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Baykal D, Bilgic B. The effects of progressive muscle relaxation exercise on dementia caregivers. Geriatr Nurs 2024; 59:491-497. [PMID: 39146639 DOI: 10.1016/j.gerinurse.2024.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/06/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024]
Abstract
While progressive muscle relaxation has demonstrated effectiveness in reducing anxiety, stress, and depression in general populations, its impact on caregivers of dementia patients remains understudied. This study investigated the effectiveness of Progressive Muscle Relaxation (PMR) in improving the well-being of dementia caregivers. Caregivers of individuals with dementia (n = 57) participated in a 3-month intervention, engaging in PMR thrice weekly. Participants completed assessments of depression, anxiety, stress, and caregiver burden at pre-test and post-intervention period. The intervention led to significant reductions in anxiety, stress, depression, and caregiver burden among participants. Female caregivers reported to have higher levels of anxiety and stress compared to males. Caregivers under financial stress showed high levels of distress and increased caregiver burden. These promising findings suggest the need for further research with larger, multicenter samples. Notably, PMR is a readily implementable intervention by nurses, requiring minimal equipment and offering a cost-effective approach to supporting caregiver well-being.
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Affiliation(s)
- Dilek Baykal
- Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, , Türkiye.
| | - Basar Bilgic
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, , Türkiye
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2
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Chen CY, Chen JH, Ree SC, Chen CH, Yu SH. Attributional styles are associated with care burden in geriatric depression: older adults and their caregivers in Taiwan. Aging Clin Exp Res 2024; 36:106. [PMID: 38714627 PMCID: PMC11076353 DOI: 10.1007/s40520-024-02762-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/19/2024] [Indexed: 05/10/2024]
Abstract
BACKGROUND Given the rising prevalence of depression among older adults and the associated increase in caregiving responsibilities, understanding factors influencing caregiver burden is crucial. Previous research has not extensively explored the impact of caregivers' attributional styles, that is, how individuals interpret the causes of life events, on their care burden. AIM This study examined the relationship between caregivers' attributional styles and their care burden for older patients with depression. METHODS This cross-sectional study enrolled older adults aged ≥ 65 years diagnosed with depression and their caregivers. Depression was diagnosed according to the DSM-V criteria for Major Depressive Disorder or Persistent Depressive Disorder. Caregivers completed the Chinese Depression Caregiver Burden Scale (CDCBS) to assess care burden, the Hamilton Depression Rating Scale (HAM-D) to evaluate patient symptom severity, the Center for Epidemiological Studies Depression Scale (CES-D) for measuring caregivers' depression, and the Chinese Depression Patient Caregiver Attribution Style Scale (CDPCAS) to assess attributional styles. Hierarchical regression analysis was used to identify the factors independently associated with the caregiver's subjectively assessed care burden. RESULTS The sample included 146 caregivers of geriatric patients with depression. Most depression patients were women (74.7%) with a mean age of 74.3 years, whereas the mean age of caregivers was 57.7 years. Hierarchical regression analysis identified that caregivers' gender (β = - 0.14, p = .044), educational level (β = 0.19, p = .008), caregivers' own depression assessed by the Center for Epidemiological Studies Depression Scale (β = 0.41, p < .001), and attributional styles, particularly manipulation (β = 0.29, p < .001) and illness/stress attributional style (β = 0.23, p = .002) as independent factors associated with care burden. Patient symptom severity assessed using the Hamilton Depression Scale was not significantly correlated with care burden after controlling for attributional styles. CONCLUSIONS Certain attributional styles, particularly the manipulation and illness/stress attributional styles, significantly increased self-reported care burden. These findings highlight the need for educational resources to change the attribution style, along with support systems and accessible mental health services for caregivers to potentially ease the care burden.
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Affiliation(s)
- Ching-Yen Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jian-Hong Chen
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Shao-Chun Ree
- Department of Psychiatry, Chang Gung Hospital, Keelung, Taiwan
- Faculty of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Hui Chen
- Department of Nursing, Chang Gung Hospital, Keelung, Taiwan
| | - Sheng-Hsiang Yu
- Department of Psychology and Counseling, National Taipei University of Education, No. 134, Sec. 2, Heping E. Rd., Da'an Dist, Taipei, Taiwan.
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Askaryzadeh Mahani M, Ghasemi M, Arab M, Baniasadi Z, Omidi A, Irani PS. The correlation between caregiver burden with depression and quality of life among informal caregivers of hemodialysis and thalassemia patients during the COVID-19 pandemic: a cross-sectional study. BMC Nurs 2023; 22:183. [PMID: 37246222 DOI: 10.1186/s12912-023-01351-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 05/23/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Lifelong provision of care to chronically ill patients increase the risk of physical and mental diseases in informal caregivers and adversely affects their quality of life. The present study examined the correlation between caregiver burden, depression, and quality of life among the informal caregivers of thalassemia and hemodialysis patients during the COVID-19 pandemic in southeastern Iran. METHODS This cross-sectional correlational study used convenience sampling to select 200 informal caregivers involved in providing direct care for patients undergoing hemodialysis (n = 70) and patients with thalassemia (130) for at least 6 months. A demographic questionnaire, Beck's Depression Inventory (BDI), the Quality-Of-Life Questionnaire (SF-36), and the Zarit Burden Interview were used to collect data in 2021. The data were analyzed with SPSS software (version 19) using frequency, percentage, independent samples t-test, ANOVA, and multivariate regression analysis. RESULTS Most of the informal caregivers of the thalassemia and hemodialysis patients (58% and 43%) reported moderate levels of caregiver burden. There were significant correlations between the caregiver burden and depression (P < 0.0001) and between the caregiver burden and the quality of life (P < 0.009). The level of depression in informal caregivers of patients undergoing hemodialysis was higher than that of the informal caregivers of patients with thalassemia, but the quality of life in the informal caregivers of the patient's undergoing hemodialysis was higher than that of the informal caregivers of the patients with thalassemia. CONCLUSION Considering the significant correlations between caregiver burden, depression, and quality of life in this study, healthcare providers are recommended to develop educational and supportive interventions to meet informal caregivers' needs, mitigate their emotional distress, fears, and concerns, and prevent caregiver burden in times of greater uncertainty.
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Affiliation(s)
- Maryam Askaryzadeh Mahani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran.
| | | | | | | | - Ali Omidi
- School of Nursing ad Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parichehr Sabaghzadeh Irani
- Student Research Committee, Razi faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Tan KP, Ang JK, Koh EBY, Pang NTP, Mat Saher Z. Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4232. [PMID: 36901243 PMCID: PMC10002240 DOI: 10.3390/ijerph20054232] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 02/15/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.
