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Turner SG, Pillemer K, Demetres M, Heaney K, Joshi S, Luebke M, Messay G, Reid MC. Physical pain among family caregivers to older adults: A scoping review of the literature. J Am Geriatr Soc 2024. [PMID: 38895995 DOI: 10.1111/jgs.19037] [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: 10/12/2023] [Revised: 05/02/2024] [Accepted: 05/12/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND AND OBJECTIVES Scholarship on the health of family caregivers to older adults continues to expand. Although existing research suggests that many family caregivers experience pain, which impacts their ability to perform caregiving tasks and is associated with care recipients' unmet needs, the scope of research on family caregivers' pain remains poorly characterized. We conducted a scoping review of research on pain among family caregivers to older adults to characterize existing evidence and identify knowledge gaps. METHODS We searched multiple databases spanning from January 2012 to July 2023, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (e.g., study design/methodology, pain measurement, caregiver pain type, and major findings). RESULTS We identified 46 eligible studies conducted in the United States (n = 19) and internationally (n = 27). Studies often focused on caregivers for older adults with specific health conditions, such as cancer (n = 11), dementia (n = 8), or stroke (n = 3). The most commonly employed pain measure was a single-item dichotomous question about pain (n = 16), followed by a visual numeric or visual analog scale (n = 11). Nine studies (five randomized controlled trials) reported on five caregiver pain management interventions, including yoga/exercise programs and caregiver education programs. DISCUSSION Existing research on family caregivers' pain offers an important foundation. However, more robust research designs are necessary. We identify possibilities for future studies in addition to opportunities for systematic investigations to support the family caregivers being relied upon to care for the increasing number of older adults.
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Affiliation(s)
- Shelbie G Turner
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - Karl Pillemer
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- College of Human Ecology, Cornell University, Ithaca, New York, USA
| | - Michelle Demetres
- Samuel J. Wood Library and C.V. Starr Biomedical Information Center, Weill Cornell Medicine, New York, New York, USA
| | - Kathleen Heaney
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- Vagelos College of Physicians and Surgeons, Columbia University, New York, USA
| | - Sama Joshi
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
- School of Medicine, University of Maryland, Baltimore, Maryland, USA
| | - Matthew Luebke
- College of Human Ecology, Cornell University, Ithaca, New York, USA
- Hackensack Meridian School of Medicine, Hackensack, New Jersey, USA
| | - Gelila Messay
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
| | - M Carrington Reid
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
- Translational Research Institute on Pain in Later Life, Weill Cornell Medicine, New York, New York, USA
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Abdullahi A, Wong TW, Ng SS. Prevalence and risks factors of caregiving-related low back pain among caregivers of stroke survivors: a systematic review and meta-analysis. Eur J Phys Rehabil Med 2023; 59:682-688. [PMID: 37851375 PMCID: PMC10795072 DOI: 10.23736/s1973-9087.23.07970-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 09/08/2023] [Accepted: 10/06/2023] [Indexed: 10/19/2023]
Abstract
INTRODUCTION Stroke causes disability that makes its survivors depend on caregivers for help. The caregivers offer help during lifting and transferring patients from one place to another. However, such activities result in the caregivers sustaining musculoskeletal injuries such as the low back pain (LBP). The aim of this study was to carry out a systematic review and meta-analysis to determine the prevalence of LBP and its risk factors among these caregivers. EVIDENCE ACQUISITION PubMED, Embase, Web of Science (WoS) and CINAHL were searched until January 2023, and cross-sectional studies were included. Data on prevalence of LBP due to caregiving activities and participants' characteristics such as sex and nature of caregiving were extracted. EVIDENCE SYNTHESIS Risks of bias of the included studies were assessed using Agency for healthcare Research and Quality (AHRQ) tool. The data were analyzed using both narrative and quantitative syntheses. In the quantitative synthesis, random effect model meta-analysis of the prevalence and odd of developing LBP between men and women; and between partial and complete caregivers was used. Fives studies (N.=644) were included. The results showed that the prevalence of LBP was 53.9%, with 96% CI from 50.0% to 57.8%. In addition, there was no statistically significant difference in the risk of developing LBP between men and women (OR=1.58, 95% CI=0.27 to 9.27, P=0.61); and between partial and complete caregivers (OR=1.33, 95% CI=0.32 to 5.61, P=0.70). CONCLUSIONS About half of caregivers of stroke survivors may experience LBP. Therefore, this should be considered during rehabilitation.
