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Bushuven S, Trifunovic-Koenig M, Klemm V, Diesener P, Haller S, Strametz R. The "Double Victim Phenomenon": Results From a National Pilot Survey on Second Victims in German Family Caregivers (SeViD-VI Study). J Patient Saf 2024; 20:410-419. [PMID: 39051764 DOI: 10.1097/pts.0000000000001251] [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: 07/27/2024]
Abstract
INTRODUCTION Second-victim phenomena may lead to severe reactions like depression or posttraumatic disorder, as well as dysfunction and absenteeism. Medical error as a cause for second victims is not limited to professionals, as family caregivers care for millions of patients at home. It remains unclear whether these are first, second, or double victims in case of error. This explorative study investigated whether second victim effects and signs of moral injury are detectable in family caregivers and whether existing instruments are applicable in lay persons. METHODS In an open convenience sampling online survey, we recruited 66 German family caregivers. Propensity score matching was conducted to obtain a balanced sample of family caregivers and qualified nurses who took part in the previous study by adjusting for age and sex. The groups were compared regarding the German Version of the Second Victim Experience and Support Tool-Revised and the German version of the Moral Injury Symptom and Support Scale for Health Professionals. RESULTS Sixty-six caregivers participated, of whom 31 completed the survey. Of all, 58% experienced a second victim-like effect, 35% experienced a prolonged effect, and 45% reported to still suffer from it. In a matched sample (22 family caregivers and 22 nurses), no significant differences were observed between the groups. DISCUSSION Regarding the limitations of this pilot study, demanding for resampling in larger populations, we could show that second victim effects and moral injury are detectable in family caregivers by validated instruments and are not inferior to professionals' experiences. Concerning the demand for further studies, we confirmed the applicability of the testing instruments but with need for item reduction to lower response burden.
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Affiliation(s)
| | | | - Victoria Klemm
- Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, Rhein-Main University of Applied Sciences, Wiesbaden, Germany
| | - Paul Diesener
- Hegau Jugendwerk Gailingen, Health Care Association District of Constance, Gailingen, Germany, Health Care Association District of Constance
| | - Susanne Haller
- Elisabeth-Kuebler-Ross Academy Stuttgart, Hospice Stuttgart, Stuttgart, Germany
| | - Reinhard Strametz
- Wiesbaden Institute for Healthcare Economics and Patient Safety, Wiesbaden Business School, Rhein-Main University of Applied Sciences, Wiesbaden, Germany
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Robertson K, Thyne M, Thomson R, Watkins L. The impact of social isolation and loneliness on the well-being of carers of a person with dementia in aotearoa New Zealand. DEMENTIA 2024:14713012241279683. [PMID: 39214523 DOI: 10.1177/14713012241279683] [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: 09/04/2024]
Abstract
Dementia is a leading cause of disability, and as the population ages, there will be a greater need for friends and family to care for people with Dementia. Unfortunately, informal care for a person with dementia is associated with poor psychological and physical health and lower quality of life of the caregiver. The aim of the present study was to understand how to best support caregivers within their communities by examining their experience of loneliness, isolation, and their relationship with well-being. The study used a representative sample of the New Zealand population in terms of ethnicity, age, gender, education, and income and asked people if they were a primary caregiver of a person with Alzheimer's Disease or related disorder. Both loneliness and isolation were linked to overall well-being; however, loneliness was a stronger predictor of satisfaction with relationships and feeling part of one's community. The findings highlight the importance of examining the multi-factorial constructs of social connectedness and question research attributing loneliness solely to reduced social involvement. As such, interventions for caregivers of a person with dementia need to target feelings of loneliness as well as their social isolation.
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Affiliation(s)
| | - Maree Thyne
- Department of Marketing, University of Otago, Dunedin, New Zealand
| | - Rob Thomson
- Department of Marketing, Dunedin, New Zealand
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Janson P, Hung CW, Willeke K, Frisch D, Berghöfer A, Heuschmann P, Zapf A, Wildner M, Stupp C, Keil T. [How effective are non-pharmacological interventions for family caregivers? A systematic review with meta-analyses]. DAS GESUNDHEITSWESEN 2024. [PMID: 39146966 DOI: 10.1055/a-2340-1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
INTRODUCTION Informal caregiving is associated with mental disorders and reduced quality of life. The aim of this systematic review was to summarize the results of methodologically high-quality intervention studies on the effectiveness of non-pharmacological interventions on patient-relevant outcomes for family caregivers in Germany. METHOD We searched three large scientific literature databases for intervention studies with a control group and a low or moderate risk of bias on the effectiveness of non-pharmacological interventions for family caregivers in Germany. RESULT Among 4,376 publications reviewed, 10 intervention studies with good methodological quality were identified. These investigated multi-component interventions or cognitive behavioral therapy for family caregivers of people with dementia (8 studies), stroke (1 study) and with general care dependency (1 study). The control groups received information material as a minimal intervention or usual standard care. Meta-analyses showed a statistically significant slight reduction in depressive symptoms 3-6 months after the start of the study as a result of cognitive behavioral therapy (standardized mean difference -0.27; 95% confidence interval -0.44 - -0.10), but this no longer reached statistical significance after 9-12 months (-0.21; -0.51 - 0.09). Multi-component interventions showed no changes in depressive symptoms either after 3-6 or after 9-12 months (-0.18; -0.40 - 0.03 and -0.14; -0.47 - 0.14, respectively). In contrast, the mental component of quality of life of family caregivers improved statistically significantly in the multi-component intervention groups compared to the control groups: slightly after 3-6 months (0.28; 0.01 - 0.56) and moderately after 9-12 months (0.45; 0.09 - 0.82). The interventions had no effect on the physical component of quality of life. CONCLUSION The reduction of depressive symptoms by behavioral therapy interventions for family caregivers appears to be only slight and not sustainable. The mental component of quality of life of people affected may be improved in the longer term by multi-component interventions. Current scientifically examined interventions for informal caregivers do not appear to have a sufficient and sustainable effect. Greater effects could possibly be achieved through more elaborate behavioral approaches, but also structural preventive measures.
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Affiliation(s)
- Patrick Janson
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Chu-Wei Hung
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Kristina Willeke
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Dieter Frisch
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Anne Berghöfer
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Heuschmann
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Zentrum für Klinische Studien Würzburg, Universitätsklinikum Würzburg, Würzburg, Germany
| | - Andreas Zapf
- Bayerisches Staatsministerium für Umwelt und Verbraucherschutz, München, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, München, Germany
| | - Manfred Wildner
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Pettenkofer School of Public Health, Ludwig-Maximilians-Universität München, München, Germany
| | - Carolin Stupp
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Thomas Keil
- Landesinstitut Gesundheit I, Bayerisches Landesamt für Gesundheit und Lebensmittelsicherheit, Erlangen, Germany
- Institut für Klinische Epidemiologie und Biometrie, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
- Institut für Sozialmedizin, Epidemiologie und Gesundheitsökonomie, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Wyman D, Butler LT, Morgan-Trimmer S, Bright P, Barber J, Budgett J, Walters K, Lang I, Rapaport P, Banks S, Palomo M, Orgeta V, Livingston G, Rockwood K, Lord K, Manthorpe J, Dow B, Hoe J, Cooper C. Process evaluation of a New psychosocial goal-setting and manualised support intervention for Independence in Dementia (NIDUS-Family). Age Ageing 2024; 53:afae181. [PMID: 39171389 DOI: 10.1093/ageing/afae181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Indexed: 08/23/2024] Open
Abstract
INTRODUCTION We report a mixed-methods process evaluation embedded within a randomised controlled trial. We aimed to test and refine a theory of change model hypothesising key causal assumptions to understand how the New Interventions for Independence in Dementia Study (NIDUS)-Family (a manualised, multimodal psychosocial intervention), was effective relative to usual care, on the primary outcome of Goal Attainment Scaling (GAS) over 1 year. METHODS In 2021-2022, intervention-arm dyads completed an acceptability questionnaire developed to test causal assumptions. We conducted qualitative interviews with dyads and intervention facilitators, purposively selected for diverse follow-up GAS scores. We collected observational data from intervention session recordings. We thematically analysed data, then integrated qualitative and quantitative data. RESULTS 174/204 (85.3%) dyads allocated to NIDUS-Family, fully completed it, 18 partially completed, while 12 received no intervention. We interviewed 27/192 (14%) of dyads receiving any sessions, and 9/10 facilitators; and observed 12 sessions. 47/192 (24.5%) of carers completed the acceptability questionnaire. We identified four themes: (A) 'Someone to talk to helps dyads feel supported'; (B) 'NIDUS-Family helps carers change their perspective'; (C) 'Personalisation helps people living with dementia maintain their identity' and (D) 'Small steps help dyads move forward'. CONCLUSION Key causal pathway mechanisms were: a respectful, trusting and impartial relationship with the facilitator: supporting the development of meaningful goals and support to find manageable solutions. Core implementation factors were delivery of the modules from a consistent facilitator across regular sessions. Core contextual factors influencing these mechanisms were dyadic participation and understanding of abilities.
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Affiliation(s)
- Danielle Wyman
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Laurie T Butler
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | | | - Peter Bright
- Faculty of Science and Engineering, School of Psychology and Sport Science at Anglia Ruskin University, Anglia Ruskin University, East Road, Cambridge CB1 1PT, UK
| | - Julie Barber
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Jessica Budgett
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Kate Walters
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Iain Lang
- University of Exeter, The Medical School, Exeter, UK
| | - Penny Rapaport
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Sara Banks
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
| | - Marina Palomo
- Camden and Islington NHS Foundation Trust, Department of Clinical Psychology, St. Pancras Hospital, 4 St. Pancras Way, London, NW1 0PE, UK
| | - Vasiliki Orgeta
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Gill Livingston
- Division of Psychiatry, University College London, Wing B, Floor 6 Maple House, 149 Tottenham Court Road, London, UK
| | - Kenneth Rockwood
- Division of Geriatric Medicine, Department of Medicine, School of Health Administration, Dalhousie University, Suite 1421-5955 Veterans' Memorial Lane, Halifax, NS B3H 4R2, Canada
| | - Kathryn Lord
- Centre for Applied Dementia Studies, University of Bradford, Richmond Road, Bradford, West Yorkshire BD7 1DP, UK
| | - Jill Manthorpe
- Social Care Workforce Research Unit, Faculty of Social Science and Public Policy, King's College London, 150 Stamford Street, London SE1 9NN, UK
| | - Briony Dow
- National Ageing Research Institute Ltd, Parkville, VIC, Australia
| | - Juanita Hoe
- Gellar Institute of Ageing and Memory, School of Medicine, University of West London, London W5 5RF, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Queen Mary University of London Wolfson Institute of Population Health, Yvonne Carter Building, Turner Street, London E1 2AB, UK
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Kipfer S, Mabire C, Vézina J, Koppitz A, Pihet S. Relationship quality perceived by family caregivers of people with dementia in the context of a psychoeducational intervention: A qualitative exploration. DEMENTIA 2024:14713012241264611. [PMID: 39104330 DOI: 10.1177/14713012241264611] [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: 08/07/2024]
Abstract
BACKGROUND Caring for a person with dementia can be a challenging experience, often associated with chronic stress and a heavy burden on family caregivers. Dementia also impacts the relationship between the caregiver and the person with dementia. The quality of this relationship is, in turn, an important factor influencing the well-being of both dyad members. The psychoeducational intervention "Learning to feel better . . . and help better" has shown positive results regarding family caregivers' subjective burden, psychological distress, and self-efficacy. However, relationship quality has not been addressed in the context of this intervention. METHODS A longitudinal constructivist grounded theory approach was used to explore relationship quality as perceived by caregivers, possible changes and intervention components facilitating or preventing such changes. Three qualitative, semi-structured interviews (before, during and after the intervention) were performed with 13 family caregivers from three different intervention groups. The resulting 39 interviews were analysed regarding individual caregiver trajectories, per time point for all caregivers and regarding specific caregiver subgroups. FINDINGS A model focusing on sustaining relationship quality in dementia was developed. It shows strategies that family caregivers develop and apply to facilitate positive interactions and feelings of connectedness with their family members with dementia. It also indicates that mastering such strategies requires reflective skills based on specific knowledge of dementia and coping strategies, which can be enhanced through active skills training, in which caregivers are guided to work on their individual stressful situations. Factors hampering change included difficulties in accepting dementia-related changes. CONCLUSION Findings suggest that psychoeducation, with active skills training based on caregivers' current daily life situations, providing systematic procedures to handle daily challenges and specific knowledge about the impact of the disease, could support them in developing and applying supportive strategies to sustain or improve their relationship to their family member with dementia.