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Affiliation(s)
- Khai Pin Tan
- Department of Psychiatry and Mental Health, Hospital Tengku Ampuan Afzan, Kuantan 25100, Pahang, Malaysia
| | - Jin Kiat Ang
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Eugene Boon Yau Koh
- Department of Psychiatry, Universiti Putra Malaysia, Serdang 43400, Selangor, Malaysia
| | - Nicholas Tze Ping Pang
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
| | - Zanariah Mat Saher
- Department of Psychiatry and Mental Health, Kuala Lumpur General Hospital, Kuala Lumpur 50586, Federal Territory of Kuala Lumpur, Malaysia
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Corallo F, Maresca G, Bonanno L, Lo Buono V, De Caro J, Bonanno C, Formica C, Quartarone A, De Cola MC. Importance of telemedicine in mild cognitive impairment and Alzheimer disease patients population during admission to emergency departments with COVID-19. Medicine (Baltimore) 2023; 102:e32934. [PMID: 36827032 PMCID: PMC9949366 DOI: 10.1097/md.0000000000032934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In March 2020, the World Health Organization declared a global pandemic due to the new coronavirus SARS-CoV-2, and several governments have planned a national quarantine to control the spread of the virus. Acute psychological effects during hospitalization in frail elderly individuals with special needs, such as patients with dementia, have been little studied. The greatest distress manifested by these kinds of patients was isolation from their families during hospitalization. Thus, structured video call interventions were carried out to family caregivers of patients diagnosed with dementia during their hospitalization in the COVID-19 ward. The purpose of this quasi-experimental study was to assess changes in cognitive and behavioral symptoms in both patients and caregivers. All study participants underwent psychological assessments. Specifically, the psychological well-being states of patients and their caregivers were measured at admission (T0) and discharge (T1) using psychometric tests and clinical scales. Each participant received an electronic device to access video calls in addition meetings were scheduled with the psychologist and medical team to keep caregivers updated on the health status of their relatives. A psychological support and cognitive rehabilitation service was also provided. Significant differences were found in all clinical variables of the caregiver group. Results showed a significant relationship in the quality of life score between the patient and caregiver groups. The results of this study has highlighted the importance of maintaining significantly effective relationships during the hospitalization period of patients admitted to COVID wards.
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Affiliation(s)
| | - Giuseppa Maresca
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
- * Correspondence: Giuseppa Maresca: IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy (e-mail: )
| | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
| | | | - Jolanda De Caro
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
| | - Carmen Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
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6
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Fu B, Mei Y, Lin B, Guo Y, Zhang Z, Qi B, Wang Y. Effects of A Benefit-Finding Intervention in Stroke Caregivers in Communities. Clin Gerontol 2022; 45:1317-1329. [PMID: 32496892 DOI: 10.1080/07317115.2020.1765062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: To verify the effectiveness and feasibility of a nine-week benefit-finding intervention on the burden, quality of life, and benefit finding of caregivers, as well as on the quality of life of stroke survivors.Methods: Benefit finding refers to the individual, social, psychological and spiritual benefits perceived by an individual experiencing stress or post-traumatic events. A randomized controlled trial was performed in which 68 stroke survivors and their caregivers were recruited from the Zhengzhou community, China, and randomly split into two groups. The intervention group included those having undergone a nine-week benefit-finding intervention, while the control group included those individuals having undergone a nine-week routine health education. At baseline and one-week post-intervention (after a 9-week intervention), the quality of life of stroke survivors and caregivers and the burden and benefit finding of caregivers were determined.Results: In comparison to the control group, caregiver benefit finding, quality of life, burden, and stroke survivor quality of life were significantly improved (P <.005).Conclusions: The intervention appears to be feasible for stroke patients and caregivers. The intervention is capable of improving the quality of life of caregivers and survivors, increasing the benefit finding of caregivers and reducing the burden of caregivers.Clinical Implications: The benefit-finding intervention is capable of improving the health condition of stroke patients and caregivers.
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Affiliation(s)
- Bo Fu
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yongxia Mei
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Beilei Lin
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yawen Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Zhenxiang Zhang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Bei Qi
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
| | - Yongli Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, China
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7
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Ayisi-Boateng NK, Opoku DA, Tawiah P, Owusu-Antwi R, Konadu E, Apenteng GT, Essuman A, Mock C, Barnie B, Donkor P, Sarfo FS. Carers’ needs assessment for patients with dementia in Ghana. Afr J Prim Health Care Fam Med 2022; 14:e1-e8. [PMID: 36073124 PMCID: PMC9453144 DOI: 10.4102/phcfm.v14i1.3595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/01/2022] Open
Affiliation(s)
- Nana K Ayisi-Boateng
- Department of Medicine, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi.
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8
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AboJabel H, Werner P. Examining the mediating effect of psychosocial resources on the relationship between ambivalent feelings and depression among Israeli Arab family caregivers of people with dementia. DEMENTIA 2022; 21:751-764. [DOI: 10.1177/14713012211053967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objectives Providing care for family members of individuals with dementia can be accompanied by a myriad of emotions, usually involving negative as well as positive feelings, or “ambivalent feelings.” Recent studies conducted among family caregivers of people with dementia have shown ambivalent feelings to be associated with serious psychological consequences, such as increased depression. However, little is known about the path leading from ambivalent feelings to depression. Thus, the aim of this study was to examine the interplay of ambivalent feelings and depression with family caregivers’ psychosocial resources—that is, their coping strategies and social support. Methods A cross-sectional study using face-to-face interviews (via structured questionnaire) was conducted with 175 Israeli Arab family caregivers (adult children and spouses) of elderly people with Alzheimer’s disease (87.4% female; 72% adult children; mean age = 54.28). Results Overall, the participants reported a mild level of depression (mean = 7.93; SD = 4.30; range 0–15) and a moderate level of ambivalent feelings (mean = 1.63; SD = 1.04; range 0–3). Additionally, as expected, ambivalent feelings made a unique—although modest—contribution, adding an additional 6% ( p < 0.001) to the explanation of depression ( R2 = 0.56, p<0.001). Whereas, neither problem-focused coping nor emotion-focused coping played a significant role in mediating the relationship between ambivalent feelings and depression, social support did mediate the relationship between these variables. Conclusions Our findings show that strengthening and expanding social networks among Israeli caregivers of people with Alzheimer’s disease can minimize the impact of experiences of emotional feelings on depression.
