Psychological distress and mental health of Thai caregivers

Effect of psychological first aid program on stress level and psychological well-being among caregivers of older adults with alzheimer's disease

Introduction

Older adults with Alzheimer’s disease (AD) experience drastic changes in their physical and mental abilities. AD patients became heavily dependent on their caregivers for everyday functions, which have significant implications not only for them but also for their caregivers. So, many AD caregivers experienced an increased level of depression and anxiety symptoms, lower perceived control, and higher burden compared to non-AD caregivers. Therefore, psychological first aid (PFA) and educational interventions are designed to enable those caregivers to meet the daily requirements of their patient care and to cope with its challenges.

Aim

Determine the effect of psychological first aid program on stress level and psychological well-being among caregivers of older adults with Alzheimer’s disease.

Design

One group pre-test post-test was followed.

Subjects

A convenience sample of one hundred (100) caregivers of older adults with AD.

Setting

All online groups concerned with the care of Alzheimer’s disease patients on Facebook.

Tools

Socio-demographic and clinical data of older adults with Alzheimer’s disease and their caregivers’ questionnaire, Alzheimer’s disease knowledge scale, Kingston caregiver stress scale, and authentic identity measures (AIM) scale of psychological well-being

Results

The psychological first aid program has highly statistically significant effect on the AD caregivers’ knowledge, stress level and psychological well-being as (t=-30.707, P = 0.000, t = 8.500, P = 0.000 & t= -4.763, P = 0.000 respectively).

Conclusion

Psychological first aid program is considered an effective intervention in decreasing the AD caregivers’ stress and increasing their psychological wellbeing and knowledge regarding delivering care for AD patients.

Mental Distress and Associated Factors Among Hospitalized Medical-Surgical Adult Inpatients in Public Hospitals, Addis Ababa, Ethiopia, 2020: Cross-Sectional Study

BACKGROUND

Mental distress is a mental or psychological syndrome which influences the health status, treatment effectiveness, and quality of care of a hospitalized medical-surgical inpatient. It is more common in a hospital setting than in a community setting. Thus, the aim of this study was to assess the prevalence of mental distress and associated factors among hospitalized medical-surgical adult inpatients in public hospitals, Addis Ababa, Ethiopia, 2020.

METHODS

An institutional-based cross-sectional study was conducted among a total of 408 study subjects from March 1 to 30, 2020. The study participants were recruited by systematic random sampling technique and data were collected using an interviewer-administered questionnaire. The collected data were entered into EpiData 3.1 and exported to SPSS version 26 for analysis, and then binary and multiple logistic regressions were performed to check the association between dependent and independent variables.

RESULTS

The prevalence of mental distress among hospitalized medical-surgical adult inpatients in public hospitals was 53.1%. Variables of being married [AOR = 2.67; 95% CI (1.065, 6.683)], private employee [AOR = 2.21; 95% CI (1.001, 4.900)], daily laborer [AOR = 4.70; 95% CI (1.218, 18.215)], rural residence [AOR = 1.85; 95% CI (1.047, 3.264)], drinking alcohol [AOR = 1.68; 95% CI (1.025, 2.740)], previous psychiatric illness [AOR = 3.40; 95% CI (1.078, 10.737)] and comorbidity [AOR = 1.93; 95% CI (1.200, 3.094)] were found to be significantly associated with mental distress.

CONCLUSION

The prevalence of mental distress was high and being married, a private employee, daily laborer, living in a rural area, previous history of psychiatric illness, alcohol use, and comorbidity were associated with mental distress among hospitalized adult inpatients. Therefore, healthcare providers should provide special consideration to those groups of patients admitted to the hospital.

Family Care, Economic Stress, and Depressive Symptoms Among Chinese Adults During the COVID-19 Outbreak: Difference by Urban and Rural Areas

Background: Although several studies have shown an association of family care with a high level of depressive symptoms, the relationship between them remains indistinguishable. Objective: This study aims to examine the associations between family care, economic stress, and depressive symptoms among Chinese adults in urban and rural areas during the COVID-19 outbreak. Methods: Based on cross-sectional data collected through online surveys from February 1st to 10th 2020 in China the present study recruited 2,858 adults. It used multiple linear regression to examine the association between family care and depressive symptoms, while economic stress was examined as moderators on the above relationship. Results: The results showed that caring for both the elderly and children was significantly associated with higher depressive symptoms compared with non-caregivers (B = 2.584, 95%CI: 1.254, 3.915), and a similar result was also found in urban areas. Also, caring for the elderly only was also had a higher level of depressive symptoms than non-caregivers in rural areas (B = 3.135, 95%CI: 0.745, 5.525). Meeting the care needs was significantly associated with lower depressive symptoms compared with unmet care needs, while for rural caregivers, the results were not significant. Besides, economic stress strengthened the effect of family care needs on depressive symptoms for sandwich-generation caregivers who provide care to both the elderly and children (B = 0.605, 95%CI: 0.077, 1.134). While in rural areas, the moderation effects of economic stress were only found for elderly caregivers (B = 1.106, 95%CI: 0.178, 2.035). Conclusion: These findings suggest that we should pay more attention to the family caregiver's mental health during the COVID-19 outbreak. In addition, more effective policies should be developed to provide financial support for family caregivers, especially for sandwich-generation caregivers and rural elderly caregivers.