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Affiliation(s)
- Stephanie Kipfer
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Switzerland
| | - Cedric Mabire
- Institute of Higher Education and Research in Healthcare-IUFRS, University of Lausanne, Lausanne University Hospital, Switzerland
| | - Jean Vézina
- School of psychology, University Laval, Québec, Canada
| | - Andrea Koppitz
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
| | - Sandrine Pihet
- School of Health Sciences Fribourg, HES-SO University of Applied Sciences and Arts Western Switzerland, Switzerland
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Altintas E, Luyat M, Gallouj K, Hülür G, El Haj M. Burden of family caregivers in Alzheimer's disease: The role of caregivers' perception of cognitive impairment. APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-7. [PMID: 38967486 DOI: 10.1080/23279095.2024.2367102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
OBJECTIVES This study examined the role of caregivers' perception of cognitive impairment in burden of family caregivers in Alzheimer's disease (AD). We hypothesized that the evaluation of cognitive impairment by family caregivers plays a pivotal role in burden. METHODS The study included 110 dyads (person with AD and their caregiver) recruited from a Memory Unit in France. The cognitive impairment and depressive symptoms of person with AD were evaluated by a geriatrician using the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale (GDS-15). Caregivers provided self-reports on the perception of cognitive impairment (IQCODE) of the care recipient, the caregiving burden (ZBI), depressive symptoms (GDS-15), and self-esteem (RSE). Descriptive analyses, comparison of different caregiver burden groups, and multinomial logistic regression analyses to understand correlates of caregiver burden were conducted with SPSS®, version 20. RESULTS The findings show that the caregivers are on average 60 years old and the majority are women. They care for persons with AD, who are on average 82 years old and most of whom are women. Our results show that the duration of caregiving, depression of the caregiver, and caregivers' perception of cognitive impairment contribute significantly to burden of caregiver. DISCUSSION This study shows that it is necessary to adopt the caregiver-centered approach to support the dyad. The role of the caregivers' perception of cognitive impairment in AD should be developed when supporting caregivers in suffering.
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Affiliation(s)
- Emin Altintas
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions, Temps, Emotions, Cognition, Lille, France
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Marion Luyat
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions, Temps, Emotions, Cognition, Lille, France
| | - Karim Gallouj
- Univ. Lille, ULR 4072 - PSITEC - Psychologie: Interactions, Temps, Emotions, Cognition, Lille, France
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
| | - Gizem Hülür
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Mohamad El Haj
- Unité de Gériatrie, Centre Hospitalier de Tourcoing, Tourcoing, France
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université de Nantes, Nantes, France
- Institut Universitaire de France, Paris, France
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Jolliff A, Fields B, Boutilier J, Dudek A, Elliott C, Zuraw M, Werner NE. Care Partner Confidence and Experiences in Legal Planning for People Living With Dementia: A Mixed-Methods Study. THE GERONTOLOGIST 2024; 64:gnad153. [PMID: 37941389 PMCID: PMC11190962 DOI: 10.1093/geront/gnad153] [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: 04/07/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Care partners of persons living with dementia perform complex legal planning tasks. The purpose of this study was to survey care partners in the United States to understand their confidence and experience in performing legal planning tasks. RESEARCH DESIGN AND METHODS This study used a parallel mixed-methods research design. We administered a web-based survey to 318 adults who self-identified as care partners of persons living with dementia. The survey contained Likert scale questions and open-ended questions about legal planning tasks. Multivariate linear regression was used to analyze quantitative data and inductive thematic analysis was used to analyze qualitative data. RESULTS Care partners were, on average, 53 years of age and 78% female. The three topics in which participants were least confident were: protecting oneself legally as a care partner; options when legal documents are not in place and a family member is not legally competent; and circumstances when legal documents should be updated or renewed. We observed significant differences in legal planning confidence between newer and more experienced care partners (p < .001); lower- and higher-income care partners (p = .01); and adult child versus spousal care partners (p < .001). Thematic analysis revealed that legal planning challenges include initiating a conversation with the person living with dementia, understanding and using legal materials, and accessing materials that accommodate individual differences. DISCUSSION AND IMPLICATIONS It is vital to develop legal planning interventions that are tailored to specific subgroups of care partners, and to maximize the clarity, comprehensiveness, and accessibility of available legal planning education.
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Affiliation(s)
- Anna Jolliff
- Department of Health and Wellness Design, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Beth Fields
- Department of Kinesiology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Justin Boutilier
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Alex Dudek
- Department of Industrial and Systems Engineering, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | | | - Matthew Zuraw
- Whiplash Technology, Inc., Palm Springs, California, USA
| | - Nicole E Werner
- Department of Health and Wellness Design, Indiana University Bloomington, Bloomington, Indiana, USA
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Park NS, Matta-Singh TD, Park J, Rhee MK, Chung S, Jang Y. Dementia Caregiving Experiences Among Korean Americans: Qualitative Inquiry Using the Stress Process Perspective. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024:1-22. [PMID: 38861569 DOI: 10.1080/01634372.2024.2366259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 06/06/2024] [Indexed: 06/13/2024]
Abstract
Dementia caregiving involves a challenging and complex process, especially for immigrant families. Using a qualitative method, this study provides an in-depth exploration of caregiving experiences among Korean American caregivers of people living with dementia. Based on various sampling strategies, 16 Korean American caregivers of family members/relatives with dementia were recruited in the greater Los Angeles area. Guided by the stress process model and the constant comparative method, themes and subthemes were derived and categorized into four domains: (1) background/context; (2) perception/appraisal; (3) resources/coping, and (4) caregiver burden/reward. Findings suggest that intervention efforts should focus on educating and training dementia caregivers.
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Affiliation(s)
- Nan Sook Park
- School of Social Work, University of South Florida, Tampa, Florida, USA
| | | | - Juyoung Park
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Min-Kyoung Rhee
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Soondool Chung
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
| | - Yuri Jang
- Edward R. Roybal Institute on Aging, Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, California, USA
- Department of Social Welfare, Ewha Womans University, Seoul, South Korea
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Neidre DB, Delgado RE, Peacock KS, Luy LP, White CL. A Scoping Review to Contribute to Knowledge About Culturally Adapting Interventions for Latino Family Caregivers of Persons Living With Dementia. J Transcult Nurs 2024:10436596241256328. [PMID: 38828565 DOI: 10.1177/10436596241256328] [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: 06/05/2024] Open
Abstract
INTRODUCTION Few interventions have focused on Latino family caregivers to persons with dementia, addressing their unique needs. This review aimed to identify best practices in cultural adaptation to make recommendations for adapting interventions for Latino family caregivers of persons living with dementia. METHOD This scoping review was conducted following the Joanna Briggs Institute Scoping Review guidelines, with findings extracted and summarized from 17 studies addressing cultural adaptation. RESULTS Frameworks guiding the adaptations were comprehensive, addressing cultural values and traditions and the social context faced by Latino family caregivers. Features of the adaptations included diverse teams of researchers and community members, including Latino family caregivers, to inform the integration of cultural values into the content, mode, and place of intervention delivery. DISCUSSION Culturally adapting evidence-based interventions will increase the number of available interventions for Latino family caregivers to persons living with dementia, thus reducing inequities in caregiver support.
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Kılıç BŞ, Hiçdurmaz D, Ayhan Y, Saka E. Perspectives of Family Caregivers of People With Alzheimer's Disease on Caregiving Experience and Needs: A Qualitative Study. J Psychosoc Nurs Ment Health Serv 2024; 62:36-45. [PMID: 37956348 DOI: 10.3928/02793695-20231106-01] [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: 11/15/2023]
Abstract
The current study aimed to investigate the perspectives of family caregivers of people with Alzheimer's disease on caregiving experience and needs. A qualitative descriptive method was used with a sample of 23 family caregivers. Data were collected through in-depth, face-to-face interviews using a pilot-tested semi-structured interview guide. Data analysis was performed via content analysis. Three major themes emerged: (1) Stuck in Caregiving, (2) A Life in Metamorphosis, and (3) Needs. Findings revealed that caregivers struggled to manage the care process, adapt to life changes, and fulfill their needs. This study provides rich data to help create interventions to assist family caregivers. [Journal of Psychosocial Nursing and Mental Health Services, 62(6), 36-45.].
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Gemito L, Alves E, Moreira J, Marques MF, Caldeira E, Ferreira R, Bico I, Pinho L, Fonseca C, Sousa L, Lopes M. Programmes Addressed to Informal Caregivers' Needs: A Systematic Literature Review. Geriatrics (Basel) 2024; 9:71. [PMID: 38920427 PMCID: PMC11202834 DOI: 10.3390/geriatrics9030071] [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: 03/20/2024] [Revised: 05/17/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
BACKGROUND Addressing informal caregivers' needs is essential for ensuring quality healthcare and promoting citizen-centred care. This systematic review assessed current knowledge about programmes aimed at meeting the needs of informal caregivers of adults who are dependent on others for daily life activities. METHODS Following the PRISMA guidelines, the electronic databases EBSCOhost Research Platform, MEDLINE, CINAHL, Scopus, Web of Science and The Virtual Health Library were searched for randomized experimental studies published between 2012 and 2022 that implemented programmes addressing informal caregivers' needs to improve their experiences, health, and well-being. Quality was assessed using the standardized critical evaluation tools from the Joanna Briggs Institute. Two independent investigators performed the eligibility assessment and data extraction. Quantitative data on the effectiveness of interventions were collected, and the content of each intervention was synthesized and aggregated into categories, through narrative synthesis. RESULTS The majority of the included studies (n = 16) were conducted in European countries and implemented a structured intervention programme compared to the provision of usual care. The studies were of fair to high methodological quality, with a higher risk of bias related to blinding. The results supported the achievement of favourable health outcomes among informal caregivers, namely improvements in mental health (n = 3) and quality of life (n = 3) and a decrease in psychological symptomatology (n = 5) and burden (n = 3). None of the interventions reported adverse outcomes; however, five studies did not describe significant differences in the outcomes assessed after the implementation of the programmes. Interventions focusing on training and educating caregivers (n = 14) and cognitive-behavioural strategies (n = 7) were the most common, while programmes focusing on emotional and psychological support as a resource to improve caregivers' psychological outcomes were scarce. CONCLUSIONS This systematic review adds to the growing body of evidence and insight showing that programmes that address informal caregivers' needs seem to contribute to better physical and psychological health outcomes through the promotion of caregivers' educational support and the implementation of cognitive-behavioural strategies. Future research should implement methodologically robust cross-country programmes tailored to informal caregivers' physical, emotional, psychosocial, societal, and educational needs throughout the care trajectory.
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Affiliation(s)
- Laurência Gemito
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Elisabete Alves
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - José Moreira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Maria Fátima Marques
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Ermelinda Caldeira
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Rogério Ferreira
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health of Beja, Polytechnic Institute of Beja, 7800-111 Beja, Portugal
| | - Isabel Bico
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Lara Pinho
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - César Fonseca
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
| | - Luís Sousa
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
- School of Health Atlântica (ESSATLA), Atlântica University, 2730-036 Barcarena, Portugal
| | - Manuel Lopes
- São João de Deus School of Nursing, University of Évora, 7000-811 Évora, Portugal; (L.G.); (E.A.); (J.M.); (M.F.M.); (E.C.); (I.B.); (C.F.); (M.L.)
- Comprehensive Health Research Centre (CHRC), 7000-811 Évora, Portugal; (R.F.)
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Lam LT, Lam MK. The Prevalence of Caregiving among Young People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:621. [PMID: 38791835 PMCID: PMC11120867 DOI: 10.3390/ijerph21050621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/29/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024]
Abstract
With the increasing number of people with chronic diseases and disabilities, the number of family members as caregivers have also been growing. Despite the attention paid to caregiving in recent years, little is known about caregiving among young people, particularly its global prevalence. The lack of information has important implications for health policy and management, resulting in the inability to form appropriate evidence-based policies and managerial decision making. This study aims to derive an estimate of the prevalence of caregiving among young people through a systematic review of the current literature. The results of this study revealed a prevalence of caregiving among younger adolescents of between 1.1% (1.06-1.14%) and 12.0% (11.02-12.98%). However, the assessment of caregiving varies across studies, and all were conducted in developed countries. These results provide information on the burden of caregiving in young people and reveal the lack of global information, calling for more research on and attention to this specific population.
