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Duangjina T, Hershberger PE, Gruss V, Fritschi C. Resilience in family caregivers of Asian older people with dementia: An integrative review. J Adv Nurs 2024. [PMID: 38863175 DOI: 10.1111/jan.16272] [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: 01/06/2024] [Revised: 05/09/2024] [Accepted: 05/29/2024] [Indexed: 06/13/2024]
Abstract
AIM To identify factors associated with resilience in family caregivers of Asian older people with dementia based on Luthar and Cicchetti's definition of resilience. DESIGN Integrative review of resilience in family caregivers of Asian older people with dementia reported by studies with quantitative and qualitative research designs. DATA SOURCES Databases used for the literature search included CINAHL, PubMed, EMBASE, PsycINFO and Google Scholar. REVIEW METHODS A total of 565 potentially relevant studies published between January 1985 and March 2024 were screened, and 27 articles met the inclusion criteria. RESULTS Family caregivers were most commonly adult children of care recipients, female and providing care in their home. Two themes emerged from the review: factors associated with adversity (dementia severity, caregiver role strain, stigma, family stress, female gender, low income and low education) and factors associated with positive adaptational outcomes (positive aspect of caregiving, social support and religiosity/spirituality). CONCLUSION In our review of Asian research, four new factors-caregiver role strain, stigma, family stress and positive aspects of caregiving-emerged alongside those previously identified in Western studies. A paradigm shift was observed from a focus on factors associated with adversity to factors associated with positive adaptational outcomes, particularly after the issuance of the WHO's 2017 global action plan for dementia. However, a gap remains between WHO policy recommendations and actual research, with studies often neglecting to address gender and socioeconomic factors. IMPACT The review findings will broaden healthcare providers' understanding of resilience in dementia caregivers and use them to develop comprehensive programmes aimed at reducing factors associated with adversity and enhancing those associated with positive adaptational outcomes. This approach can be customized to incorporate Asian cultural values, empowering caregivers to navigate challenges more effectively. NO PATIENT OR PUBLIC CONTRIBUTION This paper is an integrative review and does not include patient or public contributions.
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Affiliation(s)
- Thitinan Duangjina
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Patricia E Hershberger
- Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, Michigan, USA
| | - Valerie Gruss
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
| | - Cynthia Fritschi
- Department of Biobehavioral Nursing, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA
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da Silva-Sauer L, Garcia RB, Fonsêca ÉKG, Fernández-Calvo B. Physical activity and its relationship to burden and health concerns in family caregivers of people with dementia. Psychogeriatrics 2024; 24:165-173. [PMID: 38037197 DOI: 10.1111/psyg.13053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 10/24/2023] [Accepted: 11/20/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Caring for people with dementia (PwD) usually triggers stress and leads to mental and somatic health complaints (SHCs). Physical activity (PA) can provide burden relief in PwD caregivers, but it is not clear whether PA habits would contribute to reducing SHCs. This study aims to analyze the effect of PA on the relationship between burden and SHCs in a sample of family caregivers of PwD. METHODS One hundred and fifty-seven caregivers of PwD reported their PA habits, and completed the Giessen's Subjective Health Complaints Questionnaire (GBB-8) and the Zarit Burden Interview (ZBI). The relationship between PA habits, burden of care (ZBI), and SHCs (B-GBB-8 scale) was examined. Subsequently, the moderating effect of PA habits on the relationship between burden and SHCs was tested. RESULTS PA habit was inversely associated with ZBI (rbp = -0.242) and GBB-8 scores (rbp (Gastrointestinal) = -0.174; rbp (Musculoskeletal) = -0.195; rbp (Exhaustion) = -0.247; rbp (Cardiovascular) = -0.250; and rbp (Overall) = -0.257, respectively), whereas moderate positive correlations were found between ZBI and GBB-8 scores (r (Gastrointestinal) = 0.483; r (Musculoskeletal) = 0.536; r (Exhaustion) = 0.542; r (Cardiovascular) = 0.438; and r (Overall) = 0.598, respectively). The interaction effect of PA habit and burden was significant for the overall SHCs (b = -0.11; P < 0.05) and cardiovascular complaints (b = -0.06; P < 0.05). However, the association between burden and SHCs was significant (P < 0.001) only for sedentary caregivers. CONCLUSION These findings indicate that maintaining an active lifestyle through regular PA could potentially help alleviate the adverse effects of caregiver burden on somatic health among caregivers of PwD. Encouraging and endorsing PA interventions for informal caregivers might yield substantial advantages for their health and general well-being.
