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Majmudar IK, Mihalopoulos C, Abimanyi-Ochom J, Mohebbi M, Engel L. The association between loneliness with health service use and quality of life among informal carers in Australia. Soc Sci Med 2024; 348:116821. [PMID: 38569284 DOI: 10.1016/j.socscimed.2024.116821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024]
Abstract
OBJECTIVE The demanding nature of caregiving and limited social support can lead to informal carers experiencing loneliness, which can impact their well-being and overall health service use (HSU). The study aims to examine the association between loneliness with HSU and Health state utility values among informal carers in Australia. METHODS Data were derived from three waves (2009, 2013, and 2017) of the nationally representative longitudinal Household Income and Labour Dynamics of Australia (HILDA) survey, focusing on adult informal carers. Outcome measures included visits to the General Practitioner, the number of hospital admissions, and the SF-6D score. Generalized Estimating Equations (GEE) analysis was conducted to explore the associations between loneliness and HSU, as well as loneliness and utility values (based on SF-6D) while adjusting for age, sex, education, marital status, income, and physical/mental health conditions. RESULTS After controlling for covariates, lonely carers reported lower utility values (IRR = 0.91, 95%CI [0.89, 0.93], p < 0.001) compared to non-lonely carers. Lonely carers reported a higher number of GP visits (IRR = 1.18, 95% CI [1.04, 1.36], p < 0.05) as well as a higher likelihood of visiting specialists (AOR = 1.31, p = 0.046) and hospital doctors (AOR = 1.42, p = 0.013) compared to the non-lonely carers. CONCLUSIONS The findings of this study highlight the relationship between loneliness on both healthcare utilization and carers' overall well-being. Addressing loneliness through targeted interventions and social support systems can help improve health outcomes and potentially reduce the overall healthcare costs among informal carers in Australia.
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Affiliation(s)
- Ishani Kartik Majmudar
- Deakin University, Deakin Health Economics, School of Health and Social Development, Geelong, Victoria, 3220, Australia.
| | - Cathy Mihalopoulos
- Monash University, School of Public Health and Preventive Medicine, Health Economics Division, Melbourne, Australia.
| | - Julie Abimanyi-Ochom
- Deakin University, Deakin Health Economics, School of Health and Social Development, Geelong, Victoria, 3220, Australia.
| | | | - Lidia Engel
- Monash University, School of Public Health and Preventive Medicine, Health Economics Division, Melbourne, Australia.
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2
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Labori F, Bonander C, Svensson M, Persson J. Long-term effects on healthcare utilisation among spouses of persons with stroke. BMC Health Serv Res 2023; 23:1298. [PMID: 38001419 PMCID: PMC10675871 DOI: 10.1186/s12913-023-10286-0] [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: 09/06/2022] [Accepted: 11/06/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Stroke is a common and costly disease affecting the person with stroke and their relatives. If the negative effect on the health of informal caregivers to a person with stroke translates into an increased healthcare consumption has not yet been studied. Further, the importance of including costs and health consequences of informal caregiving in health economic evaluation supporting decision-making is an ongoing discussion. Therefore, this study aims to estimate the long-term effect on healthcare utilisation among spouses of persons with a first-ever stroke. METHOD The study population consists of spouses of persons with first-ever stroke events in 2010-2011 and a reference population matched on age, sex and municipality of residence. We have access to information on healthcare utilisation five years before and five years after the stroke event for the whole study population. Using a difference-in-difference approach, the main analysis estimates the effects on primary and specialist outpatient care visits and days with inpatient care per year. Further, we analyse the healthcare utilisation among spouses depending on the modified Rankin Scale (mRS) of the person with stroke. RESULTS Our main analysis indicates that spouses have slightly more days with inpatient care five years after the stroke event than the reference population (p = 0.03). In contrast, spouses have fewer primary and specialist outpatient care visits than the reference population following the stroke event. In the analysis where spouses' healthcare utilisation is analysed according to the mRS status of the person with stroke, we identify the most notable change in the number of visits to specialist outpatient and days with inpatient care among spouses of persons with mRS 3 (dependency in daily activities). CONCLUSION Our study suggests that being the spouse of a person with stroke has minor effects on healthcare utilisation. Further, healthcare utilisation is most affected among the spouses of persons with stroke and dependency in daily activities (mRS 3). According to our results, it does not seem vital to include spouses of persons with stroke healthcare utilisation in health economic evaluations.
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Affiliation(s)
- Frida Labori
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 463, Gothenburg, 405 30, Sweden.
| | - Carl Bonander
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 463, Gothenburg, 405 30, Sweden
| | - Mikael Svensson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 463, Gothenburg, 405 30, Sweden
- Department of Pharmaceutical Outcomes and Policy, College of Pharmacy, University of Florida, Gainesville, US
| | - Josefine Persson
- Health Economics and Policy, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Box 463, Gothenburg, 405 30, Sweden
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Ranganathan S, Tomar V, Chino F, Jain B, Patel TA, Dee EC, Mathew A. A burden shared: the financial, psychological, and health-related consequences borne by family members and caregivers of people with cancer in India. Support Care Cancer 2023; 31:420. [PMID: 37354234 DOI: 10.1007/s00520-023-07886-1] [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: 02/12/2023] [Accepted: 06/13/2023] [Indexed: 06/26/2023]
Abstract
In India, approximately 1.4 million new cases of cancer are recorded annually, with 26.7 million people living with cancer in 2021. Providing care for family members with cancer impacts caregivers' health and financial resources. Effects on caregivers' health and financial resources, understood as family and caregiver "financial toxicity" of cancer, are important to explore in the Indian context, where family members often serve as caregivers, in light of cultural attitudes towards family. This is reinforced by other structural issues such as grave disparities in socioeconomic status, barriers in access to care, and limited access to supportive care services for many patients. Effects on family caregivers' financial resources are particularly prevalent in India given the increased dependency on out-of-pocket financing for healthcare, disparate access to insurance coverage, and limitations in public expenditure on healthcare. In this paper, we explore family and caregiver financial toxicity of cancer in the Indian context, highlighting the multiple psychosocial aspects through which these factors may play out. We suggest steps forward, including future directions in (1) health services research, (2) community-level interventions, and (3) policy changes. We underscore that multidisciplinary and multi-sectoral efforts are needed to study and address family and caregiver financial toxicity in India.
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Affiliation(s)
| | | | - Fumiko Chino
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Department of Radiation Oncology and Affordability Working Group, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bhav Jain
- Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tej A Patel
- University of Pennsylvania, Philadelphia, PA, USA
| | - Edward Christopher Dee
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Aju Mathew
- Department of Oncology, MOSC Medical College, Ernakulam, Kerala, 682311, India
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4
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Effects of a Home-Based Exercise Program on Health-Related Quality of Life and Physical Fitness in Dementia Caregivers: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159319. [DOI: 10.3390/ijerph19159319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 02/04/2023]
Abstract
Regular exercise can be an effective health-promotion strategy to improve the physical and mental health of informal caregivers. A randomized controlled trial study was designed to evaluate the effects of a 9-month home-based exercise intervention on health-related quality of life (HRQoL) and physical fitness in female family caregivers of persons with dementia. Fifty-four female caregivers were randomly assigned to two groups for the 9-month study period. Participants of the intervention group (n = 25) performed two 60-min exercise sessions per week at home, under the direct supervision of a personal trainer. Participants in the control group (n = 23) continued their habitual leisure-time activities. HRQoL was assessed using the SF-36 questionnaire, and physical fitness was measured using a battery of appropriate fitness tests. After 9 months, significant improvements were observed in general health, social function, vitality, hand and leg strength, trunk flexor and extensor endurance, and aerobic endurance in the intervention group. The present intervention was highly adherent and safe for the participants, with no dropout related to the intervention. As a home-based exercise program conducted by a personal trainer face to face, it can be considered as a feasible and appropriate method to improve the most deficient HRQoL dimensions and contribute to preserving the functional capacity of female family caregivers of persons with dementia.
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Kuhlthau KA, Ames SG, Ware A, Hoover CG, Wells N, Shelton C. Research on Family Health and Children and Youth With Special Health Care Needs. Acad Pediatr 2022; 22:S22-S27. [PMID: 35248244 DOI: 10.1016/j.acap.2021.07.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/22/2021] [Accepted: 07/23/2021] [Indexed: 01/01/2023]
Abstract
Families of children and youth with special health care needs (CYSHCN) can face challenges with regard to health and well-being. Health systems are designed to support CYSHCN but do not often consider the health and well-being of their family. Despite a growing body of literature, substantial gaps remain in our understanding of the impact of caregiving on family health and well-being and mechanisms of supporting families. In order to better understand and address these gaps, a national CYSHCN network developed a national research agenda to prioritize key areas of insufficient understanding of health and well-being for families of CYSHCN. Questions identified by the research agenda include: 1) How can family resiliency and adaptability be measured and improved? 2) How can we better assess family mental health needs and implement appropriate interventions? 3) What is the impact of family health on CYSHCN health outcomes? This paper describes a review of what is currently known regarding health for families of CYSHCN, gaps in the literature focused on the research agenda questions, and recommendations for future research. Based on the research agenda and current state of research for family health of CYSHCN, the authors recommend focusing on resiliency and adaptability as outcomes, using implementation science to address mental health concerns of family members and to further assess the impact of family health on health outcomes of CYSHCN. In addition, research should have a special focus on diverse populations of families and consider these questions in the context of different family structures.
