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Hoffstädt HE, Tam MC, Stoppelenburg A, Stoevelaar R, van Bodegom-Vos L, van der Steen JT, van der Linden YM, Hartog ID. What do family caregivers of patients with life-threatening diseases need from healthcare professionals? A qualitative study. BMJ Support Palliat Care 2024:spcare-2024-005135. [PMID: 39357998 DOI: 10.1136/spcare-2024-005135] [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: 08/22/2024] [Accepted: 09/08/2024] [Indexed: 10/04/2024]
Abstract
OBJECTIVES To explore the common ground of what family caregivers need in their various roles (caregiver, care recipient and patient's partner, child or friend) from healthcare professionals across healthcare settings and disease trajectories. DESIGN Interviews were conducted with family caregivers of patients with life-threatening diseases who were treated at home, in hospitals, nursing homes or hospices between 2017 and 2022. Reflexive thematic analysis was performed. SETTING/PARTICIPANTS 63 family caregivers of 65 patients were interviewed. Of the patients, 36 (55%) had COVID-19 and 29 (45%) had other life-threatening diseases (eg, advanced cancer, dementia). The majority of family caregivers were women (83%) and children of the patient (56%). RESULTS Three themes were developed regarding family caregivers' core needs across their different roles: (1) 'feeling seen and valued', (2) 'experiencing trust in the provided care' and (3) 'experiencing guidance and security'. Actions of healthcare professionals that meet those needs relate to their contact and relationship with family caregivers, information provision, practical and emotional support, the care for the patient and facilitating the connection between family caregivers and patients. DISCUSSION Healthcare professionals should be trained in meeting family caregivers' core needs, in which their (collaborative) relationship with them plays an important role. Efforts to meet the core needs should be incorporated into healthcare organisations' workflows, and future research should investigate related barriers and facilitators.
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Affiliation(s)
| | - Marcella Cecilia Tam
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
| | - Arianne Stoppelenburg
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Rik Stoevelaar
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
| | - Leti van Bodegom-Vos
- Biomedical Data Sciences, section Medical Decision Making, Leiden University Medical Center, Leiden, Netherlands
| | - Jenny Theodora van der Steen
- Public Health and Primary Care, Leiden University Medical Center, Leiden, Netherlands
- Primary and Community Care, Radboud university medical center, Nijmegen, Netherlands
- Cicely Saunders Institute, King's College London, London, UK
| | - Yvette Milene van der Linden
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
| | - Iris Dewi Hartog
- Center of Expertise in Palliative Care, Leiden University Medical Center, Leiden, Netherlands
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, Netherlands
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Haan M, Olthuis G, Boenink M, van Gurp J. Bridging comic art and research: lessons from an interdisciplinary collaboration project in a palliative care context. MEDICAL HUMANITIES 2024; 50:475-485. [PMID: 38453454 DOI: 10.1136/medhum-2023-012750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/02/2024] [Indexed: 03/09/2024]
Abstract
The Dutch graphic novel Naasten, about palliative family caregiving, is the product of an interdisciplinary collaboration between researchers and two comic artists. This paper aims to present lessons, reflections and practical recommendations for other researchers interested in adopting (comic) arts-based research methods, in which artistic methods are used as novel ways for generating, analysing, interpreting or representing research data.Our project started with the goal of translation: we aimed at representing research findings into a more accessible, visual and textual form to stimulate discussion and reflection outside academia on moral challenges in family care. This was inspired by comics' hypothesised potential to show complex and embodied experiences, thus enabling more understanding in readers and offering powerful science communication tools. Although this goal of translation was realised in our project, we learnt along the way that the project could have benefited from a more explicit focus on interdisciplinarity from the start and by monitoring the interdisciplinary learning opportunities throughout the project. The following issues are important for any art-research collaboration: (1) an interest in and acknowledgement of each other's (potentially diverging) aims and roles: all parties should-from the start-commit themselves to interdisciplinary collaboration and to exploring the added value of using each other's methods, thereby finding a common methodological ground and language; (2) a continuous discussion of the sometimes contrasting approaches between artists and researchers: differences in using theory and story may result in different criteria for creating good art. When balancing scientific and aesthetic aims, the trustworthiness of the art work should remain an important criterion; (3) an awareness of the potential of interdisciplinary collaboration to offering new perspectives on one's scientific data collection and analysis, for example, providing other conceptualisations or indicating blind spots, provided that artists are involved in the early phases of research.
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Affiliation(s)
- Maaike Haan
- IQ Health science department, Ethics of healthcare group, Radboud university medical center, Nijmegen, The Netherlands
| | - Gert Olthuis
- IQ Health science department, Ethics of healthcare group, Radboud university medical center, Nijmegen, The Netherlands
| | - Marianne Boenink
- IQ Health science department, Ethics of healthcare group, Radboud university medical center, Nijmegen, The Netherlands
| | - Jelle van Gurp
- IQ Health science department, Ethics of healthcare group, Radboud university medical center, Nijmegen, The Netherlands
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Rashid NSA, Mohamad Marzuki MF, Abdullah NN, Mohamad M, Takshe AA, Mohd Yunus R, Chen XW. Supporting caregivers of people with dementia: insights from Demensia KITA mobile application online content development. Sci Rep 2024; 14:19302. [PMID: 39164373 PMCID: PMC11336210 DOI: 10.1038/s41598-024-69947-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 08/12/2024] [Indexed: 08/22/2024] Open
Abstract
Dementia significantly impacts caregivers, particularly in low and middle-income countries where support is often inadequate. Given the gap in affordable and culturally relevant digital resources for Malaysian dementia caregivers, we developed "Demensia KITA," a mobile application (app) specifically tailored to their needs. This study utilized a theoretical framework proposed from existing literature and the "Model of Carer Stress and Burden". This paper discusses our app content development, highlighting key findings and challenges. To assess caregivers' needs, the Nominal Group Technique (NGT) with five dementia caregivers was conducted, followed by a Focus Group Discussion (FGD) with eight medical professionals. Both sessions were conducted online via Google Meet. In the NGT, ideas were generated, organized, prioritized, reviewed, and refined by medical professionals in the FGD. Content relevant to addressing the complexities of dementia caregiving was then discussed. Topics were either adapted from established modules or newly developed from credible sources. Subsequently, these were organized into modules and themes, and subsequently underwent expert validation. From the NGT, three key domains emerged: Knowledge, Services, and Support. These were further organized into two modules: 'Patient Care for Caregivers' and 'Caregiver Wellbeing'. Within these, twelve sub-modules were identified, covering a range of topics including basic knowledge on dementia, patient care, nutritional management, oral and dental care, simple exercises, daily activity and memory rehabilitation, service directories, support groups, emotional and stress management, welfare assistance, and daily motivation. This framework was developed to address the specific needs of dementia caregivers in terms of psychoeducation, psychosocial and caregiving skills, incorporating expert opinions in the field. This study corroborates the feasibility of online methods for mobile health app content development and encourages similar research. Future studies should evaluate Demensia KITA's effectiveness in alleviating caregiver burden across all regions, assess users' acceptance, and ensure it meets the evolving needs of Malaysian caregivers with regular updates.
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Affiliation(s)
- Nurul Syaireen A Rashid
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
- Training Management Division, Ministry of Health, Menara Prisma Aras 6, Persiaran Perdana, Persint 3, 62675, Wilayah Persekutuan Putrajaya, Malaysia
| | - Muhamad Fadhil Mohamad Marzuki
- Kedah State Health Department, Ministry of Health Malaysia, Simpang Kuala, Jalan Kuala Kedah, 05400, Alor Setar, Kedah, Malaysia
| | - Nik Nairan Abdullah
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Mariam Mohamad
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Aseel A Takshe
- Department Public Health, Faculty of Communication, Arts and Sciences, Canadian University Dubai, Al Safa Street-Al Wasi City Walk Mall, P.O. Box 17781, Dubai, United Arab Emirates
| | - Raudah Mohd Yunus
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia
| | - Xin Wee Chen
- Department of Public Health Medicine, Faculty of Medicine, Universiti Teknologi MARA Sungai Buloh, 47000, Shah Alam, Selangor Darul Ehsan, Malaysia.
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Komorowski A, Demmer TR, Auer M, Schulze M, Fischer G. Addressing healthcare vulnerabilities in nursing homes : Insights from human rights monitoring in two Austrian provinces. Wien Klin Wochenschr 2024:10.1007/s00508-024-02409-2. [PMID: 39123053 DOI: 10.1007/s00508-024-02409-2] [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: 04/15/2024] [Accepted: 07/08/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Current demographic changes bear challenges for national care systems due to higher life expectancy of older citizens. Largely cut off from society, nursing home residents are at risk for violence, neglect, and other potential human rights violations. This study aimed to investigate healthcare vulnerabilities in nursing homes and evaluate the Austrian National Preventive Mechanism (NPM). METHODS Between 2017 and 2019, 55 monitoring visits were conducted in 32 nursing homes. Study outcomes from two Austrian provinces included data on infrastructure, occupancy, staffing, resident's demographics and medical conditions, as well as measures related to the functioning of the NPM. RESULTS Accessibility with mobility aids was sufficient in 87%, but assistance for persons with visual or hearing impairments solely in 20-40% of the institutions. An understaffing with nursing assistants (-5.2 full-time equivalents in Carinthia) and home helpers (-1.6 in Carinthia and Styria) was present. Less than 20% of the personnel received advanced training related to dementia and neuropsychiatric care. While 50% of the residents were diagnosed with a psychiatric disorder, approximately 36% received support from an appointed legal guardian. Of the monitoring visits 58.1% were conducted due to anonymous complaints and urgent referrals. The median processing times of the NPM and the provincial governments exceeded 250 days. CONCLUSION Human rights monitoring reveals critical aspects in nursing home care, including insufficient accessibility, understaffing and inadequate training. Although the authorities' handling times hinder prompt responses, the NPM may foster systemic improvements and accountability within nursing homes.
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Affiliation(s)
- Arkadiusz Komorowski
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria.
- Commission 3, Austrian Ombudsman Board, Singerstraße 17, 1015, Vienna, Austria.
| | - Theresa Rahel Demmer
- Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
- Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010, Vienna, Austria
| | - Marianne Auer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
- Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
| | | | - Gabriele Fischer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währingergürtel 18-20, 1090, Vienna, Austria
- Center for Public Health, Medical University of Vienna, Kinderspitalgasse 15, 1090, Vienna, Austria
- Commission 3, Austrian Ombudsman Board, Singerstraße 17, 1015, Vienna, Austria
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Romero-Mas M, Cox AM, Ramon-Aribau A, Gómez-Zúñiga B. Knowledge sharing in virtual communities of practice of family caregivers of people with Alzheimer's. BMC Geriatr 2024; 24:577. [PMID: 38965455 PMCID: PMC11223353 DOI: 10.1186/s12877-024-05045-7] [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: 05/31/2023] [Accepted: 05/06/2024] [Indexed: 07/06/2024] Open
Abstract
INTRODUCTION Knowledge sharing can only happen in the context of a trusting and supportive environment, such as evolves in communities of practice and their virtual equivalent, virtual communities of practice. The main objective of this study was to understand knowledge sharing between participants in a virtual community of practice of caregivers of people with Alzheimer's. METHODS The authors designed their own mobile application, and two virtual communities of practice were created independently and differentiated by how they were moderated: one by an expert caregiver and the other by three health professionals. 38 caregivers and four moderators were involved in the study, which ran between July 2017 and April 2018. A total of 1925 messages were exchanged within the two communities and used as data in the study. Message data was analysed using LINKS (Leveraging Internet Networks for knowledge sharing). RESULTS Participants were more motivated to acquire knowledge related to caring for the person with Alzheimer's rather than caring for themselves. The purpose of the messages was to inform others about the sender and not to seek answers. It seems that the interaction was more to socialise and to feel heard, than to gain information. Face to face meetings appear to have accelerated community development. On nearly every parameter, behaviour was significantly different in the two communities, reflecting the importance of the character of the moderator. Caring for oneself was a much stronger theme in the community that included health professionals. Experiential knowledge sharing was particularly strong in the group led by a caregiver. DISCUSSION Caregivers adapted the virtual community of practice to their own needs and mainly shared social knowledge. This focus on social support, which seems to be more valued by the caregivers than information about the disease, was not an expected pattern. Virtual communities of practice where peers count on each other, function more as a support group, whereas those moderated by health professionals function more as a place to go to acquire information. The level of interactivity points to such communities being important for knowledge sharing not mere knowledge transfer.
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Affiliation(s)
- M Romero-Mas
- Health Sciences and Welfare Faculty, University of Vic-Central University of Catalonia, Vic (Barcelona), Spain
| | - A M Cox
- Information School, University of Sheffield, Sheffield, UK
| | - A Ramon-Aribau
- Health Sciences and Welfare Faculty, University of Vic-Central University of Catalonia, Vic (Barcelona), Spain
| | - Beni Gómez-Zúñiga
- Estudis de Psicologia i Ciències de l'Educació, Universitat Oberta de Catalunya, Rambla Poblenou, 156, Barcelona, 08018, Spain.