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Affiliation(s)
- Auwal Abdullahi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Thomson W Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Shamay S Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China -
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Sahbaz T, Medin-Ceylan C. Stroke severity to determine musculoskeletal symptoms in family caregivers. Rev Lat Am Enfermagem 2023; 31:e4004. [PMID: 37820216 PMCID: PMC10561800 DOI: 10.1590/1518-8345.6725.4004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 07/12/2023] [Indexed: 10/13/2023] Open
Abstract
OBJECTIVE the objective of this study is to examine the relationship between the musculoskeletal problems experienced by the family members who care for stroke patients, physical health and disability levels. METHOD the subjects included in the study were patients and family caregivers admitted to the Kanuni Sultan Suleyman Training and Research Hospital Physical Medicine and Rehabilitation outpatient clinic with a stroke diagnosis between May 30 th, 2019, and May 30 th, 2021. The caregivers were assessed using the Extended Nordic Musculoskeletal Questionnaire. Validated scales were employed to evaluate stroke patients' physical health and disability level. RESULTS a total of 104 stroke patients and 104 caregivers who met our inclusion criteria took part in this study. Low back complaints in the last month were associated with the patients' Functional Ambulation Score (FAS), Functional Independence Measure (FIM), Stroke Impact Scale (SIS) and Brunnstrom scores. Neck pain was the second musculoskeletal complaint, but was not statistically associated with patient-related factors. Upper limb problems were associated with FAS, FIM, SIS, Brunnstrom and the Modified Ashworth Scale scores. CONCLUSION according to our findings, the low back is the body area most affected by musculoskeletal complaints in family caregivers of stroke patients, closely related to the patients' functional capacity and disability levels. CLINICAL TRIALS NUMBER NCT04901637 (1) Stroke survivors highly depend on informal caregivers for daily living. (2) Family caregivers are at an increased risk of experiencing musculoskeletal problems. (3) The caregivers' musculoskeletal symptoms are related to the level of the patient disability. (4) Preventive medicine should become a part of nursing education for family caregivers.
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Affiliation(s)
- Tugba Sahbaz
- Beykent University, Faculty of Medicine, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
| | - Cansın Medin-Ceylan
- University of Health Sciences, Istanbul Physical Therapy Rehabilitation Training and Research Hospital, Department of Physical Medicine and Rehabilitation, Istanbul, Turkey
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Abdullahi A, Aliyu K, Hassan AB, Sokunbi GO, Bello B, Saeys W, Truijen S. Prevalence of chronic non-specific low back pain among caregivers of stroke survivors in Kano, Nigeria and factors associated with it: A cross-sectional study. Front Neurol 2022; 13:900308. [PMID: 36277934 PMCID: PMC9581006 DOI: 10.3389/fneur.2022.900308] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 08/30/2022] [Indexed: 02/03/2023] Open
Abstract
Purpose Low back pain (LBP) may have a specific or non-specific cause such as abnormal posture or repetitive tasks. For instance, lifting and transferring patients during caregiving for stroke survivors may predispose the caregivers to LBP. Objectives The aim of this study is to determine the prevalence of chronic non-specific LBP and factors associated with it in caregivers of stroke survivors. Method The research design used is cross-sectional study design. Participants of the study were caregivers of stroke survivors in Kano, Nigeria who were at least 18 years old. They were included if they had at least one-month experience with caregiving for at least 1 h per day. Presence of LBP and level of disability were assessed using participants' self-report and Rolland Morris Low Back Pain Disability Questionnaire respectively. The data collected was analyzed using descriptive, Chi-square statistics and Binary Logistics Regression. Result Three hundred caregivers with mean age, 33.24 ± 10.32 years in which 207 and 93 were males and females respectively, participated in the study. The results showed that, there was a high prevalence (64.7%) of LBP among the caregivers. The prevalence was significantly associated with gender (p < 0.001), age (p = 0.029), occupation (p < 0.001) and duration of caregiving (p < 0.001) of the study participants. In addition, the result of the regression model showed that, being a female (p = 0.001), a civil servant (p = 0.031), a trader (p = 0.013), and a complete caregiver (0.001); and caregiving for a duration of 5 h or more per day (p = 0.024) are significant predictors of having LBP. Similarly, level of disability due to the presence of LBP among the study participants was significantly associated with gender (p < 0.001), occupation (p < 0.001), duration of caregiving (p = 0.025), and the nature of the caregiving (p < 0.001). Conclusion Informal caregiving for stroke survivors may result in developing chronic non-specific LBP, especially among females, Civil servants, traders, complete caregivers and those with long duration of caregiving. This can add an additional burden on the family in terms of cost of care, result in reduced quality of caregiving and cause psychological stress. Thus, it is important the health of the caregivers of stroke survivors is considered during stroke rehabilitation.
