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Yurddaş Duran İ, Keskin G. Evaluation of the coping attitudes of Alzheimer patients' relatives from the perspectives of depression, anxiety and guilt. Geriatr Nurs 2024; 59:77-85. [PMID: 38991298 DOI: 10.1016/j.gerinurse.2024.06.050] [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: 03/07/2024] [Revised: 06/12/2024] [Accepted: 06/27/2024] [Indexed: 07/13/2024]
Abstract
This study aims to assess coping attitudes in primary caregivers of individuals diagnosed with Alzheimer's disease residing in an institution, and to evaluate the association between coping attitudes and levels of guilt, depression, and anxiety among caregivers. The sample of this study consists of 150 individuals with relatives diagnosed with Alzheimer. The Beck Anxiety Inventory, the Coping Attitudes Scale, the Guilt Inventory, and the Beck Depression Inventory were used in the present study. It was determined that the participants' coping levels were below the average score and that they frequently used problem focus coping attitudes. A positive relationship was found between the emotion focused, nonfunctional coping levels of the participants and their continuous guilt, anxiety and depression levels. Depression and guilt has a strong effect on coping attitudes, while anxiety was determined to be a moderate predictive variable. Findings show that caregivers with depression, anxiety and continuous guilt use non-functional and emotional coping more frequently.
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Affiliation(s)
| | - Gülseren Keskin
- Ege University Atatürk Vocational School of Health Services, Izmir, Turkey.
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Lee YT, Yuan Q, Zhang Y, Samari E, Goveas R, Ng LL, Subramaniam M. Evaluating a mobile-based intervention to promote the mental health of informal dementia caregivers in Singapore: Study protocol for a pilot two-armed randomised controlled trial. PLoS One 2024; 19:e0305729. [PMID: 38913625 PMCID: PMC11195940 DOI: 10.1371/journal.pone.0305729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 06/03/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Informal caregivers of persons with dementia (PWD) often suffer adverse impacts on their mental health and require interventions for effective support. As they are often occupied with providing care, web-based interventions could be more convenient and efficient for them. However, there is currently a dearth of evidence-based mobile interventions to enhance the mental well-being of dementia caregivers locally, especially ones that are user-centered and culturally relevant. Hence, having designed an app based on feedback from local dementia caregivers, this study will evaluate the effectiveness of this mobile app in promoting the mental health of informal caregivers of PWD in Singapore. METHODS A pilot two-armed randomised controlled trial will be conducted on 60 informal caregivers of PWD recruited via convenience and snowball sampling. Thirty participants will be assigned to the intervention group, while another 30 will be in a waiting-list control group. Questionnaires will be administered at baseline and one month after, with the primary outcome being the difference in the change of depressive symptoms among the two groups. STATISTICAL ANALYSIS Primary analyses will follow the intention-to-treat principle and compare changes from baseline to the one-month follow-up time point relative to the control group. A repeated measures ANOVA will be conducted to examine differences between the groups over time. SIGNIFICANCE To our knowledge, this is the first study in Singapore that seeks to promote the mental health of informal dementia caregivers through a mobile-based intervention. The findings can inform the development and evaluation of future evidence-based digital interventions for local informal caregivers of PWD to address the gap in availability of such resources for them. TRIAL REGISTRATION ClinicalTrials.gov (NCT05551533). Registration date: September 22, 2022.
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Affiliation(s)
- Yun Ting Lee
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - YunJue Zhang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Ellaisha Samari
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
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Duodu PA, Okyere J, Simkhada B, Akrong R, Barker C, Gillibrand W, Simkhada P. Exploration of family caregivers' experiences on coping in dementia care in Ghana: a phenomenological study. BMC Psychol 2024; 12:361. [PMID: 38902797 PMCID: PMC11191216 DOI: 10.1186/s40359-024-01862-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 06/18/2024] [Indexed: 06/22/2024] Open
Abstract
BACKGROUND Dementia is an important public health and geriatric concern for sub-Saharan African countries, including Ghana. Evidence shows that persons living with dementia are often supported and cared for by family caregivers in the community. In the execution of these services to the persons living with dementia, family caregivers are overwhelmed and experience heightened stress that results in serious repercussions. Therefore, the aim of this study was to explore family caregivers' experiences on coping in dementia care in Ghana. METHODS Adopting a descriptive phenomenological design, individual face-to-face interviews were conducted among thirty unpaid family caregivers of persons living with dementia in Ghana. Semi-structured interview guides were used. The data analysis process followed Clarke and Braun's framework analysis. RESULTS Six themes were generated from the textual data. These themes were captioned as: (1) empathy and perspective-taking; (2) family support and cohesion; (3) coaxing and pampering of persons living with dementia; (4) humour and positive communication; (5) spiritual support; and (6) ethical/moral consideration in dementia caregiving. CONCLUSION We conclude that unpaid family caregivers of persons living with dementia in Ghana adopt varied strategies to cope with the strains of caregiving. Healthcare facilities that provide services to persons living with dementia could incorporate caregiver preparatory training or education for family caregivers. This training should focus on briefing family caregivers about the potential strains that they are likely to encounter. Also, the training could focus on equipping family caregivers with the knowledge and skills to effectively communicate and care for the persons living with dementia using person-centered approaches. Key stakeholders such as the Ghana Health Service and Alzheimer's Ghana must raise awareness about the dangers of caregivers' violation of the autonomy and freedom of persons living with dementia as they navigate through the challenges of caregiving. Lastly, faith-based institutions need to be considered as key stakeholders in dementia interventions since they could play a critical role.
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Grants
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield, United Kingdom
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Bibha Simkhada
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Ransford Akrong
- Educational Assessment and Research Center, Osu, Accra, Ghana
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Caroline Barker
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Warren Gillibrand
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
| | - Padam Simkhada
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, West Yorkshire, England, UK
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Rodrigues DF, Castanheira FSFM, de Carvalho ALRF, Pinto CMCB. Nursing interventions to empower the family caregiver of person with lower limb amputation: scoping review. Rev Bras Enferm 2024; 77:e20230264. [PMID: 38716909 PMCID: PMC11067936 DOI: 10.1590/0034-7167-2023-0264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/05/2023] [Indexed: 05/12/2024] Open
Abstract
OBJECTIVES to map nursing interventions that empower the Family caregiver of the person with lower limb amputation for is role. METHODS scoping review guided by Joanna Briggs Institute methodology conducted in different databases (including gray literature). RESULTS six studies published between 2009 and 2021 were included. Interventions of counselling and support for patients and family; peer support interventions performed by a certified pair; involvement of caregivers or family members in support groups; and key interventions for patient and family caregiver psychological balance. Two studies discussed the importance of caregiver and amputee training and development of coping skills. Another study recommended Interventions of informative support for caregivers regarding care for the amputee and adaptation to home. CONCLUSIONS results of this review allow the identification of recommendations (guidelines) for practice and recommendations/suggestions for interventions according with identified needs of family caregivers of patients with lower limb amputation.
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Affiliation(s)
- Diana Fonseca Rodrigues
- University of Porto, Institute of Biomedical Sciences Abel Salazar. Porto, Portugal
- Center for Health Technology and Services Research and Health Research Network. Porto, Portugal
- Nursing School of Porto. Porto, Portugal
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Ambrosca R, Bolgeo T, Zeffiro V, Alvaro R, Vellone E, Pucciarelli G. The Role of Spirituality in Stroke Survivors and Their Caregivers: A Systematic Review. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-024-02029-0. [PMID: 38564160 DOI: 10.1007/s10943-024-02029-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/03/2024] [Indexed: 04/04/2024]
Abstract
Although several studies have analyzed the effects of spirituality on stroke survivors' physical functioning and their caregiver's outcomes, no systematic review or meta-synthesis was found to identify the lived experiences of stroke survivors and caregivers regarding spirituality. For these reasons, this study aimed to analyze quantitively and qualitatively research relating to stroke survivors' and caregivers' experiences. The included studies were RCT studies, quasi-experimental studies, qualitative, descriptive, ethnographic, and phenomenological studies, and cross-sectional studies (n = 37), with a total of 6850 stroke survivors and 1953 caregivers enrolled. Spirituality appears to play an important role in improving the quality of life and decreasing anxiety and depression of both stroke survivors and their caregivers.
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Affiliation(s)
- Rossella Ambrosca
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Tatiana Bolgeo
- Department of Activities Research Innovation, "San Antonio e Biagio e Cesare Arrigo" Hospital, Alessandria, Italy
| | - Valentina Zeffiro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Rosaria Alvaro
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Ercole Vellone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Gianluca Pucciarelli
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
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Liu H, Liang Q, Yang Y, Liu M, Zheng B, Sun S. Impact of mechanical ventilation on clinical outcomes in ICU-admitted Alzheimer's disease patients: a retrospective cohort study. Front Public Health 2024; 12:1368508. [PMID: 38601491 PMCID: PMC11004329 DOI: 10.3389/fpubh.2024.1368508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/18/2024] [Indexed: 04/12/2024] Open
Abstract
Background Alzheimer's disease (AD) is increasingly recognized as a pressing global public health issue, demanding urgent development of scientific AD management strategies. In recent years, the proportion of AD patients in Intensive Care Units (ICU) has been on the rise. Simultaneously, the use of mechanical ventilation (MV) is becoming more prevalent among this specific patient group. Considering the pathophysiological characteristics of AD, the application of MV in AD patients may lead to different outcomes. However, due to insufficient research data, the significant impact of MV on the prognosis of AD patients in the ICU remains unclear. Therefore, we conducted this study to comprehensively evaluate the potential influence of MV on the survival rate of AD patients in the ICU. Methods We obtained data from the MIMIC-IV database for patients diagnosed with AD. Using propensity score matching (PSM), we paired patients who received MV treatment with those who did not receive treatment. Next, we conducted Cox regression analysis to evaluate the association between MV and in-hospital mortality, 7-day mortality, 28-day mortality, 90-day mortality, 4-year mortality, length of hospital stay, and ICU stay. Results The data analysis involved a cohort of 641 AD patients spanning from 2008 to 2019, inclusive. Following a 1:2 propensity score matching (PSM) procedure, 300 patients were successfully paired, comprising 123 individuals who underwent MV treatment and 177 who did not. MV demonstrated an association with an elevated risk of in-hospital mortality (HR 5.782; 95% CI 2.981-11.216; p < 0.001), 7-day mortality (HR 6.353; 95% CI 3.014-13.392; p < 0.001), 28-day mortality (HR 3.210; 95% CI 1.977-5.210; p < 0.001), 90-day mortality (HR 2.334; 95% CI 1.537-3.544; p < 0.001), and 4-year mortality (HR 1.861; 95% CI 1.370-2.527; p < 0.001). Furthermore, it was associated with a prolonged length of ICU stay [3.6(2.2,5.8) vs. 2.2(1.6,3.7); p = 0.001]. In the subgroup analysis, we further confirmed the robustness of the results obtained from the overall population. Additionally, we observed a significant interaction (p-interaction <0.05) between age, admission type, aspirin use, statin use, and the use of MV. Conclusion In patients with AD who are receiving treatment in the ICU, the use of MV has been linked to higher short-term, medium-term, and long-term mortality rates, as well as prolong ICU stays. Therefore, it is crucial to break away from conventional thinking and meticulously consider both the medical condition and personal preferences of these vulnerable patients. Personalized treatment decisions, comprehensive communication between healthcare providers and patients, formulation of comprehensive treatment plans, and a focus on collaboration between the ICU and community organizations become imperative.
