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Hipólito N, Martins S, Ruivo A, Flora S, Silva CG, Marques A, Brooks D, Cruz J. Construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in caregivers of patients with COPD. Respir Med 2022; 205:107027. [PMID: 36343503 DOI: 10.1016/j.rmed.2022.107027] [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] [Received: 06/20/2022] [Revised: 10/12/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION COPD often leads to loss of independence in daily activities which may increase the dependency on the informal caregiver, resulting in caregiving burden. Several instruments have been used to assess caregiving burden in COPD; however, their measurement properties have been poorly investigated in this population. This study assessed the construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in informal caregivers of patients with COPD. METHODS Participants completed the QASCI (higher scores indicate higher burden) and the following questionnaires to assess construct validity: Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and World Health Organization Quality of Life Instrument - Short Form (WHOQOL-Bref). QASCI was completed again one week later to assess test-retest reliability. Statistical analyses included: Pearson's (r) or Spearman's (ρ) correlations (construct validity); Cronbach's α (internal consistency); Intraclass Correlation Coefficient (ICC2,1, test-retest reliability) and Standard Error of Measurement (SEM), Minimal Detectable Change (MDC95) and Bland and Altman 95% Limits of Agreement (LoA). RESULTS Fifty caregivers (62.7 ± 9.8 years, 88% female; patients' FEV1 = 45.2 ± 21.3%predicted) participated. QASCI mean score was 28.5 ± 19.8 (moderate burden). QASCI was positively correlated with ZBI (r = 0.908; p < 0.01), HADS anxiety (r = 0.613; p < 0.01) and depression (ρ = 0.634; <0.01) and negatively correlated with WHOQOL-Bref (-0.476 to -0.739) (all p < 0.01). Cronbach's α was 0.793 for the QASCI total score (subscales: 0.747-0.932). The ICC2,1 was 0.924, SEM 2.8 and MDC95 7.8, and the LoA were -18.3 to 11.1. CONCLUSIONS The QASCI seems to be a promising measure to assess burden levels associated with informal caregiving in COPD.
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Affiliation(s)
- Nádia Hipólito
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal
| | - Sara Martins
- Clínica Albano da Silva Teixeira, R. Dom Afonso Henriques 27 A39, 3720-244, Oliveira de Azeméis, Portugal
| | - Adriana Ruivo
- Naturidade Porto de Mós, Unidade de Cuidados Continuados Integrados, R. dos Vales nº 5, 2480-109, Porto de Mós, Portugal
| | - Sofia Flora
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal
| | - Cândida G Silva
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal; School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal; Coimbra Chemistry Centre, Department of Chemistry, University of Coimbra, 3004-535, Coimbra, Portugal
| | - Alda Marques
- Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal; Institute of Biomedicine (iBiMED), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal
| | - Dina Brooks
- School of Rehabilitation Science, McMaster University, 1400 Main Street West Institute for Applied Health Sciences (IAHS) Building - Room 403, Hamilton, ON L8S 1C7, Canada; West Park Healthcare Centre, 82 Buttonwood Avenue, Toronto, ON M6M 2J5, Canada; University of Toronto, 27 King's College Cir, Toronto, ON M5S 1A1, Canada
| | - Joana Cruz
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Campus 5, Rua de Santo André, nº 66-68, 2410-541, Leiria, Portugal; School of Health Sciences, Polytechnic of Leiria, Campus 2, Morro do Lena, Alto do Vieiro - Apartado 4137, 2411-901, Leiria, Portugal; Lab 3R - Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA), University of Aveiro, Campus Universitário de Santiago, 3810-193, Aveiro, Portugal.