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Becker L, Graessel E, Pendergrass A. Predictors of the quality of the relationship between informal caregiver and care recipient in informal caregiving of older people: presentation and evaluation of a new item. BMC Psychol 2024; 12:342. [PMID: 38858769 PMCID: PMC11165870 DOI: 10.1186/s40359-024-01840-4] [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: 10/14/2022] [Accepted: 05/31/2024] [Indexed: 06/12/2024] Open
Abstract
BACKGROUND An important factor that has not been directly addressed very often in caregiver (CG) counseling to date is the quality of the relationship between the CG and the care recipient (CR). One reason is the lack of availability of a suitable assessment tool that is not strongly influenced by social desirability. Here, we present and evaluate a new item for the assessment of relationship quality (RQ) in the context of informal caregiving of older people. METHODS N = 962 informal caregivers of older people participated. Our item assessed RQ by providing three answer categories (positive, neutral, and negative) that were presented through the use of smiley faces. For evaluation, and to avoid bias due to social desirability, the neutral and negative categories were combined. We calculated a stepwise binary logistic regression. RESULTS Expected associations with the variables care burden, perceived positive aspects, and care motivation were found (all p values < 0.01). An exploratory analysis revealed that additional predictors of RQ consisted of the CR's age as well as whether the CR's diagnosis was dementia, CG's amount of dysfunctional coping, and whether the CG was caring for more than one CR. CONCLUSIONS We conclude that our item is well-suited for the assessment of RQ in the context of informal caregiving of older people. Because it uses language-free answer categories by means of smiley faces, our item can be applied easily. Bias due to social desirability can be minimized by dichotomization (i.e., combining the negative and neural answer categories). In future research, our tool should be evaluated in other contexts.
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Affiliation(s)
- Linda Becker
- Department of Psychology, Chair of Health Psychology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Nägelsbachstr. 49a, 91052, Erlangen, Germany.
- Humanwissenschaftliche Fakultät, Vinzenz Pallotti University gGmbH, Vallendar, Germany.
| | - Elmar Graessel
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Anna Pendergrass
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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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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Fan Q, Hoang MN, DuBose L, Ory MG, Vennatt J, Salha D, Lee S, Falohun T. The Olera.care Digital Caregiving Assistance Platform for Dementia Caregivers: Preliminary Evaluation Study. JMIR Aging 2024; 7:e55132. [PMID: 38630527 PMCID: PMC11063878 DOI: 10.2196/55132] [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: 12/03/2023] [Revised: 02/01/2024] [Accepted: 03/13/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The increasing prevalence of Alzheimer disease and Alzheimer disease-related dementia in the United States has amplified the health care burden and caregiving challenges, especially for caregivers of people living with dementia. A web-based care planning tool, Olera.care, was developed to aid caregivers in managing common challenges associated with dementia care. OBJECTIVE This study aims to preliminarily evaluate the quality and usability of the Olera.care platform and assess the preferences of using the technology and interests in learning about different older adult care services among caregivers. METHODS For interview 1, we aim to understand caregiving needs and let the participants start engaging with the platform. After they engage with the platform, we schedule the second interview and let the participants complete the Mobile Application Rating Scale. The survey also included sociodemographic characteristics, caregiving experiences, communication preferences in technology adoption, and older adult care service use and interests. Descriptive statistics were used to describe the quality and usability of the platform and characteristics of the participants. We conducted 2-sample 2-tailed t tests to examine the differences in the Mobile Application Rating Scale evaluation scores by caregiver characteristics. RESULTS Overall, 30 adult caregivers in Texas completed the evaluation. The majority were aged ≥50 years (25/30, 83%), women (23/30, 77%), White (25/30, 83%), and financially stable (20/30, 67%). The Olera.care platform evaluation showed high satisfaction, with an overall mean rating of 4.57 (SD 0.57) of 5, and scored well in engagement (mean 4.10, SD 0.61), functionality (mean 4.46, SD 0.44), aesthetics (mean 4.58, SD 0.53), and information quality (mean 4.76, SD 0.44) consistently across all participants. A statistically significant difference (P=.02) was observed in functionality evaluation scores by duration of caregiving, with caregivers dedicating more hours to care rating it higher than those providing less care (mean 4.6, SD 0.4 vs mean 4.2, SD 0.5). In addition, caregivers with less caregiving experience reported significantly higher evaluation scores for aesthetics (P=.04) and information quality (P=.03) compared to those with longer years of caregiving. All participants expressed a willingness to recommend the app to others, and 90% (27/30) rated the app overall positively. Most of the participants (21/30, 70%) favored anonymous interactions before receiving personalized feedback and preferred computer browsers over mobile apps. Medical home health services were the most used, with a diverse range of services being used. Caregiver support groups, medical providers, memory care, meal services, and adult day care were among the most desired services for future exploration. CONCLUSIONS The Olera.care web-based platform is a practical, engaging, easy-to-use, visually appealing, and informative tool for dementia caregivers. Future development and research are essential to enhance the platform and comprehensively evaluate it among a broader population.
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Affiliation(s)
- Qiping Fan
- Department of Public Health Sciences, Clemson University, Clemson, SC, United States
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Minh-Nguyet Hoang
- School of Medicine, Texas A&M University, College Station, TX, United States
| | - Logan DuBose
- School of Medicine, Texas A&M University, College Station, TX, United States
- Internal Medicine, George Washington University, DC, WA, United States
| | - Marcia G Ory
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Jeswin Vennatt
- School of Medicine, Texas A&M University, College Station, TX, United States
| | - Diana Salha
- School of Public Health, Texas A&M University, College Station, TX, United States
| | - Shinduk Lee
- College of Nursing, University of Utah, Salt Lake City, UT, United States
| | - Tokunbo Falohun
- Department of Biomedical Engineering, Texas A&M Univesity, College Station, TX, United States
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Rodrigues D, Silva R, Castanheira S, Carvalho L, Pinto C. Needs of Family Caregivers of People with Lower Limb Amputations: A Scoping Review. Behav Sci (Basel) 2024; 14:326. [PMID: 38667125 PMCID: PMC11047372 DOI: 10.3390/bs14040326] [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: 02/06/2024] [Revised: 03/23/2024] [Accepted: 04/09/2024] [Indexed: 04/29/2024] Open
Abstract
Lower limb amputation affects several parameters of a patient's life. Family caregivers providing care for these patients experience multiple feelings and needs; knowing caregivers' needs is essential to prepare them for this new role, as well as the health planning of this type of care. This scoping review aimed to identify and map the needs of family caregivers of people with lower limb amputations. This scoping review was conducted in accordance with the JBI methodological framework and the PRISMA-ScR reporting guidelines. A bibliographical search was carried out on the needs of family caregivers of lower limb amputees in 15 databases. Two independent reviewers extracted data using a data extraction tool developed for this scoping review. Eight studies were included in the present review (n = 6 quantitative studies; n = 2 reviews). Results indicate that family caregivers of people with lower limb amputations may experience an extensive range of needs, as follows: (i) mental health and psychological support, (ii) physical health, (iii) health and well-being, (iv) supportive care, (v) social support, and (vi) educational/informational support. The needs identified in this review can help to develop interventions and programs that provide better support during the situational transition process.
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Affiliation(s)
- Diana Rodrigues
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- ICBAS—Abel Salazar Institute of Biomedical Sciences, University of Porto, 4050-313 Porto, Portugal
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Rosa Silva
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
| | | | - Luís Carvalho
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
| | - Cristina Pinto
- Center for Health Technology and Services Research, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; (R.S.)
- Nursing School of Porto, 4200-072 Porto, Portugal
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10
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Sedzro MT, Murray L, Garnett A, Nouvet N, Kankam K, Fiadzomor P. Exploring the lived experiences of family caregivers of patients with stroke in Africa: a scoping review of qualitative evidence. Brain Inj 2024; 38:390-402. [PMID: 38317299 DOI: 10.1080/02699052.2024.2310798] [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: 04/19/2023] [Accepted: 01/23/2024] [Indexed: 02/07/2024]
Abstract
OBJECTIVE The burden of stroke is immense in African countries, with post-stroke care usually becoming the responsibility of family. This review sought to determine the current breadth and depth of qualitative evidence regarding the lived experiences of family caregivers of patients with stroke in Africa. METHODS Informed by Joanna Briggs Institute (JBI) methodology for scoping reviews, six databases were searched. Included articles were appraised for quality using the JBI checklist. A priori themes developed using the study objectives were used to synthesize study findings. RESULTS The review included 22 articles, which outlined key patterns in stroke outcomes with most articles focused on rehabilitation and the experiences, outcomes, burdens, and coping mechanisms of caregiving. The intersectionality of socio-economic status, socio-political structures, and religious or traditional beliefs, attitudes, and practices characterized etiology beliefs, treatment trajectories of stroke, and caregiving role assignment. Whereas burdens were driven by limited resources, adopted coping strategies involved spiritual or religious beliefs, optimism, resilience, and social support networks. CONCLUSIONS Family caregivers' values must be acknowledged, supported, and integrated into the traditional healthcare system to provide comprehensive stroke care. Caregivers' health and well-being should be given more attention given their necessary contribution to stroke survivorship in Africa.
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Affiliation(s)
- Mawukoenya Theresa Sedzro
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
- Department of Speech, Language & Hearing Sciences, School of Allied Health Sciences, University of Health & Allied Sciences, Ho, Volta Region, Ghana
| | - Laura Murray
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Communication Sciences & Disorders, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Anna Garnett
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Nouvet Nouvet
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
- School of Health Studies, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Keren Kankam
- Health and Rehabilitation Sciences Program, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Peace Fiadzomor
- Department of Speech, Language & Hearing Sciences, School of Allied Health Sciences, University of Health & Allied Sciences, Ho, Volta Region, Ghana
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11
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Dimtsu Assfaw A, Reinschmidt KM, Teasdale TA, Stephens L, Kleszynski KL, Dwyer K. Describing providers' perspectives on the needs and challenges of family caregivers of African American people living with dementia. Home Health Care Serv Q 2024; 43:133-153. [PMID: 38147405 DOI: 10.1080/01621424.2023.2299486] [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: 12/28/2023]
Abstract
The primary purpose of this study was to explore the needs and challenges of African American family caregivers of People living with dementia (PLWD) from the perspective of service providers including healthcare and social service providers. The study conducted three online semi-structured focus group interviews with service providers (n = 15). Data were analyzed using Braun & Clarke's guide to thematic analysis approach. Five themes emerged from the analysis of the focus group data: (i) Inadequate information about resources; (ii) Dementia education; (iii) Burden of dementia on families; (iv) Limited financial support and funding; and (v) Suggestions for needed resources. Service providers expressed the lack of community-based dementia service and support programs in African American communities. Findings from the study indicated the need to provide culturally appropriate information on dementia caregiving. This study adds to the scope of knowledge by exploring the processes of seeking help and using services.
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Affiliation(s)
- Araya Dimtsu Assfaw
- Department of Neurology- Knight Alzheimer Disease Research Center, Washington University School of Medicine in St. Louis, St. Louis, USA
| | - Kerstin M Reinschmidt
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center- Hudson College of Public Health, Oklahoma, USA
| | - Thomas A Teasdale
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center- Hudson College of Public Health, Oklahoma, USA
| | - Lancer Stephens
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center- Hudson College of Public Health, Oklahoma, USA
- Department of Health Promotion Sciences, Oklahoma Shared Clinical and Translational Research Center, Oklahoma, USA
| | - Keith L Kleszynski
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma, USA
| | - Kathleen Dwyer
- Population Health and Health Systems Science, University of Oklahoma Health Sciences Center- Fran and Earl Ziegler College of Nursing, Oklahoma, USA
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12
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Shahriari M, Nia DH, Kalij F, Hashemi MS. Challenges of home care: a qualitative study. BMC Nurs 2024; 23:215. [PMID: 38549100 PMCID: PMC10976792 DOI: 10.1186/s12912-024-01878-0] [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: 08/31/2023] [Accepted: 03/17/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Despite countless benefits of home care, unfortunately, the variety and quality of services provided by homecare centers are uncertain. This study was conducted to explore of home care challenges. METHODS The present qualitative study used the content analysis approach. A total of 17 participants, including nurses, managers of home care centers, and patients, were enrolled through purposive sampling. Data were collected using semi-structured interviews and analyzed through Granheim's qualitative content analysis method. RESULTS In order to explain the challenges of home care, after analyzing the data, 700 primary codes, 15 initial categories, sub-subcategories and two main categories, including 'infrastructural challenges' and 'challenges related to the process of home care services provision' emerged. The main category, "infrastructural challenges", consisted of 4 sub-categories (the challenge of acculturalization of home care services, economic challenges of providing services, challenges related to human resources, and the challenge of policymaking and setting regulations and rules for home care). The second main category, "challenges related to the process of home care services provision", consisted of 2 subcategories: challenges of improving the quality of home care services and the challenge of facilities for service provision. CONCLUSION In order to promote and improve the quality of home care services, in addition to providing insurance coverage for the services, acculturalization and revising the bylaws, empowering the human resource, enhancing the monitoring of the performance of home care centers, and employing modern technology need to be taken into account.
