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Kim H, Cho J, Shin S, Kim SS. Uncertainty in surrogate decision-making about end-of-life care for people with dementia: An integrative review. J Adv Nurs 2024; 80:3103-3118. [PMID: 38197503 DOI: 10.1111/jan.16038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 12/05/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024]
Abstract
AIM To describe uncertainty in surrogate decision-making regarding end-of-life care for people with dementia using Mishel's reconceptualized uncertainty in illness theory. DESIGN Integrative literature review using Whittemore and Knafl's approach. DATA SOURCES PubMed, CINAHL, EMBASE, Scopus and Web of Science were searched using terms such as uncertainty/unpredictability, decision-making/advance care planning/end-of-life care planning, surrogate/family/caregiver/proxy and dementia. The search was initially conducted on 28 September 2021 and updated on 31 July 2023. REVIEW METHODS Through systematic screening, 20 research articles were included in the analysis. Content related to uncertainty in surrogate decision-making regarding end-of-life care was extracted and analysed, focusing on the reconceptualized uncertainty in illness theory. RESULTS First, surrogate uncertainty exists in various areas of surrogate decision-making regarding end-of-life care. Second, antecedents of surrogate uncertainty include numerous intrinsic and extrinsic factors. Third, surrogates exhibited some negative psychological responses to uncertainty but continually processed and structured their uncertainty through certain approaches, leading them to grow as decision-makers. Finally, research-based evidence on surrogates' processing of uncertainty and shifts to new life perspectives remains limited. CONCLUSION Surrogates' uncertainty in decision-making regarding end-of-life care for people with dementia is well characterized using the reconceptualized uncertainty in illness theory. Healthcare providers should help surrogates manage their uncertainty in surrogate decision-making more constructively throughout the dementia trajectory. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE The findings highlight the importance of assessing how surrogates process uncertainty and gauging how to help them process uncertainty and transition to new life perspectives. IMPACT This review contributes to healthcare professionals' understanding of surrogates' uncertainty in end-of-life care planning for people with dementia, especially what they are uncertain about, what influences their uncertainty and how they process it. REPORTING METHOD This study adheres to the PRISMA reporting guidelines. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Hyejin Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Jeonghyun Cho
- College of Nursing, Institute of Health Science Research, Inje University, Busan, Korea
| | - Sungmin Shin
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
| | - Sang Suk Kim
- Red Cross College of Nursing, Chung-Ang University, Seoul, Korea
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Bora ST, Buldukoğlu K, Bailey DE. Effectiveness of an Uncertainty Management Psychoeducation Program for Schizophrenia Caregivers: A Randomized Controlled Trial. J Am Psychiatr Nurses Assoc 2024; 30:590-602. [PMID: 36475415 DOI: 10.1177/10783903221141890] [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] [Indexed: 12/13/2022]
Abstract
BACKGROUND The inconsistent course of schizophrenia causes a long-term experience of uncertainty for individuals and their families. In Turkey, no studies yet exist that have attempted to address this constant uncertainty that is experienced by caregivers of schizophrenic patients. AIMS To evaluate the effects of the Uncertainty Management Psychoeducation Program on reducing uncertainty and intolerance to uncertainty, improving psychological well-being, and coping styles in caregivers of patients with schizophrenia. METHOD Single-blinded randomized controlled trial. Caregivers of schizophrenia inpatients were recruited from the psychiatry clinic of a university-affiliated hospital. Data were collected between April 2019 and August 2020. Eligible individuals were randomly allocated to one of the two groups: intervention or control. The intervention group had five individual psychoeducation sessions: "Recognizing Uncertainty," "Cognitively Reframing Uncertainty," "Solving Uncertainty-Related Issues," "Dealing with Uncertainty Using Communication Skills," and the "Closing Session." Participants in the control group received the usual care. Uncertainty, intolerance to uncertainty, psychological well-being, and stress coping strategies were measured at two points: at baseline and immediately following the intervention. Hypotheses were tested using the Mann-Whitney U and Wilcoxon tests. RESULTS A total of 54 participants were recruited. The intervention group's ratings for "seeking social support" and "optimistic approach" were higher than the control group's ratings. Significant within-group changes in terms of "uncertainty" and "optimistic approach" were reported for the intervention group in the post-intervention. In the control group, significant changes were seen in terms of "uncertainty" and "psychological well-being" over time. CONCLUSION The Uncertainty Management Psychoeducation Program was found to be effective in reducing the level of uncertainty, increasing their optimistic approach, and seeking social support of caregivers of schizophrenic patients.