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Affiliation(s)
- Han Liu
- Institute for Global Health, University College London, London, United Kingdom
| | - Qun Liang
- First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yang Yang
- First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Min Liu
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Boyang Zheng
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shilin Sun
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Heilongjiang University of Chinese Medicine, Harbin, China
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Hernandez Chilatra JA, Browning WR, Yildiz M, Sullivan TP, Pickering CE. Emotion Regulation, Coping Strategies, and Hazardous Drinking Among Family Caregivers of People With Alzheimer's Disease and Related Dementias. Res Gerontol Nurs 2024; 17:81-90. [PMID: 38507290 DOI: 10.3928/19404921-20240229-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
PURPOSE The current study investigated hazardous drinking and alcohol use disorders among 453 family caregivers of individuals living with Alzheimer's disease and related dementias (ADRD). METHOD We examined the prevalence of hazardous drinking and its relationship with emotion regulation and coping strategies (problem-solving, social support, and avoidance) using data from the first wave of a longitudinal study on daily ADRD caregiving experiences. A binary logistic regression model was performed to predict the relationship between potential risk factors and hazardous drinking. RESULTS Findings revealed that 18.1% of ADRD caregivers screened positive for hazardous drinking based on the Alcohol Use Disorders Identification Test-Consumption. Caregivers experiencing greater difficulties in emotion regulation and greater reliance on avoidance as a coping strategy were at higher risk of screening positive for hazardous drinking. CONCLUSION These findings stress the importance of targeted interventions to improve emotion regulation and reduce avoidance coping in ADRD caregivers, ultimately enhancing their well-being. [Research in Gerontological Nursing, 17(2), 81-90.].
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Ibrahim AM, Ibrahim MM, Zaghamir DEF. Burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. Palliat Support Care 2024; 22:182-189. [PMID: 37381712 DOI: 10.1017/s1478951523000573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Alzheimer's disease is a chronic neurodegenerative disorder that results in total cognitive impairment and functional decline. Family members are the most usual caregivers worldwide, resulting in an increasing total burden and a subsequent degradation of their quality of life. OBJECTIVES To evaluate the burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. METHODS A descriptive research design was used. The study was conducted at outpatient clinics of El-Abbasya Mental Hospital in Cairo, Egypt. This study included 550 informal caregivers of Alzheimer patients. Data were gathered through questionnaires using the Sociodemographic Profile of Family Caregivers, an adopted version of the Montgomery Borgatta Caregiver Burden scale, and Health-Related Quality of Life Scale. RESULTS Nearly three quarters (73.5%) of the informal caregivers were female. Additionally, the physical burden among the informal caregivers was the highest (21.58 ± 8.13), while the psychological burden was the lowest (7.48 ± 25.35). Besides, around one-third (30%) of the informal caregivers had a total poor quality of life. SIGNIFICANCE OF RESULTS Total burden among informal caregivers of Alzheimer patients was relatively high (64.71 ± 26.86). Moreover, less than one-tenth (8%) of the informal caregivers for Alzheimer's patients had a good quality of life, whereas more than half (62%) of them had an average quality of life. In the Egyptian context, ongoing health education initiatives for those who care for Alzheimer patients are essential, and additional research employing large study sample sizes in varied contexts is strongly advised.
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Affiliation(s)
- Ateya Megahed Ibrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Family and Community Health Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Mahmoud Metwally Ibrahim
- Al-Ghad International College for Applied Medical Sciences, Saudi Arabia
- Department of Pharmacology, Al-Azhar University, Damietta, Egypt
| | - Donia Elsaid Fathi Zaghamir
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Pediatric Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
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Li B, Jin H, Yan G, Zhang C, Chen S, Wang Y, Wang T, Wan Q, Wei Z, Sun Y. Mental states in caregivers toward people with Alzheimer's disease at different stages. Front Neurol 2024; 14:1327487. [PMID: 38274888 PMCID: PMC10808319 DOI: 10.3389/fneur.2023.1327487] [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: 10/25/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Introduction Caring for people with Alzheimer's disease (AD) is burdensome, especially when family members act as caregivers. This multicenter survey first aimed to investigate caregivers' mental states as well as its influencing factors in caring for people with different severities of AD in China. Methods People with AD and their caregivers from 30 provincial regions in mainland China were enrolled from October 2020 to December 2020 to be surveyed for caregivers' mental states and living conditions, as well as caregivers' attitudes toward treatment and caring. Logistic regression was used to explore the factors that influence the positive and negative states of caregivers who care for people with different stages of AD. Results A total of 1,966 valid questionnaires were analyzed (mild AD: 795, moderate AD: 521, severe AD: 650). A total of 73.6% of caregivers maintained normal states (mild group: 71.9%, moderate group: 73.9%, severe group: 75.2%; X2 = 2.023, p = 0.364), and the proportions of caregivers with positive and negative states were 26.3% (mild group: 38.4%, moderate group: 24.6%, severe group: 13.1%; X2 = 119.000, p < 0.001) and 36.5% (mild group: 25.2%, moderate group: 36.9%, severe group: 50.2%; X2 = 96.417, p < 0.001), respectively. The major factors that both influenced caregivers' positive and negative states were the severity of AD, perceived efficacy of treatment, safety issues after AD dementia diagnosis and perceived social support (p < 0.005), while neuropsychiatric symptoms causing stress in caregivers (p < 0.001) only affected the negative states of caregivers. The results of further analysis according to disease severity showed that safety issues after AD dementia diagnosis (p < 0.005) only made significant differences in the mild-to-moderate group. Conclusion To reduce negative states and promote positive states among caregivers, flexible and sensitive caregiving support could be built on caregivers' demands in caring for people with different stages of AD. The support of emotion, social functioning and nursing skills is one of the significant ways for health workers to enhance caregivers' competency.
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Affiliation(s)
- Bei Li
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Haiqiang Jin
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Guiying Yan
- Academy of Mathematics and Systems Science, Chinese Academy of Sciences, Beijing, China
- School of Mathematical Sciences, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Zhang
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Siwei Chen
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Yue Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Ting Wang
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
| | - Qiaoqin Wan
- Nursing School of Peking University, Beijing, China
| | - Zhimin Wei
- Health Service Department of the Guard Bureau of the Joint Staff Department, Beijing, China
| | - Yongan Sun
- Department of Neurology, Peking University First Hospital, Peking University, Beijing, China
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Houle M, Ducas J, Lardon A, Descarreaux M, Marchand AA, Abboud J. Headache-related clinical features in teleworkers and their association with coping strategies during the COVID-19 pandemic. Front Public Health 2023; 11:1303394. [PMID: 38213645 PMCID: PMC10782858 DOI: 10.3389/fpubh.2023.1303394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 12/01/2023] [Indexed: 01/13/2024] Open
Abstract
Objectives The objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic. Methods This cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity. Results Results showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (ps < 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (p = 0.006) while lower migraine intensity was associated with planning (p = 0.046) and the use of positive reframing (p = 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (ps < 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (ps < 0.030). All associations remained significant after adjusting for BMI as a covariate. Discussion/conclusion Teleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.
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Affiliation(s)
- Mariève Houle
- Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
| | - Julien Ducas
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Arnaud Lardon
- Institut Franco-Européen de Chiropraxie, Paris, France
| | - Martin Descarreaux
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Andrée-Anne Marchand
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Chiropractic, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Jacques Abboud
- Groupe de recherche sur les affections neuromusculosquelettiques (GRAN), Trois-Rivières, QC, Canada
- Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Goto Y, Morita K, Suematsu M, Imaizumi T, Suzuki Y. Caregiver Burdens, Health Risks, Coping and Interventions among Caregivers of Dementia Patients: A Review of the Literature. Intern Med 2023; 62:3277-3282. [PMID: 36858522 PMCID: PMC10713358 DOI: 10.2169/internalmedicine.0911-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 01/23/2023] [Indexed: 03/03/2023] Open
Abstract
Over 55 million people reportedly suffer from dementia worldwide. In Japan, it is estimated that 1 in 5 people over 65 years old will have dementia by 2025, of which more than 20% will live with symptoms that require home/nursing care. Given the lack of effective medical treatments for dementia, informal caregivers play essential roles in allowing dementia patients to live with dignity. Our review focusing on caregiver burden showed that this burden has not been sufficiently addressed, despite having negative effects on caregivers' health, employment, and finances. It is important to consider non-pharmacological interventions that contribute to effective coping strategies for mitigating the caregiver burden. Online communication tools may be a viable intervention measure to educate caregivers on the importance of sharing resilient coping strategies to reduce their stress so that they can continue to provide care for their loved ones.
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Affiliation(s)
- Yasuyuki Goto
- Department of Healthcare Administration, Nagoya University Graduate School of Medicine, Japan
| | | | - Mina Suematsu
- Education for Community-Oriented Medicine, Nagoya University Graduate School of Medicine, Japan
| | | | - Yusuke Suzuki
- Centre for Community Liason & Patient Consultations, Nagoya University Hospital, Japan
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12
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Steinsheim G, Malmedal W, Follestad T, Olsen B, Saga S. Factors associated with subjective burden among informal caregivers of home-dwelling people with dementia: a cross-sectional study. BMC Geriatr 2023; 23:644. [PMID: 37817101 PMCID: PMC10565959 DOI: 10.1186/s12877-023-04358-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 09/27/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND It is estimated that more than 57 million people have dementia worldwide, and it is one of the leading causes of care dependency in old age. Relatives and other informal caregivers are the most important support for individuals with dementia, but caring for a loved one with dementia may burden the caregiver. Caregiver burden may have adverse outcomes for both the informal caregiver and the care recipient, including decreased quality of life. Caregiver burden is associated with several factors concerning the informal caregiver, the care recipient, and relational and other contextual factors. The aim of this study was to explore which factors are associated with informal caregivers' subjective burden when caring for individuals living at home with dementia. METHODS This study was a cross-sectional survey among informal caregivers of home-dwelling individuals with dementia in all five geographical regions of Norway. There were 540 informal caregivers who participated, 415 of whom were included in the regression analyses. Caregivers' subjective burden was assessed with the Relatives' Stress Scale. Covariates included were classified into four levels: individual (twofold: informal caregiver and person with dementia), relational, community, and time. Linear multivariable regression analyses were used to identify associations between subjective burden and included factors. RESULTS Several covariates were statistically significantly associated with subjective burden at the four levels. These covariates included self-rated health, mental distress, age, coping through resignation and denial, emotional and instrumental support, substance use, and humor at the informal caregiver level; behavioral and psychological symptoms of dementia, dementia severity, and degree of disability at the care recipient level; the extent of care, being the primary caregiver, and previous relationship satisfaction at the relational context level; and informal caregivers spending time with friends, leisure activities, social restriction, and knowledge of available health services at the community context level. CONCLUSIONS Informal caregivers' mental distress and care recipients' neuropsychiatric symptoms were the factors with the strongest association with subjective burden.
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Affiliation(s)
- Gunn Steinsheim
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway.
| | - Wenche Malmedal
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway
| | - Turid Follestad
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Clinical Research Unit Central Norway, St. Olavs Hospital, Trondheim, Norway
| | - Bonnie Olsen
- Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Susan Saga
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Postbox 8905, Trondheim, N-7491, Norway
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Tran JT, Theng B, Tzeng HM, Raji M, Serag H, Shih M, Lee WCM. Cultural Diversity Impacts Caregiving Experiences: A Comprehensive Exploration of Differences in Caregiver Burdens, Needs, and Outcomes. Cureus 2023; 15:e46537. [PMID: 37927752 PMCID: PMC10625452 DOI: 10.7759/cureus.46537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Background Many Americans are informal caregivers providing unpaid care for their loved ones living with chronic conditions, such as dementia and heart failure. As the US population continues to age and live longer with more complex chronic conditions, informal caregivers play an increasingly important role in the care of older adults with functional impairment and multiple comorbidities. Caregivers face many challenges in managing the health of themselves and their loved ones, including physical, emotional, and financial burdens, which may potentially vary by race and ethnicity. Therefore, it is critical to develop culturally tailored solutions, such as smart technology, aimed at improving the quality of life of informal caregivers and care recipients from diverse backgrounds. Methods Data were collected from a convenient sample of 69 informal caregivers in Texas who were members or volunteers for either the International Buddhist Progress Society-Dallas (IBPS Dallas) or University of Texas Medical Branch (UTMB). Caregivers answered questions about their caregiving experiences, including the type of care they provided, challenges they faced, and lessons learned. Responses were stratified by race/ethnicity (White, Hispanic, or Asian American) to assess for potential cultural differences in caregiving experiences. A chi-squared test and one-way analysis of variance (ANOVA) were conducted. Results White, Hispanic, and Asian American caregivers all reported high non-medical related needs. White, Hispanic, and Asian American care recipients all had a high degree of neurological disease and functional impairment. White and Hispanic caregivers were also more likely to offer emotional support (p=0.007) and financial support (p=0.025) than Asian American caregivers. Asian American caregivers reported greater worry about the health-related knowledge of their family members (p=0.040) than White and Hispanic caregivers. Hispanic (18.8%) and Asian American caregivers (12.5%) reported the least knowledge of caregiving-related government policies than White caregivers (43.2%) (p=0.025). Hispanic (18.8%) and Asian American caregivers (18.8%) also reported the least knowledge of available support programs and services for care recipients (p=0.001). Conclusions White, Hispanic, and Asian American informal caregivers vary in their types of worries, care provided, and challenges faced. Our study found that Asian American caregivers reported greater worry about the health-related knowledge of their family members than White and Hispanic caregivers. White caregivers were better at navigating government resources and caregiver support programs than Hispanic and Asian American caregivers. While race and ethnicity are potential factors for these observed differences, several other factors may have played a role, including age, gender, income, education, patient diagnosis, and disease severity. Future research should consider these factors and evaluate a larger and more diverse sample for more definitive racial and ethnic comparisons. Understanding disparities in caregiving experiences is a critical initial step to developing culturally appropriate interventions to reduce caregiving burden and promote the health and well-being of both patients and their informal caregivers from diverse backgrounds.
