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Stanfors M, Jacobs J. Unpaid caregiving and stress among older working-age men and women in Sweden. SSM Popul Health 2023; 23:101458. [PMID: 37397832 PMCID: PMC10310475 DOI: 10.1016/j.ssmph.2023.101458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/20/2023] [Accepted: 06/21/2023] [Indexed: 07/04/2023] Open
Abstract
Many individuals are experiencing the potentially stressful combination of providing care while still employed. In this study, the association between unpaid caregiving to another adult and self-reported stress among men and women aged 45-74 is investigated, using nationally representative time use diary data for Sweden (2000-01 and 2010-11, N = 6689). Multivariate regression analyses established that women were overall more stressed than men with the largest gender stress gap observed among intensive caregivers, providing >60 min of daily care and employed caregivers. The association between unpaid caregiving, employment, and self-reported stress is gendered. Among men, there is no caregiver effect regarding stress, but for women there is a net effect of 6-9%. Combining employment and unpaid caregiving (especially if intensive) is stressful for women but not for men. There are two potential mechanisms for this: less time for leisure and sleep. Unpaid caregiving is positively associated with stress among women when seen in relation to the way caregivers trade off time, not least to aid their recovery. These findings provide a more nuanced understanding of the time trade-offs carers make and uncover gender differences in the association between caregiving and stress that add to an existing gender stress gap. Given that unpaid caregivers are an important source of long-term care services, policymakers should consider that caregiving may be stressful and that stress impacts are gendered when designing and evaluating policies for longer working lives.
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Affiliation(s)
- Maria Stanfors
- Centre for Economic Demography, Lund University, P O Box 7080, 220 07, Lund, Sweden
| | - Josephine Jacobs
- Health Economics Resource Center, Veterans Health Administration, Palo Alto, CA, USA
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Smith LM, Onwumere J, Craig T, Kuipers E. Role of poor sleep in determining distress in caregivers of individuals with early psychosis. Early Interv Psychiatry 2019; 13:613-618. [PMID: 29417730 DOI: 10.1111/eip.12538] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 10/18/2017] [Accepted: 12/17/2017] [Indexed: 01/04/2023]
Abstract
AIM Looking after someone in the early stages of psychosis can have a negative impact on caregivers, but there is little clarity about which interventions, if any, caregivers should be offered. This study investigated sleep disturbances in early psychosis caregivers and the relationship between their sleep quality and distress. METHOD In all, 79 caregivers of patients with a recent first episode of psychosis completed self-report measures including the Pittsburgh Sleep Quality Index (PSQI), the RAND 36-item Health Survey 1.0 (SF-36) and the Experiences of Caregiving Inventory (ECI). RESULTS All caregivers were living with their relatives with psychosis and had been providing support since the onset of illness (mean duration = 92.5 weeks, SD = 84.0); 60% (47/79) obtained a global PSQI score that exceeded the established cut-off score for clinically significant sleep problems (>5). Low "sleep duration" and "sleep disturbances" contributed the most to elevated PSQI scores, with 17.7% of participants reporting regular wakening at night due to "stress" or "worries." When predicting psychological distress (SF-36) from negative appraisals of caregiving (ECI) and poor sleep (PSQI), a significant unadjusted regression model was obtained, F(2,73) = 29.440, P = .000, R2 of .447. An estimation of the indirect effect of negative thoughts about caregiving on mental distress through poor sleep was also significant (ab = -.05, 95% CI [-.09, -.02], PM = .39). CONCLUSION Caregivers of people with psychosis may have significant problems with sleep, which relates to distress and negative appraisals about caregiving. Health services need to ask caregivers directly about such issues and consider offering brief interventions to improve sleep quality.
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Affiliation(s)
- Lindsay M Smith
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Juliana Onwumere
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK.,South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, BR3 3BX, UK
| | - Thomas Craig
- King's College London, Department of Health Services and Population Research, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
| | - Elizabeth Kuipers
- King's College London, Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London, SE5 8AF, UK
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Bishop MN, Gise JE, Donati MR, Shneider CE, Aylward BS, Cohen LL. Parenting Stress, Sleep, and Psychological Adjustment in Parents of Infants and Toddlers With Congenital Heart Disease. J Pediatr Psychol 2019; 44:980-987. [DOI: 10.1093/jpepsy/jsz026] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 03/29/2019] [Accepted: 04/02/2019] [Indexed: 02/06/2023] Open
Abstract
Abstract
Objective
Parents of children with chronic medical needs report increased parenting challenges, poor sleep, and maladjustment. The impact of parenting stress on both sleep and adjustment has yet to be evaluated for parents of infants and young children with congenital heart disease (CHD). We studied the relations among parenting stress, sleep, and adjustment in parents of infants and toddlers with CHD. We expected that sleep quality would mediate the relationship between parenting stress and adjustment.
Methods
Sixty-nine parents of infants and toddlers with CHD were evaluated on self-report measures of illness-related parenting stress (Pediatric Inventory for Parents), sleep (Pittsburgh Sleep Quality Index), and psychological adjustment (Brief Symptom Index-18).
