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Liu Y, Hughes MC, Wang H. Financial train, health behaviors, and psychological well-being of family caregivers of older adults during the COVID-19 pandemic. PEC INNOVATION 2024; 4:100290. [PMID: 38799257 PMCID: PMC11127198 DOI: 10.1016/j.pecinn.2024.100290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/22/2024] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
Objectives This study aims to examine the change in financial strain, health behaviors, and psychological well-being of family caregivers of older adults during the COVID-19 pandemic and explore the differences in mental health outcomes by gender, race, and relationship status. Methods Using the 2020 National Health and Aging Trends Study COVID-19 supplement, our sample included 2026 family caregivers of older adults. Structural equation modeling was conducted. Results Caregivers with financial strain showed worse mental health than those with no financial strain. Female or adult children caregivers reported significantly less time walking, more financial strain, and a higher level of negative mental health outcomes compared to male or spouse caregivers; non-White caregivers reported greater positive mental health outcomes compared to White caregivers during the pandemic. Discussion Health professionals should consider the financial and mental health impact of COVID-19 among family caregivers when designing and delivering caregiver support programs. Innovation This study provides nationally representative estimates of several important health behaviors and health outcomes for caregivers of older adults during and after the COVID-19 pandemic, helping to fill the knowledge gap about the characteristics of caregivers whose health and well-being were most affected by the pandemic.
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Affiliation(s)
- Yujun Liu
- School of Family and Consumer Sciences, Northern Illinois University, 1425 W. Lincoln Hwy, DeKalb, IL 815-753-1301, United States of America
| | - M. Courtney Hughes
- School of Health Studies, Northern Illinois University, DeKalb, IL, United States of America
| | - Heng Wang
- Department of Family & Preventive Medicine, Rush University Medical Center, Chicago, IL, United States of America
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Garcia-Calvente MDM, Mora DJ, Del Río-Lozano M. Gender Inequalities of Health and Quality of Life in Informal Caregivers in Spain: Protocol for the Longitudinal and Multicenter CUIDAR-SE Study. JMIR Res Protoc 2024; 13:e58440. [PMID: 38954809 PMCID: PMC11252621 DOI: 10.2196/58440] [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: 03/18/2024] [Revised: 04/29/2024] [Accepted: 05/21/2024] [Indexed: 07/04/2024] Open
Abstract
BACKGROUND The aging population and increased disability prevalence in Spain have heightened the demand for long-term care. Informal caregiving, primarily performed by women, plays a crucial role in this scenario. This protocol outlines the CUIDAR-SE study, focusing on the gender-specific impact of informal caregiving on health and quality of life among caregivers in Andalusia and the Basque Country from 2013 to 2024. OBJECTIVE This study aims to analyze the gender differences in health and quality of life indicators of informal caregivers residing in 2 Spanish autonomous communities (Granada, Andalusia, and Gipuzkoa; Basque Country) and their evolution over time, in relation to the characteristics of caregivers, the caregiving situation, and support received. METHODS The CUIDAR-SE study uses a longitudinal, multicenter design across 3 phases, tracking health and quality of life indicators among informal caregivers. Using a questionnaire adapted to the Spanish context that uses validated scales and multilevel analysis, the research captures changes in caregivers' experiences amid societal crises, notably the 2008 economic crisis and the COVID-19 pandemic. A multistage randomized cluster sampling technique is used to minimize study design effects. RESULTS Funding for the CUIDAR-SE study was in 3 phases starting in January 2013, 2017, and 2021, spanning a 10-year period. Data collection commenced in 2013 and continued annually, except for 2016 and 2020 due to financial and pandemic-related challenges. As of March 2024, a total of 1294 participants have been enrolled, with data collection ongoing for 2023. Initial data analysis focused on gender disparities in caregiver health, quality of life, burden, perceived needs, and received support, with results from phase I published. Currently, analysis is ongoing for phases II and III, as well as longitudinal analysis across all phases. CONCLUSIONS This protocol aims to provide comprehensive insights into caregiving dynamics and caregivers' experiences over time, as well as understand the role of caregiving on gender inequality in health, considering regional variations. Despite limitations in participant recruitment, focusing on registered caregivers, the study offers a detailed exploration of the health impacts of caregiving in Spain. The incorporation of a gender perspective and the examination of diverse contextual factors enrich the study's depth, contributing significantly to the discourse on caregiving health complexities in Spain. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/58440.