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Affiliation(s)
- Mohsen Shahriari
- Nursing and Midwifery Care Research Center, Department of Adult Health Nursing, School of Nursing and midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Donya Hafezi Nia
- Nursing Student, Department of Psychiatric Nursing, School of Nursing and Midwifery, Donya Hafezi Nia, Isfahan University of Medical Sciences, Isfahan, MS, Iran
| | - Fatemeh Kalij
- Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, 4 Fatemeh kalij, MS, Nursing Student, Isfahan, Iran
| | - Maryam Sadat Hashemi
- Nursing & Midwifery Care Research Center, Department of Nursing Critical Care, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
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Hladkowicz E, Auais M, Kidd G, McIsaac DI, Miller J. "It's a stressful, trying time for the caretaker": an interpretive description qualitative study of postoperative transitions in care for older adults with frailty from the perspectives of informal caregivers. BMC Geriatr 2024; 24:246. [PMID: 38468202 DOI: 10.1186/s12877-024-04826-4] [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: 04/19/2023] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND Older adults with frailty have surgery at a high rate. Informal caregivers often support the postoperative transition in care. Despite the growing need for family and caregiver support for this population, little is known about the experience of providing informal care to older adults with frailty during the postoperative transition in care. The purpose of this study was to explore what is important during a postoperative transition in care for older adults with frailty from the perspective of informal caregivers. METHODS This was a qualitative study using an interpretive description methodology. Seven informal caregivers to older adults [aged ≥ 65 years with frailty (Clinical Frailty Scale score ≥ 4) who had an inpatient elective surgery] participated in a telephone-based, semi-structured interview. Audio files were transcribed and analyzed using reflexive thematic analysis. RESULTS Four themes were constructed: (1) being informed about what to expect after surgery; (2) accessible communication with care providers; (3) homecare resources are needed for the patient; and (4) a support network for the caregivers. Theme 4 included two sub-themes: (a) respite and emotional support and (b) occupational support. CONCLUSIONS Transitions in care present challenges for informal caregivers of older adults with frailty, who play an important role in successful transitions. Future postoperative transitional care programs should consider making targeted information, accessible communication, and support networks available for caregivers as part of facilitating successful transitions in care.
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Affiliation(s)
- Emily Hladkowicz
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada.
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.
- Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus Room B311, 1053 Carling Ave, Mail Stop 249, K1Y 4E9, Ottawa, ON, Canada.
| | - Mohammad Auais
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Gurlavine Kidd
- Patient Partner, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Daniel I McIsaac
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, The Ottawa Hospital, Civic Campus Room B311, 1053 Carling Ave, Mail Stop 249, K1Y 4E9, Ottawa, ON, Canada
- School of Epidemiology & Public Health, University of Ottawa, Ottawa, Canada
| | - Jordan Miller
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
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Skajaa N, Farkas DK, Laugesen K, Fuglsang CH, Henderson VW, Plana-Ripoll O, Gaist D, Sørensen HT. Mental Health Conditions in Partners and Adult Children of Stroke Survivors. JAMA Netw Open 2024; 7:e243286. [PMID: 38483386 PMCID: PMC10940969 DOI: 10.1001/jamanetworkopen.2024.3286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Accepted: 01/29/2024] [Indexed: 03/17/2024] Open
Abstract
Importance Family caregiving after critical illness has been associated with several adverse health outcomes, including various aspects of mental health, but research focusing specifically on family members of stroke survivors is limited. Objectives To examine the associations of stroke in a partner or parent with the risk of depression, substance use disorders, anxiety disorders, and self-harm or suicide. Design, Setting, and Participants This nationwide, population-based cohort study used data from Danish nationwide administrative and clinical registries (2004-2021). Participants included partners and adult children of survivors of stroke. Data analysis was performed from March to December 2023. Exposure Having a partner or parent who survived stroke. Main Outcomes and Measures The Aalen-Johansen estimator was used to compute propensity score-weighted 3-year absolute risks, risk differences, and risk ratios for depression, substance use disorders, anxiety disorders, and self-harm or suicide among partners or children of survivors of stroke compared with partners or children of survivors of myocardial infarction (MI) and matched individuals from the general population. Results The study included a total of 1 923 732 individuals: 70 917 partners of stroke survivors (median [IQR] age, 68 [59-76] years; 46 369 women [65%]), 70 664 partners of MI survivors (median [IQR] age, 65 [55-73] years; 51 849 women [73%]), 354 570 partners of individuals from the general population (median [IQR] age, 68 [59-76] years; 231 833 women [65%]), 207 386 adult children of stroke survivors (median [IQR] age, 45 [36-52] years; 99 382 women [48%]), 183 309 adult children of MI survivors (median [IQR] age, 42 [33-49] years; 88 078 women [48%]), and 1 036 886 adult children of individuals from the general population (median [IQR] age, 45 [36-52] years; 496 875 women [48%]). Baseline characteristics were well balanced across cohorts after propensity score weighting. Among partners of stroke survivors, the 3-year absolute risk was 1.0% for depression, 0.7% for substance use disorders, 0.3% for anxiety disorders, and 0.04% for self-harm or suicide. Risk ratio point estimates for the assessed outcomes ranged from 1.14 to 1.42 compared with the general population and from 1.04 to 1.09 compared with partners of MI survivors. The elevated risk of depression in partners of stroke survivors was more pronounced after severe or moderate stroke than after mild stroke. Among adult children of stroke survivors, the 3-year absolute risk was 0.6% for depression, 0.6% for substance use disorders, 0.2% for anxiety disorders, and 0.05% for self-harm or suicide. Both absolute risks and risk ratios for adult children of stroke survivors were smaller than those reported in the partner analyses. Conclusions and Relevance In this cohort study of partners and adult children of stroke survivors, risks of several mental health conditions and self-harm or suicide were moderately higher compared with the general population and, to a lesser extent, partners and adult children of MI survivors. These findings highlight the potential consequences of stroke among family members, particularly partners, and its findings may possibly serve as a quantitative foundation for the development of future stroke rehabilitation services.
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Affiliation(s)
- Nils Skajaa
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Dóra Körmendiné Farkas
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Kristina Laugesen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Cecilia Hvitfeldt Fuglsang
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - Victor W. Henderson
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
- Department of Epidemiology & Population Health, Stanford University, Stanford, California
- Department of Neurology & Neurological Sciences, Stanford University, Stanford, California
| | - Oleguer Plana-Ripoll
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
| | - David Gaist
- Research Unit for Neurology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | - Henrik Toft Sørensen
- Department of Clinical Epidemiology, Department of Clinical Medicine, Aarhus University, Aarhus University Hospital, Aarhus, Denmark
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15
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Ngamasana EL, Zarwell M, Eberly L, Gunn LH. Difference in the physical and mental health of informal caregivers pre- and post-COVID-19 National Emergency Declaration in the United States. SSM Popul Health 2024; 25:101609. [PMID: 38313872 PMCID: PMC10837638 DOI: 10.1016/j.ssmph.2024.101609] [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: 10/02/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Background The burden of informal caregiving represents a chronic stressor for the informal caregivers (ICs). The study investigates differences in the physical and mental health of ICs and that of non-informal caregivers before and during COVID-19. Methods We used data from the 2019/2020 Behavioral Risk Factor Surveillance System (BRFSS) to investigate differences in the rates of days of poor physical and mental health among ICs compared to non-informal caregivers before and after the COVID-19 National Emergency Declaration (NED). A propensity score model simulated a pseudo experimental design, comparing ICs ("treated") with non-informal caregivers ("control"). A difference-in-difference regression model estimated the incidence rate ratios for days of poor physical and mental health as a function of IC status and time of care provision. Results A total of 44,583 respondents were identified with valid responses on informal caregiving status and key sociodemographic characteristics. Of those, 6.24% (n = 3073) were ICs, matched against 15,365 non-informal caregivers. In the matched sample (n = 18,848), the incidence rate for days of poor physical health among ICs was 17% (p = 0.003) higher compared to non-informal caregivers. The incidence rate for days of poor physical health was 23% (p < 0.001) lower in the post-NED compared to the pre-NED periods. The incidence rate for days of poor mental health was 44% (p < 0.001) higher among ICs compared to non-informal caregivers and 22% higher among respondents who took the survey post-NED compared to those who answered during the pre-NED period. No statistically significant differences were found between the two groups in their incidence rates for days of poor physical and mental health from the pre-to the post-NED period. Conclusion These findings suggest a need to balance between the benefits conferred by public health restrictions versus the mental health burden that may result among certain groups, including ICs, who experience higher negative mental health outcomes.
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Affiliation(s)
- Emery Lady Ngamasana
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Meagan Zarwell
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Lori Eberly
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Laura H Gunn
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Primary Care and Public Health, Imperial College London, London, UK
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Scheerbaum P, Gräßel E, Wasic C, Pendergrass A. [Desire and Reality: Discrepancy Between the Actual Usage and the Need to Use Ambulant Support Services - Cross Sectional Study of Elderly People Living at Home in Chronic Need of Care]. DAS GESUNDHEITSWESEN 2024; 86:S13-S20. [PMID: 38395034 PMCID: PMC10949523 DOI: 10.1055/a-2003-9184] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
AIM In Germany, people in need of care are mainly cared for by their relatives who make use of various outpatient relief and support services. The aim of this study was to determine the frequency of actual use as well as the desired use of outpatient relief and support services. Dementia and non-dementia as causes behind need for care are distinguished. METHODS A representative sample of informal caregivers of statutorily insured care recipients assessed by the MD Bayern during application for a care level classification (n=958) was analyzed. The use of the following outpatient relief and support services was investigated: outpatient care service; domestic help; day care centre; meals on wheels; driving service; care service; 24-hour care; and care group. Characteristics of the care receiver, the informal caregiver and the care situation were recorded. Difference analyses were carried out using Chi² tests and t-tests. RESULTS The use of outpatient support services was low despite the high care burden on informal caregivers ranging from 1,7% for the care group to 38,4% for the outpatient care service. More than 40% of respondents did not use any of the eight services. However, from this non-user group, 72% had a desire to use at least one of the eight services in the future. Domestic help and outpatient care services were the most frequently requested services by non-users. Actual and desired use was more common for dementia than for other causes of need for care, especially for day care, care group and care service. CONCLUSION The desire for utilization is significantly higher than the reality of utilization. In general, the use of outpatient relief and support services is low. The causes of this discrepancy need to be explored. Therefore, effective strategies need to be developed to advise informal caregivers which ensure suitable respite services will be used to strengthen the home care situation.
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Affiliation(s)
- Petra Scheerbaum
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Catharina Wasic
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
| | - Anna Pendergrass
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen,
Germany
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17
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Scheuermann JS, Gräßel E, Pendergrass A. [Reconciling Employment and Informal Caregiving for an Elderly Person at Home: Factors Influencing a Reduction in Employment due to Caregiving and Work-Related Wishes of Informal Caregivers]. DAS GESUNDHEITSWESEN 2024; 86:S45-S53. [PMID: 38395038 PMCID: PMC10949857 DOI: 10.1055/a-2191-2074] [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: 02/25/2024]
Abstract
OBJECTIVE Reconciling informal caregiving and gainful employment is a challenge for many informal caregivers. The goals of this paper are to identify factors influencing care-related employment reduction, and to record work-related wishes for improving the compatibility of informal caregiving and being employed. METHODS Analyses were based on the cross-sectional Benefits of Being a Caregiver Study of 426 employed caregivers of an older person in need of care. Data were collected on characteristics of the care receivers and caregivers, and aspects of the caregiving and employment situation. Potential influencing factors of care-related employment reduction (n=426) were analyzed using binary logistic regression. The wishes regarding the compatibility of informal care at home and employment were examined descriptively using structured content analysis according to Mayring. RESULTS One quarter of the employed informal caregivers (n=108) reduced their hours of employment due to the demands of caregiving. The profile of influencing factors of a care-related employment reduction was composed of a higher number of working hours, higher effort for activities of daily living, and co-residence with the care receiver. Employed caregivers primarily expressed a desire for flexibility in working hours, a reduction in working hours, and some concessions with regard to absenteeism. CONCLUSIONS Relieving the burden on caregivers in the activities of daily living in form of formal and informal support services can probably reduce the likelihood of a care-related reduction in gainful employment.
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Affiliation(s)
- Julia-Sophia Scheuermann
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
| | - Elmar Gräßel
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
| | - Anna Pendergrass
- Zentrum für Medizinische Versorgungsforschung, Psychiatrische
und Psychotherapeutische Klinik, Uniklinikum Erlangen,
Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU),
Erlangen, Germany
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18
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Gül İ, Toygar İ, Usta Yeşilbalkan Ö. Support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. Eur J Oncol Nurs 2024; 68:102468. [PMID: 37988773 DOI: 10.1016/j.ejon.2023.102468] [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: 01/19/2023] [Revised: 10/18/2023] [Accepted: 11/09/2023] [Indexed: 11/23/2023]
Abstract
PURPOSE This study aimed to investigate support needs of carers of cancer patients and the effects of the patient's age and cancer type on their needs. METHODS In this descriptive and comparative study, the data were collected from the carers (n = 120) of the patient admitted to inpatient and outpatient clinics of a university hospital between June 2021 and October 2022. Patient identification form, carer identification form, and Carer Support Needs Assessment Tool (CSNAT) were used for data collection. The comparisons of the support needs were done for the carers according to the patient's age (<65 versus ≥65 years) and cancer type (hematological malignancies versus solid tumors). RESULTS Caring duration (19.78 ± 29.64 vs 10.33 ± 18.77 months) and caring hours per week (47.58 ± 26.90 vs 32.75 ± 25.75 h) were high in those caring for older adults. Carers of older adults need more support in providing personal care for their relatives (eg dressing, washing, toileting) (X2 = 8.000, p = 0.005). Carers of patients with hematological malignancies need more support in understanding their relative's illness (X2 = 6.136, p = 0.013), having time themselves in the day (X2 = 4.089, p = 0.043), managing their relative's symptoms, including giving medicines? (X2 = 5.263, p = 0.022), and their beliefs or spiritual concerns (X2 = 4.728, p = 0.030) compared to the carers of the patients with solid tumors. CONCLUSION The support needs of the carers vary depending on the patient's age and cancer type. Carers of older adults and patients with hematological malignancies need more support.
