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Hu CJ, Chang LH, Lo YT, Wang JJ. Exploring Healthcare Providers' Difficulties and Strategies when Caring for Community-Dwelling People With Dementia Who are at Risk of Getting Lost. J Appl Gerontol 2024:7334648241261142. [PMID: 39023860 DOI: 10.1177/07334648241261142] [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: 07/20/2024] Open
Abstract
Caring for patients with dementia at risk of getting lost is challenging for community healthcare providers. Through semi-structured interviews with 25 participants, we examined the challenges faced by these providers and the strategies they employed. We identified the following themes of challenging parts: (a) the disturbance caused by behavioral and psychological symptoms in dementia; (b) difficulty in helping older family caregivers to keep the patient from going out; (c) difficulty in changing the attitudes of the family members; families' unawareness of the risk of getting lost. We also identified the following strategies to mitigate these themes: (a) detecting the risk of getting lost through early assessment; (b) encouraging the family to use resources or devices to prevent the patient from getting lost; (c) educating the family to manage behavior and psychological symptoms of dementia; (d) strengthening the patient's crisis awareness.
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Affiliation(s)
- Chia Jung Hu
- Department of Nursing, Da-Yeh University, Changhua, Taiwan
| | - Ling Hui Chang
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
| | - Yu Tai Lo
- Department of Geriatrics and Gerontology, National Cheng Kung University Hospital, Tainan, Taiwan (R.O.C.)
- College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
| | - Jing Jy Wang
- Department of Nursing, College of Medicine, National Cheng Kung University, Tainan, Taiwan (R.O.C.)
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Ansaldo AI, Masson-Trottier M, Delacourt B, Dubuc J, Dubé C. Efficacy of COMPAs, an App Designed to Support Communication Between Persons Living With Dementia in Long-Term Care Settings and Their Caregivers: Mixed Methods Implementation Study. JMIR Aging 2024; 7:e47565. [PMID: 38963691 PMCID: PMC11258517 DOI: 10.2196/47565] [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: 03/24/2023] [Revised: 01/15/2024] [Accepted: 04/14/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND Persons living with dementia experience autonomy loss and require caregiver support on a daily basis. Dementia involves a gradual decline in communication skills, leading to fewer interactions and isolation for both people living with dementia and their caregivers, negatively impacting the quality of life for both members of the dyad. The resulting stress and burden on caregivers make them particularly susceptible to burnout. OBJECTIVE This study aims to examine the efficacy of Communication Proches Aidants (COMPAs), an app designed following the principles of person-centered and emotional communication, which is intended to improve well-being in persons living with dementia and caregivers and reduce caregiver burden. METHODS In this implementation study, volunteer caregivers in 2 long-term care facilities (n=17) were trained in using COMPAs and strategies to improve communication with persons living with dementia. Qualitative and quantitative analyses, semistructured interviews, and questionnaires were completed before and after 8 weeks of intervention with COMPAs. RESULTS Semistructured interviews revealed that all caregivers perceived a positive impact following COMPAs interventions, namely, improved quality of communication and quality of life among persons living with dementia and caregivers. Improved quality of life was also supported by a statistically significant reduction in the General Health Questionnaire-12 scores (caregivers who improved: 9/17, 53%; z=2.537; P=.01). COMPAs interventions were also associated with a statistically significant increased feeling of personal accomplishment (caregivers improved: 11/17, 65%; t15=2.430; P=.03; d=0.61 [medium effect size]). CONCLUSIONS COMPAs intervention improved well-being in persons living with dementia and their caregivers by developing person-centered communication within the dyad, increasing empathy, and reducing burden in caregivers although most caregivers were unfamiliar with technology. The results hold promise for COMPAs interventions in long-term care settings. Larger group-controlled studies with different populations, in different contexts, and at different stages of dementia will provide a clearer picture of the benefits of COMPAs interventions.
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Affiliation(s)
- Ana Inés Ansaldo
- Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Michèle Masson-Trottier
- Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
- John Hopkins Hospital, John Hopkins University, Baltimore, MD, United States
| | - Barbara Delacourt
- Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Jade Dubuc
- Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
| | - Catherine Dubé
- Laboratoire de Plasticité cérébrale, Communication et Vieillissement, Centre de recherche de l'Institut Universitaire de gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada
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Martis CS, Bhandary RP, Chandrababu R, Lakshmi R V, Bhandary PV, Noronha JA, Chakrabarty J, Tolson D, Devi ES. Caring burden and quality of life among the caregivers of people living with dementia - a cross-sectional study in Udupi district of Karnataka. Home Health Care Serv Q 2024; 43:191-204. [PMID: 38190733 DOI: 10.1080/01621424.2023.2301417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). This cross-sectional study conducted in India was designed to assess the caring burden and QoL among the caregivers of people with dementia, as well as to ascertain the relationship between QoL scores and burden. Our sample included 80 caregivers of people with dementia. Most of the caregivers (n = 59, 73.8%) had a higher level of caregiver burden. There was a negative correlation between caregiver burden scores and QoL. A higher level of caregiver stress and low QoL were experienced by caregivers of dementia patients. In developing countries like India, counseling, and education on home health care for people with dementia should be provided to reduce the burden and enhance the QoL of caregivers.
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Affiliation(s)
- Clarita Shynal Martis
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Ramesh Chandrababu
- Department of Medical Surgical Nursing, Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Vani Lakshmi R
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | | | - Judith Angelitta Noronha
- Department of Obstetrics and gynaecological nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Jyothi Chakrabarty
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Debbie Tolson
- Alzheimer Scotland Centre for Policy and Practice, University of West of Scotland, Scotland, UK
| | - Elsa Sanatombi Devi
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
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García-Vivar C, Konradsen H, Kolbrun Svavarsdóttir E, Brødsgaard A, Dieperink KB, Luttik ML, Mahrer-Imhof R, Østergaard B, Imhof L. Healthcare interventions for older people with dementia and family caregivers in Europe: A scoping review. Int J Nurs Pract 2024; 30:e13172. [PMID: 37287366 DOI: 10.1111/ijn.13172] [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: 09/27/2021] [Revised: 05/25/2023] [Accepted: 05/26/2023] [Indexed: 06/09/2023]
Abstract
AIM This study aimed to examine the extent, range and variety of research in Europe describing healthcare interventions for older people with dementia (PwD) and family caregivers. METHODS This was a scoping review and followed the PRISMA Scoping Review guideline. MEDLINE, CINAHL and Cochrane library databases were searched for studies published between 2010 and 2020. Studies reporting healthcare interventions in Europe for PwD over 65 years and their family caregivers were included. RESULTS Twenty-one studies from six European countries were included. The types of healthcare intervention identified were categorized as follows: (1) family unit intervention (interventions for both PwD and their family caregiver), (2) individual intervention (separate interventions for PwD or family caregivers) and (3) family caregiver only intervention (interventions for family caregivers only but with outcomes for both PwD and family caregivers). CONCLUSIONS This review provides insight into healthcare interventions for older PwD and family caregivers in Europe. More studies are needed that focus on the family as a unit of care in dementia.
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Affiliation(s)
- Cristina García-Vivar
- Department of Health Sciences, Public University of Navarre, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Hanne Konradsen
- Department of Gastroenterology, Herlev and Gentofte Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Solna, Sweden
| | - Erla Kolbrun Svavarsdóttir
- School of Health Sciences, Faculty of Nursing, Landspitali University Hospital, University of Iceland, Reykjavik, Iceland
| | - Anne Brødsgaard
- Department of Paediatrics and Adolescent Medicine, Copenhagen University Hospital Amager Hvidovre, Aarhus, Denmark
- Section for Nursing, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Karin B Dieperink
- Family focused healthcare research Center (FaCe), Department of Clinical Research, University of Southern Denmark and Department of Oncology, Odense University Hospital, Odense, Denmark
| | | | - Romy Mahrer-Imhof
- Family-Centred and Community-Based Care, Nursing Science & Care Ltd, Basel, Switzerland
| | - Birte Østergaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Lorenz Imhof
- Family-Centred and Community-Based Care, Nursing Science & Care Ltd, Basel, Switzerland
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Folder N, Power E, Rietdijk R, Christensen I, Togher L, Parker D. The Effectiveness and Characteristics of Communication Partner Training Programs for Families of People With Dementia: A Systematic Review. THE GERONTOLOGIST 2024; 64:gnad095. [PMID: 37439771 PMCID: PMC10949353 DOI: 10.1093/geront/gnad095] [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: 03/14/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Communication partner training (CPT) is essential in dementia care. Despite families being the largest group of community carers, previous reviews primarily focused on formal carers. This study aimed to understand the characteristics and effectiveness of CPT for families of people with dementia. RESEARCH DESIGN AND METHODS The systematic review included intervention/protocol studies on dementia CPT for families, excluding formal carers and programs not focused on communication. CINAHL, PsycINFO, SpeechBITE, Medline, SCOPUS, and Embase were searched between November 30 and December 6, 2021. After deduplication, 3,172 records were screened. Quality assessment used JBI Critical Appraisal tools and the Mixed Methods Appraisal Tool. Data synthesis utilized three reporting tools, the International Classification of Functioning, Disability, and Health, and content analysis. RESULTS Of 30 studies (27 programs), there were 10 quasi-experimental, 5 RCTs, 4 mixed methods, 4 case studies, 4 qualitative, and 2 protocols. Studies were published between 1998 and 2021 and included 671 family members. Characteristics varied with 7/27 programs including consumers during creation and one program including telehealth. One study included all reporting tool criteria. Programs typically used 4 intervention functions, with 12/27 programs addressing 3 behavior change areas. 33/74 outcome measures targeted the "Environment" of the person with dementia. Studies showed positive improvements in communication skills and knowledge, with mixed results on behavior/psychosocial outcomes. Qualitative results identified improvements in conversation and attitudes. DISCUSSION AND IMPLICATIONS CPT for families improves communication outcomes, however, quality of studies varied significantly. Future research should address gaps in telehealth, consumer involvement, and intervention descriptions.
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Affiliation(s)
- Naomi Folder
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Emma Power
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Rachael Rietdijk
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Glebe, New South Wales, Australia
| | - Iben Christensen
- Department of Nordic Studies and Linguistics, University of Copenhagen, Copenhagen, Hovedstaden, Denmark
| | - Leanne Togher
- Faculty of Medicine and Health, Sydney School of Health Sciences, The University of Sydney, Glebe, New South Wales, Australia
| | - Deborah Parker
- Faculty of Health, Graduate School of Health, University of Technology Sydney, Ultimo, New South Wales, Australia
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Arafa A, Kashima R, Shimamoto K, Kawachi H, Teramoto M, Sakai Y, Gao Q, Matsumoto C, Kokubo Y. Hypertensive disorders of pregnancy and the risk of dementia: a systematic review and meta-analysis of cohort studies. Hypertens Res 2024; 47:859-866. [PMID: 38040840 DOI: 10.1038/s41440-023-01520-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 10/16/2023] [Accepted: 11/05/2023] [Indexed: 12/03/2023]
Abstract
This study aimed to investigate the association between hypertensive disorders of pregnancy (HDP) and subsequent risk of dementia using a systematic review and meta-analysis of cohort studies. We searched PubMed and Scopus for eligible studies that investigated the association between HDP and dementia risk. Using the random-effects model, pooled hazard ratio (HR) and 95% confidence interval (CI) of dementia risk in women with HDP were calculated. We applied the I2 statistic to measure heterogeneity across studies and the test for funnel plot asymmetry to evaluate publication bias. Six cohort studies were eligible: three from the United States, two from Sweden, and one from Denmark. When combined, HDP was associated with the risk of dementia: pooled HR (95% CI) = 1.31 (1.12, 1.53). The heterogeneity across studies was moderate (I2 = 47.3%, p-heterogeneity = 0.091), but no signs of publication bias were detected. The association of HDP with vascular dementia was stronger than that with Alzheimer's disease: pooled HRs (95% CIs) = 1.66 (1.13, 2.43) and 1.29 (0.97, 1.72), respectively. In conclusion, HDP was associated with a higher risk of dementia and this association was more prominent with vascular dementia.
