articles for thorough review. Employing Caron and Bowers' dimensional analysis approach, the concept analysis aimed to elucidate neglect as a social construct shaped by diverse contexts, perspectives, and underlying assumptions. RESULTS Neglect in this context emerged as a multidimensional phenomenon, influenced by contextual elements such as activities of daily living and behavioral symptoms of dementia. It encompasses dimensions including "expectations of unmet needs", "maladaptive behaviors", and "feelings of guilt", considering the perspectives of both caregivers and individuals living with dementia. Recognizing neglect as a dyadic phenomenon emphasizes the significance of interactions between caregivers and individuals living with dementia. CONCLUSION A comprehensive understanding of neglect in dementia family caregiving is crucial for effective interventions and support systems. The dyadic perspective is vital for accurate assessment. Primary care physicians, mental health, nurses, and other health professionals play a key role in prevention and supporting family caregivers. Further research is needed to explore the dynamics of dementia caregiving settings strengthening prevention strategies against elder neglect.
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Affiliation(s)
- Jessica A Hernandez Chilatra
- McWilliams School of Biomedical Informatics, The University of Texas Health Science, Houston, TX, USA
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
| | | | - Pariya L Fazeli
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carolyn Ez Pickering
- Department of Research, Cizik School of Nursing, University of Texas Health Science Center at Houston, Houston, TX, USA
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Mérida-Herrera L, Cabrera I, García-Batalloso I, Gallego-Alberto L, Olazarán J, Losada-Baltar A, Márquez-González M. Ambivalent Feelings and Relationship Quality in Dementia Family Caregivers: Associations with Depressive Symptomatology. Clin Gerontol 2024:1-11. [PMID: 39083066 DOI: 10.1080/07317115.2024.2385536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVES Ambivalent feelings in dementia family caregivers have been found to be related to caregivers´ stress associated with the behavioral and psychological symptoms of dementia (BPSD-related stress), and depressive symptoms. Ambivalent feelings may also affect caregivers´ perceived quality of the relationship with the person living with dementia (PLwD), but this variable has been scarcely studied. This study analyzes the role of ambivalent feelings in the association between caregivers' BPSD-related stress, perceived quality of the relationship with the PLwD, and depressive symptomatology. METHODS A theoretical model was developed and tested in a sample of 390 family caregivers. RESULTS The obtained tested model had an excellent fit to the data, explaining 24% of the variance of depressive symptomatology. A significant association was found between caregivers' BPSD-related stress, ambivalent feelings, and depressive symptomatology. Also, an indirect effect in the association between ambivalent feelings and depressive symptomatology was found through the perceived quality of the relationship. CONCLUSIONS Ambivalent feelings in dementia family caregivers are associated with caregivers' BPSD-related stress, perception of a lower relationship quality, and higher depressive symptomatology. CLINICAL IMPLICATIONS Targeting caregivers' ambivalent feelings and the quality of the relationship in interventions for dementia family caregivers may decrease their distress.
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Affiliation(s)
- Laura Mérida-Herrera
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - Isabel Cabrera
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - Inés García-Batalloso
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - Laura Gallego-Alberto
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
| | - Javier Olazarán
- Service of Neurology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | - María Márquez-González
- Departamento de Psicología Biológica y de la Salud, Universidad Autónoma de Madrid, Madrid, España
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Lee JE, Nemmers NL, Svec J, Cho J. Caregiving Appraisals and Emotional Valence: Moderating Effects of Activity Participation. Res Aging 2024:1640275241263770. [PMID: 39028310 DOI: 10.1177/01640275241263770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Abstract
The present study examines the extent to which a two-factor model of affect explains how caregiving appraisals experienced by caregivers influence their own well-being. We used data from three waves of Nation Study of Caregiving (NSOC) to conduct latent growth curve models with the time-varying predictors to investigate the effect of between-person (BP) and within-person (WP) caregiving appraisals on positive and negative affect. Furthermore, we simultaneously modeled WP differences in activity participation and affective experience with multilevel modeling. Then, we tested the moderating effect of activity participation in the association between WP caregiving appraisals and emotional valence. We found that BP and WP caregiving negative appraisal also contribute to caregiver positive affect similar to that of negative affect. Time-varying effects of negative appraisals and emotional valence are consistent with the two-factor model. Future longitudinal investigations could target WP and BP activity participation to alleviate caregiving cognitive appraisal among caregivers.