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Affiliation(s)
- Lawrence T. Lam
- Faculty of Medicine, Macau University of Science and Technology, Macau SAR 999078, China
- Faculty of Health, University of Technology Sydney, Sydney, NSW 2007, Australia
| | - Mary K. Lam
- School of Health and Biomedical Science, RMIT University, Melbourne, VIC 3000, Australia;
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Teles S, Alves S, Ribeiro O, Freitas A, Ferreira A, Paúl C. Profiling early adopters of 'iSupport-Portugal': a country-specific version of a worldwide adapted digital support program for informal caregivers of people with dementia. Front Psychol 2024; 15:1359695. [PMID: 38873509 PMCID: PMC11171726 DOI: 10.3389/fpsyg.2024.1359695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/12/2024] [Indexed: 06/15/2024] Open
Abstract
Introduction Informal caregivers are the backbone of dementia care. iSupport is a World Health Organization digital support program for caregivers of people with dementia (PwD) that has been culturally adapted in several countries. iSupport was previously assessed for its feasibility in Portugal, and this country-specific version is now being utilized as a remote measurement tool (RMT). It constitutes the first internationally developed iSupport platform that is technically and scientifically enhanced to collect data on sociodemographic, clinical, and psychosocial variables of dementia care dyads. This paper characterizes the early adopters of iSupport-Portugal and discusses its exploration as a RMT. Methods Cross-sectional data were collected between February and July 2023 from users registering on isupport-portugal.pt. To characterize caregivers and PwD, eligibility was limited to unpaid caregivers assisting community dwelling PwD (n = 173). Data were collected through self-administered instruments in users' accounts. Caregivers completed psychosocial measures on burden, anxiety, depression, quality of life, desire to institutionalize and usage of community services. Textual data on caregivers' needs underwent content analysis. Results Among the early adopters of iSupport-Portugal (n = 365), 52.3% were informal caregivers, while 44.7% were health/social care professionals or others. Most caregivers were female (82.7%), middle-aged (M 51.7 years), highly educated (M 15.3 years) and supporting a parent (70.5%). Caregivers cared for a median of 24 h/week and 60.8% lived with the PwD. Neuropsychiatric symptoms were reported for 94.1% of PwD, who scored as moderately dependent (Barthel Index: M 14.0). Significant burden was reported by 88.4% of caregivers (≥21 on ZBI-22). Among caregivers scoring borderline or abnormal (≥8 on HADS) for anxiety, depression, or both (75.5%), 30.8% sought mental health counseling. Caregivers supporting a PwD not using community services scored higher on anxiety (p = 0.003), and depression (p = 0.009). Text data revealed unmet practical, emotional, and informational needs. Discussion iSupport-Portugal has garnered fair initial interest from caregivers, particularly from those who are children, highly educated, and employed. Early adopters exhibited significant psychological distress, and both practical and emotional needs, which contrast with limited use of support services for themselves and the PwD. iSupport-Portugal shows promise for descriptive research on care dyads, particularly among newer generations of caregivers.
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Affiliation(s)
- Soraia Teles
- Department of Behavioral Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Sara Alves
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Center of Research, Diagnosis, Training and Care of Dementia (CIDIFAD), SCMRA, Riba D’Ave, Portugal
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Alberto Freitas
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Ana Ferreira
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
- Faculty of Medicine, University of Porto (FMUP), Porto, Portugal
| | - Constança Paúl
- Department of Behavioral Sciences, School of Medicine and Biomedical Sciences, University of Porto (ICBAS-UP), Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
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Li W, Manuel DG, Isenberg SR, Tanuseputro P. Using Exploratory Structural Equation Modeling to Examine Caregiver Distress and Its Contributors. J Am Med Dir Assoc 2024; 25:817-825.e5. [PMID: 38341185 DOI: 10.1016/j.jamda.2023.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To develop and test the direct and indirect associations between caregiver distress and its many contributing factors and covariates. DESIGN Analysis using data from a national, cross-sectional survey of Canadian caregivers. SETTING AND PARTICIPANTS A total of 6502 respondents of the 2012 General Social Survey-Caregiving and Care-receiving who self-identified as a caregiver. METHODS We used exploratory structural equation modeling to achieve our aims. Based on literature review, we hypothesized a structural model of 5 caregiving factors that contribute to distress: caregiving burden, caregiving network and support, disruptions of family and social life, positive emotional experiences, and caregiving history. Survey items hypothesized to measure each latent factor were modeled using exploratory factor analysis (EFA). After establishing a well-fit EFA model, structural equation modeling was performed to examine the relationships between caregiving factors and caregiver distress while controlling for covariates such as caregiver's and care-recipient's sociodemographic characteristics and kinship. RESULTS EFA established a well-fit model that represented caregiver distress and its 5 contributing factors as hypothesized. Although all 5 had significant effects on caregiver distress, disruptions of family and social life contributed the most (β = 0.462), almost 3 times that of caregiving burden (β = 0.162). Positive emotional experiences also substantially reduced distress (β = -0.310). CONCLUSIONS AND IMPLICATIONS Understanding the multifaceted nature of caregiver distress is crucial for developing effective strategies to support caregivers. In addition to reducing caregiving burden, having flexible resources and policies to minimize disruptions to caregivers' families (eg, flexible work policies; family-oriented education, training, and counseling) and enhance the positive aspects of caregiving may more effectively reduce distress.
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Affiliation(s)
- Wenshan Li
- Ottawa Hospital Research Institute, Clinical Epidemiology, Ottawa, Ontario, Canada; ICES uOttawa, Ottawa, Ontario, Canada.
| | - Douglas G Manuel
- Ottawa Hospital Research Institute, Clinical Epidemiology, Ottawa, Ontario, Canada; ICES uOttawa, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sarina R Isenberg
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- ICES uOttawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada
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Gimm G, Layman S, Inoue M, Ihara ES, Pantleay H, Tompkins CJ. Mason Caregivers Aiming for Resilience, Empowerment, and Support Study: Assessing Family Caregiver Burden Post-Intervention. J Appl Gerontol 2024:7334648241243173. [PMID: 38607327 DOI: 10.1177/07334648241243173] [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: 04/13/2024] Open
Abstract
Background: Family caregivers of older adults living with dementia are known to experience higher burden levels. Methods: This empirical study conducted a sub-group analysis of burden levels of 97 family caregivers by the dementia severity of care recipients. Family caregivers were assessed before and after the 9-week Stress-Busting Program for Family CaregiversTM (SBP). Results: Family caregivers of older adults living with severe dementia had the highest baseline Zarit Burden Interview (ZBI) score of 27.7 which decreased to 25.0 (p < .05); family caregivers of those living with moderate dementia had a baseline ZBI score of 24.3 which decreased to 20.4 (p < .01); and family caregivers of those living with mild dementia had the lowest baseline ZBI score of 21.0, which decreased to 18.0 (p < .01). Conclusion: The SBP intervention was associated with a 15% reduction in burden scores for family caregivers of older adults living with dementia.
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Affiliation(s)
- Gilbert Gimm
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Shannon Layman
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Megumi Inoue
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Emily S Ihara
- Department of Social Work, George Mason University, Fairfax, VA, USA
| | - Harveen Pantleay
- Department of Social Work, George Mason University, Fairfax, VA, USA
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Wang H, Wen Z, Wang Y, Liu X, Xie J. The association between procrastination in academic writing and negative emotional states during the COVID-19 pandemic: the indirect effects of stress coping styles and self-efficacy. ANXIETY, STRESS, AND COPING 2024:1-14. [PMID: 38602251 DOI: 10.1080/10615806.2024.2339985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/01/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND AND OBJECTIVES Limited research has examined the mediating mechanisms underlying the association between procrastination in academic writing and negative emotional states during the COVID-19 pandemic. In the present study, we examined whether stress coping styles and self-efficacy for self-regulation of academic writing mediated the relationship between procrastination in academic writing and negative emotional states. DESIGN AND METHOD Graduate students (N = 475, 61.7% female, Mage of students at baseline = 29.02 years, SD = 5.72) completed questionnaires at Time 1 (March 2020; Procrastination in Academic Writing and Coping Inventory for Stressful Situations), and Time 2 (June 2020; The Self-Efficacy for Self-Regulation of Academic Writing Scale and Depression, Anxiety, and Stress Scale - 21). RESULTS Emotion-oriented coping and the self-efficacy for self-regulation of academic writing serially mediated the association between procrastination in academic writing and negative emotional states. Meanwhile, task-oriented coping and self-efficacy for self-regulation of academic writing also serially mediated the association between procrastination in academic writing and negative emotional states. CONCLUSIONS These findings provide a plausible explanation of the roles that stress coping styles and self-efficacy for self-regulation of academic writing play in the association between procrastination in academic writing and negative emotional states.
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Affiliation(s)
- Huihui Wang
- College of Teacher Education, Ningxia University, Yinchuan, People's Republic of China
| | - Zhonglin Wen
- Center for Studies of Psychological Application/School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Yang Wang
- School of Public Administration, Guangdong University of Finance, Guangzhou, People's Republic of China
| | - Xiqin Liu
- School of Foreign Languages, South China University of Technology, Guangzhou, People's Republic of China
| | - Jinyan Xie
- Center for Studies of Psychological Application/School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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Tonkikh O, Chi NC, Herr KA, Fishman SM, Young HM. Supporting the Health and Well-Being of Caregivers of Persons with Pain Strategies to address stress and improve self-care. Home Healthc Now 2024; 42:103-109. [PMID: 38437044 DOI: 10.1097/nhh.0000000000001259] [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: 03/06/2024]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses. Cite this article as: Tonkikh, O., et al. Supporting the Health and Well-Being of Caregivers of Persons with Pain. Am J Nurs 2023; 123 (6): 55-61.
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Champagne ER. Caregiver Resilience and Dance/Movement Therapy: A Theoretical Review and Conceptual Model. J Appl Gerontol 2024; 43:319-327. [PMID: 37991282 PMCID: PMC10809734 DOI: 10.1177/07334648231210679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/28/2023] [Accepted: 09/25/2023] [Indexed: 11/23/2023] Open
Abstract
With the population aging, more people are living with neurodegenerative conditions, leading to an influx of informal family caregivers, who often experience negative health outcomes. Few caregiver interventions have successfully adopted a holistic, strengths-based approach to fostering resilience. This article examines existing literature on caregiver resilience factors, which include self-efficacy, flexibility, cultivating positive emotions, and drawing on spiritual and social supports. Despite how dance/movement therapy (DMT) has been shown to foster psychological and physiological benefits, it remains underexplored for caregivers. Therapeutic mechanisms of DMT are expounded for their innate correspondence to resilience factors, and a new comprehensive model of DMT for caregiver resilience is presented, with implications for future intervention design and measurement.
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Affiliation(s)
- Eden R. Champagne
- Department of Recreation and Leisure Studies, University of Waterloo, Waterloo, ON, USA
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19
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Pihet S, Clément M, Terrapon E, Kipfer S. Adaptation of a psycho-educational group programme to improve coping in dementia caregiving: a feasibility study with mixed-methods. BMC Geriatr 2024; 24:197. [PMID: 38413890 PMCID: PMC10900645 DOI: 10.1186/s12877-024-04815-7] [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: 08/25/2022] [Accepted: 02/15/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND As the number of people living with dementia rapidly increases worldwide, the support provided by their informal caregivers remains key to the sustainability of most healthcare systems, this voluntary contribution representing 40% of the costs of dementia worldwide. Informal caregiving in dementia, however, is linked to long periods of chronic stress with frequent and serious negative consequences on the health and quality of life of the caregiver. A psycho-educational group intervention focusing on coping with the daily stress of dementia caregiving ("Learning to feel better… to help better"), developed in French-speaking Canada and showing broad effects on quality of life, was selected with the aim of 1) adapting it to a new cultural context (French-speaking Switzerland) based on identified facilitators and barriers, using a participative approach; and 2) conducting a feasibility study to evaluate whether the adapted programme showed similar or improved feasibility and effects compared to the original Canadian programme. METHODS A mixed-methods concurrent nested design was used to evaluate the feasibility and the effects on five quantitative core outcomes. Additional qualitative data helped document in depth the acceptability and impact of the intervention. RESULTS We shortened the programme from 30 to 21 h in total, which resulted in increased accessibility, in terms of facilitated recruitment of participants and inclusion of a broader range of informal caregivers. There were significant reductions in subjective burden (effect size: d = -0.32) and psychological distress (d = -0.48), as well as decreases in the stress reactions of informal caregivers related to the behaviour problems of the persons with dementia (d = -0.57). The qualitative results emphasized the usefulness of providing informal caregivers with structured procedures for efficiently tackling everyday challenges, and of enabling learning through a variety of channels and activities. CONCLUSIONS Substantial improvements are associated with this 21-h group intervention, organised in 7 sessions of 3 h each, focused on learning more efficient strategies to cope with the daily stress of dementia caregiving. This intervention empowered informal caregivers to master their daily challenges with more confidence, satisfaction and calm. TRIAL REGISTRATION ISRCTN13512408 (registration date 17.05.2021, retrospectively registered).