Results
The parents of infants and toddlers with CHD reported elevated levels of parenting stress, sleep problems, and maladjustment. The positive relationship between parenting stress and parent maladjustment was mediated by sleep quality.
Conclusions
Findings suggest that parents of infants and toddlers with CHD report high parenting stress, poor sleep, and maladjustment. Analyses indicate the stress-adjustment relationship is mediated by quality of sleep. Given the multiple demands on parents of infants and children with CHD, it is important to attend to parents’ overall functioning and mental health. Our findings highlight targets for intervention to improve the well-being of parents of young children with CHD.
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Affiliation(s)
| | - Jensi E Gise
- Department of Psychology, Georgia State University
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Stacey AF, Gill TK, Price K, Taylor AW. Differences in risk factors and chronic conditions between informal (family) carers and non-carers using a population-based cross-sectional survey in South Australia. BMJ Open 2018; 8:e020173. [PMID: 30037861 PMCID: PMC6059288 DOI: 10.1136/bmjopen-2017-020173] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND There is growing discussion on the impact of informal caregiving on the health status and morbidity of family carers. Evidence suggests a proportion of carers may be at risk of poor health outcomes. However, there are limited population-based studies that provide representative data on specific risk factors among carers (eg, blood pressure, cholesterol, smoking status, activity and body mass index) and major chronic conditions (eg, asthma, diabetes and arthritis). This study aimed to redress that imbalance. METHOD Self-reported data were from the South Australian Monitoring and Surveillance System (SAMSS), a representative cross-sectional state-wide population-based survey of 600 randomly selected persons per month. SAMSS uses computer-assisted telephone interviewing (CATI) to monitor chronic health-related problems and risk factors and to assess health outcomes. In total, 2247 family carers were identified from 35 195 participants aged 16 years and older for the 5-year period from 2010 to 2015. Logistic regression analyses examined associations of being a carer with self-reported chronic diseases and health risk factors. In addition, the population attributable risk (PAR) of being a carer was examined for selected chronic conditions. RESULTS The prevalence of carers was 6.4%, and peak age group for carers was 50-59 years. Adjusted ORs for chronic conditions in carers were significant for all chronic conditions examined. Although there is a high prevalence of self-reported risk factors and chronic conditions among carers compared with non-carers at the population level, PAR findings suggest that caregiving is associated with a small to moderate increased risk of having these chronic conditions. CONCLUSIONS Monitoring of carer health and morbidity particularly 'at risk' individuals such as female carers with asthma or diabetes remains important and provides an ongoing baseline for future surveys. To achieve this, caregiver-based studies need to become part of mainstream biomedical research at both epidemiological and clinical levels.
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Affiliation(s)
- Anne F Stacey
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Tiffany K Gill
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Kay Price
- School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia
| | - Anne W Taylor
- Population Research & Outcome Studies, Discipline of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
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Stjernswärd S, Hansson L. Effectiveness and usability of a web-based mindfulness intervention for caregivers of people with mental or somatic illness. A randomized controlled trial. Internet Interv 2018; 12:46-56. [PMID: 30135768 PMCID: PMC6096325 DOI: 10.1016/j.invent.2018.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Revised: 03/16/2018] [Accepted: 03/16/2018] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sigrid Stjernswärd
- Lund University, Department of Health Sciences, Box 157, 221 50 Lund, Sweden
| | - Lars Hansson
- Lund University, Department of Health Sciences, Sweden
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Liu HY, Yang CT, Wang YN, Hsu WC, Huang TH, Lin YE, Liu CY, Shyu YIL. Balancing competing needs mediates the association of caregiving demand with caregiver role strain and depressive symptoms of dementia caregivers: A cross-sectional study. J Adv Nurs 2017; 73:2962-2972. [DOI: 10.1111/jan.13379] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Hsin-Yun Liu
- Healthy Aging Research Center; Chang Gung University; Taoyuan Taiwan
| | - Ching-Tzu Yang
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yu-Nu Wang
- Department of Nursing; Chang Gung University of Science and Technology; Taoyuan Taiwan
| | - Wen-Chuin Hsu
- Dementia Center; Department of Neurology; Chang Gung Memorial Hospital; Taoyuan Taiwan
- School of Medicine; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Tzu-Hsin Huang
- Department of Nursing; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Yueh-E Lin
- Department of Nursing; Chang Gung Memorial Hospital; Taoyuan Taiwan
| | - Chin-Yi Liu
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
| | - Yea-Ing L. Shyu
- School of Nursing; College of Medicine; Chang Gung University; Taoyuan Taiwan
- Traumatological Division; Department of Orthopedics; Chang Gung Memorial Hospital; Taoyuan Taiwan
- Department of Nursing; Kaohsiung Chang Gung Memorial Hospital; Kaohsiung Taiwan
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Singh P, Ghosh S, Nandi S. Subjective Burden and Depression in Mothers of Children with Autism Spectrum Disorder in India: Moderating Effect of Social Support. J Autism Dev Disord 2017; 47:3097-3111. [DOI: 10.1007/s10803-017-3233-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Stjernswärd S, Hansson L. User value and usability of a web-based mindfulness intervention for families living with mental health problems. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:700-709. [PMID: 27189237 DOI: 10.1111/hsc.12360] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/13/2016] [Indexed: 06/05/2023]