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Affiliation(s)
- Hanan AboJabel
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Israel
| | - Perla Werner
- Department of Community Mental Health, University of Haifa, Mt. Carmel, Israel
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9
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Carbone EA, de Filippis R, Roberti R, Rania M, Destefano L, Russo E, De Sarro G, Segura-Garcia C, De Fazio P. The Mental Health of Caregivers and Their Patients With Dementia During the COVID-19 Pandemic: A Systematic Review. Front Psychol 2022; 12:782833. [PMID: 35002872 PMCID: PMC8740146 DOI: 10.3389/fpsyg.2021.782833] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/30/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Coronavirus Disease 2019 (COVID-19) is a worldwide public health concern. It continues to spread rapidly throughout the world causing multiple physical and psychological consequences in the population. Especially, people affected by severe psychiatric or neurological diseases are highly susceptible to serious health complications not only due to the direct effect of the infection but also to the indirect effect of COVID-19 following social distancing during lockdowns and its general social consequences. Indeed, lockdown and difficulties in using the care services produced psychological consequences in caregivers such as depression, anxiety, and worsening of the quality of life which in turn affected the ability to manage patients. Our aim was to systematically review the psychological consequences of the COVID-19 lockdown in caregivers of patients with cognitive impairment and dementia and the impact on the health of their patients. Methods: A systematic literature search was conducted by searching in MEDLINE/PubMed, Scopus, and Web of Science by two independent researchers following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. Data extraction and quality assessment were also performed. Papers were screened for eligibility by abstract and then those which met inclusion criteria were included in this review. Results: The initial search returned 410 records. After the abstract screening and the inclusion/exclusion criteria were applied, 315 were excluded because they were irrelevant, 30 because they were reviews, meta-analyses, letters to editors, editorials, guidelines, or case reports, and 10 because they were duplicates. Then, 38 out of 55 abstracts/full-text articles were excluded because they did not simultaneously assess mental health of patients and caregivers. In the end, 17 papers were deemed eligible and included in the present review. Conclusion: Based on current literature, the COVID-19 pandemic and the ensuing lockdown caused severe psychological consequences for caregivers of patients with dementia, worsening their mental health, and increasing the psychological and physical burden, independently from the severity of the disease of their relatives, which resulted also independently globally worsened.
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Affiliation(s)
- Elvira Anna Carbone
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Renato de Filippis
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Roberta Roberti
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Marianna Rania
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Laura Destefano
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy.,Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Emilio Russo
- Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | | | - Cristina Segura-Garcia
- Psychiatry Unit, Department of Medical and Surgical Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
| | - Pasquale De Fazio
- Psychiatry Unit, Department of Health Sciences, University "Magna Graecia" of Catanzaro, Catanzaro, Italy
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Care-giver wellbeing: exploring gender, relationship-to-care-recipient and care-giving demands in the Canadian Longitudinal Study on Aging. AGEING & SOCIETY 2021. [DOI: 10.1017/s0144686x21001823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
The three-way intersection of gender, relationship-to-care-recipient and care-giving demands has not, to our knowledge, been examined in relation to the wellbeing of family care-givers. We explore inequalities in depressive symptoms and life satisfaction, comparing wives, husbands, daughters and sons providing very-intensive care (36+ hours/week) with those providing less care and disparities between these groups in the factors related to disadvantage. Data from the Canadian Longitudinal Study on Aging (N = 5,994) support the existence of differences between the groups. Very-intensive care-giving wives report the most depressive symptoms and lowest life satisfaction; less-intensive care-giving sons report the fewest depressive symptoms, and less-intensive care-giving daughters report the highest life satisfaction. However, group differences in life satisfaction disappear among very-intensive care-givers. Drawing on Intersectionality and Stress Process theories, data from regression analyses reveal a non-significant gender–relationship–demand interaction term, but, health, socio-economic and social support resources play a strong mediating role between care demand and wellbeing. Analyses of the eight groups separately reveal diversity in the care-giving experience. Among less-intensive care-givers, the mediating role of resources remains strong even as differences are evident. Among very-intensive care-givers, the role of resources is less and differences in wellbeing between the groups are magnified. Policy implications emphasise the imperative to personalise services to meet the varied needs of care-givers.
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Chang CC, Wang WF, Li YY, Chen YA, Chen YJ, Liao YC, Jhang KM, Wu HH. Using the Apriori Algorithm to Explore Caregivers' Depression by the Combination of the Patients with Dementia and Their Caregivers. Risk Manag Healthc Policy 2021; 14:2953-2963. [PMID: 34285609 PMCID: PMC8286245 DOI: 10.2147/rmhp.s316361] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 06/16/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose The purpose of this study was to identify the caring scenarios that result in severe depression in caregivers caring for dementia patients. Patients and Methods A cross-sectional study with 1111 dementia patients and their caregivers in Taiwan from October 2015 to January 2020 was conducted. Gender, age, type of dementia, clinical dementia rating, walking ability, mood symptoms, behavioral symptoms, and psychological symptoms were the variables from the dementia patients. Age, relation to the patient, employment, type of primary care, frequency of care, mood symptoms, and the score from the Center for Epidemiologic Studies Depression Scale were the variables from the caregivers. A comprehensive viewpoint of both dementia patients and their caregivers was evaluated by the Apriori algorithm to find the attributes resulting in different caregiving depressions. Results Forty-seven rules were found with 18 rules of mild depressive symptomatology, 17 rules of moderate depressive symptomatology, and 12 rules of severe depressive symptomatology. A total of 7 general rules were summarized to be the severe depressive symptomatology. The results showed that an unemployed or retired caregiver with the mood symptoms such as helplessness, anger, emotional liability, or anxiety who took care of AD patients or AD patients with a moderate severity would have severe depression. Increased care frequencies (≥6 days per week) and multiple mood problems from caregivers result in severe depression. The composition of adult children, patients' aggression, and caregivers' helplessness as well as the combinations of male patients aged 75-84 years with the caregiver's mood of helplessness or nervousness and hopelessness were highly associated with severe depression. Conclusion For those caring for AD patients, severe depression was associated with the combination of different parameters to constitute each of these seven scenarios. Unlike previous studies which often evaluated one or two variables related to caregiver's depression, this study provided a more comprehensive viewpoint that enabled the collaborative team to efficiently identify and manage different scenarios by summarizing the rules of caregivers with severe depression from a systematic viewpoint.
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Affiliation(s)
- Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung City, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Yi-Ying Li
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan
| | - Yu-An Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yen-Jen Chen
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Yi-Cheng Liao
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Kai-Ming Jhang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsin-Hung Wu
- Department of Business Administration, National Changhua University of Education, Changhua, Taiwan.,Department of M-Commerce and Multimedia Applications, Asia University, Taichung City, Taiwan.,Faculty of Education, State University of Malang, Malang, East Java, Indonesia
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12
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Kunicki ZJ, Gaudiano BA, Miller IW, Tremont G, Salloway S, Darling E, Broughton MK, Kraines MA, Hoopes R, Epstein-Lubow G. Differences in Burden Severity in Adult-Child Family Caregivers and Spousal Caregivers of Persons with Dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:518-532. [PMID: 33820479 DOI: 10.1080/01634372.2021.1912242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 03/29/2021] [Accepted: 03/30/2021] [Indexed: 06/12/2023]
Abstract
Researchers are continuing to focus on the nature and sources of burden of family caregivers of persons living with dementia. Caregiving stress and burden are assessed and addressed by social workers, including at high-risk times such as hospitalization. This study tested whether adult-child family caregivers experience greater perceived burden than spousal caregivers, accounting for risks of acute stress which can accompany hospitalization for their care recipient, where social workers may be meeting with family caregivers for the first time. Family caregivers (N = 76; n = 42 adult-child; n = 34 spouse) were recruited during care-recipient clinical treatment. The settings of care included an outpatient memory care program and an inpatient geriatric psychiatry service. Results showed that adult-child caregivers reported greater burden as compared with spousal caregivers, but no differences regarding depressive symptoms, perceived stress, or grief. After controlling for demographics and location of care, being an adult-child caregiver remained a predictor of greater burden severity. Being an adult-child family caregiver may place an individual at increased risk for experiencing high burden. These findings suggest socials workers should consider how adult-child caregivers may benefit from strategies to address and reduce burden, beyond those typically offered to spousal caregivers.