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Affiliation(s)
- Karen A Kuhlthau
- Department of Pediatrics, Harvard Medical School and Massachusetts General Hospital (KA Kuhlthau), Boston, Mass.
| | - Stefanie G Ames
- Critical Care Medicine, Department of Pediatrics, University of Utah School of Medicine (SG Ames), Salt Lake City, Utah
| | - Allysa Ware
- Family Voices (A Ware, CG Hoover, and N Wells), Lexington, Mass
| | | | - Nora Wells
- Family Voices (A Ware, CG Hoover, and N Wells), Lexington, Mass
| | - Charlene Shelton
- Department of Pediatrics, ACCORDS, University of Colorado School of Medicine (C Shelton), Aurora, Colo
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6
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Yakerson A. Informal family caregiver experiences with publicly funded home care in Ontario. Home Health Care Serv Q 2021; 41:65-75. [PMID: 34842061 DOI: 10.1080/01621424.2021.2006849] [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: 10/19/2022]
Abstract
Publicly funded home care in Ontario, Canada, is a critical component of the health care system. Over the last few decades the sector has undergone numerous reforms impacting the funding and provision of services. In light of this, the purpose of this study was to examine the lived experiences of informal family caregivers who seek in-home publicly funded care for their relatives. In doing so, the goal was to understand the circumstances and challenges faced by these individuals in accessing care and obtaining respite from their duties. This knowledge is fundamental to the health care system which seeks to prevent institutionalization as well as to minimize health care costs associated with the physical and psychological outcomes of informal caregiving.
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Affiliation(s)
- Alla Yakerson
- The Graduate Program in Health, York University, Toronto, Ontario, Canada
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7
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Chou FC, Huang JJ, Hsieh KY, Kao WT, Hsu ST, Li DJ, Chou LS, Lin GG, Chen WJ. Predictors for probable posttraumatic stress disorder among outpatients with psychiatric disorders and their caregivers during the COVID-19 pandemic: A cross-sectional study in Taiwan. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_7_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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8
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McCusker J, Yaffe M, Lambert SD, Cole M, de Raad M, Belzile E, Ciampi A, Amir E, Hidalgo M. Unmet needs of family caregivers of hospitalized older adults preparing for discharge home. Chronic Illn 2020; 16:131-145. [PMID: 30079741 DOI: 10.1177/1742395318789467] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Objectives To describe unmet needs of caregivers of hospitalized older adults during the transition from hospital back home, and identify subgroups with different needs. Methods Patients and family caregivers were recruited from an acute care hospital in Montreal, Canada. Measures included Instrumental Activities of Daily Living (IADL), Hospital Anxiety and Depression Scale (HADS), Zarit burden scale, and Family Inventory of Needs. Dimensions of unmet needs were explored with principal component analysis; regression tree models were used to identify subgroups with different unmet needs. Results A total of 146 patient-caregiver dyads were recruited. Three categories of caregiver unmet needs were identified: patient medical information; role clarity and support; and reassurance. Caregiver subgroups with highest unmet needs were those with high burden of care plus depressive symptoms ( n = 46) and those caring for patients with low IADL scores ( n = 10). Discussion Caregivers with high burden and depression are those with the greatest unmet needs during the care transition.
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Affiliation(s)
- Jane McCusker
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,St. Mary's Research Centre, Montreal, Québec, Canada
| | - Mark Yaffe
- St. Mary's Research Centre, Montreal, Québec, Canada.,Department of Family Medicine, McGill University, Montreal, Quebec, Canada.,Family Medicine Centre, St. Mary's Hospital Centre, Montreal, Quebec, Canada
| | - Sylvie D Lambert
- St. Mary's Research Centre, Montreal, Québec, Canada.,Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
| | - Martin Cole
- St. Mary's Hospital Centre, Psychiatry, Montreal, Québec, Canada.,Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Manon de Raad
- St. Mary's Research Centre, Montreal, Québec, Canada
| | - Eric Belzile
- St. Mary's Research Centre, Montreal, Québec, Canada
| | - Antonio Ciampi
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.,St. Mary's Research Centre, Montreal, Québec, Canada
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9
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Shaffer KM, Tigershtrom A, Badr H, Benvengo S, Hernandez M, Ritterband LM. Dyadic Psychosocial eHealth Interventions: Systematic Scoping Review. J Med Internet Res 2020; 22:e15509. [PMID: 32130143 PMCID: PMC7081137 DOI: 10.2196/15509] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/08/2019] [Accepted: 12/19/2019] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Dyadic psychosocial interventions have been found beneficial both for people coping with mental or physical health conditions as well as their family members and friends who provide them with support. Delivering these interventions via electronic health (eHealth) may help increase their scalability. OBJECTIVE This scoping review aimed to provide the first comprehensive overview of dyadic eHealth interventions for individuals of all ages affected by mental or physical illness and their family members or friends who support them. The goal was to understand how dyadic eHealth interventions have been used and to highlight areas of research needed to advance dyadic eHealth intervention development and dissemination. METHODS A comprehensive electronic literature search of PubMed, EMBASE, Cochrane, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO was conducted for articles published in the English language through March 2019. Eligible records described a psychosocial eHealth intervention that intervened with both care recipients and their support person. RESULTS A total of 7113 records were reviewed of which 101 met eligibility criteria. There were 52 unique dyadic eHealth interventions identified, which were tested across 73 different trials. Of the unique interventions, 33 were conducted among dyads of children and their supporting parent, 1 was conducted with an adolescent-young adult care recipient population, and the remaining 18 were conducted among adult dyads. Interventions targeting pediatric dyads most commonly addressed a mental health condition (n=10); interventions targeting adult dyads most commonly addressed cancer (n=9). More than three-fourths of interventions (n=40) required some human support from research staff or clinicians. Most studies (n=64) specified one or more primary outcomes for care recipients, whereas less than one-fourth (n=22) specified primary outcomes for support persons. Where specified, primary outcomes were most commonly self-reported psychosocial or health factors for both care recipients (n=43) and support persons (n=18). Results of the dyadic eHealth intervention tended to be positive for care recipients, but evidence of effects for support persons was limited because of few studies specifying primary outcomes for supporters. Trials of dyadic eHealth interventions were most commonly randomized controlled trials (RCTs; n=44), and RCTs most commonly compared the dyadic eHealth intervention to usual care alone (n=22). CONCLUSIONS This first comprehensive review of dyadic eHealth interventions demonstrates that there is substantial, diverse, and growing literature supporting this interventional approach. However, several significant gaps were identified. Few studies were designed to evaluate the unique effects of dyadic interventions relative to individual interventions. There was also limited assessment and reporting of outcomes for support persons, and there were no interventions meeting our eligibility criteria specifically targeting the needs of older adult dyads. Findings highlight areas of research opportunities for developing dyadic eHealth interventions for novel populations and for increasing access to dyadic care.
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Affiliation(s)
- Kelly M Shaffer
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | | | - Hoda Badr
- Baylor College of Medicine, Houston, TX, United States
| | | | - Marisol Hernandez
- Memorial Sloan Kettering Cancer Center, New York, NY, United States
- CUNY School of Medicine/City College of New York, New York, NY, United States
| | - Lee M Ritterband
- Center for Behavioral Health and Technology, University of Virginia School of Medicine, Charlottesville, VA, United States
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10
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Kostiukow A, Strzelecki W, Poniewierski P, Samborski W. The estimation of the functioning of families with ASD children. AIMS Public Health 2019; 6:587-599. [PMID: 31909078 PMCID: PMC6940582 DOI: 10.3934/publichealth.2019.4.587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 11/25/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Autism Spectrum Disorder (ASD) is a disease described as a neurodevelopmental disorder as the impairment of social and communication functions. Life of the people with ASD depends on the early introduction of intensive therapeutic programmes, modifying the undesirable behaviours, and aimed at teaching social and communication skills. AIMS The goal of the present work is to estimation the functioning of families with an ASD child and compare it to the functioning of families with children not diagnosed with ASD. METHODS The study was performed using Flexibility and Cohesion Evaluation Scales. The study included 70 parents of ASD children, and 70 parents with children without diagnosed ASD, as the control group. RESULTS The parents of children with autism achieve lower results in the Balanced Cohesion sub-scale than the control group. Also, the parents of ASD children obtained higher scores in the Disengaged sub-scale than the control group. CONCLUSIONS The results of this papers can suggesting the risk of the appearance of a disturbed family system, functioning in families with children with ASD, which should be a trigger for providing these families with early family functioning diagnosis and consequent support and therapy.