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Affiliation(s)
| | - Diana Juanita Mora
- Escuela Andaluza de Salud Pública, Granada, Spain
- École des Hautes Études en Santé Publique, Rennes, France
| | - María Del Río-Lozano
- Escuela Andaluza de Salud Pública, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada, Granada, Spain
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Parmar J, L’Heureux T, Lobchuk M, Penner J, Charles L, St. Amant O, Ward-Griffin C, Anderson S. Double-duty caregivers enduring COVID-19 pandemic to endemic: "It's just wearing me down". PLoS One 2024; 19:e0298584. [PMID: 38626216 PMCID: PMC11020535 DOI: 10.1371/journal.pone.0298584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/28/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants' anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
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Affiliation(s)
- Jasneet Parmar
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya L’Heureux
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Lobchuk
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jamie Penner
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley Charles
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Oona St. Amant
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Catherine Ward-Griffin
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Sharon Anderson
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
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Tur-Sinai A, Bentur N, Fabbietti P, Lamura G. Comparing the cross-national impact of the COVID-19 pandemic on care received by community-dwelling older adults in 2020 and 2021: restoring formal home care versus polarizing informal care? Eur J Ageing 2024; 21:6. [PMID: 38265532 PMCID: PMC10808427 DOI: 10.1007/s10433-024-00800-6] [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] [Accepted: 01/08/2024] [Indexed: 01/25/2024] Open
Abstract
The COVID-19 pandemic has changed the supply of formal and informal home care to older adults in many countries across the world. This study aims to compare the initial picture of how the supply of formal and informal home care to older adults in European countries and Israel changed during the first pandemic year (from mid-2020 to mid-2021) and to examine the changes that these countries made in the provision of adequate care to older adults. Using data from the two COVID-19 waves of SHARE, we show that the provision of formal home care services improved in the investigated period, as in 2021 the share of those who reported difficulties in receiving formal home care dropped significantly compared to the previous year. By contrast, informal care provision patterns experienced a growing polarization, with some countries continuing in reporting a strong support from this source, and others moving towards a remarkable reduction in the help coming from informal networks. These findings can serve as a basis for the development of evidence-based recommendations that can inform future care policies at the national level and to implement more sustainable models for older adults living in the community.
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Affiliation(s)
- Aviad Tur-Sinai
- Department of Health Systems Management, The Max Stern Yezreel Valley College, 1930600 , Yezreel Valley, Israel
- School of Nursing, University of Rochester Medical Center, Rochester, NY, 14642-8404, USA
| | - Netta Bentur
- The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Paolo Fabbietti
- INRCA IRCCS-National Institute of Health and Science on Ageing, Unit of Geriatric Pharmacoepidemiology, 60124, Ancona, Italy.
