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Haji Assa A, Cao X, Boehm LM, Umberger RA, Carter MA. The Relationship Between Uncertainty and Psychological Distress Among Family Caregivers of Patients With Delirium in Intensive Care Units: A Cross-Sectional Survey. Dimens Crit Care Nurs 2024; 43:61-71. [PMID: 38271309 DOI: 10.1097/dcc.0000000000000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Although family caregivers experienced negative psychological symptoms associated with witnessing intensive care unit delirium in their loved ones, there is a lack of clear understanding of how delirium is associated with family caregiver psychological distress. Uncertainty could be a factor contributed to this association. OBJECTIVES The aim of this study was to examine the relationship between uncertainty and psychological distress among family caregivers of patients with delirium in intensive care units. METHODS A cross-sectional correlational design was used for this observational study of adult family caregivers of patients admitted to the intensive care unit and who reported witnessing delirium symptoms in their loved ones. Family caregivers completed an electronic survey in January 2022 that consisted of a family caregiver and patient demographic form, the Mishel Uncertainty in Illness Scale-Family Member, and the Kessler Psychological Distress Scale. Descriptive, correlational, and regression statistical analyses were applied. RESULTS One hundred twenty-one adult family caregivers were enrolled. Family caregivers reported substantial uncertainty (mean, 106.15, on a scale of 31-155) and moderate to severe psychological distress (mean, 31.37, on a scale of 10-50) regarding their witnessing of delirium episodes in their loved ones. Uncertainty was significantly correlated with psychological distress among family caregivers (rs = 0.52, P < .001). Uncertainty significantly predicted psychological distress among family caregivers (regression coefficient, 0.27; P < .001). DISCUSSION Family caregiver uncertainty was positively associated with psychological distress. This distress can interfere with family caregiver involvement in patient delirium care. These findings are essential to increase critical care nurse awareness and inform the development of nursing interventions to alleviate possible uncertainty and distress.
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Pei D, Kreps G, Zhao X. The Role of Uncertainty and Negative Emotion in Chinese Parents' Self-Medication of Children with Antibiotics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6603. [PMID: 37623186 PMCID: PMC10454897 DOI: 10.3390/ijerph20166603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/07/2023] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
Parents self-medicating their children with antibiotics (SMA) without consulting healthcare professionals is a common practice in China. Previous research has focused primarily on examining the socioeconomic factors that contribute to the prevalence of SMA. This study adopts and extends the theory of planned behavior to understand the cognitive and emotional factors that are associated with parental SMA in China. The responses to an online survey were collected from 961 parents of children aged 6-12 years old, primarily from Gansu, Shandong, and Shaanxi provinces. More than half of the participants (66.5%) engaged in parental SMA. Amoxicillin, Cephradine, and Azithromycin were the most frequently selected antibiotics used for children. Structural equation modeling showed that uncertainty was positively associated with negative emotions, which were in turn positively associated with attitude toward SMA. Uncertainty was also negatively associated with perceived behavioral control (PBC), but the association between PBC and SMA behavior was not significant. Attitude and subjective norm were both positively associated with SMA behavior. The relationship between subjective norm and attitude was also positive. Understanding the psychological factors driving parental SMA may inform tailored interventions to promote responsible antibiotic use among parents.
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Affiliation(s)
- Di Pei
- School of Public Health, Georgia State University, Atlanta, GA 30302, USA;
| | - Gary Kreps
- Department of Communication, George Mason University, Fairfax, VA 22030, USA
| | - Xiaoquan Zhao
- Department of Communication, George Mason University, Fairfax, VA 22030, USA
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Uncertainty among families of patients with cerebrovascular diseases in Japan: association with quality of life and background characteristics. Aging Clin Exp Res 2022; 34:3097-3105. [PMID: 36181638 PMCID: PMC9526199 DOI: 10.1007/s40520-022-02254-1] [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: 06/30/2022] [Accepted: 09/09/2022] [Indexed: 11/25/2022]
Abstract
Purpose To determine the relationship between family uncertainty and family quality of life (QOL) during the recovery period of patients with cerebrovascular disease in Japan, and the factors that influence family uncertainty. Methods Data were collected from copies of patient medical files and interviews with family members of 85 patients admitted to two rehabilitation wards in Japan. Family uncertainty was measured using the Japanese version of the Managing Uncertainty in Illness Scale–Family Member form (MUIS-FM) and family QOL using the World Health Organization Five Well-Being Index (WHO-5). Multiple linear regression analysis was applied to investigate associated factors. Results WHO-5 score was significantly negatively associated with MUIS-FM score (β = − 0.236, p = 0.03); other factors associated with MUIS-FM score were the Care Shared Decision-Making Questionnaire for care providers score (β = − 0.384, p < 0.001), Short Intolerance of Uncertainty Scale score (β = 0.296, p = 0.001), and history of surgical treatment (β = 0.199, p = 0.032). Conclusions Family QOL could be improved by reducing family uncertainty. It is also suggested that promoting shared decision-making between healthcare providers and patients’ families may help reduce family uncertainty. It is necessary to take into account not only family intolerance of uncertainty but also uncertainty that varies by type of acute care provided. Supplementary Information The online version contains supplementary material available at 10.1007/s40520-022-02254-1.