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Affiliation(s)
- Ahmed Arafa
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan.
- Department of Public Health, Faculty of Medicine, Beni-Suef University, Beni-Suef, Egypt.
| | - Rena Kashima
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiovascular Pathophysiology and Therapeutics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Keiko Shimamoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Haruna Kawachi
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Environmental Medicine and Population Sciences, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Masayuki Teramoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yukie Sakai
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Qi Gao
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Chisa Matsumoto
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
- Department of Cardiology, Center for Health Surveillance and Preventive Medicine, Tokyo Medical University Hospital, Shinjuku, Japan
| | - Yoshihiro Kokubo
- Department of Preventive Cardiology, National Cerebral and Cardiovascular Center, Suita, Japan
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Cummings J, Sano M, Auer S, Bergh S, Fischer CE, Gerritsen D, Grossberg G, Ismail Z, Lanctôt K, Lapid MI, Mintzer J, Palm R, Rosenberg PB, Splaine M, Zhong K, Zhu CW. Reduction and prevention of agitation in persons with neurocognitive disorders: an international psychogeriatric association consensus algorithm. Int Psychogeriatr 2024; 36:251-262. [PMID: 36876335 PMCID: PMC10480345 DOI: 10.1017/s104161022200103x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVES To develop an agitation reduction and prevention algorithm is intended to guide implementation of the definition of agitation developed by the International Psychogeriatric Association (IPA). DESIGN Review of literature on treatment guidelines and recommended algorithms; algorithm development through reiterative integration of research information and expert opinion. SETTING IPA Agitation Workgroup. PARTICIPANTS IPA panel of international experts on agitation. INTERVENTION Integration of available information into a comprehensive algorithm. MEASUREMENTS None. RESULTS The IPA Agitation Work Group recommends the Investigate, Plan, and Act (IPA) approach to agitation reduction and prevention. A thorough investigation of the behavior is followed by planning and acting with an emphasis on shared decision-making; the success of the plan is evaluated and adjusted as needed. The process is repeated until agitation is reduced to an acceptable level and prevention of recurrence is optimized. Psychosocial interventions are part of every plan and are continued throughout the process. Pharmacologic interventions are organized into panels of choices for nocturnal/circadian agitation; mild-moderate agitation or agitation with prominent mood features; moderate-severe agitation; and severe agitation with threatened harm to the patient or others. Therapeutic alternatives are presented for each panel. The occurrence of agitation in a variety of venues-home, nursing home, emergency department, hospice-and adjustments to the therapeutic approach are presented. CONCLUSIONS The IPA definition of agitation is operationalized into an agitation management algorithm that emphasizes the integration of psychosocial and pharmacologic interventions, reiterative assessment of response to treatment, adjustment of therapeutic approaches to reflect the clinical situation, and shared decision-making.
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Affiliation(s)
- Jeffrey Cummings
- Joy Chambers-Grundy Professor of Brain Science, Director, Chambers-Grundy Center for Transformative Neuroscience, Co-Director, Pam Quirk Brain Health and Biomarker Laboratory, Department of Brain Health, School of Integrated Health Sciences. University of Nevada Las Vegas (UNLV)
| | - Mary Sano
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, NYC NY and James J. Peters VAMC, Bronx NY
| | - Stefanie Auer
- Centre for Dementia Studies, University for Continuing Education Krems, Austria
| | - Sverre Bergh
- The research centre for age-related functional decline and disease, Innlandet hospital trust, Ottestad, Norway
| | - Corinne E. Fischer
- Faculty of Medicine, Department of Psychiatry, University of Toronto, Canada
| | - Debby Gerritsen
- Department of Primary and Community Care, Radboud university medical center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, the Netherlands
| | - George Grossberg
- Department of Psychiatry & Behavioral Neuroscience, Division of Geriatric Psychiatry St Louis University School of Medicine
| | - Zahinoor Ismail
- Departments Psychiatry, Neurology, Epidemiology, and Pathology, Hotchkiss Brain Institute & O’Brien Institute for Public Health University of Calgary
| | - Krista Lanctôt
- Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute; and Departments of Psychiatry and Pharmacology/Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Maria I Lapid
- Mayo Clinic Department of Psychiatry and Psychology, Rochester, MN, USA
| | - Jacobo Mintzer
- Psychiatrist, Ralph. H. Johnson VA Medical Center, Charleston, SC and Professor, College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Rebecca Palm
- Department of Nursing Science, Faculty of Health, Witten/Herdecke University, 58455 Witten, Germany
| | - Paul B. Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine
| | - Michael Splaine
- Owner Splaine Consulting, Managing Partner, Recruitment Partners LLC
| | - Kate Zhong
- Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas
| | - Carolyn W. Zhu
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine, NYC, NY and James J. Peters VAMC, Bronx NY
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Ibrahim AM, Ibrahim MM, Zaghamir DEF. Burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. Palliat Support Care 2024; 22:182-189. [PMID: 37381712 DOI: 10.1017/s1478951523000573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
BACKGROUND Alzheimer's disease is a chronic neurodegenerative disorder that results in total cognitive impairment and functional decline. Family members are the most usual caregivers worldwide, resulting in an increasing total burden and a subsequent degradation of their quality of life. OBJECTIVES To evaluate the burden of care and quality of life among informal caregivers to Alzheimer patients in Egypt. METHODS A descriptive research design was used. The study was conducted at outpatient clinics of El-Abbasya Mental Hospital in Cairo, Egypt. This study included 550 informal caregivers of Alzheimer patients. Data were gathered through questionnaires using the Sociodemographic Profile of Family Caregivers, an adopted version of the Montgomery Borgatta Caregiver Burden scale, and Health-Related Quality of Life Scale. RESULTS Nearly three quarters (73.5%) of the informal caregivers were female. Additionally, the physical burden among the informal caregivers was the highest (21.58 ± 8.13), while the psychological burden was the lowest (7.48 ± 25.35). Besides, around one-third (30%) of the informal caregivers had a total poor quality of life. SIGNIFICANCE OF RESULTS Total burden among informal caregivers of Alzheimer patients was relatively high (64.71 ± 26.86). Moreover, less than one-tenth (8%) of the informal caregivers for Alzheimer's patients had a good quality of life, whereas more than half (62%) of them had an average quality of life. In the Egyptian context, ongoing health education initiatives for those who care for Alzheimer patients are essential, and additional research employing large study sample sizes in varied contexts is strongly advised.
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Affiliation(s)
- Ateya Megahed Ibrahim
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Department of Family and Community Health Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
| | - Mahmoud Metwally Ibrahim
- Al-Ghad International College for Applied Medical Sciences, Saudi Arabia
- Department of Pharmacology, Al-Azhar University, Damietta, Egypt
| | - Donia Elsaid Fathi Zaghamir
- Department of Nursing, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Al-Kharj, Saudi Arabia
- Pediatric Nursing, Faculty of Nursing, Port Said University, Port Said, Egypt
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Vicente C, Fernandes S, Romão A, Fernandes JB. Current trends in psychotherapies and psychosocial interventions for people with dementia: a scoping review of randomized controlled trials. Front Psychiatry 2024; 15:1286475. [PMID: 38317762 PMCID: PMC10838973 DOI: 10.3389/fpsyt.2024.1286475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/09/2024] [Indexed: 02/07/2024] Open
Abstract
An outcome of dementia is a progressive decline in cognitive function. Implementing psychotherapies and psychosocial interventions is crucial for bolstering cognitive abilities, promoting independence, and elevating the quality of life for individuals with dementia. This review aims to identify current trends in psychotherapies and psychosocial interventions for people with dementia. A Scoping review was developed based on the framework proposed by Arksey and O'Malley. The literature search was conducted on electronic databases, including Scopus, Cochrane Central Register of Controlled Trials, MEDLINE, CINAHL, Nursing & Allied Health Collection, and MedicLatina. Executed in June 2023, the search focused on articles published in English, Portuguese, and Spanish between 2013 and 2023. Through this search, 1409 articles were initially identified. After selecting and analyzing the reports, sixteen trials were included in this review. Eight distinct categories were identified, covering different strategies. These categories run from computerized game-based cognitive training and reminiscence therapy to compensatory and restorative strategies, memory and attention training, calculation training, dual-task training, counseling, and personalized goal attainment. The findings of this scoping review highlight the diverse landscape of psychotherapies and psychosocial interventions for people with dementia.
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Affiliation(s)
- Célia Vicente
- Department of Nursing, Hospital Garcia de Orta, Almada, Portugal
- Nurs Lab, Caparica, Almada, Portugal
| | - Sónia Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Ana Romão
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
| | - Júlio Belo Fernandes
- Nurs Lab, Caparica, Almada, Portugal
- Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Caparica, Almada, Portugal
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10
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Schmitz D, Becker B. Chatbot-Mediated Learning For Caregiving Relatives of People With Dementia: Empirical Findings and Didactical Implications For Mulitprofessional Health Care. J Multidiscip Healthc 2024; 17:219-228. [PMID: 38250309 PMCID: PMC10799614 DOI: 10.2147/jmdh.s424790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/20/2023] [Indexed: 01/23/2024] Open
Abstract
Purpose Supporting family caregivers is a major challenge for the healthcare system. The first points of contact are physicians, nurses and social services, which are not easily accessible. For this reason, an information platform has been developed to provide information for family caregivers caring for people with dementia at home. The aim of this article is to provide an insight into the didactic design of this platform. Sample and Methods A didactic concept was developed based on didactic target group analysis and interviews with caring relatives (n=6). Results The didactic concept of the digital platform takes into account the characteristics of family caregivers as learners, such as time constraints and reciprocity. Therefore two different learning paths, a long and a short version, are offered. Reciprocity is supported by information which are related to individual characteristics of the caring relation. This is made possible by an adaptation of the didactic method "anchored instructions": Family caregivers experience a problematic caring situation. They use the platform and central concepts related to this situation are offered as anchors. In chatbot mediated learning, these concepts are identified and, ideally, relevant information is provided in a short version. These concepts are displayed as a learning map and must be proactively selected. Chatbot mediated learning has the advantage that matching concepts are offered as a pre-selection. Especially for inexperienced carers who are not familiar with the concepts, this learning path seems to be suitable. Conclusion The combination of learning through the "Information for Relatives" website and CML seems to meet all needs. In order to promote learner motivation, the chatbot should not only offer the identified concept, but also those related to this concept, in order to link new knowledge in one's own knowledge network.