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Affiliation(s)
- Jessica T Tran
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Bunnarin Theng
- John Sealy School of Medicine, University of Texas Medical Branch, Galveston, USA
| | - Huey-Ming Tzeng
- School of Nursing, University of Texas Medical Branch, Galveston, USA
| | - Mukaila Raji
- Department of Internal Medicine, Division of Geriatrics and Palliative Medicine, University of Texas Medical Branch, Galveston, USA
| | - Hani Serag
- Department of Internal Medicine, Division of Endocrinology, University of Texas Medical Branch, Galveston, USA
| | - Miaolung Shih
- Humanistic Buddhism Practice (HBP), Osher Lifelong Learning Institute at University of Texas Medical Branch, Galveston, USA
| | - Wei-Chen Miso Lee
- Department of Family Medicine, University of Texas Medical Branch, Galveston, USA
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14
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Meyer K, Rath L, Avent E, Benton D, Nash P, Wilber K. How do family caregivers of older adults cope with relationship strain? Aging Ment Health 2023; 27:1990-1999. [PMID: 37574858 DOI: 10.1080/13607863.2023.2247353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/08/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE Studies of families' experiences with caregiving to older adults most often focus on overall burden and stress. Yet, caregiving is also a type of relationship, and the onset of caregiving can contribute to relationship strain between care partners. Despite implications for both care partners, little is known about how caregivers cope with caregiving relationship strain. METHODS The authors conducted nine focus groups and 8 interviews with a purposeful sample of racially and ethnically diverse family caregivers in Los Angeles. Conventional content analysis was applied to transcripts to identify how caregivers cope with relationship strain. RESULTS Analyses revealed four overall coping approaches to manage relationship strain: (1) Self-Care; (2) Adapting Behaviors, (3) Adapting Feelings and Cognitions, and (4) Help and Support. Selected strategies likely vary by care recipient condition. For example, caregivers for persons living with dementia emphasize adapting their own behaviors and feelings, rather than trying to change their loved one's behaviors. CONCLUSIONS Findings suggest that caregivers cope with relationship strain using both interpersonal tension and care management strategies. We also identified possible variations by care recipient condition and caregiver race and ethnicity. These results suggest a need for interventions focused on caregiver coping should also be tested for effects on relationship strain.
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Affiliation(s)
- Kylie Meyer
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Archstone Foundation, Long Beach, CA, USA
| | - Laura Rath
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA
| | - Elizabeth Avent
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Paul Nash
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Kathleen Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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15
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Aspö M, Visser LNC, Kivipelto M, Boström AM, Seiger Cronfalk B. Family Members' Experiences of Young-Onset Dementia: Becoming Responsible Yet Feeling Powerless. J Multidiscip Healthc 2023; 16:2379-2390. [PMID: 37609051 PMCID: PMC10441645 DOI: 10.2147/jmdh.s418285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 07/05/2023] [Indexed: 08/24/2023] Open
Abstract
Purpose Dementia is often associated with old age but can also occur in midlife. The latter is commonly referred to as young-onset dementia (YOD). The diagnosis not only has an impact on the persons with YOD but also on their family members. For family members, the diagnosis changes their lives, as responsibilities and roles alter when the care and wellbeing of the relative increasingly come into focus. The aim of this study was to explore family members' experiences of sharing lives with a relative diagnosed with YOD - from onset of symptoms until the person relocated to a nursing home. Patients and Methods The study has a qualitative approach with in-depth interviews. In total, the study included 15 family members aged ≥18 years participated, all with a relative diagnosed with dementia before the age of 65. At the time of the interview, all had a relative living in a nursing home. The interviews were analyzed using thematic analysis. Results Two key themes were identified: Becoming responsible and Dealing with the situation. Family members found themselves increasingly responsible for many parts of their relatives' lives and forced to make decisions on their behalf. This was experienced as being lonely, as family members wished to share their responsibility. Despite of their efforts to control and deal with their situation, family members reported a lack of power to influence certain factors, such as access to appropriate healthcare services, causing feelings of distress. Conclusion These findings emphasize the need of improved and tailored support and guidance for family members of persons with YOD. Further, the findings highlight the importance of increased knowledge and awareness among social workers and other healthcare professionals regarding support to family members of persons with YOD.
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Affiliation(s)
- Malin Aspö
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Leonie N C Visser
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Department of Medical Psychology, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Quality of Care, Amsterdam, the Netherlands
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
| | - Anne-Marie Boström
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Stockholms Sjukhem, Research & Development Unit, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Berit Seiger Cronfalk
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Owokuhaisa J, Kamoga R, Musinguzi P, Muwanguzi M, Natukunda S, Mubangizi V, Asiime K, Rukundo GZ. Burden of care and coping strategies among informal caregivers of people with behavioral and psychological symptoms of dementia in rural south-western Uganda. BMC Geriatr 2023; 23:475. [PMID: 37553634 PMCID: PMC10408158 DOI: 10.1186/s12877-023-04129-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 06/23/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Caregiving is a draining role that inflicts a significant level of burden upon caregivers for older people with Behavioral and Psychological Symptoms of Dementia (BPSD). Caregiver burden is associated with poor health outcomes for both the people with BPSD and their caregivers. This study explored the burden of care and coping strategies used by informal caregivers of older people with BPSD in rural Southwestern Uganda. METHODS This was a qualitative study among informal caregivers of older people with BPSD in Rubanda and Rukiga districts. We conducted in-depth interviews with a purposive sample of 27 caregivers using an interview guide. The interviews were conducted in the local language, audio recorded, transcribed, translated into English, and thematically analyzed. RESULTS There were two major themes: caregiver burden and coping strategies. Caregiver burden was described as financial, physical, psychological and social. Caregivers mainly used emotion-focused coping strategies (religious coping, acceptance and emotional support seeking). Problem-focused coping strategies (planning) and dysfunctional coping strategies (self-distraction) were used to a lesser extent. CONCLUSION Informal caregivers of people with BPSD adopted both emotional and problem-focused coping strategies to cope with the burden of care for people with BPSD. Such coping strategies seemed to lighten the burden of caring, in the long motivating the caregivers to continue with the caring role.
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Affiliation(s)
| | - Ronald Kamoga
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Pius Musinguzi
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Moses Muwanguzi
- Mbarara University of Science and Technology, Mbarara, Uganda
| | | | | | - Keith Asiime
- Mbarara University of Science and Technology, Mbarara, Uganda
| | - Godfrey Zari Rukundo
- Mbarara University of Science and Technology, Mbarara, Uganda.
- Department of Psychiatry, Mbarara University of Science and Technology, PO Box 1410, Mbarara, Uganda.
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Salikhanov I, Katapodi MC, Kunirova G, Crape BL. Improving palliative care outcomes in remote and rural areas of LMICs through family caregivers: lessons from Kazakhstan. Front Public Health 2023; 11:1186107. [PMID: 37601198 PMCID: PMC10434554 DOI: 10.3389/fpubh.2023.1186107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Approximately 60 million people require palliative care worldwide, and nearly 80% of them live in low- and middle-income countries (LMICs). Providing palliative care in remote and rural areas of LMICs requires special consideration to ensure equitable access to healthcare. This perspective aims to deliver pragmatic, context-oriented policy recommendations designed to improve palliative care outcomes in Kazakhstan by capitalizing on existing resources and considering its unique geopolitical and sociocultural context. With approximately half of the population in Kazakhstan residing in remote and rural regions, the provision of healthcare services - specifically palliative care - mandates particular attention to ensure equal access to high-quality care. To understand challenges of implementing palliative care in remote and rural regions of Kazakhstan and to propose tailored solutions, 29 key stakeholders, including family caregivers, health professionals, and palliative care administrators, were identified in five regions of Kazakhstan. The main challenges encountered by family caregivers include lack of palliative care skills, the need for home-based care from mobile services, and high out-of-pocket expenditures. The challenges highlighted by healthcare providers and administrators were the lack of formal education in palliative care, shortage of opioids, and limited societal awareness and state support. Based on challenges elaborated from stakeholders and existing literature in palliative care and family caregiving, this perspective advocates against replicating the strategies implemented in high-income countries. Family caregivers play a critical role in implementing affordable and efficient palliative care in resource-limited settings. Enhancing their competencies through digital training and increasing access to palliative care services through mobile teams are tailored and localized solutions that address specific challenges in Kazakhstan. It is postulated that these recommendations may find utility in other LMICs, potentially benefiting nearly 48 million individuals who require these services.
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Affiliation(s)
- Islam Salikhanov
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Maria C. Katapodi
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Gulnara Kunirova
- President of the Kazakhstan Association of Palliative Care, Almaty, Kazakhstan
| | - Byron L. Crape
- Nazarbayev University School of Medicine, Nur-Sultan, Kazakhstan
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18
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Montiel-Aponte MC, Bertolucci PHF, Rocha GGV. The knowledge of memory aging questionnaire (KMAQ) in a Brazilian sample: a questionnaire for informants to recognize early signs of dementia. Dement Neuropsychol 2023; 17:e20220090. [PMID: 37261250 PMCID: PMC10229088 DOI: 10.1590/1980-5764-dn-2022-0090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 12/07/2022] [Accepted: 12/29/2022] [Indexed: 06/02/2023] Open
Abstract
Till present, only a few countries have developed support programs for caregivers and families of patients with dementia aimed to improve knowledge, skills, and strategies to deal with the patient's symptoms. However, prior to offering this special support, it is important to identify beliefs and thoughts shared by informants related to cognition in elderly people. Questionnaires are instruments that allow having this information, such as the Knowledge of Memory Aging Questionnaire (KMAQ), which was designed to assess normal and pathological changes in the aging process. Objective The aim of this study was to assess the knowledge about cognition, aging, and dementia as evaluated by the KMAQ in people who are in contact with elderly people, with and without cognitive impairment. Methods A total of 78 relatives and caregivers of elderly patients were classified into two groups: group 1: relatives of patients with dementia (n1=48), and group 2: relatives of patients without cognitive impairment (n2=30). They were asked to answer some questionnaires about dementia, including the KMAQ. Results Comparing the questionnaire's scores for normal cognitive changes items (g1: 0.53 vs. g2: 0.53, p-value: 0.99) did not show differences between the knowledge in both groups, nor shows the scores for pathological cognitive changes items (g1: 0.55 vs. g2: 0.55, p-value: 0.969). Conclusions It seems that being in contact with dementia does not improve knowledge about it. Knowledge of normal changes in cognition could make it possible to recognize "red flags" suggestive of neurodegenerative processes, allowing for earlier diagnosis and more options for treatment.
