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Needs and Quality of Life of Caregivers of Patients with Prolonged Disorders of Consciousness. Brain Sci 2023; 13:brainsci13020308. [PMID: 36831851 PMCID: PMC9953960 DOI: 10.3390/brainsci13020308] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/30/2023] [Accepted: 02/04/2023] [Indexed: 02/15/2023] Open
Abstract
Background. Many patients with severe brain damage may survive and remain in a prolonged disorder of consciousness (PDoC), impacting the quality of life (QoL) and needs of their family caregivers. However, the current literature on the factors influencing these needs is contradictory. We aim to describe the needs, QoL, and emotional distress of caregivers of patients with PDoC. Methods. Questionnaires investigating the importance and satisfaction of six categories of needs (i.e., health information, emotional, instrumental, and professional supports, community support network, and involvement in care), QoL, and emotional distress were completed by the main caregivers of PDoC patients. Results. We analyzed 177 questionnaires. Seventy-nine percent of the needs were considered as important or very important, and 44% were partially met or unmet. The needs for health information and professional support were the most important, while the needs for involvement in care and for health information were the most satisfied. Mean QoL was low and emotional distress high. Variables such as care setting and time since brain injury affected the level of QoL and distress. Conclusion. The needs for health information and professional support should receive particular attention. Given their low QoL and high distress, adequate support structures should be provided to caregivers of PDoC patients.
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Nekrasova JY, Kanarsky MM, Borisov IV, Pradhan P, Yankevich DS, Roshka SF, Petrova MV, Grechko AV. Post-Discharge Plight Of Patients With Chronic Disorders Of Consciousness: A Systematic Review Of Socioeconomic And Health Aspects. RUSSIAN OPEN MEDICAL JOURNAL 2022. [DOI: 10.15275/rusomj.2022.0412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Objective — the presented study aims to systematize and structure significant information regarding the problems of patients with disorders of consciousness (DOC) and their families after discharge from the hospital, and to search for possible solutions. Material and Methods — to identify eligible studies, we searched the Medline database (via PubMed) for studies on socioeconomic and medical issues of patients with chronic DOC at the post-hospital stage of rehabilitation for the last 20 years. Results — we included 28 studies with 21 cohorts of patients from 7 different countries in our study. The components of informal caregiver burden and their impact on the quality of life were identified and systematized. These components include high physical load, high economic costs, vast time expenditures, strong emotional involvement, and a top level of expertise in caregiving, all of which are required from the relatives. Conclusion — It was affirmed, that the lack of healthcare system support was a major contributing factor to the overall burden. Our research also showed that delivering care without receiving information, advice, and training is extremely painful for family caregivers.
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Affiliation(s)
- Julia Yu. Nekrasova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Mikhail M. Kanarsky
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Ilya V. Borisov
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Pranil Pradhan
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia; Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
| | - Dmitry S. Yankevich
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Stanislav F. Roshka
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
| | - Marina V. Petrova
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia; Peoples’ Friendship University of Russia (RUDN University), Moscow, Russia
| | - Andrey V. Grechko
- Federal Research and Clinical Center of Intensive Care Medicine and Rehabilitology, Moscow, Russia
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Boissel A, Leblond F, Pinel-Jacquemin S, Petit P, Tasseau F, Vérin É. Caregivers of people with disorders of consciousness: Relationship continuity and rupture. EVOLUTION PSYCHIATRIQUE 2022. [DOI: 10.1016/j.evopsy.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Caring for a person with dementia during the COVID-19 pandemic: a qualitative study with family care-givers. AGEING & SOCIETY 2021. [PMCID: PMC8134901 DOI: 10.1017/s0144686x21000696] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Abstract
The aim of this study was to explore the experience of family care-givers of people with dementia during the COVID-19 pandemic in the Veneto region of Italy to understand how and to what extent the emergency has affected care-givers’ lives and care routines. Twenty adult children of an ill person were interviewed via phone and video call, in adherence with the restrictions against COVID-19. Thematic analysis showed five main themes: the care-giver's experience, the care recipient's experience, relationships with care recipients, changes in the care routine and resources. Results pointed out that the time needed in the care routine and everyday activities increased during the pandemic, together with the need to find alternatives to physical activity at home. Depending on one's personal experience of COVID-19 and approach to preventive rules, the availability of resources, and formal and informal support, three main approaches to care were identified: apprehensive, mindful and fatalistic ones. The pandemic amplified the differences among these already-existing approaches to care as well as the typical challenges and difficulties experienced by family care-givers, and it resulted in an increased burden connected to practical difficulties, emotional stress and difficulties in reaching for help. These results underline the importance of strengthening the external support network for older people to help family care-givers, especially during emergencies.