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Affiliation(s)
| | | | - Donald Etheridge Bailey
- Donald Etheridge Bailey Jr., PhD, RN, FAAN, Duke University School of Nursing, Durham, NC, USA
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Haji Assa A, Cao X, Boehm LM, Umberger RA, Carter MA. The Relationship Between Uncertainty and Psychological Distress Among Family Caregivers of Patients With Delirium in Intensive Care Units: A Cross-Sectional Survey. Dimens Crit Care Nurs 2024; 43:61-71. [PMID: 38271309 DOI: 10.1097/dcc.0000000000000627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND Although family caregivers experienced negative psychological symptoms associated with witnessing intensive care unit delirium in their loved ones, there is a lack of clear understanding of how delirium is associated with family caregiver psychological distress. Uncertainty could be a factor contributed to this association. OBJECTIVES The aim of this study was to examine the relationship between uncertainty and psychological distress among family caregivers of patients with delirium in intensive care units. METHODS A cross-sectional correlational design was used for this observational study of adult family caregivers of patients admitted to the intensive care unit and who reported witnessing delirium symptoms in their loved ones. Family caregivers completed an electronic survey in January 2022 that consisted of a family caregiver and patient demographic form, the Mishel Uncertainty in Illness Scale-Family Member, and the Kessler Psychological Distress Scale. Descriptive, correlational, and regression statistical analyses were applied. RESULTS One hundred twenty-one adult family caregivers were enrolled. Family caregivers reported substantial uncertainty (mean, 106.15, on a scale of 31-155) and moderate to severe psychological distress (mean, 31.37, on a scale of 10-50) regarding their witnessing of delirium episodes in their loved ones. Uncertainty was significantly correlated with psychological distress among family caregivers (rs = 0.52, P < .001). Uncertainty significantly predicted psychological distress among family caregivers (regression coefficient, 0.27; P < .001). DISCUSSION Family caregiver uncertainty was positively associated with psychological distress. This distress can interfere with family caregiver involvement in patient delirium care. These findings are essential to increase critical care nurse awareness and inform the development of nursing interventions to alleviate possible uncertainty and distress.
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Mroz EL, Ali T, Piechota A, Matta-Singh TD, Abboud A, Sharma S, Monin JK, Fried TR. Personal Health Planning in Adult-Child Former Caregivers of Parents Living With Dementia. Am J Health Promot 2024; 38:402-411. [PMID: 37770019 PMCID: PMC10922991 DOI: 10.1177/08901171231204670] [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] [Indexed: 10/03/2023]
Abstract
PURPOSE To examine how former caregivers for parents living with dementia engage in personal health planning. DESIGN An inductive, qualitative study. SETTING Virtual, audio-recorded, semi-structured interviews. PARTICIPANTS Thirty-two midlife former primary caregivers for parents who died following advanced dementia 3 months to 3 years prior. METHOD Participants responded to a series of open-ended interview prompts. Interview recordings were transcribed and evaluated by a trained, diverse team to generate Consensual Qualitative Research (CQR) domains and categories. RESULTS Caregivers developed health planning outlooks (ie, mindsets regarding willingness and ability to engage in personal health planning) that guided health planning activities (ie, engaging in a healthy lifestyle, initiating cognitive/genetic testing, maintaining independence and aging in place, ensuring financial and legal security). An agentic outlook involved feeling capable of engaging in health planning activities and arose when caregivers witnessed the impact and feasibility of their parents' health planning. Anxiety-inducing and present-focused outlooks arose when caregivers faced barriers (eg, low self-efficacy, lack of social support, perception that parent's health planning did not enhance quality of life) and concluded that personal health planning would not be valuable or feasible. CONCLUSION Caregiving for a parent living with dementia (PLWD) shapes former caregivers' personal health planning. Interventions should support former caregivers who have developed low self-efficacy or pessimistic views on healthy aging to support them in addressing health planning activities.
