Support, needs and expectations of family caregivers regarding general practitioners - results from an online survey

Knowledge sharing in virtual communities of practice of family caregivers of people with Alzheimer's

INTRODUCTION

Knowledge sharing can only happen in the context of a trusting and supportive environment, such as evolves in communities of practice and their virtual equivalent, virtual communities of practice. The main objective of this study was to understand knowledge sharing between participants in a virtual community of practice of caregivers of people with Alzheimer's.

METHODS

The authors designed their own mobile application, and two virtual communities of practice were created independently and differentiated by how they were moderated: one by an expert caregiver and the other by three health professionals. 38 caregivers and four moderators were involved in the study, which ran between July 2017 and April 2018. A total of 1925 messages were exchanged within the two communities and used as data in the study. Message data was analysed using LINKS (Leveraging Internet Networks for knowledge sharing).

RESULTS

Participants were more motivated to acquire knowledge related to caring for the person with Alzheimer's rather than caring for themselves. The purpose of the messages was to inform others about the sender and not to seek answers. It seems that the interaction was more to socialise and to feel heard, than to gain information. Face to face meetings appear to have accelerated community development. On nearly every parameter, behaviour was significantly different in the two communities, reflecting the importance of the character of the moderator. Caring for oneself was a much stronger theme in the community that included health professionals. Experiential knowledge sharing was particularly strong in the group led by a caregiver.

DISCUSSION

Caregivers adapted the virtual community of practice to their own needs and mainly shared social knowledge. This focus on social support, which seems to be more valued by the caregivers than information about the disease, was not an expected pattern. Virtual communities of practice where peers count on each other, function more as a support group, whereas those moderated by health professionals function more as a place to go to acquire information. The level of interactivity points to such communities being important for knowledge sharing not mere knowledge transfer.

Emotional Support from Care Recipients, Caring Relationship Quality, and Caregiving Self-Efficacy among Family Caregivers of Older Adults

We analyzed 756 family caregivers (mean age = 62.3 years), investigating how emotional support from older care recipients was linked to caregivers' self-efficacy through caring relationship qualtiy. Results indicate a significant positive association between emotional support and caregivers' self-efficacy (r = 0.207, p < .01). Caring relationship quality positively correlated with emotional support (r = 0.292, p < .01) and caregivers' self-efficacy (r = 0.141, p < .01). Controlling for socialdemographic and care-related factors, relationship quality partially mediated the association between emotional support from care recipients and caregivers' self-efficacy. This suggests that interventions supporting caregivers' self-efficacy may benefit from considering both care recipients and dyadic relationships.

Family physicians' preferences for education to support family caregivers: a sequential mixed methods study

BACKGROUND

One in four Canadians is a family caregiver. Family caregivers (carers, care-partners) are relatives or chosen family, friends, or neighbors who provide 75 to 90% of the care for people with physical or mental illness, disabilities, or frailty living in community homes and assist with 15 to 30% of the care in congregate care. However, a recent (2022) Statistics Canada population health study reports 44% of family caregivers are distressed. Family physicians and primary care teams are well-positioned to support family caregivers; yet, family caregiver needs assessments tend to be ad hoc and their most common needs remain unmet. Research recommends training healthcare professionals to enhance their knowledge and skills to support family caregivers.

METHODS

The objective of this sequential mixed methods research, a survey followed by qualitative interviews, was to explore family physicians' desire and preferences for education about supporting family caregivers. 85 family physicians completed the online survey and eight took part in the interviews. Results from the survey and interviews were compared, contrasted, and interpreted together.

RESULTS

Primary care physicians expressed a desire to be better equipped to assess and support FCGs' needs. Even though most physicians (61%) were very/confident about addressing family caregivers' needs, 72% were highly/interested in education to support family caregivers of their patients. Topics with the most interest were assessing family caregivers needs in an organized way, assisting family caregivers to access resources, and address system and practice barriers to support family caregivers. The overarching theme running through the interviews was physicians hope for education to help change the patient-focused culture to inclusion of FCGs. The three themes reflect physicians' conviction about including family caregivers in patient care: We need to take care of their caregivers, Practice and system barriers thwart including family caregivers, and Practical education might help.

CONCLUSIONS

This study of family physicians' preferences for education to support family caregivers will inform the development of education about supporting family caregivers for family physicians and trainees.

[What prevention potential does the general practitioner setting offer for family caregivers?-findings from a qualitative interview study]

The support of people in need of care and assistance is often provided by caring relatives. General practitioners can play an important role in supporting this group, if they adapt to the problems and wishes of family caregivers.The aim of the exploratory study is to contrast care needs of family caregivers regarding the GP support with actually experienced care and, thereby, work out approaches for strengthening the GP's role.A total of 37 family caregivers were recruited via 13 internet forums focused on caregiving. Telephone interviews were conducted between September 2020 and March 2021.The majority of those interviewed consider the GP to be an important support body with a high level of competence and trust. The interviewees praise the GP's knowledge of the personal care situation, the responsiveness to a wide variety of problems and the focus on those in need of care. However, communication about the caring activity is often delayed significantly (late identification and addressing of family caregivers). GPs do not always address the needs of relatives to the same extent as they do to those in need of care. Only some of the doctors refer caregivers to offers of help and support.GPs can play a central role in supporting family caregivers. An crucial prerequisite for this is that family caregivers are recognized and involved at an early stage. In addition, it is important that GPs take into account the needs, desires and stresses of both caregivers and those being cared for. Consistent references to offers of help make it easier for family caregivers to organize care and to receive (psychosocial) support.