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Affiliation(s)
| | | | | | - Jinmyoung Cho
- Saint Louis University School of Medicine, Saint Louis, MO, USA
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Ng YH, Jiao K, Suen MHP, Wang J, Chow AYM. The role of the social environment on dementia caregivers' pre-death grief: A mixed- methods systematic review. DEATH STUDIES 2024:1-20. [PMID: 38497324 DOI: 10.1080/07481187.2024.2329755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
This systematic review examined the role of social environment in pre-death grief experiences of dementia caregivers. Ninety-three Chinese and English articles were included from a comprehensive search of empirical studies using nine databases. Six social environment domains were generated: the person with dementia, dyadic relationship, family members and the wider community, health and social care services, place of care, and social-cultural contexts. A complex interplay between caregivers and their social environments that aggravate and attenuate pre-death grief experiences is evident. Research has focused mainly on the effects of people with dementia and dyadic relationships and has paid modest attention to the effects of family, relatives, and health and social care services. Caregivers' experiences with their friends, fellow caregivers, the wider community, and social-cultural norms are influential but understudied. Future research could adopt a systems thinking approach with sociological perspectives to generate a comprehensive and nuanced understanding of pre-death grief experiences.
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Affiliation(s)
- Yong Hao Ng
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Keyuan Jiao
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Margaret H P Suen
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Juan Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Amy Y M Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
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Hayes OS, El Baou C, Hardy CJD, Camic PM, Brotherhood EV, Harding E, Crutch SJ. How Do Care Partners of People with Rare Dementia Use Language in Online Peer Support Groups? A Quantitative Text Analysis Study. Healthcare (Basel) 2024; 12:313. [PMID: 38338197 PMCID: PMC10855301 DOI: 10.3390/healthcare12030313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 01/19/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
We used quantitative text analysis to examine conversations in a series of online support groups attended by care partners of people living with rare dementias (PLWRD). We used transcripts of 14 sessions (>100,000 words) to explore patterns of communication in trained facilitators' (n = 2) and participants' (n = 11) speech and to investigate the impact of session agenda on language use. We investigated the features of their communication via Poisson regression and a clustering algorithm. We also compared their speech with a natural speech corpus. We found that differences to natural speech emerged, notably in emotional tone (d = -3.2, p < 0.001) and cognitive processes (d = 2.8, p < 0.001). We observed further differences between facilitators and participants and between sessions based on agenda. The clustering algorithm categorised participants' contributions into three groups: sharing experience, self-reflection, and group processes. We discuss the findings in the context of Social Comparison Theory. We argue that dedicated online spaces have a positive impact on care partners in combatting isolation and stress via affiliation with peers. We then discuss the linguistic mechanisms by which social support was experienced in the group. The present paper has implications for any services seeking insight into how peer support is designed, delivered, and experienced by participants.
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Affiliation(s)
- Oliver S. Hayes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
| | - Celine El Baou
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
- Adapt Lab, Research Department of Clinical, Educational and Health Psychology, UCL, London WC1E 7HB, UK
| | - Chris J. D. Hardy
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
| | - Paul M. Camic
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
| | - Emilie V. Brotherhood
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
| | - Emma Harding
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
| | - Sebastian J. Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, UCL, London WC1N 3AR, UK (P.M.C.); (E.V.B.); (S.J.C.)
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Olavarría L, Caramelli P, Lema J, de Andrade CB, Pinto A, Azevedo LVDS, Thumala D, Vieira MCS, Rossetti AP, Generoso AB, Carmona KC, Sepúlveda-Loyola W, Pinto LAC, Barbosa MT, Slachevsky A. Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up. J Alzheimers Dis 2024; 98:691-698. [PMID: 38427488 PMCID: PMC11175387 DOI: 10.3233/jad-231310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.
