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Yan Y, Li M, Cai T, Wang X, Dong Y, Hu X, Laureys S, Gosseries O, Grégoire C, Di H. Mood assessments of family caregivers of patients with severe brain injury in China. Qual Life Res 2024; 33:481-490. [PMID: 37971668 DOI: 10.1007/s11136-023-03539-2] [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] [Accepted: 10/04/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES Long-term care of severe brain injury patients places a significant mental burden on family caregivers, yet few studies have reported the situation in China. We aimed to describe the mood states of family caregivers of patients with severe brain injury and examine the influencing factors that affect caregivers' moods. METHODS Cross-sectional survey was used to assess the mood profiles of Chinese family caregivers between February 2019 and February 2020. Demographic data of caregivers and patients, the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder scale (GAD-7) were used to assess the level of depressive and anxiety symptoms. The quality of life score was also assessed by a visual analog scale, and the Coma Recovery Scale-Revised was used to assess the patient's consciousness. RESULT One hundred and one patients with severe brain injury (57 unresponsive wakefulness syndrome, UWS) between the age of 14 and 70 and their main family caregivers were enrolled in the study. Most caregivers displayed depressive (n = 62) and anxiety symptoms (n = 65), with 17 and 20 of these family caregivers reporting (moderately) severe depressive symptom and severe anxiety symptom, respectively. The caregiver's depressive symptom level significantly decreased as the patient's injury lasted longer (r = - 0.208, P = 0.037). Moreover, the age of the patient negatively related to the levels of depressive (r = - 0.310, P = 0.002) and anxiety symptoms (r = - 0.289, P = 0.003) in caregivers. There was a significant positive correlation between anxiety and depressive symptoms scores in family caregivers (r = 0.838, P < 0.001). The higher the level of anxiety (r = - 0.273, P = 0.006) and depressive symptoms (r = - 0.265, P = 0.007), the worse the quality of life. CONCLUSION Many family caregivers of patients with severe brain injury experience various levels of anxiety and depressive symptoms in China. Tailor-made psychological help seems imperative. Researchers and doctors can provide information about patient's conditions to assist family members in discussing rehabilitation options for patients in different states of consciousness will help to ease anxiety of family caregivers.
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Affiliation(s)
- Yifan Yan
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Meiqi Li
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
- School of Nursing, Hangzhou Normal University, Hangzhou, China
| | - Tiantian Cai
- Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xueying Wang
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China
| | - Yan Dong
- Department of Rehabilitation, Hospital of Zhejiang People's Armed Police, Hangzhou, China.
| | - Xiaohua Hu
- Department of Rehabilitation, Hospital of Zhejiang People's Armed Police, Hangzhou, China
| | - Steven Laureys
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
- Joint International Research Unit on Consciousness, CERVO Brain Research Centre, Laval University, Québec, Canada
| | - Olivia Gosseries
- Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium
- Centre du Cerveau, University Hospital of Liège, Liège, Belgium
| | - Charlotte Grégoire
- Sensation and Perception Research Group, GIGA-Consciousness, University of Liège, Liège, Belgium
| | - Haibo Di
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China.
- School of Basic Medicine, Hangzhou Normal University, Hangzhou, China.
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Roslin H, Muliira JK, Lazarus ER, Jacob D, Al-Habsi W, Al-Musallami F. Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury. Sultan Qaboos Univ Med J 2023; 23:493-501. [PMID: 38090237 PMCID: PMC10712375 DOI: 10.18295/squmj.6.2023.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/19/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to explore the caregiving preparedness and caregiver burden among Omani family caregivers (FCs) of patients with acquired brain injury (ABI). Methods This prospective observational study was conducted at the neurology clinic at Khoula Hospital, Muscat, Oman, from April 2019 to December 2021. Data were collected from 119 FCs and their patients at the time of discharge from the hospital and 16 weeks post-discharge during follow-up care. The questionnaire comprised the Zarit Burden Index, the Preparedness for Caregiving Scale, the Short-Form-12 Health Survey, and a patient symptom scale. Results The FCs were predominantly female (53.8%), and the mean age was 38.27 ± 9.11 years. Most patients had moderate to severe ABI (95.8%) due to stroke (56.3%) and trauma (30.3%). The most common patient symptoms were loss of muscle strength, speech problems, mood problems, memory loss, and change in behaviour. Most FCs were found to have low caregiving preparedness (58%) at discharge, and 19.1% were found to have a high level of caregiver burden at 16 weeks post-discharge. The length of time post-injury (P <0.01), symptom severity (P <0.01) and the FCs' physical and mental health status (P <0.01 each) were found to be significant predictors of caregiving preparedness, whereas caregiver preparedness (P <0.01), symptom severity (P <0.01), and caregivers' mental health (P = 0.028) were seen as the predictors of caregiver burden. Conclusion Omani FCs of patients with ABI tend to commence the caregiver role with inadequate preparation, and shortly after, a significant number suffer high caregiver burden. Interventions focusing on the caregiver's health and training in symptom management may improve the outcomes of FCs and patients.