Diabetes im Alter – Unterstützung Pflegebedürftiger und ihres Umfeldes

Pflegende An- und Zugehörige leisten einen erheblichen Anteil der häuslichen Pflege von älteren Menschen in Deutschland. Die Pflegesituation geht nicht selten mit biopsychosozialen Belastungen sowohl auf Seiten der Pflegenden als auch der Gepflegten einher. Um eine Gefährdung der Pflegesituation zu vermeiden, sollten Belastungen frühzeitig identifiziert werden. Essenziell ist eine rechtzeitige Aufklärung über Unterstützungs- und Hilfsangebote. Im Kontext der Pflege von Menschen mit Diabetes existieren verschiedene diabetesspezifische Unterstützungsmöglichkeiten (z. B. diabetesorientiertes Pflegeassessment), über die Pflegende informiert werden sollten. Die empathische Würdigung der Belastungen und die Wertschätzung für die Pflegetätigkeit sowie das Hervorheben möglicher positiver Aspekte derselben können entlastend wirken. Im Sinne des Empowerment-Ansatzes sollten sowohl die Bedürfnisse der Pflegenden als auch die der pflegebedürftigen Menschen mit Diabetes in Alltags- und Therapieentscheidungen – falls möglich – miteinbezogen werden.

Prerequisites for providing effective support to family caregivers within the primary care setting - results of a study series in Germany

Background

General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs. The results are used to derive starting points as to which measures would be sensible and useful to strengthen support offered to family caregivers in the primary care setting.

Methods

Between 2020 and 2021, three sub-studies were conducted: a) an online survey of 612 family caregivers; b) qualitative interviews with 37 family caregivers; c) an online survey of 3556 GPs.

Results

Family caregivers see GPs as a highly skilled and trustworthy central point of contact; there are many different reasons for consulting them on the subject of care. In the perception of caregivers, particular weaknesses in GP support are the absence of signposting to advisory and assistance services and, in many cases, the failure to involve family caregivers in good time. At the same time, GPs do not always have sufficient attention to the physical and psychological needs of family caregivers. The doctors interviewed consider the GP practice to be well suited to being a primary point of contact for caregivers, but recognise that various challenges exist. These relate, among other things, to the timely organisation of appropriate respite services, targeted referral to support services or the early identification of informal caregivers.

Conclusions

GP practices can play a central role in supporting family caregivers. Caregivers should be approached by the practice team at an early stage and consistently signposted to help and support services. In order to support care settings successfully, it is important to consider the triadic constellation of needs, wishes and stresses of both the caregiver and the care recipient. More training and greater involvement of practice staff in the support and identification of caregivers seems advisable.

[General practitioners, attitudes, procedures and challenges towards supporting family caregivers - results of a survey of primary care physicians]

BACKGROUND

 General practitioners are considered to be well suited when it comes to addressing the information and care needs of family caregivers. The aim of the present study is to examine how general practitioners assess their possibilities to support caregivers, what priorities they set and to what extent they experience challenges.

METHODS AND PARTICIPANTS

 In the course of an online survey with a postal cover letter, a total of 3,556 GPs in in Baden-Württemberg, Hesse and Rhineland-Palatinate were interviewed between February and June 2021. Due to the exploratory approach of the study, only a descriptive data analysis was carried out.

RESULTS

 68 % of the GPs surveyed often deal with family caregivers in everyday practice; 77 % consider the GP's office to be well suited as the primary point of contact for family caregivers and care coordination. Often it is caregiving relatives who ask the GP about the issue of care (89 %). Frequent contents concern a deterioration in the care situation (75 %) and a change in the need for care (84 %); consultations in the initial phase of care are less common (40 %). There are differences between urban and rural doctors in the perception of the needs of caregivers and the setting of priorities. Rural doctors give more weight to proactive and psychosocial care, whereas doctors in urban regions rely on the specialist and support network. GPs experience various challenges while supporting caregivers, including the timely organization of suitable relief offers (87 %), the referral to suitable offers of help (79 %) or the early identification of informal caregivers (59 %).

DISCUSSION

 GPs can play a central role in supporting family caregivers. A crucial prerequisite for this is that family caregivers are recognized and involved at an early stage. Consistent references to offers of help make it easier for family caregivers to organize care and to receive (psychosocial) support. In addition, it is important that GPs take into account the needs, desires and stresses of both caregivers and those being cared for.