Abstract
Mental health problems affect the patients and their families, who may also need therapeutic interventions. Mindfulness interventions have shown beneficial health effects for clinical and healthy populations. A web-based mindfulness intervention was tailored to address families' needs of support and tested in a pilot intervention study. The aim of this study was to explore the participants' experiences of using an 8-week web-based mindfulness programme in terms of user value and usability. Qualitative semi-structured interviews were carried out over the phone (Spring 2015, Sweden) with 15 randomly selected participants after the 3-month follow-up as part of the pilot study. Data were also collected through usability surveys online post intervention and at the 3-month follow-up. Qualitative data were analysed with content analysis and quantitative data with descriptive statistics. The analysis of the interviews resulted in four categories describing the participants' experiences of the programme's usability and value: A valuable and flexible tool that requires time and discipline, New perspective and coping strategies for an enhanced well-being, I'm important too - my limits, my responsibility, and Taming the inner critic. The programme's usability was satisfactory and largely corroborated by the surveys. The programme was experienced as a valuable tool to cope with stress in both private and professional contexts, making it a viable option to support families living with mental health problems. Time for self-care, a widened perspective, a less judgmental and more accepting attitude, deterring automatic reactions and setting limits helped the participants to deal with their situation and health. The programme's ease and flexibility of use were major advantages, although the training requires discipline. Motivators and barriers to use were illuminated, which should be considered in the development of further online services and study designs.
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Affiliation(s)
| | - Lars Hansson
- Department of Health Sciences, Lund University, Lund, Sweden
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Stjernswärd S, Hansson L. Effectiveness and Usability of a Web-Based Mindfulness Intervention for Families Living with Mental Illness. Mindfulness (N Y) 2016; 8:751-764. [PMID: 28515801 PMCID: PMC5408047 DOI: 10.1007/s12671-016-0653-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Families living with mental illness express needs of support and experiences of burden that may affect their own health detrimentally and hence also their ability to support the patient. Mindfulness-based interventions have shown beneficial health effects in both clinical and healthy populations. The aim of the current study was to explore the effectiveness and usability of a web-based mindfulness program for families living with mental illness, which was first tested in a feasibility study. The study was designed as a randomized controlled trial with an experiment group and a wait-list control group with assessments on primary and secondary outcomes at baseline, post-intervention, and at a 3-month follow-up. Significant positive improvements in mindfulness and self-compassion, and significant decreases in perceived stress and in certain dimensions of caregiver burden were found, with good program usability. Easily accessible mindfulness-based interventions may be useful in addressing caregivers' needs of support and in preventing further ill health in caregivers. Further studies are needed, among others, to further customize interventions and to investigate the cost-effectiveness of such programs.
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Affiliation(s)
- Sigrid Stjernswärd
- Department of Health Sciences, Lund University, Box 157, 221 50 Lund, Sweden
| | - Lars Hansson
- Department of Health Sciences, Lund University, Box 157, 221 50 Lund, Sweden
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Anum J, Dasti R. Caregiver Burden, Spirituality, and Psychological Well-Being of Parents Having Children with Thalassemia. JOURNAL OF RELIGION AND HEALTH 2016; 55:941-955. [PMID: 26400043 DOI: 10.1007/s10943-015-0127-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The research determined the relationship of caregiving burden, spirituality and psychological well-being of parents of Pakistani thalassemic patients in a crosssectional research design. The sociodemographic form, Montgomery-Borgatta burden measure (Montgomery et al. in Who should care for the elderly? An east-west value divide. World Scientific, River Edge, pp 27-54, 2000), Multidimensional Measure of Islamic Spirituality (Dasti and Sitwat in J Muslim Ment Health 8(2):47-67, 2014. doi: 10.3998/jmmh.10381607.0008.204 ) and Ryff Scale of Psychological Well-being (Ryff in J Pers Soc Psychol 57(6):1069-1081, 1989. doi: 10.1037/0022-3514.57.6.1069 ) were administered on a sample of 80 parents (32 fathers and 48 mothers) recruited from different Thalassemic Centers of Lahore city, Pakistan. Data were analyzed through correlation and mediational analyses. Results indicated that the caregiver burden was negatively correlated with the psychological well-being and the domains of spirituality, while the psychological well-being and spirituality were positively correlated. We identified that the caregiver burden has direct effect on the psychological well-being of the parents and it influences the psychological well-being through the pathway of the two domains of spirituality, i.e., self-discipline and meanness-generosity. These results highlighted the role of spirituality upon the psychological well-being of caregivers, which could be utilized to prevent pathological influences (such as hard feelings, hopelessness, depressed mood, anxiety, and relationship problems) of caregiver burden and enhance psychological well-being through spiritual counseling. Caregivers can work on their well-being and burden by disciplining their lives and forgoing hard feelings toward others.