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Affiliation(s)
- Daniela Schmitz
- Department for Human Medicine, Junior Professorship for Innovative and Digital Methods of Teaching and Learning in Multiprofessional Health Care, Witten/Herdecke University, Witten, NRW, Germany
| | - Britta Becker
- Department for Human Medicine, Junior Professorship for Innovative and Digital Methods of Teaching and Learning in Multiprofessional Health Care, Witten/Herdecke University, Witten, NRW, Germany
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Tahami Monfared AA, Khachatryan A, Hummel N, Kopiec A, Martinez M, Zhang R, Zhang Q. Assessing Quality of Life, Economic Burden, and Independence Across the Alzheimer's Disease Continuum Using Patient-Caregiver Dyad Surveys. J Alzheimers Dis 2024; 99:191-206. [PMID: 38640156 DOI: 10.3233/jad-231259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Background Alzheimer's disease (AD) and mild cognitive impairment (MCI) have negative quality of life (QoL) and economic impacts on patients and their caregivers and may increase along the disease continuum from MCI to mild, moderate, and severe AD. Objective To assess how patient and caregiver QoL, indirect and intangible costs are associated with MCI and AD severity. Methods An on-line survey of physician-identified patient-caregiver dyads living in the United States was conducted from June-October 2022 and included questions to both patients and their caregivers. Dementia Quality of Life Proxy, the Care-related Quality of Life, Work Productivity and Activity Impairment, and Dependence scale were incorporated into the survey. Regression analyses investigated the association between disease severity and QoL and cost outcomes with adjustment for baseline characteristics. Results One-hundred patient-caregiver dyads were assessed with the survey (MCI, n = 27; mild AD, n = 27; moderate AD, n = 25; severe AD, n = 21). Decreased QoL was found with worsening severity in patients (p < 0.01) and in unpaid (informal) caregivers (n = 79; p = 0.02). Dependence increased with disease severity (p < 0.01). Advanced disease severity was associated with higher costs to employers (p = 0.04), but not with indirect costs to caregivers. Patient and unpaid caregiver intangible costs increased with disease severity (p < 0.01). A significant trend of higher summed costs (indirect costs to caregivers, costs to employers, intangible costs to patients and caregivers) in more severe AD was observed (p < 0.01). Conclusions Patient QoL and functional independence and unpaid caregiver QoL decrease as AD severity increases. Intangible costs to patients and summed costs increase with disease severity and are highest in severe AD.
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Thyrian JR, Boekholt M, Biernetzky O, Blotenberg I, Teipel S, Killimann I, Hoffmann W. Informal Caregivers of People with Dementia in Germany: Psychosocial Characteristics and Unmet Needs. J Alzheimers Dis 2024; 99:1235-1242. [PMID: 38759002 DOI: 10.3233/jad-231055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Background Caregivers of people with dementia living at home (CPwDh) are likely to be affected by a range of health problems. However, CPwDh are often regarded as accompanying persons and receive less attention in research and care. Little is known about this population and their needs in Germany. However, better knowledge of CPwDH is needed to design effective interventions. Objective The objective of this report is to describe the situation of CPwDh and highlight differences based on sex and living situation. Methods This was a cross-sectional analysis of the psychosocial characteristics of participants in the GAIN trial, a cluster-randomized, controlled intervention trial investigating the effectiveness of a care management program. A total of n = 192 CPwDh were recruited in GP offices, memory clinics or through public campaigns in the German federal state of Mecklenburg-Western Pomerania. The inclusion criteria were an age of 18 years or above, being a CPwDh, written informed consent. In a comprehensive digital assessment, psychosocial variables, burden, and care needs were assessed. Results Partners, women, and people living in the same household represented the majority of caregivers, and their mean number of needs was 8.7. Overall, participants indicated a mild to moderate burden. There are differences in burden based on sex and living situation, with caregivers living with people with dementia showing less burden and different psychosocial demographics. Conclusions There is a need for interventions to reduce caregivers' unmet needs in the CPwDh. Such interventions should consider differences in sex and living situation to better address individual caregiver needs.
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Affiliation(s)
- Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Melanie Boekholt
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Olga Biernetzky
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
| | - Iris Blotenberg
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
| | - Stefan Teipel
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Ingo Killimann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Rostock, Germany
- Department for Psychosomatic and Psychotherapeutical Medicine, Rostock University Medical Center, Rostock, Germany
| | - Wolfgang Hoffmann
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
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13
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Wang J, Chen H, Yang L, Yu X, Zhang D, Zhao Q, Xiao M. Effectiveness of the Stress Process Model-Based Program in Dementia Caregiving (DeCare-SPM) for Family Caregivers: A Study Protocol for a Randomized Controlled Trial. J Multidiscip Healthc 2023; 16:3507-3519. [PMID: 38024118 PMCID: PMC10658953 DOI: 10.2147/jmdh.s438342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
This paper aims to describe a randomized controlled trial protocol evaluating the effectiveness, cost, and process of a stress process model-based program in dementia caregiving (DeCare-SPM) for family caregivers. Family caregivers of individuals with dementia will be recruited from memory clinics and community settings and randomly assigned to either DeCare-SPM or usual care. DeCare-SPM comprises three face-to-face sessions (ie, problem-based coping, emotion-based coping, meaning-based coping), and a fourth session (ie, social support) including weekly telephone-based consultation for four weeks and then monthly face-to-face boosters. Outcomes will be measured at baseline (T0), and at one (T1), three (T2), and six months (T3). The primary outcome is positive aspects of caregiving and secondary outcomes are caregiving (ie, sense of competence, caregiver burden, social support, anxiety, depression, and quality of life), dementia-related (ie, care dependency, neuropsychiatric symptoms, and quality of life), and stress-related biomarkers of blood and saliva. In addition, process and economic evaluations will be performed. Mixed-effects models will be used to assess intervention effects. Content analysis will be performed on the qualitative data. This paper described the protocol for comprehensive evaluation of the effectiveness, cost, and process of the theory-driven DeCare-SPM to inform how and why interventions work. It highlights the need to reduce challenges and enhance the positive aspects of dementia care. The DeCare-SPM will provide evidence-based insights into how to support and empower family caregivers in their important roles, thereby, leading to improved dementia care.
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Affiliation(s)
- Jun Wang
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Hongmei Chen
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Lin Yang
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Xiuli Yu
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Dandan Zhang
- Qinggang Senior Care Center, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People’s Republic of China
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Michael AE, Michael N, Erfurth A, Kujovic M. Clozapine for the treatment of aggressiveness and agitation in advanced dementia. Psychogeriatrics 2023; 23:963-972. [PMID: 37673659 DOI: 10.1111/psyg.13017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/05/2023] [Accepted: 08/16/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Distressing behavioural symptoms, particularly agitation and aggressiveness, remain a difficult problem in everyday clinical practice in the treatment of multimorbid patients with dementia. Clozapine may be an effective therapeutic alternative in this context. METHODS In a retrospective study, patients who had a diagnosis of dementia and had been treated in a specialized geriatric psychiatry unit with clozapine between August 2018 and February 2022 were included, and medical records were systematically reviewed. The Clinical Global Impressions Scale was used to assess improvement, and the Pittsburgh Agitation Scale for symptom reduction. In addition, side effects and clinical features were documented in detail. RESULTS A total of 31 patients (median age 82 years) were identified with a mean clozapine dose of 47.2 (SD 35.6) mg. A total of 13 patients tolerated clozapine very well, 10 showed tolerable side effects, and in 10 patients side effects were the reason for stopping clozapine. Behavioural symptoms improved significantly, as indicated by the assessment scores. CONCLUSIONS In summary, clozapine was effective and well tolerated in 23 patients, suggesting that low-dose clozapine may help to alleviate the suffering of difficult-to-treat multimorbid patients with advanced dementia and their caregivers. However, particular attention should be paid to adverse drug reactions, especially in patients with cardiovascular and pulmonary impairment.
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Affiliation(s)
- Arwed E Michael
- Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University Bochum, Bochum, Germany
| | - Nikolaus Michael
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, Elbroich Hospital, Düsseldorf, Germany
- University of Münster, Münster, Germany
| | - Andreas Erfurth
- University of Münster, Münster, Germany
- 1st Department of Psychiatry and Psychotherapeutic Medicine, Klinik Hietzing, Vienna, Austria
| | - Milenko Kujovic
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
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Kızılkaya M, Atuğ M. Views of Family Members Who Take Care of an Elderly Person they Live with on Ageism, Spirituality and Death in Turkey: A Qualitative Approach. JOURNAL OF RELIGION AND HEALTH 2023; 62:3095-3109. [PMID: 37266900 DOI: 10.1007/s10943-023-01837-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/11/2023] [Indexed: 06/03/2023]
Abstract
This descriptive qualitative research examined the views of people caring for an elderly family member on ageism, spirituality, and death. A total of 12 people who lived in the same house as the elderly person they cared for made up the study sample. Data were collected via face-to-face, in-depth interviews using a structured interview format. The content analysis method was used for the data analysis. The analysis of the study data yielded three themes: the definition of ageism, the meaning of spirituality and its effects on care, and the position of death in life. The results indicated that living with and caring for an elderly individual made the lives of the family members providing care meaningful, spirituality was important in the care of elderly individuals, and caregivers could be considered at risk in terms of the burden of care. It is recommended that health professionals support caregivers sharing the same house with an elderly family member through training programs on the burden of care, spiritual care, and death.
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Affiliation(s)
- Mehtap Kızılkaya
- Department of Mental Health and Diseases Nursing, Faculty of Nursing, Aydın Adnan Menderes University, Aydın, Turkey.
| | - Mahsun Atuğ
- Aydın Adnan Menderes University Research and Application Hospital, Aydın, Turkey
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Hutagalung ER, Soegyanto AI, Ahmad MS, Mandasari M. Analysis of Oral Health Literacy in Caregivers of Special Needs Individuals in Special Schools and Social Institutions in Jakarta. Dent J (Basel) 2023; 11:221. [PMID: 37754341 PMCID: PMC10529690 DOI: 10.3390/dj11090221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 09/16/2023] [Accepted: 09/18/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Individuals with special needs (IWSN) are susceptible to oral conditions such as caries and periodontal disease. In order to improve oral health of IWSN, it is important to improve the oral health literacy (OHL) of caregivers, as they play an important role in the daily hygiene and personal care of these people. OBJECTIVE This study aimed to analyze the OHL in caregivers of IWSN in special schools (informal caregivers) and social institutions for people with disabilities (professional caregivers) in Jakarta, Indonesia. METHODS The study was conducted with a cross-sectional and descriptive analytic design with a cluster sampling method of 400 informal and professional caregivers. The study utilized the validated Health Literacy Dentistry-Indonesian Version (HeLD-ID) questionnaire to measure OHL. Quantitative data was analyzed using non-parametric Kruskal Wallis and Mann Whitney tests (significant level p < 0.05). RESULTS The median total OHL score of respondents was 3.14 (0.24-4) for informal caregivers and 3.21 (0-4) for professional caregivers. The OHL score of the two populations showed significant differences in the domains of receptivity (p = 0.036), understanding (p = 0.030), and economic barriers (p = 0.022). Significant differences in OHL scores were also noted among caregivers according to their sociodemographic characteristics, such as level of education, and number of IWSN handled. CONCLUSION Informal and professional caregivers in this study showed good level of OHL. To elucidate the relationship between caregiver's level of OHL with IWSN, further study is necessary.
