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Unson C, Njoku A, Bernard S, Agbalenyo M. Racial and Ethnic Disparities in Chronic Stress among Male Caregivers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6188. [PMID: 37372773 DOI: 10.3390/ijerph20126188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Whereas research on caregiving is well documented, less is known about gender inequalities in caregiver stress, coping mechanisms, and health outcomes, all of which may vary by race, ethnicity, and socioeconomic status. This scoping review investigated racial and ethnic disparities using the Stress Process Model among male caregivers. Several databases were searched including Academic Search Premier, Medline Complete, APA PsycInfo, CINHAL, Google, ProQuest, and Web of Science. Included were peer-reviewed articles in English, published from 1990 to 2022. A total of nine articles fulfilled inclusion criteria. Most of the articles indicated that compared to White male caregivers, African American male caregivers provided more hours of care, assisted with more activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and experienced more financial stress. In terms of coping style, one study found African American male caregivers, compared to White male caregivers, held negative religious beliefs. Another study showed that they were at a higher risk for stroke than their White counterparts. The search revealed a dearth of studies on racial disparities in stress, coping, and health outcomes among male caregivers. Further research is needed on the experiences and perspectives of male minority caregivers.
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Affiliation(s)
- Christine Unson
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, 493 Fitch Street, New Haven, CT 06515, USA
| | - Anuli Njoku
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, 493 Fitch Street, New Haven, CT 06515, USA
| | - Stanley Bernard
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, 493 Fitch Street, New Haven, CT 06515, USA
| | - Martin Agbalenyo
- Department of Public Health, College of Health and Human Services, Southern Connecticut State University, 493 Fitch Street, New Haven, CT 06515, USA
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Hengelaar AH, Wittenberg Y, Kwekkeboom R, Van Hartingsveldt M, Verdonk P. Intersectionality in informal care research: a scoping review. Scand J Public Health 2023; 51:106-124. [PMID: 34232094 PMCID: PMC9903248 DOI: 10.1177/14034948211027816] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Aim: Informal caregivers share common experiences in providing care to someone with health and/or social needs, but at the same time their experiences differ across diverse backgrounds such as gender, age, culture, as these aspects of diversity co-shape these experiences. This scoping review aims to explore how aspects of diversity, across their intersections, are currently incorporated in informal care research and discusses how an intersectional perspective can further develop our understanding of informal care. Methods: A scoping review was performed to map relevant caregiving literature from an intersectionality perspective. Key terms 'informal care' and 'intersectionality' were used for a search in four databases resulting in the inclusion of 28 articles. All 28 studies were analysed based on a scoping review created intersectionality informed coding scheme. Results: Aspects of diversity are largely understudied in informal care research, in particular across their intersections and from a critical perspective. This intersectional informed analysis revealed that when studying diverse caregiving experiences the use of intersections of dimensions of diversity provides a nuanced understanding of these experiences. Conclusions: Adopting an intersectional perspective ensures that not only different categories or social identities of caregivers are included in future studies, but the mutual relationships between these categories embedded in their specific context are actually studied.
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Affiliation(s)
- Aldiene H. Hengelaar
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands,Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands,Aldiene H Hengelaar, Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, Amsterdam UMC, location VUmc, Tafelbergweg 51, PO box 2557/1000, 1081 Amsterdam, HV, The Netherlands. E-mail:
| | - Yvette Wittenberg
- Faculty of Social and Behavioral Sciences, University of Amsterdam, The Netherlands,Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Rick Kwekkeboom
- Faculty of Applied Social Sciences and Law, Amsterdam University of Applied Sciences, The Netherlands
| | - Margo Van Hartingsveldt
- Department of Occupational Therapy, Amsterdam University of Applied Sciences, The Netherlands
| | - Petra Verdonk
- Department of Ethics, Law and Humanities, Amsterdam Public Health Research Institute, The Netherlands
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Zarzycki M, Seddon D, Bei E, Morrison V. Why do they care? A qualitative systematic review and meta-synthesis of personal and relational motivations for providing informal care. Health Psychol Rev 2022; 17:344-376. [PMID: 35383541 DOI: 10.1080/17437199.2022.2058581] [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: 11/04/2022]
Abstract
Informal caregiving is crucial to the sustainability of health and social care systems globally. With ageing populations and a rising prevalence of acute and chronic health conditions, the need for informal care is growing, making it important to understand what motivates individuals to care and to continue caring. This paper reports findings of a systematic review which examined determinants of motivations and willingness to provide informal care. A systematic search was conducted using six electronic databases and a wide range of additional sources. 105 qualitative studies published before August 2019 were included with 103 of them reporting on personal and relational motivations, and the contextual factors underpinning these. Grounded theory-based, thematic synthesis was applied to synthesise the literature. This meta-synthesis reports on findings from across the world spanning three decades, with data from over 2500 caregivers across a range of health conditions. This paper presents the relational, personal and contextual themes. It highlights the significance of reciprocity, affection, family values and caregiving obligations. Personal characteristics, finding meaning, illness perceptions, situational and temporal aspects of caregiving are also identified as important in shaping motivations and willingness to care and to continue caring. Implications for theory, research, policy and practice are discussed.