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Affiliation(s)
- Jawaria Anum
- Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan.
| | - Rabia Dasti
- Centre for Clinical Psychology, University of the Punjab, Lahore, Pakistan
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Stjernswärd S, Hansson L. Outcome of a web-based mindfulness intervention for families living with mental illness - A feasibility study. Inform Health Soc Care 2016; 42:97-108. [PMID: 27245198 DOI: 10.1080/17538157.2016.1177533] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Families living with a person with mental illness can experience distress requiring therapeutic interventions. Web-based mindfulness interventions have shown beneficial health outcomes for both clinical and healthy populations, and may help families cope and overcome barriers that can otherwise hinder a help-seeking process. AIMS To develop and assess outcomes of a web-based mindfulness intervention for families living with a person with mental illness. METHODS A pilot study investigating an 8-week web-based mindfulness intervention with a pre-post design and follow-up after 3 months, with mindfulness as the primary outcome and perceived stress, caregiver burden and self-compassion as secondary outcomes. The study included a sample of 97 persons approached by advertisement in newspapers, newsletters, and online. RESULTS The study showed significant improvements in levels of mindfulness post-intervention and at follow-up as well as significant improvements in levels of perceived stress, caregiver burden, and self-compassion both post-intervention and at follow-up. DISCUSSION Acceptability and feasibility of the intervention were high, outcomes were relevant, and the intervention showed positive and significant results supporting the hypothesis that the intervention may help families cope with a stressful situation. CONCLUSION Further randomized controlled studies of the intervention are needed to investigate the intervention's effectiveness, including dose-effect studies.
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Affiliation(s)
| | - Lars Hansson
- a Lund University , Department of Health Sciences , Lund , Sweden
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Walker ER, Barmon C, McGee RE, Engelhard G, Sterk CE, DiIorio C, Thompson NJ. A dyadic model of living with epilepsy based on the perspectives of adults with epilepsy and their support persons. Epilepsy Behav 2015; 53:1-9. [PMID: 26515151 PMCID: PMC4674340 DOI: 10.1016/j.yebeh.2015.09.023] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/25/2015] [Accepted: 09/12/2015] [Indexed: 11/30/2022]
Abstract
Epilepsy is a chronic condition that significantly affects the lives of individuals with epilepsy and their support persons, though few studies have examined the experiences of both. To examine these experiences and explore the interpersonal relationships between dyad members, we conducted in-depth interviews with 22 persons with epilepsy and 16 support persons. Data analysis was guided by a grounded theory perspective. We developed a model that shows how epilepsy impacts the lives of both persons with epilepsy and their support persons and how the experiences of persons with epilepsy and supporters influence one another. The core model elements were seizure and treatment factors, relationship characteristics, self-management, seizure control, support provided, illness intrusiveness, and quality of life. Persons with epilepsy moved through the model in five trajectories depending on seizure control, relationship type, and gender. Support providers followed four trajectories based on seizure control, perception of burden, and support for themselves. Persons with epilepsy and their primary support providers have varied experiences in how epilepsy affects their lives. This model could serve as a basis for future research and intervention efforts focused on ways to reduce illness intrusiveness and improve quality of life for persons with epilepsy and their supporters.
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Affiliation(s)
| | | | - Robin E. McGee
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - George Engelhard
- Division of Educational Studies, Emory University; Present address: Department of Educational Psychology, University of Georgia
| | - Claire E. Sterk
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - Colleen DiIorio
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
| | - Nancy J. Thompson
- Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Emory University
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de Oliveira GR, Neto JF, de Camargo SM, Lucchetti ALG, Espinha DCM, Lucchetti G. Caregiving across the lifespan: comparing caregiver burden, mental health, and quality of life. Psychogeriatrics 2015; 15:123-132. [PMID: 25521215 DOI: 10.1111/psyg.12087] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Revised: 09/02/2014] [Accepted: 09/11/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Care can be considered a lifelong process, but caring for a child is different from caring for an older adult. The present study aims to compare the caregiving process from infancy through old age by evaluating differences in caregiver burden, mental health, and quality of life and to describe the factors that could impact these outcomes. METHODS To compare different groups of caregivers, we included 300 caregivers recruited from admissions to a tertiary acute hospital: 100 caregivers of children, 100 caregivers of adults, and 100 caregivers of older adults. A self-administered questionnaire was used that covered the following: sociodemographics, depression (Beck Depression Inventory), anxiety (Beck Anxiety Inventory), quality of life (Short Form Health Survey (SF-36)), religiosity (Duke Religion Index) and caregiver burden (Zarit Caregiver Burden Interview). RESULTS A comparison between groups was performed (through χ2 and anova), and a linear regression analysis was used to assess the related factors. We found that children's caregivers had more depressive symptoms (higher Beck Depression Inventory scores), better physical health (SF-36: physical functioning and SF-36: Physical Component Summary), and lower pain (SF-36: bodily pain) than other caregivers. We found that caregivers of adults had better mental health (SF-36: mental health and SF-36: Mental Component Summary) than other caregivers and that caregivers of older adult had a higher caregiver burden (Zarit Caregiver Burden Interview scores) than other caregivers. After we controlled for baseline characteristics, only depressive symptoms and caregiver burden remained statistically significant. CONCLUSION In conclusion, there are important differences between caregiving across the lifespan. Caregiving for children was associated with more depressive symptoms, and caregiving for older adults was associated with higher caregiver burden. Further studies are needed to replicate these findings in other settings.
