Study progress, recreational activities, and loneliness in young adult carers: a national student survey

The Effects of the Connecting all Generations Through the Gerontech (CARETech) Program on Motivating Young People to Enter the Elderly Care Sector

PURPOSE

This study aims to organize an intergenerational program to provide unemployed young people with operational skills related to gerontechnology and the experience required to deliver digital outreach rehabilitation services to community-dwelling older people.

METHODS

A quasi-experimental research design was adopted. The young participants received a 12-session training program on the management of common chronic diseases, communication with older people, the functions and use of interactive games, and techniques to teach and match interactive games with older people. The perception of elderly outcomes (i.e., knowledge and attitude toward elderly care, willingness to care for the elderly), personal outcomes (i.e., life satisfaction, self-efficacy), and desired vocational outcomes (i.e., hours worked in the nongovernmental organization's center, hours spent with older people) were evaluated preprogram and postprogram.

RESULTS

Fifty-one young people joined the program. A statistically significant improvement was seen from preprogram to postprogram in their willingness to care for the elderly (p = .016) and life satisfaction (p = .005), as well as in the number of hours that they spent in the community center volunteering or engaged in social services for older people.

DISCUSSION

The findings proved that the program could improve the willingness of young people to care for older people, as well as improve their own life satisfaction. Using gerontechnology can serve to bridge the intergenerational gap and bring benefits to both young adults and older people. It may provide policy makers with a way to address the manpower shortage in elderly care services and help frail older people to age in place.

Do Health and Well-Being Change Around the Transition to Informal Caring in Early Adulthood? A Longitudinal Comparison Between the United Kingdom and Germany

PURPOSE

Providing care in early adulthood may have long-term consequences, given the importance of this life stage for life-course transitions. This study aimed to analyze how the transition into caring during young adulthood (17-29 years old) influenced health and life satisfaction in the United Kingdom and Germany.

METHODS

Datasets were from 10 annual waves of the UK Household Longitudinal Study and the German Socioeconomic Panel between the years 2009-2018. We used propensity score matching to match young adult carers (YACs) to similar noncarers to address the endogeneity of unpaid care provision. Then we applied piecewise growth curves to observe changes in self-rated health (United Kingdom N = 2,851; Germany N = 454) and life satisfaction (United Kingdom N = 2,263; Germany N = 449) between YAC and noncarers before, during, and after the onset of care. We assessed carer status, weekly hours spent on care, and duration of care.

RESULTS

In the United Kingdom, life satisfaction decreased and the probability of reporting poor health increased after becoming a YAC, particularly for those who reported caring for more weekly hours. However, no such differences were found between YAC and noncarers in Germany.

DISCUSSION

The onset and intensity of caring responsibilities during early adulthood influenced health and life satisfaction in the United Kingdom but not in Germany. One possible interpretation for these differences may be attributed to the different welfare contexts in which YACs are providing informal care. Our results highlight the importance of identifying and supporting the needs of young adults who are providing informal care while making key life-course transitions.

Children as next of kin's experiences, practices, and voice in everyday life: a systematic review of studies with Norwegian data (2010-2022)

Aims: This systematic review aims to identify and describe how children of parents with mental illness, substance dependence, or severe physical illness/injury, experience and practise their everyday life. Methods: The review followed the four stepwise recommendations of Harden and colleagues when including quantitative and qualitative studies on peoples' experiences and views. In all, 23 studies with data from Norway (2010-2022) have been included. Brown and Clark's thematic analysis was applied. Results: Three themes were constructed from the reviewed articles: (a) Children practice their relational agency by actively doing practical tasks, occasionally jobs to maintain family economy, and organising fun activities with the ill parent. (b) Emotional ambivalence when their own needs were set aside in favour of the parents. They loved their parents but also felt guilt, anger, disappointment, shame, fear of inheriting the illness and longed for a 'normal' everyday life. (c) Supportive contextual factors were, for example, at least one significant adult recognising them, participating in leisure activities, socialising with friends, and talking with other peers who shared similar experiences as next of kin. Obstructive factors were lack of information and recognition as well as silence and lack of dialogue within the family and/or health professional. Conclusions: There is a strong need for more knowledge and competence on the situation and needs of these children when it comes to professionals, parents and the public. Public health initiatives are needed to honour their agency and recognise their contributions in present time to prevent psychosocial problems later in life.

