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Ibrahim AM, Ibrahim MM, Zaghamir DEF. Burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. Palliat Support Care 2024; 22:182-189. [PMID: 37381712 DOI: 10.1017/s1478951523000573] [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: 06/30/2023]
Abstract
BACKGROUND Alzheimer's disease is a chronic neurodegenerative disorder that results in total cognitive impairment and functional decline. Family members are the most usual caregivers worldwide, resulting in an increasing total burden and a subsequent degradation of their quality of life. OBJECTIVES To evaluate the burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. METHODS A descriptive research design was used. The study was conducted at outpatient clinics of El-Abbasya Mental Hospital in Cairo, Egypt. This study included 550 informal caregivers of Alzheimer patients. Data were gathered through questionnaires using the Sociodemographic Profile of Family Caregivers, an adopted version of the Montgomery Borgatta Caregiver Burden scale, and Health-Related Quality of Life Scale. RESULTS Nearly three quarters (73.5%) of the informal caregivers were female. Additionally, the physical burden among the informal caregivers was the highest (21.58 ± 8.13), while the psychological burden was the lowest (7.48 ± 25.35). Besides, around one-third (30%) of the informal caregivers had a total poor quality of life. SIGNIFICANCE OF RESULTS Total burden among informal caregivers of Alzheimer patients was relatively high (64.71 ± 26.86). Moreover, less than one-tenth (8%) of the informal caregivers for Alzheimer's patients had a good quality of life, whereas more than half (62%) of them had an average quality of life. In the Egyptian context, ongoing health education initiatives for those who care for Alzheimer patients are essential, and additional research employing large study sample sizes in varied contexts is strongly advised.
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Affiliation(s)
- Ateya Megahed Ibrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Family and Community Health Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Mahmoud Metwally Ibrahim
- Al-Ghad International College for Applied Medical Sciences, Saudi Arabia
- Department of Pharmacology, Al-Azhar University, Damietta, Egypt
| | - Donia Elsaid Fathi Zaghamir
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Pediatric Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
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2
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Nogueira AJ, Ribeiro MT. The Psychological Experience of Grandparents: Proposal of a Qualitative Clinical Assessment Tool in Pediatric Palliative Care. Clin Pract 2024; 14:122-131. [PMID: 38248434 PMCID: PMC10801506 DOI: 10.3390/clinpract14010010] [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: 10/30/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 01/23/2024] Open
Abstract
In Portugal, there are over 7800 children with life-limiting conditions. The context of pediatric palliative care represents a complex and distressing experience for families. Compared to parental caregivers and healthy siblings, grandparents are underexplored in the literature and clinical practice. The aim of the present study is to propose a psychological experience assessment tool of grandparents in this context. It consists of a sociodemographic and clinical data sheet and a semi-structured interview based on sharing a testimony with other grandparents. On the basis of the latter, 10 dimensions were explored through the grandparents' own perspective: representation of the illness; representation of the sick grandchild; changes in routine and life; family impact; grandparents' contributions to the family system; social support and coping strategies; emotional impact; triple concern; needs identification; and post-traumatic growth. The tool can be used in person or remotely and may be combined with other instruments. Its application enables a personalized identification of needs and challenges for each family, promoting the adjustment of the clinical intervention to their wellbeing and resilience from an eco-systemic perspective. The clinical tool is presented in detail and its importance in the context of research and systemic intervention is discussed.
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Affiliation(s)
- Alexandra Jóni Nogueira
- CICPSI, Faculty of Psychology, University of Lisbon, Alameda da Universidade, 1649-013 Lisbon, Portugal;
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3
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Nogueira AJ, Ribeiro MT. A psychological experience assessment protocol of parent caregivers in paediatric palliative care. Ann Med 2023; 55:2268093. [PMID: 38010855 PMCID: PMC10836293 DOI: 10.1080/07853890.2023.2268093] [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: 07/19/2023] [Accepted: 10/02/2023] [Indexed: 11/29/2023] Open
Abstract
Background: Paediatric Palliative Care (PPC) has undergone rapid growth in Portugal, where there are over 7800 children with life-limiting conditions. This is a complex experience for families due to the ongoing threat and vulnerability caused by the emergence of an illness, and therefore several studies have tended to focus on the adaptation of parent caregivers. The aim of the present study is to present a psychological experience assessment protocol of parents in PPC. Methods: It consists of a socio-demographic and clinical questionnaire and a semi-structured interview based on an incomplete narrative deriving from the Unwanted Guest Metaphor. Results: On the basis of the latter, 10 dimensions of the experience in the parental subsystem were explored through parents' own perspective, namely: confrontation with the diagnosis; representation of the illness; emotional impact; day-to-day challenges; family impact; resources and social support; coping strategies; posttraumatic growth; representation of the sick child; and future perspectives. Discussion: The protocol can be used in person or remotely and its application enables the identification of specific needs and the establishment of psychotherapeutic goals and strategies for each family, thus enhancing their well-being and resilience, from an eco-systemic perspective. Conclusions: The protocol is presented in detail and its importance in the context of research and systemic intervention in PPC is discussed.