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Affiliation(s)
- Emily L. Mroz
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Talha Ali
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Amanda Piechota
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | | | - Anissa Abboud
- Department of Health Policy, Yale School of Public Health, New Haven, CT, USA
| | - Shubam Sharma
- Department of Psychological Science, Kennesaw State University, Kennesaw, GA, USA
| | - Joan K. Monin
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Terri R. Fried
- Section of Geriatrics, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
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Alselami S, Butcher HK, Longo J. The Uncertainty in Family Caregivers of Hospitalized Persons With a Stroke in Saudi Arabia: Unitary Caring Perspective. ANS Adv Nurs Sci 2024; 47:104-120. [PMID: 38132430 DOI: 10.1097/ans.0000000000000519] [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: 12/23/2023]
Abstract
Uncertainty is a universal experience of family caregivers caring for persons with a stroke and affects caregivers' readiness to care for their family members with a stroke. Guided by the unitary caring theory and unitary-caring hermeneutic-phenomenological research method, this study was conducted among 15 family caregivers of persons in the hospital who have survived strokes through in-depth semi-structured interviews. Five essences emerged from the analysis: living in a dark reality; yearning for professional support; enduring a life full of tribulations; attempting resolution; and creating new patterns of living. Each of the 5 essences was interpreted from Smith's unitary caring theory perspective.
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Affiliation(s)
- Seham Alselami
- Nursing, King Saud bin Abdul-Aziz University for Health Sciences, Jeddah, Saudi Arabia (Dr Alselami); and Nursing, Florida Atlantic University, Boca Raton (Drs Butcher and Longo)
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Kates J, Pogorzelska-Maziarz M, Uppal M, Gerolamo AM. The impact of dementia family caregiving on adolescent well-being: A scoping review. DEMENTIA 2023; 22:910-928. [PMID: 36880693 DOI: 10.1177/14713012231161385] [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: 03/08/2023]
Abstract
With rates of dementia on the rise and upward trends in multigenerational households, the number of families providing care to persons with dementia is likely to increase. Although caregiver stress in adults has been well-documented, less is known about the impact of dementia family caregiving on adolescents. We conducted a scoping review to assess research on the impact of dementia family caregiving on adolescents. Eight articles representing five studies were identified. Findings suggest that while adolescents developed strategies to cope with the challenges of dementia caregiving, the long-term impact of caregiving on overall well-being has not been well described. Further, research has shown inconsistent findings with studies reporting both improved and strained adolescent relationships. The paucity of research on the impact of dementia family caregiving on the well-being of adolescents is a serious omission given that adolescents are at high-risk for emerging health problems.