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Affiliation(s)
- Loreto Olavarría
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Psychiatry Department, Faculty of Medicine, Universidad de Chile
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - José Lema
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Caíssa Bezerra de Andrade
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Alejandra Pinto
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Lílian Viana dos Santos Azevedo
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Daniela Thumala
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- School of Psychology, Faculty of Social Sciences, University of Chile
| | | | | | - Alana Barroso Generoso
- Geriatric Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Karoline Carvalho Carmona
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
| | | | | | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte (MG), Brazil
- Geriatric Medicine, Faculdade Ciências Médicas de Minas Gerais, Belo Horizonte (MG), Brazil
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Memory and Neuropsychiatric Center (CMYN), Memory Unit - Neurology Department, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Thomas Hebdon MC, Cloyes KG, Vega M, Rosenkranz SJ, Reblin M, Tay D, Mooney K, Ellington L. Hospice Family Caregivers' Uncertainty, Burden, and Unmet Needs in Prospective Audio Diaries. J Hosp Palliat Nurs 2023; 25:321-329. [PMID: 37851960 PMCID: PMC10843703 DOI: 10.1097/njh.0000000000000975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Hospice cancer caregivers' (HCCs') burden and unmet needs are well documented in the literature through retrospective, standardized self-report surveys. Hospice cancer caregiver daily experiences of burden and unmet needs are rarely captured within a real-time context. The purpose of this secondary data analysis was to characterize HCCs' day-to-day burden and unmet needs with prospective HCC (N = 50) audio diary data between hospice enrollment and patient death. Uncertainty theory provided a framework for analysis. Diaries were transcribed, analyzed deductively and inductively, and organized thematically. Uncertainty in day-to-day experiences was an important driver of HCC burden and unmet needs. Unmet needs included unclear/unmet expectations regarding hospice care team support; not understanding the extent of HCC role and involvement; and communication challenges with hospice team members. Sources of HCCs' burden were dissonance between how they "should" feel and how they actually felt; feeling alone/having no outlet to express feelings; concerns about their own health and subsequent patient impact; and feeling helpless/occupying a liminal space. Uncertainty surrounding HCCs' experiences encompassed interactions with hospice care teams and the nature of end-of-life caregiving with symptom management, the dying process, and the HCC role. Hospice care teams can respond to uncertainty through assessment, understanding, and recognition of the daily context of HCCs.
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Affiliation(s)
| | | | | | | | | | - Djin Tay
- University of Utah, College of Nursing
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Mouchaers I, Metzelthin S, van Haastregt J, Vlaeyen E, Goderis G, Verbeek H. Exploring the Support and Involvement of Family Caregivers for Reablement Programs: A Qualitative Study. J Multidiscip Healthc 2023; 16:2993-3005. [PMID: 37849961 PMCID: PMC10577240 DOI: 10.2147/jmdh.s424147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023] Open
Abstract
Background Reablement is a person-centered, holistic approach promoting older adults' participation through social, leisure, and physical activities. Family caregivers are seldom involved in reablement services despite their wish to be an active member of the care team and expressing a need for more support and recognition. The voice of family caregivers is often forgotten when evaluating services such as reablement. Little is known how family caregivers can be involved and supported more effectively in reablement services, therefore the aim of our research is to investigate the perceived support and involvement of family caregivers. Methods As part of the TRANS-SENIOR project, we studied perceived support and involvement of family caregivers during and after geriatric rehabilitation, a setting in which principles of reablement, like goal setting and training of daily activities, are applied. In total, fourteen semi-structured interviews were conducted with family caregivers of people admitted to a geriatric rehabilitation facility. Thematic analysis was used. Results Results reflected four themes: (1) support for family caregivers, (2) involvement in care, (3) trusting care professionals, and (4) asking for and accepting support. Family caregivers' experiences with support from care professionals were mainly ambivalent. While caregivers expressing a lack of support and information whilst also indicating that they do not expect to be supported by care professionals. Regarding involvement, caregivers wanted to be involved; ie express their opinion and be involved in decision-making. However, more involvement could also lead to a higher burden. Conclusion There is a discrepancy between the perceived support and involvement of family caregivers, their expressed needs, and their expectations of care professionals. A personalized approach is needed to create room for the family caregiver to be an active participant in the care process while also providing the right amount of support, when preferred by the caregiver.