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Affiliation(s)
- Mikołaj Zarzycki
- School of Human & Behavioural Sciences, College of Human Sciences, Bangor University, Bangor, UK
| | - Diane Seddon
- School of Medical & Health Sciences, Bangor University, Bangor, UK
| | - Eva Bei
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, Israel
| | - Val Morrison
- School of Human & Behavioural Sciences, College of Human Sciences, Bangor University, Bangor, UK
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Deskins BP, Letvak S, Kennedy-Malone L, Rowsey PJ, Bedini L, Rhew D. The Experiences of African American Male Caregivers. Healthcare (Basel) 2022; 10:healthcare10020252. [PMID: 35206867 PMCID: PMC8871800 DOI: 10.3390/healthcare10020252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African American men who acted as caregivers to adult chronically ill or debilitated loved ones, the majority of whom provided care during the COVID-19 pandemic. The revised Sociocultural Stress and Coping Model (R-SSCM) guided this study. Individual interviews were conducted via the Zoom application. Content analysis revealed four themes: (1) “My time to take the reins”, (2) “It’s a male thang”, (3) “Caring amid a pandemic”, and (4) “Effects of the caregiver’s journey”. This study’s findings in relation to the literature provide overdue attention to the African American male caregiving experience, especially in relation to the COVID-19 pandemic. The implications of our findings include the need for more culturally congruent support services for African American male caregivers, as well as increased efforts to encourage trust in the healthcare system—especially in relation to vaccination for the SARS-CoV-2 virus.
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Affiliation(s)
| | - Susan Letvak
- School of Nursing, UNC Greensboro, Greensboro, NC 27402, USA; (L.K.-M.); (P.J.R.)
- Correspondence: ; Tel.: +1-336-256-1024
| | | | | | - Leandra Bedini
- School of Health and Human Sciences, UNC Greensboro, Greensboro, NC 27402, USA;
| | - Denise Rhew
- Cone Health, Greensboro, NC 27401, USA; (B.P.D.); (D.R.)
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Zarzycki M, Morrison V, Bei E, Seddon D. Cultural and societal motivations for being informal caregivers: a qualitative systematic review and meta-synthesis. Health Psychol Rev 2022; 17:247-276. [PMID: 35081864 DOI: 10.1080/17437199.2022.2032259] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Informal caregiving constitutes the mainstay of a society's care supply. Motivations for caring and continuing to provide care are crucial to understanding the nature of caregiver experiences and their relationship with the person/people they support. This systematic review of qualitative evidence examines determinants of motivations and willingness to provide informal care. 105 qualitative studies published before August 2019 and fitting the inclusion criteria were identified, 84 of them pertaining to cultural and societal motivations for caregiving. Grounded theory-based, thematic synthesis was conducted. Cultural and societal factors strongly underpinned motivations and willingness for informal caregiving. The main cultural motives for caregiving were cultural values and beliefs encompassing the ethnocultural context of the caregiving role, culture-specific norms, cultural and spiritual beliefs, illness beliefs and socialisation. Societal norms and perceived expectations, such as gendered roles, norms and expectations of caregiving, and perceptions of health and social care services further shaped caregiver motivations and willingness to provide care. These meta-synthesis findings contribute towards novel understandings about the cultural and societal aspects shaping informal care provision. These findings bear important implications for theory, research, policy and practice; all of which contributing to the issue of the sustainability of informal care from a 'macro' perspective.