The mental health impact of school bullying among young carers in Australia: a causal mediation analysis

Informal care can exert adverse effects on the mental health of young people. Bullying victimisation is an important determinant of mental disorders. Young carers are at elevated risk of bullying. We quantify the mental health effects of informal care among Australian adolescents and the extent to which these effects are transmitted through school bullying. We used data from the Longitudinal Study of Australian Children. Participants were classified as non-carers, light carers (caring for < 10 h/week) and moderate-to-heavy carers (caring for 10 + h/week). Mental health was measured using the Kessler Psychological Distress Scale (K10). Using a counterfactual approach to mediation analysis, total effects (TE) of informal care on mental health were decomposed into natural direct effects (NDE-mental health effects not transmitted through school bullying) and natural indirect effects (NIE-mental health effects transmitted through school bullying). The TE of informal caring was 0.71 (95%CI - 0.03, 1.49) for light carers and 1.72 (95%CI 0.45, 3.02) for moderate-to-heavy carers. While school bullying explained 27% of the TE among moderate-to-heavy carers (NIE: 0.46; 95%CI 0.12, 0.91) there was weak evidence of mediation for light carers. Our findings indicate that the mental health effects of moderate-to-heavy caregiving can be reduced by school bullying interventions.

Assessing health, psychological distress and financial well-being in informal young adult caregivers compared to matched young adult non-caregivers

Young adult caregivers (YACs) are faced with the atypical challenge of providing informal (i.e. not paid) care to a family member, while simultaneously at a critical developmental stage in which many major life decisions and milestones are taking place. Adding the challenge of caring for a family member during this already complex time period may have a detrimental impact on young adults' (YAs) own overall health and well-being. The aim of this study was to examine differences in overall health, psychological distress, and financial strain among a propensity matched sample of YACs compared to young adult non-caregivers (YANCs) from a nationally representative database and to examine differences in these outcomes by caregiving role (caring for a child vs. other family member). YAs (aged 18-39, N = 178) identifying as a caregiver (n = 74) were matched with YANCs (n = 74) on age, gender, and race. Results revealed that YACs exhibited higher psychological distress, lower overall health and more sleep disturbance and higher financial strain compared to YANCs. YAs caring for family members other than children also reported higher anxiety and fewer hours spent caregiving compared to YAs caring for a child. YACs appear to be at risk for impairments in health and well-being compared to their matched peers. Longitudinal research is needed to understand how caregiving during young adulthood impacts health and well-being across time.

Risk and protective factors associated with mental health status in an Italian sample of students during the fourth wave of COVID-19 pandemic

BACKGROUND

It is well known that the COVID-19 pandemic has caused a global health crisis, especially for young people. However, most studies were conducted during the first waves of the pandemic. Few Italian studies specifically attempted to broadly assess young people's mental health status during the fourth wave of the pandemic.

METHODS

This study aimed at evaluating the mental health status among a group of Italian adolescents and young adults during the fourth wave of the COVID-19 pandemic. 11,839 high school students and 15,000 university students (age range 14-25) were asked to complete a multidimensional online survey, of which 7,146 (26,6%) agreed to participate. The survey also included standardized measures for depression, anxiety, anger, somatic symptoms, resilience, loneliness and post-traumatic growth. Two separate clusters were identified through cluster analysis. Random forest, classification tree and logistic regressions analyses were applied to identify factors associated to a good or a poor level of mental health and, thus, to define students' mental health profiles.

RESULTS

Overall, the students in our sample showed high levels of psychopathology. The clustering methods performed identified two separate clusters reflecting groups of students with different psychological features, that we further defined as "poor mental health" and "good mental health". The random forest and the logistic regressions found that the most discriminating variables among those two groups were: UCLA Loneliness Scale score, self-harm behaviors, Connor-Davidson Resilience Scale-10 score, satisfaction with family relationships, Fear of COVID-19 Scale score, gender and binge eating behaviors. The classification tree analysis identified students' profiles, showing that, globally, poor mental health was defined by higher scores of loneliness and self-harm, followed by being of female gender, presenting binge eating behaviors and, finally, having unsatisfying family relationships.

CONCLUSIONS

The results of this study confirmed the major psychological distress caused by the COVID-19 pandemic in a large sample of Italian students, and provided further insights regarding those factors associated with a good or poor mental health status. Our findings suggest the importance of implementing programs targeting aspects that have been found to be associated to a good mental health.