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Affiliation(s)
- Esther Rotiur Hutagalung
- Oral Medicine Residency Program, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia;
| | | | - Mas Suryalis Ahmad
- Special Needs Dentistry Program, Universiti Teknologi MARA, Shah Alam 40450, Malaysia;
| | - Masita Mandasari
- Department of Oral Medicine, Faculty of Dentistry, Universitas Indonesia, Jakarta 10430, Indonesia;
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17
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Chang AK, Kim BK, Kim AY. The impact of aromatherapy-based oral care on oral conditions, salivary pH, and halitosis in older adults with dementia: Pilot study. Geriatr Nurs 2023; 53:109-115. [PMID: 37536001 DOI: 10.1016/j.gerinurse.2023.07.010] [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: 04/17/2023] [Revised: 07/14/2023] [Accepted: 07/14/2023] [Indexed: 08/05/2023]
Abstract
Inadequate oral care and poor oral health in older adults are known to increase the risk of dementia. Dementia patients residing in long-term care facilities are especially vulnerable to oral diseases due to their care-resistant behavior. This study aimed to investigate the effects of a 7-day oral care program based on an aroma solution in 58 dementia patients (29 each in the experimental and control groups) admitted to a long-term care hospital in South Korea. The experimental group received oral care with a solution containing peppermint, tea tree, and lemon essential oils, and the control group with a saline solution. The effectiveness of oral care was assessed by the participants' oral condition, salivary pH, and halitosis. The experimental group showed significant improvements (P<.001) in all three outcomes, indicating that oral care with an aroma solution can improve the oral health of older dementia patients residing in long-term care facilities.
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Affiliation(s)
- Ae Kyung Chang
- Professor, College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Bo Kyoung Kim
- College of Nursing Science, Kyung Hee University, Seoul, South Korea
| | - Ah Young Kim
- College of Nursing Science, Kyung Hee University, Seoul, South Korea..
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18
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Esmaeili M, Dehghan Nayeri N, Bahramnezhad F, Fattah Ghazi S, Asgari P. Effectiveness of a Supportive Program on Caregiver Burden of Families Caring for Patients on Invasive Mechanical Ventilation at Home: An Experimental Study. Creat Nurs 2023; 29:229-237. [PMID: 37800733 DOI: 10.1177/10784535231195507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
The prevalence of patients on mechanical ventilation who are being supported at home is increasing. Due to these patients' complex and chronic conditions, the subjective burden on their family caregivers increases after discharge. The aim of this study was to evaluate the effectiveness of a supportive home care program on the caregiver burden of families caring for patients on invasive mechanical ventilation at home. Sixty patients hospitalized in three university-affiliated hospitals in Tehran, Iran between 7/2020 and 8/2021 were randomly assigned to one of two groups: A supportive home care program, and routine hospital education. The supportive home care program included six educational sessions delivered in the hospital before discharge, and home visits and continued education after discharge. Caregiver burden was measured using the Zarit Burden Interview. Results showed that caregiver burden increased significantly (p ≥ .001) after discharge without the supportive home care program intervention. Follow-up by nurses after discharge is essential to reduce the psychological burden of caring for patients on invasive mechanical ventilation at home.
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Affiliation(s)
- Maryam Esmaeili
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Dehghan Nayeri
- Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Bahramnezhad
- Nursing and Midwifery Care Research Center, Spiritual Health Group, Research Center of Quran, Hadith and Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Samrand Fattah Ghazi
- Fellowship of Critical Care Medicine, Imam Khomeini hospital complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Parvaneh Asgari
- School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
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Hovsepian VE, Sadak T, Schlak AE, Liu J, Poghosyan L. The Association between Primary Care Practices' Structural Capabilities and Hospitalizations among Persons Living with Dementia. J Appl Gerontol 2023:7334648231155444. [PMID: 36738162 DOI: 10.1177/07334648231155444] [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] [Indexed: 02/05/2023] Open
Abstract
Background: Persons living with dementia (PLWD) are more likely to be hospitalized than individuals without dementia. Little is known about key features (i.e., structural capabilities) in primary care practices where PLWD receive care. This study assessed the relationship between structural capabilities (i.e., care coordination, community integration, and reminder systems) and hospitalizations among PLWD. Methods: We conducted a secondary analysis of cross-sectional data from 5001 PLWD in 192 practices and used three datasets: nurse practitioner surveys, Medicare claims, and Minimum Data Set. Using generalized estimating equations, we evaluated the association between structural capabilities and hospitalizations. Results: PLWD who received care from practices with care coordination were less likely to have hospitalizations (OR = 0.62, p < .05). No statistically significant associations were observed between community integration and reminder systems and hospitalizations. Conclusion: Primary care practices need to tailor structural capabilities to address the needs of PLWD to reduce hospitalizations.
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Affiliation(s)
- Vaneh E Hovsepian
- School of Nursing, 16142University of Pennsylvania, Philadelphia, PA, USA
| | - Tatiana Sadak
- 7284University of Washington, WA School of Nursing, Seattle, WA, USA
| | | | - Jianfang Liu
- Columbia University School of Nursing, New York, NY, USA
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The effectiveness of yoga therapy on caregivers of people living with dementia: A systematic review and meta-analysis of randomized controlled trials. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2023. [DOI: 10.1016/j.cegh.2022.101192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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21
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Simsek Yurt N, Yavuz E. Assessment of the Burden of Care and Burnout Level in Caregivers of Dementia Patients in a Home Care Setting. EURASIAN JOURNAL OF FAMILY MEDICINE 2022. [DOI: 10.33880/ejfm.2022110402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Aim: This study aims to evaluate the factors affecting the care burden and burnout levels of caregivers with dementia patients receiving home care services.
Methods: This descriptive study was conducted in Samsun Training and Research Hospital Home Care Services which paid a visit at home between March 20 and June 20, 2021. The caregivers of the patients who were followed up by the diagnosis of dementia were included in the study after having agreed to participate in the study with their written informed consents. The 'Socio-demographic Data Form', 'Zarit Burden Interview' and 'Maslach Burnout Inventory’ were administered to caregivers during face-to-face interviews.
Results: A total of 157 caregivers were included in our study, of which 70.1% (n=110) were women. 68.2% (n=107) were in the 40-64 years age group. The mean Zarit Burden Interview score was calculated as 47.10±16.14 (min=21, max=85). 76.4% of caregivers had moderate to severe escalated care burden. Once the impact of the increase in caregiver burden score on Maslach Burnout Inventory subgroups was examined, the relationship was found to be positively significant with emotional exhaustion and depersonalization, and negatively significant with personal achievement.
Conclusion: As the burden of care increases, the level of burnout of individuals increases. Female gender, illiteracy, lack of income, duration of care given which is prolonged for more than one year, and daily care duration exceeding 12 hours were determined as outstanding factors that increase the care burden and level of burnout.
Keywords: home care services, caregivers, dementia, caregiver burnout
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Affiliation(s)
| | - Erdinc Yavuz
- Department of Family Medicine, Samsun University School of Medicine
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22
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Green G, Halevi Hochwald I, Radomyslsky Z, Nissanholtz-Gannot R. Family Caregiver's Depression, Confidence, Satisfaction, and Burden Regarding End-of-Life Home Care for People With End-Stage Dementia. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221147961. [PMID: 36573833 DOI: 10.1177/00302228221147961] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
To detect differences between two care services units: regarding family-caregiver (FC) depression, perceived-burden and confidence in the provision of care to people with end-stage dementia (PWESD); examine predictors such as FC age, depression, confidence in the provision of care to PWESD and satisfaction with the community-home-care service to burden; and explore a mediation model.The participants were 139 FC, caring for PWESD living at home. The questionnaire was composed of FC background characteristics, perceived-burden, satisfaction with the community-home-care services, depression, and confidence in the provision of care to the PWESD. HCUs' FC felt significantly more burdened than HHUs' FC. Furthermore, satisfaction with the community-home-care services mediated the relationship between FC confidence in the provision of care to the PWESD and FC burden. The study results may affect the development of end-of-life care policies and services which meet the needs of PWESD and their FC.
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Affiliation(s)
- Gizell Green
- School of Nursing, Ariel University, Ariel, Israel
| | | | - Zorian Radomyslsky
- Maccabi Healthcare Services, Tel-Aviv, Israel
- School of Health Sciences, Ariel University, Ariel, Israel
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Sanprakhon P, Chaimongkol N, Hengudomsub P, Lach HW. An Integrative Stress Reduction Program for Family Caregivers of Persons With Advanced Dementia: A Pilot Study. J Gerontol Nurs 2022; 48:26-32. [PMID: 36169291 DOI: 10.3928/00989134-20220908-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The current study sought to pilot test and examine the effects of an integrative stress reduction program (ISRP) on caregiver stress and sleep quality and behavioral and psychological symptoms of dementia (BPSD) of care recipients. Family caregivers (N = 12) of persons with moderate to severe dementia were recruited from memory clinics in Thailand. Twelve caregivers participated in five educational sessions on dementia care, stress, and BPSD management over 4 weeks. The Relative Stress Scale and Pittsburgh Sleep Quality Index were used to measure caregiver outcomes. The Neuropsychiatric Inventory was used to measure BPSD of care recipients. Outcome variables were collected at baseline, postintervention, and follow up. Data were analyzed using one-way repeated measures analysis of variance. Participants reported statistically decreased stress, improved sleep quality, and decreased BPSD among care recipients postintervention and at follow up (all p < 0.001). The ISRP was feasible and shows promise in reducing stress and improving sleep quality in caregivers and lessening BPSD in care recipients. [Journal of Gerontological Nursing, 48(10), 26-32.].
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Lin LJ, Li KY. Comparing the effects of olfactory-based sensory stimulation and board game training on cognition, emotion, and blood biomarkers among individuals with dementia: A pilot randomized controlled trial. Front Psychol 2022; 13:1003325. [PMID: 36204759 PMCID: PMC9531625 DOI: 10.3389/fpsyg.2022.1003325] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022] Open
Abstract
Olfactory dysfunction can indicate early cognitive decline and is associated with dementia symptoms. We developed an olfactory-based sensory stimulation program and investigated its effects on cognition and emotion, and board game training were used as a comparison. In this parallel design pilot study, 30 participants with mild to moderate dementia were equal randomly assigned to the control (CONT), olfactory stimulation with cognitive training (OS), and board game (BG) groups. Two participants were withdrawn from CONT and OS groups, respectively. The intervention was a 12-week program with one 30-min session twice a week. We employed a blood-based biomarker technique and several cognitive and psychological tests to measure basal and after-intervention values. No significant differences were observed between the groups after intervention, as measured using the Mini-Mental State Examination, Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), Top International Biotech Smell Identification Test, and Geriatric Depression Scale (GDS). The results showed that the OS group had a lower plasma Tau level than the other groups following intervention, whereas the CONT group had a significantly increased plasma amyloid ß1-42 level. OS participants had a lower concentration ratio of plasma Tau and amyloid Aß1-42 and showed more stable or improved cognition, olfactory function, and mood state. Both the OS and BG groups had a higher percentage of participants with stable or improved cognition and emotion. Taken together, these results suggest that olfactory-based sensory stimulation can be a beneficial intervention for patients with dementia.