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Affiliation(s)
- Mikołaj Zarzycki
- School of Human & Behavioural Sciences, College of Human Sciences, Bangor University, Bangor LL57 2DG, Wales, United Kingdom; Telephone
| | - Val Morrison
- School of Human & Behavioural Sciences, College of Human Sciences, Bangor University, Bangor LL57 2DG, Wales, United Kingdom;
| | - Eva Bei
- Department of Psychology, Faculty of Social Sciences, Bar-Ilan University, Ramat Gan, 5290002, Israel;
| | - Diane Seddon
- School of Health Sciences, Bangor University, Bangor LL57 2DG, Wales, United Kingdom;
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Finn C, Boland P. Male family carers' experiences of formal support - a meta-ethnography. Scand J Caring Sci 2020; 35:1027-1037. [PMID: 33107643 DOI: 10.1111/scs.12919] [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: 01/12/2020] [Revised: 07/11/2020] [Accepted: 10/05/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Men represent a growing proportion of unpaid family carers across Europe. Comparative studies have proposed male carers experience their caring role differently to females; men are less likely to avail of formal support services than women. Social ideas around masculinity have been linked to the help-seeking behaviours of male carers, as well as men's attitudes around accessing formal support. More understanding about this role from the perspective of male carers is required. METHODS The study followed a meta-ethnography process starting with a systematic literature search of five electronic databases. The methodological quality of the selected studies was evaluated using the Mc Master checklist. Using NVivo 12 software, primary data were analysed and themes throughout the papers were identified. Results were synthesised as a meta-ethnography that retained direct quotes from the studies. RESULTS Two themes and five sub-themes were developed from the data. The first theme was 'Men's experiences of formal support' which contained sub-themes 'Reluctance to step back', 'A space to share emotions' and 'Education diminishes burden'. The second theme was 'Coping without Formal Support' with sub-themes 'Satisfied without help' and 'Duty prevents help seeking'. CONCLUSIONS Fear of perceived failure and a loss of control in the caring relationship were key factors in men's low trust and dissatisfaction with available services. To engage more male carers, formal service providers should acknowledge men's wish to be seen as competent in the care role as well as their desire to stay involved in decision-making around care for their family member. Support services that were collaborative, education-based and gender-sensitive were favoured by male carers.
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Affiliation(s)
- Caroline Finn
- Castletroy, University of Limerick, Limerick, Ireland
| | - Pauline Boland
- School of Allied Health, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland.,Ageing Research Centre (ARC), Health Research Institute, University of Limerick, Limerick, Ireland
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Francis LE, Bowman KF, Kypriotakis G, Rose JH. Relationships and emotional wellbeing among African American and White advanced cancer caregivers. PATIENT EDUCATION AND COUNSELING 2011; 85:446-453. [PMID: 21439755 PMCID: PMC3134587 DOI: 10.1016/j.pec.2011.01.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 01/03/2011] [Accepted: 01/21/2011] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Advanced cancer family caregivers who have good relationships with other family members and with patient's health care providers (PHCPs) have less emotional distress than caregivers with poor relationships. Given a history of different experiences in medical settings among Whites and African Americans, we examined moderation effects by race. METHODS Baseline data from an ongoing study were collected via telephone interviews with 397 family caregivers of advanced cancer patients at two cancer clinics. Depressed mood and anxiety were measured with the 14-item Profile of Mood States. RESULTS Caregivers reporting good relationships with family (p<.001) and PHCPs (p<.001) had lower anxiety and less depressed mood (family, p<.01; PHCP, p<.001). Caregiver race moderated relationship quality: Whites with good PHCP relationships felt less depressed mood (p<.01) and anxiety (p<.01). African Americans with good family relationships showed less depressed mood (p<.05), but no association with anxiety. CONCLUSION Good relationships are important for caregivers, but PHCPs may have more influence on the wellbeing of White than of African American caregivers. PRACTICE IMPLICATIONS Developing relationships with caregivers of advanced cancer patients may improve wellbeing for caregivers. In addition, creating strategies to support family relationships may be a useful intervention, especially for African American advanced cancer caregivers.
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Affiliation(s)
- Linda E Francis
- Department of Medicine, Case Western Reserve University, Cleveland, OH, USA.
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Northfield S, Nebauer M. The Caregiving Journey for Family Members of Relatives With Cancer. Clin J Oncol Nurs 2010; 14:567-77. [DOI: 10.1188/10.cjon.567-577] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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