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Affiliation(s)
- Mariel Carolina Montiel-Aponte
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Programa de Pós-Graduação em Neurologia e Neurociências, São Paulo SP, Brazil
| | - Paulo Henrique Ferreira Bertolucci
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia, São Paulo SP, Brazil
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Hospital São Paulo, Ambulatório de Neurologia Comportamental, São Paulo SP, Brazil
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19
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Donath C, Pendergrass A, Gräßel E. [Staying Healthy While Caregiving at Home? Risk and Protective Factors for Dysfunctional Coping in Family Caregivers]. Psychother Psychosom Med Psychol 2023. [PMID: 36878309 DOI: 10.1055/a-1984-8250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
OBJECTIVE In Germany, 3.3 million people in need of care are cared for at home. More than half (54%) of informal caregivers estimate their own stress as high or very high [1]. Coping strategies, including dysfunctional ones, are used to cope with stress. These bear the risk of negative health consequences. The aim of this study is to assess the frequency of dysfunctional coping strategies among informal caregivers and to identify protective and risk factors for these unfavorable coping mechanisms. METHODS A cross-sectional study with N=961 interviewed informal caregivers in Bavaria was conducted in 2020. Dysfunctional coping strategies (substance use and abandonment/avoidance) were assessed. Additionally, subjective stress, positive aspects of caregiving, caregiving motives, characteristics of the caregiving situation as well as caregivers' cognitive evaluation of the care situation and their subjective assessment of available resources (based on the Transactional Stress Model) were recorded. Descriptive statistics were used to explore the frequency of dysfunctional coping behavior. Linear regressions were run, after statistical precondition testing, to investigate which predictors can be identified for dysfunctional coping. RESULTS 14.7% of respondents reported using alcohol or other substances at least some of the time in difficult situations, and 47.4% of respondents had given up dealing with the care situation. Subjective caregiver burden (p<0.001), the motive to care out of obligation (p=0.035), and resources for manageability of the caregiving situation rated as insufficient (p=0.029) were identified as risk factors for dysfunctional coping in a significant overall model with medium fit (F (10)=16.776; p<0.001). DISCUSSION AND CONCLUSION Dysfunctional coping concerning the stress related to the caregiving situation is not uncommon. The most promising target for intervention is subjective caregiver burden. This is known to be reduced by the use of formal and informal help [2, 3]. However, this requires overcoming the problem of low rates of use of counseling and other support services [4]. Newer digital promising approaches to this are being developed [5, 6].
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Affiliation(s)
- Carolin Donath
- Bereich Medizinische Psychologie und Medizinische Soziologie, Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum, Erlangen
| | - Anna Pendergrass
- Bereich Medizinische Psychologie und Medizinische Soziologie, Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum, Erlangen
| | - Elmar Gräßel
- Bereich Medizinische Psychologie und Medizinische Soziologie, Psychiatrische und Psychotherapeutische Klinik, Universitätsklinikum, Erlangen
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Tan KP, Ang JK, Koh EBY, Pang NTP, Mat Saher Z. Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4232. [PMID: 36901243 PMCID: PMC10002240 DOI: 10.3390/ijerph20054232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.
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Affiliation(s)
- Khai Pin Tan
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan 25100, Pahang, Malaysia
| | - Jin Kiat Ang
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Nicholas Tze Ping Pang
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
| | - Zanariah Mat Saher
- Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur 50586, Federal Territory of Kuala Lumpur, Malaysia
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Leidl BF, Fox-Davis D, Walker FO, Gabbard J, Marterre B. Layers of Loss: A Scoping Review and Taxonomy of HD Caregivers' Spiritual Suffering, Grief/Loss and Coping Strategies. J Pain Symptom Manage 2023; 65:e29-e50. [PMID: 36198334 PMCID: PMC9790041 DOI: 10.1016/j.jpainsymman.2022.09.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/16/2022] [Accepted: 09/23/2022] [Indexed: 02/03/2023]
Abstract
CONTEXT Huntington's disease (HD), an incurable, multi-generational, autosomal dominant disorder, creating unique challenges and a myriad of spiritually-related stressors in those affected and their familial caregivers. Spiritual suffering, experiences of grief/loss, and coping strategies have not been systematically studied in HD caregivers. OBJECTIVES To comprehensively define spiritual suffering, grief/loss, and coping strategies used by HD caregivers. METHODS A PRISMA-ScR scoping literature review was conducted. Data from included research articles were organized thematically using induction and open coding. A grounded, deductive approach was used to delineate a demarcated taxonomy of themes, which encompasses all three over-arching domains. Four reviewers, employing a modified Delphi approach, ascertained which themes were demonstrated by research participants in each study. RESULTS 36 of 583 articles met the review criteria; none were published in the palliative care literature. Investigations primarily focused on intrapersonal (self-image) distress and existential angst; only rarely looking deeper into divine/transpersonal suffering, disrupted religious relationships, or meaning distress. HD caregivers experience profound grief/loss, expressed as disenfranchised grief that is associated with the ambiguous loss of their loved one, loss of family structure, social connectedness, and personal losses. Half of the studies reported maladaptive HD caregiver coping strategies-characterized by dysfunctional escape schemes; in contrast, transcendent/creative strategies were often unexplored. CONCLUSION HD caregivers experience prolonged grief and other forms of spiritual suffering as they progressively lose their loved ones and disruption to their own lives. With an improved assessment tool, teams with spiritual and palliative care experts will better be able to support HD family caregivers.
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Affiliation(s)
- Bethany Faith Leidl
- Wake Forest University School of Medicine, (B.F.L., B.M.) Winston-Salem, North Carolina
| | | | - Francis O Walker
- Department of Neurology, Emeritus, Winston-Salem, (F.O.W.) North Carolina, USA
| | - Jennifer Gabbard
- Department of Internal Medicine, Section on Gerontology and Geriatrics (Palliative Care), (J.G., B.M.) Winston-Salem, North Carolina
| | - Buddy Marterre
- Wake Forest University School of Medicine, (B.F.L., B.M.) Winston-Salem, North Carolina; Department of Internal Medicine, Section on Gerontology and Geriatrics (Palliative Care), (J.G., B.M.) Winston-Salem, North Carolina; Department of General Surgery, (B.M.) Winston-Salem, North Carolina.
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Maximiano-Barreto MA, Ottaviani AC, Luchesi BM, Chagas MHN. Empathy Training for Caregivers of Older People: A Systematic Review. Clin Gerontol 2022:1-12. [PMID: 36148523 DOI: 10.1080/07317115.2022.2127390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES To identify empathy training models and the effects on psychological concerns in paid and unpaid caregivers of older people. METHODS A systematic review was conducted. Searches for relevant articles were performed in the Embase, LILACS, PsycInfo, Pubmed, Scopus and Web of Science databases using the following search strategy: "Empathy AND (Education OR Training OR Intervention) AND Caregiver." No restrictions were imposed regarding language or year of publication. RESULTS Empathy training for caregivers of older people were performed in six studies, three of which identified a significant increase in empathy levels and consequent reduction in psychological concerns. Empathy training focused on aspects of empathy and/or the caregiver had significant effects on the outcome variables. Moreover, training conducted online, by telephone and/or in person can generate satisfactory results. The other three studies that conducted training with a focus on aspects of dementia and/or old age did not present any effect on the outcome variables. CONCLUSIONS Empathy training for caregivers of older people can increase levels of this ability, especially in the cognitive domain, as well as diminish psychological concerns caused by the negative impact of providing care. CLINICAL IMPLICATIONS Empathy training directed at empathic abilities and/or aspects of providing care can be effective at increasing levels of this ability. Moreover, training in different care contexts can minimize the negative impacts of providing care.
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Affiliation(s)
| | | | - Bruna Moretti Luchesi
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, Brazil
- Campus de Três Lagoas, Federal University of Mato Grosso Do Sul, Três Lagoas, Brazil
| | - Marcos Hortes Nisihara Chagas
- Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, Brazil
- Bairral Institute of Psychiatry, Itapira, Brazil
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Li Y, Aierken A, Ding X, Pan Y, Chen Y. Dependency-associated individual, family, community, and social factors from a resilience framework among elderly people. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03670-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Vu M, Mangal R, Stead T, Lopez-Ortiz C, Ganti L. Impact of Alzheimer's Disease on Caregivers in the United States. Health Psychol Res 2022; 10:37454. [PMID: 35999976 PMCID: PMC9392839 DOI: 10.52965/001c.37454] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/19/2022] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND/OBJECTIVE First discovered by Alois Alzheimer in 1906, Alzheimer's disease (AD) has become a growing global health concern with numerous implications for individuals and modern society. As patients' symptoms of dementia continue to worsen, they gradually grow more limited in their independence. As a result, family members and close acquaintances often become caregivers for the patient and become more involved in maintaining the patient's lifestyle. The authors of this research sought to study what motivates caregivers to look after AD patients and the impact of AD on their lifestyles and physical, mental, and social health. METHODS The authors crafted a survey of fourteen questions and collected data from 200 caregivers regarding AD's impact on their physical, emotional, and social health along with their key demographic and background information (e.g. whether or not they are a caregiver for a patient with AD). RESULTS The results indicate that most AD caregivers are family members (78%). AD often strains the caregiver's relationship with the patient (47.5%), and 58% of participating caregivers report extreme stress levels while 65% realize it is incredibly difficult to take care of a patient. Because of the increased levels of stress, 47% of participating caregivers sleep less; 43% feel more isolated from their family; and, 35.5% did not try to get help from others. Love and a strong sense of duty seem to be the primary motivation for caregivers to take care of a patient. Worry for the patient (50%), financial worries (12.5%), lack of medical experience (10.5%), and their own health (10.5%) seem to be the primary stressors for caregivers. Caregivers rely on numerous support systems and coping mechanisms, with physical activity (54.5%) and increased alcohol and marijuana usage (35.5%) the most frequent. CONCLUSIONS Although caregivers have support systems and found coping methods that would alleviate their burden of caring for a patient with AD, the clear negative impact AD has on caregivers affects their physical, mental, and social health. As there is currently no cure for AD, compassion and greater support for caregivers are necessary.
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Affiliation(s)
- Megan Vu
- Trinity Preparatory School, Winter Park, FL, USA
| | - Rohan Mangal
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Thor Stead
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | | | - Latha Ganti
- Emergency Medicine, University of Central Florida College of Medicine, Orlando, FL, USA; Envision Physician Services, Nashville, TN, USA
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AboJabel H, Werner P. The mediating effect of social support and coping strategies on the relation between family stigma and caregiver burden among Israeli Arab family caregivers of people with Alzheimer's disease (AD). Aging Ment Health 2022; 26:1597-1603. [PMID: 33904814 DOI: 10.1080/13607863.2021.1916881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Many studies have attempted to identify the factors that are associated with caregiver burden among family caregivers of people with Alzheimer's disease (AD), because of its plethora of negative consequences. One unique factor that has been investigated recently is family stigma. However, the path leading from family stigma to caregiver burden has not been thoroughly studied. Hence, this study had two main objectives. The first was to examine whether family stigma was a predictor of caregiver burden among Israeli Arab family caregivers of a person with AD. The second was to examine the interplay of family stigma and caregiver burden with coping strategies and social support. METHODS Structured face-to-face interviews were conducted with 175 Israeli Arab family caregivers (adult children and spouses) of elderly people with AD (87.4% female; 71.4% adult children; mean age = 54.28). RESULTS Overall, the participants reported moderate levels of caregiver burden and family stigma. Additionally, as expected, family stigma made a unique - although modest - contribution to the explanation of caregiver burden. Whereas neither problem-focused coping nor emotion-focused coping played a significant role in mediating the relation between family stigma and caregiving burden, social support did mediate the relation between these variables. CONCLUSIONS Our findings reveal how social support is important as a specific way to reduce the impact of family stigma on caregiver burden.