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Affiliation(s)
- Alexandra Jóni Nogueira
- CICPSI, Faculty of Psychology, University of Lisbon, Alameda da Universidade, Lisboa, Portugal
| | - Maria Teresa Ribeiro
- CICPSI, Faculty of Psychology, University of Lisbon, Alameda da Universidade, Lisboa, Portugal
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4
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Tinajero-Chávez LI, Mora-Romo JF, Bravo-Doddoli A, Cruz-Narciso BV, Calleja N, Toledano-Toledano F. Design, Development, and Validation of the Self-Perceived Health Scale (SPHS). Healthcare (Basel) 2023; 11:2007. [PMID: 37510448 PMCID: PMC10379989 DOI: 10.3390/healthcare11142007] [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: 06/02/2023] [Revised: 06/19/2023] [Accepted: 06/29/2023] [Indexed: 07/30/2023] Open
Abstract
Health is a multidimensional concept with notable psychological factors, such as self-perceived health (SPH). SPH is defined as the subjective assessment of individual health status, and it integrates information related to both physical and psychological aspects, such as lifestyle. This study describes the development of the Self-Perceived Health Scale (SPHS), and its validation in a Mexican sample (n = 600). Exploratory factor analysis (n = 303) and confirmatory factor analysis (n = 293) were carried out, and they supported the three-dimensionality of the SPH construct: physical health, psychological health, and healthy lifestyle. A final 12-item scale was obtained, and the scale showed adequate validity and reliability, as well as measurement invariance between sexes, indicating its robustness.
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Affiliation(s)
- Lorena Ishel Tinajero-Chávez
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | - José Fernando Mora-Romo
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico
| | - Andrea Bravo-Doddoli
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | | | - Nazira Calleja
- Facultad de Psicología, Universidad Nacional Autónoma de México, Ciudad Universitaria, Coyoacán, Mexico City 04510, Mexico
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Márquez 162, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
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5
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Nogueira AJ, Ribeiro MT. "The Key Is to Value Every Little Achievement": A Qualitative Study of the Psychological Experience of Parent Caregivers in Paediatric Palliative Care. Clin Pract 2023; 13:670-683. [PMID: 37366931 DOI: 10.3390/clinpract13030062] [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: 05/02/2023] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
In Europe, Portugal has been identified as the country with the most rapid evolution of paediatric palliative care provision, which is a highly complex experience for families. The present descriptive-exploratory study seeks to contribute to the understanding of the psychological experience of life-limiting conditions in parent caregivers. A total of 14 families completed a sociodemographic and clinical data sheet and answered a structured online interview based on an incomplete narrative resulting from the Unwanted Guest Metaphor. A thematic analysis of the various narratives was performed through an inductive-deductive process. The results provide a holistic view of 10 essential dimensions in the parental psychological experience and contribute to the design of intervention methodologies in an eco-systemic approach. The importance of clear communication with health professionals, an awareness of the unpredictability of the disease, the desire for more self-care, the difficulty in understanding their children's needs and the threat implicit in everyday life are some of the main findings. This research emphasizes the importance of having opportunities of emotional expression and psychoeducation about anxiety' management, enhancing the perception of positive characteristics in children with palliative needs and creating time for the couple. The study has some limitations, such as the small sample size, and suggests that further research should explore the father's experience.
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6
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Toledano-Toledano F, Jiménez S, Moral de la Rubia J, Merino-Soto C, Rivera-Rivera L. Positive Mental Health Scale (PMHS) in Parents of Children with Cancer: A Psychometric Evaluation Using Item Response Theory. Cancers (Basel) 2023; 15:2744. [PMID: 37345081 DOI: 10.3390/cancers15102744] [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: 04/02/2023] [Revised: 05/03/2023] [Accepted: 05/11/2023] [Indexed: 06/23/2023] Open
Abstract
Mental health is currently a public health issue worldwide. However, evidence is lacking regarding the validity of the instruments used to measure and assess positive mental health in specific populations. The objective of this study was to evaluate the psychometric properties of the PMHS using IRT. A cross-sectional retrospective study with non-probabilistic convenience sampling was conducted with 623 parents of children undergoing cancer treatment at the National Institute of Health in Mexico City. The participants responded to a battery of tests, including a sociodemographic questionnaire, the PMHS, Measurement Scale of Resilience, Beck Depression Inventory, Inventory of Quality of Life, Beck Anxiety Inventory, an interview regarding caregiver burden, and the World Health Organization Well-Being Index. PMHS responses were analyzed using Samejima's graded response model. The PMHS findings indicated that the IRT-based graded response model validated the single latent trait model. The scale scores were independent of depression, anxiety, well-being, caregiver burden, quality of life, and resilience. The PMHS scores were associated with low subjective well-being. The PMHS findings reveal that from an IRT-based perspective, this scale is unidimensional and is a valid, reliable, and culturally relevant instrument for assessing positive mental health in parents of children with chronic diseases.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
| | - Said Jiménez
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, Monterrey 64460, Mexico
| | - Cesar Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, 34, Lima 15011, Peru
| | - Leonor Rivera-Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Av. Universidad No. 655 Col. Santa María Ahuacatitlán, Cuernavaca 62100, Mexico
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7
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León-Hernández R, Rodríguez-Pérez AC, Pérez-González YM, de Córdova MIP, de León-Escobedo R, Gómez-Gutiérrez T, Toledano-Toledano F. Psychosocial Factors Associated with Self-Management in Patients with Diabetes. Healthcare (Basel) 2023; 11:healthcare11091284. [PMID: 37174826 PMCID: PMC10178053 DOI: 10.3390/healthcare11091284] [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: 02/24/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/15/2023] Open
Abstract
Despite the significant advances in research on diabetes, relatively few researchers have examined the theoretical and empirical usefulness of explanatory models that contribute to self-management of the disease. In response to the theoretical and empirical approaches related to this topic, the objective of this research was to assess a hypothetical model to explain self-management behavior in patients with type II diabetes through structural equation modeling in a population of users of the services of the State Health Department of Tamaulipas, Mexico. The study used a cross-sectional and explanatory design. The sample was intentional. A total of 183 patients with a diabetes diagnosis completed a sociodemographic data questionnaire, the Partners in Health Scale, the Duke-UNC-11, the Family Apgar, the Self-Efficacy Scale, the Personal Health Questionnaire and the Physical Activity Scale. The results indicated that the hypothetical model was improved by excluding the exercise variable. The appropriate model was used to determine the effects of depression, social support, self-efficacy, family functioning, years of formal education and years with a diagnosis on self-management. The goodness-of-fit indices (GFIs) were good, i.e., χ2/gl = 0.89 (p = 0.529), root mean square error of approximation (RMSEA) = 0.000, and comparative fit index (CFI) = 1.000, with an acceptable degree of parsimony (PNFI = 0.409 and PGFI = 317). The model explained 33.6% of the variance. Therefore, this model represents an important advance in knowledge concerning self-management and provides empirical and theoretical evidence, particularly for the Mexican or Latino population.