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Wood AW, Gonzalez J, Barden SM. Mindful caring: using mindfulness-based cognitive therapy with caregivers of cancer survivors. J Psychosoc Oncol 2015; 33:66-84. [PMID: 25397963 DOI: 10.1080/07347332.2014.977418] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Caregivers of cancer survivors face many burdens that often require treatment by mental health professionals. One intervention, mindfulness-based cognitive therapy, aims to help individuals change the ways in which they relate to their thoughts rather than changing their thoughts. In this manuscript, we discuss the use and adaption of mindfulness-based cognitive therapy with caregivers of cancer survivors as a way to decrease caregiver burden and increase caregiver quality of life. A session-by-session breakdown of how to tailor mindfulness-based cognitive therapy to caregivers of cancer survivors is provided.
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Affiliation(s)
- Andrew W Wood
- a Department of Child , Family, and Community Sciences, University of Central Florida , Orlando , FL , USA
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Gallagher S, Howard S, Heffernan M. Differential hemodynamic effects during the provision of active and passive support in the laboratory. Psychol Health 2015; 30:1088-102. [DOI: 10.1080/08870446.2015.1024246] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Tuithof M, ten Have M, van Dorsselaer S, de Graaf R. Emotional disorders among informal caregivers in the general population: target groups for prevention. BMC Psychiatry 2015; 15:23. [PMID: 25884352 PMCID: PMC4337323 DOI: 10.1186/s12888-015-0406-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/03/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are indications that informal caregiving negatively impacts caregivers' mental health, but this was hardly examined using diagnoses of mental disorders and most studies used convenience samples without including non-caregivers as reference group. We examine whether informal caregivers more often have any emotional disorder, i.e. mood or anxiety disorder, than non-caregivers. Identify key risk indicators for any emotional disorder among informal caregivers in the general population. METHODS Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey (n = 5,303; aged 21-68). Respondents were defined as informal caregiver when they provided unpaid care in the 12 months preceding the second wave to a family member, partner or friend who needed care because of physical or mental problems, or ageing. Twelve-month DSM-IV diagnoses of emotional disorders were assessed using the Composite International Diagnostic Interview 3.0. Key risk indicators were identified using the following aspects: prevalence, odds ratio, attributable risk proportion, and number needed to treat. Sociodemographic, caregiving-related and other characteristics were considered as risk indicators. RESULTS In the past year, 31.1% of the respondents provided informal care, which ranged in time spent (8 or more hours/week: 32.1%) and duration (longer than 1 year: 48.7%). Informal caregiving was not associated with having any 12-month emotional disorder. Among caregivers, giving care to a first-degree relative, partner or close friend and giving emotional support increased the risk for any emotional disorder. Moreover, using all aspects, target groups were identified for prevention: caregivers without a job, living without a partner, and with a lack of social support. CONCLUSIONS Although informal caregivers do not have an increased risk of emotional disorders, key risk indicators were identified using four aspects. Especially informal caregivers with limited resources (unemployment, living without a partner, lack of social support) may benefit from targeted prevention whereas general prevention measures may be desirable for carers with a burdensome care situation (giving care to a close loved one or providing emotional support).
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
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Stansfeld S, Smuk M, Onwumere J, Clark C, Pike C, McManus S, Harris J, Bebbington P. Stressors and common mental disorder in informal carers--an analysis of the English Adult Psychiatric Morbidity Survey 2007. Soc Sci Med 2014; 120:190-8. [PMID: 25259657 PMCID: PMC4224501 DOI: 10.1016/j.socscimed.2014.09.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 08/18/2014] [Accepted: 09/14/2014] [Indexed: 11/19/2022]
Abstract
This study investigates potential explanations of the association between caring and common mental disorder, using the English Adult Psychiatric Morbidity Survey 2007. We examined whether carers are more exposed to other stressors additional to caring--such as domestic violence and debt--and if so whether this explains their elevated rates of mental disorder. We analysed differences between carers and non-carers in common mental disorders (CMD), suicidal thoughts, suicidal attempts, recent stressors, social support, and social participation. We used multivariate models to investigate whether differences between carers and non-carers in identifiable stressors and supports explained the association between caring and CMD, as measured by the revised Clinical Interview Schedule. The prevalence of CMD (OR=1.64 95% CI 1.37-1.97), suicidal thoughts in the last week (OR=2.71 95% CI 1.31-5.62) and fatigue (OR=1.33 95% CI 1.14-1.54) was increased in carers. However, caring remained independently associated with CMD (OR=1.58 1.30-1.91) after adjustment for other stressors and social support. Thus caring itself is associated with increased risk of CMD that is not explained by other identified social stressors. Carers should be recognized as being at increased risk of CMD independent of the other life stressors they have to deal with. Interventions aimed at a direct reduction of the stressfulness of caring are indicated. However, carers also reported higher rates of debt problems and domestic violence and perceived social support was slightly lower in carers than in non-carers. So carers are also more likely to experience stressors other than caring and it is likely that they will need support not only aimed at their caring role, but also at other aspects of their lives.