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Gazzi L, Comini L, Scalvini S, Taccolini I, Vitacca M. Feasibility of telepsychology support for patients with advanced cardiorespiratory diseases and their caregivers. Front Psychol 2022; 13:909417. [PMID: 36033038 PMCID: PMC9405428 DOI: 10.3389/fpsyg.2022.909417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 07/12/2022] [Indexed: 11/25/2022] Open
Abstract
Objective The aim of this study was to test the feasibility of telepsychology support for patients with severe cardiorespiratory disease and their caregivers. A secondary objective was to explore pre-post relationships between patients' and caregivers' clinical measures. Methods A telehealth program incorporating telepsychology support, i.e., an “on-demand” phone service with a psychologist, was provided to consecutive cardiorespiratory patients at discharge from inpatient rehabilitation and to their caregivers. At the start and end of the 1-year program, participants were interviewed “face-to-face,” and their anxiety/depression level, patients' quality of life (MRF-28, SF-36, and MQOL), and caregivers' (n = 18) family strain (FSQ) and needs (CNA) were assessed: we analyzed the correlations and evaluated customer satisfaction. Results Of 80 eligible individuals, 40 took part in this study: 22 patients (FVC = 39 ± 14%; EF = 39 ± 13%) and 18 caregivers. Eleven (28%, 6 patients and 5 caregivers) requested tele-psychological support, resulting in 51 consultations focused on anxiety, difficulty in patient management, worry about the patient's emotional state, and need for emotional support; 3 participants underwent a tailored psychotherapy program. All participants expressed high satisfaction with the service. At enrolment, anxiety was less evident in patients (73% men) than in caregivers, while depressive symptoms were more evident (6.5 ± 3.1), and correlated with MRF-28 and MQOL. Caregivers' (94% women) FSQ showed a “strongly recommended” need for support; at enrolment, high levels of anxiety/depression were correlated with high FSQ (for both, p < 0.05); depressive symptoms correlated negatively with age (p = 0.025) and positively with emotional needs (p = 0.025); anxiety was positively correlated with education level (p = 0.048). At follow-up, patients' perception of support (n = 13/22) tended to increase (p = 0.089), while caregivers' strain (n = 10/18) tended to decline (to within the “range of attention”). At enrolment, caregivers' anxiety/depression and strain correlated with patients' quality of life (for both; p < 0.05). At follow-up, caregivers' strain correlated with patients' quality of life (p = 0.028) and cognitive performance (p = 0.048). Conclusion Telepsychology support associated with a telehealth service is feasible and satisfying for both participants and psychological management. A suitable support program can benefit both patients and caregivers, particularly those at higher risk of depressive symptoms (younger caregivers) and anxiety (all caregivers).
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Affiliation(s)
- Lidia Gazzi
- Psychology Service, Neurorehabilitation Unit of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
- *Correspondence: Lidia Gazzi
| | - Laura Comini
- Scientific Direction of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Simonetta Scalvini
- Cardiac Rehabilitation and Continuity Care Unit and Telemedicine Service of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Irene Taccolini
- Cardiac Rehabilitation and Continuity Care Unit and Telemedicine Service of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
| | - Michele Vitacca
- Respiratory Rehabilitation of the Institute of Lumezzane, Istituti Clinici Scientifici Maugeri IRCCS, Brescia, Italy
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She H, Man Y. Anticipatory Burden in Adult-Child Caregivers: A Concept Analysis. Healthcare (Basel) 2022; 10:healthcare10020356. [PMID: 35206970 PMCID: PMC8872093 DOI: 10.3390/healthcare10020356] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/06/2023] Open
Abstract
This study aims to analyze the concept of anticipatory burden in adult-child caregivers. A systematic literature review was performed using four databases, Pubmed, CINAHL, PsycINFO and Medline, with the keywords of “anticipatory burden” and “anticipated burden”. Simplified Wilson’s classic concept analysis modified by Walker and Avant was employed to identify the attributes, antecedents and consequences of anticipatory burden in the adult-child caregivers. Eighteen articles were analyzed. Attributes of anticipatory burden in adult-child caregivers were found to be: (1) subjective burden, (2) anticipation, (3) overestimation, (4) inability, and (5) family relationship. Antecedents were identified as: (1) potential care recipients, (2) caregiving willingness, and (3) a lack of resources. Consequences included: (1) prediction of caregiving willingness, (2) impacts on caregivers’ health, (3) intervention promotion, and (4) behavioral changes. As the adult-child caregiver is one of the main types of family caregivers for the fast-growing aging population, it is important to understand the attributes, antecedents, and consequences of their anticipatory burden. Based on the results of this study, resources such as intervention, policy, and counseling services are recommended to help adult-child caregivers lower their anticipatory burden and get better prepared for providing family care.