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Affiliation(s)
- Jeannette Kates
- College of Nursing, 6559Thomas Jefferson University, Philadelphia, PA, USA
| | | | - Muskaan Uppal
- College of Life Sciences, 518109Thomas Jefferson University, Philadelphia, PA, USA
| | - Angela M Gerolamo
- College of Nursing, 6559Thomas Jefferson University, Philadelphia, PA, USA
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Gaylord S, Faurot KR, Shafer J, Harr E, Lathren C, Roth I, Giscombe K, Sheffield-Abdullah K, Williams S. Easing the burden of dementia caregiving: Protocol development for a telephone-delivered mindfulness intervention for rural, African American families. Contemp Clin Trials Commun 2022; 30:101031. [PMID: 36387990 PMCID: PMC9641173 DOI: 10.1016/j.conctc.2022.101031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 10/22/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Background There have been few interventions targeted for rural African American (AA) caregivers of persons with dementia despite their unique cultural, geographic, health-related and socio-economic needs, including relatively less access to-and willingness to engage with-formal supports and resources. One effective intervention, Mindfulness-based stress reduction (MBSR), has been found to be culturally acceptable in AA populations; however, no studies have assessed feasibility, acceptability and impact of an adapted mindfulness intervention targeting rural AA dementia caregivers. Aims The purpose of this study is to 1) determine the feasibility and acceptability of a telephone-delivered mindfulness training intervention in decreasing caregiver burden among rural, AA, informal caregiving teams of people with dementia; 2) to explore the effects of the training on caregiver burden and relevant secondary outcomes for both caregiving team members, including emotional regulation, tolerance of uncertainty, emotional and physical health, family conflict within the informal caregiving team, and self-efficacy; and 3) to explore comfort with and willingness to adopt technologies to access mindfulness practices and existing caregiving educational resources. Methods Our study utilizes a single-group, uncontrolled design to assess the feasibility and acceptability of telephone-delivered mindfulness training designed to alleviate burden for rural caregivers of AA individuals with moderate to severe dementia. A care partner-the person who provides additional help -is included in the intervention. The primary outcome is feasibility of the telephone-delivered mindfulness intervention as assessed by an 85% retention rate with completion of at least 6 of the intervention sessions. Pre- and post-participation interviews assess acceptability.
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Affiliation(s)
- Susan Gaylord
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Keturah R. Faurot
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jennifer Shafer
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Corresponding author. Program on Integrative Medicine, Campus Box 7260, University of North Carolina, Chapel Hill, NC, 27599-7200, USA.
| | - Elondra Harr
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christine Lathren
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Isabel Roth
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kessonga Giscombe
- Program on Integrative Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Sharon Williams
- Department of Speech and Hearing Sciences, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Hedman R, Hillerås P, Tyrrell M. Living in uncertainty while a spouse is undergoing a cognitive assessment: Voices of women care partners. DEMENTIA 2022; 21:2631-2646. [PMID: 36131252 PMCID: PMC9583288 DOI: 10.1177/14713012221128448] [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] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Women often support partners with cognitive symptoms during the assessment process and when they are receiving a cognitive diagnosis. Living with a partner with cognitive symptoms can be stressful; however, there is limited insights into the specific experiences of older women during the assessment process. Previous research indicates that there are gender differences in the experiences of spousal caregiving; however, further research is needed in regard to the experiences of men and women as care partners. Therefore, the aim of the present study was to describe women's experiences of living with a partner undergoing a cognitive assessment. METHODS Semi-structured interviews were conducted with seven women when their male partners commenced a cognitive assessment and after the assessment had been completed. The interviews were analysed with abductive content analysis. FINDINGS Uncertainty permeated the women's experiences. Antecedents, attributes and strategies to manage the uncertainty were described. CONCLUSION The participants expressed informational and existential uncertainty when their partner underwent a cognitive assessment. A lack of knowledge regarding the assessment process and cognitive diagnoses, especially mild cognitive impairment, was identified. Further, there was a need to process existential uncertainty evoked by the situation.
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Affiliation(s)
- Ragnhild Hedman
- Department of Nursing Science, 25548Sophiahemmet University, Stockholm, Sweden
| | - Pernilla Hillerås
- Red Cross University College, Huddinge, Sweden.,Department of Neurobiology, Care Sciences and Society, 97092Karolinska Institutet, Stockholm, Sweden
| | - Marie Tyrrell
- Department of Nursing Science, 25548Sophiahemmet University, Stockholm, Sweden.,Department of Neurobiology, Care Sciences and Society, 97092Karolinska Institutet, Stockholm, Sweden
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Warner L, Tipping L. "Can Everyday Assistive Technologies Provide Meaningful Support to Persons With Dementia and Their Informal Caregivers? Evaluation of Collaborative Community Program". J Appl Gerontol 2022; 41:2022-2032. [PMID: 35586889 DOI: 10.1177/07334648221101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
One of the most challenging caregiving roles today is providing informal care to an individual with dementia. A new program, "AT-Home with Dementia," was created by three collaborative social service agencies to offer simple assistive technologies to persons with dementia and their informal caregivers. Staff, equipped with a traveling kit of everyday devices, offered items during home visits to enhance memory, functional activities, safety, and comfort of persons with dementia. A limited formative program review led to improvements in the new program's reach, service delivery, and data. The results showed that the program enhanced the home environment of the caregiving dyad and led to greater independence of persons with dementia (PWD) and self-assurance among caregivers. Existing community agencies may refer to this program to serve individuals with early-stage dementia. Finally, community agencies and funders may consider adapting this program to provide support to the informal care providers and PWD.