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Affiliation(s)
- Anna Kostiukow
- Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, 61-545 Poznań, 28 Czerwca 1956 r Street 135/147
| | - Wojciech Strzelecki
- Department and Clinic of Clinical Psychology, Poznan University of Medical Sciences, Collegium Stomatologicum, Bukowska 70 Street, 60-812 Poznań
| | - Piotr Poniewierski
- Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, 61-545 Poznań, 28 Czerwca 1956 r Street 135/147
| | - Włodzimierz Samborski
- Department and Clinic of Rheumatology and Rehabilitation, Poznan University of Medical Sciences, 61-545 Poznań, 28 Czerwca 1956 r Street 135/147
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11
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Sandoval F, Tamiya N, Lloyd-Sherlock P, Noguchi H. The relationship between perceived social support and depressive symptoms in informal caregivers of community-dwelling older persons in Chile. Psychogeriatrics 2019; 19:547-556. [PMID: 30864201 PMCID: PMC6900012 DOI: 10.1111/psyg.12438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 01/22/2019] [Accepted: 01/23/2019] [Indexed: 12/20/2022]
Abstract
AIM Depression among caregivers of older persons is a serious concern, but it is often overlooked and neglected in developing countries. The aim of this study was to examine the relationship between perceived social support and depression in informal caregivers of community-dwelling older persons in Chile. METHODS We analyzed cross-sectional secondary data on 377 dyads of community-dwelling older persons and their informal caregivers from a nationwide survey in Chile. The Duke-UNC Functional Social Support Questionnaire (FSSQ) was used to measure caregivers' perceived social support, and the Center for Epidemiologic Studies Depression Scale assessed their depression. RESULTS In this study, 76.9% of the caregivers perceived a high level of social support, and 46.9% were assessed as having depression. Based on multivariable analysis, factors that decrease the likelihood of being depressed are a high level of social support (odds ratio (OR) = 0.311, 95% confidence interval (CI): 0.167-0.579) and having taken holidays in the past 12 months (OR = 0.513, 95%CI: 0.270-0.975). Factors that increase the likelihood of being depressed are being a female caregiver (OR = 2.296, 95%CI: 1.119-4.707), being uninsured (OR = 4.321, 95%CI: 1.750-10.672), being the partner or spouse of the care recipient (OR = 3.832, 95%CI: 1.546-9.493), and the number of hours of care (OR = 1.053, 95%CI: 1.021-1.085). CONCLUSION Higher levels of perceived social support and holidays were associated with lower levels of depression. However, being female, being the care recipient's partner or spouse, being uninsured, and having long care periods had detrimental effects. Interventions to preserve and enhance perceived social support could help improve depressive symptoms in informal caregivers. Additionally, support should be available to caregivers who are women, uninsured, and the care recipient's partner or spouse, as well as those who provide care for long hours, to ensure they have respite from their caregiving role.
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Affiliation(s)
- Felipe Sandoval
- Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Japan.,School of International Development, University of East Anglia, Norwich, UK
| | - Nanako Tamiya
- Faculty of Medicine, Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
| | | | - Haruko Noguchi
- School of International Development, University of East Anglia, Norwich, UK
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12
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Ivan Vun JS, Cheah WL, Helmy H. Mental Health Status and Its Associated Factors Among Caregivers of Psychiatric Patients in Kuching, Sarawak. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2019; 14:18-25. [PMID: 31827731 PMCID: PMC6818693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Caregivers have a high risk of mental health disorders. The quality of patient care is inseparable from the mental health status of caregivers. The objective of this research was to study the mental health status among caregivers of psychiatric patients and its associated factors. METHOD A cross-sectional study was conducted among 198 caregivers in Kuching from January till July 2014. The respondents were recruited using systematic sampling and were required to provide information on sociodemographic and environmental factors as well as complete the Hospital Anxiety and Depression Scale (HADS) questionnaire. The data was analysed using the IBM SPSS Statistical Software Version 20.0. RESULTS The prevalence rates of anxiety and depression among caregivers were 32.8% and 27.8%, respectively. The caregiver's age (OR=0.97, 95% CI = 0.953 - 0.996), the perception of caregiving as an economic burden (OR= 2.70, 95% CI= 1.256 - 5.803) and the dependence of the patient (OR= 2.27, 95% CI= 1.087 - 4.719) were associated with anxiety. A caregiver who was male (OR= 2.21, 95% CI= 1.143 - 4.262), a caretaker who held the perception that a patient was dependent on them (OR=2.53, 95% CI= 1.203 - 5.337), and a caretaker who lacked stress-coping skills (OR=2.48, 95% CI= 1.030 - 5.973) were found to be significant factors in depression. CONCLUSION A high prevalence of probable anxiety and depression among caregivers points to the need to screen caregivers. There is a vital need to train healthcare workers to be able to detect early anxiety and depression. Culturally sensitive research should be carried out for different ethnicity, and improving the support system for caregivers is necessary.
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Affiliation(s)
- J S Ivan Vun
- DrPH, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. E-mail :
| | - W L Cheah
- PhD, Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. E-mail :
| | - H Helmy
- MComMed, Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia. E-mail :
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13
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Teixeira RJ, Remondes-Costa S, Graça Pereira M, Brandão T. The impact of informal cancer caregiving: A literature review on psychophysiological studies. Eur J Cancer Care (Engl) 2019; 28:e13042. [PMID: 30990936 DOI: 10.1111/ecc.13042] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 02/16/2019] [Accepted: 03/25/2019] [Indexed: 12/19/2022]
Abstract
Caregiving can be experienced as a stressful process, which can cause psychological and physical consequences. The combination of prolonged stress and the physical demands of caregiving may impair the physiological functioning of caregivers and increase the risk of health problems creating considerable stress in the life of caregivers regarding emotional, physical, social and financial areas. This literature review explored studies that used measures of the autonomic nervous system in caregivers of oncology patients such as electrodermal and cardiovascular (re)activity. The results revealed that caregivers had elevated stress levels and a serious autonomic imbalance that may, in the long term, trigger negative health consequences such as infectious diseases, cancer progression, cardiovascular disease and even premature death. The results showed the need to carry out preventive strategies in this population, in order to improve the autonomic profile of caregivers of cancer patients.
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Affiliation(s)
- Ricardo João Teixeira
- School of Psychology, University of Minho, Braga, Portugal.,Psychotherapy Department, Clínica da Ordem, Porto, Portugal.,Institute of Research and Advanced Training in Health Sciences and Technologies, CESPU, Gandra, Portugal
| | | | | | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia (CIP-UAL), Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
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Shaffer KM, Nightingale CL. Comparison of Healthcare Utilization Between Informal Caregivers and Non-Caregivers: An Analysis of the Health Information National Trends Survey. J Aging Health 2019; 32:453-461. [PMID: 30793639 DOI: 10.1177/0898264319830262] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: The demands of providing unpaid care for someone with a disabling health condition (i.e., informal caregiving) can limit attention to one's own health needs. Using a nationally representative survey, this study examines whether caregivers report different healthcare utilization relative to non-caregivers. Method: Participants in the Health Information National Trends Survey 5, Cycle 1 reported whether they provided unpaid care and healthcare utilization outcomes. Logistic regressions and chi-square tests with jackknife variance estimation were used. Results: Caregivers (N = 391) did not differ from non-caregivers (N = 2,894) in time since routine checkup or number of healthcare appointments in the past year (p values > .25). Among caregivers, number of healthcare appointments differed according to caregivers' relationship to the care recipient (p = .04). Discussion: Findings suggest that informal caregivers access routine healthcare at a frequency similar to non-caregivers. Further research should determine whether this utilization is optimal, or whether increased utilization during caregiving might help attenuate caregivers' longer term morbidity.
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Affiliation(s)
- Kelly M Shaffer
- University of Virginia School of Medicine, Charlottesville, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
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15
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Shaffer KM, Chow PI, Cohn WF, Ingersoll KS, Ritterband LM. Informal Caregivers' Use of Internet-Based Health Resources: An Analysis of the Health Information National Trends Survey. JMIR Aging 2018; 1:e11051. [PMID: 31518244 PMCID: PMC6715019 DOI: 10.2196/11051] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 01/05/2023] Open
Abstract
Background Informal caregivers express strong interest in technology innovations to help them in their caregiving role; however, divides across sociodemographic characteristics in internet and technology access may preclude the most vulnerable caregivers from accessing such resources. Objective This study aims to examine caregivers’ internet use, both generally and for seeking health-related information, and whether usage differs as a function of caregivers’ characteristics. Methods Data were analyzed from the Health Information National Trends Survey 5 Cycle 1. Participants were included in analyses if they self-identified as providing uncompensated care to a close individual. Caregivers reported internet use factors, age, education, rurality, general health, distress, and objective caregiving burden. We used chi-square tests of independence with jackknife variance estimation to compare whether internet use factors differed by caregivers’ characteristics. Results A total of 77.5% (303/391) caregivers surveyed reported ever using the internet. Of internet users, 88.1% (267/303) accessed from a home computer and 83.2% (252/303) from a mobile device. Most caregivers accessed health information for themselves (286/391, 73.1%) or others (264/391, 67.5%); fewer communicated with a doctor over the Web (148/391, 37.9%) or had a wellness app (171/391, 43.7%). Caregivers reporting younger age, more education, and good health were more likely to endorse any of these activities. Furthermore, two-thirds of caregivers (258/391, 66.0%) endorsed trust in health information from the internet. Conclusions Computers and mobile devices are practical platforms for disseminating caregiving-related information and supportive services to informal caregivers; these modalities may, however, have a more limited reach to caregivers who are older, have less education, and are in poorer health.