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Affiliation(s)
- Hangying She
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH 44106, USA
- Correspondence:
| | - Yuncheng Man
- Case School of Engineering, Case Western Reserve University, Cleveland, OH 44106, USA;
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Nestola T, Orlandini L, Ferrari A, Monzani V, Gallimbeni G, Bergamaschini LC, Cesari M. Predictors of Successful Oxygen Weaning in Older Patients Undergoing Pulmonary Rehabilitation. J Am Med Dir Assoc 2020; 21:1153-1156. [PMID: 32173309 DOI: 10.1016/j.jamda.2020.01.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 10/15/2019] [Accepted: 01/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To identify clinical and/or functional variables predictive of successful oxygen-weaning among older patients affected by respiratory insufficiency undergoing pulmonary rehabilitation. DESIGN Retrospective study. SETTING AND PARTICIPANTS Data are from 154 patients aged 65 years and older (mean age = 78.1 years; female 50.6%) admitted to a pulmonary rehabilitation unit to follow an in-patient program. Patients must require oxygen therapy at admission. METHODS All patients performed the 6-Minute Walking Test at admission and before discharge as well as a spirometry at a steady state. Multivariate logistic regressions were performed to identify positive and negative predictors of successful oxygen weaning. RESULTS Successful oxygen weaning was obtained in 47 participants (30.5%). The restrictive pattern was associated with a 4-fold likelihood of successful oxygen weaning at the end of the rehabilitation program compared with the obstructive one. A positive association was also found for arterial oxygenation index (PaO2/FiO2 ratio) at baseline. A decreased likelihood of successful oxygen weaning was reported for the subjective dyspnea perception score at exertion evaluated with a modified Borg scale. CONCLUSIONS AND IMPLICATIONS The restrictive pattern, PaO2/FiO2 ratio, and modified Borg dyspnea scale score under exertion were significantly associated with successful oxygen-weaning. The identified predictors may support clinicians at precociously identifying patients who may not require oxygen therapy after discharge. Therefore, these findings would make it possible for clinicians to better tailor the rehabilitation program.
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Affiliation(s)
- Tiziano Nestola
- University of Milan, Milan, Italy; ASP IMMeS Pio Albergo Trivulzio, Milan, Italy
| | - Laura Orlandini
- University of Milan, Milan, Italy; ASP IMMeS Pio Albergo Trivulzio, Milan, Italy.
| | | | - Valter Monzani
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Luigi C Bergamaschini
- ASP IMMeS Pio Albergo Trivulzio, Milan, Italy; Department of Clinical and Biomedical Sciences L. Sacco Hospital, Milano, Italy
| | - Matteo Cesari
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy; Department of Medical Sciences and Community Health, University of Milan, Milan, Italy
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Chu HH, Lee KS, Ho Lee K, Chung JH, Shin KC, Hwang TY. Association of physical and psychological health status between chronic obstructive pulmonary disease patients and their family caregivers. Health Care Women Int 2019; 40:1019-1030. [PMID: 31169476 DOI: 10.1080/07399332.2019.1617292] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We performed this cross-sectional study with 72 chronic obstructive pulmonary disease (COPD) patients and their family caregivers to analyze relationship of physical and psychological health status between COPD patients and caregivers. Most caregivers were female (100%). Caregiver depression and burden were significantly associated with caregiving hours. In path analysis, the higher the patient's social support, the higher the patient's self-efficacy. The higher the patient's self-efficacy, the lower the care burden of the caregiver. Based on our results, there was a significant correlation of physical and psychological factors between patients and family caregivers.