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Affiliation(s)
- İrem Gül
- Ege University Faculty of Nursing, Medical Nursin Department, İzmir, Turkey.
| | - İsmail Toygar
- Muğla Sıtkı Koçman University, Fethiye Faculty of Health Sciences, Muğla, Turkey.
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Zhylkybekova A, Grjibovski AM, Glushkova N, Koshmaganbetova GK. Exploring the burden and support needs of informal caregivers for the older adults in Kazakhstan: a mixed-methods study protocol. Front Public Health 2024; 11:1248104. [PMID: 38249404 PMCID: PMC10796845 DOI: 10.3389/fpubh.2023.1248104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Background The growing population of older adults, often affected by chronic illnesses, disabilities, or frailty has led to a substantial increase in the need for informal caregivers. Objective This paper is a protocol for a study that aims to investigate the effects of caregiving on informal caregivers of older adults in Kazakhstan with special emphasis on the cultural context. Methods The protocol outlines a mixed-methods study that will be conducted in four cities in Kazakhstan. A total of 400 informal caregivers of older adults with two or more limitations in Activities of Daily Living (ADL) will be recruited to participate in a survey, aiming to evaluate care-related burdens and quality of life and health-related quality of life. The Institute for Medical Technology Assessment (iMTA) Valuation of Informal Care Questionnaire (iVICQ) was selected to be the main research instrument. Additionally, a subset of participants who express their willingness to participate will be selected from the pool of survey respondents to engage in semi-structured interviews, allowing for a deeper understanding of their experiences and providing insights into their social and medical support needs. Conclusion This study will be the first investigation of the impact of caregiving on informal caregivers of older adults in Central Asia. The results will contribute to the literature by providing insights into older adults care within the specific national and cultural context of Kazakhstan with potential generalization to other Central Asian republics of the former USSR.
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Affiliation(s)
- Aliya Zhylkybekova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
| | - Andrej M. Grjibovski
- Central Scientific Research Laboratory, Northern State Medical University, Arkhangelsk, Russia
- Department of Epidemiology and Modern Vaccination Technologies, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Biology, Ecology and Biotechnology, Northern (Arctic) Federal University, Arkhangelsk, Russia
| | - Natalya Glushkova
- Department of Epidemiology, Biostatistics and Evidence Based Medicine, Al-Farabi Kazakh National University, Almaty, Kazakhstan
| | - Gulbakit K. Koshmaganbetova
- Department of Evidence-Based Medicine and Scientific Management, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
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Minaei-Moghadam S, Manzari ZS, Vaghee S, Mirhosseini S. Effectiveness of a supportive care program via a smartphone application on the quality of life and care burden among family caregivers of patients with major depressive disorder: a randomized controlled trial. BMC Public Health 2024; 24:66. [PMID: 38166907 PMCID: PMC10762964 DOI: 10.1186/s12889-023-17594-4] [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: 09/15/2023] [Accepted: 12/27/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The majority of patients with major depressive disorder require care that has generally affected caregivers' lives. Providing care could cause negative experiences as a care burden and deteriorate quality of life. However, there is a lack of evidence about caregiver training-based informatics and its impact on the caregiver's life. METHODS This experimental study was carried out in Mashhad, Iran. A total of 60 primary family caregivers of patients with major depressive disorder were included in the study between February and July 2021. The quadruple block randomization method was used to allocate the participants into control and intervention groups. In the intervention group, family caregivers used the application with weekly phone calls for one month. The app contains the most important points of patient care and has the possibility of communicating with the nurse. The Novak and Guest Care Burden Inventory and the short form of the World Health Organization Quality of Life Questionnaire were completed before and after the intervention. Data analysis was performed using chi-squared tests, independent sample t tests, and analysis of covariance. RESULTS At baseline, the mean scores of care burden and quality of life were homogeneous between the two groups. After the intervention, the mean scores of care burden and quality of life were significantly reduced and improved in the intervention group compared with the control group (p < 0.001). CONCLUSIONS Using the application with the ability to communicate with the caregiver, along with educational support, helps to strengthen the relationship between the family caregiver and the nurse. Despite the effectiveness of the present intervention, before including this form of implementation of support in care programs, it is necessary to evaluate its other positive aspects in future studies. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT), IRCT20210202050222N1. Registered on 05/02/2022.
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Affiliation(s)
- Somaye Minaei-Moghadam
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Zahra Sadat Manzari
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Saeed Vaghee
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Seyedmohammad Mirhosseini
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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21
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Hudelmayer A, Zur Kammer K, Schütz J. [An app for informal care : User experiences and obstacles from the perspective of family caregivers]. Z Gerontol Geriatr 2023; 56:623-629. [PMID: 37855901 PMCID: PMC10709374 DOI: 10.1007/s00391-023-02249-1] [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] [Accepted: 09/20/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND A target group for digital services are people who are involved in informal care arrangements. Family caregivers often undertake the organization and coordination of care, which is associated with a high need for information. OBJECTIVE The study examined the extent to which family caregivers perceive the use of a mobile digital application as facilitating day to day care, in particular regarding information needs. MATERIAL AND METHODS A market-ready mobile smartphone app was used by 16 informal caregivers over several months. Qualitative interviews were conducted to investigate which app features are being used in real informal care situations and which are perceived as added value. The analysis was carried out with content analysis according to Kuckartz. RESULTS The app was sporadically used and satisfaction with the information it provides depends on the care situation itself. The participants see added value and facilitation through the app mainly at the beginning of a care situation. They expressed the wish for requirements that have not yet been integrated, e.g., regional information or individual adaptations. CONCLUSION For digital support options to develop the desired potential, those involved in informal care must be aware of them at an early stage. Further prerequisites for care apps to be perceived as added value by the target group are a trustworthy presentation of the contents, the customizability and that they are up to date.
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Affiliation(s)
- Annika Hudelmayer
- Bayerisches Zentrum Pflege Digital, Hochschule Kempten, Albert-Einstein-Str. 6, 87437, Kempten (Allgäu), Deutschland.
| | - Kenneth Zur Kammer
- Bayerisches Zentrum Pflege Digital, Hochschule Kempten, Albert-Einstein-Str. 6, 87437, Kempten (Allgäu), Deutschland
| | - Johanna Schütz
- Bayerisches Zentrum Pflege Digital, Hochschule Kempten, Albert-Einstein-Str. 6, 87437, Kempten (Allgäu), Deutschland
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22
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Buckinx F, Adam S, Aubertin-Leheudre M, De Saint Hubert M, Mouton A, Potier F, Reginster JY, Bruyere O. Quality of Life and Health Determinants of Informal Caregivers Aged 65 Years and Over. EPIDEMIOLOGIA 2023; 4:464-482. [PMID: 37987311 PMCID: PMC10660726 DOI: 10.3390/epidemiologia4040039] [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: 10/02/2023] [Revised: 10/25/2023] [Accepted: 10/30/2023] [Indexed: 11/22/2023] Open
Abstract
Informal caregivers' own quality of life, health status, and determinants are poorly understood despite their concern for the health of the individuals they assist. To compare the quality of life and the health determinants of older informal caregivers with those of older adults without caregiving responsibilities. An online survey was designed to investigate the quality of life and the health determinants of people aged 65 years and over, with a focus on informal caregivers. In addition to socio-demographic data, the number of informal caregivers was ascertained and the Zarit scale of caregiver burden was applied. Quality of life (SF-12) and health determinants (access to technology and level of physical activity (IPAQ)) were assessed and compared between informal caregivers and non-caregivers. A total of 111 participants were included in the study (70 ± 3.83 years, 71.2% women). The majority of respondents (91.8%) were Belgian. One-third of the respondents identified themselves as informal caregivers and declared themselves as having a severe burden (61.9 ± 15.2/88). Socio-demographic characteristics and access to technology were similar between informal caregivers and non-caregivers (p > 0.05). However, informal caregivers had a lower SF-12 score in the mental score domain (44.3 ± 10.2 vs. 50.7 ± 7.0; p = 0.004) and a lower level of physical activity (434 ± 312 METS/min/week vs. 1126 ± 815 METS/min/week; p = 0.01) than their peers. Informal caregivers reported a lower quality of life and a lower level of physical activity than their peers. Given the recognized importance of physical activity for overall health, this survey highlights the need to promote physical activity among older informal caregivers.
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Affiliation(s)
- Fanny Buckinx
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium
| | - Stéphane Adam
- Psychology of Aging Unit, University of Liège, 4000 Liège, Belgium
| | - Mylène Aubertin-Leheudre
- Département des Sciences de L'activité Physique & Centre de Recherche de L'institut Universitaire de Gériatrie de Montréal, Faculté des Sciences, Université du Québec à Montréal, Montréal, QC H3W 1W5, Canada
| | - Marie De Saint Hubert
- Department of Geriatric Medicine, CHU UCL Namur, Institut de Recherche Santé Société, UCLouvain, 5530 Yvoir, Belgium
| | - Alexandre Mouton
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Department of Sports Sciences, University of Liège, 4000 Liège, Belgium
| | - Florence Potier
- Department of Geriatric Medicine, CHU UCL Namur, Institut de Recherche Santé Société, UCLouvain, 5530 Yvoir, Belgium
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium
| | - Olivier Bruyere
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, 4000 Liège, Belgium
- Research Unit for a Life-Course Perspective on Health & Education-RUCHE, Department of Sports Sciences, University of Liège, 4000 Liège, Belgium
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23
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Cardwell KL, Hume TA, McKenna OJ, Pilutti LA, Fakolade A. Symptom Management Among Multiple Sclerosis Care Partners in Canada. Int J MS Care 2023; 25:281-287. [PMID: 37969913 PMCID: PMC10634598 DOI: 10.7224/1537-2073.2022-113] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
BACKGROUND Managing the heterogeneity and unpredictability of multiple sclerosis (MS) symptoms can be difficult for MS care partners. This study aimed to characterize the symptoms managed by MS care partners, recognize relationships between symptom management difficulty and other aspects of the caregiving role, and identify supplemental sources of care-giving support used by care partners. METHODS A Canadian cohort of MS care partners completed an online survey capturing care-partner characteristics, care-recipient symptoms, care-partner difficulty with managing symptoms, and sources of caregiving assistance. Descriptive analysis, analysis of variance, and χ2 tests were used to compare differences in care-partner characteristics by symptom management difficulty groups, defined as low (<4 symptoms), medium (5-7 symptoms), and high difficulty (>7 symptoms). RESULTS Care partners to individuals with MS (N = 475) reported a median of 8 symptoms (IQR = 4) experienced by their care-recipients. The most frequent symptoms reported were fatigue (89.1%), weakness (87.2%), and depression (81.9%). Care partners reported a median of 6 (IQR = 5) symptoms being somewhat or very difficult to manage. Balance or mobility impairments (20.3%), depression (14.3%), and vision difficulties (13.1%) were most frequently reported as very difficult to manage. Assisting with activities of daily living (P < .001) and time spent caregiving (P = .035) varied significantly between symptom management difficulty groups. Additional help available was reported by 77.5%, 17.8%, and 41.6% of care partners reporting low, medium, and high symptom management difficulty, respectively (P < .001). CONCLUSIONS Care partners of individuals with MS report difficulty in managing multiple, variable symptoms and often have no additional help. These findings suggest that MS care partners experience difficulty managing many diverse symptoms and may benefit from additional support.
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Affiliation(s)
- Katherine L. Cardwell
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Taylor A. Hume
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Odessa J. McKenna
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Lara A. Pilutti
- From the Interdisciplinary School of Health Sciences (KLC, TAH, LAP), the Faculty of Medicine (OJMK), and the Brain and Mind Research Institute (LAP), University of Ottawa, Ottawa, ON, Canada
| | - Afolasade Fakolade
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON, Canada (AF)
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24
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Banadinović M, Vočanec D, Lukačević Lovrenčić I, Lončarek K, Džakula A. Role and perspectives of informal care: a qualitative study of informal caregivers in the Republic of Croatia. BMJ Open 2023; 13:e074454. [PMID: 37827736 PMCID: PMC10582946 DOI: 10.1136/bmjopen-2023-074454] [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: 04/06/2023] [Accepted: 09/18/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES Population ageing and the prevalence of multimorbidity represent major challenges for healthcare systems. People who need long-term care have complex conditions requiring both health and social services. Informal caregivers are emerging as an important part of the long-term care ecosystem. This paper aims to explore the position and capacities of informal caregivers in Croatia. DESIGN Health and social care legislative documents were analysed using a structured set of keywords. In addition, focus groups were conducted with informal caregivers who cared for a family member. The qualitative method of thematic analysis was used. SETTING AND PARTICIPANTS Two focus groups were conducted with 15 caregivers (13 women and 2 men). Geographically, participants came from all four NUTS2 Croatian regions. All participants cared for a close family member. The length of care provision ranged from 3 to 35 years. Focus groups were conducted using the Zoom platform. RESULTS The analysis of the documents indicates the fragmentation of national policy into health and social policy. Long-term care as a term is recognised only in health policy. However, some components related to long-term care are part of social policy. Caregivers are recognised in social policy, although not in healthcare. In focus groups, three main themes were identified as follows: (1) position and role of the caregivers in the system and society; (2) types of care based on the recipient's need and (3) support for the caregivers. CONCLUSION The research showed that the process of exercising certain rights and services for caregivers is not sufficiently clear and feasible in practice. There is a lack of a clearly defined role of caregivers and relationships towards professional care providers in the system. The key to improving long-term care is connecting community services, including health and social services, both formal and informal, with the process of providing care.