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Affiliation(s)
- Kelly M Shaffer
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, United States.,Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Philip I Chow
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Wendy F Cohn
- Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Karen S Ingersoll
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Lee M Ritterband
- Center for Behavioral Health & Technology, Department of Psychiatry and Neurobehavioral Sciences, University of Virginia School of Medicine, Charlottesville, VA, United States
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16
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Teixeira RJ, Applebaum AJ, Bhatia S, Brandão T. The impact of coping strategies of cancer caregivers on psychophysiological outcomes: an integrative review. Psychol Res Behav Manag 2018; 11:207-215. [PMID: 29872357 PMCID: PMC5973462 DOI: 10.2147/prbm.s164946] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose A growing number of studies have explored the psychosocial burden experienced by cancer caregivers, but less attention has been given to the psychophysiological impact of caregiving and the impact of caregivers’ coping strategies on this association. This paper reviews existing research on the processes underlying distress experienced by cancer caregivers, with a specific focus on the role of coping strategies on psychophysiological correlates of burden. Methods A broad literature search was conducted in health-related databases namely MEDLINE, Science Citations Index Expanded, Scopus, and PsycINFO, using relevant search terms. All types of studies published in English were considered for inclusion. Results We found that cancer caregiving was related to increased blood pressure, dysregulation of autonomic nervous system, hypothalamic–pituitary–axis dysregulation, immune changes, and poor health-related behaviors. We also found that problem-focused coping was associated with decreased caregiver burden, decreased depression, and better adjustment, while emotion-focused coping was related to higher levels of posttraumatic growth and psychological distress. The way coping impacts psychophysiological correlates of burden, however, remains unexplored. Conclusion A better understanding of the psychophysiological elements of caregiver burden is needed. We propose a model that attends specifically to factors that may impact psychophysiological correlates of burden among cancer caregivers. Based on the proposed model, psychosocial interventions that specifically target caregivers’ coping and emotion regulation skills, family functioning, and self-care are endemic to the preservation of the health and well-being of this vulnerable population.
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Affiliation(s)
- Ricardo João Teixeira
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal.,Clínica daOrdem, Porto, Portugal.,CESPU, Institute of Research and Advanced Training in Health Sciences and Technologies, Gandra, Portugal.,MamaHelp, Breast Cancer Support Center, Porto, Portugal
| | | | - Sangeeta Bhatia
- Department of Psychology, Gargi College, University of Delhi, New Delhi, India
| | - Tânia Brandão
- Departamento de Psicologia, Centro de Investigação em Psicologia (CIP-UAL), Universidade Autónoma de Lisboa Luís de Camões, Lisboa, Portugal
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17
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Mental Health Interventions for Parent Carers of Children with Autistic Spectrum Disorder: Practice Guidelines from a Critical Interpretive Synthesis (CIS) Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020341. [PMID: 29443933 PMCID: PMC5858410 DOI: 10.3390/ijerph15020341] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/01/2018] [Accepted: 02/10/2018] [Indexed: 11/24/2022]
Abstract
Parent carers of children with Autism Spectrum Disorder (ASD) often report increased levels of stress, depression, and anxiety. Unmet parent carer mental health needs pose a significant risk to the psychological, physical, and social well-being of the parents of the child affected by ASD and jeopardize the adaptive functioning of the family as well as the potential of the child affected by ASD. This systematic review identifies key qualities of interventions supporting the mental health of parent carers and proposes practitioner-parent carer support guidelines. A search of four databases (Medline, PubMed, PsycINFO, and Social Science Data) was conducted to identify studies that met the following criteria: (1) an intervention was delivered to parent carers of a child with ASD under the age of 18 years; (2) the research design allowed for a comparison on outcomes across groups; and (3) outcome measures of the parent carers’ mental health were used. A total of 23 studies met the inclusion criteria. A critical interpretive synthesis approach was used to produce an integrated conceptualization of the evidence. Findings suggest practitioner guidelines to support the mental health and wellbeing of parent carers should include addressing the parent’s self-perspective taking and skill for real time problem-solving.
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18
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Souza ALR, Guimarães RA, de Araújo Vilela D, de Assis RM, de Almeida Cavalcante Oliveira LM, Souza MR, Nogueira DJ, Barbosa MA. Factors associated with the burden of family caregivers of patients with mental disorders: a cross-sectional study. BMC Psychiatry 2017; 17:353. [PMID: 29070012 PMCID: PMC5655908 DOI: 10.1186/s12888-017-1501-1] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/02/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Caregivers are responsible for the home care of family members with mental-health disorders often experience changes in their life that can generate stress and burden. The aim of this study was to identify factors associated with the burden of caregivers of family members with mental disorders. METHODS This cross-sectional study was conducted with a non-probability sample of family caregivers, whose patients attended a community services program, the Psychosocial Care Centers, in three cities in the southwest region of Goiás State, Central Brazil. Data collection took place from June 2014 to June 2015. The participants were 281 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview (ZBI). Bivariate analyses (t test, analysis of variance, and Pearson correlation) were performed, and variables with values of p < 0.10 and gender were included in a multiple-linear regression model. Values of p < 0.05 were considered significant. RESULTS The caregivers were mostly female and parents of the patients, were married, with low education, and of low income. The mean ZBI score was 27.66. The factors independently associated with caregivers' burden were depression, being over 60 years of age, receiving no help with caregiving, recent patient crisis, contact days, and having other family members needing care. CONCLUSIONS This study identified factors that deserve the attention of community services and can guide programs, such as family psycho-education groups, which may help to minimize or prevent the effects of burden on family caregivers responsible for patients' home care.
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Affiliation(s)
- Ana Lúcia Rezende Souza
- Physiotherapy Course, Federal University of Goiás, Jataí, Goiás Brazil
- Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás Brazil
- Physical Education Course, Federal University of Goiás, Jataí, Goiás Brazil
| | - Rafael Alves Guimarães
- Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Goiás Brazil
| | | | | | | | - Mariana Rezende Souza
- Post Graduated Program in Social and Preventive Dentistry of the Faculty of Dentistry, Paulista State University, Araçatuba, São Paulo, Brazil
| | | | - Maria Alves Barbosa
- Faculty of Medicine, Federal University of Goiás, Goiânia, Goiás Brazil
- Faculty of Nursing, Federal University of Goiás, Goiânia, Goiás Brazil
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19
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How Medicine Has Changed the End of Life for Patients With Cardiovascular Disease. J Am Coll Cardiol 2017; 70:1276-1289. [DOI: 10.1016/j.jacc.2017.07.735] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 07/13/2017] [Accepted: 07/19/2017] [Indexed: 12/20/2022]
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20
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Pilapil M, Coletti DJ, Rabey C, DeLaet D. Caring for the Caregiver: Supporting Families of Youth With Special Health Care Needs. Curr Probl Pediatr Adolesc Health Care 2017; 47:190-199. [PMID: 28803827 DOI: 10.1016/j.cppeds.2017.07.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Caregivers of youth with special health care needs (YSHCN) are a critical part of the health care team. It is important for pediatric providers to be cognizant of the burden and strain caregiving can create. This article will discuss the health, psychological, social, and financial effects of caregiving, as well as strategies to screen for caregiver strain among families of YSHCN. Caregivers of YSHCN, for example, are more likely to report poor health status and demonstrate higher rates of depression and anxiety. Numerous validated screens for caregiver strain have been developed to address the multi-faceted effects of caregiving. Finally, we will discuss strategies to alleviate caregiver strain among this vulnerable population. We will describe services pediatric providers can encourage caregivers to utilize, including financial support through Supplemental Security Income (SSI), benefits available through the Family Medical Leave Act (FMLA), and options for respite care. Addressing caregiver strain is an important aspect of maintaining a family centered approach to the care of YSHCN.