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Affiliation(s)
- Zachary J Kunicki
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Brandon A Gaudiano
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Ivan W Miller
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Geoffrey Tremont
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Stephen Salloway
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Brown University, The Warren Alpert Medical School, Providence, Rhode Island, USA
| | - Ellen Darling
- Department of Psychiatry, Rhode Island Hospital, Providence, Rhode Island, USA
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | | | - Morganne A Kraines
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
| | - Ryan Hoopes
- Department of Psychology, Clark University, Worcester, Massachusetts, USA
| | - Gary Epstein-Lubow
- Brown University, Department of Psychiatry and Human Behavior, The Warren Alpert Medical School, Providence, Rhode Island, USA
- Butler Hospital, Providence, Rhode Island, USA
- Department of Health Services, Policy and Practice, Brown University School of Public Health, Providence, Rhode Island, USA
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13
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Wuttke-Linnemann A, Palm S, Scholz L, Geschke K, Fellgiebel A. Introduction and Psychometric Validation of the Resilience and Strain Questionnaire (ResQ-Care)- A Scale on the Ratio of Informal Caregivers' Resilience and Stress Factors. Front Psychiatry 2021; 12:778633. [PMID: 34899433 PMCID: PMC8652286 DOI: 10.3389/fpsyt.2021.778633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Informal caregivers are a particularly vulnerable population at risk for adverse health outcomes. Likewise, there are many scales available assessing individual caregiver burden and stress. Recently, resilience in caregivers gained increasing interest and scales started to assess resilience factors as well. Drawing on a homeostatic model, we developed a scale assessing both caregivers' stress and resilience factors. We propose four scales, two covering stress and two covering resilience factors, in addition to a sociodemographic basic scale. Based on the stress:resilience ratio, the individual risk of adverse health outcomes and suggestions for interventions can be derived. Methods: A total of 291 informal caregivers filled in the ResQ-Care as part of a survey study conducted during the second wave of the COVID-19 pandemic in Germany. Exploratory factor analysis was performed. Validity analyses were examined by correlations with the Brief Resilience Scale (BRS), the Perceived Stress Scale (PSS-4) and the Geriatric Depression Scale (GDS-15). Results: The data fitted our proposed four-factor solution well, explaining 43.3% of the variance. Reliability of each scale was at least acceptable with Cronbach's α ≥0.67 and MacDonald's ω ≥0.68 for all scales. The two strain scales weighed more than the resilience scales and explained 65.6% of the variance. Convergent and discriminant validity was confirmed for the BRS and PSS-4, whereas the GDS-15 correlation pattern was counterintuitive. Conclusion: The factor structure of the ResQ-Care scale was confirmed, with good indications of reliability and validity. Inconsistent correlations of the scales with the GDS-15 might be due to a reduced validity of GDS-15 assessment during the COVID-19 lockdown.
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Affiliation(s)
| | - Svenja Palm
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Lea Scholz
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany
| | - Katharina Geschke
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany
| | - Andreas Fellgiebel
- Center for Mental Health in Old Age, Landeskrankenhaus (AöR), Mainz, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center Mainz, Mainz, Germany.,Hospital for Psychiatry, Psychosomatic and Psychotherapy, Agaplesion Elisabethenstift, Darmstadt, Germany
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14
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Self-reported symptoms of depression and anxiety among informal caregivers of persons with dementia: a cross-sectional comparative study between Sweden and Italy. BMC Health Serv Res 2020; 20:1114. [PMID: 33267856 PMCID: PMC7709414 DOI: 10.1186/s12913-020-05964-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 11/24/2020] [Indexed: 12/03/2022] Open
Abstract
Background Around 50 million people worldwide are diagnosed with dementia and this number is due to triple by 2050. The majority of persons with dementia receive care and support from their family, friends or neighbours, who are generally known as informal caregivers. These might experience symptoms of depression and anxiety as a consequence of caregiving activities. Due to the different welfare system across European countries, this study aimed to investigate factors associated with self-reported depression and anxiety among informal dementia caregivers both in Sweden and Italy, to ultimately improve their health and well-being. Methods This comparative cross-sectional study used baseline data from the Italian UP-TECH (n = 317) and the Swedish TECH@HOME (n = 89) studies. Main outcome variables were the severity of self-reported anxiety and depression symptoms, as measured by the Hospital Anxiety and Depression Scale (HADS). HADS scores were investigated using descriptive and bivariate statistics to compare means and standard deviations. Linear regressions were used to test for associations between potential factors and self-reported symptoms of depression and anxiety. Results Italian informal caregivers reported more severe symptoms of depression and anxiety than Swedish caregivers. In Italy, a higher number of hours of caregiving was associated with anxiety symptoms (β = − 1.205; p = 0.029), being 40–54 years-old with depression symptoms (β = − 1.739; p = 0.003), and being female with symptoms of both depression (β = − 1.793; p < 0.001) and anxiety (β = 1.474; p = 0.005). In Sweden, a higher number of hours of caregiving and being < 39 years-old were associated with depression symptoms (β = 0.286; p < 0.000; β = 3.945; p = 0.014) and a higher number of hours of caregiving, the lack of additional informal caregivers and dementia severity were associated with anxiety symptoms (β = 0.164; p = 0.010; β = − 1.133; p = 0.033; β = − 1.181; p = 0.031). Conclusion Multiple factors are associated with self-reported symptoms of depression and anxiety among informal caregivers in Sweden and Italy. Factors found in this study partly differ between the two countries, suggesting the important role of cultural and social factors affecting the experience of caregiving. A deeper knowledge of these factors may increase the knowledge on potential protective and risk factors, provide information to policymakers and ultimately improve the psychological well-being of informal caregivers to people with dementia across Europe.