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Affiliation(s)
- Maja Banadinović
- Firefly - Association for Helping Children and Families Facing Malignant Diseases, Zagreb, Croatia
| | - Dorja Vočanec
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Iva Lukačević Lovrenčić
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
| | - Karmen Lončarek
- Department of Integrated and Palliative Care, Rijeka University Hospital Center, Rijeka, Croatia
| | - Aleksandar Džakula
- Department of Social Medicine and Organization of Health Care, Andrija Štampar School of Public Health, University of Zagreb School of Medicine, Zagreb, Croatia
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25
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Sami R, Salehi K, Hashemi M, Haghighat S, Atashi V. Barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease in Iran: a descriptive qualitative study. BMJ Open 2023; 13:e073972. [PMID: 37802628 PMCID: PMC10565240 DOI: 10.1136/bmjopen-2023-073972] [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: 03/24/2023] [Accepted: 09/01/2023] [Indexed: 10/10/2023] Open
Abstract
OBJECTIVES Chronic obstructive pulmonary disease is a chronic disease with numerous complications. Therefore, its effective management depends on home-based pulmonary rehabilitation. The effectiveness of home-based pulmonary rehabilitation programmes in turn depends on patient adherence to them. The aim of this study was to explore the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. DESIGN Qualitative descriptive design. SETTING The lung care wards of Al-Zahra and Khorshid teaching hospitals and the comprehensive lung care clinic of Khorshid hospital, Isfahan, Iran. PARTICIPANTS Participants patients with chronic obstructive pulmonary disease (n=20), their family caregivers (n=15) and healthcare providers (n=14) recruited via purposive sampling. RESULTS The five main categories of the barriers to adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease were patient-related barriers, caregivers' caregiving burden, limited support for patients, healthcare providers' limited professional competence and ineffective home-based pulmonary rehabilitation planning. CONCLUSION Different and complex factors related to patients, families and healthcare providers can affect adherence to home-based pulmonary rehabilitation among patients with chronic obstructive pulmonary disease. Healthcare authorities can use the findings of this study to develop strategies to support patients with chronic obstructive pulmonary disease and their family caregivers and thereby reduce the physical and mental complications of Chronic obstructive pulmonary disease.
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Affiliation(s)
- Ramin Sami
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Kobra Salehi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan, Iran
| | - Marzieh Hashemi
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran
| | - Shila Haghighat
- Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Vajihe Atashi
- Nursing and Midwifery Care Research Center, Adult Health Nursing Department, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
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Richardson CL, Black D, Lindsey L, Nazar H. Community pharmacies as a place for informal carer support in mental health and wellbeing. Int J Clin Pharm 2023; 45:1302-1306. [PMID: 37269442 PMCID: PMC10239217 DOI: 10.1007/s11096-023-01606-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/12/2023] [Indexed: 06/05/2023]
Abstract
There are 5.3 million informal carers in the United Kingdom who take on caring responsibilities for family and friends. Informal carers can be forgotten patients within health and care services, yet because of carer burden, they are at risk of deterioration in health and wellbeing. There are higher levels of anxiety, depression, burnout and low self-esteem amongst carers but, to our knowledge work to date has mainly focused on supporting carers to provide better care for their family member, and less on carers' health and wellbeing. There is increasing interest in social prescribing as a method of linking patients with community-based services to improve health and wellbeing. Initiatives have included social prescribing via community pharmacies which are already recognized to be accessible for support and signposting. The coming together of community pharmacy services and social prescribing could represent a framework to better support carers in their mental health and wellbeing.
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Affiliation(s)
- Charlotte Lucy Richardson
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK.
| | - David Black
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
| | - Laura Lindsey
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
| | - Hamde Nazar
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, King George VI Building, Newcastle Upon Tyne, NE2 7RU, UK
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27
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Scheuermann JS, Gräßel E, Pendergrass A. Predictors of expressed, felt, and normative needs for informal caregiver counseling : Domestic care for people aged 65+ years. Z Gerontol Geriatr 2023; 56:395-401. [PMID: 36018386 PMCID: PMC10406654 DOI: 10.1007/s00391-022-02097-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Informal caregivers (CGs) often fail to recognize or express a need for informal caregiver counseling (ICC) but ICC is an essential but relatively rarely used support service for CGs. OBJECTIVE Our aim is to identify predictors of CGs' need for ICC. Stirling et al.'s need model, which includes three needs (expressed, felt, and normative), serves as a theoretical basis. MATERIAL AND METHODS Analyses are based on cross-sectional data (n = 958) from the "Benefits of being a caregiver" study. Predictors of the need to use ICC were analyzed with binary logistic regression. A sensitivity analysis using multiple linear regression was performed for the metric value of normative needs. RESULTS We found that 6.8% of CGs currently or have recently used ICC. This expressed need was related to higher education and higher effort in instrumental activities; 24.1% of CGs reported an intention to use ICC in the future. This felt need was related to male gender, lower care level, more problem-focused coping, and a desire for more informal help. Objective need for ICC (normative need), which was related to a higher burden of care, less experienced benefits, and negative relationship quality, was reported by 21.4% of CGs. According to a sensitivity analysis, higher education, a desire for informal help, and living in separate households also predicted a normative need for counseling. DISCUSSION Current utilization is significantly lower than the subjectively perceived and objectively existing need for ICC. The identified predictors provide initial strategies for motivating more CGs to use ICC.
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Affiliation(s)
- Julia-Sophia Scheuermann
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Elmar Gräßel
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
| | - Anna Pendergrass
- Center for Health Service Research in Medicine, Department of Psychiatry and Psychotherapy, Uniklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Schwabachanlage 6, 91054, Erlangen, Germany
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28
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Larocque S, Rietze L, Heale R. Helping the helpers: Understanding information and support needs of caregivers in underserved communities. DEATH STUDIES 2023; 48:361-370. [PMID: 37427573 DOI: 10.1080/07481187.2023.2230551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Informal caregivers caring for patients at the end of life in rural geographic areas may have inadequate support due to insufficient community-based palliative care services. We conducted a parallel mixed-methods study to understand informal caregivers' unmet supportive, educational, and informational needs living in rural areas with limited community-based palliative care services. Forty-four caregivers of loved ones that died at home between December 2017 and September 2020 completed the Carer Support Needs Assessment Tool (CSNAT) and 14 caregivers were interviewed. Using a parallel mixed analysis, results showed that caregiver distress was associated with unmet information needs about how to accurately assess and manage pain levels and identify signs and symptoms of end-of-life. Caregivers needed more support related to available, knowledgeable, and well-trained home health care providers, accessible equipment, 24-hour respite care, accessible grief counseling, and a central triage contact number for community support.
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Affiliation(s)
- Sylvie Larocque
- School of Nursing, Laurentian University, Sudbury, Ontario, Canada
| | - Lori Rietze
- School of Nursing, Laurentian University, Sudbury, Ontario, Canada
| | - Roberta Heale
- School of Nursing, Laurentian University, Sudbury, Ontario, Canada
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29
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Premanandan S, Ahmad A, Cajander Å, Ågerfalk P, van Gemert-Pijnen L. Designing and Evaluating IT Applications for Informal Caregivers: Protocol for a Scoping Review. JMIR Res Protoc 2023; 12:e47650. [PMID: 37410533 PMCID: PMC10360011 DOI: 10.2196/47650] [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: 03/28/2023] [Revised: 05/17/2023] [Accepted: 06/01/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND A growing number of informal caregivers in many countries are important for effective functioning of health care in our society. Hence, they must receive the required support and services to continue providing care. IT applications can be used to support informal caregivers in their caregiving activities. However, evidence-informed guidelines for developing such IT applications and their evaluation are scarce. Hence, this scoping review can aid researchers and designers by providing design recommendations for IT apps for caregivers and potentially improve the design of IT applications for caregivers to meet their needs better. OBJECTIVE This study aims to describe the proposal for a scoping review of current practices and recommendations in designing and evaluating IT applications for informal caregivers. The scoping review will also discuss the opportunities and challenges in designing these IT applications. METHODS We will use a 5-step scoping review methodology to map relevant literature published as follows: (1) identify the research question, (2) identify relevant studies, (3) select relevant studies for review, (4) chart the data from selected literature, and (5) summarize and report results. A structured search will be conducted in PubMed, Scopus, IEEE digital library, Web of Science, and ACM Digital Library databases. In addition, hand searches of reference lists and keyword searches in Google Scholar will also be conducted. Inclusion criteria will be researched (journal and conference) articles focused on IT applications designed for use by informal caregivers and study type to be qualitative studies. Two reviewers will independently identify articles for review and extract data. Conflicts will be discussed, and a third reviewer will be consulted if a consensus cannot be reached. These data will be analyzed using thematic analysis. RESULTS The results from this scoping review will be presented in a narrative form, and additional data on study characteristics will be presented in diagrams or tabular format. Uppsala University first initiated this scoping review protocol in December 2021 as part of the European Union-funded project ENTWINE. This work was also supported by the Swedish Research Council and the Swedish Cancer Society. The results will be presented in August 2023 and will be disseminated through a report to the European Union and a peer-reviewed journal publication. In addition, the team plans to share its findings on various public platforms, including social media, blog posts, and relevant conferences and workshops. CONCLUSIONS This is, to our knowledge, the first study to map the literature on the design and evaluation of IT applications for informal caregivers. The scoping review's results will detail the requirements, design suggestions, and user preferences, as well as the usability criteria and features of IT applications for informal caregivers. A mapping of studies could inform the design and implementation of future IT applications for informal caregivers. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/47650.
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Affiliation(s)
- Shweta Premanandan
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Awais Ahmad
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Åsa Cajander
- Division of Visual Information and Interaction, Department of Information Technology, Uppsala University, Uppsala, Sweden
| | - Pär Ågerfalk
- Department of Informatics and Media, Uppsala University, Uppsala, Sweden
| | - Lisette van Gemert-Pijnen
- Centre for eHealth and Wellbeing Research, Department of Psychology, Health & Technology, University of Twente, Enschede, Netherlands
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de Jong L, Schmidt T, Carstens AK, Damm K. The impact of different care dependencies on people's willingness to provide informal care: a discrete choice experiment in Germany. HEALTH ECONOMICS REVIEW 2023; 13:35. [PMID: 37269446 DOI: 10.1186/s13561-023-00448-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/25/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Informal care provided by family members, friends, or neighbors is a major pillar in the German long-term care system. As the number of care-dependent older adults grow, ensuring their future care still relies on the willingness of family members, friends, or neighbors to assume the role of an informal caregiver. This study aimed to investigate the impact on people's willingness to provide informal care to a close relative with predominately cognitive compared to physical impairments. METHODS An online survey was distributed to the general population in Germany, which resulted in 260 participants. A discrete choice experiment was created to elicit and quantify people's preferences. A conditional logit model was used to investigate preferences and marginal willingness-to-accept values were estimated for one hour of informal caregiving. RESULTS Increased care time per day (hours) and expected duration of caregiving were negatively valued by the participants and reduced willingness to care. Descriptions of the two care dependencies had a significant impact on participants' decisions. Having to provide care to a close relative with cognitive impairments was slightly preferred over caring for a relative with physical impairments. CONCLUSIONS Our study results show the impact of different factors on the willingness to provide informal care to a close relative. How far the preference weights as well as the high willingness-to-accept values for an hour of caregiving can be explained by the sociodemographic structure of our cohort needs to be investigated by further research. Participants slightly preferred caring for a close relative with cognitive impairments, which might be explained by fear or discomfort with providing personal care to a relative with physical impairments or feelings of sympathy and pity towards people with dementia. Future qualitative research designs can help understand these motivations.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany.
| | - Torben Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
| | - Ann-Katrin Carstens
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Hannover, Germany
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Qi C, Wang Y, Qi X, Jiao Y, Que C, Chen Y. Barriers to providing internet-based home care services for urban older adults in China: a qualitative study of the service providers. BMC Geriatr 2023; 23:320. [PMID: 37221471 DOI: 10.1186/s12877-023-04028-4] [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: 06/07/2022] [Accepted: 05/08/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Due to the increasingly aging population in China and the changes in social and family structure, older adults' care problems are becoming more and more prominent. To meet the home care needs of urban older adults, the Chinese government has launched Internet-Based Home Care Services (IBHCS). Although this model innovation can significantly relieve care problems, more and more evidence shows that there are many barriers in the process of IBHCS supply. The current literature is mostly from the perspective of the service users, and there are very few studies on the experience of service providers. METHODS In this study, we took a qualitative phenomenological approach and used semi-structured interviews to investigate service providers' daily experiences and the barriers they encounter. A total of 34 staff from 14 Home Care Service Centers (HCSCs) were included. Interviews were transcribed and analyzed using thematic analysis. RESULTS We identified the barriers that service providers encounter in IBHCS supply: (1) bureaucratic repression: unreasonable policy plans, harsh assessment, excessive paperwork, different preferences of government leaders, and obstacles caused by COVID-19 control lead to a shift of focus in their work; (2) profitability crisis in the market: high service costs, dampened effective demand, government intervention in setting prices, and parent companies' excessively high sales targets hinder the service supply process; (3) client-related challenges: the crisis of confidence, the dilemma of popularizing new technology, and communication barriers lead to rejection by older adults; (4) job dissatisfaction: low and unstable salary, heavy tasks, poor social acceptance of occupations, and lack of professional value reduce work enthusiasm. CONCLUSION We have investigated the barriers faced by service providers when providing IBHCS for urban older adults in China, providing empirical evidence in the Chinese context for the relevant literature. In order to provide IBHCS better, it is necessary to improve the institutional environment and market environment, strengthen publicity and communication, target customer needs, and adjust the working conditions of front-line workers.