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Affiliation(s)
- Stephen Stansfeld
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK.
| | - Melanie Smuk
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Juliana Onwumere
- Department of Psychology, King's College London, Institute of Psychiatry, De Crespigny Park, Denmark Hill, London SE5 8AZ UK
| | - Charlotte Clark
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Cleo Pike
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts & The London School of Medicine & Dentistry, Queen Mary University of London, Old Anatomy Building, Charterhouse Square, London EC1M 6BQ, UK
| | - Sally McManus
- NatCen Social Research, 35 Northampton Square, London EC1V 0AX UK
| | - Jenny Harris
- Florence Nightingale School of Nursing and Midwifery, Kings College, London, UK
| | - Paul Bebbington
- UCL Mental Health Sciences Unit, 2nd Floor, Charles Bell House 67-73, Riding House Street, London W1W 7EJ, UK
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Smith L, Onwumere J, Craig T, McManus S, Bebbington P, Kuipers E. Mental and physical illness in caregivers: results from an English national survey sample. Br J Psychiatry 2014; 205:197-203. [PMID: 25061119 DOI: 10.1192/bjp.bp.112.125369] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Caregivers make a significant and growing contribution to the social and medical care of people with long-standing disorders. The effective provision of this care is dependent on their own continuing health. AIMS To investigate the relationship between weekly time spent caregiving and psychiatric and physical morbidity in a representative sample of the population of England. METHOD Primary outcome measures were obtained from the Adult Psychiatric Morbidity Survey 2007. Self-report measures of mental and physical health were used, along with total symptom scores for common mental disorder derived from the Clinical Interview Schedule-Revised. RESULTS In total, 25% (n = 1883) of the sample identified themselves as caregivers. They had poorer mental health and higher psychiatric symptom scores than non-caregivers. There was an observable decline in mental health above 10 h per week. A twofold increase in psychiatric symptom scores in the clinical range was recorded in those providing care for more than 20 h per week. In adjusted analyses, there was no excess of physical disorders in caregivers. CONCLUSIONS We found strong evidence that caregiving affects the mental health of caregivers. Distress frequently reaches clinical thresholds, particularly in those providing most care. Strategies for maintaining the mental health of caregivers are needed, particularly as demographic changes are set to increase involvement in caregiving roles.
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Affiliation(s)
- Lindsay Smith
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
| | - Juliana Onwumere
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
| | - Tom Craig
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
| | - Sally McManus
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul Bebbington
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
| | - Elizabeth Kuipers
- Lindsay Smith, MA, MSc, Juliana Onwumere, PhD, DClinPsy, Department of Psychology, Institute of Psychiatry, King's College London; Tom Craig, MBBS, PhD, FRCPsych, Department of Health Services and Population Research, Institute of Psychiatry, King's College London; Sally McManus, MSc, NatCen Social Research, London; Paul Bebbington, PhD, FRCP, FRCPsych, Unit of Mental Health Sciences, Faculty of Brain Sciences, University College London Medical School, London; Elizabeth Kuipers, PhD, FBPS, AcSS, Department of Psychology, Institute of Psychiatry, King's College London and NIHR Biomedical Research Unit at the South London and Maudsley NHS Foundation Trust, London, UK
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A mixed methods analysis of support for self-management behaviors: perspectives of people with epilepsy and their support providers. Epilepsy Behav 2014; 31:152-9. [PMID: 24413284 PMCID: PMC4152858 DOI: 10.1016/j.yebeh.2013.11.023] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Revised: 11/15/2013] [Accepted: 11/23/2013] [Indexed: 11/22/2022]
Abstract
Social support is associated with improved self-management for people with chronic conditions, such as epilepsy; however, little is known about the perceived ease or difficulty of receiving and providing support for epilepsy self-management. We examined patterns of epilepsy self-management support from the perspectives of both people with epilepsy and their support persons. Fifty-three people with epilepsy and 48 support persons completed a survey on epilepsy self-management support. Of these individuals, 22 people with epilepsy and 16 support persons completed an in-depth interview. Rasch measurement models were used to evaluate the degree of difficulty of receiving or providing support often for nine self-management tasks. We analyzed model-data fit, person and item location along the support latent variable and differential person and item functioning. Qualitative methods were used to provide context and insight into the quantitative results. The results demonstrated good model-data fit. Help with seizures was the easiest type of support to receive or provide more often, followed by rides to a doctor's appointments and help avoiding seizure triggers. The most difficult types of support to receive or provide more often were reminders, particularly for taking and refilling medications. While most participants' responses fit the model, responses of several individuals misfit the model. Person misfit generally occurred because the scale items did not adequately capture some individuals' behaviors. These results could be useful in designing interventions that use support as a means of improving self-management. Additionally, the results provide information to improve or expand current measures of support for epilepsy self-management to better assess the experiences of people with epilepsy and their support persons.