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Affiliation(s)
- Sandrine Pihet
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland.
- Haute Ecole de Santé Fribourg, Route Des Arsenaux 16a, 1700, Fribourg, Switzerland.
| | - M Clément
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - E Terrapon
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
| | - S Kipfer
- School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Fribourg, Switzerland
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Wang S, Qin J, Cheung DSK, Tyrovolas S, Leung SHI, Leung AYM, Davidson PM. E-bibliotherapy for improving the psychological well-being of informal caregivers of people with dementia: a randomized controlled trial protocol. BMC Nurs 2024; 23:84. [PMID: 38303009 PMCID: PMC10832133 DOI: 10.1186/s12912-024-01706-5] [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: 11/08/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Providing informal care for individuals with dementia is frequently a challenging and demanding experience that can have detrimental effects on the psychological well-being of caregivers. Regrettably, community-based caregiver services often prove inadequate, highlighting the necessity for innovative approaches to support caregivers. AIM To test the efficacy of e-bibliotherapy in improving the psychological well-being of informal caregivers of people with dementia. METHOD The study is divided into two phases. In phase 1, the research team will co-design the e-bibliotherapy app with caregivers. In phase 2, a randomized controlled trial will be conducted among 192 informal caregivers of people with dementia in Hong Kong. Caregivers will be randomly assigned to either the e-bibliotherapy group or the control group using simple randomization. Outcome measures will encompass caregivers' psychological well-being, caregiving appraisal, mental health, saliva cortisol levels as an indicator of stress, and health-related quality of life for caregivers. Data will be collected at baseline, immediately post intervention, and 3 months and 6 months post intervention. General linear mixed model will be employed to analyze intervention effects. Qualitative interviews will be undertaken to explore caregiver experiences within this study and evaluate intervention acceptability using conventional content analysis methods. DISCUSSION This study represents a pioneering effort in utilizing e-bibliotherapy to enhance the psychological well-being of informal caregivers of individuals with dementia, addressing the existing gap in caregiver services and facilitating knowledge dissemination within the community. TRIAL REGISTRATION The trial has been registered on ClinicalTrial.gov (Ref: NCT05927805).
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China.
| | - Jing Qin
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | - Stefanos Tyrovolas
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA, USA
| | - Sze Him Isaac Leung
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong SAR, China
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Messina A, Amati R, Annoni AM, Bano B, Albanese E, Fiordelli M. Culturally Adapting the World Health Organization Digital Intervention for Family Caregivers of People With Dementia (iSupport): Community-Based Participatory Approach. JMIR Form Res 2024; 8:e46941. [PMID: 38265857 PMCID: PMC10851118 DOI: 10.2196/46941] [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: 03/06/2023] [Revised: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Informal caregivers of people with dementia are at high risk of developing mental and physical distress because of the intensity of the care provided. iSupport is an evidence-based digital program developed by the World Health Organization to provide education and support for the informal everyday care of people living with dementia. OBJECTIVE Our study aims to describe in detail the cultural adaptation process of iSupport in Switzerland. We specifically focused on the participatory strategies we used to design a culturally adapted, Swiss version of iSupport that informed the development of the desktop version, mobile app, and printed manual. METHODS We used a mixed methods design, with a community-based participatory approach. The adaptation of iSupport followed the World Health Organization adaptation guidelines and was developed in 4 phases: content translation, linguistic and cultural revision by the members of the community advisory board, validation with formal and informal caregivers, and refinement and final adaptation. RESULTS The findings from each phase showed and consolidated the adjustments needed for a culturally adapted, Swiss version of iSupport. We collected feedback and implemented changes related to the following areas: language register and expressions (eg, from "lesson" to "chapter" and from "suffering from" dementia to "affected by" dementia), resources (hyperlinks to local resources for dementia), contents (eg, from general nonfamiliar scenarios to local and verisimilar examples), graphics (eg, from generalized illustrations of objects to human illustrations), and extra features (eg, a glossary, a forum session, and a read-aloud option, as well as a navigation survey). CONCLUSIONS Our study provides evidence on how to culturally adapt a digital program for informal caregivers of people living with dementia. Our results suggest that adopting a community-based participatory approach and collecting lived experiences from the final users and stakeholders is crucial to meet local needs and to inform the further development, testing, and implementation of digital interventions in a specific cultural context.
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Affiliation(s)
- Anna Messina
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Rebecca Amati
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Anna Maria Annoni
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Beatrice Bano
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera italiana, Lugano, Switzerland
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Sabatini S, Turner SG, Morris RG, Opdebeeck C, Thom JM, Hunt A, Allan L, Pentecost C, Clare L. Correlates of felt age in caregivers of people with dementia: findings from the IDEAL study. Front Psychol 2024; 14:1287842. [PMID: 38282846 PMCID: PMC10811155 DOI: 10.3389/fpsyg.2023.1287842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Accepted: 12/04/2023] [Indexed: 01/30/2024] Open
Abstract
Objective Family relationships influence how people appraise their own aging and how their appraisals impact their health. We analyzed felt age (FA) among family caregivers of people with dementia. Methods and measures We used a stratified sample of 1,020 spousal and 202 adult-child caregivers from the IDEAL study. We estimated cross-sectional associations and bidirectional influences between caregivers' FA and their health and wellbeing (depression, number of health conditions, stress, positive aspects of caregiving) over 2 years. Results Among spousal caregivers, 25% had a younger FA and 36% had an older FA. Among adult-child caregivers, 21.8% had a younger FA and 36.1% had an older FA. In spousal and adult-child caregivers an older FA was cross-sectionally associated with higher depression, number of health conditions, and stress, and fewer positive aspects of caregiving. In spousal caregivers, hours of care per day moderated the association between FA and depression, and FA was associated with stress 1 year later. Conclusion Caregiving may impact FA and its relationship with health. We urge continued research on the connections between caregiving and FA, and how interventions might support caregivers' positive views on their own aging, which will translate views on aging scholarship to meaningfully improve caregivers' lives.
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Affiliation(s)
- Serena Sabatini
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Shelbie G. Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, New York, NY, United States
| | - Robin G. Morris
- Department of Psychology, King's College London Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Carol Opdebeeck
- Department of Psychology, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jeanette M. Thom
- School of Health Sciences, The University of Sydney, Darlington, NSW, Australia
| | - Anna Hunt
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Louise Allan
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Claire Pentecost
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Linda Clare
- REACH: The Centre for Research in Ageing and Cognitive Health, University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
- NIHR Applied Research Collaboration South-West Peninsula, Exeter, United Kingdom
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Li B, Jin H, Yan G, Zhang C, Chen S, Wang Y, Wang T, Wan Q, Wei Z, Sun Y. Mental states in caregivers toward people with Alzheimer's disease at different stages. Front Neurol 2024; 14:1327487. [PMID: 38274888 PMCID: PMC10808319 DOI: 10.3389/fneur.2023.1327487] [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: 10/25/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Caring for people with Alzheimer's disease (AD) is burdensome, especially when family members act as caregivers. This multicenter survey first aimed to investigate caregivers' mental states as well as its influencing factors in caring for people with different severities of AD in China. Methods People with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for caregivers' mental states and living conditions, as well as caregivers' attitudes toward treatment and caring. Logistic regression was used to explore the factors that influence the positive and negative states of caregivers who care for people with different stages of AD. Results A total of 1,966 valid questionnaires were analyzed (mild AD: 795, moderate AD: 521, severe AD: 650). A total of 73.6% of caregivers maintained normal states (mild group: 71.9%, moderate group: 73.9%, severe group: 75.2%; X2 = 2.023, p = 0.364), and the proportions of caregivers with positive and negative states were 26.3% (mild group: 38.4%, moderate group: 24.6%, severe group: 13.1%; X2 = 119.000, p < 0.001) and 36.5% (mild group: 25.2%, moderate group: 36.9%, severe group: 50.2%; X2 = 96.417, p < 0.001), respectively. The major factors that both influenced caregivers' positive and negative states were the severity of AD, perceived efficacy of treatment, safety issues after AD dementia diagnosis and perceived social support (p < 0.005), while neuropsychiatric symptoms causing stress in caregivers (p < 0.001) only affected the negative states of caregivers. The results of further analysis according to disease severity showed that safety issues after AD dementia diagnosis (p < 0.005) only made significant differences in the mild-to-moderate group. Conclusion To reduce negative states and promote positive states among caregivers, flexible and sensitive caregiving support could be built on caregivers' demands in caring for people with different stages of AD. The support of emotion, social functioning and nursing skills is one of the significant ways for health workers to enhance caregivers' competency.
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Affiliation(s)
- Bei Li
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Haiqiang Jin
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Guiying Yan
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China
- School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Zhang
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Siwei Chen
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Yue Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ting Wang
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Qiaoqin Wan
- Nursing School of Peking University, Beijing, China
| | - Zhimin Wei
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Yongan Sun
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
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24
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BeLue R, Kuzmik A, Dix M, Luckett C, Paudel A, Resnick B, Boltz M. An exploration of the cultural appropriateness of the family-centered function-focused care intervention. DEMENTIA 2024; 23:7-22. [PMID: 37902027 DOI: 10.1177/14713012231206288] [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: 10/31/2023]
Abstract
The Family-centered Function Focused Care (Fam-FFC) intervention, is a nurse-family care partnership model aimed to improve the physical and cognitive recovery in hospitalized persons living with Alzheimer's Disease Related Dementias (ADRD) while improving the care partner's experiences. Discussions of patients' needs and preferences between nurses and the patient's close family members have been found to be useful in preventing excessive stress in persons with dementia, while lessening the anxiety of care partners. However, the efficacy of dementia-specific interventions is influenced in part by the degree to which the interventions are flexible and sensitive to the patient's and care-partner's condition, needs, and preferences, including cultural preferences. Therefore, the purpose of this study is to assess the cultural appropriateness of Fam-FFC using the Ecological Validity Model (EVM). This qualitative, descriptive study included 28 consented care partners drawn from a sample of 455 dyads enrolled in the Fam-FFC intervention. An interview guide was created based on the EVM. Participants provided demographic data. Thematic analysis was conducted to analyze transcribed interviews. The majority of the sample was female (79%), Non-Hispanic (96%) and half were married. One-half of the sample represented Black care partners and one-half were White. Seventy-nine percent lived with their family member with ADRD. Three major themes were identified from the thematic analysis including Care Partner Identity, Care Partner Preferences, and Goals of Care for functional recovery of their family member living with dementia. In this study care partners wanted more social services as well as home care that supported not just physical needs but also social and recreational needs. Findings from the study offer guidance on improving the Fam-FFC intervention including strengthening education and resources on partner self-care.