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Affiliation(s)
- Ines Mouchaers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Silke Metzelthin
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
| | - Jolanda van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Geert Goderis
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Hilde Verbeek
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
- Living Lab in Ageing and Long Term Care, Maastricht, the Netherlands
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Asfia SKBM, Bucholc J, McCaffrey N, Mihalopoulos C, Muldowney A, Engel L. Understanding the Quality of Life Impacts of Providing Informal Care to People with Dementia: A Systematic Review of Qualitative Studies. J Alzheimers Dis 2022; 88:1293-1309. [PMID: 35754273 DOI: 10.3233/jad-220219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is currently a lack of a comprehensive review identifying the broad scope of factors that impact quality of life (QoL) of informal carers of people with dementia to validate existing measures and inform the provision of support services for carers of people with dementia that impact QoL domains important to them. OBJECTIVE To explore and identify QoL impacts on informal carers from providing care to people with dementia. METHODS A systematic review was conducted across four databases: EMBASE, CINAHL, PsychINFO, and Medline. Eligible studies consisted of published, peer-reviewed, qualitative studies focusing on lived experiences of informal carers of people with dementia. Non-English studies and quantitative studies were excluded. Screening of included studies was conducted independently by three reviewers. A "best-fit" framework synthesis was used to combine the qualitative data, applying deductive and inductive analysis techniques. Quality assessment was conducted using the Critical Appraisal Skills Programme. RESULTS Of the 4,251 articles identified, 59 articles were included. Five main themes pertaining to QoL aspects were identified that included coping (emotion-coping and problem-coping), relationship with the person with dementia (sense of loss and change in relationship), support (formal support and informal support), interference with life (control over caring situation and freedom and independence), and health (physical health, emotional and mental health, and social health). CONCLUSION This study identified domains of QoL that are impacted by providing informal care to people living with dementia, offering a conceptual framework for instrument validation and development as well as guidance for service provision.
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Affiliation(s)
| | - Jessica Bucholc
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Nikki McCaffrey
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia
| | - Cathrine Mihalopoulos
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
| | - Anne Muldowney
- Carers Australia, Unit 2/11 McKay Ln, Turner, Australian Capital Territory, Australia
| | - Lidia Engel
- Deakin University, Institute for Health Transformation, Burwood, Victoria, Australia.,Monash University, School of Public Health and Preventive Medicine, Melbourne, Victoria, Melbourne, Australia
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Gallego-Alberto L, Smaling HJ, Francke AL, van de Brug T, van der Steen JT, Joling KJ. The relationship between guilt feelings, conflicts with staff and satisfaction with care in relatives of nursing home residents with dementia: A longitudinal analysis. DEMENTIA 2021; 21:5-20. [PMID: 34250841 DOI: 10.1177/14713012211024015] [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] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Family caregivers often experience guilt after nursing home placement. The aim of the present study was to describe family caregivers' guilt over time and assess the impact of conflicts with staff and satisfaction with care on guilt. METHOD Data of 222 family caregivers at three assessments during one-year follow-up were used. In addition to caregivers' guilt and the variables conflicts with staff and satisfaction with the care, potential confounders were measured: sociodemographic data, clinical characteristics of the person with dementia, and caregiver burden. Linear mixed model analyses were performed to examine the longitudinal relationships between variables. RESULTS Guilt remained stable over time. Unadjusted models showed that conflicts with staff were positively associated with guilt (β = 0.11; p < 0.001; 95% CI: 0.06 to 0.16) and satisfaction with care showed a negative association with guilt (β = -0.10; p< 0.05; 95% CI: -0.18 to -0.01). After adjusting for the confounders, only the positive association of guilt with conflicts with staff was similar as in the unadjusted analysis (β = 0.11; p < 0.001; 95% CI: 0.05 to 0.16), whereas satisfaction with care was not significantly associated with guilt in the adjusted analyses (β = -0.07; p = 0.10; 95% CI: -0.16 to 0.01). DISCUSSION More conflicts with staff are associated with stronger guilt feelings. Guilt feelings are experienced by caregivers even after the admission of the person with dementia, and they remain stable over time. Further studies should focus on how to address guilt in family caregivers of people with dementia living in nursing homes.
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Affiliation(s)
- Laura Gallego-Alberto
- Faculty of Psychology, Autonomous University of Madrid, Department of Biological and Health Psychology, Madrid, Spain
| | - Hanneke Ja Smaling
- Department of Public Health and Primary Care, 4501Leiden University Medical Center, Leiden, The Netherlands; Department of Public and Occupational Health, Amsterdam University Medical Centers, Location VU University Medical Center, Amsterdam, The Netherlands
| | - Anneke L Francke
- Nivel - Netherlands Institute of Health Services Research in Utrecht, and VU University Medical Center, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Tim van de Brug
- Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, 4501Leiden University Medical Center, Leiden, The Netherlands; Department of Primary and Community Care, Radboud university medical center, Nijmegen, The Netherlands; Department of Public and Occupational Health, Amsterdam University Medical Centers, VU University Medical Center, Amsterdam, The Netherlands
| | - Karlijn J Joling
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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