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Affiliation(s)
- Rodrigo León-Hernández
- Consejo Nacional de Ciencia y Tecnología, Av. de los Insurgentes Sur 1582, Crédito Constructor, Benito Juárez, Mexico City 03940, Mexico
| | - Andrea C Rodríguez-Pérez
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Adolfo López Mateos S/N, Universidad, Tampico, Tamaulipas 89109, Mexico
| | - Yessica M Pérez-González
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Adolfo López Mateos S/N, Universidad, Tampico, Tamaulipas 89109, Mexico
| | - María I P de Córdova
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Adolfo López Mateos S/N, Universidad, Tampico, Tamaulipas 89109, Mexico
| | - Raúl de León-Escobedo
- Facultad de Medicina de Tampico, "Dr. Alberto Romo Caballero" Universidad Autónoma de Tamaulipas, Tamaulipas 89000, Mexico
| | - Tranquilina Gómez-Gutiérrez
- Facultad de Enfermería Tampico, Universidad Autónoma de Tamaulipas, Adolfo López Mateos S/N, Universidad, Tampico, Tamaulipas 89109, Mexico
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez Instituto Nacional de Salud, Dr. Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Unidad de Investigación Multidisciplinaria en Salud, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Calzada México-Xochimilco 289, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
- Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Periférico Sur 4860, Arenal de Guadalupe, Tlalpan, Mexico City 14389, Mexico
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8
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Mountcastle L, Zajdel M, Robinson T, Keller KR, Gelles S, Livinski AA, Kikani B, Lea DE, Koehly LM. The impact of caregiving for children with chronic conditions on the HPA axis: A scoping review. Front Neuroendocrinol 2023; 69:101062. [PMID: 36773674 PMCID: PMC10182255 DOI: 10.1016/j.yfrne.2023.101062] [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: 06/09/2022] [Revised: 01/12/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023]
Abstract
Caregiving has been robustly linked to caregiver health through the dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis in the context of caregiving for an adult with a chronic illness. However, little research examines the physiological impact of caregiving for a child with a chronic illness despite high burden and unique stressors. In this review, we explore the links of caregiving for a child with a congenital, chromosomal, or genetic disorder to the regulation or dysregulation of the HPA axis. A search was conducted in PubMed, Embase, and the Web of Science and 15 studies met inclusion criteria. Overall, there were inconsistent links of caregiving to HPA axis functioning, perhaps due to the heterogeneity across disease contexts, study designs, and biomarker measurement. Future research should standardize measurement and study designs, increase participant diversity, and examine moderators of the links of caregiving to the HPA axis.
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Affiliation(s)
- Lindsey Mountcastle
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Melissa Zajdel
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute.
| | - Taylor Robinson
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Krystyna R Keller
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Shani Gelles
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Alicia A Livinski
- National Institutes of Health Library, Office of Research Services, Office of the Director, National Institutes of Health, Bethesda, MD, USA
| | - Bijal Kikani
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Dawn E Lea
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
| | - Laura M Koehly
- Social Network Methods Section, Social and Behavioral Research Branch, National Human Genome Research Institute
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Merino-Soto C, Núñez Benítez MÁ, Domínguez-Guedea MT, Toledano-Toledano F, Moral de la Rubia J, Astudillo-García CI, Rivera-Rivera L, Leyva-López A, Angulo-Ramos M, Flores Laguna OA, Hernández-Salinas G, Rodríguez Castro JH, González Peña OI, Garduño Espinosa J. Medical outcomes study social support survey (MOS-SSS) in patients with chronic disease: A psychometric assessment. Front Psychiatry 2023; 13:1028342. [PMID: 36713918 PMCID: PMC9874003 DOI: 10.3389/fpsyt.2022.1028342] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
Purpose Currently, information on the psychometric properties of the Medical outcomes study-social support survey (MOS-SSS) for patients with chronic disease in primary health care, suggests problems in the dimensionality, specifically predominant unidimensionality in a multidimensional measure. The aim of this study was to determine the internal structure (dimensionality, measurement invariance and reliability) and association with other variables. Methods A total of 470 patients with chronic disease from a Family Medicine Unit at the Instituto Mexicano del Seguro Social, IMSS, with a mean age of 51.51 years were included. Participants responded to the Questionnaire of Sociodemographic Variables (Q-SV), SF-36 Health-Related Quality of Life Scale-version 1.1, and MOS-SSS. Results Non-parametric (Mokken scaling analysis) and parametric (confirmatory factor analysis) analyses indicated unidimensionality, and three-factor model was not representative. A new 8-item version (MOS-S) was developed, where measurement invariance, equivalence with the long version, reliability, and relationship with the SF-36 were satisfactory. Conclusion The MOS-SSS scale is unidimensional, and the shortened version yields valid and reliable scores for measuring social support in patients with chronic disease at the primary health care.