| | - Giovanni Lamura
- INRCA IRCCS-National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, 60124, Ancona, Italy
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Elayan S, Bei E, Ferraris G, Fisher O, Zarzycki M, Angelini V, Ansmann L, Buskens E, Hagedoorn M, von Kutzleben M, Lamura G, Looijmans A, Sanderman R, Vilchinsky N, Morrison V. Cohort profile: The ENTWINE iCohort study, a multinational longitudinal web-based study of informal care. PLoS One 2024; 19:e0294106. [PMID: 38236932 PMCID: PMC10796045 DOI: 10.1371/journal.pone.0294106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/25/2023] [Indexed: 01/22/2024] Open
Abstract
Informal care is a key pillar of long-term care provision across Europe and will likely play an even greater role in the future. Thus, research that enhances our understanding of caregiving experiences becomes increasingly relevant. The ENTWINE iCohort Study examines the personal, psychological, social, economic, and geographic factors that shape caregiving experiences. Here, we present the baseline cohort of the study and describe its design, recruitment methods, data collection procedures, measures, and early baseline findings. The study was conducted in nine countries: Germany, Greece, Ireland, Israel, Italy, the Netherlands, Poland, Sweden, and the United Kingdom. The study comprised a web-based longitudinal survey (baseline + 6-month follow-up) and optional weekly diary assessments conducted separately with caregivers and care recipients. From 14 August 2020 to 31 August 2021, 1872 caregivers and 402 care recipients were enrolled at baseline. Participants were recruited via Facebook and, to a lesser extent, via the study website or caregiver/patient organisations. Caregiver participants were predominantly female (87%) and primary caregivers (82%), with a median age of 55 years. A large proportion (80%) held at least post-secondary education, and two-thirds were married/partnered. Over half of the caregivers were employed (53%) and caring for a person with multiple chronic conditions (56%), and nearly three-quarters were caring for either a parent (42%) or a spouse/partner (32%). About three-quarters of care recipient participants were female (77%), not employed (74%), and had at least post-secondary education (77%), with a median age of 55 years. Over half of the care recipients were married/partnered (59%), receiving care primarily from their spouses/partners (61%), and diagnosed with multiple chronic conditions (57%). This study examining numerous potential influences on caregiving experiences provides an opportunity to better understand the multidimensional nature of these experiences. Such data could have implications for developing caregiving services and policies, and for future informal care research.
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Affiliation(s)
- Saif Elayan
- Faculty of Economics and Business, Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - Eva Bei
- Faculty of Social Sciences, Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Oliver Fisher
- Department of Economics and Social Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Mikołaj Zarzycki
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - Viola Angelini
- Faculty of Economics and Business, Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - Lena Ansmann
- Department of Health Services Research, Division of Organizational Health Services Research, University of Oldenburg, Oldenburg, Germany
- Faculty of Medicine, Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
| | - Erik Buskens
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Milena von Kutzleben
- Department of Health Services Research, Division of Organizational Health Services Research, University of Oldenburg, Oldenburg, Germany
| | - Giovanni Lamura
- IRCCS INRCA-National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Noa Vilchinsky
- Faculty of Social Sciences, Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Val Morrison
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
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Lestari SK, Eriksson M, de Luna X, Malmberg G, Ng N. Volunteering and instrumental support during the first phase of the pandemic in Europe: the significance of COVID-19 exposure and stringent country's COVID-19 policy. BMC Public Health 2024; 24:99. [PMID: 38183001 PMCID: PMC10768320 DOI: 10.1186/s12889-023-17507-5] [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: 05/05/2023] [Accepted: 12/16/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND The COVID-19 control policies might negatively impact older adults' participation in volunteer work, instrumental support provision, and the likelihood of receiving instrumental support. Studies that quantify changes in these activities and the related factors are limited. The current study aimed to examine the level of volunteering, instrumental support provision and receipt before and during the first phase of the COVID-19 pandemic in Europe and to determine whether older adults' volunteering, instrumental support provision and receipt were associated with individual exposure to COVID-19 and the stringency of country's COVID-19 control policy during the first phase of the COVID-19 pandemic. METHODS A cross-sectional survey using data from the Survey of Health, Ageing and Retirement in Europe (SHARE) Corona Survey 1 was designed to focus on community-dwelling Europeans aged ≥50 years. History of participation in volunteering work and instrumental support provision or receipt was assessed from the previous SHARE Wave data. The country's COVID-19 control policy stringency index (S-Index) was from the Oxford COVID-19 Government Response Tracker database. A total of 45,669 respondents from 26 European countries were included in the volunteering analysis. Seventeen European countries were included in the analyses of instrumental support provision (N = 36,518) and receipt (N = 36,526). The multilevel logistic regression model was fitted separately to analyse each activity. RESULTS The level of volunteering and instrumental support provision was lower during the pandemic, but instrumental support receipt was higher. The country S-Index was positively associated with support provision (OR:1.13;95%CI:1.02-1.26) and negatively associated with support receipt (OR:0.69;95%CI:0.54-0.88). Exposure to COVID-19 was positively associated with support receipt (OR:1.64;95%CI:1.38-1.95). COVID-19 exposure on close ones positively associated with volunteering (OR:1.47;95%CI:1.32-1.65), support provision (OR:1.28;95%CI:1.19-1.39), and support receipt (OR:1.25;95%CI:1.15-1.35). CONCLUSIONS The COVID-19 pandemic impacted older Europeans' volunteering, instrumental support provision, and instrumental support receipt from outside their household. When someone close to them was exposed to COVID-19, older Europeans were likely to receive instrumental support and to volunteer and provide instrumental support. A stricter country's COVID-19 control policy might motivate older adults to provide instrumental support, but it prevents them from receiving instrumental support from outside their households.