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Affiliation(s)
- Mariecel Pilapil
- Division of General Pediatrics, Department of Pediatrics, Division of General Internal Medicine, Department of Medicine, Hofstra Northwell School of Medicine, Hempstead, NY
| | - Daniel J Coletti
- Division of General Internal Medicine, Hofstra Northwell School of Medicine, Hempstead, NY
| | - Cindy Rabey
- Division of Adolescent Medicine, Department of Pediatrics, Cohen Children's Medical Center, New Hyde Park, NY
| | - David DeLaet
- Icahn School of Medicine at Mount Sinai, New York, NY
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21
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Molebatsi K, Ndetei DM, Opondo PR. Caregiver burden and correlates among caregivers of children and adolescents with psychiatric morbidity: a descriptive cross sectional study. J Child Adolesc Ment Health 2017; 29:117-127. [DOI: 10.2989/17280583.2017.1340301] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - David M. Ndetei
- Department of Psychiatry, University of Nairobi; Africa Mental Health Foundation. Nairobi, Kenya
| | - Phillip R. Opondo
- Department of Psychiatry, University of Botswana, Gaborone, Botswana
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22
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Zegwaard MI, Aartsen MJ, Grypdonck MHF, Cuijpers P. Trust: an essential condition in the application of a caregiver support intervention in nursing practice. BMC Psychiatry 2017; 17:47. [PMID: 28148235 PMCID: PMC5288942 DOI: 10.1186/s12888-017-1209-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 01/18/2017] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND The recent policy of deinstitutionalization of health care in Western countries has resulted in a growing number of people - including elderly - with severe mental illness living in the community where they rely on families and others for support in daily living. Caregiving for partners, parents, children, and significant others can be a stressful experience and has been associated with psychosocial problems and poorer physical health. To support caregivers, a new, complex, nurse-led caregiver - centered intervention was developed. The intervention focuses on preventing deterioration in the wellbeing of caregivers. The objective of this study is to obtain a better understanding of the potentials of this new intervention. METHODS We applied an interpretative qualitative field study at two Dutch mental health care institutes. Thirteen caregivers participated in a one-time semi-structured interview. RESULTS From the caregivers' perspective, a trusting relationship between caregivers and the mental health nurse is an essential condition for the depth and hence the effectiveness of the caregiver-centered counseling intervention. In this trusting relationship three overlapping and mutually reinforcing phases were identified (1) phase of engagement, (2) recognition of personal needs and (3) hope and optimism. Each phase encompasses key experiences that enhanced trust in that phase. CONCLUSIONS Collaborative relationships between caregivers and mental health nurses provide a framework in which the mental health nurse can assess and help not only patients but also caregivers to gain insight into their situation and take on new roles and responsibilities in ways that promote their wellbeing.
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Affiliation(s)
- Marian I. Zegwaard
- Altrecht Mental Health Care, Gedachtengang 1, 3705 WH Zeist, The Netherlands
| | - Marja J. Aartsen
- 0000 0000 9151 4445grid.412414.6NOVA Norwegain Social Research, Oslo and Akershus University College, Postbox 4, St. Olavs plass, Oslo, 0130 Norway
| | - Mieke HF Grypdonck
- 0000 0001 2069 7798grid.5342.0University Centre for Nursing and Midwifery, Ghent University, De Pintelaan 185, block 5K3, 9000 Ghent, Belgium
| | - Pim Cuijpers
- 0000 0004 1754 9227grid.12380.38Department of Clinical, Neuro and Developmental Psychology, VU University Amsterdam, Van der Boechorststraat 1, Amsterdam, 1081, BT The Netherlands
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23
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Boele FW, Grant R, Sherwood P. Challenges and support for family caregivers of glioma patients. ACTA ACUST UNITED AC 2017. [DOI: 10.12968/bjnn.2017.13.1.8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - Robin Grant
- Consultant neurologist, Edinburgh Centre for Neuro-Oncology
| | - Paula Sherwood
- Professor, University of Pittsburgh (Acute and Tertiary Care, School of Nursing)
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24
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Zhou Y, Ning Y, Rosenheck R, Sun B, Zhang J, Ou Y, He H. Effect of living with patients on caregiver burden of individual with schizophrenia in China. Psychiatry Res 2016; 245:230-237. [PMID: 27562225 DOI: 10.1016/j.psychres.2016.08.046] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 08/14/2016] [Accepted: 08/14/2016] [Indexed: 10/21/2022]
Abstract
Caregiver burden may be especially high in China. However, there has been no empirical study comparing burden experienced by caregivers who live with their patient kin and caregivers live separately from their kin. This study compared caregiver burden in cohabiting and non-cohabiting families and examined characteristics that may account for observed differences ion experienced burden. Patients were evaluated on symptoms, insight, attitudes toward medication before discharge and their prime caregivers were evaluated on family burden shortly after admission. Bivariate analysis of covariance and multiple regression analyses were used to compare burden between these two groups and to identify factors that might account for observed differences between them. Of 243 schizophrenic patients, 4.9% lived with their primary caregivers. Caregiver burden was greater among caregivers living with patient kin on three factors, caregiver distress, disrupted routines and assistance provided by caregivers, but not on caregiver perceptions of behavioral problems or suicidality. Multiple regression analysis showed that living with caregiver explained 6.7%, 8.3% and 6.7% of the variance in distress, disrupted routines and helpfulness. Living with a patient was by far the strongest correlate of increased burden experienced by schizophrenia caregivers in this study and these caregivers should be offered community-based support.
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Affiliation(s)
- Yanling Zhou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yuping Ning
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Robert Rosenheck
- Department of Psychiatry, Yale University School of Medicine, New Haven, USA
| | - Bin Sun
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Jie Zhang
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Yufen Ou
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Hongbo He
- The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China.
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25
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Sharma N, Chakrabarti S, Grover S. Gender differences in caregiving among family - caregivers of people with mental illnesses. World J Psychiatry 2016; 6:7-17. [PMID: 27014594 PMCID: PMC4804270 DOI: 10.5498/wjp.v6.i1.7] [Citation(s) in RCA: 337] [Impact Index Per Article: 42.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/15/2015] [Accepted: 12/13/2015] [Indexed: 02/05/2023] Open
Abstract
All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly assuming roles as caregivers. However, the experience of men while providing care has not been explored adequately. The impact of gender on caregiving outcomes may be mediated by several other variables including patient-related factors, socio-demographic variables, and effects of kinship status, culture and ethnicity, but these have seldom been considered in the research on gender differences. Finally, it is apparent that methodological variations in samples, designs and assessments between studies contribute a great deal to the observed gender differences. This review highlights all these issues and concludes that there is much need for further research in this area if the true nature of gender differences in family-caregiving of mental illnesses is to be discerned.
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26
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Perlick DA, Berk L, Kaczynski R, Gonzalez J, Link B, Dixon L, Grier S, Miklowitz DJ. Caregiver burden as a predictor of depression among family and friends who provide care for persons with bipolar disorder. Bipolar Disord 2016; 18:183-91. [PMID: 27004622 DOI: 10.1111/bdi.12379] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 11/18/2015] [Accepted: 01/12/2016] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Over one-third of caregivers of people with bipolar disorder report clinically significant levels of depressive symptoms. This study examined the causal relationship between depression and caregiver burden in a large sample of caregivers of adult patients with bipolar disorder. METHODS Participants were 500 primary caregivers of persons with bipolar disorder enrolled in the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD).This study evaluates the strength and direction of the associations between caregiver burden and depressive symptoms at baseline and at six- and 12-month follow-up using cross-lagged panel analyses, controlling for the clinical status of patients and sociodemographic variables. RESULTS Higher levels of overall caregiver burden at baseline were associated with increased levels of depressive symptoms among caregivers at follow-up (F = 8.70, df = 1,290, p < 0.001), after controlling for baseline caregiver depression, gender, race, age, social support, and patients' clinical status. By contrast, caregiver depression at baseline was not significantly associated with caregiver burden at follow-up (F = 1.65, p = 0.20). CONCLUSIONS Caregiver burden is a stronger predictor of caregiver depressive symptoms over time than the reverse. Interventions that help alleviate caregiver burden may decrease depressive symptoms.
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Affiliation(s)
- Deborah A Perlick
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - Lesley Berk
- Mental Health and Wellbeing Research Centre, Faculty of Health, Deakin University, Geelong, VIC, Australia.,Department of Psychiatry, University of Melbourne, Parkville, VIC, Australia
| | - Richard Kaczynski
- Veterans Affairs New England Mental Illness Research, Education and Clinical Center, West Haven, CT, USA.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jodi Gonzalez
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, USA
| | - Bruce Link
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa Dixon
- Department of Psychiatry, Columbia University, New York, NY, USA.,Center for Practice Innovations, New York State Psychiatric Institute, New York, NY, USA
| | - Savannah Grier
- James J. Peters Department of Veterans Affairs Medical Center and VISN 3 Mental Illness, Research, Education and Clinical Center (MIRECC), Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine, Mount Sinai, New York, NY, USA
| | - David J Miklowitz
- Division of Child and Adolescent Psychiatry, UCLA Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
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27
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Otero P, Smit F, Cuijpers P, DeRubeis RJ, Torres Á, Vázquez FL. Differential response to depression prevention among a sample of informal caregivers: Moderator analysis of longer-term follow-up trial data. Psychiatry Res 2015; 230:271-8. [PMID: 26456895 DOI: 10.1016/j.psychres.2015.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 06/11/2015] [Accepted: 09/02/2015] [Indexed: 10/23/2022]
Abstract
Depression is one of the most common mental disorders in caregivers. Therefore, preventive interventions for this population are needed, especially for caregivers with subclinical symptoms of depression. However, no study to date has identified the characteristics of caregivers that help to predict who will or will not benefit from such a preventive intervention. This study aimed to identify moderators of response to intervention comparing problem solving and usual care in indicated prevention of depression among informal caregivers. A randomized controlled trial was conducted involving 173 participants who were allocated to the problem-solving intervention (n=89) or the usual-care control-group (n=84), with 12-months follow-up. Socio-demographic, care-related and clinical variables at baseline were analyzed as potential moderators of intervention response at 12-months follow-up. Age and emotional distress emerged as significant moderators. Those caregivers younger than 65 years and with higher emotional distress at baseline were more likely to benefit from the intervention than from usual care. Simultaneous consideration of multiple moderators found that intervention was indicated for 95.4% of the sample. Considering these moderators in clinical decision-making could contribute to matching treatments and health service users in a more personalized and effective way.