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Affiliation(s)
- Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Haifa, Israel
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26
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Shin JY, Habermann B. Nursing research in caregivers of people with Parkinson's disease from 2011 to 2021: A scoping review. Appl Nurs Res 2022; 66:151590. [DOI: 10.1016/j.apnr.2022.151590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 04/09/2022] [Accepted: 04/30/2022] [Indexed: 10/18/2022]
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27
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Gutierrez-Baena B, Romero-Grimaldi C. Predictive model for the preparedness level of the family caregiver. Int J Nurs Pract 2022; 28:e13057. [PMID: 35388583 PMCID: PMC9285821 DOI: 10.1111/ijn.13057] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 03/14/2022] [Accepted: 03/24/2022] [Indexed: 11/26/2022]
Abstract
Background Many caregivers are insufficiently prepared, and little is known about measures that can be employed to enhance their preparedness. Aim The aim of this study was to explore the factors associated with caregiver preparedness and establish a predictive model including the relationship between preparedness, burden, resilience and anxiety. Design A cross‐sectional design was used. Methods The sample included 172 family caregivers who were selected from one private hospital and daytime nursing centres. Caregivers were recruited from 2018 to 2019; they completed assessments for caregiver preparedness, anxiety, resilience and burden. A multiple linear regression analysis was performed to identify the factors associated with preparedness. Results Preparedness was significantly associated with high levels of resilience and a low level of burden, while it was not associated with anxiety. Caregivers' gender, experience and cohabitation status were the main predictors. Resilience is an explanatory factor for caregiver preparedness in the predictive model. Conclusion The demographic variables related to preparedness can be used to guide efforts to meet the needs of vulnerable caregivers. A caregiver's preparedness depends on their level of burden and resilience. Nursing interventions focused on these aspects could make the caregiver's role easier and improve the quality of care provided. What is already known about this topic?
Many caregivers are inadequately prepared for this role, and ensuring adequate preparedness is important for family caregivers. Preparedness and factors predictive of this in Spanish family caregivers have not been well‐documented. Resilience, burden and anxiety affect caregivers, but the degree to which they influence caregivers' preparation levels is unknown.
What is the contribution of this paper?
Specific factors influence the preparedness of family caregivers. Men and caregivers who do not cohabit in the same household with the care‐dependent person may present greater deficits in preparedness. Moreover, poor health and lack of experience in caring can result in inadequate caregiving performance. Readiness, resilience and burden are significantly related, and the best predictor of family caregivers' preparedness is resilience. Resilience leads to greater preparedness in caregivers, and better‐prepared caregivers experience a lighter burden.
What are the implications of this paper?
Knowing the factors associated with preparedness in advance will allow health‐care professionals to prevent deficits in vulnerable family caregivers. Resilience is a decisive factor which prevents negative consequences such as low preparedness. A resilient coping style can diminish the burden and promote successful adaptation in caregivers.
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Affiliation(s)
- Belen Gutierrez-Baena
- Nursing Faculty Salus Infirmorum, University of Cadiz, Cadiz, Spain.,Hospital Viamed Bahia de Cádiz, Chiclana de la Frontera, Cadiz, Spain
| | - Carmen Romero-Grimaldi
- Nursing Faculty Salus Infirmorum, University of Cadiz, Cadiz, Spain.,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
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Bussè C, Barnini T, Zucca M, Rainero I, Mozzetta S, Zangrossi A, Cagnin A. Depression, Anxiety and Sleep Alterations in Caregivers of Persons With Dementia After 1-Year of COVID-19 Pandemic. Front Psychiatry 2022; 13:826371. [PMID: 35222125 PMCID: PMC8866969 DOI: 10.3389/fpsyt.2022.826371] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Social isolation due to COVID-19 pandemic has an important psychological impact particularly in persons with dementia and their informal caregivers. AIM To assess frequency and severity of long-term stress-related symptoms in caregivers of patients with dementia 1-year after the beginning of COVID-19 pandemic and to identify predictors of psychological outcomes. METHODS Eighty-five caregivers were involved in a longitudinal study with 1-year follow-up during pandemic in Italy. At baseline in April 2020 a telephone interview assessed socio-demographic characteristics of caregivers and self-perception of distress symptoms. After 1 year, between March and April 2021, the same standardized interview was delivered to the caregivers' sample. In addition, scales assessing levels of depression and anxiety (DASS-21), sleep disturbances (PSQI) and coping strategies (COPE-NVI) were administered to the caregivers and to 50 age and sex-matched non-caregivers subjects. Linear regression analysis was performed to investigate the power of baseline variables to predict long-term psychological outcomes. RESULTS After 1 year of pandemic frequency of caregivers' stress-related symptoms increased respect to baseline: depression (60 vs. 5, 9%; p < 0.001), anxiety (45, 9 vs. 29, 4%; p = 0.035), irritability (49, 4 vs. 24, 7%; p < 0.001), and anguish (31, 7 vs. 10, 6%; p < 0.001). Frequency of severe depression was higher in caregivers than in non-caregivers (p = 0.002) although mean levels of depression were comparable in the two groups. Long-term higher depression was predicted by a model built on baseline information (r2 = 0.53, p < 0.001) where being female (t = -3.61, p < 0.001), having lower education (t = -2.15, p = 0.04), presence of feelings of overwhelm (t = 2.29, p = 0.02) and isolation (t = 2.12, p = 0.04) were significant predictors. Female sex was also predictive of anxiety (t = -2.7, p = 0.01) and poor sleep quality (t = -2.17, p = 0.03). DISCUSSION At 1 year follow-up caregivers of patients with dementia reported higher prevalence of all stress-related symptoms respect to the acute phase of lockdown, particularly depression. Long-lasting stressful conditions may cause exhaustion of resilience factors and increased depression. Planning interventions should support caregivers to enable them to continue with their role during pandemic.
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Affiliation(s)
- Cinzia Bussè
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
| | - Teresa Barnini
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
| | - Milena Zucca
- Department of Neuroscience “Rita Levi Montalcini, ” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Innocenzo Rainero
- Department of Neuroscience “Rita Levi Montalcini, ” Aging Brain and Memory Clinic, University of Torino, Torino, Italy
| | - Stefano Mozzetta
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
| | | | - Annachiara Cagnin
- Department of Neuroscience (DNS), University of Padova, Padova, Italy
- Padova Neuroscience Center, University of Padova, Padova, Italy
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AboJabel H, Werner P. Examining the mediating effect of psychosocial resources on the relationship between ambivalent feelings and depression among Israeli Arab family caregivers of people with dementia. DEMENTIA 2022; 21:751-764. [DOI: 10.1177/14713012211053967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives Providing care for family members of individuals with dementia can be accompanied by a myriad of emotions, usually involving negative as well as positive feelings, or “ambivalent feelings.” Recent studies conducted among family caregivers of people with dementia have shown ambivalent feelings to be associated with serious psychological consequences, such as increased depression. However, little is known about the path leading from ambivalent feelings to depression. Thus, the aim of this study was to examine the interplay of ambivalent feelings and depression with family caregivers’ psychosocial resources—that is, their coping strategies and social support. Methods A cross-sectional study using face-to-face interviews (via structured questionnaire) was conducted with 175 Israeli Arab family caregivers (adult children and spouses) of elderly people with Alzheimer’s disease (87.4% female; 72% adult children; mean age = 54.28). Results Overall, the participants reported a mild level of depression (mean = 7.93; SD = 4.30; range 0–15) and a moderate level of ambivalent feelings (mean = 1.63; SD = 1.04; range 0–3). Additionally, as expected, ambivalent feelings made a unique—although modest—contribution, adding an additional 6% ( p < 0.001) to the explanation of depression ( R2 = 0.56, p<0.001). Whereas, neither problem-focused coping nor emotion-focused coping played a significant role in mediating the relationship between ambivalent feelings and depression, social support did mediate the relationship between these variables. Conclusions Our findings show that strengthening and expanding social networks among Israeli caregivers of people with Alzheimer’s disease can minimize the impact of experiences of emotional feelings on depression.
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Affiliation(s)
- Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Israel
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30
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Malczewska M, Janus E. Relationship Between Home Caregivers and Caregivers Employed at Selected Institutions Providing Assistance to Seniors with Their Care Recipients Suffering from Dementia. REHABILITACJA MEDYCZNA 2022. [DOI: 10.5604/01.3001.0015.7038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Introduction: There are many difficulties connected with caring for an elderly person sufferring dementia. Symptoms such as aggression or apathy, as well as the progressive nature of the disorder, affect the attitude of both home and institutional caregivers towards the people for whom they care. An important element related to the provision of care is the relationship between a senior with dementia and those who provide the care (home and institutional caregivers). The aim of the article is to characterise and compare these relations.
Material and methods: The study comprised 124 participants, 57 professional caregivers and 67 home carers. Two standardised questionnaires were used: the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Quality of Carer-Patient Relationship - QCPR Questionnaire. Additionally, the respondents provided socio-demographic data. The study was conducted via electronic media in the first quarter of 2021.
Results: It was found that there is a significant difference in the relationship between home and institutional caregivers, with their charges in the dimension of "warmth and attachment" (measured by QCPR). People providing professional care have significantly higher scores in this area. There was also a significant difference between scores in the 'no conflict and criticism' dimension (measured by QCPR) for home and professional caregivers. Institutional caregivers, in relation to their care recipients, have a higher level of this indicator than home caregivers.
Conclusions: Relationships between seniors with dementia and institutional or home carers differ with regard to some issues. The differences in relationships with seniors suffering dementia may be due to the time spent caring for this person and the caregiver's response to symptoms of dementia.
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Affiliation(s)
- Magdalena Malczewska
- Institute of Applied Sciences, University of Physical Education in Kraków, Poland
| | - Edyta Janus
- Institute of Applied Sciences, University of Physical Education in Kraków, Poland
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31
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Peavy G, Mayo AM, Avalos C, Rodriguez A, Shifflett B, Edland SD. Perceived Stress in Older Dementia Caregivers: Mediation by Loneliness and Depression. Am J Alzheimers Dis Other Demen 2022; 37:15333175211064756. [PMID: 34986661 PMCID: PMC10580727 DOI: 10.1177/15333175211064756] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Coupled with aging, chronic stress experienced by dementia caregivers often leads to deteriorating health. Comparing caregivers and non-caregivers, we tested whether depression and loneliness mediate the relationship between caregiver status and a measure of chronic stress, the Perceived Stress Scale. Seventy-six cognitively normal older adults (mean age 72.7) were identified as caregivers or non-caregivers based on the functional independence of a paired family member. Caregivers reported more perceived stress, depression, and loneliness than non-caregivers. Using multiple mediation analyses, we found that loneliness and depression mediated the relationship of caregiver status with perceived stress. The loneliness effect on perceived stress was both direct and via its relationship with depressive symptoms. The findings suggest loneliness as a likely point of intervention to reduce caregiver stress. Initiatives to enable caregivers to maintain or develop social relationships apart from caregiver responsibilities may mitigate stress and its negative impact on mental and physical health.
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Affiliation(s)
- Guerry Peavy
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Ann M. Mayo
- Hahn School of Nursing and Health Science, University of San Diego, San Diego, CA, USA
| | - Cynthia Avalos
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Amanda Rodriguez
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Benjamin Shifflett
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Steven D. Edland
- School of Public Health and Human Longevity Research, University of California, San Diego, La Jolla, CA, USA
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32
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Koljack CE, Miyasaki J, Prizer LP, Katz M, Galifianakis N, Sillau SH, Kluger BM. Predictors of Spiritual Well-Being in Family Caregivers for Individuals with Parkinson's Disease. J Palliat Med 2021; 25:606-613. [PMID: 34818097 DOI: 10.1089/jpm.2020.0797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Parkinson's disease (PD) is a common neurodegenerative illness that causes disability through both motor and nonmotor symptoms. Family caregivers provide substantial care to persons living with PD, often at great personal cost. While spiritual well-being and spirituality have been suggested to promote resiliency in caregivers of persons living with cancer and dementia, this issue has not been explored in PD. Objective: The aim of this study was to identify predictors of spiritual well-being in PD patients' caregivers. Design: A cross-sectional analysis was performed. Our primary outcome measure, the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), was measured in caregivers alongside measures of patient quality of life, symptom burden, global function, grief, and spiritual well-being and caregiver mood, burden, and perceptions of patient quality of life. Univariate correlation and multiple regression were used to determine associations between predictor variables and caregiver FACIT-Sp. Setting/Subjects: PD patient/caregiver dyads were recruited through three academic medical centers in the United States and Canada and regional community support groups. Results: We recruited 183 dyads. Patient faith, symptom burden, health-related quality of life, depression, motor function, and grief were significant predictors of caregiver spiritual well-being. Predictive caregiver factors included caregiver depression and anxiety. These factors remained significant in combined models, suggesting that both patient and caregiver factors make independent contributions to caregiver spiritual well-being. Conclusions: The present study suggests that both patient and caregiver factors are associated with spiritual well-being in PD. Further study is needed to understand the causal relationship of these factors and whether interventions to support caregiver spiritual well-being improve outcomes for caregivers or patients. Clinicaltrials.gov registration NCT02533921.