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Affiliation(s)
- Septi Kurnia Lestari
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden.
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden.
| | - Malin Eriksson
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Xavier de Luna
- Umeå School of Business, Economics and Statistics, Umeå University, Umeå, Sweden
| | - Gunnar Malmberg
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
- Department of Geography, Umeå University, Umeå, Sweden
| | - Nawi Ng
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
- School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
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Wasilewski MB, Szigeti Z, Sheppard CL, Minezes J, Hitzig SL, Mayo AL, Robinson LR, Lung M, Simpson R. "You want them to be partners in therapy, but that's tricky when they're not there": A qualitative study exploring caregiver involvement across the continuum of care during the early COVID pandemic. Clin Rehabil 2024; 38:109-118. [PMID: 37518867 PMCID: PMC10631287 DOI: 10.1177/02692155231191011] [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: 01/26/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
OBJECTIVE Widespread visitor restrictions were implemented during the COVID-19 pandemic at acute and inpatient rehabilitation hospitals. Family caregivers were physically isolated from their loved ones, which challenged engagement in patient care and readiness for their role. Thus, we aimed to explore the involvement of family caregivers in COVID-19 patients as they journeyed across the care continuum during the early phase of the COVID-19 pandemic. DESIGN We employed a qualitative descriptive approach. PARTICIPANTS We conducted interviews with family caregivers, COVID-19 patients, and healthcare providers between August 2020 and February 2021. SETTING Participants were recruited from a single hospital network in Toronto, Ontario, Canada. Interviews were recorded and transcribed. Data were analyzed thematically. RESULTS A total of 27 participants were interviewed-12 healthcare providers, 10 patients, and 5 family caregivers. Four themes were identified: (a) Caregivers were shut out in acute COVID care, (b) Patient discharge from inpatient rehabilitation was turbulent for caregivers, (c) Caregivers were unprepared to support loved ones in the community, and (d) Patient discharge to home was heavily dependent on caregiver availability. CONCLUSIONS Visitor restrictions prevent family caregivers from being physically present at patients' bedside, leading to complex and detrimental impacts such as caregivers feeling that they were not engaged in their loved one's care planning until they were discharged. In turn, discharge to the community was met with several challenges including caregivers feeling underprepared and unsupported to meet their loved one's unique care requirements. This was exacerbated by a lack of community-based resources due to ongoing pandemic restrictions.
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Affiliation(s)
- Marina B Wasilewski
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Zara Szigeti
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Christine L Sheppard
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Jacqueline Minezes
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Sander L Hitzig
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy & Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Amanda L Mayo
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Lawrence R Robinson
- St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Maria Lung
- Musculoskeletal/STAR Rehab and Restorative Transitional Unit, St John's Rehab, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Robert Simpson
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
- Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Medina-Perucha L, Jacques-Aviñó C, López-Jiménez T, Maiz C, Berenguera A. Spanish residents' experiences of care during the first wave of the COVID-19 syndemic: a photo-elicitation study. Int J Qual Stud Health Well-being 2023; 18:2172798. [PMID: 36779532 PMCID: PMC9930786 DOI: 10.1080/17482631.2023.2172798] [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] [Indexed: 02/14/2023] Open
Abstract
PURPOSE The main aim of this research was to explore experiences of care during the lockdown of the first wave of COVID-19 syndemic in Spain. METHODS This is a qualitative and explorative study using self-photo-elicitation as a data collection method. Fifteen participants (Twelve women and three men) shared 25 photographs and one video between the June 18 and August, 2020. Participants' photographs and texts were collected online. Data were analysed based on Thematic Analysis. RESULTS Three emerging categories were constructed: 1) the deconstruction of care: self-care and collective care 2) the crisis of care and gendered care, 2) beyond anthropocentrism: animalism and ecology. Findings indicate the need to understand "care" in terms of social reproduction, including self-care, care towards other humans and non-human animals, and collective care. Also, the need to care for planetary health and to be in contact with nature as a form of self-care and social care. CONCLUSIONS Care in a period of social and health crisis puts human relationships and also non-human life at the centre. Care requires adopting taking an ecological one-health perspective.