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Affiliation(s)
- Patricia Otero
- Unit of Depressive Disorders, Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Campus Vida, 15782 Santiago de Compostela, Spain.
| | - Filip Smit
- Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands; Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University, Amsterdam, The Netherlands
| | - Robert J DeRubeis
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, United States of America
| | - Ángela Torres
- Department of Psychiatry, Radiology and Public Health, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando L Vázquez
- Department of Clinical Psychology and Psychobiology, University of Santiago de Compostela, Santiago de Compostela, Spain
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28
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Rumpold T, Schur S, Amering M, Kirchheiner K, Masel EK, Watzke H, Schrank B. Informal caregivers of advanced-stage cancer patients: Every second is at risk for psychiatric morbidity. Support Care Cancer 2015; 24:1975-1982. [DOI: 10.1007/s00520-015-2987-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 10/09/2015] [Indexed: 11/29/2022]
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Saxena M. Variables That Can Enhance and Complicate Sibling Caregiving of Individuals With Intellectual and Developmental Disabilities. JOURNAL OF POLICY AND PRACTICE IN INTELLECTUAL DISABILITIES 2015. [DOI: 10.1111/jppi.12127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Quality of Life and Social Isolation Among Caregivers of Adults with Schizophrenia: Policy and Outcomes. Community Ment Health J 2015; 51:591-7. [PMID: 25690154 DOI: 10.1007/s10597-015-9848-6] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Accepted: 02/10/2015] [Indexed: 10/24/2022]
Abstract
Services have been increasingly directed at supporting carers of people living with mental illness but it is difficult to evaluate the impact of service change where benchmarks for carer functioning are sparse. Sixty Australian carers were assessed regarding their quality of life, psychological distress, social isolation and caregiving experience. Their scores were compared with two matched community samples and previous studies. Carers were ten times more likely to be socially isolated and quality of life was significantly less than matched community samples. Over 40 % of the carer sample met criteria for probable psychiatric disorder. Comparison of caregiving experiences with a study 15 years ago showed no improvement in negative caregiving experiences. Carers still face considerable challenges to their wellbeing as they support people living with mental illness, in spite of progress in the development of policy and services.
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Olagunju AT, Asoegwu CN, Campbell EA, Akinbode AA, Aina OF, Nwawolo CC. Impact of emotional distress on caregivers burden among Nigerian children with Obstructive Adenotonsillar hypertrophy. Int J Pediatr Otorhinolaryngol 2015; 79:858-862. [PMID: 25858906 DOI: 10.1016/j.ijporl.2015.03.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 03/01/2015] [Accepted: 03/05/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND Despite the significance of the role of caregivers among children with Obstructive Adenotonsillar hypertrophy (OAT), their caregiving experience and emotional well-being are given poor attention in research, policy and service design. This study represents a novel effort sought to investigate the burden experienced by caregivers of children with OAT and the impact of emotional distress on their caregiving burden. METHODOLOGY A total of one hundred consecutive caregivers of children with OAT were interviewed with designed socio-demographic questionnaire. This was subsequently followed by administration of General Health Questionnaire-12 (GHQ-12) to ascertain emotional distress using cut-off score ≥ 3 and Zarit Caregivers Burden of care scale was used to characterize the pattern of burden experienced by these caregivers. RESULTS In this study, the mean ages of children with OAT and their caregivers were 36.7(± 21.8) months and 34.4(± 5.4) years, respectively. The affected children were mainly males (68%), while their caregivers were predominantly females (84%). Fifty-seven percent of children with OAT were schooling but 13% of them had academic delay. Majority of the caregivers (66%) had a tertiary level of education. Of the total participants, up to 43% reported various degrees of burden of care, with majority (34%) of them reporting mild to moderate burden of care. In the same vein, 48% were emotionally distressed. Following regression analyses, emotional distress was independently associated with burden of care among participants (Odds ratio [OR]=0.108; 95% Confidence Interval [95% CI]=0.043-0.272; p < 0.001). CONCLUSION Caregivers of children with OAT reported the experience of various degrees of burden, and worse among caregivers with emotional distress. Overall, the level of distress and burden observed in this study were many-fold what has been reported among caregivers of other populations of children. The results of this study support the proposal of proactive measures to address the psychosocial needs of caregivers as integral to the care of children with OAT. Further research on the well-being of caregivers is also justified.
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Affiliation(s)
- Andrew T Olagunju
- Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003 Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003 Lagos, Nigeria.
| | - Chinyere N Asoegwu
- Department of Ear, Nose and Throat, Lagos University Teaching Hospital, PMB 12003 Lagos, Nigeria
| | - Elizabeth A Campbell
- Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003 Lagos, Nigeria
| | - Abiola A Akinbode
- Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003 Lagos, Nigeria
| | - Olatunji F Aina
- Department of Psychiatry, College of Medicine, University of Lagos, PMB 12003 Lagos, Nigeria; Department of Psychiatry, Lagos University Teaching Hospital, PMB 12003 Lagos, Nigeria
| | - Clement C Nwawolo
- Department of Ear, Nose and Throat, Lagos University Teaching Hospital, PMB 12003 Lagos, Nigeria; Department of Ear, Nose and Throat, College of Medicine, University of Lagos, PMB 12003 Lagos, Nigeria
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Prevalence of major depressive episodes in non-professional caregivers. Psychiatry Res 2015; 226:333-9. [PMID: 25667119 DOI: 10.1016/j.psychres.2014.12.066] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Revised: 12/18/2014] [Accepted: 12/19/2014] [Indexed: 11/18/2022]
Abstract
Despite research demonstrating the psychological burden associated with caregiving, there is limited information regarding the real rates of clinical depression among non-professional caregivers (NCs) of dependent patients. The goals of the current study are (a) to report the prevalence of major depressive episodes (MDEs) and the frequency of depressive symptoms in NCs from Galicia (Spain) and (b) to examine the relationship between MDEs and characteristics of caregivers, care recipients, and the care situation. A sample of 504 NCs providing care to persons with all kinds of disorders that result in dependency was randomly selected, and the occurrence of MDEs was assessed by trained interviewers who applied the Structured Clinical Interview for DSM-IV Axis I Disorders-Clinician Version (SCID-CV). Overall, 8.9% of NCs met the criteria for a current MDE. Sleep problems, diminished ability to think or concentrate, and depressed mood were the clinical depressive symptoms most frequently reported. MDEs were significantly more common among NCs older than 55 years old (odds ratio [OR]=1.96; 95% confidence interval [CI]: 1.02-3.75) and those who were unemployed (OR=3.43; 95% CI 1.02-11.48). The findings highlight the magnitude of major depression in this population.
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Tuithof M, ten Have M, van Dorsselaer S, de Graaf R. Emotional disorders among informal caregivers in the general population: target groups for prevention. BMC Psychiatry 2015; 15:23. [PMID: 25884352 PMCID: PMC4337323 DOI: 10.1186/s12888-015-0406-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Accepted: 02/03/2015] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND There are indications that informal caregiving negatively impacts caregivers' mental health, but this was hardly examined using diagnoses of mental disorders and most studies used convenience samples without including non-caregivers as reference group. We examine whether informal caregivers more often have any emotional disorder, i.e. mood or anxiety disorder, than non-caregivers. Identify key risk indicators for any emotional disorder among informal caregivers in the general population. METHODS Data were used from the second wave of the Netherlands Mental Health Survey and Incidence Study-2 (NEMESIS-2), a nationally representative face-to-face survey (n = 5,303; aged 21-68). Respondents were defined as informal caregiver when they provided unpaid care in the 12 months preceding the second wave to a family member, partner or friend who needed care because of physical or mental problems, or ageing. Twelve-month DSM-IV diagnoses of emotional disorders were assessed using the Composite International Diagnostic Interview 3.0. Key risk indicators were identified using the following aspects: prevalence, odds ratio, attributable risk proportion, and number needed to treat. Sociodemographic, caregiving-related and other characteristics were considered as risk indicators. RESULTS In the past year, 31.1% of the respondents provided informal care, which ranged in time spent (8 or more hours/week: 32.1%) and duration (longer than 1 year: 48.7%). Informal caregiving was not associated with having any 12-month emotional disorder. Among caregivers, giving care to a first-degree relative, partner or close friend and giving emotional support increased the risk for any emotional disorder. Moreover, using all aspects, target groups were identified for prevention: caregivers without a job, living without a partner, and with a lack of social support. CONCLUSIONS Although informal caregivers do not have an increased risk of emotional disorders, key risk indicators were identified using four aspects. Especially informal caregivers with limited resources (unemployment, living without a partner, lack of social support) may benefit from targeted prevention whereas general prevention measures may be desirable for carers with a burdensome care situation (giving care to a close loved one or providing emotional support).