Internal and external resources, tiredness and the subjective well-being of family caregivers of older adults: a case study from western Thailand, Southeast Asia

This study examined the effects of several aspects of care-giving on the subjective well-being (SWB) of family caregivers of older adults. These aspects were comprised of external resources including social support, affection, and internal resources including confidence, positive appraisal and coping strategies, and tiredness. The level of happiness (0-10) was used as the gauge of SWB. The data were from a cross-sectional study of 270 primary family caregivers in western Thailand. Multiple regression models controlling for age, gender, kinship to care for recipients, self-rated health, duration and hours of care-giving were estimated. Both social support in terms of appreciation and admiration for care-giving, as opposed to such care being considered a caregivers' duty, as well as inner strength derived from a positive attitude and self-perceived ability in care-giving were positively associated with SWB. Tiredness had a significant negative association with SWB. The implications of these findings for policy and intervention programs are discussed.

State of household need for caregivers and determinants of psychological burden among caregivers of older people in Thailand: An analysis from national surveys on older persons

OBJECTIVES

To explore the levels and trends of household need for caregivers of older people and to explore the impact of potential determinants of psychological burden among caregivers of older people in Thailand.

METHODS

The secondary data analysis was performed using the Survey of Older Persons in Thailand 2007, 2011, and 2014 datasets which conducted by the National Statistical Office of Thailand. The household need for caregivers of older persons refers to having at least one older person in the household who needs a caregiver for assistance with activities of daily living. Caregiver mental health, which is confined to the available 2011 data, is defined as a state of psychological burden. Ordinal logistic regression models were used to explore the impact of potential determinants of psychological caregiver burden.

RESULTS

The household need for caregivers in Thailand tends to be increasing, from 5.0% in 2007 to 6.6% in 2014. The levels of the household need for caregivers were significantly higher in urban areas, Bangkok, and high socioeconomic households. In terms of psychological caregiver burden, the Thai Mental Health Indicators in 2011 produced, on average, a fair level of mental health, but one-fourth of caregivers had poor mental health. Duration of care for older people, household wealth, and functional dependency significantly predict total caregiver burden. Household characteristics are vital in predicting psychological caregiver burden, and the adjusted effect of the fifth quintile of household wealth was high (odds ratio = 2.34; 95% confidence interval = 1.47-3.73).

CONCLUSION

The increasing need for caregiving in households with an older person can lead to a higher caregiver burden, particularly among those caregivers who care for dependent older people in poor households. Longer duration of caregiving is a factor that mitigates this burden.

Effectiveness of Caregivers' Yoga Module on Psychological Distress and Mental Well-Being among Caregivers of Patients Admitted to Neurological Rehabilitation Wards of a Tertiary Care Institute, Bengaluru, Karnataka, India

Background Caregivers of patients admitted to neurorehabilitation wards may experience higher psychological distress (PD) and poor mental well-being (MWB). This study aimed to empower caregivers to cope effectively with PD and maintain well-being by practicing yoga.

Materials and Methods A total of 34 caregivers were randomized to the experimental group (EG) and waitlisted control group in a multiphase manner. Data were collected using sociodemographic schedule, Kessler’s Psychological Distress scale–10, and Warwick–Edinburgh’s Mental Well-being Scale. Caregivers’ yoga module (CYM) consisting of satsanga (theory), asanas (postures), pranayama (breath control), imagery, meditation, and relaxation techniques was taught to those in the EG at 35 m/d for eight consecutive days. They were encouraged to continue on their own for another 3 weeks. Posttest data were collected from both groups on the 15th and 29th days. Analysis was done with IBM SPSS statistics version 22 (IBM Corp., Armonk, New York, United States).

Results There was statistically significant reduction of PD and improvement of MWB among caregivers of EG within (PD: F = 17.78, p < 0.001; MWB: F = 5.48, p < 0.03) and between (PD: F = 15.87, p < 0.001; MWB: F = 15.87, p < 0.01) the groups after the CYM. A significant negative correlation was found between pretest MWB and PD ( r =–0.579, p < 0.01). Caregivers who were married and caregivers’ perception of poor improvement of patient condition were significantly associated with PD.

Conclusion Findings provide preliminary evidence for the effectiveness of CYM on PD and MWB among caregivers of patients admitted to neurorehabilitation wards.