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Affiliation(s)
- Rhonda BeLue
- College for Health, Community and Policy, Community Engagement and Partnerships, The University of Texas at San Antonio, USA
| | - Ashley Kuzmik
- Ross and Carol Nese College of Nursing, Penn State, USA
| | - Michaila Dix
- College of Public Health and Social Justice, Department of Health Management and Policy, Saint Louis University, USA
| | - Camille Luckett
- College for Public Health and Social Justice, Saint Louis University, USA
- University of Maryland School of Nursing, USA
| | - Anju Paudel
- Ross and Carol Nese College of Nursing, Penn State, USA
| | | | - Marie Boltz
- Ross and Carol Nese College of Nursing, Penn State, USA
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Wilson CF, Turnbull S. Connecting, learning, supporting: Caregivers' experiences of a stress and distress biopsychosocial group intervention. DEMENTIA 2024; 23:23-40. [PMID: 37897035 PMCID: PMC10798010 DOI: 10.1177/14713012231207946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/29/2023]
Abstract
BACKGROUND Family caregivers are fundamental in supporting people living with dementia to remain at home, however, psychological distress can occur as a result of their caring role. Research into interventions for caregivers of people living with young-onset dementia, including their experience of and the mediating processes of such interventions, remains limited. METHODS An Interpretative Phenomenological Analysis explored caregiver experiences and influence on caregiving of participating in a "Responding to Distress in Dementia" group. Five family caregivers were interviewed with discussions covering the period from first noticing symptoms to the interview session. RESULTS Within the group experience, four superordinate themes were identified: 'connecting to other caregivers', 'learning about caregiving', 'group factors' and 'reduced caregiver distress'. During the post-group period, three superordinate themes were recognised: 'maintaining support', 'applying learning', and 'normalising caregiving'. CONCLUSIONS The study highlighted several interrelated themes involving creating connections amongst caregivers with similar experiences, social learning, and supportive learning through group structure and facilitation. Many of the processes reflected those found in existing dementia caregiver intervention research. Recommendations included facilitating peer support groups and exploring whole-family approaches.
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Affiliation(s)
- Craig F Wilson
- Institute of Health and Wellbeing, University of Glasgow, UK
| | - Sue Turnbull
- Institute of Health and Wellbeing, University of Glasgow, UK
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26
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Rochon EA, Sy M, Phillips M, Anderson E, Plys E, Ritchie C, Vranceanu AM. Bio-Experiential Technology to Support Persons With Dementia and Care Partners at Home (TEND): Protocol for an Intervention Development Study. JMIR Res Protoc 2023; 12:e52799. [PMID: 38157239 PMCID: PMC10787328 DOI: 10.2196/52799] [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: 09/15/2023] [Revised: 11/14/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND Alzheimer disease and related dementias are debilitating and incurable diseases. Persons with dementia and their informal caregivers (ie, dyads) experience high rates of emotional distress and negative health outcomes. Several barriers prevent dyads from engaging in psychosocial care including cost, transportation, and a lack of treatments that target later stages of dementia and target the dyad together. Technologically informed treatment and serious gaming have been shown to be feasible and effective among persons living with dementia and their care partners. To increase access, there is a need for technologically informed psychosocial interventions which target the dyad, together in the home. OBJECTIVE This study aims to develop the toolkit for experiential well-being in dementia, a dyadic, "bio-experiential" intervention for persons with dementia and their caregivers. Per our conceptual model, the toolkit for experiential well-being in dementia platform aims to target sustained attention, positive emotions, and active engagement among dyads. In this paper, we outline the protocol and conceptual model for intervention development and partnership with design and development experts. METHODS We followed the National Institutes of Health (NIH) stage model (stage 1A) and supplemented the model with principles of user-centered design. The first step includes understanding user needs, goals, and strengths. We met this step by engaging in methodology and definition synthesis and conducting focus groups with dementia care providers (N=10) and persons with dementia and caregivers (N=11). Step 2 includes developing and refining the prototype. We will meet this step by engaging dyads in up to 20 iterations of platform β testing workshops. Step 3 includes observing user interactions with the prototype. We will meet this step by releasing the platform for feasibility testing. RESULTS Key takeaways from the focus groups include balancing individualization and the dyadic relationship and avoiding confusing stimuli. As of September 2023, we have completed focus groups with providers, persons with dementia, and their caregivers. Additionally, we have conducted 4 iterations of β testing workshops with dyads. Feedback from focus groups informed the β testing workshops; data have not yet been formally analyzed and will be reported in future publications. CONCLUSIONS Technological interventions, particularly "bio-experiential" technology, can be used in dementia care to support emotional health among persons with a diagnosis and caregivers. Here, we outline a collaborative intervention development process of bio-experiential technology through a research, design, and development partnership. Next, we are planning to test the platform's feasibility as well as its impact on clinical outcomes and mechanisms of action. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52799.
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Affiliation(s)
- Elizabeth A Rochon
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
| | - Maimouna Sy
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
| | | | | | - Evan Plys
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Christine Ritchie
- Mongan Institute Center for Aging and Serious Illness and the Division of Palliative Care and Geriatric Medicine, Department of Medicine, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
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27
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Tasseron-Dries PEM, Smaling HJA, Nakanishi M, Achterberg WP, van der Steen JT. What are best practices for involving family caregivers in interventions aimed at responsive behaviour stemming from unmet needs of people with dementia in nursing homes: a scoping review. BMJ Open 2023; 13:e071804. [PMID: 38149428 PMCID: PMC10711828 DOI: 10.1136/bmjopen-2023-071804] [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: 01/16/2023] [Accepted: 11/03/2023] [Indexed: 12/28/2023] Open
Abstract
OBJECTIVES This study aimed to determine best practices for involving family caregivers in interventions aimed at preventing and reducing responsive behaviour stemming from unmet needs, including pain. DESIGN Scoping review, reported according to the Preferred Reporting Items for Systematic Reviews, Meta-Analyses extension for Scoping Reviews reporting guideline. DATA SOURCES PubMed, Embase, Emcare, Web of Science, COCHRANE Library, PsycINFO, Academic Search Premier and Cinahl searched up to 23 July 2023. ELIGIBILITY CRITERIA Studies reporting on family involvement in interventions for nursing home residents with dementia were included. DATA EXTRACTION AND SYNTHESIS Two researchers independently extracted the data, followed by a content analysis. RESULTS Of the 1486 records screened, 20 studies were included. Family caregivers were involved in interventions aimed at planning care, life review (eg, documentation of life experiences of their relative), and selecting activities for their relative. Family caregivers preferred an active role in developing optimal care for their relative. Drivers of success and barriers to family involvement centred around three themes: (1) communication between all involved; (2) prerequisites (organisational and other conditions) and (3) personal circumstances (family's coping and skills). CONCLUSION Best practices for involving family caregivers in interventions aimed at addressing responsive behaviour in residents with dementia concerned those interventions in which family caregivers were given an important role in managing responsive behaviour. This means that, in order to achieve an active role of family caregivers in the whole care process, their needs must be taken into account. TRIAL REGISTRATION NUMBER The protocol of the review was regisered at OSF; https://osf.io/twcfq.
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Affiliation(s)
- Petra E M Tasseron-Dries
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Stichting Warande (Nursing Home Organization), Zeist, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Hanneke J A Smaling
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Miharu Nakanishi
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
| | - Wilco P Achterberg
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- University Network of the Care Sector South Holland, Leiden University Medical Center, Leiden, The Netherlands
| | - Jenny T van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Primary and Community Care, and Radboudumc Alzheimer Center, Radboud university medical center, Nijmegen, The Netherlands
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28
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Wong D, Pike K, Stolwyk R, Allott K, Ponsford J, McKay A, Longley W, Bosboom P, Hodge A, Kinsella G, Mowszowski L. Delivery of Neuropsychological Interventions for Adult and Older Adult Clinical Populations: An Australian Expert Working Group Clinical Guidance Paper. Neuropsychol Rev 2023:10.1007/s11065-023-09624-0. [PMID: 38032472 DOI: 10.1007/s11065-023-09624-0] [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: 04/12/2022] [Accepted: 10/16/2023] [Indexed: 12/01/2023]
Abstract
Delivery of neuropsychological interventions addressing the cognitive, psychological, and behavioural consequences of brain conditions is increasingly recognised as an important, if not essential, skill set for clinical neuropsychologists. It has the potential to add substantial value and impact to our role across clinical settings. However, there are numerous approaches to neuropsychological intervention, requiring different sets of skills, and with varying levels of supporting evidence across different diagnostic groups. This clinical guidance paper provides an overview of considerations and recommendations to help guide selection, delivery, and implementation of neuropsychological interventions for adults and older adults. We aimed to provide a useful source of information and guidance for clinicians, health service managers, policy-makers, educators, and researchers regarding the value and impact of such interventions. Considerations and recommendations were developed by an expert working group of neuropsychologists in Australia, based on relevant evidence and consensus opinion in consultation with members of a national clinical neuropsychology body. While the considerations and recommendations sit within the Australian context, many have international relevance. We include (i) principles important for neuropsychological intervention delivery (e.g. being based on biopsychosocial case formulation and person-centred goals); (ii) a description of clinical competencies important for effective intervention delivery; (iii) a summary of relevant evidence in three key cohorts: acquired brain injury, psychiatric disorders, and older adults, focusing on interventions with sound evidence for improving activity and participation outcomes; (iv) an overview of considerations for sustainable implementation of neuropsychological interventions as 'core business'; and finally, (v) a call to action.
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Affiliation(s)
- Dana Wong
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia.
| | - Kerryn Pike
- School of Psychology and Public Health & John Richards Centre for Rural Ageing Research, La Trobe University, Melbourne, Australia
- School of Applied Psychology, Griffith University, Gold Coast, Australia
| | - Rene Stolwyk
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Kelly Allott
- , Orygen, Parkville, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - Adam McKay
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
- MERRC, Rehabilitation and Mental Health Division, Epworth HealthCare, Richmond, Australia
| | - Wendy Longley
- Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Sydney, Australia
- The Uniting War Memorial Hospital, Waverley, Sydney, Australia
| | - Pascalle Bosboom
- MindLink Psychology, West Perth, Australia
- School of Psychological Science, University of Western Australia, Crawley, Australia
| | | | - Glynda Kinsella
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Loren Mowszowski
- Faculty of Science, School of Psychology & Brain and Mind Centre, The University of Sydney, Sydney, Australia
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29
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Goto Y, Morita K, Suematsu M, Imaizumi T, Suzuki Y. Caregiver Burdens, Health Risks, Coping and Interventions among Caregivers of Dementia Patients: A Review of the Literature. Intern Med 2023; 62:3277-3282. [PMID: 36858522 PMCID: PMC10713358 DOI: 10.2169/internalmedicine.0911-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/23/2023] [Indexed: 03/03/2023] Open
Abstract
Over 55 million people reportedly suffer from dementia worldwide. In Japan, it is estimated that 1 in 5 people over 65 years old will have dementia by 2025, of which more than 20% will live with symptoms that require home/nursing care. Given the lack of effective medical treatments for dementia, informal caregivers play essential roles in allowing dementia patients to live with dignity. Our review focusing on caregiver burden showed that this burden has not been sufficiently addressed, despite having negative effects on caregivers' health, employment, and finances. It is important to consider non-pharmacological interventions that contribute to effective coping strategies for mitigating the caregiver burden. Online communication tools may be a viable intervention measure to educate caregivers on the importance of sharing resilient coping strategies to reduce their stress so that they can continue to provide care for their loved ones.
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Affiliation(s)
- Yasuyuki Goto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Japan
| | | | - Mina Suematsu
- Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Japan
| | | | - Yusuke Suzuki
- Centre for Community Liason & Patient Consultations, Nagoya University Hospital, Japan
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30
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Wrede N, Töpfer NF, Wilz G. Between- and within-person effects of affective experiences on coping in CBT: Direct effects and interplay with therapeutic alliance and resource activation. Psychother Res 2023:1-15. [PMID: 37922397 DOI: 10.1080/10503307.2023.2277290] [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] [Received: 05/25/2023] [Accepted: 10/25/2023] [Indexed: 11/05/2023] Open
Abstract
OBJECTIVE The role of affective experiences (AE) in cognitive-behavioral therapy (CBT) has rarely been investigated. We examined between- and within-person effects of AE on coping in CBT for family caregivers and interactions with therapeutic alliance and resource activation. METHODS 67 family caregivers rated AE, therapeutic alliance, resource activation, and coping after each of 12 sessions of telephone-based CBT. We examined direct session-to-session effects of AE on coping in structural equation modeling and interactions of AE with therapeutic alliance and resource activation in multilevel models. RESULTS AE did not directly predict coping. Instead, within-person effects of AE interacted with simultaneous within-person emotional bond. Given strong emotional bond, AE positively predicted coping, whereas given weak emotional bond, AE negatively predicted coping. Further, cross-level interactions of between-person AE and within-person agreement on collaboration and resource activation indicated that these positively predicted coping only in dyads with high between-person AE. CONCLUSION AE may enhance coping when complemented with strong emotional bond. Further, within-person effects of agreement on collaboration and resource activation seem to rely on a certain degree of between-person AE. Results are discussed in relation to current findings on emotional processing in CBT.