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Affiliation(s)
- Hyun-Hye Chu
- Respiratory Center, Yeungnam University Hospital , Daegu , Korea
| | - Kyeong-Soo Lee
- Department of Preventive Medicine & Public Health, College of Medicine, Yeungnam University , Daegu , Korea
| | - Kwan Ho Lee
- Department of Internal Medicine, College of Medicine, Yeungnam University , Daegu , Korea
| | - Jin Hong Chung
- Department of Internal Medicine, College of Medicine, Yeungnam University , Daegu , Korea
| | - Kyeong-Cheol Shin
- Department of Internal Medicine, College of Medicine, Yeungnam University , Daegu , Korea
| | - Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, College of Medicine, Yeungnam University , Daegu , Korea
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Cruz J, Marques A, Machado A, O'Hoski S, Goldstein R, Brooks D. Informal caregiving in COPD: A systematic review of instruments and their measurement properties. Respir Med 2017; 128:13-27. [DOI: 10.1016/j.rmed.2017.05.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Revised: 05/04/2017] [Accepted: 05/05/2017] [Indexed: 12/20/2022]
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Collier A, Breaden K, Phillips JL, Agar M, Litster C, Currow DC. Caregivers' Perspectives on the Use of Long-Term Oxygen Therapy for the Treatment of Refractory Breathlessness: A Qualitative Study. J Pain Symptom Manage 2017; 53:33-39. [PMID: 27840229 DOI: 10.1016/j.jpainsymman.2016.06.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 06/06/2016] [Accepted: 06/23/2016] [Indexed: 11/26/2022]
Abstract
CONTEXT Despite limited clinical evidence, long-term oxygen therapy (LTOT) is used for the management of refractory breathlessness in people with life-limiting illnesses who are not necessarily hypoxemic. OBJECTIVES The aim of this study was to understand caregiver factors associated with caring for someone with LTOT from the perspectives and experiences of caregivers themselves. METHODS The qualitative study used semistructured interviews. The study was conducted in two states in Australia. Participants (n = 20) were self-nominated caregivers of people receiving LTOT for refractory breathlessness in the palliative setting. RESULTS Data analyses established one overarching theme titled: "Oxygen giveth (something to help caregivers relieve breathlessness) and oxygen taketh away (from patients who lose some autonomy)." The theme captured caregivers' feelings of extreme distress in response to witnessing refractory breathlessness, and oxygen fulfilling several critical and beneficial roles in this context. In parallel, caregivers also explicitly and implicitly articulated several downsides to the use of LTOT. CONCLUSION Caregivers find caring for someone with refractory breathlessness extremely distressing. The benefits of LTOT are often overestimated, whereas its potential harms are underestimated. As significant stakeholders of people receiving LTOT, caregivers should be provided with opportunities to collaborate with clinicians in evidence-based decision making, efforts should be made to provide them with information and education about the most effective pharmacological and nonpharmacological strategies to manage refractory breathlessness in a palliative care setting including the appropriate use of LTOT to enable them to do so.
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Affiliation(s)
- Aileen Collier
- Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
| | - Katrina Breaden
- School of Nursing and Midwifery, Flinders University, Adelaide, South Australia, Australia
| | - Jane L Phillips
- Centre for Cardiovascular and Chronic Diseases, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Meera Agar
- Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia; South West Sydney Clinical School, University of New South Wales, Sydney, Australia; Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caroline Litster
- Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
| | - David C Currow
- Discipline Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia
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Costa TFD, Gomes TM, Viana LRDC, Martins KP, Costa KNDFM. Acidente vascular encefálico: características do paciente e qualidade de vida de cuidadores. Rev Bras Enferm 2016; 69:933-939. [DOI: 10.1590/0034-7167-2015-0064] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 07/10/2016] [Indexed: 11/22/2022] Open
Abstract
RESUMO Objetivo: investigar a associação entre os domínios da qualidade de vida relacionada à saúde dos cuidadores familiares e as características sociodemográficas dos indivíduos com sequelas de AVE. Método: pesquisa descritiva, transversal, quantitativa, realizada com 136 cuidadores familiares de indivíduos com sequelas de AVE, mediante entrevistas domiciliárias de abril a junho de 2013. Resultados: verificou-se que os cuidadores de indivíduos com idade inferior a 65 anos, casados, com dez a 12 anos de escolaridade, apresentaram maiores escores, respectivamente nos domínios 'Aspectos sociais', 'Aspectos emocionais' e 'Saúde mental'. Entretanto, os cuidadores de pacientes com maior grau de incapacidade obtiveram menor escore no domínio 'Saúde mental'. Conclusão: os resultados permitem refletir acerca da necessidade de inserir os cuidadores familiares de indivíduos com sequelas de AVE no planejamento de cuidados prestados pelos profissionais de saúde.
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Mansfield E, Bryant J, Regan T, Waller A, Boyes A, Sanson-Fisher R. Burden and Unmet Needs of Caregivers of Chronic Obstructive Pulmonary Disease Patients: A Systematic Review of the Volume and Focus of Research Output. COPD 2016; 13:662-7. [DOI: 10.3109/15412555.2016.1151488] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Elise Mansfield
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
| | - Jamie Bryant
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
| | - Timothy Regan
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
| | - Amy Waller
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
| | - Allison Boyes
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
| | - Rob Sanson-Fisher
- Health Behaviour Research Group, Priority Research Centre for Health Behaviour, University of Newcastle & Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, New South Wales, Australia
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