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Affiliation(s)
- Lora Warner
- Department of Public & Environmental Affairs, 14749University of Wisconsin - Green Bay, Green Bay, WI, USA
| | - LaReina Tipping
- Aging & Disability Resource Center of Brown County, formerly employed at Curative Connections, Inc, Green Bay, WI, USA
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Moberg C, Grundberg Å, Konradsen H, Kallström AP, Leung AY, Kabir ZN. Meeting own needs and supporting ability to care: Family caregivers' and health care professionals' perspectives on professional support provided through a potential mobile application. DEMENTIA 2022; 21:1120-1134. [PMID: 35300535 DOI: 10.1177/14713012211065313] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND A majority of persons with dementia in Sweden live in their own homes and are often cared for by family members. Caring for a family member may be a positive experience. It may, however, also be a negative experience as symptoms like disturbing behavior and delusions may be difficult to encounter. The burden of being a family caregiver has been shown to affect the caregivers' quality of life. OBJECTIVE To explore stakeholders' perspectives on a potential mobile application through which family caregivers could be supported by healthcare professionals in caring for a person with dementia living at home. METHOD Eight individual interviews with family caregivers and a focus group with eight healthcare professionals specialized in dementia care were analyzed using content analysis method. RESULTS The findings suggest that a mobile application can support family caregivers to meet their own needs in terms of finding structure in everyday life, how to get information and support in their own pace, and how to care for themselves. The findings also suggest the necessity of accessing relevant contact networks to be supported in the ability to care for a family member with dementia. CONCLUSION Healthcare and social services mediated support provided through user-friendly mobile application has the potential to support family caregivers both in taking care of a person with dementia and caring for themselves. Moreover, it is important that the information provided to family caregivers is personalized according to the needs of the family caregivers as the family member's dementia advances.
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Affiliation(s)
- Cecilia Moberg
- Department of Neurobiology, Care Sciences and Society, NVS, 27106Karolinska Institutet, Stockholm, Sweden
| | - Åke Grundberg
- Department of Learning, Informatics, Management and Ethics, LIME, 27106Karolinska Institutet, Stockholm, Sweden
| | - Hanne Konradsen
- Department of Neurobiology, Care Sciences and Society, NVS, Karolinska Institutet, Stockholm, Sweden; Faculty of Health and Medical Sciences, Department of Clinical Medicine, 4321University of Copenhagen, Kobenhavn, Denmark; Department of Gastroenterology, Herley and Gentofte Hospital, Copenhagen, Denmark
| | - Ana Paula Kallström
- Department of Neurobiology, Care Sciences and Society, NVS, 27106Karolinska Institutet, Stockholm, Sweden
| | - Angela Ym Leung
- Centre for Gerontological Nursing, School of Nursing, 105806The Hong Kong Polytechnic University of Hong Kong, China
| | - Zarina N Kabir
- Department of Neurobiology, Care Sciences and Society, NVS, 27106Karolinska Institutet, Stockholm, Sweden
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Haji Assa A, Umberger RA. A concept analysis of family caregivers' uncertainty of patient's illness. Nurs Forum 2022; 57:121-126. [PMID: 34463349 DOI: 10.1111/nuf.12645] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
AIM To analyze and examine the concept of uncertainty of the patient's illness among family caregivers. BACKGROUND Promoting family caregivers' health is significant in nursing. Family caregivers may experience uncertainty related to their loved ones' illness. A lack of clarity exists regarding the uncertainty concept among family caregivers and its implications in nursing. DATA SOURCE A review of the literature that focused on family caregivers of adult patients using PubMed, CINAHL, and Scopus databases was completed. METHODS The Walker and Avant framework was applied to identify the attributes, antecedents, and consequences of family caregivers' uncertainty. RESULTS Eight articles were analyzed. Attributes of family caregivers' uncertainty included the patient's illness probability and family caregivers' perception of the illness. Antecedents included the characteristics of the patient's illness, factors associated with the family caregivers' perception of the illness, and family responsibilities of caregiving. The consequences included family caregivers' emotional, psychological, and financial outcomes. Family caregivers' uncertainty is defined as the perception of the inability to process information regarding the patient's illness trajectory when caring for significant others' illness. CONCLUSIONS Individuals can perceive uncertainty differently as a patient-facing uncertainty in illness versus a family caregiver facing uncertainty of their loved ones' illness.