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Affiliation(s)
- Auwal Abdullahi
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
- *Correspondence: Auwal Abdullahi
| | - Kamilu Aliyu
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
| | - Auwal Bello Hassan
- Department of Medical Rehabilitation (Physiotherapy), College of Medical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | | | - Bashir Bello
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
| | - Wim Saeys
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
| | - Steven Truijen
- Department of Rehabilitation Sciences and Physiotherapy, University of Antwerp, Antwerp, Belgium
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Gomes NP, Pedreira LC, Nunes SFL, Alvarez AM, Siewert JS, Oliveira LMSD. Musculoskeletal disorders of older adults: an integrative literature review. Rev Bras Enferm 2021; 74:e20200626. [PMID: 34037194 DOI: 10.1590/0034-7167-2020-0626] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/06/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze in available scientific literature what problems are caused to the musculoskeletal system of caregivers of older adults in the home environment. METHODS an integrative literature review indexed in the PubMed, CINAHL, Web of Science, SCOPUS, BDENF, LILACS and SciELO databases. RESULTS the sample totaled 17 studies that showed three thematic categories: Care overload for caregivers' health; Caregivers' physical illness; Caregiver self-neglect. CONCLUSION the evidence identified health problems for caregivers of older adults, regarding the musculoskeletal system, demonstrating the importance of considering intervention strategies that provide guidelines for self-care guidelines, in order to prevent musculoskeletal complications resulting from older adults' care activities at home.
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Marima P, Gunduza R, Machando D, Dambi JM. Correlates of social support on report of probable common mental disorders in Zimbabwean informal caregivers of patients with stroke: a cross-sectional survey. BMC Res Notes 2019; 12:514. [PMID: 31420002 PMCID: PMC6697905 DOI: 10.1186/s13104-019-4551-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 08/10/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Stroke is a major global public health burden. Unfortunately, stroke invariably leads to functional limitations, consequently, most stroke survivors are hugely dependent on family members/informal caregivers in carrying out essential daily activities. The increased demands of caregiving negatively impact caregivers' mental health. Nevertheless, caregivers who receive an adequate amount of social support are likely to adjust better to the caregiving role. We sought to determine the impact of social support on the mental wellbeing of 71 caregivers of patients with stroke in Zimbabwe, a low-resourced country. RESULTS The mean caregiver age was 41.5 (SD 13.8) years. Patients had a mean age of 65.2 (SD 15.3) years with most being functionally dependent (93.2%). 45.1% of the caregivers showed excessive psychiatric morbidity. The mean Multidimensional Scale of Perceived Social Support (MSPSS) score was 44 (SD 9.4), denoting high levels of social support. Caregivers who received an adequate amount of social support were likely to report of lower psychiatric morbidity (Rho = - 0.285, p = 0.016). Furthermore, caregiver who were; poorer, were caring for more functionally-dependent patients, and did not receive additional assistance were likely to report of poor mental health functioning. There is therefore a strong need to implement context-specific caregivers wellness programs.