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Affiliation(s)
- Cesar Merino-Soto
- Instituto de Investigación de Psicología, Universidad de San Martín de Porres, Surquillo, Peru
| | | | | | - Filiberto Toledano-Toledano
- Hospital Infantil de México Federico Gómez, Unidad de Investigación en Medicina Basada en Evidencias, Mexico City, Mexico
- Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Unidad de Investigación Sociomédica, Mexico City, Mexico
- Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Dirección de Investigación y Diseminación del Conocimiento, Mexico City, Mexico
| | | | | | - Leonor Rivera-Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Ahidée Leyva-López
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública (INSP), Cuernavaca, Morelos, Mexico
| | - Marisol Angulo-Ramos
- Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Dirección de Investigación y Diseminación del Conocimiento, Mexico City, Mexico
| | - Omar Arodi Flores Laguna
- Facultad de Ciencias Empresariales y Jurídicas, Universidad de Montemorelos, Montemorelos, Mexico
| | - Gregorio Hernández-Salinas
- Tecnológico Nacional de México/Instituto Tecnológico Superior de Zongolica-Extensión Tezonapa, Heroica Veracruz, Mexico
| | - Jorge Homero Rodríguez Castro
- División de Estudios de Posgrado e Investigación, Tecnológico Nacional de Mexico/Instituto Tecnologico de Ciudad Victoria, Ciudad Victoria, Tamaulipas, Mexico
| | - Omar Israel González Peña
- Hospital Infantil de México Federico Gómez, Unidad de Investigación en Medicina Basada en Evidencias, Mexico City, Mexico
| | - Juan Garduño Espinosa
- Dirección de Investigación, Hospital Infantil de México Federico Gómez, Instituto Nacional de Salud, Mexico City, Mexico
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10
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Jiménez S, Moral de la Rubia J, Varela-Garay RM, Merino-Soto C, Toledano-Toledano F. Resilience measurement scale in family caregivers of children with cancer: Multidimensional item response theory modeling. Front Psychiatry 2022; 13:985456. [PMID: 36727086 PMCID: PMC9885114 DOI: 10.3389/fpsyt.2022.985456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Currently, information about the psychometric properties of the Resilience Measurement Scale (RESI-M) in family caregivers of children with cancer according to item response theory (IRT) is not available; this information could complement and confirm the findings available from classical test theory (CTT). The objective of this study was to test the five-factor structure of the RESI-M using a full information confirmatory multidimensional IRT graded response model and to estimate the multidimensional item-level parameters of discrimination (MDISC) and difficulty (MDIFF) from the RESI-M scale to investigate its construct validity and level of measurement error. METHODS An observational study was carried out, which included a sample of 633 primary caregivers of children with cancer, who were recruited through nonprobabilistic sampling. The caregivers responded to a battery of tests that included a sociodemographic variables questionnaire, the RESI-M, and measures of depression, quality of life, anxiety, and caregiver burden to explore convergent and divergent validity. RESULTS The main findings confirmed a five-factor structure of the RESI-M scale, with RMSEA = 0.078 (95% CI: 0.075, 0.080), TLI = 0.90, and CFI = 0.91. The estimation of the MDISC and MDIFF parameters indicated different values for each item, showing that all the items contribute differentially to the measurement of the dimensions of resilience. CONCLUSION That regardless of the measurement approach (IRT or CTT), the five-factor model of the RESI-M is valid at the theoretical, empirical, and methodological levels.