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Affiliation(s)
- Amal Haji Assa
- Nursing Science PhD Program, College of Graduate Health Sciences, The University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Reba A Umberger
- Department of Acute and Tertiary Care, The University of Tennessee Health Science Cente, Memphis, Tennessee, USA
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Prins M, Willemse B, van der Velden C, Pot AM, van der Roest H. Involvement, worries and loneliness of family caregivers of people with dementia during the COVID-19 visitor ban in long-term care facilities. Geriatr Nurs 2021; 42:1474-1480. [PMID: 34678687 PMCID: PMC8526350 DOI: 10.1016/j.gerinurse.2021.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/29/2021] [Accepted: 10/01/2021] [Indexed: 01/10/2023]
Abstract
To prevent COVID-19 from spreading in long-term care facilities (LTCFs), the Dutch government took restrictive measures, including a visitor-ban in LTCFs. This study examined the relationship between involvement of family caregivers (FCs) of people with dementia (PwD) living in LTCFs and FCs mental health during the visitor-ban, and whether this relationship was moderated by the frequency of alternative contact with PwD during the visitor-ban and FC resilience. This cross-sectional study collected data from 958 FCs. FCs who visited PwD more frequently before, were more worried during the visitor-ban than those with lower visiting frequency. FCs who visited the PwD daily before, but had minimal weekly contact during the visitor-ban, worried less. Resilient FCs who did social and task-related activities before, experienced less loneliness during the visitor-ban. It is advisable for healthcare professionals to reach out to these groups, to facilitate ongoing contact and help them overcome their loneliness.
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Affiliation(s)
- Marleen Prins
- Erasmus School of Health Policy & Management, Health Care Governance (HCG), Burg. Oudlaan 50, 3000 DR Rotterdam, Zuid-Holland, The Netherlands; Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands.
| | - Bernadette Willemse
- Care Farm Reigershoeve Foundation, Oosterweg 5B, 1968 KM, Heemskerk, Noord-Holland, The Netherlands
| | - Claudia van der Velden
- Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands
| | - Anne Margriet Pot
- Erasmus School of Health Policy & Management, Health Care Governance (HCG), Burg. Oudlaan 50, 3000 DR Rotterdam, Zuid-Holland, The Netherlands; Optentia Research Focus Area, P O Box 1174, North-West University, Vanderbijlpark, 1900 South Africa
| | - Henriëtte van der Roest
- Netherlands Institute of Mental Health and Addiction, Department on Aging, Da Costakade 45, 3500 AS, Utrecht, Utrecht, The Netherlands
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Kwon JH, Hong GRS. [Influence of Self-care on Burnout in Primary Family Caregiver of Person with Dementia]. J Korean Acad Nurs 2021; 51:217-231. [PMID: 33993127 DOI: 10.4040/jkan.20274] [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: 11/26/2020] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to identify the influence of self-care on burnout experienced by primary family caregivers of persons with dementia. METHODS The subjects of the study were 156 primary family caregivers of persons with dementia at home in Korea. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and hierarchical multiple regression using IBM SPSS Statistics ver. 24.0 for Windows. RESULTS The mean scores for self-care and burnout were 42.35 and 61.60, respectively. Self-care, subjective health status, living with a person with dementia, and behavioral and psychological symptoms of dementia were significant factors affecting burnout in family caregivers. Self-care was identified as the strongest factor affecting burnout, explaining 13.9% of burnout with controlling factors in caregivers and care receivers. CONCLUSION To prevent burnout in primary family caregivers of persons with dementia, self-care of family caregivers should be emphasized. In nursing education, family caregivers should be recognized and approached as nursing clients who are responsible for taking care of their health. In nursing practice and research, digital self-care or self-care improvement intervention programs should be designed to help family caregivers, and further studies on self-care centered on health of family caregivers should be conducted.