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Affiliation(s)
- Li-jung Lin
- Graduate Institute of Sport, Leisure, and Hospitality Management, National Taiwan Normal University, Taipei, Taiwan
| | - Kuan-yi Li
- Department of Occupational Therapy, Graduate Institute of Behavioral Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Movement Disorders Section, Department of Neurology, Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- *Correspondence: Kuan-yi Li,
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Tani J, Yang YH, Chen CM, Siow CY, Chang TS, Yang K, Yao J, Hu CJ, Sung JY. Domain-Specific Cognitive Prosthesis for Face Memory and Recognition. Diagnostics (Basel) 2022; 12:diagnostics12092242. [PMID: 36140643 PMCID: PMC9497523 DOI: 10.3390/diagnostics12092242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 09/05/2022] [Accepted: 09/09/2022] [Indexed: 11/18/2022] Open
Abstract
The present study proposes a cognitive prosthesis device for face memory impairment as a proof-of-concept for the domain-specific cognitive prosthesis. Healthy subjects (n = 6) and a patient with poor face memory were enrolled. An acquaintance face recognition test with and without the use of cognitive prosthesis for face memory impairment, face recognition tests, quality of life, neuropsychological assessments, and machine learning performance of the cognitive prosthesis were followed-up throughout four weeks of real-world device use by the patient. The healthy subjects had an accuracy of 92.38 ± 4.41% and reaction time of 1.27 ± 0.12 s in the initial attempt of the acquaintance face recognition test, which changed to 80.48 ± 6.23% (p = 0.06) and 2.11 ± 0.20 s (p < 0.01) with prosthesis use. The patient had an accuracy of 74.29% and a reaction time of 6.65 s, which improved to 94.29% and 3.28 s with prosthesis use. After four weeks, the patient’s unassisted accuracy and reaction time improved to 100% and 1.23 s. Functional MRI study revealed activation of the left superior temporal lobe during face recognition task without prosthesis use and activation of the right precentral motor area with prosthesis use. The prosthesis could improve the patient’s performance by bypassing the brain area inefficient for facial recognition and employing the area more efficiently for the cognitive task.
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Affiliation(s)
- Jowy Tani
- Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Medical University Biomed Accelerator, Taipei Medical University, Taipei 106339, Taiwan
- Taipei Medical University Biodesign Center, Taipei Medical University, Taipei 106339, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
| | - Yao-Hua Yang
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
| | - Chao-Min Chen
- Biomed Innovation Center, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
| | - Co Yih Siow
- Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei 110301, Taiwan
| | - Tsui-San Chang
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
| | - Kai Yang
- MediXgraph Inc., Fremont, CA 94555, USA
| | - Jack Yao
- MediXgraph Inc., Fremont, CA 94555, USA
| | - Chaur-Jong Hu
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
- Department of Neurology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 235041, Taiwan
- Correspondence: (C.-J.H.); (J.-Y.S.); Tel.: +886-2-2930-7930 (ext. 6940) (J.-Y.S.)
| | - Jia-Ying Sung
- Department of Neurology, Wan Fang Hospital, Taipei Medical University, Taipei 116079, Taiwan
- Department of Neurology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110301, Taiwan
- Taipei Neuroscience Institute, Taipei Medical University, New Taipei City 235041, Taiwan
- Correspondence: (C.-J.H.); (J.-Y.S.); Tel.: +886-2-2930-7930 (ext. 6940) (J.-Y.S.)
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Rodríguez-Mora Á, Mateo Guirola T, Mestre JM. Overload and Emotional Wellbeing in a Sample of Spanish Caregivers of Alzheimer's Patients during COVID-19 pandemic. Exp Aging Res 2022; 49:389-406. [PMID: 36036728 DOI: 10.1080/0361073x.2022.2115739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Carers of Alzheimer's suffer from caregiver overload, anxiety and depression. Changes in caregiving brought about by pandemic restrictions (COVID-19) may play a role. The aim was to explore the caregiver profile and assess the influence of the pandemic on informal and formal caregivers in a Spanish sample. METHOD Sixty caregivers participated. An ad hoc questionnaire, ZBI, STAI and BDI were administered. RESULTS Informal caregivers were more overloaded, anxious and depressed than professional caregivers. Both groups perceived themselves to be more sad, worried and stressed than in the pre-pandemic situation. The pandemic-generated variables associated with caregiving did not influence caregiver overload in both groups. In informal caregivers, worsening of the patient with stress and changes in perceived social support with anxiety and depression. In professional caregivers, changes in routine were associated with stress and lower depression and changes in perceived social support with higher caregiver strain. Changes in caregiving routine and changes in perceived social support were predictors of overload and emotional distress in both caregivers. CONCLUSIONS Overload was not influenced by the pandemic situation. Changes in caregiving routine and lack of social support were found to be predictors of overload and emotional distress in both types of caregivers.
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Affiliation(s)
- Álvaro Rodríguez-Mora
- Instituto Universitario para el Desarrollo Social y Sostenible, Universidad de Cádiz, Cádiz, Spain.,Department of Psychology, Universidad de Cádiz, Cádiz, Spain
| | | | - José M Mestre
- Instituto Universitario para el Desarrollo Social y Sostenible, Universidad de Cádiz, Cádiz, Spain.,Department of Psychology, Universidad de Cádiz, Cádiz, Spain.,Instituto de Investigación e Innovación Biomédica de Cádiz, Universidad de Cádiz, Cádiz, Spain
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Tian Z, Xiong C, Wang Y, Tao H, Zhou S, Yan J. Association between familism and mental health in dementia caregivers: a systematic review and meta-analysis. Psychogeriatrics 2022; 22:469-477. [PMID: 35636744 DOI: 10.1111/psyg.12843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 03/20/2022] [Accepted: 04/12/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Dementia caregivers suffer from mental health problems while caring for dementia patients. As a core value, familism has been linked to the mental health of dementia caregivers. This study aims to systematically review the familism of dementia caregivers and to examine the association between familism and mental health of anxiety, depression, and burden in empirical research studies. METHODS We conducted a systematic search in various databases like Medline, PubMed, and Embase databases from inception till April 2021. Fisher's z was calculated with correlation coefficient or regression coefficient values for three familism dimensions and mental health of anxiety, depression, and burden. All statistical analyses were performed using Comprehensive Meta-Analysis (CMA) version 2.0 software. RESULTS A total of seven studies with 1178 participants were eligible for the meta-analysis. For caregivers' anxiety, three of seven studies, with 358 participants, were examined in terms of the average corrected correlation coefficient across the studies. It was found that dementia caregivers' familism was significantly related to anxiety. The pooled z-value was 0.148 (95% CI = 0.043-0.253). In addition, caregivers' familism significantly affected depression (z = 0.080; 95% CI = 0.003-0.156), as did familial obligation (z = 0.122; 95% CI = 0.034-0.211), but perceived family support was not associated with this (z = 0.051, 95% CI = -0.038-0.140). As for caregiver burden, there was no evidence that familism was significantly associated with it (z = -0.073; 95% CI = -0.297 to 0.151), including familial obligation and perceived family support (z = -0.087 and -0.089, respectively; 95% CI = -0.278 to 0.104 and -0.335 to 0.157, respectively). CONCLUSIONS An association between caregiver familism and anxiety/depression exists in dementia patients. More research is needed to explore the relationship between familism and burden.
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Affiliation(s)
- Zhiwu Tian
- Blood Purification Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Chuyan Xiong
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yingmin Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hongmei Tao
- Blood Purification Centre, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Shuang Zhou
- Department of Nephrology, The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China
| | - Jun Yan
- School of Nursing, Sun Yat-sen University, Guangzhou, China
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Mukherjee R, Bhattacharyya B, Mukherjee A, Das G, Das S, Biswas A. Health status of persons with dementia and caregivers' burden during the second wave of COVID-19 pandemic: an Indian study. Dement Neuropsychol 2022; 16:284-291. [PMID: 36619844 PMCID: PMC9762382 DOI: 10.1590/1980-5764-dn-2021-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 01/11/2023] Open
Abstract
Due to the disruption of normal flow of treatment during the restrictions related to the coronavirus disease 2019 (COVID-19) pandemic, the health status of persons with dementia (PwD) and their caregivers' burden might worsen. Objective The article aims to find out the health status of PwD and caregivers' burden during the peak of second wave of COVID-19 and make a comparison with the preceding trough phase. Methods The study was conducted with 53 PwD and their caregivers in two phases. On their visit to the hospital during the unlock phase (phase 1), data were collected for CDR from PwD, and NPI-Q and ZBI from their caregivers. During the peak of second wave (phase 2), data were collected for NPI-Q, ZBI, and DASS-21 through telephonic communication, and statistical analyses were performed on the collected data. Results Significantly higher caregiver burden (p=0.001) and neuropsychiatric symptoms (NPSs) [both in severity (p=0.019) and distress (p=0.013)] were observed among the respondents during the peak of second wave of the pandemic as compared to the preceding trough phase. Positive correlations were observed between the caregiver burden and depression, anxiety, and stress of the caregivers (p<0.001) and between the severity of dementia in PwD and caregiver burden (p<0.001) for both the first and second phases. Positive correlation was also observed between the severity of dementia in PwD and depression (p=0.042) and stress (p=0.023) of caregivers. Conclusions Significant increase in the burden and distress was observed among caregivers due to increased NPSs of PwD during the second wave of COVID-19 pandemic.
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Affiliation(s)
- Ruchira Mukherjee
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Bidisha Bhattacharyya
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Adreesh Mukherjee
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Goutam Das
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Sujata Das
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
- Rabindranath Tagore International Institute of Cardiac Sciences,
Department of Neuropsychology, Kolkata, India
| | - Atanu Biswas
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
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van Dongen DHE, Havermans D, Deckers K, Olff M, Verhey F, Sobczak S. A first insight into the clinical manifestation of posttraumatic stress disorder in dementia: a systematic literature review. Psychogeriatrics 2022; 22:509-520. [PMID: 35474626 DOI: 10.1111/psyg.12830] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 02/19/2022] [Accepted: 03/14/2022] [Indexed: 12/24/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent disorder worldwide and often co-occurs in dementia. Both have a major impact on disease burden and quality of life. PTSD may be difficult to recognize in dementia and a structured diagnostic method is lacking. In order to get insight into the clinical diagnostics of PTSD in dementia, this systematic literature review evaluates the clinical presentation of PTSD and other relevant symptoms in people with dementia. PubMed, PsycINFO, Embase, and CINAHL were searched for all publications through 30 December 2021. Articles were included which met the following criteria: (i) description of at least one case with a current diagnosis of dementia and co-morbid PTSD; (ii) clinical presentation of symptoms being adequately described; (iii) no difference being made between chronic PTSD, PTSD with re-activation, and delayed onset PTSD. Of the 947 identified abstracts, 13 papers met the inclusion criteria and were included (describing 30 cases). Based on our rating, only one case completely fulfilled the DSM-5 criteria of PTSD. Avoidance was only described in three cases. Most commonly described symptoms were irritability and anger (E1, 9%), persistent negative emotional state (D4, 9%), and sleep disturbances (E6, 8%). In 93% of the case reports, other symptoms were also described, i.e. memory problems (58%), screaming (33.3%), and wandering (22.2%). People with dementia who have experienced a traumatic event seem to present, based on our rating method, with insufficient symptoms to meet all criteria for a PTSD DSM-5 diagnosis. The DSM-5 core symptom of avoidance was absent in most of the cases. Clinical presentation consists mainly of symptoms of irritability, anger, persistent negative emotional state, and sleep disturbances, often accompanied by other symptoms. These findings suggest that older people with dementia may have other symptom presentations than people without dementia.