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Affiliation(s)
- Said Jiménez
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Mexico City, Mexico
| | | | - Rosa María Varela-Garay
- Departamento de Trabajo Social y Servicios Sociales, Facultad de Ciencias Sociales, Universidad Pablo de Olavide, Seville, Spain
| | - Cesar Merino-Soto
- Instituto de Investigación en Psicología, Universidad de San Martin de Porres, Lima, Peru
| | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, National Institute of Health, Mexico City, Mexico.,Unidad de Investigación Sociomédica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico.,Dirección de Investigación y Diseminación del Conocimiento, Instituto Nacional de Ciencias e Innovación para la Formación de Comunidad Científica, INDEHUS, Mexico City, Mexico
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11
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Moermans VR, Mengelers AM, Bleijlevens MH, Verbeek H, de Casterle BD, Milisen K, Capezuti E, Hamers JP. Caregiver decision-making concerning involuntary treatment in dementia care at home. Nurs Ethics 2021; 29:330-343. [PMID: 34872409 PMCID: PMC8958636 DOI: 10.1177/09697330211041742] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dementia care at home often involves decisions in which the caregiver must weigh safety concerns with respect for autonomy. These dilemmas can lead to situations where caregivers provide care against the will of persons living with dementia, referred to as involuntary treatment. To prevent this, insight is needed into how family caregivers of persons living with dementia deal with care situations that can lead to involuntary treatment. OBJECTIVE To identify and describe family caregivers' experiences regarding care decisions for situations that can lead to involuntary treatment use in persons living with dementia at home. RESEARCH DESIGN A qualitative descriptive interview design. Data were analysed using the Qualitative Analysis Guide of Leuven. PARTICIPANTS AND RESEARCH CONTEXT A total of 10 family caregivers providing care for 13 persons living with dementia participated in in-depth semi-structured interviews. Participants were recruited by registered nurses via purposive sampling. ETHICAL CONSIDERATION The study protocol was approved by the Ethics Committee of the University Hospitals Leuven and the Medical Ethical Test Committee Zuyderland. FINDINGS Family caregivers experience the decision-making process concerning care dilemmas that can lead to involuntary treatment as complicated, stressful and exhausting. Although they consider safety and autonomy as important values, they struggle with finding the right balance between them. Due to the progressive and unpredictable nature of dementia, they are constantly seeking solutions while they adapt to new situations. Family caregivers feel responsible and experience social pressure for the safety of persons living with dementia. They may be blamed if something adverse happens to the persons living with dementia, which increases an already stressful situation. Their experience is influenced by characteristics of the care triad (persons living with dementia, professional and family caregivers) such as practical and emotional support, knowledge, and previous experiences. DISCUSSION AND CONCLUSION To prevent involuntary treatment, professionals need to proactively inform family caregivers, and they need to support each other in dealing with complex care situations.
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Affiliation(s)
- Vincent Ra Moermans
- Maastricht University, The Netherlands; White Yellow Cross Limburg, Belgium; Living Lab in Ageing and Long-Term Care, the Netherlands
| | | | | | - Hilde Verbeek
- Maastricht University, The Netherlands; Living Lab in Ageing and Long-Term Care, The Netherlands
| | | | - Koen Milisen
- KU Leuven, Belgium; University Hospitals Leuven, Belgium
| | | | - Jan Ph Hamers
- Maastricht University, The Netherlands; Living Lab in Ageing and Long-Term Care, The Netherlands
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Chandran A, Sikka K, Thakar A, Lodha R, Irugu DVK, Kumar R, Sharma SC. The impact of pediatric tracheostomy on the quality of life of caregivers. Int J Pediatr Otorhinolaryngol 2021; 149:110854. [PMID: 34352673 DOI: 10.1016/j.ijporl.2021.110854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 07/01/2021] [Accepted: 07/22/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Pediatric tracheostomy is a challenge in otolaryngology practice and it is associated with greater morbidity and mortality than in adults; hence, constant vigilance by the designated family caregiver is critical. This study was designed to assess the impact of on quality of life of caregivers in a homecare setting as a result of the presence of child with a tracheostomy. METHODS This was a combined retrospective and prospective cohort study with caregivers of children younger than 16 years who had undergone a tracheostomy, had been discharged home with a tracheostomy tube and completed 6 months of domiciliary tracheostomy care. The consenting primary caregivers were assessed for their quality of life based on the PedsQL v 4.0 questionnaires across various domains. RESULTS We identified the primary caregivers of 85 children who had undergone a tracheostomy during the study period. The children's median age was 3.5 years (range, 9 months to 14 years). The mean caregiver health-related quality of life (HRQOL) score was 59.3, the mean family functioning score was 62.8, and the mean total family impact score was 54.7 with relative deficits seen in caregiver's social functioning (56.9) and emotional functioning (53.2). Good or average quality of physical and social function was seen among 74 % and 65 % of caregivers respectively while only 55 % were reported having good or average emotional function. Emotional disturbance, interfering with everyday family activities, and sleep disturbance were the major concerns among caregivers. CONCLUSION The biopsychosocial consequences of caring for a child with a tracheostomy are profound for the family, affecting the quality of life of caregivers and adding to the emotional and social burden of the child's family.
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Affiliation(s)
- Aswin Chandran
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kapil Sikka
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Alok Thakar
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Lodha
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - D V K Irugu
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Rakesh Kumar
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Suresh C Sharma
- Department of Otolaryngology, Head & Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
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13
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Farah BQ, do Prado WL, Malik N, Lofrano-Prado MC, de Melo PH, Botero JP, Cucato GG, de Almeida Correia M, Ritti-Dias RM. Barriers to physical activity during the COVID-19 pandemic in adults: a cross-sectional study. SPORT SCIENCES FOR HEALTH 2021; 17:441-447. [PMID: 33815618 PMCID: PMC7998080 DOI: 10.1007/s11332-020-00724-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 12/01/2020] [Indexed: 01/01/2023]
Abstract
Social isolation due to the coronavirus disease 2019 (COVID-19) pandemic has reduced physical activity levels in both men and women. The identification of barriers to physical activity may assist in developing strategies to increase levels of physical activity during this pandemic. The study aim was identify the barriers to regular participation in physical during the COVID-19 pandemic in Brazilian adults. This cross-sectional study included 1570 [56.6% women; aged: 39.1 (37.7–40.7) years old] in social isolation due COVID-19. Barriers to physical activity were obtained using the validated questionnaires. “Laziness and fatigue” (50.2%), “lack of motivation” (31.2%), “lack of appropriate facilities/equipment/space” (17.4%), and “lack of time” (13.0%) were the barriers most prevalent in the study. Lack of motivation (OR = 1.49; 95% CI = 1.19–1.86) and lack of appropriate facilities/equipment/space (OR = 2.11; 95% CI = 1.57–2.83) were most associated with impacting physical activity levels due to the COVID-19, independent of sex, age, education level, days of social isolation and status weight. In conclusion, personal barriers to physical activity are common between both sexes, with lack of motivation and lack of appropriate facilities/equipment/space most associated with a decreased level of physical activity due to the COVID-19 pandemic.