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Mengelers AMHJ, Moermans VRA, Bleijlevens MHC, Verbeek H, Capezuti E, Tan F, Milisen K, Hamers JPH. Involuntary treatment in dementia care at home: Results from the Netherlands and Belgium. J Clin Nurs 2020; 31:1998-2007. [PMID: 32918342 PMCID: PMC9292312 DOI: 10.1111/jocn.15457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 07/20/2020] [Accepted: 07/22/2020] [Indexed: 01/01/2023]
Abstract
Aims and objectives To gain insight into the request, use and associated factors of involuntary treatment in people with dementia (PwD) receiving professional home care in the Netherlands and Belgium. Background Most of the PwD remain living at home as long as possible. Due to complex care needs, this can result in an increased risk for care provided against the wishes of the client and/or to which the client resists, referred to as involuntary treatment. Design Secondary data analyses of two cross‐sectional surveys. Methods Dementia case managers and district nurses filled in a questionnaire for each PwD in their caseload. This study included data of 627 PwD receiving professional home care in the Netherlands and 217 in Belgium. The same methodology (questionnaire and variables) was used in both samples. Descriptive statistics and multi‐level logistic regression analyses were used to analyse the data. The study adhered to the STROBE checklist. Results More than half of the PwD (50.7%) living at home received involuntary treatment (Belgium 68.2% and the Netherlands 44.7%). Nonconsensual care (82.7%) was the most common, followed by psychotropic medication (40.7%) and physical restraints (18.5%). Involuntary treatment use was associated with living alone, greater ADL dependency, lower cognitive ability, higher family caregiver burden and receiving home care in Belgium versus the Netherlands. Involuntary treatment was most often requested by family caregivers. Conclusions Involuntary treatment is often used in PwD, which is in line with previous findings indicating dementia as a risk factor for involuntary treatment use. More research is needed to gain insight into variations in prevalence across other countries, which factors influence these differences and what countries can learn from each other regarding prevention of involuntary treatment. Relevance to clinical practice To provide person‐centred care, it is important to study ways to prevent involuntary treatment in PwD and to stimulate dialogue between professional and family caregivers for alternative interventions.