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Affiliation(s)
- Dorien H E van Dongen
- Department of clinical geriatrics, Zuyderland Medical Hospital, Sittard-Heerlen, The Netherlands
| | - Demi Havermans
- Department of Psychiatry and Neuropsychology and Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology and Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience & Public Health, Amsterdam UMC, Amsterdam, The Netherlands.,Department of psychotrauma, ARQ National Psychotrauma Centre, Diemen, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology and Alzheimer Centrum Limburg, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Sjacko Sobczak
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen-Maastricht, The Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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30
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Lee SJ, Seo HJ, Choo ILH, Kim SM, Park JM, Yang EY, Choi YM. Evaluating the Effectiveness of Community-Based Dementia Caregiver Intervention on Caregiving Burden, Depression, and Attitude Toward Dementia: A Quasi-experimental Study. Clin Interv Aging 2022; 17:937-946. [PMID: 35711677 PMCID: PMC9196278 DOI: 10.2147/cia.s361071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/29/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Accumulating evidence of the effects of dementia caregiving on individuals, society, and health has generated intervention studies to reduce the stress among family caregivers of people with dementia. This study aims to evaluate the effectiveness of a family support program, community-based dementia caregiver intervention (CDCI), among family caregivers of people with dementia compared with a control group (no intervention). Patients and Methods This study is a quasi-experimental, non-randomized controlled trial conducted in six dementia relief centers of a community healthcare center in Korea. Family caregivers of 83 patients with dementia were recruited; of these 78 were included in the final study, with 40 in the intervention group and 38 in the control group. Analysis of covariance (ANCOVA) was used to compare the mean difference in the scores of the total short-form Zarit Burden Interview (SZBI), personal strain, role strain, depression, and attitude between the groups. Results Compared with controls, in the intervention group, the adjusted mean score of personal strain (F = 4.353, t = 0.041) and attitude toward dementia (F = 10.284, t = 0.002) differed significantly after the intervention, with a small to moderate effect. There was no significant difference in the total SZBI, role strain, or depression mean score. Conclusion The findings suggest that CDCI may be an effective intervention strategy to reduce personal strain and enhance the attitudes of family caregivers of people with dementia.
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Affiliation(s)
- Su Jung Lee
- College of Nursing, Inje University, Gimhae, South Korea
| | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - I L Han Choo
- Department of Neuropsychiatry, Chosun University and Chosun University Hospital, Gwangju, South Korea
| | - Seong Min Kim
- Department of Nursing, Donggang University, Gwangju, South Korea
| | - Jeong Min Park
- Department of Nursing, Nambu University, Gwangju, South Korea
| | - Eun-Young Yang
- Department of Nursing, Donggang University, Gwangju, South Korea
| | - Yu Mi Choi
- College of Nursing, Graduate School of Chungnam National University, Daejeon, South Korea
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Wiloth SS, Kiefer A, Wittek M, Arroyo y Villora T, Obermeier M, Schmitt E, Kruse A. Rethinking a Traditional Method of Participation: “Town-Hall Meetings” to Support Family Carers of People with Dementia. J Alzheimers Dis 2022; 87:981-990. [DOI: 10.3233/jad-215582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A growing number of people with dementia, a simultaneous decline of professional caregivers, and changing family structures clearly illustrate the societal relevance of the question of how dementia care can be arranged and delivered in the future. The demand for innovative solutions especially to support family carers requires a deeper insight into their life situation and a focused perception of their needs. This article presents the main hypothesis that specific forms of social integration and participation based on an equal dialogue between family caregivers, the public, and policymakers is needed to achieve that. Therefore, the main point here is to give family caregivers of people with dementia a voice to learn how to better support them in caring as well as self-care. A learning process triggered by a dialogue might result in a higher level of community readiness to implement new forms of support or social innovations. The hypothesis will be supported by John Dewey’s theory of political and democratic learning and the model of transformative learning according to Jack Mezirow indicating that learning particularly succeeds in interpersonal communication. In this context, the Town-Hall Meeting method and its potential to promote interpersonal communication and reflexive learning is discussed. The article addresses an important debate, namely that of how dementia care and support of family carers can succeed. It also sets the direction for future empirical research as the Town-Hall Meeting method might be applicable for gerontological action and participatory research.
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Affiliation(s)
| | - Anna Kiefer
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Maren Wittek
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | | | - Monika Obermeier
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
- Philosophical Seminar, Heidelberg University, Heidelberg, Germany
| | - Eric Schmitt
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Andreas Kruse
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
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Adewuyi M, Morales K, Lindsey A. Impact of Experiential Dementia Care Learning on Knowledge, Skills and Attitudes of Nursing Students: A Systematic Literature Review. Nurse Educ Pract 2022; 62:103351. [DOI: 10.1016/j.nepr.2022.103351] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 04/01/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022]
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Polastri M, Cappelletto F. Alzheimer's disease: fighting, losing and hoping. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2022. [DOI: 10.12968/ijtr.2022.0010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, St Orsola University Hospital, Bologna, Italy
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Ha EH. Home-dwelling older adults' attitudes and perceptions of dementia: A Q-methodological study in South Korea. Jpn J Nurs Sci 2022; 19:e12467. [PMID: 34981635 DOI: 10.1111/jjns.12467] [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: 08/26/2021] [Revised: 11/15/2021] [Accepted: 11/26/2021] [Indexed: 11/30/2022]
Abstract
AIM Older adult attitudes and perceptions of dementia can have a major impact on early diagnosis, efforts to prevent and appropriately treat it, as well as being a family burden. The aim of this study is to explore attitudes and perceptions of dementia of home-dwelling older adults using Q-methodology. METHOD A total of 42 adults, age 65 or over, who live in South Korea ranked 37 Q statements about their attitudes and perceptions of dementia into A Q sort table grid. RESULTS The following three distinct viewpoints were extracted: (1) it is my responsibility to prevent and to care about dementia (family-centered view); (2) there are no ways to treat dementia (despairing views); and (3) dementia is a national responsibility (nation-centered view). CONCLUSION Based on these results, central and local government and communities should work together with older adults to manage dementia and reflect these three viewpoints when developing systematic dementia management programs.
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Affiliation(s)
- Eun-Ho Ha
- Department of Nursing, Jungwon University, Goesan-gun, South Korea
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35
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Kokorelias KM, Naglie G, Gignac MA, Rittenberg N, Cameron JI. A qualitative exploration of how gender and relationship shape family caregivers' experiences across the Alzheimer's disease trajectory. DEMENTIA 2021; 20:2851-2866. [PMID: 33998323 PMCID: PMC8678646 DOI: 10.1177/14713012211019502] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Caregiving experiences are not static. They change across the disease trajectory and care continuum. However, it is not clear how caregiver gender or relationship type is related to evolving caregiver experiences over time. This qualitative study informed by constructivist grounded theory and framework analysis explored the experiences over time of men and women who were adult children and spousal caregivers to persons with Alzheimer's disease. Forty spousal (10 husbands and 10 wives) and adult children (10 sons and 10 daughters) caregivers to persons with Alzheimer's disease were interviewed using a semi-structured interview guide. Our findings suggest the experiences of caregiving, examined through a gender and relationship type lens, are complex and variable. The caregiving experience was not related to gender or relationship type alone, but often to a combination of the two. For instance, spousal caregivers did not immediately accept the diagnosis, with wives being more optimistic than husbands about a slow progression of the disease. Adult children caregivers were concerned about the ways the caregiving role would impact their personal and career obligations and sought ways to mitigate the changes to their daily lives. Sons and husband caregivers largely utilized home and community health services to assist with personal care tasks, whereas daughters and wives utilized the same services to allow them to complete other caregiving tasks (e.g., housekeeping). Recognition of the complex inter-relationships among gender and relationship type on caregiving experiences supports the need for family-centered interventions. This article also extends sex and gender research as it highlights that an in-depth understanding of the caregiving experience cannot be understood by gender alone and relationship type must also be considered.
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Affiliation(s)
| | - Gary Naglie
- Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada; Department of Medicine, Rotman Research Institute, 7942Baycrest Health Sciences, Toronto, ON, Canada
| | - Monique Am Gignac
- Dalla Lana School of Public Health, 274071University of Toronto, Toronto, ON, Canada; 7966Institute for Work and Health, Toronto, ON, Canada
| | - Nira Rittenberg
- Department of Occupational Therapy and Occupational Sciences, 7938The Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jill I Cameron
- Department of Occupational Science and Occupational Therapy, The Temerty Faculty of Medicine, University of Toronto; Rehabilitation Sciences Institute, 12366University of Toronto, Toronto, ON, Canada
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Heng WAM, Lin YP, Chua WL, Chan EY. The early stages of caregiving: A qualitative study into the caregiving experiences of Asian family caregivers of persons with newly-diagnosed dementia. Geriatr Nurs 2021; 42:1517-1524. [PMID: 34735998 DOI: 10.1016/j.gerinurse.2021.10.015] [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: 08/11/2021] [Revised: 10/12/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022]
Abstract
In Asian societies, the responsibility of caring for persons with dementia often falls upon an immediate family member. However, little attention has been paid to the early stages of caregiving, as well as their transition into a more experienced caregiver. Thus, a qualitative descriptive study involving a purposive sample of 11 main family caregivers of a person with newly diagnosed dementia was recruited from a tertiary hospital in Singapore. Three themes emerged from the data analysis: (1) Suspicions to seeking confirmation of dementia, (2) Grappling with dementia diagnosis, and (3) Making adjustments for the future. Areas of needs and support identified during the early caregiving journey suggest the need for caregivers to be prepared for the practical and emotional challenges. Unique to the Asian culture, our findings put forth the advocacy of engaging persons with dementia in the discussions of their long-term care and options.
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Affiliation(s)
| | | | - Wei Ling Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ee-Yuee Chan
- Nursing Research Unit, Nursing Service, Tan Tock Seng Hospital, Singapore; Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Fu W, Li J, Fang F, Zhao D, Hao W, Li S. Subjective burdens among informal caregivers of critically ill patients: a cross-sectional study in rural Shandong, China. BMC Palliat Care 2021; 20:167. [PMID: 34674691 PMCID: PMC8532289 DOI: 10.1186/s12904-021-00858-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Accepted: 09/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Informal caregivers are the main source of care for the critically ill, especially after discharge or during the terminal stages at home. However, the concern for informal caregivers is often overshadowed by critically ill patients. The purpose of this study is to determine the influencing factors of the subjective burden of informal caregivers and to seek solutions accordingly. METHODS Between July and August 2019, a cross-sectional study was conducted in Shandong, China, focusing on family caregivers and critically ill patients. Subjective caregiver burden was measured by the Chinese version of Zarit Burden Interview (ZBI). The stress process model was used to identify conditions relevant to the caregiving burden and to assess their impact on family caregivers. RESULTS 554 samples were selected for analysis. The average scores of Zarit Caregiver Burden Interview (ZBI) scores in this study was 30.37±19.04 (n=554). ZBI scores of older, less educated, and spouse caregivers were significantly lower (4.12; 95%CI, 0.42 to 7.81; P =0.029). Objective and subjective burdens increased proportionally. Secondary role stress factors included the higher out-of-pocket (OOP) costs of critical diseases and lower household income, both of which increased caregivers' subjective burdens (1.28; 95%CI, -0.06 to 2.63; p=0.062). Formal medical aid systems played a positive role in reducing subjective caregiving burdens (-7.31; 95%CI, -13.23 to -1.40; p=0.016). CONCLUSIONS Health policies should address both the direct medical burdens and the intangible psychological burdens of critical diseases.