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Affiliation(s)
- Leandro da Silva-Sauer
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
| | - Ricardo Basso Garcia
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
| | - Égina Karoline Gonçalves Fonsêca
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
- Department of Neuroscience, University of São Paulo, Ribeirão Preto, Brazil
| | - Bernardino Fernández-Calvo
- Laboratory of Ageing and Neurodegenerative Disorder, Department of Psychology, Federal University of Paraíba, João Pessoa, Brazil
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Córdoba, Córdoba, Spain
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Córdoba, Spain
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Feng Y, Liu X, Zhang S, Lin T, Guo X, Chen J. Relationship among post-traumatic growth, spiritual well-being, and perceived social support in Chinese women with gynecological cancer. Sci Rep 2024; 14:4847. [PMID: 38418533 PMCID: PMC10902294 DOI: 10.1038/s41598-024-55605-5] [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] [Received: 07/02/2023] [Accepted: 02/26/2024] [Indexed: 03/01/2024] Open
Abstract
This study aimed to examine the correlation between post-traumatic growth (PTG), spiritual well-being (SWB), perceived social support (PSS), and demographic and clinical factors in Chinese gynecological cancer patients. Through convenience sampling, we conducted a cross-sectional study of 771 adult patients with gynecological cancer. The European Organization for Research and Treatment for Cancer Quality of Life Questionnaire-Spiritual Well-being 32 (EORTC QLQ-SWB32), Post-traumatic Growth Inventory (PTGI), and Multidimensional Scale of Perceived Social Support (MSPSS) were used to measure SWB, PTG, and PSS. A Multiple Linear Regression Model was used to determine the possible factors contributing to PTG. The subscale with the highest centesimal score in the PTGI was the Appreciation of Life Scale, and the lowest was New Possibility. Gynecologic cancer patients with younger ages (B = - 0.313, P = 0.002), perceived more family support (B = 1.289, P < 0.001), had more existential (B = 0.865, P = 0.010), and had religious belief (B = 5.760, P = 0.034) may have more PTG. Spiritual well-being, perceived social support, younger age, and religious beliefs are associated with post-traumatic growth in gynecological cancer patients. Healthcare staff could provide more professional support to younger patients with religious beliefs. Promoting social support and spiritual well-being could potentially serve as effective interventions for boosting PTG among gynecological cancer.
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Affiliation(s)
- Yue Feng
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xingcan Liu
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Shixi Zhang
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Tangwei Lin
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Xiujing Guo
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China
| | - Jing Chen
- Department of Gynecological Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
- Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, China.
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Duangjina T, Fink AM, Gruss V. Resilience in Family Caregivers of Asian Older Adults With Dementia: A Concept Analysis. ANS Adv Nurs Sci 2023; 46:E145-E160. [PMID: 36728751 DOI: 10.1097/ans.0000000000000471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Asian family caregivers of older adults with dementia have stressful caregiving situations over long periods; they must become resilient to recover from adversity. A conceptual definition of resilience specific to Asian family caregivers is important for understanding their caregiving phenomena and the relationships with mental health and psychological well-being. The purpose of this concept analysis was to define resilience in family caregivers of Asian older adults with dementia using Walker and Avant's method. The findings of the analysis will guide future research about the modifiable factors that will prevent negative health outcomes in this population of caregivers.