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Affiliation(s)
- Angela M. H. J. Mengelers
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
| | - Vincent R. A. Moermans
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
- Department of Nursing White Yellow Cross Limburg Genk Belgium
| | - Michel H. C. Bleijlevens
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
| | - Hilde Verbeek
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
| | - Elizabeth Capezuti
- Hunter College The Graduate Center of City University of New York New York NY USA
| | - Frans Tan
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
| | - Koen Milisen
- Department of Public Health & primary Care Academic Centre for Nursing and Midwifery KU Leuven Leuven Belgium
- Division of Geriatric Medicine University Hospitals Leuven Leuven Belgium
| | - Jan P. H. Hamers
- Faculty of Health, Medicine and Lifesciences CAPHRI Care and Public Health Research Institute Maastricht University Maastricht The Netherlands
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Unson C, Flynn D, Chukwurah Q, Glendon MA, Testut T. Uncertainty in Transition of African American Caregivers. Issues Ment Health Nurs 2020; 41:445-454. [PMID: 32186923 DOI: 10.1080/01612840.2019.1678080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to gain an understanding of the ambiguities and uncertainties experienced by a diverse group of African-American caregivers. The study applied Schlossberg's transition theory (TT) and Mishel's revised uncertainty theory to narratives of self-identified African-American caregivers who provided care at least 5 h a week. The men (6) and women (8) were mostly unmarried, mostly caring for a parent or grandparent. The caregivers' average age was 52 (SD = 19; ages ranged from 24 to 82 years); and the care recipients' average age was 84 (SD = 9). Six care recipients had dementia and the remainder had multiple disease diagnoses. Narratives were obtained by in-depth interviews or focus group discussions. These were audio-recorded, transcribed verbatim professionally and analyzed independently by trained coders. Schlossberg's TT contextualized whereas Mishel's RUIT illuminated the characteristics of the transition, its associated uncertainty, and their relationship to the development of caregiver stress. Situational factors such as difficulties with illness symptoms of the care recipient, conflict between previous experience and current expectations and the adjustments to the new caregiving role, burdened younger caregivers more than older caregivers. Self-factors related to lack of knowledge about the illness and feelings of lack of control. Social support was predominantly provided by family members, and its absence resulted in conflict among siblings and caregiver stress. The most common coping strategies include religiosity, expectations of reciprocity, and coming to terms with the uncertainty. Understanding the feelings, perceptions and needs of caregivers in transition is tantamount to providing nursing care.
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Affiliation(s)
- Christine Unson
- Department of Public Health, Southern Connecticut State University, New Haven, Connecticut, USA
| | - Deborah Flynn
- Department of Public Health, Southern Connecticut State University, New Haven, Connecticut, USA
| | | | - Mary Anne Glendon
- Department of Nursing, Southern Connecticut State University, New Haven, Connecticut, USA
| | - Tammy Testut
- Sacred Heart University, College of Nursing, Fairfield, Connecticut, USA
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16
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Kovaleva M, Spangler S, Clevenger C, Hepburn K. Chronic Stress, Social Isolation, and Perceived Loneliness in Dementia Caregivers. J Psychosoc Nurs Ment Health Serv 2018; 56:36-43. [DOI: 10.3928/02793695-20180329-04] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Accepted: 03/08/2018] [Indexed: 01/02/2023]
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17
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Poucher ZA, Tamminen KA, Kerr G. Providing Social Support to Female Olympic Athletes. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2018; 40:217-228. [PMID: 30185099 DOI: 10.1123/jsep.2018-0008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Support providers may experience positive and negative outcomes associated with supporting others. However, there is a lack of research on support provision to elite athletes and the views of athletes' support providers. This study addressed this gap by exploring the experiences of providing and receiving support between female Olympians and their main support providers. Five female Olympians and their main support providers participated in separate semistructured interviews. It appeared that support provision was personally and professionally rewarding, as well as challenging, for support providers, and athletes were generally satisfied with the support they received. Athletes appeared highly dependent on their support providers, but both athletes and support providers felt that high levels of support were necessary for athletic success. Further research is needed to understand how support providers are able to foster their own personally supportive relationships and whether high levels of interpersonal dependence are required to achieve athletic success.
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18
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Hurt CS, Cleanthous S, Newman SP. Further explorations of illness uncertainty: carers’ experiences of Parkinson’s disease. Psychol Health 2017; 32:549-566. [DOI: 10.1080/08870446.2017.1283041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Catherine S. Hurt
- Centre for Health Services Research, School of Health, City, University London, London, UK
| | | | - Stanton P. Newman
- Centre for Health Services Research, School of Health, City, University London, London, UK
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Abstract
The purpose of this article is to report the discovery of a Parsesciencing inquiry on the universal humanuniverse living experience of feeling unsure. In discussion with the scholar, 10 historians described their experiences. The discerning extant moment of the living experience of feeling unsure was found to be as follows: Feeling unsure is disquieting trepidation with pursuing endeavors arising with joining with-distancing from affiliations.
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