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Affiliation(s)
- Phillipa Marima
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
| | - Ropafadzo Gunduza
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- Ronelle Isaacs Physiotherapists, 91 Rhino Street, Windhoek, Namibia
| | - Debra Machando
- Department of Psychiatry, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- Department of Psychology, University of Cape Town, Rondebosch, Cape Town, 7701 South Africa
| | - Jermaine M. Dambi
- Department of Rehabilitation, University of Zimbabwe, College of Health Sciences, P.O Box A178, Avondale, Harare, Zimbabwe
- School of Health and Rehabilitation Sciences, Faculty of Health Sciences, University of Cape Town Observatory, Cape Town, 7700 South Africa
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Vincent-Onabajo G, Puto Gayus P, Masta MA, Ali MU, Gujba FK, Modu A, Hassan SU. Caregiving Appraisal by Family Caregivers of Stroke Survivors in Nigeria. J Caring Sci 2018; 7:183-188. [PMID: 30607358 PMCID: PMC6311622 DOI: 10.15171/jcs.2018.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2018] [Accepted: 10/22/2018] [Indexed: 11/11/2022] Open
Abstract
Introduction: Attending to caregiving experiences of family caregivers of stroke survivors is important in person-centered stroke rehabilitation. This study explored caregiving appraisals by family caregivers of stroke survivors in Nigeria. Methods: A cross-sectional survey of family caregivers' negative and positive appraisals of caregiving was conducted using the 24-item 4-domain revised Caregiving Appraisal Scale (rCAS). Mann Whitney U and Kruskal-Wallis tests were used to identify differences in caregiving appraisals based on specific caregiver and stroke survivor variables. Results: Seventy-three caregiver and care recipient dyads participated in the study. Mean age of the caregivers was 31.51 (9.82) years. From a score of 5, and higher scores depicting higher appraisal, mean (SD) score for caregiving satisfaction and caregiving mastery (positive appraisal domains) was 4.23 (0.97) and 4.04 (0.92) respectively while 2.29 (0.98) and 2.11 (0.93) were respectively recorded for caregiving burden and environmental impact (negative appraisal). Caregivers' gender, age, and employment status resulted in significantly different appraisals with female caregivers having higher caregiving mastery (U = 446, P<0.05), caregiving satisfaction (U = 384.5, P<0.01), and also caregiving burden (U = 382.5, P<0.01) compared to their male counterparts; while older (U = 330; P<0.05) and employed (U = 437.5, P<0.05) family caregivers reported higher caregiving satisfaction and burden respectively than younger and unemployed family caregivers. Conclusion: Given the comparatively higher positive caregiving appraisal, and the documented benefits of positive caregiving appraisal, efforts should be geared towards identifying effective means of reinforcing positive appraisal, and reducing negative stroke caregiving appraisal, especially for female, older and employed family caregivers.
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Affiliation(s)
- Grace Vincent-Onabajo
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Pwadi Puto Gayus
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Mamman Ali Masta
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Muhammad Usman Ali
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Fatima Kachalla Gujba
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Ali Modu
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Saleh Usman Hassan
- Department of Medical Rehabilitation (Physiotherapy), College of Medical
Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
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Prevalence of Balance Impairment Among Stroke Survivors Undergoing Neurorehabilitation in Nigeria. J Stroke Cerebrovasc Dis 2018; 27:3487-3492. [PMID: 30205998 DOI: 10.1016/j.jstrokecerebrovasdis.2018.08.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 08/08/2018] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Poststroke balance impairment adversely affects stroke outcomes and addressing the impairment is expected to constitute an important focus of neurorehabilitation. AIMS To examine the prevalence and factors associated with balance impairment after stroke. METHODS Ninety-five stroke survivors undergoing neurorehabilitation at 2 government hospitals in Northern Nigeria participated in this cross-sectional study. Berg Balance Scale (BBS) was used to assess the presence of balance impairment (BBS score of 0-20). Prevalence of balance impairment was presented as frequency and percentage while demographic and stroke-related determinants of balance impairments were identified using logistic regression analysis. RESULTS Thirty-five (36.8%) stroke survivors had balance impairment, and age, gender, and poststroke duration were statistically significant determinants. Stroke survivors aged less than 40 years (odds ratio [OR] = .14 [confidence interval [CI] = .20-.94]) and 40-59 years (OR = .23 [CI = .06-.81]) had a lower likelihood of having balance impairment compared to stroke survivors aged 60 years and above. Similarly, males had a lower likelihood of having balance impairment (OR = 1.60 [CI = .05-.55]) compared to females while those in the acute/subacute phase of stroke had a 7-fold likelihood of having balance impairment (OR = 7.74 [CI = 2.63-22.79]) compared to those with chronic stroke. CONCLUSIONS Poststroke balance impairment appears to be significantly influenced by stroke survivors' age, gender, and poststroke duration. Hence, these variables should be considered when planning rehabilitation strategies for improving balance after stroke.
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