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Affiliation(s)
- Laura Medina-Perucha
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autónoma de Barcelona Bellaterra, Cerdanyola del Vallès, Spain,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
| | - Constanza Jacques-Aviñó
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autónoma de Barcelona Bellaterra, Cerdanyola del Vallès, Spain,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain,CONTACT Constanza Jacques-Aviñó Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol) Gran Via de les Corts Catalanes, 587 attic, Barcelona08007, Spain
| | - Tomàs López-Jiménez
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autónoma de Barcelona Bellaterra, Cerdanyola del Vallès, Spain,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain
| | - Catuxa Maiz
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Anna Berenguera
- Unitat Transversal de Recerca, Fundació Institut Universitari per a la recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain,Universitat Autónoma de Barcelona Bellaterra, Cerdanyola del Vallès, Spain,Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Spain,Departament d’Infermeria, Universitat de Girona, Girona, Spain
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Zwar L, König HH, Hajek A. Mental health, social integration and support of informal caregivers during the second wave of the COVID-19 pandemic: A population-based representative study from Germany. Arch Gerontol Geriatr 2023; 114:105085. [PMID: 37311371 PMCID: PMC10238121 DOI: 10.1016/j.archger.2023.105085] [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: 04/13/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The study analyzed mental health, social integration and social support of informal caregivers of individuals aged ≥60 years compared to non-caregivers during the second wave of the COVID-19 pandemic. METHODS A quantitative, cross-sectional study was conducted with a sample drawn randomly from the nationally representative online panel forsa.omninet in Germany between March 4th and 19th 2021. In total, 3022 adults aged ≥40 years from Germany were questioned, including 489 adults providing informal care for adults aged ≥60 years between December 2020 and March 2021. Depressive (PHQ-9) and anxiety symptoms (GAD-7), loneliness (De Jong Gierveld Scale), social exclusion (Bude & Lantermann Scale) and social network support (Lubben's Social Network Scale) were measured. Adjusted OLS regression analyses and additional moderator analyses (moderators: perceived restrictions and danger of infection due to the COVID-19 pandemic) were conducted. RESULTS Significant higher levels of depressive and anxiety symptoms and more social support were found among informal caregivers compared to non-caregivers. Loneliness and social exclusion did not differ between both groups. Perceived restrictions by the pandemic significantly moderated the association between informal caregiving and social support - social support was stronger among caregivers with higher levels of perceived restrictions by the pandemic. CONCLUSION Informal caregivers are faced with worse mental health than non-caregivers during the pandemic, although their social support was stronger, in particular in dependence of higher levels of perceived restrictions by the pandemic. Thus, results indicate a need for an informal-care-specific policy and more professional support for informal caregivers during a health crisis.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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10
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Bergmann M, Wagner M. Back to normal? The health care situation of home care receivers across Europe during the COVID-19 pandemic and its implications on health. PLoS One 2023; 18:e0287158. [PMID: 37871044 PMCID: PMC10593209 DOI: 10.1371/journal.pone.0287158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 10/10/2023] [Indexed: 10/25/2023] Open
Abstract
The COVID-19 pandemic began impacting Europe in early 2020, posing significant challenges for individuals requiring care. This group is particularly susceptible to severe COVID-19 infections and depends on regular health care services. In this article, we examine the situation of European care recipients aged 50 years and older 18 months after the pandemic outbreak and compare it to the initial phase of the pandemic. In the descriptive section, we illustrate the development of (unmet) care needs and access to health care throughout the pandemic. Additionally, we explore regional variations in health care receipt across Europe. In the analytical section, we shed light on the mid- and long-term health consequences of COVID-19-related restrictions on accessing health care services by making comparisons between care recipients and individuals without care needs. We conducted an analysis using data from the representative Corona Surveys of the Survey of Health, Ageing and Retirement in Europe (SHARE). Our study examines changes in approximately 3,400 care-dependent older Europeans (aged 50+) interviewed in 2020 and 2021, comparing them with more than 45,000 respondents not receiving care. The dataset provides a cross-national perspective on care recipients across 27 European countries and Israel. Our findings reveal that in 2021, compared to the previous year, difficulties in obtaining personal care from someone outside the household were significantly reduced in Western and Southern European countries. Access to health care services improved over the course of the pandemic, particularly with respect to medical treatments and appointments that had been canceled by health care institutions. However, even 18 months after the COVID-19 outbreak, a considerable number of treatments had been postponed either by respondents themselves or by health care institutions. These delayed medical treatments had adverse effects on the physical and mental health of both care receivers and individuals who did not rely on care.