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15
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Abu Bakar ZH, Damanhuri HA, Makpol S, Wan Kamaruddin WMA, Abdul Sani NF, Amir Hamzah AIZ, Nor Aripin KN, Mohd Rani MD, Noh NA, Razali R, Mazlan M, Abdul Hamid H, Mohamad M, Wan Ngah WZ. Effect of Age on the Protein Profile of Healthy Malay Adults and its Association with Cognitive Function Competency. J Alzheimers Dis 2020; 70:S43-S62. [PMID: 30594926 PMCID: PMC6706781 DOI: 10.3233/jad-180511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Background: Many studies on biochemical and psychological variables have aimed to elucidate the association between aging and cognitive function. Demographic differences and protein expression have been reported to play a role in determining the cognitive capability of a population. Objective: This study aimed to determine the effect of age on the protein profile of Malay individuals and its association with cognitive competency. Methods: A total of 160 individuals were recruited and grouped accordingly. Cognitive competency of each subject was assessed with several neuropsychological tests. Plasma samples were collected and analyzed with Q Exactive HF Orbitrap. Proteins were identified and quantitated with MaxQuant and further analyzed with Perseus to determine differentially expressed proteins. PANTHER, Reactome, and STRING were applied for bioinformatics output. Results: Our data showed that the Malay individuals are vulnerable to the deterioration of cognitive function with aging, and most of the proteins were differentially expressed in concordance. Several physiological components and pathways were shown to be involved, giving a hint of a promising interpretation on the induction of aging toward the state of the Malays’ cognitive function. Nevertheless, some proteins have shown a considerable interaction with the generated protein network, which provides a direction of focus for further investigation. Conclusion: This study demonstrated notable changes in the expression of several proteins as age increased. These changes provide a promising platform for understanding the biochemical factors affecting cognitive function in the Malay population. The exhibited network of protein-protein interaction suggests the possibility of implementing regulatory intervention in ameliorating Malay cognitive function.
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Affiliation(s)
- Zulzikry Hafiz Abu Bakar
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Hanafi Ahmad Damanhuri
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Suzana Makpol
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | | | - Nur Fathiah Abdul Sani
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Ahmad Imran Zaydi Amir Hamzah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Khairun Nain Nor Aripin
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Mohd Dzulkhairi Mohd Rani
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Nor Azila Noh
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Persiaran MPAJ, Jalan Pandan Utama, Pandan Indah, Kuala Lumpur, Malaysia
| | - Rosdinom Razali
- Department of Psychiatry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif Bandar Tun Razak, Kuala Lumpur, Malaysia
| | - Musalmah Mazlan
- Faculty of Medicine, Universiti Teknologi Mara, Jalan Hospital, Selangor Darul Ehsan, Malaysia
| | - Hamzaini Abdul Hamid
- Department of Radiology Hospital Chancellor Tuanku Mukhriz, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
| | - Mazlyfarina Mohamad
- Department Diagnostic and Applied Health Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Wan Zurinah Wan Ngah
- Department of Biochemistry, Universiti Kebangsaan Malaysia Medical Center, Jalan Yaacob Latif, Kuala Lumpur, Malaysia
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16
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Dogan B, Ozmen S, Memis CO, Sair A, Akyol A, Sevincok L. Affective temperament traits may explain high expressed emotion in caregivers of patients with Alzheimer's disease. Psychogeriatrics 2020; 20:746-753. [PMID: 32638506 DOI: 10.1111/psyg.12588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 03/16/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The negative interactions between Alzheimer's disease (AD) patients and their caregivers may provoke criticism, hostility, and emotional overinvolvement that characterise highly expressed emotion (EE) attitudes. In this study, we hypothesised that affective temperament traits of AD caregivers are related to their high EE levels independent from other patient and caregiver characteristics. METHODS Eighty AD patients were assessed through Clinical Dementia Rating Scale (CDR), and Mini-Mental State Examination. Expressed Emotion Scale (EES), Temperament Evaluation of Memphis, Pisa, Paris and San Diego auto-questionnaire, and Hamilton Depression Rating Scale were applied to the caregivers. The high (n = 41) and low EE caregivers (n = 39) were compared with respect to some sociodemographic and clinical characteristics of the patients and caregivers, and affective temperament traits of caregivers. The associations of caregiver EES scores with multiple variables related to patients and caregivers were examined by Pearson correlation tests. We performed multiple linear regression analysis to determine the possible predictors of total EES scores. RESULTS High EE caregivers had significantly higher depressive, cyclothymic, and anxious temperament traits than in low EE subjects. A weak positive correlation was found between the total EES scores and Personal Care scores of CDR. Home and hobbies subscale scores of CDR had a moderately significant positive correlation with total EES scores. There was also moderate significant positive correlations between total EE scores and depressive, cyclothymic, anxious, and irritable temperament traits. Linear regression analysis indicated that depressive temperament significantly predicted the high levels of caregiver EE. CONCLUSION These findings suggest that caregivers' depressive temperament is predominantly related to their EE levels even after controlling for the severity of AD, and lower educational level of caregivers. Our results may provide evidence that high EE might be a reflection of caregivers' depressive temperament traits, in accordance with the trait hypothesis.
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Affiliation(s)
- Bilge Dogan
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | - Simel Ozmen
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
| | | | - Ahmet Sair
- Department of Neurology, Adnan Menderes University, Aydin, Turkey
| | - Ali Akyol
- Department of Neurology, Adnan Menderes University, Aydin, Turkey
| | - Levent Sevincok
- Department of Psychiatry, Adnan Menderes University, Aydin, Turkey
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17
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Harris EC, D'Angelo S, Syddall HE, Linaker C, Cooper C, Walker-Bone K. Relationships between informal caregiving, health and work in the Health and Employment After Fifty study, England. Eur J Public Health 2020; 30:799-806. [PMID: 32494804 PMCID: PMC7445037 DOI: 10.1093/eurpub/ckaa078] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND To investigate the prevalence of caregiving and its relationship with work, health and socio-economic circumstances in the Health and Employment After Fifty (HEAF) study. METHODS The HEAF study comprises 8134 men and women aged 50-64 years recruited from 24 general practices. Socio-demographic, lifestyle and health characteristics and hours per week giving personal care were elicited by postal questionnaire. Objective clinical information about diagnoses/medications was retrieved from health records. Work-related and health risk factors for intense caring responsibilities (≥20 h/week vs. no hours) were explored using logistic regression with adjustment for age and social class. RESULTS In all, 644 (17%) men and 1153 (26%) women reported caring responsibilities, of whom 93 and 199 were intense caregivers, who were more likely to be socio-economically disadvantaged; less likely to be working and, if combining caring with working (41 men and 90 women), more likely to be part-time/working shifts, than non-carers. Men caring ≥20 h/week were more likely to have COPD and to report musculoskeletal pain, poor/fair self-rated health, depression and sleep problems. Among working women, caring ≥20 h/week was associated with these same health outcomes and also with a doctor-diagnosed mental health problem or musculoskeletal pain in the previous year. CONCLUSIONS Caregiving is common and unequal in the HEAF cohort, with more high-intensity informal care provided by those with greater levels of socio-economic deprivation, which could affect their employment and health. Caregivers need support to lead long, healthy lives, rather than becoming care needers themselves. Employers and governments need to take caregiving into account and support it actively.