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Affiliation(s)
- Caiyun Qi
- Department of social work, Shandong University, Jinan, China
| | - Yuan Wang
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China.
| | - Xiaonan Qi
- Department of management, School of applied technology and health industries, Anshan Normal University, Anshan, China
| | - Yunhe Jiao
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China
| | - Chuanqi Que
- department of social work, The Chinese University of Hong Kong, Hong Kong, China
| | - Yufei Chen
- Department of labor and social security, Jilin University, Qianjin Street 2699, Changchun, China
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Mishra N, Datti RS, Tewari A, Sirisety M. Exploring the positive aspects of caregiving among family caregivers of the older adults in India. Front Public Health 2023; 11:1059459. [PMID: 37275495 PMCID: PMC10232965 DOI: 10.3389/fpubh.2023.1059459] [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: 10/01/2022] [Accepted: 05/05/2023] [Indexed: 06/07/2023] Open
Abstract
Background Caregiving is a committed role that focuses on providing the required support and care to a care receiver who is either ill, disabled, or dependent to the extent that they are incapable of independent functioning. The topic of caregiving has been extensively studied worldwide, mainly focused on the negative aspects of caregiving, like caregiver stress, burden, role conflicts, and burnout among caregivers. However, limited efforts have been made to understand the positive aspects of caregiving among informal caregivers who spend most of their time in this unpaid role. The present study addresses this concern by exploring the positive aspects of caregiving among family caregivers of older persons in India. Methodology This is a qualitative study, which was conducted, using the existential-phenomenological approach. In this study, a purposive sampling technique was used, and a total of a 100 family caregivers participated from four cities in India, namely Prayagraj, Pune, Visakhapatnam, and Guwahati. Twenty-five family caregivers between the age of 30-50 years participated from each of these four cities. The data was collected using six semi-structured interview questions on positive aspects of caregiving based on the lived experiences of caregivers. The interview schedule was developed based on the PERMA model and finalized after the pilot study. Each interview took 30-50 min and was recorded and transcribed. Results The data was analyzed using thematic analysis. Some commonalities and differences were observed in the responses given by family caregivers from the four cities. Four major themes that emerged for the "Nature of positive caregiving" among participants from all four cities are "Caregiver's attitude," "Care and compassion," "Roles and responsibilities," and "Beliefs and values." Four significant themes for the "Factors contributing to positive caregiving" are "Meaningfulness in life," "Sense of belongingness," "Personal growth," and "Empathetic understanding." Conclusion Based on the study's findings, it can be said that the themes were associated with the PERMA model. Positive caregiving is an important indicator of caregivers' and care receivers' well-being. The findings have implications for planning some action research, training, and counseling programs for promoting positive aspects of caregiving among informal caregivers.
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Affiliation(s)
- Nidhi Mishra
- Department of Applied Psychology, School of Humanities and Social Sciences, Gandhi Institute of Technology and Management (GITAM), Visakhapatnam, India
| | - Ravi S. Datti
- Department of Applied Psychology, School of Humanities and Social Sciences, Gandhi Institute of Technology and Management (GITAM), Visakhapatnam, India
| | - Ashutosh Tewari
- Venture Development Center, Gandhi Institute of Technology and Management (GITAM), Visakhapatnam, India
| | - Maneela Sirisety
- Department of Applied Psychology, School of Humanities and Social Sciences, Gandhi Institute of Technology and Management (GITAM), Visakhapatnam, India
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Chistell F, Stängle S, Fringer A. "Loneliness is a monotonous thing": descriptive qualitative research on the loneliness of caring relatives. BMC Nurs 2023; 22:161. [PMID: 37189144 DOI: 10.1186/s12912-023-01327-4] [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: 02/03/2022] [Accepted: 05/03/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND The phenomenon of loneliness is increasing worldwide. Caring relatives (CRs) are at high risk of suffering from loneliness. Although some studies have already investigated the issue of loneliness among CRs, there is a lack of evidence to help understand the experience of loneliness in depth. The aim of this study is to record and analyse the experience of loneliness among CRs of chronically ill people. Specifically, the aim is to develop a conceptual model based on the concepts of social, emotional, and existential loneliness. METHODOLOGY A qualitative-descriptive research design with narrative semistructured interviews was chosen. Thirteen CRs-three daughters, six wives and four husbands-participated in the study. The participants were an average of 62.5 years old. The interviews took place from September 2020 to January 2021 and lasted an average of 54 min. The data were analysed inductively using coding. The analysis was carried out in the following three coding phases: initial open coding, axial coding, and selective coding. The central phenomenon was abductively generated from the main categories. RESULTS A chronic illness gradually changes the participants' normal lives over time. A feeling of social loneliness is experienced, as their quality of social contacts no longer meets their needs. Thoughts about the future and the question of why are omnipresent can create a feeling of existential loneliness. Lack of communication in the partnership or in the family relationship, the changed personality of the ill person as well as the resulting role shift are stressful. Moments of closeness and tenderness become rare, and a change in togetherness takes place. In such moments, there is a strong feeling of emotional loneliness. Personal needs rapidly fade into the background. One's own life comes to a standstill. Accordingly, loneliness is perceived by the participants to be a stagnant life and is experienced as monotonous and painful. Feelings such as helplessness, powerlessness, frustration, anger, and sadness accompany this loneliness. CONCLUSION The study results show that the feeling of loneliness is present and experienced in a similar way by CRs, regardless of age and relationship to an ill person and that a need for action must derive from this. With the conceptual model, it is possible to offer versatile starting points for nursing practice, such as sensitization, to foster further research into the topic.
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Affiliation(s)
- Flurina Chistell
- Department Internal Medicine, Regional Hospital Surselva, Ilanz, Switzerland
| | - Sabrina Stängle
- School of Health Professions, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz, 9, Winterthur, 8400, Switzerland
| | - André Fringer
- School of Health Professions, ZHAW Zurich University of Applied Sciences, Katharina-Sulzer-Platz, 9, Winterthur, 8400, Switzerland.
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de Jong L, Schmidt T, Stahmeyer JT, Eberhard S, Zeidler J, Damm K. Willingness to provide informal care to older adults in Germany: a discrete choice experiment. THE EUROPEAN JOURNAL OF HEALTH ECONOMICS : HEPAC : HEALTH ECONOMICS IN PREVENTION AND CARE 2023; 24:425-436. [PMID: 35689744 PMCID: PMC10060358 DOI: 10.1007/s10198-022-01483-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 05/12/2022] [Indexed: 06/05/2023]
Abstract
As the German population is continually aging and the majority of older adults still wish to 'age in place', the need for informal care provided by family and friends will correspondingly continue to increase. In addition, while the need for formal (professional) care services is also likely to increase, the supply already does not meet the demand in Germany today. The aim of our study is the elicitation of people's willingness to provide informal care by means of a discrete choice experiment. The self-complete postal survey was disseminated to a random sample of the German general population in Lower Saxony. Data cleansing resulted in a final sample size of 280 participants. A conditional logit and a latent class model were estimated. All attributes were judged as highly relevant by the respondents. The results revealed that an increase in the care hours per day had the greatest negative impact overall on the willingness to provide informal care in our sample. The marginal willingness-to-accept for 1 h of informal care was €14.54 when having to provide informal care for 8 h in reference to 2 h per day. This value is considerably higher than the national minimum wage of €9.82. A three-class latent class model revealed preference heterogeneity. While a monetary compensation is often discussed to increase the willingness and availability of informal care in a country, our results show that this statement could not be generalized within our entire sample.
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Affiliation(s)
- Lea de Jong
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany.
| | - Torben Schmidt
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
| | | | - Sveja Eberhard
- Health Services Research Unit, AOK Lower Saxony, Hannover, Germany
| | - Jan Zeidler
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
| | - Kathrin Damm
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Str.7, 30159, Hannover, Germany
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Xiao F, Cao S, Xiao M, Xie L, Zhao Q. Patterns of home care and community support preferences among older adults with disabilities in China: a latent class analysis. BMC Geriatr 2023; 23:117. [PMID: 36869322 PMCID: PMC9983178 DOI: 10.1186/s12877-023-03830-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 02/16/2023] [Indexed: 03/05/2023] Open
Abstract
BACKGROUND Ageing in place is the preferred choice for most older adults worldwide. The role of the family as a core care resource has diminished as a result of changes in family structure, thus extending the responsibility for caring for older adults from within the family to outside it and requiring considerably more support from society. However, there is a shortage of formal and qualified caregivers in many countries, and China has limited social care resources. Therefore, it is important to identify home care patterns and family preferences to provide effective social support and reduce government costs. METHODS Data were obtained from the Chinese Longitudinal Healthy Longevity Study 2018. Latent class analysis models were estimated using Mplus 8.3. Multinomial logistic regression analysis was adopted to explore the influencing factors with the R3STEP method. Lanza's method and the chi-square goodness-of-fit test were used to explore community support preferences among different categories of families of older adults with disabilities. RESULTS Three latent classes were identified based on older adults with disabilities' characteristics (degree of disability, demand satisfaction), caregivers' characteristics (length of providing care, care performance) and living status: Class 1- mild disability and strong care (46.85%); Class 2- severe disability and strong care (43.92%); and Class 3- severe disability and incompetent care (9.24%). Physical performance, geographic region and economic conditions jointly influenced home care patterns (P < 0.05). Home visits from health professionals and health care education were the top two forms of community support that were most preferred by the older adults with disabilities' families (residual > 0). Families in the Class 3 subgroup preferred personal care support more than those in the other two subgroups (P < 0.05). CONCLUSION Home care is heterogeneous across families. Older adults' degrees of disability and care needs may be varied and complex. We classified different families into homogeneous subgroups to reveal differences in home care patterns. The findings can be used by decision-makers in their attempts to design long-term care arrangements for home care and to adjust the distribution of resources for the needs of older adults with disabilities.
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Affiliation(s)
- Feng Xiao
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Songmei Cao
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Liling Xie
- Department of Nursing, First Branch of the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Vrettos I, Anagnostopoulos F, Voukelatou P, Panayiotou S, Kyvetos A, Nikas A, Kollia D, Niakas D. Factors associated with health-related quality of life of informal caregivers of older patients and the mediating role of subjective caregivers' burden. Psychogeriatrics 2023; 23:286-297. [PMID: 36597270 DOI: 10.1111/psyg.12930] [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: 10/07/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Caregiving has been associated with increased subjective burden and decreased health-related quality of life (HRQOL) for caregivers. The aim of the study was to clarify the precise relationship between caregivers' burden, caregivers' HRQOL, and other risk factors, considering that subjective burden was a risk factor for poor HRQOL, which may also mediate the effects of some known risk factors. METHODS In this cross-sectional study, patients' and their informal caregivers' characteristics were recorded for 311 patient-caregiver dyads. Subjective caregiver burden and caregivers' HRQOL were assessed using the Zarit Burden Interview and the 12-item Short-Form Health Survey (SF-12), respectively. Mediation analysis was used to examine the relationships between variables. Caregivers' mental component summary (MCS) and physical component summary (PCS) scores were regarded as outcome variables, caregivers' subjective burden was considered the mediator, and patients' and caregivers' characteristics were treated as predictors. RESULTS Caregivers' subjective burden was negatively related to both PCS and MCS of caregivers' HRQOL, after controlling for the effects of demographic and clinical variables. Moreover, significant associations, mostly indirect via caregivers' subjective burden, existed between caregivers' socio-demographic characteristics, duration of caregiving, patients' frailty status, patients' co-morbidity, and caregivers' HRQOL. CONCLUSION Caregivers' subjective burden plays a major and mediating role on influencing caregivers' HRQOL. Our findings may direct future research and promote the implementation of interventions to reduce caregivers' burden and improve caregivers' HRQOL.