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Affiliation(s)
- Wenhao Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Jiajia Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
| | - Feng Fang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Wenting Hao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China
| | - Shixue Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, 250012, China.
- NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan, 250012, China.
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Hozumi A, Tagai K, Shinagawa S, Kamimura N, Shigenobu K, Kashibayashi T, Azuma S, Yoshiyama K, Hashimoto M, Ikeda M, Shigeta M, Kazui H. Clinical profiles of people with dementia exhibiting with neuropsychiatric symptoms admitted to mental hospitals: A multicenter prospective survey in Japan. Geriatr Gerontol Int 2021; 21:825-829. [PMID: 34310003 DOI: 10.1111/ggi.14248] [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: 03/30/2021] [Revised: 06/12/2021] [Accepted: 07/06/2021] [Indexed: 11/27/2022]
Abstract
AIMS Patients with severe behavioral and psychological symptoms of dementia (BPSD) are often admitted to mental hospitals, while, inpatient care could also lead to prolonged hospital stay. The present study aims to survey clinical profiles of patients who required inpatient treatment for BPSD, and then establish the criteria for introducing inpatient treatment through assessment by certified psychiatrists. METHODS We performed a prospective survey about clinical characteristics of people with dementia who required treatment of BPSD at 12 mental medical institutions. All patients were assessed by certified psychiatrists to determine the optimal treatment settings: outpatient or inpatient. The multivariate logistic regression analysis was performed to specify factors contributed to the judgement of clinicians. Subsequently, the receiver operating characteristic curve analysis was conducted to explore a score derived from the Neuropsychiatric Inventory to divide patients into outpatient or inpatient groups. RESULTS The present study included 386 patients, of which 242 were admitted to mental hospitals. BPSD were classified into four domains, and aggressive BPSD was significantly associated with assessment for inpatient treatment; the adjusted odds ratio was approximately 2 regardless of dementia severity. Furthermore, the composite score of agitation, irritability and aberrant behavior showed the highest area under the curve value (=0.706), which differentiated inpatients from outpatients with a sensitivity of 76% and a specificity of 54%. CONCLUSIONS Aggressive BPSD was the risk factor for inpatient treatment. The composite score of the Neuropsychiatric Inventory subdomain-related aggressive BPSD could be a screening tool to introduce inpatient treatment for BPSD. Geriatr Gerontol Int 2021; 21: 825-829.
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Affiliation(s)
- Asami Hozumi
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan.,Fukkokai Soubu Hospital, Chiba, Japan
| | - Kenji Tagai
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | | | - Naoto Kamimura
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | | | - Tetsuo Kashibayashi
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
| | - Shingo Azuma
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan.,Department of Psychiatry, Mizuma Hospital, Kaizuka, Japan
| | - Kenji Yoshiyama
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Mamoru Hashimoto
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Manabu Ikeda
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Masahiro Shigeta
- Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Hiroaki Kazui
- Department of Neuropsychiatry, Kochi Medical School, Kochi University, Kochi, Japan
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Effect of Demographic and Health Dynamics on Cognitive Status in Mexico between 2001 and 2015: Evidence from the Mexican Health and Aging Study. Geriatrics (Basel) 2021; 6:geriatrics6030063. [PMID: 34202004 PMCID: PMC8293108 DOI: 10.3390/geriatrics6030063] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 06/17/2021] [Accepted: 06/17/2021] [Indexed: 11/17/2022] Open
Abstract
Sources of health disparities such as educational attainment, cardiovascular risk factors, and access to health care affect cognitive impairment among older adults. To examine the extent to which these counteracting changes affect cognitive aging over time among Mexican older adults, we examine how sociodemographic factors, cardiovascular diseases, and their treatment relate to changes in cognitive function of Mexican adults aged 60 and older between 2001 and 2015. Self and proxy respondents were classified as dementia, cognitive impairment no dementia (CIND), and normal cognition. We use logistic regression models to examine the trends in dementia and CIND for men and women aged 60 years or older using pooled national samples of 6822 individuals in 2001 and 10,219 in 2015, and sociodemographic and health variables as covariates. We found higher likelihood of dementia and a lower risk of CIND in 2015 compared to 2001. These results remain after adjusting for sociodemographic factors, cardiovascular diseases, and their treatment. The improvements in educational attainment, treatment of diabetes and hypertension, and better access to health care in 2015 compared to 2001 may not have been enough to counteract the combined effects of aging, rural residence disadvantage, and higher risks of cardiovascular disease among older Mexican adults.
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Tsai CF, Hwang WS, Lee JJ, Wang WF, Huang LC, Huang LK, Lee WJ, Sung PS, Liu YC, Hsu CC, Fuh JL. Predictors of caregiver burden in aged caregivers of demented older patients. BMC Geriatr 2021; 21:59. [PMID: 33446114 PMCID: PMC7809883 DOI: 10.1186/s12877-021-02007-1] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Accepted: 01/04/2021] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Dementia in the oldest-old is projected to increase exponentially as is the burden of their caregivers who may experience unique challenges and suffering. Thus, we aim to investigate which factors are associated with older caregivers' burden in caring demented outpatients in a multicenter cohort. METHODS Patients and their caregivers, both aged ≧65 years, in the National Dementia Registry Study in Taiwan (T-NDRS) were included in this study. Caregiver burden was measured with the short version of the Zarit Burden Interview (ZBI). The correlations between the ZBI scores and characteristics of caregivers and patients, including severity of dementia, physical comorbidities, instrumental activities of daily living (IADL), neuropsychiatric symptoms assessed by the Neuropsychiatric Inventory (NPI), and family monthly income, were analyzed. RESULTS We recruited 328 aged informal caregiver-patient dyads. The mean age of caregivers was 73.7 ± 7.0 years, with female predominance (66.8%), and the mean age of patients was 78.8 ± 6.9 years, with male predominance (61.0%). Multivariable linear regression showed that IADLs (β = 0.83, p < 0.001) and NPI subscores of apathy (β = 3.83, p < 0.001)and irritability (β = 4.25, p < 0.001) were positively associated with ZBI scores. The highest family monthly income (β = - 10.92, p = 0.001) and caregiver age (β = - 0.41, p = 0.001) were negatively correlated with ZBI scores. CONCLUSIONS Older caregivers of older demented patients experience a higher care burden when patients had greater impaired functional autonomy and the presence of NPI symptoms of apathy and irritability. Our findings provide the direction to identify risky older caregivers, and we should pay more attention to and provide support for these exhausted caregivers.
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Affiliation(s)
- Chia-Fen Tsai
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Wei-Shen Hwang
- Department of Psychiatry, Division of Geriatric Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, Tungs' Taichung Metroharbor Hospital, Taichung, Taiwan
| | - Jun-Jun Lee
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University, College of Medicine, Kaohsiung, Taiwan.,Department of Information Management, National Sun Yat-sen University, Kaohsiung, Taiwan
| | - Wen-Fu Wang
- Department of Neurology, Changhua Christian Hospital, Changhua, Taiwan.,Department of Holistic Wellness, Ming Dao University, Changhua, Taiwan
| | - Ling-Chun Huang
- Department of Neurology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, 112, Taiwan
| | - Li-Kai Huang
- Department of Neurology, Shuang Ho Hospital, Taipei, Taipei Medical University, New Taipei City, Taiwan.,Graduate Institute of Humanities in Medicine, Taipei Medical University, Taipei, Taiwan.,The PhD program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Wei-Ju Lee
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan.,Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
| | - Pi-Shan Sung
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Chien Liu
- Neurological Center of Cardinal Tien Hospital, Taipei, Taiwan.,Fu Jen University School of Medicine, Taipei, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jong-Ling Fuh
- Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan. .,Division of General Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
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Tan GTH, Yuan Q, Devi F, Wang P, Ng LL, Goveas R, Chong SA, Subramaniam M. Factors associated with caregiving self-efficacy among primary informal caregivers of persons with dementia in Singapore. BMC Geriatr 2021; 21:13. [PMID: 33407201 PMCID: PMC7789728 DOI: 10.1186/s12877-020-01951-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 12/08/2020] [Indexed: 11/24/2022] Open
Abstract
Background Informal caregivers of persons with dementia (PWD) are often associated with negative health outcomes. Self-efficacy in dementia caregiving has been reported to have protective effects on caregiver’s health. This study aims to examine the factors associated with the domains of caregiving self-efficacy among informal caregivers in Singapore, a country with a rapidly aging population and a 10% prevalence of dementia among older adults. Methods Two hundred eighty-two informal caregivers were recruited and data including participant’s caregiving self-efficacy, sociodemographic information, perceived social support, positive aspects of caregiving, knowledge of dementia, as well as behavioral and memory problems of care recipients were collected. A confirmatory factor analysis (CFA) was performed for the 3-factor model of the Revised Scale for Caregiving Self-Efficacy (RSCSE), and multiple linear regressions were conducted using the RSCSE subscales as dependent variables. Results Our CFA found that the RSCSE 3-factor model proposed by the original scale developer was an acceptable fit among informal caregivers in Singapore. Having established that the 3-factor model of the RSCSE was compatible among our sample, a series of multiple regressions were conducted using each of the factors as a dependent variable. Regressions revealed several factors that were significantly associated with caregiving self-efficacy. Importantly, outlook on life was positively associated to all 3 domains of the RSCSE, while social support was positively associated with self-efficacy in obtaining respite and controlling upsetting thoughts. Conclusion The 3-factor model of the RSCSE was found to be an appropriate fit for our sample. Findings from this study elucidated important novel insights into the factors that influences caregiving self-efficacy amongst informal caregivers in Singapore. Crucially, caregivers’ outlook on life and social support should be improved in order to enhance their caregiving self-efficacy.