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Boissel A, Leblond F, Pinel-Jacquemin S, Petit P, Tasseau F, Vérin É. Les proches aidants des personnes en état de conscience altérée : ruptures et continuité dans les relations. EVOLUTION PSYCHIATRIQUE 2021. [DOI: 10.1016/j.evopsy.2020.10.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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ThØgersen CMS, Glintborg C. Ambiguous loss and disenfranchised grief among spouses of brain injury survivors. NORDIC PSYCHOLOGY 2021. [DOI: 10.1080/19012276.2020.1862699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Cecilie Marie Schmidt ThØgersen
- Center for Developmental and Applied Psychological Science (CeDAPS), Department of Communication and Psychology, Aalborg University, Aalborg Ø, Denmark
| | - Chalotte Glintborg
- Center for Developmental and Applied Psychological Science (CeDAPS), Department of Communication and Psychology, Aalborg University, Aalborg Ø, Denmark
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Imani-Goghary Z, Ghaljeh M. The experience of family caregivers caring for a patient with chronic disorders of consciousness: a qualitative content analysis. Int J Palliat Nurs 2020; 26:301-309. [PMID: 32841084 DOI: 10.12968/ijpn.2020.26.6.301] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Management of a patient with chronic disorders of consciousness is a long-term and stressful situation for family caregivers. AIMS The aim of this study was to describe the experiences of family caregivers of patients with chronic disorders of consciousness. METHODS Purposeful sampling was used, data were collected through semi-structured, in-depth interviews at participants' homes. Data were analysed using qualitative content analysis. FINDINGS Results indicated that family caregivers of patients with chronic disorders of consciousness face many difficulties in providing care to vegetative state (VS) and minimally conscious state (MCS) patients; they experience it as a challenging type of care, which influences their mental health. CONCLUSION Family caregivers are faced with many challenges because of the high burden of care, round-the-clock concern, taking care of an alive but unresponsive patient without receiving enough support. They experience mental and inner turmoil because of social isolation and dealing with contradictory feelings in their daily life.
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Affiliation(s)
- Zahra Imani-Goghary
- Assistant Professor of Nursing, Sirjan School of Medical Science, Sirjan, Iran
| | - Mahnaz Ghaljeh
- Assistant Professor of Nursing, Community Nursing Research Center, Zahedan University of Medical Science, Zahedan, Iran
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8
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Caregivers of people with disorders of consciousness: which burden predictors? Neurol Sci 2020; 41:2773-2779. [PMID: 32279220 DOI: 10.1007/s10072-020-04394-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 04/03/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Caregivers of patients diagnosed with disorders of consciousness (DoCs) play a pivotal role in the care pathway of these patients. Due to the high costs of care, among other symptoms and disorders previously described in the literature, they can manifest also mood and stress-related disorders which greatly impact their life and increase their burden. It is noteworthy to identify which factors are better related to the manifestation of mood and stress-related disorders to care for the caregivers in time. However, no studies have explored which factors are related to the manifestation of these disorders within this population yet. MATERIALS AND METHODS We explored with different questionnaires whether patient-, caregiver-, and caregiving environment-related factors are associated with mood and stress-related disorders on 114 caregivers of patients with DoCs. RESULTS Our results showed that female caregivers manifested higher levels of both depression and prolonged grief disorder; furthermore, the presence of economic problems increased the levels of depression. Moreover, different levels of caregivers' depression, anxiety, anger expression, and prolonged grief disorder were closely linked to the degree of behavioural responsiveness of the patients. CONCLUSIONS Our results highlighted the need to consider also caregivers' mood and stress-related disorders when defining the care pathway of patients with DoCs; indeed, caregivers constitute the main environment of DoC patients and they need tailored interventions aimed at reducing their burden due to caregiving.