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Affiliation(s)
- Claire E Koljack
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Janis Miyasaki
- Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada
| | | | - Maya Katz
- Department of Neurology, University of California San Francisco Medical Center, San Francisco, California, USA
| | - Nick Galifianakis
- Department of Neurology, University of California San Francisco Medical Center, San Francisco, California, USA
| | - Stefan H Sillau
- Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Benzi M Kluger
- Department of Neurology and Medicine, University of Rochester Medical Center, Rochester, New York, USA
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Roman Meller M, Patel S, Duarte D, Kapczinski F, de Azevedo Cardoso T. Bipolar disorder and frontotemporal dementia: A systematic review. Acta Psychiatr Scand 2021; 144:433-447. [PMID: 34390495 DOI: 10.1111/acps.13362] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To detail the biological, clinical and neurocognitive characteristics differentiating bipolar disorder (BD) from frontotemporal dementia (FTD) and to investigate whether BD is a risk factor for FTD. METHODS A total of 16 studies were included in this systematic review. Five studies described biological and/or neurocognitive characteristics between patients with BD and FTD, and 11 studies investigated whether BD was a risk factor for FTD. RESULTS Individuals with FTD presented higher levels of serum neurofilament light chain, greater grey matter reduction in frontal, parietal and temporal lobes, and increased slow wave oscillations in channels F3, F4, T3, T5, T4 and T6 within an electroencephalogram (EEG), relative to individuals with BD. Patients with FTD presented greater deficits in executive function and theory of mind compared to patients with BD in a euthymic state, and more deficits in verbal fluency compared to patients with BD in a current mood episode. Patients with BD in a current mood episode showed greater impairment in attention, working memory, verbal memory and executive function relative to individuals with FTD. In addition, retrospective studies showed that 10.2%-11.6% of patients with behavioural variant FTD (bvFTD) had a preceding history of BD. CONCLUSION Biological and neurocognitive characteristics help to distinguish between BD and FTD, and it may help to reach a more precise diagnosis. In addition, individuals with BD are at higher risk of developing FTD. More studies are needed to identify the predictors of the conversion between BD to FTD.
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Affiliation(s)
- Marina Roman Meller
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Swara Patel
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada
| | - Dante Duarte
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Flavio Kapczinski
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Instituto Nacional de Ciência e Tecnologia Translacional em Medicina (INCT-TM), Porto Alegre, Brazil.,Bipolar Disorder Program, Laboratory of Molecular Psychiatry, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil.,Department of Psychiatry, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Taiane de Azevedo Cardoso
- School of Interdisciplinary Science, Life Sciences Program, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Pelaccia T, Sibilia J, Fels É, Gauer L, Musanda A, Severac F, Abbiati M. And if we had to do it all over again, would we send medical students to the emergency departments during a pandemic? Lessons learned from the COVID-19 outbreak. Intern Emerg Med 2021; 16:1967-1974. [PMID: 33453012 PMCID: PMC7811345 DOI: 10.1007/s11739-020-02629-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 12/31/2020] [Indexed: 11/22/2022]
Abstract
The COVID-19 pandemic has led to increased staffing needs in emergency departments. The question quickly arose as to whether it was appropriate to offer medical students the opportunity to assist this staff. The dilemma stems in part from the potential impact on their psychological well-being as well as their academic and clinical performances. We sought to determine the level of anxiety of medical students during the COVID-19 outbreak, and whether it was higher among the students who chose to return to the clinical setting, especially in first-line units (i.e., emergency departments and resuscitation units). In May 2020, 1180/1502 (78.5%) undergraduate medical students at Strasbourg Medical School (France) completed a questionnaire assessing their anxiety and clinical experience. A 2018 cohort of undergraduate medical students served as the baseline. The 2020 COVID cohort had higher rates of anxiety than the 2018 cohort. This difference was specifically observed in the students who chose not to return to the clinical setting during the crisis (N = 684, 59%). At linear regression, the main factors associated with anxiety were gender (p < 0.005) and perceived clinical activity personal conditions (p < 0.001). Employment site, including COVID first-line units, was not correlated with anxiety. Working in the clinical setting during the COVID-19 outbreak is not a risk factor for anxiety in medical students. Instead, it is an active coping strategy, suggesting that there are no barriers to allowing students to return to clinical settings during a pandemic, including first-line units, in terms of their psychological well-being.
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Affiliation(s)
- Thierry Pelaccia
- Prehospital Emergency Care Service (SAMU 67), Strasbourg University Hospital, Strasbourg, France.
- Centre for Training and Research in Health Sciences Education (CFRPS), Faculty of Medicine, University of Strasbourg, Strasbourg, France.
| | - Jean Sibilia
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Élodie Fels
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - Lucas Gauer
- Strasbourg University Hospital, 1 place de l'Hôpital, Strasbourg, France
| | - Audrey Musanda
- Faculty of Medicine, University of Strasbourg, Strasbourg, France
| | - François Severac
- Public Health Service, GMRC, Strasbourg University Hospital, Strasbourg, France
| | - Milena Abbiati
- Institute of Legal Psychiatry, Lausanne University Hospitals, Lausanne, Switzerland
- Unit of Development and Research (UDREM), Faculty of Medicine, University of Geneva, Geneva, Switzerland
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35
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Han A, Kim TH, Hong H. A factorial randomized controlled trial to examine separate and combined effects of a simulation-based empathy enhancement program and a lecture-based education program on family caregivers of people with dementia. Aging Ment Health 2021; 25:1930-1940. [PMID: 32426989 DOI: 10.1080/13607863.2020.1768214] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES The present study was a 2 × 2 factorial randomized controlled trial that examined if a simulation-based empathy enhancement program and a lecture-based education program, together or separately, improved outcomes of family caregivers of people with dementia. METHOD A total of 101 participants were randomly assigned to simulation-based education only, lecture-based education only, simulation-based education plus lecture-based education, or treatment as usual. Data were analyzed using a two-way analysis of covariance while controlling for pretest results, kinship, and gender. RESULTS Statistically significant interaction effects between the simulation program and the lecture program were found in the levels of well-being and helplessness. The lecture program accompanied by the simulation program led to higher level of well-being in terms of happiness and lower level of helplessness than the lecture program alone. Caregivers with the lecture program provided led to less frequent use of dysfunctional coping strategies than those with no lecture program provided. Caregivers with the simulation program provided led to more frequent use of emotion-focused coping strategies than those with no simulation program provided. CONCLUSIONS Findings of the present study support benefits of combined of and separate simulation-based and lecture-based programs on family caregivers of people with dementia in important outcomes affecting quality of care and quality of lives in families of people with dementia. Further studies are needed to identify intervention components that can improve empathy of family caregivers of people with dementia and be embedded into a multicomponent program tailored better to families in different needs.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju College of Medicine, Wonju, South Korea
| | - Hyeon Hong
- Department of Occupational Therapy, Yonsei University, Wonju, South Korea
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Bahçecioğlu Turan G, Köse S, Aksoy M. Analysis of nursing students' obsessive and coping behaviors during the COVID-19 pandemic. Perspect Psychiatr Care 2021; 57:1628-1636. [PMID: 33484182 PMCID: PMC8014582 DOI: 10.1111/ppc.12728] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/28/2020] [Accepted: 12/29/2020] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study was conducted to examine the obsessive behaviors and coping behaviors of nursing students during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN AND METHODS This descriptive study was conducted between October 4 and October 17, 2020. FINDINGS In this study, it was found that nursing students had a mean total COVID-19 Obsessive Compulsive Scale score of 3.88 ± 3.02 and a mean total Ways of Coping Inventory (WCI) score of 47.05 ± 11.68. When the subscales of the WCI were examined, mean scores were found to be 13.64 ± 4.85 for the self-confident approach, 8.91 ± 3.35 for the optimistic approach, 7.25 ± 2.24 for the seeking social support approach, 10.97 ± 4.43 for the helpless approach, and 6.24 ± 3.20 for the submissive approach. PRACTICE IMPLICATIONS Nursing students have low levels of obsession with COVID-19 and moderate levels of coping behaviors. For this reason, it is very important to recognize the psychological symptoms of today's nursing students-the health workforce of the future-and to determine priorities for their solution.
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Affiliation(s)
| | - Semra Köse
- Faculty of Health Sciences, Necmettin Erbakan University, Konya, Turkey
| | - Meyreme Aksoy
- Faculty of Health Science, Siirt University, Siirt, Turkey
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Resilience, Emotional Intelligence, and Occupational Performance in Family Members Who Are the Caretakers of Patients with Dementia in Spain: A Cross-Sectional, Analytical, and Descriptive Study. J Clin Med 2021; 10:jcm10184262. [PMID: 34575373 PMCID: PMC8469665 DOI: 10.3390/jcm10184262] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 09/10/2021] [Accepted: 09/16/2021] [Indexed: 11/16/2022] Open
Abstract
Background: The concern in the scientific community for the study of people with dementia and their families is comprehensible, especially the importance of knowing the effects that caring for the patient has on their family dynamic, paying special attention to the main caregiver. The objective of this study was to analyze the relationship of resilience and emotional intelligence with functional performance in the main caregivers of people with dementia in Spain according to the phase of the disease. Methods: A cross-sectional, descriptive, and analytical study was carried out. A total of 144 primary family caregivers of patients with dementia in Spain were included in the study. The following variables were measured: sociodemographic, psychosocial, and occupational, as well as resilience and emotional intelligence. Results: The caregivers obtained a low moderate resilience (mean = 64.01 ± 14.5), an emotional intelligence bordering between moderate and high (mean = 78.48 ± 14.82), and a 61.8% self-care categorized as somewhat and quite a bit. The presence of higher levels of resilience in family caregivers of people with dementia were positively related to the time spent on self-care (r = 0.227; p = 0.033) and leisure (r = 0.262; p = 0.014), especially in the moderate phase of the disease, while in the severe phase, this relationship appeared with productivity (r = 0.355; p = 0.034). The higher levels of emotional intelligence were positively related to a greater time dedicated to self-care (r = 0.233, p = 0.005), as well as the data observed in the moderate and severe phase (r = 0.214; p = 0.046 and r = 0.398; p = 0.016 respectively). Conclusions: The primary caregivers of relatives with dementia who have higher levels of resilience and emotional intelligence spend more time on self-care and leisure activities, especially in the moderate phase of the disease.
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Lan X, Wu Q, Chen X, Jin S, Yi B. Caregiver burden among informal caregivers of hospitalized patients with frailty: A cross-sectional survey. Geriatr Nurs 2021; 42:948-954. [PMID: 34134042 DOI: 10.1016/j.gerinurse.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 05/21/2021] [Accepted: 05/24/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to investigate the status of caregiver burden among informal caregivers of hospitalized frail older patients and explore the associated factors. A total of 191 frail older patients and their informal caregivers were recruited from the inpatient units of the three teaching hospitals. We collected data using the FRAIL scale, the Zarit Burden Interview, and the Simplified Coping Style Questionnaire. We used descriptive statistics, Pearson correlation coefficients, one-way analysis of variance, and multiple linear regression for the data analysis. The caregivers of hospitalized frail older patients experienced a moderate caregiver burden (26.476±11.289). The regression model for caregiver burden was significant. Male caregivers, taking care of patients before hospitalization, experiencing negative emotions, and negative coping styles were significantly associated with caregiver burden, F (7, 183) = 15.13, p <. 001. The findings suggest that early identification of caregiver burden and focused interventions for alleviating caregiver burden are needed.