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Woodford J, Farrand P, Richards D, Llewellyn DJ. Psychological treatments for common mental health problems experienced by informal carers of adults with chronic physical health conditions (Protocol). Syst Rev 2013; 2:9. [PMID: 23369319 PMCID: PMC3599247 DOI: 10.1186/2046-4053-2-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 01/15/2013] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Improved life expectancy is resulting in increased outpatient treatment of people with chronic physical health conditions and reliance on the provision of informal care in the community. However, informal care is also associated with increased risk of experiencing common mental health difficulties such as depression and anxiety. Currently there is a lack of evidence-based treatments for such difficulties, resulting in poor health outcomes for both the informal carer and care recipient. METHODS/DESIGN Electronic databases will be systemically searched for randomised controlled trials examining the effectiveness of psychological interventions targeted at treating depression or anxiety experienced by informal carers of patients with chronic physical health conditions. Database searches will be supplemented by contact with experts, reference and citation checking and grey literature. Both published and unpublished research in English language will be reviewed with no limitations on year or source. Individual, group and patient-carer dyad focused interventions will be eligible. Primary outcomes of interest will be validated self-report or clinician administered measures of depression or anxiety. If data allows a meta-analysis will examine: (1) the overall effectiveness of psychological interventions in relation to outcomes of depression or anxiety; (2) intervention components associated with effectiveness. DISCUSSION This review will provide evidence on the effectiveness of psychological interventions for depression and anxiety experienced by informal carers of patients with chronic physical health conditions. In addition, it will examine intervention components associated with effectiveness. Results will inform the design and development of a psychological intervention for carers of people with chronic physical health conditions experiencing depression and anxiety. PROSPERO registration number: CRD42012003114.
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Affiliation(s)
- Joanne Woodford
- Mood Disorders Centre, Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK.
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Estrada-Martínez LM, Caldwell CH, Bauermeister JA, Zimmerman MA. Stressors in multiple life-domains and the risk for externalizing and internalizing behaviors among African Americans during emerging adulthood. J Youth Adolesc 2012; 41:1600-12. [PMID: 22722890 PMCID: PMC3777545 DOI: 10.1007/s10964-012-9778-3] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 05/31/2012] [Indexed: 01/22/2023]
Abstract
Behavioral and mental health outcomes have been associated with experiencing high levels of stress. Yet, little is known about the link between the nature of stressors, their accumulation over time, and the risk for externalizing and internalizing outcomes. Compared to the general population, African Americans are exposed to a disproportionate number of stressors beginning earlier in life. Incorporating Agnew's General Strain Theory into the study of stress, this study examined whether different kinds of stressors are equally salient in the risk for violent behaviors and depressive symptoms among African Americans transitioning into young adulthood. It further examined the effects of the accumulation of stressors in different life domains and their effect on risks. This study utilized data from an African American subsample of an ongoing longitudinal study that followed 604 adolescents (53 % females) from 9th grade into adulthood. Multilevel growth curve models were used to examine how changes in stressors across multiple life domains related to violent behaviors and depressive symptoms. We found that continued exposure to perceived daily stress and racial discrimination stress increased the risk for violent behaviors during young adulthood, and exhibited a nonlinear relationship between the accumulation of stressors and risk for violence. Moreover, we found that exposure to perceived daily stress, financial stress, neighborhood stress, and racial discrimination stress increased the risk of depressive symptoms and led to a linear relationship between the accumulation of stressors and risk for depressive symptoms. Findings suggest identifiable stressors that can persist over time to influence risks at young adulthood.
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Affiliation(s)
- Lorena M. Estrada-Martínez
- George Warren Brown School of Social Work, Washington University in St. Louis, One Brookings Drive, Campus Box 1196, St. Louis, MO 63130, (o) 314-935-3518, (f) 314-935-8511
| | - Cleopatra H. Caldwell
- Health Behavior and Health Education, University of Michigan School of Public Health, 2846 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029, (o) 734-647-3176, (f) 734-763-7379
| | - José A. Bauermeister
- Health Behavior and Health Education, University of Michigan School of Public Health, 3822 SPH I, 1415 Washington Heights, Ann Arbor, MI 48109-2029, (o) 734-615-8414, (f) 734-763-7379
| | - Marc A. Zimmerman
- Health Behavior and Health Education, University of Michigan School of Public Health, 3790A SPH I, 1415 Washington Heights, An Arbor, MI 48109-2029, (o) 734-647-0224, (f) 734-763-7379
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Contador I, Fernández-Calvo B, Palenzuela DL, Miguéis S, Ramos F. Prediction of burden in family caregivers of patients with dementia: a perspective of optimism based on generalized expectancies of control. Aging Ment Health 2012; 16:675-82. [PMID: 22746193 DOI: 10.1080/13607863.2012.684666] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The aim of this study was to investigate the predictors of burden for informal caregivers of patients with dementia. Based on a multidimensional approach of the optimism model proposed by Palenzuela, we assessed the moderating role of generalized expectancies of control (GEC) between caregiver stress and burden. A total of 130 patients with dementia and their main family caregivers were assessed from different rural areas of the province of Salamanca (Spain). Patients with dementia underwent a protocol to assess dementia stage, cognitive-functional impairment and behavioural symptoms. Meanwhile, the 20-item Battery of Generalized Expectancies of Control Scales of Palenzuela was completed by the family caregivers. Clinical variables of patients with dementia (progression and behavioural disorders) and GEC (success, self-efficacy, contingency, helplessness and luck) were considered as potential predictors of burden in the hierarchical regression analysis. The Zarit Burden Interview (ZBI) Scale was used as an outcome measure. The results indicated that the clinical variables could not predict burden in caregivers significantly; however, beliefs in personal abilities (self-efficacy) and internal locus of control (contingency) explained up to 32% of the variance in the ZBI scores. Family caregivers with high expectancies of self-efficacy and contingency are less vulnerable to stress. This research supports a base for interventions with informal caregivers and further study.