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Affiliation(s)
- Marlous Tuithof
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Margreet ten Have
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Saskia van Dorsselaer
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
| | - Ron de Graaf
- Netherlands Institute of Mental Health and Addiction, PO Box 725, 3500 AS, Utrecht, the Netherlands.
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Medrano M, Rosario RL, Payano AN, Capellán NR. Burden, anxiety and depression in caregivers of Alzheimer patients in the Dominican Republic. Dement Neuropsychol 2014; 8:384-388. [PMID: 29213930 PMCID: PMC5619188 DOI: 10.1590/s1980-57642014dn84000013] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Alzheimer's disease (AD) has a major impact by limiting the ability to live
independently. This condition of dependency involves all members of the family,
particularly those who take direct care of patients. The changes that take place
in caregivers' lives may alter their health and have an effect on the care of
the sick.
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Affiliation(s)
- Martin Medrano
- MD, Professor of Geriatrics at Pontificia Universidad Católica Madre y Maestra. Director of the Unit for Clinical Research, Memory and Alzheimer (UCIMA). Chief of Geriatrics at University Hospital Jose Ma. Cabral & Baez, Santiago, Dominican Republic
| | - Rebeca López Rosario
- MD, School of Medicine, Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
| | - Anyolina Núñez Payano
- MD, School of Medicine, Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
| | - Natacha Reynoso Capellán
- MD, School of Medicine, Pontificia Universidad Católica Madre y Maestra, Santiago, Dominican Republic
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Caregiving among American Indians and Alaska Natives with cancer. Support Care Cancer 2014; 23:1607-14. [PMID: 25416095 DOI: 10.1007/s00520-014-2512-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 11/10/2014] [Indexed: 01/02/2023]
Abstract
PURPOSE Caregivers are an important source of support for oncology patients during cancer diagnosis and treatment, often helping patients manage barriers to care. Our study had three goals: to describe the characteristics of caregivers for American Indian and Alaska Native (AI/AN) oncology patients, to assess the similarities and differences between the perceptions of caregivers and patients regarding barriers to cancer care, and to compare AI/AN caregivers to non-AI/AN caregivers on perceived barriers to cancer care. METHODS We conducted a structured interview that assessed perceived barriers to cancer care with a paired sample of 98 adult caregivers and 98 AI/AN oncology patients and to assess the degree of agreement between these two groups. We also investigated whether AI/AN and non-AI/AN caregivers had differing perceptions of barriers to cancer care. RESULTS Caregivers reported that their role was very meaningful and not highly stressful. Caregivers and patients agreed 70 % of the time on specific barriers to cancer care. Both groups overwhelmingly reported financial and family or work issues as major barriers to care, whereas trust in providers was the least frequently endorsed barrier. A comparison of AI/AN and non-AI/AN caregivers revealed that AI/AN caregivers identified confidentiality among clinical staff as a significant barrier, whereas non-AI/AN caregivers perceived financial barriers as more significant. CONCLUSIONS Finances, family, and work are perceived as the largest barriers to the receipt of cancer care for AI/AN oncology patients. Both patients and caregivers trusted health-care providers. Assessing barriers to care early in the assessment process may result in better engagement with cancer treatment by patients and their caregivers.
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Günbey E, Karabulut H. Multidimensional scale of perceived social support in patients with obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol 2014; 271:3067-71. [PMID: 24939177 DOI: 10.1007/s00405-014-3136-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/05/2014] [Indexed: 11/28/2022]
Abstract
Social support is a very important aspect of debilitating diseases. Obstructive sleep apnea syndrome (OSAS) is a common disabling disease that impairs a patient's quality of life and affects a patient's environment. The Multidimensional Scale of Perceived Social Support (MSPSS) is used to measure the perception of the sufficiency of social support for individuals. The aim of this study is to evaluate the relationship of the MSPSS to the Apnea-Hypopnea Index (AHI), age and gender in patients with OSAS. In this study, 183 subjects with a diagnosis of OSAS were enrolled. Patients were evaluated with the MSPSS in terms of age, gender and polysomnography results. According to the results of this study, the MSPSS has found to be higher in men than in women with OSAS and higher in moderate-severe OSAS than in mild OSAS. The MSPSS can be an important indicator of how patients cope with the disease.
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Affiliation(s)
- Emre Günbey
- School of Medicine, Department of Otolaryngology, Ondokuz Mayıs University, Kurupelit, Samsun, 55139, Turkey,
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Blanco V, Rohde P, Vázquez FL, Torres Á. Identification of caregivers at greatest risk of major depression in two prevention studies. Psychother Res 2013; 24:578-93. [DOI: 10.1080/10503307.2013.847989] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Psychosocial burden on informal caregivers of patients with bipolar mood disorders. MIDDLE EAST CURRENT PSYCHIATRY 2013. [DOI: 10.1097/01.xme.0000433783.67281.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pandit LV, Vishnuvardhan G. Impact of age and gender on the coping styles and psychiatric morbidity faced by informal primary caregivers of HIV-infected individuals living in India. J Int Assoc Provid AIDS Care 2013; 13:24-8. [PMID: 23612766 DOI: 10.1177/2325957412456742] [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: 11/15/2022] Open
Abstract
BACKGROUND Primary caregivers of HIV-infected patients face enormous burden, which if inappropriately coped, leads to psychiatric morbidity. Little is known of what role caregiver's age and gender play in this. PURPOSE To assess the socio-demographic profile and the influence of age and gender on coping strategies and psychiatric morbidity. PROCEDURE Sixty caregivers were assessed on a semistructured sociodemographic proforma, a coping checklist, and the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; [SCID-I]). MAIN FINDINGS Majority of the carers were young, equally from both genders, and used the same number of coping strategies which increased with age. "Avoidance" was preferred by males and older carers. Youngsters had maximum psychiatric morbidity, majority of the depressed were females, while 90% of nicotine dependants were males. CONCLUSION Gender, but not age, decided the style of coping and extent of psychiatric morbidity hence gender-specific interventions will improve the quality of life of the carers and their wards.
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Associations between adolescent depression and parental mental health, before and after treatment of adolescent depression. Eur Child Adolesc Psychiatry 2013; 22:3-11. [PMID: 22836732 DOI: 10.1007/s00787-012-0310-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
Abstract
The negative impacts of parental mental health problems on children and adolescents are well known, but the relationship between a child's depression and their parents' health is not so well understood. Being a carer/parent of someone with mental illness can be associated with negative outcomes for the caregiver. This paper reports the associations between the mental health of adolescents with major depression and their parents, before and after treatment of the adolescent's depression. Data were collected as part of the Adolescent Depression Antidepressants and Psychotherapy Trial, a randomised controlled trial of selective serotonin reuptake inhibitors with and without cognitive behaviour therapy in 208 clinic-recruited adolescents with major depression. The baseline severity of depression in the adolescent was significantly associated with both maternal and paternal mental health (as rated by the General Health Questionnaire). This effect was not confounded by other psychiatric symptoms. The degree of improvement in parental and child mental health was positively correlated across time. Our results support the hypothesis that there is a significant association between parental mental health and adolescent depressive symptoms. This study was not able to establish the direction of this association. In clinical practice, the findings demonstrate the importance of considering the mental health of the parents when treating depressed adolescents.
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Enhancing quality of life and mastery of informal caregivers of high-grade glioma patients: a randomized controlled trial. J Neurooncol 2012; 111:303-11. [PMID: 23212677 DOI: 10.1007/s11060-012-1012-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022]
Abstract
High-grade gliomas (HGG) are serious primary brain tumors that may prevent the patient from functioning normally in social, emotional and cognitive respect. Often the partner's role will convert to that of informal caregiver. Consequently, they may experience significant stress and reductions in caregiver mastery, negatively affecting their health-related quality of life (HRQOL). We aimed at (1) determining factors that impact HRQOL and mastery of caregivers of HGG patients, and (2) investigate if a structured intervention consisting of psychoeducation and cognitive behavioral therapy leads to improvements in the mental component of HRQOL and mastery of caregivers. Fifty-six patient-caregiver dyads were randomly assigned to the intervention group or the care as usual group. The intervention program consisted of six one-hour sessions with a psychologist. Participants completed questionnaires concerning their perceptions of the patients' HRQOL (SF-36), neurological functioning (BN20), and cognitive functioning (MOS), and concerning their own HRQOL (SF-36) and feelings of caregiver mastery (CMS) both at baseline (i.e. before randomization) and every 2 months thereafter until 8 months later, five times in total. Patients' HRQOL and neurological functioning were found to be related to HRQOL and feelings of mastery of the informal caregiver at baseline. The intervention helped caregivers in maintaining a stable level of HRQOL and improved feelings of mastery over an 8 month period. Our findings suggest that informal caregivers can benefit from a psychological intervention as it is a helpful tool in maintaining a stable level of mental functioning and caregiver mastery.