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Affiliation(s)
- Hema Roslin
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Eilean R. Lazarus
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Devakirubai Jacob
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Warda Al-Habsi
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
| | - Fatma Al-Musallami
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
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Needs and Quality of Life of Caregivers of Patients with Prolonged Disorders of Consciousness. Brain Sci 2023; 13:brainsci13020308. [PMID: 36831851 PMCID: PMC9953960 DOI: 10.3390/brainsci13020308] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/15/2023] Open
Abstract
Background. Many patients with severe brain damage may survive and remain in a prolonged disorder of consciousness (PDoC), impacting the quality of life (QoL) and needs of their family caregivers. However, the current literature on the factors influencing these needs is contradictory. We aim to describe the needs, QoL, and emotional distress of caregivers of patients with PDoC. Methods. Questionnaires investigating the importance and satisfaction of six categories of needs (i.e., health information, emotional, instrumental, and professional supports, community support network, and involvement in care), QoL, and emotional distress were completed by the main caregivers of PDoC patients. Results. We analyzed 177 questionnaires. Seventy-nine percent of the needs were considered as important or very important, and 44% were partially met or unmet. The needs for health information and professional support were the most important, while the needs for involvement in care and for health information were the most satisfied. Mean QoL was low and emotional distress high. Variables such as care setting and time since brain injury affected the level of QoL and distress. Conclusion. The needs for health information and professional support should receive particular attention. Given their low QoL and high distress, adequate support structures should be provided to caregivers of PDoC patients.
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Olorunfemi O, Nwozichi C. Hermeneutic phenomenology of lived experience of family caregivers of critically-ill patients sustained by healthcare technologies in Benin City, Nigeria. MGM JOURNAL OF MEDICAL SCIENCES 2022. [DOI: 10.4103/mgmj.mgmj_185_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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Nayeri ND, Ahmadi Chenari H, Esmaeili M, Farsi Z, Baumann SL. Caring for Patients in a Coma Following a Traumatic Brain Injury in Iran. Nurs Sci Q 2021; 35:111-118. [PMID: 34939493 DOI: 10.1177/08943184211051372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The study described here is the process of caring for patients in a coma following a traumatic brain injury (TBI) in Iran. The data that were analyzed come from in-depth semistructured interviews of 20 key participants and associated memos and field notes. The MAXQDA 10 qualitative analysis software was used to assist with the coding of the data. Ten catagories and 26 subcategories were identified from the primary analysis, which fit well into four themes. The main themes that were identified were chaos and confusion, inconsistent quality, multilateral support, and improving care. The processes of caring for persons in a coma following a TBI were found to be an ever-changing, multidimensional, context-dependent process.
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Affiliation(s)
- Nahid Dehghan Nayeri
- Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Ahmadi Chenari
- Assistant Professor, Department of Medical Surgical Nursing, Ferdows School of Paramedical and Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Maryam Esmaeili
- Associate Professor, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Farsi
- Associate Professor, Research and Community Health Department, Faculty of Nursing, Aja University of Medical Sciences, Tehran, Iran
| | - Steven L Baumann
- Professor, Hunter College of the City University of New York, Williston Park, NY, USA
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Research Needs for Prognostic Modeling and Trajectory Analysis in Patients with Disorders of Consciousness. Neurocrit Care 2021; 35:55-67. [PMID: 34236623 DOI: 10.1007/s12028-021-01289-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 05/22/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND The current state of the science regarding the care and prognosis of patients with disorders of consciousness is limited. Scientific advances are needed to improve the accuracy, relevance, and approach to prognostication, thereby providing the foundation to develop meaningful and effective interventions. METHODS To address this need, an interdisciplinary expert panel was created as part of the Coma Science Working Group of the Neurocritical Care Society Curing Coma Campaign. RESULTS The panel performed a gap analysis which identified seven research needs for prognostic modeling and trajectory analysis ("recovery science") in patients with disorders of consciousness: (1) to define the variables that predict outcomes; (2) to define meaningful intermediate outcomes at specific time points for different endotypes; (3) to describe recovery trajectories in the absence of limitations to care; (4) to harness big data and develop analytic methods to prognosticate more accurately; (5) to identify key elements and processes for communicating prognostic uncertainty over time; (6) to identify health care delivery models that facilitate recovery and recovery science; and (7) to advocate for changes in the health care delivery system needed to advance recovery science and implement already-known best practices. CONCLUSION This report summarizes the current research available to inform the proposed research needs, articulates key elements within each area, and discusses the goals and advances in recovery science and care anticipated by successfully addressing these needs.