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Affiliation(s)
- Nicolas Wrede
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
| | - Nils F Töpfer
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
| | - Gabriele Wilz
- Institute of Psychology, Department of Counseling and Clinical Intervention, Friedrich-Schiller-University Jena, Jena, Germany
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Supaporn K, Isaramalai SA, Chuchuen U, Manee P. Effectiveness of home-based palliative care programmes for older people and their family caregivers in Thailand. Int J Palliat Nurs 2023; 29:518-526. [PMID: 38039127 DOI: 10.12968/ijpn.2023.29.11.518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
BACKGROUND People in Thailand receiving palliative care at home can have complex needs and this means that the family caregiver can have a high burden of care. AIM To assess the impact of a nursing care activities for a home-based palliative care programme (NHBPC) on the care burden among family caregivers and the care quality in older people at the palliative care stage. METHODS This quasi-experimental repeated measure study was used to investigate the effects of the nursing care activities for a NHBPC programme. RESULTS The mean caregiving burden and care quality scores in the experimental and control groups at post-test and 2-weeks follow-up showed significant differences (p<.05). In addition, improvement was not seen in the control group. CONCLUSION The NHBPC programme significantly improved caregiving burden and quality of care in Thai older people and their family caregiver. This confirms that the NHBPC programme plays a crucial role in helping them to improve quality of life.
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Affiliation(s)
- Kanyanat Supaporn
- Lecturer, Department of Mental Health and Psychiatric Nursing, Faculty of Nursing, Srinakharinwirot University, Thailand
| | - Sang-Arun Isaramalai
- Assistant Professor, Department of Community Health Nurse Practitioner, Faculty of Nursing, Prince of Songkla University, Thailand
| | - Uayart Chuchuen
- Assistant Professor, Department of Community Health Nurse Practitioner, Faculty of Nursing, Prince of Songkla University, Thailand
| | - Patcharin Manee
- Director, Ban La Wa, Health PromotingHospital, Nakhonnayok, Thailand
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32
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You J, Qiao J, Dong Y, Vitaliano PP. A Double Whammy? Psychosocial Disadvantages of Dementia Caregivers with Cancer Histories. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1090-1107. [PMID: 37115196 DOI: 10.1080/01634372.2023.2207392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 04/18/2023] [Accepted: 04/19/2023] [Indexed: 06/19/2023]
Abstract
Guided by the Diathesis-Stress model, this study examined how cancer history interacted with caregiving status to determine the psychosocial functioning of dementia caregivers. This study assessed a set of indicators for psychological health and social connections among 85 spousal caregivers of persons with Alzheimer's disease and 86 age- and gender-matched spouses of healthy controls at study entry and 15-18 months later. Results showed that dementia caregivers with cancer histories reported lower social connections relative to caregivers without cancer histories or non-caregivers with or without cancer histories, and reported lower psychological health relative to non-caregivers with and without cancer histories at two time points. The findings highlight that a history of cancer is a predisposing vulnerability factor for psychosocial dysfunctions among dementia caregivers and address gaps in knowledge about the psychosocial adjustment of cancer survivors as caregivers.
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Affiliation(s)
- Jin You
- Department of Psychology, Wuhan University, Wuhan, China
| | - Jinhui Qiao
- Department of Psychology, Wuhan University, Wuhan, China
| | - Yue Dong
- Centre for Behavioral Economics, Society and Technology, School of Economics and Finance, Queensland University of Technology, Australia
| | - Peter P Vitaliano
- School of Medicine, University of Washington at Seattle, Seattle, Washington, USA
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33
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Sainz M, James T, Strader U, Gore J, Epps F. "I Didn't Know I Needed to Be Still": Experiences of Black Dementia Caregivers Attending Tailored Online Worship Services. Res Gerontol Nurs 2023; 16:273-282. [PMID: 37450781 DOI: 10.3928/19404921-20230706-03] [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: 07/18/2023]
Abstract
The current study aimed to determine the feasibility and preliminary efficacy of culturally appropriate online worship services for Black dementia caregivers. Researchers met online with families six times over 8 weeks. Each meeting consisted of families viewing a short, uniquely tailored worship service. Preand post-surveys were conducted, and caregivers participated in in-depth, semi-structured interviews to discuss their experiences with the online worship services. All caregivers (N = 24) identified as Christian and African American. There was no significant mean difference between pre- and post-survey results, but there was a trend toward improving perception of caregiver role, caregiver burden, and dyadic relationship. Observations and interviews revealed two themes, Experiences and Feasibility of Engaging With Culturally Appropriate Online Worship Services. Although the preliminary efficacy of the online worship services remains to be investigated, our results suggest resources developed for caregivers of people living with dementia should be carefully tailored to ensure they are culturally appropriate and responsive. [Research in Gerontological Nursing, 16(6), 273-282.].
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La Torre D, Van Oudenhove L, Vanuytsel T, Verbeke K. Psychosocial stress-induced intestinal permeability in healthy humans: What is the evidence? Neurobiol Stress 2023; 27:100579. [PMID: 37842017 PMCID: PMC10569989 DOI: 10.1016/j.ynstr.2023.100579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/17/2023] Open
Abstract
An impaired intestinal barrier function can be detrimental to the host as it may allow the translocation of luminal antigens and toxins into the subepithelial tissue and bloodstream. In turn, this may cause local and systemic immune responses and lead to the development of pathologies. In vitro and animal studies strongly suggest that psychosocial stress is one of the factors that can increase intestinal permeability via mast-cell dependent mechanisms. Remarkably, studies have not been able to yield unequivocal evidence that such relation between stress and intestinal permeability also exists in (healthy) humans. In the current Review, we discuss the mechanisms that are involved in stress-induced intestinal permeability changes and postulate factors that influence these alterations and that may explain the translational difficulties from in vitro and animal to human studies. As human research differs highly from animal research in the extent to which stress can be applied and intestinal permeability can be measured, it remains difficult to draw conclusions about the presence of a relation between stress and intestinal permeability in (healthy) humans. Future studies should bear in mind these difficulties, and more research into in vivo methods to assess intestinal permeability are warranted.
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Affiliation(s)
- Danique La Torre
- Translational Research Center in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
| | - Lukas Van Oudenhove
- Translational Research Center in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Leuven Brain Institute, KU Leuven, Leuven, Belgium
- Cognitive and Affective Neuroscience Lab, Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, USA
| | - Tim Vanuytsel
- Translational Research Center in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, Faculty of Medicine, KU Leuven, Leuven, Belgium
- Division of Gastroenterology and Hepatology, Leuven University Hospital, Leuven, Belgium
| | - Kristin Verbeke
- Translational Research Center in Gastrointestinal Disorders (TARGID), Department of Chronic Diseases and Metabolism, Faculty of Medicine, KU Leuven, Leuven, Belgium
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Steinsheim G, Malmedal W, Follestad T, Olsen B, Saga S. Factors associated with subjective burden among informal caregivers of home-dwelling people with dementia: a cross-sectional study. BMC Geriatr 2023; 23:644. [PMID: 37817101 PMCID: PMC10565959 DOI: 10.1186/s12877-023-04358-3] [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: 06/26/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND It is estimated that more than 57 million people have dementia worldwide, and it is one of the leading causes of care dependency in old age. Relatives and other informal caregivers are the most important support for individuals with dementia, but caring for a loved one with dementia may burden the caregiver. Caregiver burden may have adverse outcomes for both the informal caregiver and the care recipient, including decreased quality of life. Caregiver burden is associated with several factors concerning the informal caregiver, the care recipient, and relational and other contextual factors. The aim of this study was to explore which factors are associated with informal caregivers' subjective burden when caring for individuals living at home with dementia. METHODS This study was a cross-sectional survey among informal caregivers of home-dwelling individuals with dementia in all five geographical regions of Norway. There were 540 informal caregivers who participated, 415 of whom were included in the regression analyses. Caregivers' subjective burden was assessed with the Relatives' Stress Scale. Covariates included were classified into four levels: individual (twofold: informal caregiver and person with dementia), relational, community, and time. Linear multivariable regression analyses were used to identify associations between subjective burden and included factors. RESULTS Several covariates were statistically significantly associated with subjective burden at the four levels. These covariates included self-rated health, mental distress, age, coping through resignation and denial, emotional and instrumental support, substance use, and humor at the informal caregiver level; behavioral and psychological symptoms of dementia, dementia severity, and degree of disability at the care recipient level; the extent of care, being the primary caregiver, and previous relationship satisfaction at the relational context level; and informal caregivers spending time with friends, leisure activities, social restriction, and knowledge of available health services at the community context level. CONCLUSIONS Informal caregivers' mental distress and care recipients' neuropsychiatric symptoms were the factors with the strongest association with subjective burden.
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Affiliation(s)
- Gunn Steinsheim
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway.
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway
| | - Turid Follestad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinical Research Unit Central Norway, St. Olavs Hospital, Trondheim, Norway
| | - Bonnie Olsen
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Susan Saga
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway
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Huertas-Domingo C, Losada-Baltar A, Romero-Moreno R, Gallego-Alberto L, Márquez-González M. Sociocultural factors, guilt and depression in family caregivers of people with dementia. Kinship differences. Aging Ment Health 2023; 27:1655-1665. [PMID: 37020430 DOI: 10.1080/13607863.2023.2195821] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 03/18/2023] [Indexed: 04/07/2023]
Abstract
OBJECTIVES This study aims to analyze the role that family obligations and social desirability have for understanding guilt and depressive symptoms in family caregivers. A theoretical model is proposed to analyze this significance based on the kinship with the person cared for. METHODS Participants are 284 family caregivers of people with dementia divided into four kinship groups (husbands, wives, daughters and sons). Face-to-face interviews were conducted assessing sociodemographic variables, familism (family obligations), dysfunctional thoughts, social desirability, frequency and discomfort associated with problematic behaviors, guilt and depressive symptoms. Path analyses are performed to analyze the fit of the proposed model and multigroup analysis to study potential differences between kinship groups. RESULTS The proposed model fits the data well and explains significant percentages of variance of guilt feelings and depressive symptomatology for each group. The multigroup analysis suggests that, for daughters, higher family obligations were associated with depressive symptomatology through a report of higher dysfunctional thoughts. For daughters and wives, an indirect association between social desirability and guilt was observed through reaction to problematic behaviors. CONCLUSION The results support the need to consider the significance of sociocultural aspects such as family obligations and the desirability bias in the design and implementation of interventions for caregivers, especially for daughters. Considering that the variables that contribute to explaining caregivers' distress vary depending on the relationship with the person cared for, individualized interventions may be warranted depending on the kinship group.
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Affiliation(s)
| | - Andrés Losada-Baltar
- Departamento de Psicología, Universidad Rey Juan Carlos, Madrid, Comunidad de Madrid, Spain
| | - Rosa Romero-Moreno
- Departamento de Psicología, Universidad Rey Juan Carlos, Madrid, Comunidad de Madrid, Spain
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Becker S, Chowdhury M, Tavilsup P, Seitz D, Callahan BL. Risk of neurodegenerative disease or dementia in adults with attention-deficit/hyperactivity disorder: a systematic review. Front Psychiatry 2023; 14:1158546. [PMID: 37663597 PMCID: PMC10469775 DOI: 10.3389/fpsyt.2023.1158546] [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] [Received: 02/04/2023] [Accepted: 08/02/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose of review Several psychiatric disorders have been associated with an increased risk of developing a neurodegenerative disease and/or dementia. Attention-deficit/hyperactivity disorder (ADHD), a neurodevelopmental disorder, has been understudied in relation to dementia risk. We summarized existing literature investigating the risk of incident neurodegenerative disease or dementia associated with ADHD. Recent findings We searched five databases for cohort, case-control, and clinical trial studies investigating associations between ADHD and neurodegenerative diseases/dementia in May 2023. Study characteristics were extracted by two independent raters, and risk of bias was assessed using the Newcastle Ottawa Scale. Search terms yielded 2,137 articles, and seven studies (five cohort and two case-control studies) ultimately met inclusion criteria. Studies examined the following types of neurodegeneration: all-cause dementia, Alzheimer's disease, Parkinson's and Lewy body diseases, vascular dementia, and mild cognitive impairment. Heterogeneity in study methodology, particularly covariates used in analyses and types of ratios for risk reported, prevented a meta-analysis and data were therefore summarized as a narrative synthesis. The majority of studies (4/7) demonstrated an overall low risk of bias. Summary The current literature on risk of developing a neurodegenerative disease in ADHD is limited. Although the studies identified present evidence for a link between ADHD and subsequent development of dementia, the magnitude of the direct effect of ADHD on neurodegeneration is yet to be determined and better empirically designed studies are first needed. Furthermore, the mechanism of how or why ADHD is associated with an increased risk of developing a neurocognitive disorder is still unclear and should be explored in future studies. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022348976, the PROSPERO number is CRD42022348976.