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Balhara YPS, Verma R, Sharma S, Mathur S. A study of predictors of anxiety and depression among stroke patient-caregivers. J Midlife Health 2012; 3:31-5. [PMID: 22923977 PMCID: PMC3425146 DOI: 10.4103/0976-7800.98815] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Context: Caregivers play an important role in supporting people with illness either acute or chronic. It is important to explore caregiver's emotional turmoil as it helps in exploring their burden which can have impact on the patient's illness and functioning apart from their own. Aims: The current study aimed at assessing the predictors of anxiety and depression among caregivers of patients with stroke. Settings and Design: Seventy-five consecutive patient-caregiver dyads were recruited in the study. Materials and Methods: Patients and caregivers were assessed using a semi-structured proforma for the sociodemographic details. Subsequently these dyads were assessed for anxiety and depression levels using the Hospital Anxiety and Depression Scale. Statistical Analysis Used: Chi-square tests (for categorical variables) were used to find difference between the patients and the caregivers on different variables. Additionally Cramer's V-test and phi test were used for 2*4 contingency tables. Linear regression model was used. Results: Linear regression revealed that anxiety level in caregivers was predicted by the sex of care giver. Conclusions: Caring for the patients with stroke presents increased burden to the care givers which manifests as increased rate of anxiety and depression among them. It is important to assess the care givers along with the patients for emergence of these negative affective states. One needs to be extra cautious if the patient happens to be the primary earning member of the family.
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Affiliation(s)
- Yatan Pal Singh Balhara
- National Drug Dependence Treatment Centre (NDDTC), All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Fauth E, Hess K, Piercy K, Norton M, Corcoran C, Rabins P, Lyketsos C, Tschanz J. Caregivers' relationship closeness with the person with dementia predicts both positive and negative outcomes for caregivers' physical health and psychological well-being. Aging Ment Health 2012; 16:699-711. [PMID: 22548375 PMCID: PMC3430821 DOI: 10.1080/13607863.2012.678482] [Citation(s) in RCA: 107] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Closer relationships between caregivers and care recipients with dementia are associated with positive outcomes for care recipients, but it is unclear if closeness is a risk or protective factor for the health and psychological wellbeing of caregivers. We examined 234 care dyads from the population-based Cache County Dementia Progression Study. Caregivers included spouses (49%) and adult offspring (51%). Care recipients mostly had dementia of the Alzheimer’s type (62%). Linear mixed models tested associations between relationship closeness at baseline or changes in closeness prior to versus after dementia onset, with baseline levels and changes over time in caregiver affect (Affect Balance Scale, ABS), depression (Beck Depression Inventory, BDI), and mental and physical health (components of the Short-Form Health Survey, SF-12). After controlling for demographic characteristics of the caregiver, number of caregiver health conditions, and characteristics of the care recipient (type of dementia, functional ability, and behavioral disturbances), we found that higher baseline closeness predicted higher baseline SF-12 mental health scores (better mental health) and lower depression. Higher baseline closeness also predicted greater worsening over time in ABS and SF-12 mental health. In addition, caregivers who reported a loss of closeness in their relationship with the care recipient from pre- to post-dementia displayed improved scores on ABS and SF-12 mental health, but worse SF-12 physical health over the course of the study. These results suggest that closeness and loss of closeness in the care dyad may be associated with both positive and adverse outcomes for caregivers, both cross-sectionally and over time.
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Affiliation(s)
- Elizabeth Fauth
- Family, Consumer, and Human Development, Utah State University, Logan, USA.
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Abstract
RÉSUMÉCet article examine la littérature internationale rédigée en anglais sur le thème du soutien social et des soins gérontologiques depuis le début des années 1990. La littérature s’est développée, mais il manque de consensus sur le sens des termes et sur la mesure. L’intérêt reste une constante pour l’aide pratique, les prestations de soutien social, et la demande et les résultats négatifs pour les aidants, avec de plus en plus de questions plus théoriques, auxquelles on accorde de moins en moins d’importance, sur les résultats négatifs du soutien reçu, ainsi que sur les conséquences positives de la prestation de soins. Le soutien social, néanmoins, est dûment reconnu comme un déterminant social de la santé et reçoit l’attention au niveau des politiques—qui sont tous deux d’importants changements à partir de deux décennies—et ajoutent a l’intérêt ce domaine recevra de chercheurs dans les décennies à venir. Il reste de nombreuses questions sans réponses quant à l’évolution du contexte sociétal, mais il est clair que le soutien social des personnes – y compris la vieillesse et tout au long de la vie – se poursuivra dans l’avenir, quoique dans des formes toujours renouvelées.
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MacFarlane MM. Family Centered Care in Adult Mental Health: Developing a Collaborative Interagency Practice. ACTA ACUST UNITED AC 2011. [DOI: 10.1080/08975353.2011.551100] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Franco C, Sola MDM, Justo E. [Reducing psychological discomfort and overload in Alzheimer's family caregivers through a mindfulness meditation program]. Rev Esp Geriatr Gerontol 2010; 45:252-8. [PMID: 20541288 DOI: 10.1016/j.regg.2010.03.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2009] [Revised: 03/16/2010] [Accepted: 03/16/2010] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This study analyzes the effects that a mindfulness development meditation program has on psychological discomfort and overload in main family caregivers of Alzheimer dementia patients. MATERIAL AND METHODS A quasi-experimental (group comparison) design with pretest/post-test/follow-up measurements was employed in an experimental and a control group. The evaluation instruments used were the SCL-90-R Questionnaire and the Caregiver Overload Scale. RESULTS The statistical analyses done show a significant reduction in the three general indices and in the various dimensions of psychological discomfort, as well as in the caregiver overload variable in the experimental group compared to the control group at the end of the intervention. However, the improvements found in the experimental group were lower in the follow-up evaluation done four months after intervention, with significantly higher scores than in post-test in all the dimensions. CONCLUSIONS These results are in agreement with other studies in which it was found that intervention for Alzheimer caregivers is effective in the short term, but the effect becomes diluted over time, so measurements and policies for these caregivers have to enable the beneficial effects of intervention reducing psychological discomfort and overload to be maintained.
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Affiliation(s)
- Clemente Franco
- Departamento de Psicología Evolutiva y de la Educación, Universidad de Almería, Almería, Spain.
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A'Campo LEI, Spliethoff-Kamminga NGA, Macht M, Roos RAC. Caregiver education in Parkinson's disease: formative evaluation of a standardized program in seven European countries. Qual Life Res 2009; 19:55-64. [PMID: 19946755 PMCID: PMC2804793 DOI: 10.1007/s11136-009-9559-y] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2009] [Indexed: 11/28/2022]
Abstract
PURPOSE The formative evaluation of a standardized psychosocial education program for patients with Parkinson's disease (PD) and their caregivers. The results of the participation of the caregivers are presented next to the data of the patients. METHODS Caregivers (n = 137) and patients with PD (n = 151) participated in the 8-week program in separate groups. Measurements were performed on psychosocial problems (BELA-P/A-k), health state (EQ-5D VAS), quality of life (PDQ-39) and depression (SDS) 1 week before and 1 week after the program. Participants rated their mood on a visual analogue scale before and after each session, and they filled in an evaluation questionnaire after the last session. RESULTS Scores on the BELA-P/A-k improved significantly on the 'bothered by scale' as well as the 'need for help scale'. No improvements were found on EQ-5D VAS, PDQ-39 and SDS. Mood ratings improved significantly after each session. Most participants evaluated the program as positive. Feedback led to improvements in the program, which are incorporated in a final manual. CONCLUSIONS The program was feasible to run in the different countries. This exploratory study led to improvements in the program and recommendations for further research. A study on the effectiveness of the program is the next step.
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Affiliation(s)
- L E I A'Campo
- Department of Neurology, Leiden University Medical Center (LUMC), Leiden, The Netherlands.
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Funk LM, Kobayashi KM. "Choice" in filial care work: moving beyond a dichotomy. CANADIAN REVIEW OF SOCIOLOGY = REVUE CANADIENNE DE SOCIOLOGIE 2009; 46:235-252. [PMID: 20027751 DOI: 10.1111/j.1755-618x.2009.01213.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
In this paper, we discuss the concept of"choice" in filial care work. A dichotomy between choice and obligation is constructed in theoretical and empirical literature on filial care work. However, this dichotomy does not adequately reflect family caregiving experiences; for instance, choice and obligation are not mutually exclusive motivations. Rather, choice and obligation are "relational" and "contextual" and manifest in the interaction between macro- and micro-contexts. The choice-obligation dichotomy is also ideological. At the moral-political level, it promotes the downloading of responsibility by governments to family, obscures the complexity of filial relationships, and may even promote psychological ambivalence.
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Affiliation(s)
- Laura M Funk
- Centre on Aging, University of Victoria, Sedgewick Rm A123, PO Box 1700 STN CSC, British Columbia, Canada, V8W 2Y2.
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