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Haji Assa A, Umberger RA. A concept analysis of family caregivers' uncertainty of patient's illness. Nurs Forum 2022; 57:121-126. [PMID: 34463349 DOI: 10.1111/nuf.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
AIM To analyze and examine the concept of uncertainty of the patient's illness among family caregivers. BACKGROUND Promoting family caregivers' health is significant in nursing. Family caregivers may experience uncertainty related to their loved ones' illness. A lack of clarity exists regarding the uncertainty concept among family caregivers and its implications in nursing. DATA SOURCE A review of the literature that focused on family caregivers of adult patients using PubMed, CINAHL, and Scopus databases was completed. METHODS The Walker and Avant framework was applied to identify the attributes, antecedents, and consequences of family caregivers' uncertainty. RESULTS Eight articles were analyzed. Attributes of family caregivers' uncertainty included the patient's illness probability and family caregivers' perception of the illness. Antecedents included the characteristics of the patient's illness, factors associated with the family caregivers' perception of the illness, and family responsibilities of caregiving. The consequences included family caregivers' emotional, psychological, and financial outcomes. Family caregivers' uncertainty is defined as the perception of the inability to process information regarding the patient's illness trajectory when caring for significant others' illness. CONCLUSIONS Individuals can perceive uncertainty differently as a patient-facing uncertainty in illness versus a family caregiver facing uncertainty of their loved ones' illness.
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Affiliation(s)
- Amal Haji Assa
- Nursing Science PhD Program, College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Reba A Umberger
- Department of Acute and Tertiary Care, The University of Tennessee Health Science Cente, Memphis, Tennessee, USA
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Modelling User Preference for Embodied Artificial Intelligence and Appearance in Realistic Humanoid Robots. INFORMATICS 2020. [DOI: 10.3390/informatics7030028] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Realistic humanoid robots (RHRs) with embodied artificial intelligence (EAI) have numerous applications in society as the human face is the most natural interface for communication and the human body the most effective form for traversing the manmade areas of the planet. Thus, developing RHRs with high degrees of human-likeness provides a life-like vessel for humans to physically and naturally interact with technology in a manner insurmountable to any other form of non-biological human emulation. This study outlines a human–robot interaction (HRI) experiment employing two automated RHRs with a contrasting appearance and personality. The selective sample group employed in this study is composed of 20 individuals, categorised by age and gender for a diverse statistical analysis. Galvanic skin response, facial expression analysis, and AI analytics permitted cross-analysis of biometric and AI data with participant testimonies to reify the results. This study concludes that younger test subjects preferred HRI with a younger-looking RHR and the more senior age group with an older looking RHR. Moreover, the female test group preferred HRI with an RHR with a younger appearance and male subjects with an older looking RHR. This research is useful for modelling the appearance and personality of RHRs with EAI for specific jobs such as care for the elderly and social companions for the young, isolated, and vulnerable.
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Leal-Costa C, Lopez-Villegas A, Catalan-Matamoros D, Robles-Musso E, Lappegård KT, Bautista-Mesa RJ, Peiró S, Lopez-Liria R. Long-Term Socioeconomic Impact of Informal Care Provided to Patients with Pacemakers: Remote vs. Conventional Monitoring. Healthcare (Basel) 2020; 8:healthcare8020175. [PMID: 32560171 PMCID: PMC7348891 DOI: 10.3390/healthcare8020175] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/06/2020] [Accepted: 06/11/2020] [Indexed: 02/02/2023] Open
Abstract
The impact of informal care immediately after pacemaker (PM) implantation has been well established; however, not much is known about its long-term effects. The present study compared personal characteristics, associated problems, workloads, time, and costs related to informal care provided to patients with PM under remote monitoring (RM) vs. conventional monitoring (CM) in the hospital, five years after implantation. The PONIENTE study was a controlled, non-randomized or masked clinical trial conducted with information obtained from the perspective of informal caregivers. Data were collected at 12 and 60 months after PM implantation. The patients in the study were assigned to two different groups: remote monitoring (RM) and conventional monitoring (CM). The “Disability, personal autonomy, and dependency situations survey” (EDAD) was administered to collect information on sociodemographic characteristics, time, care difficulties, health status, professional aspects, and impact on economic, family, or leisure aspects of the main caregivers providing care to patients with pacemakers. After five years, 55 patients completed the study (RM = 21; CM = 34). The average age was 63.14 years (SD = 14.90), 96% of them were women, and the most predominant marital status was married (72%). Informal caregivers lived in the homes of the patients in 70% of cases, and 88% indicated that they had to provide care six to seven days a week. The average cost per patient during the monitoring period studied was 13.17% lower in the RM group than in the CM group, and these differences were not statistically significant (p = 0.35). This study found similar results in the two groups under study with respect to sociodemographic characteristics, workload, time, and problems associated with health, leisure and family members. The costs associated with care were higher in the CM group; however, these differences were not statistically significant.