Does It Matter Who You Provide Care for? Mental Health and Life Satisfaction in Young Adult Carers Associated with Type of Relationship and Illness Category-A National Student Survey

There is limited knowledge on how caring contexts impact young adults providing informal care for persons with chronic conditions. This study examines associations between outcomes in young adult carers (YACs) and type of relationship (e.g., close or distant family member, partner, or someone outside the family) and type of illness in the care-receiver (e.g., mental, physical illness/disability, or substance abuse). A total of 37,731 students (age 18-25, mean 22.3 years, 68% females) in higher education in Norway completed a national survey on care responsibilities, hours of daily caring, relationship and type of illness, mental health problems (Hopkins Symptoms Checklist-25) and life satisfaction (Satisfaction With Life Scale). More mental health problems and lower life satisfaction were found among YACs compared to students without care responsibilities. The poorest outcomes were reported by YACs caring for a partner, followed by YACs caring for a close relative. Hours spent on daily caring was highest when caring for a partner. Poorer outcomes were reported by YACs caring for someone affected by substance abuse, followed by mental health problems and physical illness/disability. At-risk groups among YACs should be acknowledged and offered support. Future studies are needed to investigate the potential mechanism for the associations between care context variables and YAC outcomes.

Caregiving Responsibilities and Mental Health Outcomes in Young Adult Carers during the COVID-19 Pandemic: A Longitudinal Study

This study investigated caregiving responsibilities and associated mental health outcomes in young adult carers during the COVID-19 pandemic and had three aims: (1) to investigate differences in caregiving responsibilities across two groups of young adult carers (parental illness context vs. ill non-parent family member context) relative to non-carers, (2) to identify COVID-19/lockdown correlates of caregiving responsibilities, and (3) to examine the longitudinal associations between caregiving responsibilities and mental health outcomes. Of the 1048 Italians aged 18-29 (Mage = 24.48, SDage = 2.80; 74.33% female) who consented to complete online surveys at Time 1, 813 reported no ill family member (non-carers). Young adult carers included 162 with an ill parent and 73 with an ill non-parent family member. The study included 3 time points: 740 participants completed Time 2 assessment (Mage = 24.35, SDage = 2.81; 76.76% female), while 279 completed Time 3 assessment (Mage = 24.78, SDage = 2.72; 79.93% female). Key variables measured were 13 COVID-19/lockdown factors at Times 1 and 2, caregiving responsibilities at Time 2, and mental health outcomes at Time 3 (fear of COVID-19, anxiety, depression, wellbeing). Two COVID-19/lockdown factors were significantly correlated with higher caregiving responsibilities: insufficient home space, and greater time spent working and learning from home. As predicted, young adult carers reported higher caregiving responsibilities than non-carers, and this effect was greater in young adults caring for an ill parent compared to young adults caring for an ill non-parent family member. As expected, irrespective of family health status, caregiving responsibilities were longitudinally related to poorer mental health outcomes, operationalised as higher fear of COVID-19, anxiety, and depression, and lower wellbeing. Elevated young adult caregiving is an emerging significant public health issue that should be addressed through a multipronged approach that includes education about young adult carer needs for personnel across all relevant sectors and flexible care plans for ill family members that include a 'whole family' biopsychosocial approach.

Are We All the Same When Faced with an Ill Relative? A Person-Oriented Approach to Caring Activities and Mental Health in Emerging Adult Students

Dealing with the illness/disability of a relative is part of everyday life for many students, who may have to take on caring responsibilities. Fulfilling a caring role during emerging adulthood has been associated with poorer mental health. This study adopts a person-oriented approach in exploring the caring experience in relation to mental health. The sample comprised 3273 students (M_age = 20.19 years, SD_age = 1.89; 80.35% female) who answered a series of questionnaires. A cluster analysis identified six patterns of caregiving activities in terms of their nature and extent: few caring activities; household chores; household and financial/practical help; emotional care; sibling care; and many caring activities with emotional and personal care. A series of analyses showed that caring activities differed according to age, gender, living arrangements, financial status, the ill/disabled relative being supported, and the relative’s type of illness/disability. A multivariate analysis of covariance showed that emerging adult students with patterns featuring household chores had better mental health than those with few caring activities. Overall, our findings indicate that having an ill/disabled relative can lead an individual to take on a wide range of caring responsibilities that may have varying consequences for emerging adult students’ mental health.