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Affiliation(s)
| | - Qi Yuan
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Singapore
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Alexopoulos P, Soldatos R, Kontogianni E, Frouda M, loanna Aligianni S, Skondra M, Passa M, Konstantopoulou G, Stamouli E, Katirtzoglou E, Politis A, Economou P, Alexaki M, Siarkos K, Politis A. COVID-19 Crisis Effects on Caregiver Distress in Neurocognitive Disorder. J Alzheimers Dis 2021; 79:459-466. [DOI: 10.3233/jad-200991] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: The outbreak of the COVID-19 pandemic seems to have mental health implications for both people with neurocognitive disorder and their caregivers. Objective: The study aimed to shed light on relations between caregiver mental reaction to the pandemic and caregiver distress related to neuropsychiatric symptoms, memory impairment progression, and functional impairment of people with neurocognitive disorder during the period of confinement in Greece. Methods: The study included caregivers of patients with mild (N = 13) and major (N = 54) neurocognitive disorder. The caregiver-based telephone interview was based on items of the neuropsychiatric inventory questionnaire, the AD8 Dementia Screening Instrument, and the Bristol Activities of Daily Living Scale. Regarding the mental impact of the COVID-19 crisis on caregivers, four single questions referring to their worries in the last seven days were posed, in addition to the scales Generalized Anxiety Disorder 7-Item (GAD-7) and the 22-item Impact of Event Scale-revised (IES-R). A stepwise linear regression model was employed for studying the relationship between caregiver distress and demographic and clinical data and caregiver mental reaction to COVID-19 pandemic outbreak. Results: Caregiver distress severity during the confinement period was influenced not only by memory deficits (p = 0.009) and neuropsychiatric symptoms (p < 0.001) of patients, but also by caregiver hyperarousal (p = 0.003) and avoidance symptoms (p = 0.033) and worries directly linked to the COVID-19 crisis (p = 0.022). Conclusion: These observations provide further evidence for the urgent need for support of caregivers of patients with neurocognitive disorder during the COVID-19 pandemic.
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Affiliation(s)
- Panagiotis Alexopoulos
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum rechts der Isar, Faculty of Medicine, Technische Universität München, Munich, Germany
- Psychogeriatric unit for neurocognitive assessment and caregiver counselling, Patras Office of The Hellenic Red Cross, Patras, Greece
- Patras Dementia Day Care Center, Corporation for Succor and Care of Elderly and Disabled –FRODIZO, Patras, Greece
| | - Rigas Soldatos
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evangelia Kontogianni
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Maria Frouda
- Patras Dementia Day Care Center, Corporation for Succor and Care of Elderly and Disabled –FRODIZO, Patras, Greece
| | - Souzana loanna Aligianni
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
| | - Maria Skondra
- Department of Psychiatry, Patras University Hospital, Faculty of Medicine, School of Health Sciences, University of Patras, Patras, Greece
- Psychogeriatric unit for neurocognitive assessment and caregiver counselling, Patras Office of The Hellenic Red Cross, Patras, Greece
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, Patras, Greece
| | - Maria Passa
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgia Konstantopoulou
- Special Office for Health Consulting Services and Faculty of Education and Social Work, School of Humanities and Social Sciences, University of Patras, University of Patras, Patras, Greece
| | - Evangelia Stamouli
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Evgenia Katirtzoglou
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Anastasios Politis
- Charing Cross Hospital, Department of Neurosurgery, Imperial College London
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), University of Patras, Patras, Greece
| | - Maria Alexaki
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Kostas Siarkos
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Antonios Politis
- First Department of Psychiatry, Eginition Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
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Ohno S, Chen Y, Sakamaki H, Matsumaru N, Yoshino M, Tsukamoto K. Humanistic burden among caregivers of patients with Alzheimer's disease or dementia in Japan: a large-scale cross-sectional survey. J Med Econ 2021; 24:181-192. [PMID: 33467967 DOI: 10.1080/13696998.2021.1877149] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
AIMS As the population in Japan is rapidly aging, the prevalence of dementia, particularly Alzheimer's Disease (AD), is expected to increase, resulting in a growing need for caregivers. This study aims to quantify and compare the humanistic burden of caregivers of AD/dementia patients with caregivers of patients with other conditions in Japan. MATERIALS AND METHODS This cross-sectional study used data from the 2018 Japan National Health and Wellness Survey (NHWS). Outcome measures included the Short-Form 12-item Health Survey (SF-12) for health-related quality-of-life (HRQoL), EuroQol 5-dimension scale (EQ-5D) for health states utilities, impact of health on productivity and activity, and evaluation of depression and anxiety. Multivariate analysis was used to compare across groups, with adjustment for potential confounding effects. RESULTS A total of 805 caregivers of AD/dementia patients, 1,099 other caregivers, and 27,137 non-caregivers were identified. Both AD/dementia caregivers and other caregivers had lower HRQoL and EQ-5D scores, higher total activity impairment, and more caregivers tended to experience anxiety than non-caregivers. There were no significant differences in the involvment in basic and instrumental activities of daily living (ADL) between AD/dementia caregivers and caregivers of other conditions. Notably, AD/dementia caregivers were more involved in making treatment decisions and finance management than other caregivers. Among AD/dementia caregivers caring for one patient, 395 patients lived in the community and 282 in an institution. AD/dementia caregivers whose patients lived in the community were more significantly involved in basic and instrumental ADL. Caregivers of patients with both AD/dementia and cancer had higher caregiving burden than caregivers of patients with either condition. CONCLUSIONS Caregivers of AD/dementia patients in Japan reportedly experienced significant humanistic burden which is associated with patients' living arrangements and the presence of an additional chronic condition. Therefore, provision of effective care/support is essential to relieve the burden experienced by the caregivers.
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Affiliation(s)
- Shinya Ohno
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
- Chugai Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Hiroyuki Sakamaki
- Graduate School of Health Innovation, Kanagawa University of Human Services, Kawasaki, Japan
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | | | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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Thyrian JR, Kracht F, Nikelski A, Boekholt M, Schumacher-Schönert F, Rädke A, Michalowsky B, Vollmar HC, Hoffmann W, Rodriguez FS, Kreisel SH. The situation of elderly with cognitive impairment living at home during lockdown in the Corona-pandemic in Germany. BMC Geriatr 2020; 20:540. [PMID: 33375944 PMCID: PMC7770747 DOI: 10.1186/s12877-020-01957-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/10/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The outbreak of the Corona virus is a challenge for health care systems worldwide. The aim of this study is to analyze a) knowledge about, and feelings related to the Corona-pandemic. Describe b) loneliness, depression and anxiety and, c) the perceived, immediate impact of the lockdown on frequency of social contacts and quality of health care provision of people with cognitive impairment during social distancing and lockdown in the primary care system and living at home in Germany. METHODS This analysis is based on data of a telephone-based assessment in a convenience sample of n = 141 people with known cognitive impairment in the primary care setting. Data on e.g. cognitive and psychological status prior to the pandemic was available. Attitudes, knowledge about and perceived personal impact of the pandemic, social support, loneliness, anxiety, depression, change in the frequency of social activities due to the pandemic and perceived impact of the pandemic on health care related services were assessed during the time of lockdown. RESULTS The vast majority of participants are sufficiently informed about Corona (85%) and most think that the measures taken are appropriate (64%). A total of 11% shows one main symptom of a depression according to DSM-5. The frequency of depressive symptoms has not increased between the time before pandemic and lockdown in almost all participants. The sample shows minimal (65.0%) or low symptoms of anxiety (25%). The prevalence of loneliness is 10%. On average seven activities have decreased in frequency due to the pandemic. Social activities related to meeting people, dancing or visiting birthdays have decreased significantly. Talking with friends by phone and activities like gardening have increased. Utilization of health care services like day clinics, relief services and prescribed therapies have been reported to have worsened due to the pandemic. Visits to general practitioners decreased. CONCLUSIONS The study shows a small impact of the pandemic on psychological variables like depression, anxiety and loneliness in the short-term in Germany. There is a decrease in social activities as expected. The impact on health care provision is prominent. There is a need for qualitative, in-depth studies to further interpret the results.
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Affiliation(s)
- Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany.
- Institute for Community Medicine, Department of Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany.
| | - Friederike Kracht
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Angela Nikelski
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
| | - Melanie Boekholt
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Fanny Schumacher-Schönert
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Anika Rädke
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Horst Christian Vollmar
- Institute of General Practice and Family Medicine, Faculty of Medicine, Ruhr-University Bochum (RUB), Bochum, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
- Institute for Community Medicine, Department of Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/ Greifswald, Ellernholzstr. 1-2, 17489, Greifswald, Germany
| | - Stefan H Kreisel
- Division of Geriatric Psychiatry, Department of Psychiatry and Psychotherapy, Evangelisches Klinikum Bethel, University Hospital OWL - Campus Bielefeld-Bethel, Bielefeld, Germany
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Busquet-Duran X, Jiménez-Zafra EM, Manresa-Domínguez JM, Tura-Poma M, Bosch-delaRosa O, Moragas-Roca A, Galera Padilla MC, Martin Moreno S, Martínez-Losada E, Crespo-Ramírez S, López-Garcia AI, Torán-Monserrat P. Describing Complexity in Palliative Home Care Through HexCom: A Cross-Sectional, Multicenter Study. J Multidiscip Healthc 2020; 13:297-308. [PMID: 32256078 PMCID: PMC7090197 DOI: 10.2147/jmdh.s240835] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/18/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Complexity has become a core issue in caring for patients with advanced disease and/or at the end-of-life. The Hexagon of Complexity (HexCom) is a complexity assessment model in the process of validation in health-care settings. Our objective is to use the instrument to describe differences in complexity across disease groups in specific home care for advanced disease and/or at the end-of-life patients, both in general and as relates to each domain and subdomain. METHODS Cross-sectional study of home care was conducted in Catalonia. The instrument includes 6 domains of needs (clinical, psychological/emotional, social/family, spiritual, ethical, and death-related), 4 domains of resources (intrapersonal, interpersonal, transpersonal, and practical), and 3 levels of complexity (High (H), Moderate (M), and Low (L)). Interdisciplinary home care teams assessed and agreed on the level of complexity for each patient. RESULTS Forty-three teams participated (74.1% of those invited). A total of 832 patients were assessed, 61.4% of which were cancer patients. Moderate complexity was observed in 385 (47.0%) cases and high complexity in 347 (42.4%). The median complexity score was 51 for cancer patients and 23 for patients with dementia (p<0.001). We observed the highest level of complexity in the social/family domain. Patients/families most frequently used interpersonal resources (80.5%). CONCLUSIONS This study sheds light on the high-intensity work of support teams, the importance of the social/family domain and planning the place of death, substantial differences in needs and resources across disease groups, and the importance of relationship wellbeing at the end-of-life.
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Affiliation(s)
- Xavier Busquet-Duran
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Department of Nursing, University Foundation of Bages (FUB), University of Vic. Central University of Catalunya, Barcelona, Spain
| | - Eva Maria Jiménez-Zafra
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Josep Maria Manresa-Domínguez
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Metropolitan Nord Unit of Research Support, University Institute of Research in Primary Care (IDIAP) Jordi Gol, Barcelona, Spain
- Department of Nursing, Autonomous University of Barcelona, Barcelona, Spain
| | - Magda Tura-Poma
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | | | - Anna Moragas-Roca
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Maria Concepción Galera Padilla
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Susana Martin Moreno
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Emilio Martínez-Losada
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | | | - Ana Isabel López-Garcia
- Home Care Program, Support Team, PADES Granollers, Vallès Oriental Primary Health Care Services, Catalan Institute of Health, Barcelona, Spain
| | - Pere Torán-Monserrat
- Multidisciplinary Research Group on Health and Society (GREMSAS), Barcelona, Spain
- Metropolitan Nord Unit of Research Support, University Institute of Research in Primary Care (IDIAP) Jordi Gol, Barcelona, Spain
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