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Steppacher I, Kissler J. A problem shared is a problem halved? Comparing burdens arising for family caregivers of patients with disorders of consciousness in institutionalized versus at home care. BMC Psychol 2018; 6:58. [PMID: 30547843 PMCID: PMC6295043 DOI: 10.1186/s40359-018-0272-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 11/28/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Disorders-of-consciousness (DOC) are rare conditions leading to very severe physical and mental disabilities. Providing care for DOC patients has been described as a stressful experience, eroding the physical and psychological health of the caregiver. Different forms of care may have different impacts on the caregivers and institutionalized care has been suggested to have an unburdening effect, but this possibility has never been empirically studied. To address this issue, in this study caregiver-burden between family-caregivers who provide home care themselves and those who have placed their patients in a specialized care unit is compared. METHOD The demographics of the caregivers, life satisfaction, coping strategies, meaning in life, and grief reactions were assessed with questionnaires in 81 long term (m = 7.9 years) caregivers (44 patients in specialized care-units, 37 patients taken care of at home). RESULTS Caregiver groups were similar on the vast majority of demographic factors. Remarkably, there were no major differences in self-assessed burden and distress between the two caregiver groups. They both demonstrated generally reduced life satisfaction, were especially dissatisfied with their amount of spare time, and many caregivers in both groups demonstrated long lasting grief reactions, as well as a somewhat enhanced crisis of meaning. However, caregivers with patients in institutionalized care exhibited enhanced self-accusation as well as reduced satisfaction with their own health. Home care caregivers, on the other hand, report below average opportunities to care for themselves. CONCLUSION Surprisingly, placement in institutionalized care in itself does not seem to disburden caregivers as much as expected as the amount of subjective care-giving burden and reported distress is on average similarly high, although profiles differ somewhat according to type of care. Moreover, vast inter-individual variability can be observed. Further research should address the mechanisms that foster positive adjustment and reduce negative impacts for care providers regardless of type of care, enabling the health care system, institutions and self-aid groups alike, to provide more specific support for caregivers by addressing the topics of quality-of-life, own health, self care, and grief reactions.
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Affiliation(s)
- Inga Steppacher
- Department of Psychology, University of Bielefeld, Bielefeld, Germany
| | - Johanna Kissler
- Department of Psychology, University of Bielefeld, Bielefeld, Germany
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Yang YM, Kim JI. Lived Experience of the Mother's Caring of Adult Children with Persistent Vegetative State. KOREAN JOURNAL OF WOMEN HEALTH NURSING 2017; 23:287-298. [PMID: 37684907 DOI: 10.4069/kjwhn.2017.23.4.287] [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: 10/20/2017] [Revised: 12/11/2017] [Accepted: 12/13/2017] [Indexed: 09/10/2023] Open
Abstract
PURPOSE The purpose of this study was to deepen understanding the nature of the care experience by the mothers with adult children in persistent vegetative state. METHODS Participants were 7 mothers caring for their adult children in persistent vegetative state. Data were collected individually through in-depth interviews on their lived experiences. Also texts were included as data from literary works, novels, movies, essays, and arts containing on patients with persistent vegetative state and their mothers. Data were analyzed by van Manen's phenomenological methodology. RESULTS The essential themes of caring experiences of the mothers were as follows. The theme in relation to lived time has shown as back to the past and caring experience related lived body has emerged as locked the body in children. The theme related lived space was getting into the swamp and the theme in lived others was derived as lonely struggle into. CONCLUSION The nature of mothers' caring experiences for adult children in persistent vegetative state is summarized as 'Do not off hand of hope in a locked state'. This study suggests long-term supports are necessary for mothers to care persistent vegetative state children.