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Affiliation(s)
- E Clare Harris
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Stefania D'Angelo
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Holly E Syddall
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Cathy Linaker
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK.,Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Karen Walker-Bone
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.,MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
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18
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Marsack-Topolewski CN. Quality of Life among Compound Caregivers and Noncompound Caregivers of Adults with Autism. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:379-391. [PMID: 32401186 DOI: 10.1080/01634372.2020.1765063] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 06/11/2023]
Abstract
Children diagnosed with autism spectrum disorder (ASD) are reaching adulthood and require some form of lifelong care. Many parents continue caring for their adult children with ASD for as long as physically possible. As parents age, many also may provide care for another loved one, such a spouse or parent. This study compares compound (those providing care for multiple loved ones) and noncompound parental caregivers (those providing care solely for an adult child with ASD) on six dimensions of quality of life (enjoys life, life is meaningful, ability to concentrate, accepts bodily appearance, satisfied with self, and frequency of negative feelings). Specifically, this study determined the extent to which compound and noncompound caregivers' quality of life differed. The present study included 320 parents (age 50 or older) of adult children (18 or older) diagnosed with ASD who completed a web-based survey. T-tests for independent samples compared the six dimensions and overall quality of life between compound and noncompound caregivers. Results indicated that compound caregivers were less able to concentrate and had fewer negative feelings than noncompound caregivers. Further research is needed to determine the effects of caregiving on the multidimensional aspects of quality of life.
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19
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Marsack CN, Hopp FP. Informal Support, Health, and Burden Among Parents of Adult Children With Autism. THE GERONTOLOGIST 2020; 59:1112-1121. [PMID: 29982655 DOI: 10.1093/geront/gny082] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Many adults with autism spectrum disorders require lifelong reliance on caregiver support. As these caregivers age and experience health challenges, social support can be critical. This study seeks to understand if caregiver health moderates the relationship between informal social support and caregiver burden. RESEARCH DESIGN AND METHODS A total of 320 parents (age 50+ years) of adult children diagnosed with ASD were recruited from autism organizations and support groups and completed a web-based survey. Separate moderation analyses were used to determine if caregiver health was moderating the relationship between informal social support and composite caregiver burden, as well as the separate domains of developmental, time dependence, emotional burden, and impact of caregiving on finances. For each analysis, perceptions of available informal social support were the independent variable, composite and domains of caregiver burden were dependent variables, and parents' self-reported general health was the moderating variable. RESULTS Caregiver health had a statistically significant moderating effect when predicting the relationships between informal social support and composite caregiver burden, as well as time dependence burden and impact of caregiving on finances. DISCUSSION AND IMPLICATIONS Increased attention should be focused on supporting the current and future needs of both aging caregivers and their adult children with ASD. Future research on the dynamics of social support, health, and burden is also urgently needed to address the growing number of aging caregivers of adults diagnosed with ASD.
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Affiliation(s)
| | - Faith P Hopp
- School of Social Work, Wayne State University, Detroit, Michigan
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20
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Owokuhaisa J, Rukundo GZ, Wakida E, Obua C, Buss SS. Community perceptions about dementia in southwestern Uganda. BMC Geriatr 2020; 20:135. [PMID: 32293301 PMCID: PMC7158106 DOI: 10.1186/s12877-020-01543-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 03/31/2020] [Indexed: 11/24/2022] Open
Abstract
Background With the increasing number of people surviving into older age in Africa, dementia is becoming a public health concern. Understanding the social dynamics of dementia in resource-limited settings is critical for developing effective interventions. We explored community perceptions about people with dementia in southwestern Uganda. Methods Fifty-nine individuals (aged 19–85 years, 56% female) participated in seven focus group discussions. In addition, 22 individual in-depth interviews were conducted among individuals (aged 22–84 years, 36% female). Both interviews and focus group discussions were audio recorded, transcribed verbatim, and evaluated using a quantitative content analysis approach. Results Five themes were generated during content analysis: i) Labeling of the illness, ii) Presentation of the person with dementia, iii) Causation, iv) Impact of the disease on people with dementia and their caregivers and v) Views on how to address unmet needs in dementia care. Dementia was commonly referred to as “okuhuga”or “okwebwayebwa” (also, oruhuzyo/ empugye / akahuriko) which translates as “mental disorientation”. The participants reported that most people with dementia presented with forgetfulness, defecating and urinating on themselves, wandering away from home, going out naked, and picking up garbage. Some participants perceived memory problems as a normal part of the aging process, while others attributed the cause of dementia to syphilis, cancer, allergy, old age, satanic powers, witchcraft, poor nutrition, or life stress. Participants reported multiple sources of stress for caregivers of people with dementia, including financial, social, and emotional burdens. Finally, participants suggested that community and governmental organizations should be involved in meeting the needs of people with dementia and their caregivers. Conclusions Community members in southwestern Uganda largely identified dementia as a problem that comes with older age, and can identify key features of dementia presentation. Participants identified significant stressors affecting people with dementia and their caregivers, and reported that families and caregivers would benefit from education on the management of symptoms of dementia, and assistance in overcoming associated financial, social, and emotional burdens related to caretaking.
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Affiliation(s)
- Judith Owokuhaisa
- Department of Internal Medicine, Faculty of Medicine, Mbarara University of Science and Technology, P. O. Box 1410, Mbarara, Uganda.
| | - Godfrey Zari Rukundo
- Department of Psychiatry, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Edith Wakida
- Office of Research Administration, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Celestino Obua
- Department of Pharmacology, Faculty of Medicine, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Stephanie S Buss
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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21
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Alfakhri AS, Alshudukhi AW, Alqahtani AA, Alhumaid AM, Alhathlol OA, Almojali AI, Alotaibi MA, Alaqeel MK. Depression Among Caregivers of Patients With Dementia. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 55:46958017750432. [PMID: 29345180 PMCID: PMC5798670 DOI: 10.1177/0046958017750432] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
We aimed to assess depressive symptoms in caregivers of patients with dementia, taking into account variables such as severity of dementia, sex, age, and financial state of the patient. We recruited 222 caregivers of patients with dementia from King Abdulaziz Medical City, Saudi Alzheimer’s Disease Association, and online, from February to June 2017, and employed the Patient Health Questionnaire to assess depression, and the Blessed Dementia Scale to assess severity of dementia. The prevalence of clinical depression among the caregivers was 14.9%. Minimal symptoms of depression were experienced by 96 caregivers (43.2%), moderate by 45 (20.3%), moderate-severe by 15 (6.8%), and severe by 8 (3.6%). Forty-six patients had mild dementia (22%), 73 had moderate (34.9%), and 90 had severe (43.1%). Caregivers of patients with dementia experience considerable burden and lower level of health-related quality of life and may be predisposed to developing clinical depression.