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Affiliation(s)
- Ioannis Vrettos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Fotios Anagnostopoulos
- Department of Psychology, Panteion University of Social and Political Sciences, Athens, Greece
| | - Panagiota Voukelatou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Stefani Panayiotou
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Andreas Kyvetos
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Anastasios Nikas
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Dafni Kollia
- 2nd Department of Internal Medicine, General and Oncology Hospital of Kifissia "Agioi Anargyroi", Athens, Greece
| | - Dimitris Niakas
- Department of Health Economics, School of Health Sciences, National and Kapodistrian University of Athens, Athens, Greece
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Boeykens D, Sirimsi MM, Timmermans L, Hartmann ML, Anthierens S, De Loof H, De Vliegher K, Foulon V, Huybrechts I, Lahousse L, Pype P, Schoenmakers B, Van Bogaert P, Van den Broeck K, Van Hecke A, Verhaeghe N, Vermandere M, Verté E, Van de Velde D, De Vriendt P. How do people living with chronic conditions and their informal caregivers experience primary care? A phenomenological-hermeneutical study. J Clin Nurs 2023; 32:422-437. [PMID: 35178849 DOI: 10.1111/jocn.16243] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 01/17/2023]
Abstract
AIMS AND OBJECTIVES Gaining insight in how people living with chronic conditions experience primary healthcare within their informal network. BACKGROUND The primary healthcare system is challenged by the increasing number of people living with chronic conditions. To strengthen chronic care management, literature and policy plans point to a person-centred approach of care (PCC). A first step to identify an appropriate strategy to implement PCC is to gain more insight into the care experiences of these people and their informal caregivers. DESIGN A phenomenological-hermeneutical philosophy is used. The study is in line with the Consolidated Criteria for Reporting Qualitative Research Guidelines (COREQ). METHOD In-depth, semi-structured interviews with people living with chronic conditions and informal caregiver dyads (PCDs) (n = 16; 32 individuals) were conducted. An open-ended interview guide was used to elaborate on the PCDs' experiences regarding primary care. A purposive, maximal variation sampling was applied to recruit the participants. RESULTS Based on sixteen PCDs' reflections, ten themes were identified presenting their experiences with primary care and described quality care as listening and giving attention to what people with chronic conditions want, to what they strive for, and above all to promote their autonomy in a context wherein they are supported by a team of formal caregivers, family and friends. CONCLUSION To meet the PCDs' needs, self-management should be addressed in an interprofessional environment in which the PCD is an important partner. The findings may facilitate a shift to encourage PCDs in their strengths by enabling them to share their personal goals and by working towards meaningful activities in team collaboration. RELEVANCE TO CLINICAL PRACTICE Three strategies-self-management support, goal-oriented care, and interprofessional collaboration-have been suggested to improve the PCDs' primary care experiences. These strategies could guide nursing practice in using more and improve high-quality nursing care.
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Affiliation(s)
- Dagje Boeykens
- Department of Rehabilitation Sciences, Occupational Therapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Muhammed Mustafa Sirimsi
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium.,Department of Primary Care and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Lotte Timmermans
- Department of Public Health and Primary Care, Faculty of Medicine, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Maja Lopez Hartmann
- Department of Welfare and Health, Karel de Grote University of Applied Sciences and Arts, Antwerp, Belgium
| | - Sibyl Anthierens
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Hans De Loof
- Laboratory of Physiopharmacology, Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, Faculty of Pharmaceutical Sciences, KU Leuven, Leuven, Belgium
| | - Ine Huybrechts
- Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium.,Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Lies Lahousse
- Department of Bioanalysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium
| | - Peter Pype
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Birgitte Schoenmakers
- Department of Public Health and Primary Care, Faculty of Medicine, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Peter Van Bogaert
- Faculty of Medicine and Health Sciences, Centre for Research and Innovation in Care, University of Antwerp, Antwerp, Belgium
| | - Kris Van den Broeck
- Department of Primary Care and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Ann Van Hecke
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Faculty of Medicine and Health Sciences, University Centre of Nursing and Midwifery, Ghent University, Ghent, Belgium
| | - Nick Verhaeghe
- Department of Public Health and Primary Care, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Research group Social and Economic Policy and Social Inclusion, Research Institute for Work and Society, KU Leuven - HIVA, Leuven, Belgium
| | - Mieke Vermandere
- Department of Public Health and Primary Care, Faculty of Medicine, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Emily Verté
- Department of Primary Care and Interdisciplinary Care, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.,Department of Family Medicine and Chronic Care, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Dominique Van de Velde
- Department of Rehabilitation Sciences, Occupational Therapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Patricia De Vriendt
- Department of Rehabilitation Sciences, Occupational Therapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium.,Department of Occupational Therapy, Artevelde University of Applied Sciences, Ghent, Belgium.,Frailty in Ageing (FRIA) Research Group, Department of Gerontology and Mental Health and Wellbeing (MENT) research group, Faculty of Medicine and Pharmacy, Vrije Universiteit, Brussels, Belgium
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Mårtensson E, Coumoundouros C, Sörensdotter R, von Essen L, Woodford J. Psychological interventions for symptoms of depression among informal caregivers of older adult populations: A systematic review and meta-analysis of randomized controlled trials. J Affect Disord 2023; 320:474-498. [PMID: 36174787 DOI: 10.1016/j.jad.2022.09.093] [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: 01/27/2022] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Symptoms of depression are commonly experienced by informal caregivers of older adults, however there is uncertainty concerning effectiveness of psychological interventions targeting symptoms of depression in this population. Further, there is uncertainty concerning important clinical moderators, including intervention type and care recipient health condition. This review examined the effectiveness of psychological interventions targeting symptoms of depression in informal caregivers of older adults. METHODS PubMed, CINAHL, Embase, PsycINFO, Cochrane Library and Web of Science were searched. Risk of bias was assessed using the Cochrane Risk of Bias tool version 2. RESULTS Fifteen studies were identified and twelve (1270 participants) provided data for the meta-analysis. Interventions included cognitive behavioral therapy (4 studies), problem-solving therapy (4 studies); non-directive supportive therapy (4 studies) and behavioral activation (3 studies). A small effect size favouring the intervention was found for symptoms of depression (g = -0.49, CI = -0.79, -0.19, I2 = 83.42 %) and interventions were effective in reducing incidence of major depression (OR = 0.177, CI = 0.08, 0.38), caregiver burden (g = -0.35, CI = -0.55, -0.15) and psychological distress (g = -0.49, CI = -0.70, -0.28). Given high heterogeneity, findings should be interpreted with caution. Overall risk of bias was high. LIMITATIONS Studies were limited to those in English or Swedish. CONCLUSION Psychological interventions may be effective in reducing symptoms of depression among informal caregivers of older adults. However, evidence is inconclusive due to heterogeneity, high risk of bias, and indirectness of evidence.
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Affiliation(s)
- Erika Mårtensson
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, 752 37 Uppsala, Sweden; Centre for Gender Research, Uppsala University, 752 36 Uppsala, Sweden.
| | - Chelsea Coumoundouros
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, 752 37 Uppsala, Sweden.
| | | | - Louise von Essen
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, 752 37 Uppsala, Sweden.
| | - Joanne Woodford
- Healthcare Sciences and e-Health, Department of Women's and Children's Health, Uppsala University, 752 37 Uppsala, Sweden.
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Tokovska M, Šolcová J. The Burden of Next-of-Kin Carers of Dementia Sufferers in the Home Environment. Healthcare (Basel) 2022; 10:2441. [PMID: 36553965 PMCID: PMC9778319 DOI: 10.3390/healthcare10122441] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/26/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022] Open
Abstract
The role and responsibilities of next-of-kin carers are significant, filling several years of their lives and causing them to experience a burden of care. This study was conducted to investigate the burden of next-of-kin carers for dementia sufferers in Slovakia. Data were compiled via the Relatives' Stress Scale (RSS) screening instrument through a survey of 112 primary next-of-kin carers and analysed using the statistical tests of descriptive statistics, means, scores and significance differences (Wilcoxon test). This is one of the few scales which provides: (a) specific measures of caregiver stress, and (b) is standardised for a population of informal carers in the home environment. The profiles of Slovak next-of-kin carers were identified with statistically significant characteristics (gender, age of carers). The study identified a high level of caregiving stress (82.15%), and selected factors were found to be significant in all burden dimensions: emotional stress (p = 0.001), social stress (p = 0.003), and negative feelings (p = 0.002). The results emphasise the need for coordination of healthcare and social services, possibly by expanding the network of social support groups, operating a counselling hotline/chat, and introducing national educational programmes for the next-of-kin carers of dementia sufferers. The results are also a source of reference for the umbrella organisation 'the Slovak Alzheimer's Society' to access when implementing changes at a national level.
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Affiliation(s)
- Miroslava Tokovska
- Department of Health and Exercise, School of Health Sciences, Kristiania University College, Prinsens gate 7-9, 0152 Oslo, Norway
| | - Jana Šolcová
- Department of Social Work, Faculty of Education, Matej Bel University, Ruzova 11, 974 11 Banska Bystrica, Slovakia
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Shoukr EMM, Mohamed AAER, El-Ashry AM, Mohsen HA. Effect of psychological first aid program on stress level and psychological well-being among caregivers of older adults with alzheimer's disease. BMC Nurs 2022; 21:275. [PMID: 36217138 PMCID: PMC9551605 DOI: 10.1186/s12912-022-01049-z] [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: 03/09/2022] [Accepted: 09/23/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Older adults with Alzheimer’s disease (AD) experience drastic changes in their physical and mental abilities. AD patients became heavily dependent on their caregivers for everyday functions, which have significant implications not only for them but also for their caregivers. So, many AD caregivers experienced an increased level of depression and anxiety symptoms, lower perceived control, and higher burden compared to non-AD caregivers. Therefore, psychological first aid (PFA) and educational interventions are designed to enable those caregivers to meet the daily requirements of their patient care and to cope with its challenges. Aim Determine the effect of psychological first aid program on stress level and psychological well-being among caregivers of older adults with Alzheimer’s disease. Design One group pre-test post-test was followed. Subjects A convenience sample of one hundred (100) caregivers of older adults with AD. Setting All online groups concerned with the care of Alzheimer’s disease patients on Facebook. Tools Socio-demographic and clinical data of older adults with Alzheimer’s disease and their caregivers’ questionnaire, Alzheimer’s disease knowledge scale, Kingston caregiver stress scale, and authentic identity measures (AIM) scale of psychological well-being Results The psychological first aid program has highly statistically significant effect on the AD caregivers’ knowledge, stress level and psychological well-being as (t=-30.707, P = 0.000, t = 8.500, P = 0.000 & t= -4.763, P = 0.000 respectively). Conclusion Psychological first aid program is considered an effective intervention in decreasing the AD caregivers’ stress and increasing their psychological wellbeing and knowledge regarding delivering care for AD patients.
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How do elderly people with malnutrition and their families perceive collaborative practice in primary care? A phenomenological study. Br J Nutr 2022; 129:1786-1792. [PMID: 35790213 DOI: 10.1017/s0007114522002045] [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: 11/07/2022]
Abstract
As a frequent and serious problem in elderly people, malnutrition is a complex health issue. It requires comprehensive care through interprofessional collaborative practice (IPCP) engaging five health professionals in primary care consisting of a physician, dentist, nurse, dietitian and pharmacist. In Indonesia, the usual care involves monthly health screening in community programmes named Posyandu. The current study aimed to explore perceptions of elderly people with malnutrition and their families' experiences with interprofessional teams compared with usual care in primary care. This qualitative study used the phenomenological approach based on Creswell. Interviews were conducted with fourteen elderly people and their families in the intervention group and fourteen elderly people with their families in the control group. Data were analysed using the four steps of descriptive qualitative analysis described by Giorgi, including comparing the experiences of both groups. Elderly people with malnutrition in the intervention group had more valued experiences regarding two-way communication with the IPCP team and felt it involved more comprehensive care for malnutrition management. Participants in the control group experienced communication between the health care providers and elderly people; however, it was not clear enough. There were overlapping roles among health care providers in the usual care. However, both groups shared the experience that family members are partners in nutritional management. Elderly people and their families in the intervention group have more valuable experiences related to two-way communication and comprehensive care. Family as partners was experienced in both the intervention and control groups.
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Caregiving solutions in Mexican households during COVID-19 lockdown. SN SOCIAL SCIENCES 2022; 2:49. [PMID: 35475267 PMCID: PMC9023673 DOI: 10.1007/s43545-022-00363-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 04/12/2022] [Indexed: 11/02/2022]
Abstract
The COVID-19 quarantine in Mexico has meant that household members spend more time inside the home, increasing the demand for direct and indirect care by minors, the elderly, chronically ill and disabled. This forced a reconfiguration of the provision of these services by household members. The aim of the document is twofold: first, to describe socioeconomic and demographic aspects of Mexican households around care activities during the quarantine and second, to estimate the determinants of the provision of care in the quarantine. The information was obtained from the Survey of Care and COVID-19 in Mexican Homes during Quarantine (SCCMHQ). The propensity score-matching technique is used as a quasi-experimental procedure to estimate the causal effects of a treatment variable (presence of minors, elderly, chronically ill, disability, or domestic service in the home) in Mexican households. The Probit model shows that age and economic dependency are determinants of caregiving for treatment groups with minors, disability and chronic disease. In addition, sex, home income, and current employment situation are significant for treatment groups with a disability, paid domestic work, and minors, respectively. A positive “net” effect of the treatment variables in the probability of care provision was also observed. Particularly, the existence of minors at home was highly effective to promote direct and indirect care. The confinement solution is characterized by a balance between genders, except in the case of households with disabilities. This shows that a cultural and functional change is possible in the distribution of care responsibilities, which can be consolidated through public policies.