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Affiliation(s)
- Young Mi Yang
- Department of Nursing, Backsuk University, Cheonan, Korea
| | - Jeung Im Kim
- Department of Nursing, Backsuk University, Cheonan, Korea
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Soeterik SM, Connolly S, Playford ED, Duport S, Riazi A. The psychological impact of prolonged disorders of consciousness on caregivers: a systematic review of quantitative studies. Clin Rehabil 2017; 31:1374-1385. [PMID: 28933608 DOI: 10.1177/0269215517695372] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Systematic review of the nature, frequency and severity of psychological experiences of people who have a close relationship with a person with a prolonged disorder of consciousness. DATA SOURCES Cochrane Library, Web of Science, PsycINFO, PubMed, Embase®, MEDLINE®, Allied and Complementary Medicine™, were searched from inceptions until December 2016 with additional hand searching of reference lists of included articles. REVIEW METHODS Studies were included that used quantitative methodologies and psychological measures to investigate experiences. The PRISMA statement was followed with inclusion criteria set a priori. A data synthesis summarized psychological constructs studied. RESULTS A total of 18 studies (ranging between n = 16-487 participants) met the inclusion criteria with 15 of 18 studies focused on the primary caregiver. A total of 23 standardized psychological measures were identified to assess four primary psychological constructs: Loss and grief, psychological wellbeing changes, burden and use of coping strategies. CONCLUSIONS Small sample sizes, limited variables and reliance on observational methods affected quality. Caregivers do find ways to manage independently, but some exhibit clinically significant psychological distress that does not change over time alone and may get worse.
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Affiliation(s)
- Sonja M Soeterik
- 1 Department of Psychology, Royal Holloway University of London, Egham, UK.,2 Institute of Neuro-palliative Rehabilitation, Royal Hospital for Neuro-disability, London, UK
| | - Sarah Connolly
- 3 Ascot Rehab, Royal Hospital for Neuro-disability London, Surrey, UK
| | - E Diane Playford
- 2 Institute of Neuro-palliative Rehabilitation, Royal Hospital for Neuro-disability, London, UK.,4 Warwick Medical School, University of Warwick, Coventry, UK
| | - Sophie Duport
- 2 Institute of Neuro-palliative Rehabilitation, Royal Hospital for Neuro-disability, London, UK
| | - Afsane Riazi
- 1 Department of Psychology, Royal Holloway University of London, Egham, UK
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Portuguese validation of the Prolonged Grief Disorder Questionnaire–Predeath (PG–12): Psychometric properties and correlates. Palliat Support Care 2017; 15:544-553. [DOI: 10.1017/s1478951516001000] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ABSTRACTObjective:This study aimed to contribute to the validation of the Portuguese version of the Prolonged Grief Disorder Questionnaire–Predeath (PG–12), examining its psychometric properties, including factorial, discriminant, and predictive validity. The prevalence of predeath prolonged grief disorder (PGD) and its psychosocial correlates were also analyzed.Method:The PG–12 was assessed in a sample of family caregivers (FCs) of oncological patients in palliative care. The factorial and discriminant validity of the PG–12 were evaluated by confirmatory factor analysis. The prevalence of predeath PGD was calculated and correlated with sociodemographic characteristics, perception of illness, intensity of care, coping, and caregiver burden. Prospective data were used to assess predictive validity.Results:The sample was composed of 94 FCs, mostly female (78.8%) and daughters (61.3%), with a mean age of 52.02 (SD = 12.87). The PG–12 has been shown to be reliable, to have high internal consistency, to be monofactorial in structure, and to be independent from depression, anxiety, and burden, although predeath grief influences these symptoms. In our sample, 33% met the criteria for predeath PGD. The circumstances and coping mechanisms are also correlated with predeath grief. The PG–12 has also been shown to be predictive of postdeath outcome.Significance of results:The PG–12 can be a useful screening tool for early identification of risk for maladjustment to loss among family caregivers.