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Affiliation(s)
- Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioural Science, University of Salamanca, Spain.
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An avalanche of ignoring--a qualitative study of health care avoidance in women with malignant breast cancer wounds. Cancer Nurs 2011; 34:277-85. [PMID: 21252644 DOI: 10.1097/ncc.0b013e3182025020] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A contributing factor to development of malignant wounds is patient-related delay caused by health care avoidance. OBJECTIVE The purpose of this study was to describe the experience of health care avoidance in women with advanced breast cancer who have developed malignant wounds. METHODS A qualitative study was conducted based on semistructured interviews. Seventeen women with advanced breast cancer (median age, 69 years; range, 47-90 years) who had avoided medical treatment despite development of malignant wounds participated. Systematic text-condensation analysis was used. RESULTS The women deliberately avoided health care for a median of 24 months (minimum, 3 months; maximum, 84 months). Despite being aware of the development of a malignant wound from a breast lump, the women avoided health care because of negative health care experiences and extremely burdening life situations. The women did not seek health care until their situations became unmanageable. The essence--"an avalanche of ignoring"--is pointing to the escalating, powerful development of destructive feelings behind health care avoidance. CONCLUSIONS Health care avoidance may be a way of coping both for women who are primary and/or bereaved caregivers. Oncologists and nurses may contribute to the prevention hereof by means of information about the early signs of cancer, benefits of early diagnosis and treatment, and by paying special attention to these women, who may be at high risk for avoidant behaviors. IMPLICATIONS FOR PRACTICE In a preventive perspective, it seems advantageous to bring into focus the health of primary and bereaved caregivers, thereby potentially reducing patient delay and ultimately improving survival.
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Little KG, Wilks SE. Psychometric evaluation of a proposed Alzheimer's aggression scale. Am J Alzheimers Dis Other Demen 2011; 26:373-80. [PMID: 21737406 PMCID: PMC10845433 DOI: 10.1177/1533317511414553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
The purpose of this study was to evaluate a popular measure of Alzheimer's disease (AD) memory and behavior problems and to determine whether its aggressive behavior items coalesced empirically as a subscale to form a psychometrically viable AD aggression measure for clinicians. Data from self-report questionnaires were examined from 419 informal AD caregivers in the southern United States. Principal axis factoring revealed a unidimensional solution with robust item loadings on the single factor. Three forms of reliability analysis indicated moderately strong internal consistency on this proposed measure. Evidence of convergent validity analysis was suggested via the measure's significant correlations to theoretically linked constructs. The proposed measure emerged as a reliable and valid tool for health care practitioners for the appraisal of problematic AD aggression behaviors from the caregiver perspective.
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Affiliation(s)
- Kristina G. Little
- LSU School of Social Work, Louisiana State University, Baton Rouge, LA, USA
| | - Scott E. Wilks
- LSU School of Social Work, Louisiana State University, Baton Rouge, LA, USA
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Abstract
OBJECTIVES To examine the effects of filial piety - the practice of filial respect of and care for parents - on depressive symptoms among adult children caregivers of elderly Arab parents in Israel, and to identify factors that may mediate the association. METHOD Cross-sectional data were collected in 2006-2007 by a structured interview from 250 randomly sampled Arab-Israeli adult children caregivers (response rate, 94%). Path analysis was used to examine the study objectives. RESULTS Filial piety was not directly related to depression, but rather worked indirectly through caregiving burden. Caregiver depression was predicted positively by caregiving burden, while burden was predicted negatively by filial piety. Sense of mastery emerged as a major (negative) predictor and as a mediator between caregiving burden and depressive symptoms. CONCLUSION The analysis showed that caregiving burden in this population of traditional caregivers was associated with depressive symptoms, while most other variables were mediated through caregiving burden, sense of mastery, or filial piety. Researchers and practitioners should be sensitive to issues of family care among such traditional populations in transition.
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Affiliation(s)
- Rabia Khalaila
- School of Nursing, Zefat Academic College, Zefat, Israel.
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Watt E, Murphy M, Pascoe E, Scanlon A, Gan S. An evaluation of a structured learning programme as a component of the clinical practicum in final year bachelor of nursing programme: a pre-post-test analysis. J Clin Nurs 2011; 20:2286-93. [DOI: 10.1111/j.1365-2702.2010.03621.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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