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Affiliation(s)
- Xiuyan Lan
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China; Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China.
| | - Qingqing Wu
- The Second Affiliated of Fujian Traditional Chinese Medical University
| | - Xiaohuan Chen
- Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China; Nursing Department, Fujian Provincial Hospital, Fuzhou, China.
| | - Shuang Jin
- Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China; Nursing Department, Fujian Provincial Hospital, Fuzhou, China
| | - Bilan Yi
- Department of Pulmonary and Critical Care Medicine, Fujian Provincial Hospital, Fuzhou, China; Fujian Medical University Affiliated Clinical Medical Institute, Fuzhou, China
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Lee Y, Song Y. Coping as a Mediator of the Relationship between Stress and Anxiety in Caregivers of Patients with Acute Stroke. Clin Nurs Res 2021; 31:136-143. [PMID: 34105381 DOI: 10.1177/10547738211021223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
According to Lazarus and Folkman's theory, stress and coping affect an individual's anxiety, which is an adaptive outcome. This study examined the mediation effects of stress-coping strategies on the relationship between stress and anxiety in caregivers of patients with acute stroke. A cross-sectional descriptive design was used to analyze a total of 131 caregivers caring for patients with acute stroke at a university hospital. The Caregivers Stress Scale, Ways of Coping Questionnaire, and Korean Beck Anxiety Inventory were used to quantify the participants' responses. Our results revealed that emotion-focused coping (β = .56, p < .001) partially mediated the relationship between stress and anxiety (Z = 3.30, p < .001), suggesting its ability to exacerbate anxiety in the short term by acting as a mediator between stress and anxiety. Developing appropriate coping strategies for caregivers of patients with acute stroke is therefore critical for reducing their anxiety.
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Affiliation(s)
- Yoonmi Lee
- Kyungpook National University, Daegu, South Korea
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40
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Jia J, Xu J, Liu J, Wang Y, Wang Y, Cao Y, Guo Q, Qu Q, Wei C, Wei W, Zhang J, Yu E. Comprehensive Management of Daily Living Activities, behavioral and Psychological Symptoms, and Cognitive Function in Patients with Alzheimer's Disease: A Chinese Consensus on the Comprehensive Management of Alzheimer's Disease. Neurosci Bull 2021; 37:1025-1038. [PMID: 34050523 PMCID: PMC8275730 DOI: 10.1007/s12264-021-00701-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/06/2021] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cognitive disorder in the elderly. Its main clinical manifestations are cognitive decline (C), behavioral and psychological symptoms (B), and a decline in the activities of daily living (A), also known as ABC symptoms. Early identification and evaluation of ABC symptoms are helpful for establishing the accurate diagnosis, comprehensive treatment, and prognosis of AD. To guide Chinese clinical practice for optimization of the comprehensive management of AD, in 2018, The Academy of Cognitive Disorder of China gathered 22 neurologists and gerontologists in China to build a consensus on the comprehensive management of AD. Based on a review of the evidence, the consensus summarizes the pathogenesis, pathological changes, clinical manifestations, evaluation, diagnosis, drug and non-drug treatment, and patient care for AD. Focus group discussion was used to establish a flowchart of comprehensive ABC management for AD patients. The new consensus provides a feasible AD management process for clinicians.
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Affiliation(s)
- Jianjun Jia
- Department of Neurology, The Second Medical Center, People's Liberation Army General Hospital, Beijing, 100853, China.
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Jun Liu
- Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, 510120, China
| | - Yongjun Wang
- Cognitive Impairment Department, Shenzhen Kangning Hospital, Shenzhen, 518118, China
| | - Yanjiang Wang
- Department of Neurology, Daping Hospital, Army Medical University, Chongqing, 400042, China
| | - Yunpeng Cao
- Department of Neurology, The First Hospital of China Medical University, Shenyang, 210112, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiaotong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Qiuming Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710061, China
| | - Cuibai Wei
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing, 100053, China
| | - Wenshi Wei
- Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, 200040, China
| | - Junjian Zhang
- Department of Neurology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, China
| | - Enyan Yu
- Department of Psychology, Chinese Academy of Sciences Cancer Hospital of the University of the Chinese Academy of Sciences, Hangzhou, 310022, China
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Liu B, Liu J, Shi JS. SAMP8 Mice as a Model of Age-Related Cognition Decline with Underlying Mechanisms in Alzheimer's Disease. J Alzheimers Dis 2021; 75:385-395. [PMID: 32310176 DOI: 10.3233/jad-200063] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Alzheimer's disease (AD) is a highly age-related cognitive decline frequently attacking the elderly. Senescence-accelerated mouse-prone 8 (SAMP8) is an ideal model to study AD, displaying age-related learning and memory disorders. SAMP8 mice exhibit most features of pathogenesis of AD, including an abnormal expression of anti-aging factors, oxidative stress, inflammation, amyloid-β (Aβ) deposits, tau hyperphosphorylation, endoplasmic reticulum stress, abnormal autophagy activity, and disruption of intestinal flora. SAMP8 mice, therefore, have visualized the understanding of AD, and also provided effective ways to find new therapeutic targets. This review focused on the age-related pathogenesis in SAMP8 mice, to advance the understanding of age-related learning and memory decline and clarify the mechanisms. Furthermore, this review will provide extensive foundations for SAMP8 mice used in therapeutics for AD.
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Affiliation(s)
- Bo Liu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Lab of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Jie Liu
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Lab of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, China
| | - Jing-Shan Shi
- Key Laboratory of Basic Pharmacology of Ministry of Education and Joint International Research Lab of Ethnomedicine of Ministry of Education, Zunyi Medical University, Zunyi, China
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Caring for a person with dementia during the COVID-19 pandemic: a qualitative study with family care-givers. AGEING & SOCIETY 2021. [PMCID: PMC8134901 DOI: 10.1017/s0144686x21000696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
The aim of this study was to explore the experience of family care-givers of people with dementia during the COVID-19 pandemic in the Veneto region of Italy to understand how and to what extent the emergency has affected care-givers’ lives and care routines. Twenty adult children of an ill person were interviewed via phone and video call, in adherence with the restrictions against COVID-19. Thematic analysis showed five main themes: the care-giver's experience, the care recipient's experience, relationships with care recipients, changes in the care routine and resources. Results pointed out that the time needed in the care routine and everyday activities increased during the pandemic, together with the need to find alternatives to physical activity at home. Depending on one's personal experience of COVID-19 and approach to preventive rules, the availability of resources, and formal and informal support, three main approaches to care were identified: apprehensive, mindful and fatalistic ones. The pandemic amplified the differences among these already-existing approaches to care as well as the typical challenges and difficulties experienced by family care-givers, and it resulted in an increased burden connected to practical difficulties, emotional stress and difficulties in reaching for help. These results underline the importance of strengthening the external support network for older people to help family care-givers, especially during emergencies.
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Campione JR, Zebrak KA. Predictors of Unmet Need Among Informal Caregivers. J Gerontol B Psychol Sci Soc Sci 2021; 75:2181-2192. [PMID: 31907540 DOI: 10.1093/geronb/gbz165] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES This study investigates the relationship of caregiver demographics, caregiving intensity, caregiver support use, and aspects of the caregiving situation to a self-reported measure of unmet need among U.S. informal caregivers of older adults living at home with various conditions. METHODS Response data from 1,558 caregiver participants interviewed by telephone during the December 2016 baseline period of the Outcome Evaluation of the National Family Caregiver Support Program were used. Caregivers who responded "Definitely No" to the question "Are you receiving all the help you need?" were classified as reporting unmet need. Logistic regression was used to find significant factors associated with unmet need among the full sample and among caregivers tiered by three levels of burden. RESULTS Unmet need was reported by 22% of the caregivers. In a fully adjusted model, unmet need was predicted by higher levels of caregiving intensity, non-White race of the caregiver, and the caregiver not feeling appreciated by their care recipient. Other predictors associated with unmet need were no use of caregiver educational services, fewer respite hours, not living in a rural area, and caregiver having an education past high school. DISCUSSION Caregivers who do not feel appreciated by their care recipient and non-White caregivers should be identified as potential targets for intervention to address unmet need, especially if they are also reporting higher levels of caregiver burden. Understanding the factors associated with self-reported unmet need can assist caregiver support programs in measuring and addressing the needs of informal caregivers to support their continued caregiving.
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Affiliation(s)
- Joanne R Campione
- Department of Healthcare Delivery Research and Evaluation, Westat, Inc., Rockville, Maryland
| | - Katarzyna A Zebrak
- Department of Healthcare Delivery Research and Evaluation, Westat, Inc., Rockville, Maryland
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Kim B, Noh GO, Kim K. Behavioural and psychological symptoms of dementia in patients with Alzheimer's disease and family caregiver burden: a path analysis. BMC Geriatr 2021; 21:160. [PMID: 33663416 PMCID: PMC7934246 DOI: 10.1186/s12877-021-02109-w] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 02/18/2021] [Indexed: 11/25/2022] Open
Abstract
Background Studies reported the relationship between behavioural and psychological symptoms of dementia (BPSD), cognitive function, caregiver burden, and therapeutic effects. However, the causal relationship between BPSD in community-dwelling patients with Alzheimer’s disease (AD) and caregiver burden is yet to be established. This study aimed to classify BPSD in patients with AD and identify the relationship between BPSD and the factors affecting family caregiver burden. Methods Path analysis was conducted at a neurology outpatient clinic of a tertiary general hospital in South Korea. The medical records of 170 patients, aged ≥50 years, diagnosed with or suspected for AD were retrospectively reviewed. We investigated cognitive function (Korean version of the Mini-Mental-State Exam), dementia stages (Korean version of the Expanded Clinical Dementia Rating scale), depression (Short-form Geriatric Depression Scale-Korea), activities of daily living (ADL; Korean version of the Barthel Activities of Daily Living index), instrumental activities of daily living (IADL; Seoul-Instrumental Activities of Daily Living), and BPSD and caregiver burden (Korean Neuropsychiatric Inventory). Considering the characteristic features of BPSD with various symptoms, BPSD was classified using factor analysis. Factor extraction was performed using principal component analysis, followed by Varimax factor rotation. Results Mean total BPSD score was 17.66 ± 20.67, and the mean score for family caregiver burden was 9.65 ± 11.12. Symptom cluster-1 (hyperactivity symptoms) included disinhibition, irritability, and agitation/aggression. Symptom cluster-2 (psychosis symptoms) included hallucinations, anxiety, elation/euphoria, delusions, and depression/dysphoria. Symptom cluster-3 (physical behaviour symptoms) included appetite and eating abnormalities, apathy/indifference, aberrant motor behaviour, sleep, and night-time behaviour disturbances. Dementia stages, ADL, and IADL had indirect effects on family caregiver burden through hyperactivity, psychosis, and physical behaviour symptoms, indicating that BPSD exerted a complete mediating effect. Conclusions Unlike previous studies, we classified BPSD symptoms into similar symptom clusters to evaluate its effect on caregiver burden, rather than collectively investigating the 12 symptoms of BPSD. As the dementia stage worsens, symptom clusters in BPSD serve as a medium between ADL and IADL degradation and for the increase in caregivers’ burden. The development and implementation of therapeutic, nursing interventions, and policies focusing on dementia stages, ADL, and IADL, delaying and preventing BPSD can alleviate family caregivers’ burden.