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Covelli V, Sattin D, Giovannetti AM, Scaratti C, Willems M, Leonardi M. Caregiver's burden in disorders of consciousness: a longitudinal study. Acta Neurol Scand 2016; 134:352-359. [PMID: 26748540 DOI: 10.1111/ane.12550] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To study the changes in the burden of informal caregivers of patients with disorders of consciousness (DOC) over time. MATERIALS AND METHODS Short Form-12, Family Strain Questionnaire, Beck Depression Inventory and Coping Orientations to Problem Experiences were administered. RESULTS Data collected on 216 informal caregivers of patients with DOC (59.6% females, mean age 53.4 ± 12.7 years old) were analysed at two time-points (mean distance is 2.7 years). Results of the national study revealed that caregivers' mental health improved (T0: M = 41.1, SD = 11.8; T1: M = 45.8, SD = 11.7), whereas the emotional burden (T0: M = 7.4, SD = 3.6; T1: M = 6.6, SD = 3.9) and the presence of depressive symptoms (T0: M = 14.3, SD = 9.3; T1: M = 11.7, SD = 10.2) as well as the need for information about the disease (T0: M = 2.7, SD = 1.2; T1: M = 2.2, SD = 1.4), thoughts of death (T0: M = 3.6, SD = 1.5; T1: M = 3.1, SD = 1.6) and the use of avoiding coping strategy (T0: M = 7.8, SD = 1.0; T1: M = 6.0, SD = 1.3) decreased at T1. Furthermore, depressive symptoms positively correlated with the emotional burden (0.580) and negatively with the mental health component of caregivers' self-perceived health condition (-0.473). Physical (-0.308) and mental health (-0.444) negatively correlated with emotional burden. Finally, the acute event and patients' health condition still have a deep impact on the economic situation of the family. CONCLUSION Although high level of burden was observed, it tends to decrease over time, except for financial burden. Hence, this study suggests the importance to plan strategies or targeted interventions in order to reduce the psychosocial and financial burden associated with caregiving.
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Affiliation(s)
- V. Covelli
- Department of Psychology; e-Campus University; Milan Italy
| | - D. Sattin
- Neurology; Public Health and Disability Unit and Coma Research Centre - Scientific Directorate; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
| | - A. M. Giovannetti
- Neuroimmunology Unit; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
| | - C. Scaratti
- Neurology; Public Health and Disability Unit and Coma Research Centre - Scientific Directorate; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
| | - M. Willems
- Neurology; Public Health and Disability Unit and Coma Research Centre - Scientific Directorate; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
| | - M. Leonardi
- Neurology; Public Health and Disability Unit and Coma Research Centre - Scientific Directorate; Neurological Institute C. Besta IRCCS Foundation; Milan Italy
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Zylberman R, Carolei A, Sacco S, Mallia P, Pistoia F. An Innovative Model of a Home-Like Environment for People in Vegetative and Minimally Conscious States. Neurohospitalist 2016; 6:14-9. [PMID: 26753053 DOI: 10.1177/1941874415596747] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND PURPOSE Many forms of assisted living have been proposed for people who have a loss of autonomy in activities of daily living. Despite the increasing prevalence of vegetative and minimally conscious states, no dedicated residential accommodation has been implemented for patients with chronic disorders of consciousness (DOCs). METHODS This is a descriptive study addressing an innovative model of in-house assistance, named Casa Iride, which has recently been implemented in the attempt to ensure health, safety, and well-being for people with DOCs and their families. RESULTS Our findings show that Casa Iride enables severely disabled individuals to live with dignity within a customized domestic environment. At the same time, it provides support for caregivers from both a practical and a psychological point of view. CONCLUSIONS The results so far indicate a virtuous cycle that brings health, social, psychological, ethical, and economic advantages: the individuals receive all the assistance needed; the families share a place with other people with similar challenges, become more aware of their situation, and learn to cope with it and to maintain their productivity at work; and the care flow of patients through intensive care units and intensive rehabilitation wards is not delayed by a lack of post discharge services.