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Affiliation(s)
- Breno Quintella Farah
- Federal Rural University of Pernambuco, Rua Dom Manuel de Medeiros, s/n Dois Irmãos, Recife, PE 52171-900 Brazil
- Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Wagner Luiz do Prado
- Department of Kinesiology, California State University San Bernardino, San Bernardino, USA
| | - Neal Malik
- Department of Health Science and Human Ecology, California State University San Bernardino, San Bernardino, CA USA
| | | | - Paulo Henrique de Melo
- Graduate Program in Physical Education, Federal University of Pernambuco (UFPE), Recife, Brazil
| | - Joao Paulo Botero
- Human Movement Science and Rehabilitation Graduation Program, Sao Paulo Federal University, Santos, São Paulo Brazil
| | - Gabriel Grizzo Cucato
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, England, UK
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Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18020748. [PMID: 33477253 PMCID: PMC7830523 DOI: 10.3390/ijerph18020748] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/02/2020] [Accepted: 12/09/2020] [Indexed: 01/10/2023]
Abstract
Chronic diseases in childhood can affect the physical and mental health of patients and their families. The objective of this study was to identify the sociodemographic and psychosocial factors that predict resilience in family caregivers of children with cancer and to define whether there are differences in the levels of resilience derived from these sociodemographic variables. Three hundred and thirty family caregivers of children with cancer, with an average age of 32.6 years were interviewed. The caregivers responded to a battery of tests that included a questionnaire of sociodemographic variables, the Measuring Scale of Resilience, the Beck Depression Inventory, the Inventory of Quality of Life, the Beck Anxiety Inventory, an interview of caregiver burden and the World Health Organization Well-Being Index. The main findings indicate that family caregivers of children with cancer reported high levels of resilience, which were associated positively with quality of life, psychological well-being and years of study and associated negatively with depression, anxiety and caregiver burden. The variables that predicted resilience in families of children with cancer were quality of life, psychological well-being, depression and number of children. Family caregivers who were married and Catholic showed higher resilience scores. We conclude that being a caregiver in a family with children with cancer is associated with symptoms of anxiety and with depressive episodes. These issues can be overcome through family strength, well-being, quality of life and positive adaptation processes and mobilization of family resources.
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Toledano-Toledano F, Moral de la Rubia J, Nabors LA, Domínguez-Guedea MT, Salinas Escudero G, Rocha Pérez E, Luna D, Leyva López A. Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study. Healthcare (Basel) 2020; 8:healthcare8040456. [PMID: 33153086 PMCID: PMC7712866 DOI: 10.3390/healthcare8040456] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 10/25/2020] [Accepted: 10/28/2020] [Indexed: 12/16/2022] Open
Abstract
Quality of life (QOL) is a key aspect of the health care process for children with chronic diseases and their families. Although clinical evidence regarding the impact of chronic disease on children exists, few studies have evaluated the effects of the interaction between sociodemographic and psychosocial factors on the family caregiver's QOL, indicating a significant gap in the research literature. The present study aimed to identify the predictors of the QOL of parents of children with chronic diseases. Three parental sociodemographic predictors (age, schooling, and family income) and four psychosocial predictors (family functioning, social support, depression, and resilience) were examined. In this cross-sectional study, 416 parents of children with chronic diseases who were hospitalized at a National Institute of Health in Mexico City were interviewed. The participants completed a sociodemographic variables questionnaire (Q-SV) designed for research on family caregivers of children with chronic disease. The predicted variable was assessed through the World Health Organization Quality of Life Questionnaire. The four psychosocial predictors were assessed through the Family Functioning Scale, Social Support Networks Scale, Beck Depression Inventory, and Measurement Scale of Resilience. The regression model explained 42% of the variance in parents' QOL. The predictors with positive weights included age, schooling, monthly family income, family functioning, social support networks, and parental resilience. The predictors with negative weights included depression. These findings suggest that strong social relationships, a positive family environment, family cohesion, personal resilience, low levels of depression, and a family income twice the minimum wage are variables associated with better parental QOL.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Evidence-Based Medicine Research Unit, Hospital Infantil de Mexico Federico Gómez, National Institute of Health, Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico
- Correspondence: ; Tel.: +52-55-8009-4677
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Carlos Canseco, 110, Esq. Aguirre Pequeño, Col. Mitras Centro, Monterrey 64460, Mexico;
| | - Laura A. Nabors
- School of Human Services, College of Education, Criminal Justice, and Human Services, University of Cincinnati, Cincinnati, OH 45221-0068, USA;
| | - Miriam Teresa Domínguez-Guedea
- Department of Psychology and Communication Sciences, University of Sonora, Blvd. Luis Encinas y Rosales, Col. Centro S/N Hermosillo, Sonora 83000, Mexico;
| | - Guillermo Salinas Escudero
- Centro de Estudios Económicos y Sociales en Salud, Hospital Infantil de Mexico Federico Gómez, National Institute of Health, Márquez 162, Doctores, Cuauhtémoc, Mexico City 06720, Mexico;
| | - Eduardo Rocha Pérez
- Servicio Nacional de Sanidad, Inocuidad y Calidad Agroalimentaria (Senasica), Anillo Perif. 5010, Insurgentes Cuicuilco, Coyoacán, Mexico City 04530, Mexico;