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Affiliation(s)
- Thitinan Duangjina
- Faculty of Nursing, Chiang Mai University, Chiang Mai, Thailand (Ms Duangjina); and Biobehavioral Nursing Science Department, College of Nursing, University of Illinois Chicago, Chicago (Ms Duangjina and Drs Fink and Gruss)
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Wang Q, Chen S, Liu W, Zan C, Sheng Y. Validation of the Chinese version of the Family Crisis Oriented Personal Evaluation Scales in families of patients with dementia. Geriatr Nurs 2022; 45:131-139. [PMID: 35421839 DOI: 10.1016/j.gerinurse.2022.03.008] [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: 01/19/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 11/29/2022]
Abstract
Caring for people with dementia causes heavy care burdens to their families. Family coping is important in decreasing burdens and promoting family adaptation. To comprehensively assess and understand these issues, we validated the Chinese version of the Family Crisis Oriented Personal Evaluation Scales (F-COPES) which is widely used to evaluate family coping. Data for psychometric property evaluation were obtained from 215 family members of patients with dementia. The instrument showed satisfactory content validity (scale content validity index 0.98), convergent validity (r = 0.50, P < 0.01), and internal consistency (Cronbach's alpha 0.86). The confirmatory factor analysis identified six factors, namely, acquiring relatives' support, acquiring friends' support, acquiring neighbors' or others' support, seeking spiritual support, reframing, and passive appraisal (χ2/df 1.86, CFI 0.88, TLI 0.87, PGFI 0.68, RMSEA 0.06). This instrument may serve as a useful scale for assessing the coping behaviors of families of patients with dementia in mainland China.
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Affiliation(s)
- Qingyan Wang
- Department of Clinical Nursing, School of Nursing, Xuzhou Medical University, Xuzhou Medical University Affiliated Oriental People's Hospital, Xuzhou, 221004, China
| | - Sanmei Chen
- Department of Global Health Nursing, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, 734-8551, Japan
| | - Weiwei Liu
- School of Nursing, Army Medical University, Chongqing, 400038, China
| | - Chang Zan
- Department of Clinical Nursing, School of Nursing, Xuzhou Medical University, Xuzhou Medical University Affiliated Oriental People's Hospital, Xuzhou, 221004, China
| | - Yu Sheng
- School of Nursing, Peking Union Medical College, Beijing, 100144, China.
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Mao S, Lu H, Zhang Y, Yu J, Li X, Peng J, Liang Y. Evaluation of Psychosocial Pathways to Family Adaptation of Chinese Patients With Liver Cancer Using the McCubbin's Family Resilience Model. Front Psychiatry 2021; 12:703137. [PMID: 34975555 PMCID: PMC8717998 DOI: 10.3389/fpsyt.2021.703137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 11/26/2021] [Indexed: 12/24/2022] Open
Abstract
Background and Aim: With the prolonged survival time of patients with liver cancer, these families may face tremendous pressure and development dilemmas that can easily lead to family adaptation crises. Correspondingly, family adaptation crises adversely affect the quality of life of patients and family members. Basing on McCubbin's resilience model of family stress, adjustment, and adaptation, and considering the key factors affecting family resilience based on a review of literature, this study involved a construction of a family adaptation influencing factors model in Chinese liver cancer patients, which was then verified and revised. Methods: This cross-sectional study was conducted between August and December 2020. Using convenience sampling, we selected 265 liver cancer families from the liver tumor center of a teaching hospital affiliated with a university in Shanghai, China. Data from 252 patients with liver cancer and their caregivers were used to identify the factors and pathways associated with family adaptation. The relationships were modeled using structural equations. Results: A total of 265 liver cancer families participated in the survey, and 252 valid questionnaires were returned, with a response rate of 95.09%. The pathway regression coefficients of six factors (family burden, individual resilience, family problem-solving and coping, inner family support, outer family social support, and family function) in the model were found to be statistically significant (P < 0.05), indicating that all of them were significantly associated with family adaptation. Among them, inner family support, outer family social support, and family function were direct influencing factors, while the others were indirect. The path coefficients of the total effect of the determinants on family adaptation were as follows (from largest to smallest): individual resilience (0.562), family function (0.483), outer family social support (0.345), family burden (-0.300), inner family support (0.293), family problem-solving and coping (0.127). Conclusions: Our findings suggest that clinical nurses should not only pay particular attention to direct influencing factors, develop strategies to strengthen the overall family function, encourage patients and caregivers to utilize inner family and outer family social support, but should also consider indirect influence factors, focus on the vital role of the individual, and promote patients' and caregivers' personal and family coping ability.
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Affiliation(s)
- Shirou Mao
- School of Nursing, Fudan University, Shanghai, China
| | - Huijuan Lu
- School of Nursing, Fudan University, Shanghai, China
| | - Yuxia Zhang
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jingxian Yu
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaorong Li
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jian Peng
- School of Nursing, Fudan University, Shanghai, China
| | - Yan Liang
- School of Nursing, Fudan University, Shanghai, China
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