The hidden cost of informal care: An empirical study on female caregivers' subjective well-being

Using data from the China Health and Nutrition Survey (CHNS), this study investigated the impact of informal care on female caregivers' subjective well-being in China. We found that informal care significantly reduced the subjective well-being of female caregivers using the instrumental variable (IV) ordered probit model. Our results revealed that the care effect on subjective well-being was more significant for rural caregivers than for urban caregivers. The more hours or more recipients care was provided for, the greater the negative impact on subjective well-being. Based on these findings, we further identified the two channels of 'wealth' and 'health' through which informal care lowered subjective well-being. These results have implications for policy makers in overcoming the challenges involved in constructing and developing a supportive system of informal care in China.

Tools for the Measurement of Psychological Aspects of Organ Donation among the Families of Brain-dead People

BACKGROUND

According to the basic ethical principle of non-maleficence, organ procurement systems need to be accountable to donor families. As organ donation can be potentially traumatic, donor families are at risk of developing psychological damage. Appropriate measurement tools are needed to diagnose such disorders and develop appropriate treatment measures.

OBJECTIVE

To examine the appropriateness of measurement tools and approaches used in previous studies for assessing donor families' psychological well-being.

METHODS

A structured online search was conducted in electronic databases namely ScienceDirect, PubMed, ProQuest, Scopus, Ovid, and Web of Science. The main inclusion criterion was the use of psychological assessment tools for data collection.

RESULTS

10 studies were included in which different tools had been used for measuring donor families' psychological well-being in the following 5 dimensions: stress, depression, grief, general health, and positive legacy of trauma. The major pitfalls of the reviewed studies were failure to specifically assess complicated grief and differentiating it from other psychological disorders, diversity of the tools used for psychological well-being assessment, and lack of clear definitions of donor families' psychological well-being and its dimensions.

CONCLUSION

Donor families' psychological well-being is a complex and multidimensional concept and the existing measurement tools cannot accurately assess it. Therefore, the concept needs to be clearly explored and defined. Developing a comprehensive measurement tool or a set of scales is necessary for the early diagnosis of any impairment in donor families' psychological well-being.

Psychological well-being over time among informal caregivers caring for persons with dementia living at home

OBJECTIVES

To investigate informal caregivers' psychological well-being and predicted increase in psychological well-being, when caring for persons with dementia (PwDs) living at home, related to caregiver, PwD and formal care (FC) factors.

METHOD

A cohort study at baseline and 3 months' follow-up in eight European countries. Caregivers included (n = 1223) were caring for PwDs aged ≥ 65 years at home. Data on caregivers, PwDs and FC were collected using standardized instruments. Regression analysis of factors associated with caregiver psychological well-being at baseline and 3 months later was performed.

RESULTS

Factors associated with caregiver psychological well-being at baseline were positive experience of caregiving, low caregiver burden, high quality of life (QoL) for caregivers, male gender of PwD, high QoL of PwD, few neuropsychiatric symptoms and depressive symptoms for the PwD. At follow-up, caregivers with increased psychological well-being experienced of quality of care (QoC) higher and were more often using dementia specific service. Predicting factors for caregivers' increased psychological well-being were less caregiver burden, positive experience of caregiving, less supervision of the PwD and higher caregiver QoL, if PwD were male, had higher QoL and less neuropsychiatric symptoms. Furthermore, higher QoC predicted increased caregivers' psychological well-being.

CONCLUSION

Informal caregiving for PwDs living at home is a complex task. Our study shows that caregivers' psychological well-being was associated with, among other things, less caregiver burden and higher QoL. Professionals should be aware of PwD neuropsychiatric symptoms that might affect caregivers' psychological well-being, and provide proper care and treatment for caregivers and PwDs.

Characteristics and well-being of informal caregivers: Results from a nationally-representative US survey

OBJECTIVES

Given ongoing concerns about high levels of burden reported among some informal caregivers, the goal of this study was to characterize their sociodemographics, health, and well-being.

METHODS

Using cross-sectional data from a large nationally representative survey in the United States (N = 438,712) we identified adults who provided informal care to friends or family members with a health problem, long-term illness, or disability. Descriptive statistics and propensity matching were used to characterize caregivers and compare their health and social support to sociodemographically-similar adults who were not caregivers. Logistic regression models examined associations between caregiving and respondents' mental health, general health, perceived social support, and sleep problems.

RESULTS

A total of 111,156 (25.3%) participants reported being caregivers, most of whom reported good mental health (90%) good general health (83%), and adequate social support (77%). After adjusting for respondents' gender, caregivers reported worse mental health than non-caregivers (odds ratio (OR) = 1.35, 95% confidence interval (CI) = 1.31-1.39 for >15 days poor mental health in the past month) but better general health (OR = 0.96, 95%CI = 0.94-0.98 for fair or poor health). Men caregivers reported somewhat worse overall health than non-caregivers (OR = 1.09, 95%CI = 1.05-1.13) whereas women reported better overall health.

DISCUSSION

Although reporting good overall well-being, caregivers remain vulnerable for worse outcomes than non-caregivers. Caregiving is associated with poor mental health, and may have additional impacts on the physical health of caregiving men.