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Affiliation(s)
| | - Ahmed W Alshudukhi
- 1 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ali A Alqahtani
- 1 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | | | - Omer A Alhathlol
- 1 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Abdullah I Almojali
- 1 King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
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Sambasivam R, Liu J, Vaingankar JA, Ong HL, Tan ME, Fauziana R, Picco L, Chong SA, Subramaniam M. The hidden patient: chronic physical morbidity, psychological distress, and quality of life in caregivers of older adults. Psychogeriatrics 2019; 19:65-72. [PMID: 30182505 PMCID: PMC6635743 DOI: 10.1111/psyg.12365] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/20/2018] [Accepted: 07/18/2018] [Indexed: 12/04/2022]
Abstract
AIM Increasing demands for care provision to older adults require good physical and mental health among caregivers. Few studies have examined the health status and correlates of quality of life among caregivers of older adults. The present study therefore sought to examine the prevalence of chronic physical conditions, psychological distress, and correlates of physical and mental quality of life among caregivers of older adults (≥60 years) in Singapore. METHODS Participants were 285 informal caregivers who were providing care to an older relative. Participants were recruited at the Institute of Mental Health, Singapore, and they completed self-report measures on chronic physical morbidity, psychological distress, and physical and mental quality of life. Multiple regression models were constructed to examine correlates of physical and mental quality of life. RESULTS More than half of the caregivers had at least one chronic physical condition (58.6%) and psychological distress (52.6%). Chronic physical morbidity, psychological distress, and secondary education status were associated with lower physical quality of life. Psychological distress, younger age, primary education status, and more time spent caregiving were associated with lower mental quality of life. CONCLUSION Poor physical and mental health among caregivers may impair their ability to provide adequate care to older adults with progressive medical needs. It is important for medical practitioners not to neglect the physical and mental health of caregivers through continued assessment of chronic physical morbidity, psychological distress, and quality of life.
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Affiliation(s)
| | - Jianlin Liu
- Research Division, Institute of Mental Health, Singapore, Singapore
| | | | - Hui L Ong
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Min-En Tan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Restria Fauziana
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Louisa Picco
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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23
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Brigola AG, Barbieri MC, Luchesi BM, Grazziano EDS, Machado RC, Dupas G, Pavarini SCI. Association between depressive syndrome and visual complaints among elderly caregivers. JORNAL BRASILEIRO DE PSIQUIATRIA 2018. [DOI: 10.1590/0047-2085000000209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
ABSTRACT Objectives To determine depressive syndrome in community-dwelling elderly caregivers; and to test the association between such syndrome and both visual complaints (VC) and aspects of care. Methods This is a cross-sectional study conducted with 332 elderly caregivers. Geriatric Depression Scale (GDS-15) was used to screen for depressive symptoms (cutoff > 5 points). Logistic regression was performed to identify associations between depression and both VC and aspects related to care. Results Median age of the caregivers was 68 years. The majority was female (75.9%) and took care of a spouse (84.3%). The prevalence of depressive syndrome was 22.6%. The syndrome was associated with VC when it affected activities of daily living (OR = 2.4; 95% CI: 1.37-4.27) and caring for an individual with cognitive impairment (OR = 1.85; 95% CI: 1.05-3.26). Conclusions While measured aspects of care did not exert an influence on the incidence of depressive symptoms, VC associated to functional limitation and caring for elderly individuals with cognitive impairment was associated with such symptoms in the elderly caregivers.
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Voutilainen A, Ruokostenpohja N, Välimäki T. Associations Across Caregiver and Care Recipient Symptoms: Self-Organizing Map and Meta-analysis. THE GERONTOLOGIST 2018; 58:e138-e149. [PMID: 28329837 DOI: 10.1093/geront/gnw251] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Purpose of the Study The main objective of this study was to reveal generalizable associations across caregiver burden (CGB), caregiver depression (CGD), care recipient cognitive ability (CRCA), and care recipient behavioral and psychological symptoms of dementia (BPSD). Design and Methods Studies published between 2004 and 2014 and reporting CGB and/or CGD together with CRCA and/or BPSD were included. Only 95 out of 1,955 studies provided enough data for data clustering with the Self-Organizing Map (SOM) and 27 of them for meta-analyses based on correlation coefficients. Results Caregiver and care recipient symptoms were not tightly associated with each other, except for the CGB-BPSD interaction at the individual level. SOM emphasized the cluster comprising studies reporting low CGB, low CGD, high CRCA, and few BPSD. Meta-analyses indicated high heterogeneity between the original studies. Implications Relationships between caregiver and care recipient symptoms should be treated as situation-specific phenomena, at least when the symptoms are moderate at most. Dementia caregiving per se should not be understood as a source of stress and mental health problems. More systematic and coherent use of measures is necessary to enable a comprehensive analysis of caregiving.
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Affiliation(s)
- Ari Voutilainen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Nora Ruokostenpohja
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Yilmaz CK, Aşiret GD, Çetinkaya F, OludaĞ G, Kapucu S. Effect of progressive muscle relaxation on the caregiver burden and level of depression among caregivers of older patients with a stroke: A randomized controlled trial. Jpn J Nurs Sci 2018; 16:202-211. [DOI: 10.1111/jjns.12234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 06/20/2018] [Accepted: 07/05/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Güler Duru Aşiret
- Nursing Department, Faculty of Health ScienceAksaray University Aksaray Turkey
| | - Funda Çetinkaya
- Nursing Department, Faculty of Health ScienceAksaray University Aksaray Turkey
| | - Gülay OludaĞ
- Aksaray State Hospital Home Care Unit Aksaray Turkey
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Omranifard V, Haghighizadeh E, Akouchekian S. Depression in Main Caregivers of Dementia Patients: Prevalence and Predictors. Adv Biomed Res 2018. [PMID: 29531932 PMCID: PMC5841004 DOI: 10.4103/2277-9175.225924] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: The most common neurodegenerative disease is dementia. Family of dementia patients says that their lives have been changed extensively after happening of dementia to their patients. One of the problems of family and caregivers is depression of the caregiver. In this study, we aimed to find the prevalence of depression and factors can affect depression in the dementia caregivers. Materials and Methods: This study was cross-sectional study with convenient sampling method. Our society was 96 main caregivers of dementia patients in the year 2015 in Iran. We had two questionnaires, a demographic and Beck Depression Inventory (BDI). BDI Cronbach's alpha is 0.86 for psychiatric patients and 0.81 for nonpsychiatric persons, and Beck's scores are between 0 and 64. We used SPSS version 22 for statistical analysis. Results: According to Beck depression test, 69.8% (n = 67 out of 96) of all caregivers had scores in the range of depression. In bivariate analysis, we found higher dementia severity and lower support of other family members from the caregiver can predict higher depression in the caregiver. As well, in regression analysis using GLM model, we found higher age and lower educational level of the caregiver can predict higher depression in the caregiver. Moreover, regression analysis approved findings about severity and support of other family members in bivariate analysis. Conclusion: High-level depression is found in caregivers of dementia patients. It needs special attention from healthcare managers, clinicians and all of health-care personnel who deals with dementia patients and their caregivers.
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Affiliation(s)
- Victoria Omranifard
- Department of Psychiatry, Noor Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ebrahim Haghighizadeh
- Medical Student, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahla Akouchekian
- Department of Psychiatry, Noor Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
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27
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Kowalska J, Gorączko A, Jaworska L, Szczepańska-Gieracha J. An Assessment of the Burden on Polish Caregivers of Patients With Dementia: A Preliminary Study. Am J Alzheimers Dis Other Demen 2017; 32:509-515. [PMID: 28990393 PMCID: PMC10852757 DOI: 10.1177/1533317517734350] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
INTRODUCTION The aim of the study was to assess the level of burden of caregivers of persons with dementia and to analyze the factors related to the sense of burden. METHODS The study group consisted of 58 caregivers with an average age of 54.7 (± 12.6) and 45 (78%) were women. The Caregiver Burden Scale, the Beck Depression Inventory (BDI), the Berlin Social Support Scale (BSSS), and the Satisfaction with Life Scale (SWLS) were used. RESULTS In the study group, 93% could rely on help in caring for the patient, provided mainly by the family. Most caregivers demonstrated a medium level of burden (2.63 ± 0.61). A significant correlation was found between the level of caregiver burden and caregiving frequency, BSSS, BDI, and SWLS. CONCLUSIONS A lot of factors influence the caregivers' burden. It appears necessary to take into consideration the cultural, religious, and economic distinctiveness of the country in question.