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Affiliation(s)
| | - Antonio Lopez-Villegas
- Social Involvement of Critical and Emergency Medicine, CTS-609 Research Group, Hospital de Poniente, 04700 El Ejido-Almería, Spain
- Correspondence: ; Tel.: +34-950-022-935
| | - Daniel Catalan-Matamoros
- Department of Journalism and Communication, Universidad Carlos III de Madrid, 28903 Madrid, Spain;
- Health Sciences CTS-451 Research Group, University of Almería, 04120 Almería, Spain
| | | | - Knut Tore Lappegård
- Institute of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, 9019 Tromsø, Norway;
- Division of Medicine, Nordland Hospital, 8005 Bodø, Norway
| | | | - Salvador Peiró
- Health Services Research Unit, FISABIO-PUBLIC HEALTH, 46020 Valencia, Spain;
| | - Remedios Lopez-Liria
- Department of Nursing Science, Physiotherapy and Medicine, Hum-498 Research Team, Health Research Centre, University of Almería, 04120 El Ejido-Almería, Spain;
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Nemati S, Rassouli M, Ilkhani M, Baghestani AR, Nemati M. Development and validation of 'caring ability of family caregivers of patients with cancer scale (CAFCPCS)'. Scand J Caring Sci 2020; 34:899-908. [PMID: 31922626 DOI: 10.1111/scs.12797] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 11/13/2019] [Indexed: 11/30/2022]
Abstract
AIM Family caregivers have limited abilities that make them vulnerable to the care needs of patients. Therefore, it seems necessary to evaluate their caring ability. The aim of this study was to design an instrument for assessing the caring ability of family caregivers of cancer patients. METHODS This was a sequential exploratory mixed-method study, carried out in two qualitative and quantitative phases. The concept of caring ability and its dimensions were explained using conventional content analysis in the qualitative phase. The research participants included 41 family caregivers of cancer patients and professional caregivers who were selected using purposeful sampling method until reaching data saturation. The scale items were designed using the results of the qualitative phase of the study, as well as the review of relevant literature. In the quantitative phase, the scale was validated using content and face validity, construct validity, as well as internal consistency and stability. RESULTS The primary item pool was prepared in 108 items. Content validity was determined using CVR with a cut-off point (0.62), CVI with a cut-off point (0.8) and kappa coefficient (κ) (>0.75). The validity of 72 items was confirmed. Then, the overlapping items were merged and eventually the 45-item scale entered the face validity stage and five items with an impact factor < 1.5 were omitted. Results of KMO = 0.904 and Bartlett = 6184.012 (p < 0.001) justified the need for factor analysis. Scree plot indicates five factors with eigenvalues above 1 and 67.7% of the total variance, including 'Effective role play, Fatigue and Surrender, Trust, Uncertainty, and Caring ignorance'. Reliability of the 31-item instrument indicated a Cronbach's alpha coefficient of 0.93 and ICC of 0.94. CONCLUSIONS Caring abilities scale (CAI) of family caregivers of patients with cancer is a valid and reliable instrument that can assess caregivers' caring ability.