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Affiliation(s)
- Bokyoung Kim
- Department of Nursing, Catholic Kwandong University, Gangneung, South Korea
| | - Gie Ok Noh
- Department of Nursing, Konyang University, 158 Gwanjeodong-ro, Seo-gu, Daejeon, 35365, South Korea.
| | - Kyunghee Kim
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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Li Q, Zhang H, Zhang M, Li T, Ma W, An C, Chen Y, Liu S, Kuang W, Yu X, Wang H. Prevalence and Risk Factors of Anxiety, Depression, and Sleep Problems Among Caregivers of People Living With Neurocognitive Disorders During the COVID-19 Pandemic. Front Psychiatry 2021; 11:590343. [PMID: 33488423 PMCID: PMC7820074 DOI: 10.3389/fpsyt.2020.590343] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 12/01/2020] [Indexed: 02/05/2023] Open
Abstract
Objectives: To estimate the prevalence of anxiety, depression, and sleep problems among caregivers of persons living with neurocognitive disorders (PLWND) during the COVID-19 pandemic in China and investigate whether the COVID-19-related experiences were associated with the presence of anxiety, depression, and sleep problems. Methods: From March 1 to 31, 2020, 160 caregivers of PLWND participated in an online cross-sectional survey on the prevalence of anxiety, depression, and sleep problems. The 7-item Generalized Anxiety Disorder Scale (GAD-7) was administered to measure anxiety symptoms, and the 2-item Patient Health Questionnaire (PHQ-2) was used to assess depressive symptoms. Questions on sleep duration and sleep quality enquired about sleep problems. Six items were used to explore the COVID-19-related experiences, including community-level infection contact and the level of exposure to media information. We computed the prevalence rate of anxiety, depressive symptoms, and sleep problems. Univariate and multivariate logistic regression analyses were performed to investigate factors associated with these mental health problems. Results: The prevalence rate of anxiety, depression, and sleep problems were 46.9%, 36.3%, and 9.4%. Approximately 55 participants (34.4%) presented with two or more mental health problems. Women had a higher risk of developing anxiety symptoms (OR, 5.284; 95% CI, 2.068-13.503; p = 0.001). Having a mental disorder (OR, 5.104; 95% CI, 1.522-17.114; p = 0.008) was associated with an increased risk of depressive symptoms. Caregivers who preferred to access positive information (OR, 0.215; 95% CI, 0.058-0.793; p = 0.021) was associated with decreased risk of sleep problems. Conclusion: Anxiety and depressive symptoms were common among caregivers of older adults with dementia or mild cognitive impairment during the COVID-19 pandemic. Being female was an independent risk factor for experiencing anxiety symptoms. Preexisting mental disorders increased the risk of depressive symptoms among caregivers, while caregivers who prefer to access positive media information decreased sleep problems.
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Affiliation(s)
- Qiuxuan Li
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
| | - Haifeng Zhang
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
| | - Ming Zhang
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
- Department of Psychiatry, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Tao Li
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
| | - Wanxin Ma
- Taiyanggong Community Health Center, Beijing, China
| | - Cuixia An
- The First Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yanmei Chen
- The Third People's Hospital of Qinghai Province, Xining, China
| | - Sha Liu
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorders, First Hospital of Shanxi Medical University, Taiyuan, China
- Department of Psychiatry, First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan, China
| | - Weihong Kuang
- Department of Psychiatry, Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Xin Yu
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
| | - Huali Wang
- National Health Commission Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders, Peking University Institute of Mental Health (Sixth Hospital), Beijing, China
- Beijing Dementia Key Laboratory, Beijing, China
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Nguyen KH, Comans T. Making the Invisible Companion of People with Dementia Visible in Economic Studies: What Can We Learn from Social Science? Healthcare (Basel) 2021; 9:healthcare9010044. [PMID: 33466492 PMCID: PMC7824847 DOI: 10.3390/healthcare9010044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 12/22/2020] [Accepted: 12/30/2020] [Indexed: 11/16/2022] Open
Abstract
The dyadic perspective is important to understand the mutual influence and interdependence of both the person living with dementia and their care partner. This perspective is routinely adopted in social research programs for dementia and many dyadic interventions have been developed. However, economic evaluation and modelling to date has often failed to incorporate caregivers’ perspectives, and their respective costs and outcomes while giving care for the person with dementia. On the occasions that this has been done, caregivers were represented as “informal costs” associated with dementia. This limited perspective cannot incorporate two-way interactions of the dyad in economic evaluations of dementia programs. This paper provides an overview of the possible interactions between people living with dementia and care partners as discovered in social science literature in the past 20 years. We demonstrate the strength of the relationships and discuss strategies for incorporating the dyadic perspective in economic evaluations of dementia programs in the future.
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Dourado MCN, Belfort T, Monteiro A, de Lucena AT, Lacerda IB, Gaigher J, Baptista MAT, Brandt M, Kimura NR, de Souza N, Gasparini P, Rangel R, Marinho V. COVID-19: challenges for dementia care and research. Dement Neuropsychol 2020; 14:340-344. [PMID: 33354285 PMCID: PMC7735054 DOI: 10.1590/1980-57642020dn14-040002] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
The COVID-19 pandemic has raised significant concerns about the management and care for people with dementia and their caregivers. In this context, this work will discuss how social isolation or social distancing caused by the pandemic may impact the clinical management of people with dementia, caregivers’ health, and dementia research. The pandemic disrupts all forms of social interaction and may increase the behavioral impairment of people with dementia. Regarding pharmacological treatment, telemedicine is an option, but the context of social isolation raises questions about how to manage people with dementia with lack of cognitive stimulation and non-pharmacological treatment. In addition, the impact of the pandemic on caregivers should be considered. There is some evidence that telephone counseling can reduce depressive symptoms of caregivers of people with dementia. In dementia research, social isolation imposes researchers to modify their study protocols in order to continue collecting data by developing remote tools to assess the participants such as electronic informed consent and online questionnaires and tests. Thus, there is an urgent need for the evaluation and refinement of interventions to address several cognitive, behavioral, and clinical aspects of the long-term impact of the pandemic in dementia.
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Affiliation(s)
| | - Tatiana Belfort
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Alexandre Monteiro
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Aline Tavares de Lucena
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Isabel Barbeito Lacerda
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Julia Gaigher
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Maria Alice Tourinho Baptista
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle Brandt
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Nathália Ramos Kimura
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Natalie de Souza
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Paula Gasparini
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Rogéria Rangel
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Valeska Marinho
- Center for Alzheimer's Disease, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Dooley J, Webb J, James R, Davis H, Read S. Everyday experiences of post-diagnosis life with dementia: A co-produced photography study. DEMENTIA 2020; 20:1891-1909. [PMID: 33241719 PMCID: PMC8369903 DOI: 10.1177/1471301220973632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
There has been surprisingly little research capturing people’s everyday lives in the early years following a diagnosis of dementia. This project was co-produced by three people with dementia and two university researchers. The co-researchers with dementia formulated the aims of this project as: (1) to explore post-diagnosis life with dementia and (2) to use data collection methods as a form of peer support and confidence building for the participants. The intent was to provide the opportunity to learn new skills and support participants to share their experiences without putting them on the spot. Five participants with recent diagnoses received a photography lesson and cameras to take photographs of their everyday lives. This was followed with a focus group in which the photographs were discussed. The participants used their photographs to explain: (1) the differences between their past and present with dementia, (2) how dementia affected their thought processes, (3) pets and grandchildren as facilitators of reciprocal joy and support, (4) the emotional effects of living with a dementia diagnosis, and (5) the solace and stability of nature in a changing world. The participants’ creative use of photography supported them to express the complex emotions felt after a diagnosis of dementia and they reported the benefit of doing this in an environment with peers going through the same experiences. The role of the co-researchers with dementia was the key to the success of this project, drawing on their own experiences to design the project and support the participants. Future research should draw on the experiences of people with dementia to design research projects and care interventions.
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Affiliation(s)
- Jemima Dooley
- Centre for Academic Primary Care, Bristol Medical School, 1980University of Bristol, UK
| | - Joe Webb
- Norah Fry Centre for Disability Studies, School for Policy Studies, 1980University of Bristol, UK
| | - Roy James
- Member of the Forget-Me-Not Research Group, UK
| | - Harry Davis
- Member of the Forget-Me-Not Research Group, UK
| | - Sandy Read
- Member of the Forget-Me-Not Research Group, UK
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Durán-Gómez N, Guerrero-Martín J, Pérez-Civantos D, López Jurado CF, Palomo-López P, Cáceres MC. Understanding Resilience Factors Among Caregivers of People with Alzheimer's Disease in Spain. Psychol Res Behav Manag 2020; 13:1011-1025. [PMID: 33262666 PMCID: PMC7700077 DOI: 10.2147/prbm.s274758] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 11/02/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) caregivers resilience involves the interaction between different risk and protective factors. Context of care, objective stressors, perceived stressors caregiver assessment, mediators factors and consequences of care were associated with resilience. We have developed a more integrated and operational conceptual model of resilience and care than previous models in our sociocultural environment. PURPOSE To assess the resilience of caregivers of people with AD and the related factors grouped according to an established operational conceptual model of Alzheimer´s caregivers stress. PATIENTS AND METHODS A total of 120 primary informal caregivers of AD persons in Badajoz (Spain) were included in a cross-sectional design. The following variables have been measured on AD persons and caregivers: socio-demographic data, dependency level, cognitive decline, neuropsychiatric and behavioral symptoms, anxiety, depression, severity of somatic symptoms, level of burden, self-esteem, coping, social support, health-related quality of life (HRQOL) and resilience. RESULTS Most of the caregivers reported symptoms of anxiety (63.3%) and depression (62.5%). We found out higher levels of resilience in caregivers with lower dependence caring (p=0.004). Higher resilience levels of caregivers were related to minor depressive (p=0.006) and anxiety symptoms (p=0.000), and higher HRQOL (p=0.000). Coping dimension mostly used was problem-based strategies such as active coping, positive reinterpretation and acceptance (p= 0.000). CONCLUSION Those caregivers reporting higher levels of resilience exhibited moderate to intense indicators of burden, fewer symptoms of depression and anxiety and fewer somatic symptoms. They also used adequate problem-focused coping strategies, showed higher levels of HRQOL and demonstrated an appropriate perception of social support. Despite the fact that the characteristics relating to the care context and to social support exert an undeniable influence on caregiver resilience, it would appear that the caregiver's own intra-psychic resources reveal stronger correlations. RELEVANCE FOR CLINICAL PRACTICE The early and accurate identification of caregivers with lower levels of resilience could enable the implementation of vital psychological and educative support interventions to help caregivers to improve their well-being.
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Lima S, Sevilha S, Pereira MG. Quality of life in early-stage Alzheimer's disease: the moderator role of family variables and coping strategies from the patients' perspective. Psychogeriatrics 2020; 20:557-567. [PMID: 32212217 DOI: 10.1111/psyg.12544] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 10/16/2019] [Accepted: 02/22/2020] [Indexed: 11/30/2022]
Abstract
AIM This study assessed the effects of sociodemographic and psychological variables on quality of life (QOL), as well as the moderator role of family variables and coping strategies in the relationship between psychological morbidity and QOL, based on patients' perspective. METHODS This study used a cross-sectional design. A total of 158 patients with early Alzheimer's disease completed the Mini-Mental State Examination, the Montreal Cognitive Assessment, the Hospital Anxiety and Depression Scale, the Ways of Coping Questionnaire, the Spiritual and Religious Attitudes in Dealing with Illness, the Family Adaptability and Cohesion Evaluation Scales, the Family Satisfaction Scale, the Family Communication Scale, the Barthel Index, and the Quality of Life in Alzheimer's Disease Scale. RESULTS Being a man, having a higher education, and engaging in more exercise activity were associated with better QOL. Lower levels of cognitive impairment, psychological morbidity, and spirituality predicted better QOL. Also, lower levels of functionality, family communication, family satisfaction, and family functioning contributed to worse QOL. Gender, psychological morbidity, and functionality contributed significantly to QOL. Family satisfaction, family communication, and coping strategies moderated the relationship between psychological morbidity and QOL. CONCLUSION Intervention in early-stage Alzheimer's disease should focus on patients' coping strategies and family context, particularly family satisfaction and communication, to foster QOL.
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Affiliation(s)
- Sara Lima
- School of Psychology, University of Minho, Braga, Portugal
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