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Affiliation(s)
- Sara Becker
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Mohammad Chowdhury
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Pattara Tavilsup
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Dallas Seitz
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Brandy L. Callahan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
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Aspö M, Visser LNC, Kivipelto M, Boström AM, Seiger Cronfalk B. Family Members' Experiences of Young-Onset Dementia: Becoming Responsible Yet Feeling Powerless. J Multidiscip Healthc 2023; 16:2379-2390. [PMID: 37609051 PMCID: PMC10441645 DOI: 10.2147/jmdh.s418285] [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: 05/27/2023] [Accepted: 07/05/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose Dementia is often associated with old age but can also occur in midlife. The latter is commonly referred to as young-onset dementia (YOD). The diagnosis not only has an impact on the persons with YOD but also on their family members. For family members, the diagnosis changes their lives, as responsibilities and roles alter when the care and wellbeing of the relative increasingly come into focus. The aim of this study was to explore family members' experiences of sharing lives with a relative diagnosed with YOD - from onset of symptoms until the person relocated to a nursing home. Patients and Methods The study has a qualitative approach with in-depth interviews. In total, the study included 15 family members aged ≥18 years participated, all with a relative diagnosed with dementia before the age of 65. At the time of the interview, all had a relative living in a nursing home. The interviews were analyzed using thematic analysis. Results Two key themes were identified: Becoming responsible and Dealing with the situation. Family members found themselves increasingly responsible for many parts of their relatives' lives and forced to make decisions on their behalf. This was experienced as being lonely, as family members wished to share their responsibility. Despite of their efforts to control and deal with their situation, family members reported a lack of power to influence certain factors, such as access to appropriate healthcare services, causing feelings of distress. Conclusion These findings emphasize the need of improved and tailored support and guidance for family members of persons with YOD. Further, the findings highlight the importance of increased knowledge and awareness among social workers and other healthcare professionals regarding support to family members of persons with YOD.
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Affiliation(s)
- Malin Aspö
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Leonie N C Visser
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Berit Seiger Cronfalk
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Poe AA, Vance DE, Patrician PA, Dick TK, Puga F. Resilience in the context of dementia family caregiver mental health: A concept analysis. Arch Psychiatr Nurs 2023; 45:143-151. [PMID: 37544690 DOI: 10.1016/j.apnu.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 03/31/2023] [Accepted: 06/19/2023] [Indexed: 08/08/2023]
Abstract
Resilience has been identified as a key concept for dementia family caregiver mental health; however, the concept is not well defined. A concept analysis examining dementia caregiver resilience was conducted using Rodger's Evolutionary Method. The aim of this concept analysis was to describe the historical perspective, attributes, antecedents, and consequences of resilience as it relates to dementia caregiver mental health. Key attributes of dementia caregiver resilience were acceptance, coping strategies, social support, self-appraisal, and spirituality. The results from this concept analysis provide the foundation for the development of resilience-based interventions to support the well-being of dementia family caregivers.
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Affiliation(s)
- Abigail A Poe
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA.
| | - David E Vance
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Tracey K Dick
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Frank Puga
- School of Nursing, The University of Alabama at Birmingham, Birmingham, AL, USA
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Ramirez M, De Anda S, Jin H, Herrera JR, Wu S. Health Information-Seeking Behavior of Latino Caregivers of People Living with Dementia: A Mixed-Methods Study. J Appl Gerontol 2023; 42:1738-1748. [PMID: 36932723 PMCID: PMC10440225 DOI: 10.1177/07334648231163430] [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: 03/19/2023] Open
Abstract
This mixed-methods study examined the health information-seeking behavior of Latino caregivers of people living with dementia. A structured survey and semi-structured interviews were conducted with 21 Latino caregivers in Los Angeles, California. For triangulation, semi-structured interviews were also conducted with six healthcare and social service providers. The interview transcripts were coded and analyzed via thematic analysis, while the survey data were summarized using descriptive statistics. The results show that caregivers sought information on what changes to expect as dementia progresses. Some desired detailed (limited) information to be better prepared (to worry less). The most common action to address their information needs was searching the Internet. However, those who did this tended to be concerned about the quality of information. Overall, this study sheds light on how much detail Latino caregivers desire in the information they need and the actions they take to obtain this information.
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Affiliation(s)
- Magaly Ramirez
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Sofia De Anda
- Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, WA, USA
| | - Haomiao Jin
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, USA
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Joseph R Herrera
- Rancho/USC Geriatric Neurobehavior and Alzheimer's Center, Downey, CA, USA
| | - Shinyi Wu
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
- Daniel J. Epstein Department of Industrial and Systems Engineering, Viterbi School of Engineering, University of Southern California, Los Angeles, CA, USA
- Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
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Puga F, Wang D, Rafford M, Poe A, Pickering CEZ. The relationship between daily stressors, social support, depression and anxiety among dementia family caregivers: a micro-longitudinal study. Aging Ment Health 2023; 27:1291-1299. [PMID: 36038530 PMCID: PMC9971344 DOI: 10.1080/13607863.2022.2116392] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/15/2022] [Indexed: 11/01/2022]
Abstract
Objectives: This study aimed to examine the relationships between daily stress, social support, and the mental health of dementia family caregivers.Methods: A national sample of family caregivers (N = 165) completed daily diary surveys over 21 days (n = 2,841). Mixed-level models were used to examine the daily odds of experiencing depression and anxiety-related symptoms when risk factors, such as the stress of managing behavioral symptoms of dementia (BSDs) exhibited by the person living with dementia, and protective factors, such as social support, were reported on a given day.Results: Dementia caregivers were more likely to report depression and anxiety-related symptoms when BSDs were present and perceived as more bothersome than usual. Specific BSDs, including restless behaviors and intense emotions, were also found to increase the daily odds of experiencing depression and anxiety symptoms. The daily odds of depression symptoms decreased on days when caregivers reported receiving instrumental support, while the daily odds of anxiety symptoms increased on days when caregivers reported receiving emotional support.Conclusions: The daily odds of experiencing depression and anxietyvary based on the presence of specific BSDs and social support. These findings support the need for targeted interventions to improve the day-to-day well-being of dementia family caregivers.
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Affiliation(s)
- Frank Puga
- School of Nursing, The University of Alabama at Birmingham, Birmingham AL, USA
| | - Danny Wang
- School of Nursing, The University of Alabama at Birmingham, Birmingham AL, USA
| | - Meghan Rafford
- School of Nursing, The University of Alabama at Birmingham, Birmingham AL, USA
| | - Abigail Poe
- School of Nursing, The University of Alabama at Birmingham, Birmingham AL, USA
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Saragosa M, Kuluski K, Okrainec K, Jeffs L. “Seeing the day-to-day situation”: A grounded theory of how persons living with dementia and their family caregivers experience the hospital to home transition and beyond. J Aging Stud 2023. [DOI: 10.1016/j.jaging.2023.101132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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Tonkikh O, Chi NC, Herr KA, Fishman SM, Young HM. Supporting the Health and Well-Being of Caregivers of Persons with Pain. Am J Nurs 2023; 123:55-61. [PMID: 37233141 DOI: 10.1097/01.naj.0000938740.48023.71] [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: 05/27/2023]
Abstract
This article is part of a series, Supporting Family Caregivers: No Longer Home Alone, published in collaboration with the AARP Public Policy Institute. Results of focus groups, conducted as part of the AARP Public Policy Institute's No Longer Home Alone video project, supported evidence that family caregivers aren't given the information they need to manage the complex care regimens of family members. This series of articles and accompanying videos aims to help nurses provide caregivers with the tools they need to manage their family member's health care at home. This new group of articles provides practical information nurses can share with family caregivers of persons living with pain. To use this series, nurses should read the articles first, so they understand how best to help family caregivers. Then they can refer caregivers to the informational tear sheet-Information for Family Caregivers-and instructional videos, encouraging them to ask questions. For additional information, see Resources for Nurses.
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Affiliation(s)
- Orly Tonkikh
- Orly Tonkikh is a Heather M. Young Postdoctoral Fellow at the Betty Irene Moore School of Nursing at the University of California, Davis, in Sacramento. Nai-Ching Chi is an assistant professor in the College of Nursing at the University of Iowa in Iowa City, where Keela A. Herr is the Kelting Professor in Nursing, associate dean for faculty, and codirector of the Csomay Center for Gerontological Excellence. Scott M. Fishman is a professor, the Anderson Endowed Chair in Wellness, the Fullerton Endowed Chair in Pain Medicine, and executive vice chair in the Department of Anesthesiology and Pain Medicine at the University of California, Davis, School of Medicine in Sacramento, where he is also executive director of the Office of Wellness Education and director of the Center for Advancing Pain Relief. Heather M. Young is a professor and founding dean emerita in the Betty Irene Moore School of Nursing at the University of California, Davis, and national director of the Betty Irene Moore Fellowship for Nurse Leaders and Innovators. This work was funded by the Mayday Fund and the Ralph C. Wilson, Jr. Foundation. Contact author: Orly Tonkikh, . The authors have disclosed no potential conflicts of interest, financial or otherwise
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Eaton J, Neller S, Fernandez Cajavilca M, Johnson JK, Ellington L. Iterative Review and Revision of the Enhancing Active Caregiver Training (EnACT) Intervention. J Alzheimers Dis Rep 2023; 7:461-467. [PMID: 37313489 PMCID: PMC10259071 DOI: 10.3233/adr-220096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 05/02/2023] [Indexed: 06/15/2023] Open
Abstract
Interventions that actively engage dementia caregivers show promise in reducing the negative outcomes of caregiving but lack optimization and systematic testing. The purpose of this manuscript is to describe an iterative process developed to refine an intervention to enhance active engagement. A three-stage review process with content experts was developed to refine activities in preparation for focus group feedback and pilot testing. We identified caregiving vignettes, reorganized engagement techniques, and optimized focus group activities for online delivery to promote caregiver access and safety. The framework developed from this process is included, along with a template to guide intervention refinement.
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Affiliation(s)
| | - Sarah Neller
- College of Nursing, University of Tennessee, Knoxville, Knoxville, TN, USA
| | | | - Julene K. Johnson
- Institute for Health & Aging, University of California, San Francisco, San Francisco, CA, USA
| | - Lee Ellington
- College of Nursing, University of Utah, Salt Lake City, UT, USA
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Montiel-Aponte MC, Bertolucci PHF, Rocha GGV. The knowledge of memory aging questionnaire (KMAQ) in a Brazilian sample: a questionnaire for informants to recognize early signs of dementia. Dement Neuropsychol 2023; 17:e20220090. [PMID: 37261250 PMCID: PMC10229088 DOI: 10.1590/1980-5764-dn-2022-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/29/2022] [Indexed: 06/02/2023] Open
Abstract
Till present, only a few countries have developed support programs for caregivers and families of patients with dementia aimed to improve knowledge, skills, and strategies to deal with the patient's symptoms. However, prior to offering this special support, it is important to identify beliefs and thoughts shared by informants related to cognition in elderly people. Questionnaires are instruments that allow having this information, such as the Knowledge of Memory Aging Questionnaire (KMAQ), which was designed to assess normal and pathological changes in the aging process. Objective The aim of this study was to assess the knowledge about cognition, aging, and dementia as evaluated by the KMAQ in people who are in contact with elderly people, with and without cognitive impairment. Methods A total of 78 relatives and caregivers of elderly patients were classified into two groups: group 1: relatives of patients with dementia (n1=48), and group 2: relatives of patients without cognitive impairment (n2=30). They were asked to answer some questionnaires about dementia, including the KMAQ. Results Comparing the questionnaire's scores for normal cognitive changes items (g1: 0.53 vs. g2: 0.53, p-value: 0.99) did not show differences between the knowledge in both groups, nor shows the scores for pathological cognitive changes items (g1: 0.55 vs. g2: 0.55, p-value: 0.969). Conclusions It seems that being in contact with dementia does not improve knowledge about it. Knowledge of normal changes in cognition could make it possible to recognize "red flags" suggestive of neurodegenerative processes, allowing for earlier diagnosis and more options for treatment.