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Affiliation(s)
| | - Antonio Carolei
- Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, L'Aquila, Italy
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, L'Aquila, Italy
| | - Pierre Mallia
- Bioethics Research Programme, Faculty of Medicine & Surgery, University of Malta, Msida, Malta
| | - Francesca Pistoia
- Department of Biotechnological and Applied Clinical Sciences, Neurological Institute, University of L'Aquila, L'Aquila, Italy
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Giovannetti AM, Covelli V, Sattin D, Leonardi M. Caregivers of patients with disorder of consciousness: burden, quality of life and social support. Acta Neurol Scand 2015; 132:259-69. [PMID: 25808669 DOI: 10.1111/ane.12392] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate quality of life (QoL) and its predictors, psychological burden and level of perceived social support in caregivers of patients with disorder of consciousness. MATERIALS & METHODS World Health Organization Quality of Life-Bref (WHOQOL-BREF), State Trait Anxiety Inventory-Y (STAI-Y), Beck Depression Inventory (BDI-II), Prolonged Grief Disorder Questionnaire, Coping Orientations to Problem Experiences, State-Trait Anger Expression Inventory-2 (STAXI-2), and the Medical Outcome Study Social Support Survey (MOS-SSS) were administered. One-sample t-tests were performed to compare WHOQOL-BREF, STAI-Y and STAXI-2 mean scores to the respective normative sample (NS). Pearson correlation was calculated between time dedicated to patient's care, WHOQOL-BREF, BDI-II, STAI-Y and MOS-SSS scores. Hierarchical multiple regression analyses were performed to evaluate which variables have predictive power on QoL. RESULTS A total of 129 caregivers, 68.2% female, mean age 52.8 years, were enrolled. Three WHOQOL-BREF domains were significantly lower. Anxiety and anger were in line with NS. 28.7% of the sample reported high level of depressive symptoms; 20.9% satisfied the prolonged grief disorder criteria. No differences emerged between caregivers and chronic ill patients' scores at MOS-SSS. STAI-Y, BDI-II and WHOQOL-BREF scores positively correlated. MOS-SSS domains inversely correlate with BDI-II scores. BDI-II results the most relevant predictor of QoL. CONCLUSIONS Study results provided innovative information about caregivers' poor QoL, difficulties in social support and high levels of burden. Time dedicated to care is not strictly related to burden, while social support perceived is highly associated with caregivers' depressive symptoms that are strong predictor of poor QoL. Supportive intervention able to integrate psychological, social and environmental levels is needed.
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Affiliation(s)
- A. M. Giovannetti
- Neurology, Public Health and Disability Unit and Coma Research Centre; Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan Italy
| | - V. Covelli
- Università degli Studi eCampus; Via Isimbardi; 10 - 22060 Novedrate (CO) Italy
| | - D. Sattin
- Neurology, Public Health and Disability Unit and Coma Research Centre; Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan Italy
| | - M. Leonardi
- Neurology, Public Health and Disability Unit and Coma Research Centre; Scientific Directorate; Neurological Institute Carlo Besta IRCCS Foundation; Milan Italy
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Goudarzi F, Abedi H, Zarea K, Ahmadi F. Multiple Victims: The Result of Caring Patients in Vegetative State. IRANIAN RED CRESCENT MEDICAL JOURNAL 2015; 17:e23571. [PMID: 26328066 PMCID: PMC4553169 DOI: 10.5812/ircmj.23571] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/12/2014] [Revised: 09/29/2014] [Accepted: 10/22/2014] [Indexed: 11/16/2022]
Abstract
Background: Having a patient in a vegetative state in the family is a complicated and stressful experience. Caring for such patients with complete disability at home is very challenging. Objectives: The present study aimed to explore the outcomes of caring for patients in a vegetative state for families and caregivers at home. Patients and Methods: In this qualitative study, 16 vegetative patients’ caregivers were selected through purposive sampling. Unstructured interviews and observations were used for data gathering. Data collection was continued until saturation of data and emergence of the main themes. Data analysis was performed by the content analysis method. Results: The analysis of the gathered data led to three themes: “lost main caregiver”, “affected caring partner” and “affected family”. Each theme had some subthemes and subcategories. Conclusions: The three emerged themes in this study showed that all the family members of vegetative patients, depending on their responsibilities, were affected by physical, mental, social and economic issues.