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Affiliation(s)
- Michael Bergmann
- Munich Research Institute for the Economics of Aging and SHARE Analyses (MEA-SHARE), Munich, Germany
- SHARE Berlin Institute (SBI), Berlin, Germany
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Kulkarni A, Salave M, Deuskar M. Journeying Apart: Exploring Informal Caregiver Experiences and Unmet Closures in Caring for COVID-19 Deceased. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231206512. [PMID: 37844259 DOI: 10.1177/00302228231206512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
The current study investigates the experiences and expectations of informal caregivers who lost their loved ones to the COVID-19 virus. The unusual circumstances of the deaths including physical isolation from their loved ones during the final hours before death significantly impacted their grieving process. In this interpretative phenomenological study, caregivers' experiences are explored through the lens of grief models and Gestalt perspectives. By thematic coding, seven superordinate themes emerged: Inability to accept death, Unfair nature of death, Helplessness, Regret and self-blame, Shattering of assumptive world, Using work as a distraction and Lack of government facilities. The findings of this study suggest that a significant number of informal caregivers continue suffering through the distress caused by the death of their loved ones in the pandemic, highlighting the need for grief counselling interventions for such bereaved informal caregivers.
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Affiliation(s)
| | - Manasi Salave
- Department of Psychology, Fergusson College, Pune, India
| | - Megha Deuskar
- Department of Psychology, Fergusson College, Pune, India
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12
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Dale J, Nanton V, Day T, Apenteng P, Bernstein CJ, Grason Smith G, Strong P, Procter R. Uptake and Use of Care Companion, a Web-Based Information Resource for Supporting Informal Carers of Older People: Mixed Methods Study. JMIR Aging 2023; 6:e41185. [PMID: 37733406 PMCID: PMC10556998 DOI: 10.2196/41185] [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: 07/27/2022] [Revised: 03/10/2023] [Accepted: 05/30/2023] [Indexed: 09/22/2023] Open
Abstract
BACKGROUND Informal carers play a major role in supporting relatives and friends who are sick, disabled, or frail. Access to information, guidance, and support that are relevant to the lives and circumstances of carers is critical to carers feeling supported in their role. When unmet, this need is known to adversely affect carer resilience and well-being. To address this problem, Care Companion was co-designed with current and former carers and stakeholders as a free-to-use, web-based resource to provide access to a broad range of tailored information, including links to local and national resources. OBJECTIVE This study aimed to investigate the real-world uptake and use of Care Companion in 1 region of England (with known carer population of approximately 100,000), with local health, community, and social care teams being asked to actively promote its use. METHODS The study had a convergent parallel, mixed methods design and drew on the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Data included metrics from carers' use of Care Companion, surveys completed by users recruited through general practice, and interviews with carers and health and social care providers regarding their views about Care Companion and their response to it. Quantitative data were analyzed using descriptive statistics. Interview data were analyzed thematically and synthesized to create overarching themes. The qualitative findings were used for in-depth exploration and interpretation of quantitative results. RESULTS Despite awareness-raising activities by relevant health, social care, and community organizations, there was limited uptake with only 556 carers (0.87% of the known carer population of 100,000) registering to use Care Companion in total, with median of 2 (mean 7.2; mode 2) visits per registered user. Interviews with carers (n=29) and stakeholders (n=12) identified 7 key themes that influenced