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Family Physician's and Primary Care Team's Perspectives on Supporting Family Caregivers in Primary Care Networks. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063293. [PMID: 33806725 PMCID: PMC8005195 DOI: 10.3390/ijerph18063293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 03/14/2021] [Accepted: 03/18/2021] [Indexed: 12/24/2022]
Abstract
Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.
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Pinazo-Clapés C, Pinazo-Hernandis S, Sales A. Effects of an Educational Program for Professional Caregivers on Behavioral Alterations in Nursing Home Residents: Pilot Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8845. [PMID: 33260699 PMCID: PMC7731200 DOI: 10.3390/ijerph17238845] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 11/21/2020] [Accepted: 11/24/2020] [Indexed: 11/25/2022]
Abstract
This pilot study aims to analyze the effectiveness of a type of non-pharmacological intervention such as the educating and training of professional caregivers on behavioral alterations and prescription of psychotropic drugs of older adults in nursing homes. One hundred and forty-five people from two nursing homes were randomized to either treatment (educational training program for healthcare professionals) or a no-treatment group. Twenty-two professional caregivers in the experimental group received 20 h of a training program. Five data collection points were collected (pre and post, and three follow-ups, all six months apart). Intervention consisted of the behavioral alterations and psychopharmacological treatment. The analysis of variance for repeated measures showed significant differences in the time-group interaction for the educational program's effectiveness in reducing behavior alterations and psycho-pharmaceuticals' record. The results show that an improvement in the educating and training of professional caregivers can reduce behavioral alterations (F3,407 = 9.29, p < 0.001, η2= 0.063) and prescription of psychotropic drugs (F2,10 = 18.90, p < 0.001, η2 = 0.117). In addition, these effects are maintained over time. Educating health professionals on ways to care for residents who present behavioral alterations may be one alternative for improving the quality of care that residents receive. Non-pharmacological interventions, besides being individualized and adapted to the needs and experiences of individuals, achieve effects that last longer at low cost. An educational program shows new alternatives to pharmacological intervention, achieving a reduction in behavioral alterations without the costs and effects that psychopharmaceuticals entail.
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Affiliation(s)
| | | | - Alicia Sales
- Department of Developmental Psychology, Faculty of Psychology, University of Valencia, 46010 Valencia, Spain
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Parmar J, Anderson S, Abbasi M, Ahmadinejad S, Brémault-Phillips S, Chan K, Charles L, Dobbs BM, Khera AS, Stickney-Lee J, Tian PGJ. Support for family caregivers: A scoping review of family physician's perspectives on their role in supporting family caregivers. HEALTH & SOCIAL CARE IN THE COMMUNITY 2020; 28:716-733. [PMID: 31858674 DOI: 10.1111/hsc.12928] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 11/26/2019] [Accepted: 11/21/2019] [Indexed: 06/10/2023]
Affiliation(s)
- Jasneet Parmar
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
- Covenant Health-Network of Excellence in Seniors' Health and Wellness, Edmonton, AB, Canada
- Grey Nuns Community Hospital, Marguerite Health Services Centre, Edmonton, AB, Canada
| | - Sharon Anderson
- Covenant Health-Network of Excellence in Seniors' Health and Wellness, Edmonton, AB, Canada
- Grey Nuns Community Hospital, Marguerite Health Services Centre, Edmonton, AB, Canada
| | - Marjan Abbasi
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Saeed Ahmadinejad
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, AB, Canada
| | - Karenn Chan
- Department of Family Medicine, Division of Care of the Elderly, University of Alberta, Edmonton, AB, Canada
| | - Lesley Charles
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
- Care of the Elderly, Glenrose Rehabilitation Hospital-East, Edmonton, AB, Canada
| | - Bonnie M Dobbs
- Department of Family Medicine, University of Alberta, Edmonton, AB, Canada
- Department of Family Medicine, Division of Care of the Elderly, University of Alberta, Edmonton, AB, Canada
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB, Canada
| | - Amandeep Sheny Khera
- Department of Family Medicine, Division of Care of the Elderly, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Stickney-Lee
- Supportive Living for AHS in the Edmonton Zone, Site Chief for Geriatrics at the Sturgeon Community Hospital, Edmonton, AB, Canada
| | - Peter George J Tian
- Department of Family Medicine, Division of Care of the Elderly, University of Alberta, Edmonton, AB, Canada
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