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Fiorini L, Sorrentino A, Pistolesi M, Becchimanzi C, Tosi F, Cavallo F. Living With a Telepresence Robot: Results From a Field-Trial. IEEE Robot Autom Lett 2022. [DOI: 10.1109/lra.2022.3155237] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Laura Fiorini
- Department of Industrial Engineering, University of Florence, Florence, Italy
| | | | - Mattia Pistolesi
- Department of Architecture, Ergonomics & Design Lab (LED), Department of Architecture, Ergonomics & Design Lab (LED), University of Florence, Florence, Italy
| | - Claudia Becchimanzi
- Department of Architecture, Ergonomics & Design Lab (LED), Department of Architecture, Ergonomics & Design Lab (LED), University of Florence, Florence, Italy
| | - Francesca Tosi
- Department of Architecture, Ergonomics & Design Lab (LED), Department of Architecture, Ergonomics & Design Lab (LED), University of Florence, Florence, Italy
| | - Filippo Cavallo
- Department of Industrial Engineering, University of Florence, Florence, Italy
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Glomsås HS, Knutsen IR, Fossum M, Christiansen K, Halvorsen K. Family caregivers' involvement in caring for frail older family members using welfare technology: a qualitative study of home care in transition. BMC Geriatr 2022; 22:223. [PMID: 35303816 PMCID: PMC8932075 DOI: 10.1186/s12877-022-02890-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/02/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Demographic, economic and organisational changes challenge home care services. Increased use of welfare technology and involvement of family members as co-producers of care are political initiatives to meet these challenges. However, these initiatives also involve ethical aspects. METHOD The aim of this qualitative study was to explore family caregivers' experience of involvement and possible ethical aspects of caring for frail older family members receiving home care services supported by welfare technology. This study used a qualitative explorative and descriptive design within a phenomenological-hermeneutical approach. Sixteen interviews with eighteen family caregivers were conducted. The participants were sons, daughters, siblings and spouses of frail older people receiving home care services with the support of welfare technology. Data were analysed using reflexive thematic analysis. The COREQ checklist was used. RESULTS The analysis led to five main themes. First, the family caregivers' experienced caring as meaningful but increasingly demanding concerning the changes in home care services. Second, they experienced a change in relationships, roles, tasks, and responsibilities related to more family involvement and the use of welfare technology. This also challenged their sense of autonomy. However, welfare technology helped them deal with responsibilities, especially safety. The family caregivers requested early involvement, dialogue for care decisions, more cooperation and support from health professionals. Third, the participants experienced that health professionals decided the conditions for co-production without discussion. Their need for information and knowledge about welfare technology were not met. Fourth, the family caregivers felt that the health professionals did not adequately recognise their unique knowledge of the care receiver and did not use this knowledge for customising the welfare technology to the care receiver and their families. Fifth, the family caregivers expressed concern about service and welfare technology inequality in home care services. CONCLUSIONS Co-production in the involvement of family caregivers in care is still not an integral part of home care service. Welfare technology was appreciated, but the family caregivers called for early involvement to ensure successful and safe implementation and use. More attention needs to be given to ethical concerns about the change in relations, transfer of tasks and responsibility, and risk of inequality.
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Affiliation(s)
- Heidi Snoen Glomsås
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
| | - Ingrid Ruud Knutsen
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
| | - Mariann Fossum
- Faculty of Health and Sport Sciences, Institute of Health and Nursing Science, University of Agder, Postboks 422, N-4604 Kristiansand, Norway
| | - Karin Christiansen
- Faculty of Health Sciences, Research Centre for Health and Welfare Technology, VIA University College, Hedeager 2, DK-8200 Aarhus, Denmark
| | - Kristin Halvorsen
- Faculty of Health Sciences, Institute of Nursing and health promotion, Oslo Metropolitan University, Postbox 4, St. Olavs plass, N-0130 Oslo, Norway
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International Comparison of Social Support Policies on Long-Term Care in Workplaces in Aging Societies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063284. [PMID: 35328971 PMCID: PMC8955393 DOI: 10.3390/ijerph19063284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 02/26/2022] [Accepted: 03/08/2022] [Indexed: 11/16/2022]
Abstract
A decrease in the working-age population in aging societies causes a shortage of employees in workplaces due to long-term care (LTC) leave for family and relatives as well as longer working hours or overwork among those remaining in the workplace. We collected and analyzed literature and guidelines regarding social-support policies on LTC in workplaces in seven countries (Canada, France, Germany, Japan, Sweden, the UK, and the USA) to propose an effective way of occupational health support for those in need. Our analysis indicated the existence of a system that incorporates the public-assistance mechanism of providing unused paid leave to those in need. Additionally, recipients of informal care provided by employees tended to expand to non-family members under the current occupational health system. On the other hand, the health management of employees as informal caregivers remained neglected. Likewise, salary compensation and financial support for LTC-related leave need to be improved. In order to monitor and evaluate the progress and achievement of current legal occupational health systems and programs related to the social support of LTC among employees, the available national and/or state-based quantitative data should be comparable at the international level.
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Programs Addressed to Family Caregivers/Informal Caregivers Needs: Systematic Review Protocol. J Pers Med 2022; 12:jpm12020145. [PMID: 35207634 PMCID: PMC8876290 DOI: 10.3390/jpm12020145] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/18/2022] [Accepted: 01/20/2022] [Indexed: 12/10/2022] Open
Abstract
(1) Background: considering the growing increase in informal caregivers or family caregivers, it is critical to identify the unmet care needs of informal caregivers to improve their experiences, health, and well-being, contributing to the achievement of care needs of the elderly or people with adult dependency and promotion of successful transitions from health services to the community/home. (2) Objective: to identify the current state of knowledge about programs addressed to family caregivers/informal caregivers needs. (3) Methods: a systematic review will be undertaken with resource to databases from EBSCOhost Research Platform, Scopus, Web of Science, The Virtual Health Library (VHL). Studies published after January 2011 in English, Spanish, French, Italian and Portuguese will be considered. This review will consider all studies that report on any intervention program targeting family caregivers/informal caregivers who need to improve their experiences, health, and well-being, contributing to the meeting of their needs or those who have dementia and cognitive impairment, mental disorders, impairments in activities of daily living, frailty and/or who need health care and/or promoting successful transitions of community. (4) Discussion: The results of this review could be used to develop an intervention model to meet the needs of the family caregivers/informal caregivers. Furthermore, these findings will help to guide the construction of health policies regarding family caregivers/informal caregivers, as well their needs.
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Petrovic M, Bonanno S, Landoni M, Ionio C, Hagedoorn M, Gaggioli A. Healing with Stories: using the Transformative Storytelling technique to generate empowering narratives for informal caregivers. A Method Demonstration (Preprint). JMIR Form Res 2022; 6:e36405. [PMID: 35802492 PMCID: PMC9382549 DOI: 10.2196/36405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 05/11/2022] [Accepted: 06/01/2022] [Indexed: 01/19/2023] Open
Abstract
Background Objective Methods Results Conclusions
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Affiliation(s)
- Milica Petrovic
- ExperienceLab, Università Cattolica del Sacro Cuore, Milan, Italy
| | | | - Marta Landoni
- Department of Psychology, Centro di Ricerca sulle Dinamiche Evolutive ed Educative, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Chiara Ionio
- Department of Psychology, Centro di Ricerca sulle Dinamiche Evolutive ed Educative, Università Cattolica del Sacro Cuore, Milan, Italy
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Andrea Gaggioli
- Research Center in Communication Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
- IRCCS, Istituto Auxologico Italiano, Milan, Italy
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Biliunaite I, Kazlauskas E, Sanderman R, Andersson G. Informal caregiver support needs and burden: a survey in Lithuania. BMJ Open 2022; 12:e054607. [PMID: 34983768 PMCID: PMC8728458 DOI: 10.1136/bmjopen-2021-054607] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 12/08/2021] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION A demand for informal care exists worldwide. Lithuania presents an interesting case example where the need for the informal care is increasing, but relatively little research has been conducted documenting caregivers' experiences and needs. OBJECTIVES The main objective of this study was to investigate Lithuanian informal caregiver characteristics, support needs and burden. In addition, the impact of the COVID-19 on the caregiver's and care receiver's well-being was investigated. METHODS The study was conducted online between May and September 2020. Informal caregivers and individuals with informal caregiving experiences were invited to participate in the survey. The survey questionnaire comprised 38 multiple-choice items including participant demographic characteristics, availability of the support, support needs, well-being and the impact of the COVID-19 pandemic. In addition, caregiver burden was assessed with the 24-item Caregiver Burden Inventory (CBI). RESULTS A total of 226 individuals completed the survey. Most of the participants were women (87.6%). Almost half of the participants (48.7%) were not receiving any support, and a total of 73.9% expressed a need to receive more professional support. Participants were found to experience high burden on the CBI (M=50.21, SD=15.63). Women were found to be significantly more burdened than men (p=0.011). Even though many participants experienced psychological problems (55.8%), only 2.2% were receiving any psychological support. Finally, majority of the participants did not experience any changes in their own (63.7%) or the well-being of their care receiver (68.1%) due to the COVID-19 pandemic. CONCLUSION Most of the participants were identified as intensive caregivers experiencing a high burden. A majority did not experience changes in their well-being due to COVID-19. We propose several recommendations for increasing accessibility and availability of support for informal caregivers in Lithuania based on the study findings.
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Affiliation(s)
- Ieva Biliunaite
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Evaldas Kazlauskas
- Center for Psychotraumatology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Boyt N, Ho AK, Morris-Bankole H, Sin J. Internet-facilitated interventions for informal caregivers of patients with neurodegenerative disorders: Systematic review and meta-analysis. Digit Health 2022; 8:20552076221129069. [PMID: 36276187 PMCID: PMC9585576 DOI: 10.1177/20552076221129069] [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: 12/13/2021] [Accepted: 09/11/2022] [Indexed: 11/15/2022] Open
Abstract
Objective This systematic review explored the effectiveness of internet-delivered interventions in improving psychological outcomes of informal caregivers for neurodegenerative-disorder (ND) patients. Methods We searched seven databases for English-language papers published from 1999 to May 2021. Study-eligibility required that interventions used a minimum 50% internet-facilitation, targeting unpaid, adult informal caregivers of community-based ND-patients. We included randomised controlled trials (RCTs) and pre-post evaluative studies reporting outcomes for at least one-time point post-intervention. Independent quality checks on abstract and full-text screening were completed. Data extraction encompassed interventions' features, approaches, theoretical bases and delivery-modes. The Integrated quality Criteria for the Review Of Multiple Study designs (ICROMS) framework assessed risk of bias. Alongside narrative synthesis, we calculated meta-analyses on post-intervention using outcome measures from at least two RCTs to assess effectiveness. Results Searches yielded 51 eligible studies with 3180 participants. In 48 studies, caregivers supported a dementia-diagnosed individual. Intervention-durations encompassed four weeks to 12 months, with usage-frequency either prescribed or participant-determined. The most frequently-used approach was education, followed by social support. We calculated meta-analyses using data from 16 RCTs. Internet-delivered interventions were superior in improving mastery (g = 1.17 [95% CI; 0.1 to 2.24], p = 0.03) and reducing anxiety (g = -1.29 [95% CI; -1.56 to -1.01], p < 0.01), compared to all controls. Findings were equivocal for caregivers' quality of life, burden and other outcomes. High heterogeneity reflected the multifarious combinations of approaches and delivery-modes, precluding assessment of the most efficacious intervention features. Analyses using burden and self-efficacy outcomes' follow-up data were also non-significant compared to all comparator-types. Although 32 studies met the ICROMS threshold scores, we rated most studies' evidence quality as 'very-low'. Conclusions This review demonstrated some evidence for the efficacy of internet-delivered interventions targeting informal ND-caregivers. However, more rigorous studies, with longer follow-ups across outcomes and involving NDs other than dementia, are imperative to enhance the knowledge-base.
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Affiliation(s)
- Neil Boyt
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Aileen K Ho
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Hannah Morris-Bankole
- School of Psychology & Clinical Language Sciences, University of Reading, Earley Gate, RG6 6AL, England
| | - Jacqueline Sin
- School of Health Sciences, University of London, Myddelton Street Building, Myddelton Street, London, EC1R 1UW, England
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Prerequisites for providing effective support to family caregivers within the primary care setting - results of a study series in Germany. BMC FAMILY PRACTICE 2021; 22:252. [PMID: 34937549 PMCID: PMC8697448 DOI: 10.1186/s12875-021-01601-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 12/03/2021] [Indexed: 11/10/2022]
Abstract
Background General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs. The results are used to derive starting points as to which measures would be sensible and useful to strengthen support offered to family caregivers in the primary care setting. Methods Between 2020 and 2021, three sub-studies were conducted: a) an online survey of 612 family caregivers; b) qualitative interviews with 37 family caregivers; c) an online survey of 3556 GPs. Results Family caregivers see GPs as a highly skilled and trustworthy central point of contact; there are many different reasons for consulting them on the subject of care. In the perception of caregivers, particular weaknesses in GP support are the absence of signposting to advisory and assistance services and, in many cases, the failure to involve family caregivers in good time. At the same time, GPs do not always have sufficient attention to the physical and psychological needs of family caregivers. The doctors interviewed consider the GP practice to be well suited to being a primary point of contact for caregivers, but recognise that various challenges exist. These relate, among other things, to the timely organisation of appropriate respite services, targeted referral to support services or the early identification of informal caregivers. Conclusions GP practices can play a central role in supporting family caregivers. Caregivers should be approached by the practice team at an early stage and consistently signposted to help and support services. In order to support care settings successfully, it is important to consider the triadic constellation of needs, wishes and stresses of both the caregiver and the care recipient. More training and greater involvement of practice staff in the support and identification of caregivers seems advisable.
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