registration, use, and perceived value: stakeholders' signposting of carers to Care Companion, expectations about Care Companion, activity levels and conflicting priorities, experience of using Care Companion, relevance to personal circumstances, social isolation and networks, and experience with digital technology. Although many interviewed carers felt that it was potentially useful, few considered it as being of direct relevance to their own circumstances. For some, concerns about social isolation and lack of hands-on support were more pressing issues than the need for information. CONCLUSIONS The gap between the enthusiastic views expressed by carers during Care Companion's co-design and the subsequent low level of uptake and user experience observed in this evaluation suggests that the co-design process may have lacked a sufficiently diverse set of viewpoints. Numerous factors were identified as contributing to Care Companion's level of use, some of which might have been anticipated during its co-design. More emphasis on the development and implementation, including continuing co-design support after deployment, may have supported increased use.
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Affiliation(s)
- Jeremy Dale
- Academic Primary Care Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Veronica Nanton
- Academic Primary Care Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Theresa Day
- Academic Primary Care Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Patricia Apenteng
- Institute of Applied Health Research, University of Birmingham, Birmingham, United Kingdom
| | - Celia Janine Bernstein
- Academic Primary Care Unit, Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | | | - Peter Strong
- Centre for Complexity Science, University of Warwick, Coventry, United Kingdom
- The Alan Turing Institute, London, United Kingdom
| | - Rob Procter
- The Alan Turing Institute, London, United Kingdom
- Department of Computer Science, University of Warwick, Coventry, United Kingdom
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Idemoto K, Niitsu T, Shiina A, Kobori O, Onodera M, Ota K, Miyazawa A, Tachibana M, Kimura M, Seki R, Hashimoto T, Yoshimura K, Ito S, Nakazato M, Igarashi Y, Shimizu E, Iyo M. Association between precautionary behaviors against coronavirus disease and psychosocial factors in outpatients with a pre-existing disease and their attendants. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e141. [PMID: 38867827 PMCID: PMC11114330 DOI: 10.1002/pcn5.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 08/20/2023] [Accepted: 08/25/2023] [Indexed: 06/14/2024]
Abstract
Aim The spread of the novel coronavirus infection (coronavirus disease 2019 [COVID-19]) has caused behavioral changes and mental illness in patients and their attendants during its early phase. The present study aimed to examine the association between precautionary behaviors against COVID-19 and psychosocial factors in outpatients with pre-existing disease and their attendants. Methods We conducted a cross-sectional paper-based questionnaire survey in Chiba University Hospital on 1019 patients and 513 attendants, and a web-based questionnaire survey in Japan on 3981 individuals from the general population. We evaluated the participants' anxiety about COVID-19, depression, health anxiety, and precautionary behaviors. Results Regarding knowledge and anxiety about COVID-19, the protective factors for the high precautionary behaviors group were knowledge of COVID-19 (odds ratio [OR] = 1.178, 95% confidence interval [CI]: 1.099-1.263), anxiety about the spread of COVID-19 (OR = 1.348, 95% CI: 1.243-1.461), and anxiety about infecting someone with COVID-19 (OR = 1.135, 95% CI: 1.039-0.239). Regarding psychosocial factors, the protective factors for the high precautionary behaviors group were patients (OR = 1.759, 95% CI: 1.056-2.929), their attendants (OR = 3.892, 95% CI: 1.416-10.700), health anxiety (OR = 2.005, 95% CI: 1.451-2.772), and nondepression states (OR = 1.368, 95% CI: 1.004-1.864). Conclusion Our findings suggest that patients and their attendants may perform high precautionary behaviors. Health anxiety and nondepression states may be associated with high precautionary behaviors.