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Affiliation(s)
- Mariel Carolina Montiel-Aponte
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pós-Graduação em Neurologia e Neurociências, São Paulo SP, Brazil
| | - Paulo Henrique Ferreira Bertolucci
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Hospital São Paulo, Ambulatório de Neurologia Comportamental, São Paulo SP, Brazil
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McMahon K, McFerran K, Clark IN, Odell-Miller H, Stensæth K, Tamplin J, Baker FA. Learning to use music as a resource: the experiences of people with dementia and their family care partners participating in a home-based skill-sharing music intervention: a HOMESIDE sub-study. Front Med (Lausanne) 2023; 10:1205784. [PMID: 37275362 PMCID: PMC10232877 DOI: 10.3389/fmed.2023.1205784] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 05/03/2023] [Indexed: 06/07/2023] Open
Abstract
An increasing number of people with dementia receive informal care from family members to help them remain living in the community. Music therapy is particularly beneficial for supporting the wellbeing of people living with dementia. However, little is known about how music therapy might support people with dementia and their family care partners as dyads. This study explored the experiences of six dyads participating in a 12-week home-based skill-sharing music intervention facilitated by a music therapist. We examined their experiences during the intervention period and in the 3-6 months following. This study was conducted within a larger randomised control trial, HOMESIDE. Data was collected through video-recorded music-based interviews, participant diaries, and a semi-structured interview. Data was analysed using an abductive and relational-centred research approach in consideration of the Contextual Connection Model of Health Musicking for People Living with Dementia and Their Family Care Partners. The study found fifteen themes that describe dyads' supported experiences of sharing music in their homes. These were organised into three global themes: (1) experiences were shaped by complex influences; (2) a connected musical ecosystem; and (3) music was a resource for wellbeing. This study highlighted the important role of personalised facilitation and the therapeutic relationship as dyads learned to use music as a resource through a process of trial and error. The implications for skill-sharing, indirect music therapy and direct music therapy practice are discussed.
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Affiliation(s)
- Kate McMahon
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Katrina McFerran
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Imogen N. Clark
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Helen Odell-Miller
- Cambridge Institute for Music Therapy Research, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karette Stensæth
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
| | - Felicity A. Baker
- Faculty of Fine Arts and Music, The University of Melbourne, Melbourne, VIC, Australia
- Centre for Research in Music and Health, Norwegian Academy of Music, Oslo, Norway
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Wiegelmann H, Wolf-Ostermann K, Janssen N, van Hout H, Vroomen JLM, Arzideh F. Sociodemographic structure and health care-related outcomes of community-dwelling dementia caregiving dyads: a latent class replication study. BMC Health Serv Res 2023; 23:482. [PMID: 37173765 PMCID: PMC10182645 DOI: 10.1186/s12913-023-09505-5] [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: 08/03/2022] [Accepted: 05/04/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND The identification of dyadic subgroups of individuals living with dementia and their informal caregivers can help to design effective tailored support. In a previous German study, we identified six dementia dyad subgroups by applying Latent Class Analysis (LCA). Results showed sociodemographic heterogeneity as well as differences in health care outcomes (i.e., quality of life, health status, caregiver burden) between subgroups. The objective of this study is to determine if the dyad subgroups from the previous analysis can be replicated in a similar but distinct Dutch sample. METHODS A LCA 3-step procedure was applied to baseline data from the COMPAS study, a prospective cohort study. LCA is a statistical approach used to identify heterogeneous subgroups within populations based on their pattern of answers on a set of categorical variables. Data comprises 509 community-living individuals with predominantly mild to moderate dementia and their informal caregivers. A narrative analysis was used to compare latent class structures of the original versus the replication study. RESULTS Six distinct dementia dyad subgroups were identified: A subgroup of "adult-child-parent relation with younger informal caregiver" (31.8%), a "couple with female informal caregiver of older age" group (23.1%), an "adult-child-parent relation with middle-aged informal caregiver" group (14.2%), a "couple with middle-aged female informal caregiver" group (12.4%), a "couple with older male informal caregiver" group (11.2%) and a "couple with middle-aged male informal caregiver" group (7.4%). Quality of life of individuals with dementia was rated better in couples than in adult-child-relationships. Worst health for caregivers was reported by subgroups with female informal caregivers living together with male individuals with dementia in couple relationships. A subgroup with older female informal caregivers in couple relationships report the most severe burden on physical and mental health. In both studies, a model with six subgroups fitted the data best. Although substantive similarities between the subgroups of both studies appeared, considerable differences are also evident. CONCLUSION This replication study confirmed the existence of informal dementia dyad subgroups. The observed differences between the subgroups provide useful contributions for a more tailored health care services for informal caregivers and individuals living with dementia. Furthermore, it underlines the relevance of dyadic perspectives. To facilitate replication studies and increase the validity of evidence, a standardization of collected data across studies would be beneficial.
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Affiliation(s)
- Henrik Wiegelmann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany.
| | - Karin Wolf-Ostermann
- Institute for Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | - Niels Janssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, the Netherlands
| | - Hein van Hout
- General Practice & Medicine of Older People, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Janet L MacNeil Vroomen
- Internal Medicine, Section Geriatrics, Amsterdam University Medical Center, Amsterdam, the Netherlands
| | - Farhad Arzideh
- University Medical Center Knappschaftskrankenhaus Bochum, Bochum, Germany
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Jagoda T, Dharmaratne S, Rathnayake S. Informal carers' information needs in managing behavioural and psychological symptoms of people with dementia and related mHealth applications: a systematic integrative review to inform the design of an mHealth application. BMJ Open 2023; 13:e069378. [PMID: 37169501 PMCID: PMC10439342 DOI: 10.1136/bmjopen-2022-069378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/25/2023] [Indexed: 05/13/2023] Open
Abstract
OBJECTIVE To review and synthesise the evidence on informal carers' information needs in managing behavioural and psychological symptoms of dementia (BPSD) of their care recipients and related mobile health (mHealth) applications to inform the design of an mHealth application. DESIGN This is a systematic integrative review guided by Whittemore and Knafl's five-stages framework. Six databases were searched: Cochrane, CINAHL, Embase, MEDLINE, ProQuest and PsycINFO. The key concepts included 'dementia', 'behavioural and psychological symptoms', 'informal carers' and ('information need' or 'mHealth application'). Peer-reviewed full-text articles published in English from 2000 to 2022 were included. The methodological rigour of studies was analysed using the Mixed Methods Appraisal Tool V.2018. Preferred Reporting Items for Systematic Reviews and Meta-Analyses-2020 reporting guidelines were followed. RESULTS This review included 34 studies, including quantitative (n=13), qualitative (n=17) and mixed-method (n=4) studies. Four major themes emerged from the reported studies: the need for addressing information needs on managing BPSD, the role of support systems in managing BPSD, self-care for carers and the role of mHealth applications in providing education and support for carers. In managing BPSD, carers seek knowledge about dementia and BPSD, the roles of the carers and misconceptions about BPSD. One study reported an mHealth application to monitor the behavioural issues of people with dementia. CONCLUSION Informal carers of people with dementia face a number of challenges when providing care for BPSD of their care recipients. The lack of knowledge on managing BPSD is a significant challenge. Support systems such as professional, social, residential, legal and eHealth have a significant role in managing the BPSD of people with dementia in the community. mHealth interventions are sparse to support BPSD management. These findings can be used in designing an mHealth application that addresses needs related to managing BPSD of informal carers of people with dementia. PROSPERO REGISTRATION NUMBER CRD42021238540.
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Affiliation(s)
- Thilanka Jagoda
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Department of Nursing and Midwifery, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
| | - Samath Dharmaratne
- Department of Community Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
- Postgraduate Institute of Medical Sciences, University of Peradeniya, Peradeniya, Sri Lanka
- Institute for Health Metrics and Evaluation, Department of Health Metrics Sciences, School of Medicine University of Washington, Seattle, Washington, USA
| | - Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
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49
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Herron DL, Runacres J, Danton I, Beardmore J. Carers' experiences of caring for a friend or family member with dementia during the Covid-19 pandemic. DEMENTIA 2023; 22:576-593. [PMID: 36630524 PMCID: PMC9843153 DOI: 10.1177/14713012221150298] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES This study aimed to explore carers' experiences of supporting a family member or friend with dementia through COVID-19 and experiences of hope and resilience during this time. METHODS Qualitative longitudinal research was undertaken in the UK, with 13 unpaid carers of people living with dementia who took part in two semi-structured interviews 8 weeks apart between June and October 2020. All transcripts were analysed using reflexive thematic analysis. FINDINGS Four themes were developed and included: COVID-19 impacted negatively upon everyday living; carer resilience: adapting to COVID-19; analysis of risk: safeguarding the person living with dementia; and thinking about the future with COVID-19. CONCLUSIONS The results illustrated how the sudden changes which occurred during the pandemic negatively impacted on carers and people living with dementia in several ways, including additional responsibilities and taking away hope. The importance of continued formal and informal support for carers and people living with dementia during COVID-19 were highlighted. Formal services, care homes, and organisations need to be supported to implement procedures to ensure a safe environment during future lockdowns or periods of social restrictions. This will enable carers to remain visiting their family members and increase their confidence in accessing services and allowing paid carers to support their family member with dementia. These results have also illustrated the resilience of carers, who adapted to sudden changes which impacted negatively on their wellbeing and the wellbeing of the person living with dementia.
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Affiliation(s)
- Daniel L Herron
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Jessica Runacres
- Midwifery and Allied Health, School of Health, Science and Wellbeing, Centre of Excellence in Healthcare Education, 7703Staffordshire University, Stoke-on-Trent, UK
| | - Ian Danton
- School of Psychology, 2939University of Derby, Derby, UK
| | - Jack Beardmore
- Department of Psychology, School of Health, Science and Wellbeing, 7703Staffordshire University, Stoke-on-Trent, UK
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50
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Łuc M, Pawłowski M, Jaworski A, Fila-Witecka K, Szcześniak D, Augustyniak-Bartosik H, Zielińska D, Stefaniak A, Pokryszko-Dragan A, Chojdak-Łukasiewicz J, Krajewska M, Pawłowski T, Szepietowski JC, Rymaszewska J. Coping of Chronically-Ill Patients during the COVID-19 Pandemic: Comparison between Four Groups. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4814. [PMID: 36981722 PMCID: PMC10049622 DOI: 10.3390/ijerph20064814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 02/26/2023] [Accepted: 03/03/2023] [Indexed: 06/18/2023]
Abstract
In many countries, the COVID-19 pandemic led to healthcare reorganization limiting access to diagnostic or therapeutic procedures for chronically-ill patients. In this article, we describe the psychological consequences and coping strategies of several groups of chronically-ill patients. During the cross-sectional survey conducted in 2020, we enrolled 398 patients with four different chronic conditions (psoriasis, multiple sclerosis, and patients who have undergone a kidney transplant or received dialysis). The study sample was examined regarding the experienced stress levels (Perceived Stress Scale) and coping strategies (Brief-COPE). All four groups of patients most commonly declared using problem-focused coping strategies and least commonly reported the use of avoidant coping. Higher levels of perceived stress strongly correlated with self-blaming. The participants who declared previous psychiatric treatment or psychotherapy were more likely to use self-blaming, behavioral disengagement, substance use, and avoidant coping, while previous psychotherapy additionally correlated with emotion-focused coping. Group comparison identifies patients with a chronic neurological disease, such as multiple sclerosis, at higher risk of a less beneficial coping profile than kidney transplant recipients. Further focus on education and early interventions in at-risk individuals is needed, and widely targeted mental health programs are indicated in order to improve the mental health of patients suffering from chronic diseases.
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Affiliation(s)
- Mateusz Łuc
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Marcin Pawłowski
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Arkadiusz Jaworski
- Students Research Association, Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | | | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Hanna Augustyniak-Bartosik
- Dialysis Unit, Department of Nephrology and Transplantology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Dorota Zielińska
- Department of Nephrology and Transplantology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Aleksandra Stefaniak
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | | | | | - Magdalena Krajewska
- Dialysis Unit, Department of Nephrology and Transplantology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Tomasz Pawłowski
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Jacek C. Szepietowski
- Department of Dermatology, Venerology and Allergology, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | - Joanna Rymaszewska
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
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