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Affiliation(s)
- Joanna Kowalska
- 1 Department of Physiotherapy, University School of Physical Education, Wroclaw, Poland
| | - Agata Gorączko
- 1 Department of Physiotherapy, University School of Physical Education, Wroclaw, Poland
| | - Lilianna Jaworska
- 1 Department of Physiotherapy, University School of Physical Education, Wroclaw, Poland
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28
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Hager K, Henneges C, Schneider E, Lieb M, Kraemer S. Alzheimer-Demenz: Verlauf und Belastung der Pflegepersonen. DER NERVENARZT 2017; 89:431-442. [DOI: 10.1007/s00115-017-0371-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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29
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Bień-Barkowska K, Doroszkiewicz H, Bień B. Silent strain of caregiving: exploring the best predictors of distress in family carers of geriatric patients. Clin Interv Aging 2017; 12:263-274. [PMID: 28203067 PMCID: PMC5295808 DOI: 10.2147/cia.s125664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Objectives The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. Methods A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. Results The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. Conclusion Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs.
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Affiliation(s)
| | | | - Barbara Bień
- Department of Geriatrics, Medical University of Białystok, Białystok, Poland
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30
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Tremont G, Davis JD, Ott BR, Galioto R, Crook C, Papandonatos GD, Fortinsky RH, Gozalo P, Bishop DS. Randomized Trial of the Family Intervention: Telephone Tracking-Caregiver for Dementia Caregivers: Use of Community and Healthcare Resources. J Am Geriatr Soc 2016; 65:924-930. [PMID: 28008609 DOI: 10.1111/jgs.14684] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVES To examine the effects of a telephone-delivered intervention, Family Intervention: Telephone Tracking-Caregiver (FITT-C), on community support and healthcare use by dementia caregivers. DESIGN Randomized, controlled trial. SETTING Academic medical center. PARTICIPANTS Dyads (n = 250) of distressed informal dementia caregivers and care recipients. INTERVENTION Caregivers were randomly assigned to receive the FITT-C (n = 133) or telephone support (TS; n = 117). Both groups received 16 telephone contacts from a master's-level therapist over 6 months. The FITT-C intervention provided psychoeducation, problem solving, and other directive approaches based on assessment of critical areas (e.g., mood, behavior, family functioning, social support). TS provided supportive therapeutic strategies. MEASUREMENTS Outcome variables were caregiver report of community support service use, number of visits to the emergency department (ED) for caregivers and care recipients, and hospital stays for caregivers during the interventions. RESULTS Intervention groups did not differ in demographic characteristics, use of support services, or use of healthcare resources at baseline. Caregivers who received the FITT-C used community support services at end of treatment significantly more than those receiving TS (P = .02). FITT-C caregivers had a significantly lower rate of ED visits (rate difference 9.5%, P = .048) and hospital stays (rate difference 11.4%, P = .01) over the 6-month course of the intervention than TS caregivers. Care recipient use of community or medical resources did not differ according to group. CONCLUSION An entirely telephone-delivered intervention was effective in increasing caregiver engagement in community resources and reducing caregiver use of hospital-based healthcare resources. Results highlight the potential effect of FITT-C on healthcare use.
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Affiliation(s)
- Geoffrey Tremont
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Jennifer D Davis
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Brian R Ott
- Department of Neurology, Rhode Island Hospital, Brown University, Providence, Rhode Island.,Department of Neurology, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Rachel Galioto
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island.,Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, Rhode Island
| | - Cara Crook
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island
| | | | - Richard H Fortinsky
- UConn Center on Aging, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Pedro Gozalo
- Center for Gerontology and Health Care Research, Department of Health Services, Policy, and Practice, Brown University, Providence, Rhode Island
| | - Duane S Bishop
- Department of Psychiatry, Rhode Island Hospital, Brown University, Providence, Rhode Island
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31
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Chan WC, Lautenschlager N, Dow B, Ma SL, Wong CSM, Lam LCW. A home-based exercise intervention for caregivers of persons with dementia: study protocol for a randomised controlled trial. Trials 2016; 17:460. [PMID: 27655115 PMCID: PMC5031263 DOI: 10.1186/s13063-016-1582-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 08/27/2016] [Indexed: 12/23/2022] Open
Abstract
Background Family members, who provide the majority of care for persons with dementia, are especially vulnerable to developing depression. Interventions targeting their depressive symptoms have been proposed but their efficacies vary considerably. It has been suggested that interventions carried out in the home setting and involving both caregivers and care recipients are more efficacious. This study aims to compare the efficacy of a home-based structured exercise programme involving both persons with dementia and their caregivers with nonexercise social contact control in treating depression among caregivers. Methods/design This is a parallel-group, assessor-blind, randomised controlled trial. A total of 136 caregiver-care-recipient dyads (i.e. 272 participants in total) will be recruited and randomly allocated to either a home-based structured exercise (sitting Tai Chi) group or a social contact control group. The trial comprises a 3-month intervention phase followed by an extended observation phase of another 3 months. All participants will be assessed at baseline, 6th week, 12th week and 24th week. The primary outcome will be the reduction in depression among caregivers as measured by the Hamilton Rating Scale for Depression. The secondary outcomes will be burden, quality of life, cognitive performance and balance ability of the caregivers, as well as the neuropsychiatric symptoms, cognitive function, balance and functional abilities of the persons with dementia. We will also examine whether the brain-derived neurotrophic factor gene modulates mood changes in response to exercise. Discussion The findings offer a potential avenue of intervention by providing a low-cost, safe and effective treatment for depression among dementia caregivers, which may in turn also benefit the care recipients. Trial registration ClinicalTrials.gov Identifier: NCT02132039, registered on 28 April 2014.
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Affiliation(s)
- Wai Chi Chan
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.
| | - Nicola Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.,NorthWestern Aged Mental Health, Royal Park Campus, Parkville, VIC, Australia.,School of Clinical Neurosciences and the Western Australia Centre and Health and Ageing, University of Western Australia, Perth, WA, Australia
| | - Briony Dow
- National Ageing Research Institute, The University of Melbourne, Melbourne, VIC, Australia
| | - Suk Ling Ma
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Tai Po, Hong Kong
| | - Corine Sau Man Wong
- Department of Psychiatry, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Linda Chiu Wa Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Tai Po Hospital, Tai Po, Hong Kong
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