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-8° Piso, esq. Eje 5 Sur (Eugenia), Vertiz Narvarte, Benito Juárez, Mexico City 03020, Mexico;
| | - Ahidée Leyva López
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca Morelos 62100, Mexico;
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The Social Support Networks Scale (SSNS) for Family Caregivers of Children with Cancer: A Psychometric Evaluation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217820. [PMID: 33114556 PMCID: PMC7663442 DOI: 10.3390/ijerph17217820] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/20/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
Currently, information about the psychometric properties of the Social Support Networks Scale (SSNS) for family caregivers of children with cancer is not yet available; therefore, there is no empirical evidence of its validity and reliability to support its use in this population. The aim of this study is to determine a factorial model of the SSNS, estimate its internal consistency reliability, describe its distribution, and check its concurrent validity. A convenience sample of 633 family caregivers of children with cancer hospitalized in a National Institute of Health in Mexico City was collected. The SSNS, a sociodemographic variables questionnaire, and three instruments that evaluated family functioning, quality of life, and resilience were applied. The five-factor model had a poor data fit and lacked discriminant validity. The sample was divided. In a subsample of 316 participants, exploratory factor analysis suggested a four-factor model. When testing the four-factor model through confirmatory factor analysis, religious support was independent of family support, friend support, and lack of support. In the other subsample of 317 participants, the one-factor model for religious support had a good fit, and the correlated three-factor model, with the remaining factors, showed an acceptable fit. Reliability ranged from acceptable (Guttman's λ2 = 0.72) to good (λ2 = 0.88). Socio-family support and its three factors were correlated with family functioning, resilience, and quality of life. Religious support was correlated with four factors of resilience and quality of life. A scale of socio-family support with three factors and an independent scale for religious support are defined from the SSNS, and they showed internal consistency and construct validity.
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17
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Validity and Reliability of the Beck Anxiety Inventory (BAI) for Family Caregivers of Children with Cancer. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217765. [PMID: 33114144 PMCID: PMC7672631 DOI: 10.3390/ijerph17217765] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 10/05/2020] [Accepted: 10/13/2020] [Indexed: 12/30/2022]
Abstract
Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer.
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Toledano-Toledano F, Luna D. The psychosocial profile of family caregivers of children with chronic diseases: a cross-sectional study. Biopsychosoc Med 2020; 14:29. [PMID: 33110443 PMCID: PMC7583305 DOI: 10.1186/s13030-020-00201-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 10/18/2020] [Indexed: 12/23/2022] Open
Abstract
Background A family caregiver is defined as a person who has a significant emotional bond with the patient; this caregiver is a family member who is a part of the patient’s family life cycle; offers emotional-expressive, instrumental, and tangible support; and provides assistance and comprehensive care during the chronic illness, acute illness, or disability of a child, adult, or elderly person. The objectives of this study were to identify the psychosocial profiles of family caregivers of children with chronic diseases and to establish the relationship between these profiles and sociodemographic variables. Methods A cross-sectional study was conducted involving 401 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to the Sociodemographic Variables Questionnaire (Q-SV) for research on family caregivers of children with chronic disease and a battery of 7 instruments that examined anxiety, caregiver burden, family support, depression, resilience, parental stress, and the World Health Organization Well-Being Index. Results A hierarchical cluster analysis and its confirmation through a nonhierarchical cluster analysis confirmed two profiles of caregivers of pediatric patients with chronic diseases. Profile 1, called Vulnerability of family caregivers, is characterized by high levels of anxiety, depression, parental stress and caregiver burden, accompanied by low levels of family support, resilience, and well-being. Profile 2, called Adversity of family caregivers, shows an inverse pattern, with high levels of family support, resilience, and well-being and low levels of anxiety, depression, parental stress and caregiver burden. The sociodemographic characteristics are similar for both profiles, with the exception of the caregiver’s family type. Profile 1 shows more single-parent caregivers, while profile 2 includes more caregivers with a nuclear family. However, the type of family did not reach significance for predicting the caregiver’s profile in a bivariate logistic regression model. Conclusions The psychosocial profile of family caregivers of children with chronic diseases can be structured according to their psychosocial characteristics. Although no causal factors were detected that define criteria for belonging to one or another profile, the characteristics identified for each indicate the need for specific and differentiated intervention strategies for families facing adversity, risk and vulnerability during a child’s disease.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Evidence-Based Medicine Research Unit, Hospital Infantil de México Federico Gómez, National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, 06720 México City, Mexico
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-8° Piso, esq. Eje 5 Sur (Eugenia). Vertiz Narvarte, 03020, Benito Juárez, Mexico City, Mexico