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Affiliation(s)
- Shahnaz Nemati
- Nursing & Midwifery School, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.,Director General, Health Promotion & Nursing Services, MOH, Tehran, Iran
| | - Mahnaz Ilkhani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ahmad Reza Baghestani
- Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Nemati
- Department of Obstetrics and Gynecology, School of Medicine, Shahrekord University of Medical Sciences, Shahrekord, Iran
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Lacerda MS, Prado PRD, Barros ALBLD, Lopes JDL. Depressive symptoms in the family caregivers of patients with heart failure: an integrative review. ACTA ACUST UNITED AC 2019; 40:e20180057. [PMID: 31188982 DOI: 10.1590/1983-1447.2019.20180057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Accepted: 11/16/2018] [Indexed: 11/22/2022]
Abstract
AIMS Identify the occurrence of depressive symptoms in family caregivers of patients with heart failure and the correlation of other variables with depressive symptoms. DESIGN/METHOD The literature review was conducted in the Web of Science, Medline, LILACS and PubMed databases in March 2017. Papers published between 2004 and 2016, written in English, Spanish or Portuguese were included. The descriptors used were health, heart failure, depression, caregivers, and family. RESULTS 26 papers were selected. 6% to 64% reported depressive symptoms. Depressive symptoms were associated with patients' and caregivers' characteristics. In most cases, depressive symptoms were greater among family caregivers than in the general population and were mainly associated with care burden and quality of life. CONCLUSIONS The studies report depressive symptoms in caregivers of patients with heart failure.
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Affiliation(s)
- Marianna Sobral Lacerda
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Patrícia Rezende do Prado
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Alba Lúcia Bottura Leite de Barros
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
| | - Juliana de Lima Lopes
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Enfermagem, Programa de Pós-Graduação em Enfermagem. São Paulo, São Paulo, Brasil
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Grant JS, Graven LJ. Problems experienced by informal caregivers of individuals with heart failure: An integrative review. Int J Nurs Stud 2018; 80:41-66. [PMID: 29353711 DOI: 10.1016/j.ijnurstu.2017.12.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 11/13/2017] [Accepted: 12/30/2017] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The purpose of this review was to examine and synthesize recent literature regarding problems experienced by informal caregivers when providing care for individuals with heart failure in the home. DESIGN Integrative literature review. DATA SOURCES A review of current empirical literature was conducted utilizing PubMed, CINAHL, Embase, Sociological Abstracts, Social Sciences Full Text, PsycARTICLES, PsycINFO, Health Source: Nursing/Academic Edition, and Cochrane computerized databases. 19 qualitative, 16 quantitative, and 2 mixed methods studies met the inclusion criteria for review. REVIEW METHODS Computerized databases were searched for a combination of subject terms (i.e., MeSH) and keywords related to informal caregivers, problems, and heart failure. The title and abstract of identified articles and reference lists were reviewed. Studies were included if they were published in English between January 2000 and December 2016 and examined problems experienced by informal caregivers in providing care for individuals with heart failure in the home. Studies were excluded if not written in English or if elements of caregiving in heart failure were not present in the title, abstract, or text. Unpublished and duplicate empirical literature as well as articles related to specific end-stage heart failure populations also were excluded. Methodology described by Cooper and others for integrative reviews of quantitative and qualitative research was used. Quality appraisal of the included studies was evaluated using the Joanna Briggs Institute critical appraisal tools for cross-sectional quantitative and qualitative studies. RESULTS Informal caregivers experienced four key problems when providing care for individuals with heart failure in the home, including performing multifaceted activities and roles that evolve around daily heart failure demands; maintaining caregiver physical, emotional, social, spiritual, and financial well-being; having insufficient caregiver support; and performing caregiving with uncertainty and inadequate knowledge. CONCLUSIONS Informal caregivers of individuals with heart failure experience complex problems in the home when providing care which impact all aspects of their lives. Incorporating advice from informal caregivers of individuals with heart failure will assist in the development of interventions to reduce negative caregiver outcomes. Given the complex roles in caring for individuals with heart failure, multicomponent interventions are potentially promising in assisting informal caregivers in performing these roles.
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Affiliation(s)
- Joan S Grant
- University of Alabama at Birmingham, School of Nursing, 1701 University Blvd, Birmingham, AL 35294-1210, United States.
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Cameron J, Thompson DR, Szer D, Greig J, Ski CF. Dyadic incongruence in chronic heart failure: Implications for patient and carer psychological health and self-care. J Clin Nurs 2017; 26:4804-4812. [DOI: 10.1111/jocn.13836] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2017] [Indexed: 01/21/2023]
Affiliation(s)
- Jan Cameron
- Australian Centre for Heart Health; Melbourne Australia
- School of Clinical Sciences; Monash University; Melbourne Australia
| | - David R Thompson
- Department of Psychiatry; University of Melbourne; Melbourne Australia
| | - Dion Szer
- Cognition and Emotion Research Centre; Australian Catholic University; Melbourne Australia
| | - Johanna Greig
- Cognition and Emotion Research Centre; Australian Catholic University; Melbourne Australia
| | - Chantal F Ski
- Department of Psychiatry; University of Melbourne; Melbourne Australia
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