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Affiliation(s)
- Fateme Goudarzi
- Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Heidarali Abedi
- Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, IR Iran
- Corresponding Author: Heidarali Abedi, Faculty of Nursing and Midwifery, Isfahan (Khorasgan) Branch, Islamic Azad University, Isfahan, IR Iran. Tel: +98-3135354058, Fax: +98-3135354065, E-mail:
| | - Kourosh Zarea
- Department of Nursing, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, IR Iran
| | - Fazlollah Ahmadi
- Department of Nursing, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IR Iran
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Cipolletta S, Pasi M, Avesani R. Vita tua, mors mea: The experience of family caregivers of patients in a vegetative state. J Health Psychol 2014; 21:1197-206. [PMID: 25253627 DOI: 10.1177/1359105314550348] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aims to understand whether, and possibly how, caregivers of patients in a vegetative state experience an emotional paradox between life and death. Individual semi-structured interviews were conducted with 24 (19 females and 5 males) caregivers of vegetative state patients living in northern Italy. Data were analysed using interpretative phenomenological analysis. Caregivers felt they were the only ones able to understand and give answer to patients' needs, but neglected their own lives in their total commitment to the patient. The findings highlight the importance for vegetative state caregivers in considering new possibilities of life that go beyond the assistance of vegetative state patients.
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Cipolletta S, Amicucci L. The family experience of living with a person with amyotrophic lateral sclerosis: a qualitative study. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2014; 50:288-94. [PMID: 25043818 DOI: 10.1002/ijop.12085] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/05/2014] [Accepted: 06/05/2014] [Indexed: 12/12/2022]
Abstract
Living with a person with amyotrophic lateral sclerosis (ALS) is a complex and difficult experience. Most research involves only the primary caregiver and uses a quantitative approach. The aim of this study was to explore the experience of family members who live with ALS patients until their death. In-depth, semi-structured interviews were conducted with 13 family members of ALS patients now deceased. Transcripts were analysed using interpretative phenomenological analysis. Three main themes were identified: "Meaning of ALS," including the peculiarity of ALS and its comparison with other illnesses, the explanation of ALS, emotions, coping strategies, personal change and difficult choices; "Family relationships," including centripetal vs. centrifugal forces, role changes, ALS as a family disease, ALS as a family solution, openness towards the outside world; and "Healthcare context," including access to services, information and humanization. One finding was that families of a person with ALS need more supportive interaction and information during the patients' illness and their end-of-life. This study is an invitation to understand families' experience and subsequently help them to find new ways to cope with the situation.
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Affiliation(s)
| | - Linda Amicucci
- Department of General Psychology, University of Padua, Italy
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Bastianelli A, Gius E, Cipolletta S. Changes over time in the quality of life, prolonged grief and family strain of family caregivers of patients in vegetative state: A pilot study. J Health Psychol 2014; 21:844-52. [DOI: 10.1177/1359105314539533] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study explored changes over time and in the internal standards of the quality of life, prolonged grief and family strain of informal caregivers of patients in vegetative state. Data obtained from 52 caregivers showed high levels of prolonged grief and family strain, and low quality of life. A decrease of caregivers’ quality of life and an increase of family strain were found by adopting a response shift procedure. Only prolonged grief did not change during time. Clinical intervention with the caregivers of vegetative state patients should be differentiated on the basis of the duration of the caring experience.
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