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Toledano-Toledano F, Moral de la Rubia J, McCubbin LD, Cauley B, Luna D. Brief version of the coping health inventory for parents (CHIP) among family caregivers of children with chronic diseases. Health Qual Life Outcomes 2020; 18:104. [PMID: 32307007 PMCID: PMC7168940 DOI: 10.1186/s12955-020-01357-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/08/2020] [Indexed: 01/10/2023] Open
Abstract
Background The Coping Health Inventory for Parents (CHIP) has demonstrated good psychometric properties in several language forms and has been used to assess the coping behaviors of families facing disease. However, the CHIP has not been validated in Mexico among families of children with chronic conditions, where it could be useful for research and intervention. The objectives of this instrumental study were to obtain a version of the CHIP for the Spanish language in Mexico, establish the factor structure of the Mexican version of the CHIP, probe its internal consistency reliability, and assess its concurrent construct validity. Methods A nonprobability sample of 405 family caregivers of children with chronic diseases responded to a battery of measurement instruments that included the CHIP, the Beck Anxiety Inventory, and the Beck Depression Inventory. The sample was randomly divided into two parts. In one subsample (190 participants), an exploratory factor analysis was performed using a principal component analysis and oblique rotation. In the second subsample (215 participants), a confirmatory factor analysis was performed using maximum likelihood estimation. Results The scale was reduced to 16 items (CHIP-16) with factorial loads greater than .50. The empirical criteria used to determine the number of factors converged on the following five factors: belief and trust (McDonald ω = .85), spouse/partner relationship (ω = .79), home care (ω = .77), family involvement (ω = .75), and security/stability (ω = .79). The overall internal consistency was good (ω = .88). The five-factor model showed acceptable fit indices and high parsimony. The mean CHIP-16 scores and the Spouse/partner relationship scores among the caregivers with anxiety were greater than those among the caregivers without anxiety. The mean home-care scores among the women were greater than those among men. Conclusions The 16-item version of the CHIP showed good internal consistency and construct validity; thus, the CHIP-16 is a useful instrument for measuring and assessing coping in family caregivers of children with chronic diseases.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Unidad de investigación en Medicina Basada en Evidencias del Hospital Infantil de México Federico Gómez National Institute of Health, Dr. Márquez 162, Doctores, Cuauhtémoc, 06720, México City, Mexico.
| | - José Moral de la Rubia
- Facultad de Psicología, Universidad Autónoma de Nuevo León, Dr. Carlos Canseco, 110, Esq. Dr. Aguirre Pequeño, Col. Mitras Centro, 64460, Monterrey, Mexico
| | - Laurie D McCubbin
- College of Education and Human Development, University of Louisville, 1905S1st St, Louisville, KY, 40208, USA
| | - Bridget Cauley
- College of Education and Human Development, University of Louisville, 1905S1st St, Louisville, KY, 40208, USA
| | - David Luna
- Comisión Nacional de Arbitraje Médico, Mitla No. 250-10° Floor, esq. Axis 5 South (Eugenia). Col. Narvarte, 03020, Benito Juárez, Mexico City, Mexico
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Toledano-Toledano F, Domínguez-Guedea MT. Psychosocial factors related with caregiver burden among families of children with chronic conditions. Biopsychosoc Med 2019; 13:6. [PMID: 30899323 PMCID: PMC6407238 DOI: 10.1186/s13030-019-0147-2] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The impact of looking after children who live with complex chronic conditions is a growing public health issue. However, it is unclear whether sociodemographic and psychosocial variables can be used to predict the burden on the caregiver and how the profiles of families of children with chronic diseases are defined and structured. The objective of this study was to identify multivariate sociodemographic and psychosocial variables as well as sociocultural and familial factors to analyze the caregiver burden of family caregivers of children with chronic diseases. METHODS A cross-sectional study was conducted involving 416 family caregivers of children with chronic diseases at the National Institute of Health in Mexico City. The participants responded to a questionnaire on sociodemographic variables and a battery of 7 instruments that examined caregiver burden, family support, parental stress, anxiety, support networks, family functioning, historic-psycho-socio-cultural premises and the World Health Organization Well-Being Index. RESULTS A multivariate analysis using hierarchical multiple regression models showed that the variables included in the psychosocial and sociodemographic profile as a whole explained 40% of the variance in caregiver burden, taking sociocultural historical premises, stressors and anxiety into account as positive individual predictors. Negative individual predictors for caregiver burden included upper secondary education, social support networks, family support, family functioning and well-being. The sociodemographic profiles of family caregivers were as follows: female (81.7%); mean age, 31.7 years (standard deviation [SD], 8 years); married (79.3%); nuclear family (60%); basic education (62.7%); unpaid work (66.3%); and a daily household income of approximately 4 USD (61.1%). CONCLUSIONS The caregiver burden of family caregivers of children with chronic diseases is defined and structured based on personal, family, and sociocultural factors. These features provide evidence to conduct research and implement intervention strategies with regard to families facing adversity, risk and vulnerability during a child's disease.
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Affiliation(s)
- Filiberto Toledano-Toledano
- Evidence-Based Medicine Research Unit, Children’s Hospital of Mexico Federico Gómez, National Institute of Health, Mexico. Dr. Márquez 162, Col. Doctores, Del. Cuauhtémoc, C.P. 06720 Mexico City, Mexico
| | - Miriam Teresa Domínguez-Guedea
- Department of Psychology and Communication Sciences, University of Sonora. Blvd. Luis Encinas y Rosales, Col. Centro S/N, 83000 Hermosillo, Sonora Mexico
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