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Affiliation(s)
- Keita Idemoto
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Tomihisa Niitsu
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Akihiro Shiina
- Division of Clinical Neuroscience, Center for Forensic Mental HealthChiba UniversityChibaJapan
| | - Osamu Kobori
- Department of PsychologyInternational University of Health and WelfareAkasakaJapan
| | - Misaki Onodera
- Department of Medical Education, Graduate School of MedicineChiba UniversityChibaJapan
| | - Kiyomitsu Ota
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Atsuhiro Miyazawa
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Masumi Tachibana
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Makoto Kimura
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Ryota Seki
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
| | - Tasuku Hashimoto
- Department of PsychiatryInternational University of Health and WelfareNaritaJapan
| | - Kensuke Yoshimura
- Center for Next Generation of Community HealthChiba UniversityChibaJapan
| | - Shoichi Ito
- Department of Medical Education, Graduate School of MedicineChiba UniversityChibaJapan
| | - Michiko Nakazato
- Department of PsychiatryInternational University of Health and WelfareNaritaJapan
| | - Yoshito Igarashi
- Division of Clinical Neuroscience, Center for Forensic Mental HealthChiba UniversityChibaJapan
| | - Eiji Shimizu
- Department of Cognitive Behavioral Physiology, Graduate School of MedicineChiba UniversityChibaJapan
| | - Masaomi Iyo
- Department of Psychiatry, Graduate School of MedicineChiba UniversityChibaJapan
- Division of Clinical Neuroscience, Center for Forensic Mental HealthChiba UniversityChibaJapan
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Damian AC, Mihăilescu AI, Anghele C, Ciobanu CA, Petrescu C, Riga S, Dionisie V, Ciobanu AM. Quality of Life Predictors in a Group of Informal Caregivers during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1486. [PMID: 37629776 PMCID: PMC10456842 DOI: 10.3390/medicina59081486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The informal caregiver's contribution to the wellbeing of dementia patients is critical since these individuals become dependent on others for all daily activities. Our goal was to investigate the dynamics of anxiety, depression, burnout, sleep, and their influence on quality of life over a 6-month period in the context of pandemic distress in a sample of informal caregivers of Alzheimer's patients. Materials and Methods: For this prospective, longitudinal study, we conducted a 6-month telephonic survey between 2021 and 2022, administering a series of questionnaires at three timepoints (baseline, 3 months and 6 months) to a group of informal caregivers of patients suffering from dementia due to Alzheimer's disease. Results: A total of 110 caregivers were included at baseline, out of which 96 continued to the second stage and 78 followed through to the last stage. The majority of the participants were female (most likely the patients' daughters), around 55 years old, living in urban areas, married, with children, having a high school degree or a higher education degree, and working in jobs that required physical presence; in the best-case scenario, they were sharing their responsibilities with another two-three caregivers. More than half of the 110 participants (50.9%) reported mild to moderate anxiety at baseline, and 27.3% reported significant anxiety, with no changes between the three timepoints, F(2, 154) = 0.551, p = 0.57; 25% reported moderate-severe depression at the start, with no changes between the three timepoints, F(2, 154) = 2.738, p = 0.068; and many reported a decrease in quality of life, poor quality of sleep, and decreased fear of COVID infection. Cynicism, professional effectiveness, anxiety, depression, and sleep quality explained up to 87.8% of the variance in quality of life. Conclusions: Caregivers' decreased quality of life during the pandemic was explained by their levels of burnout, anxiety, and depression throughout the 6-month period.
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Affiliation(s)
- Ana Claudia Damian
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | - Alexandra Ioana Mihăilescu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
- Department of Medical Psychology, Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Cristina Anghele
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | | | - Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Vlad Dionisie
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
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Morgan T, Gott M, Williams L, Naden J, Wang Y, Smith B, Fanueli E, Budi Setyawati M, Morgan K, Robinson J, Anderson N, Carey M, Moeke-Maxwell T. A bad time to die? Exploring bereaved families/wha-nau experiences of end-of-life care under COVID-19 restrictions: a qualitative interview study. Palliat Care Soc Pract 2023; 17:26323524231189525. [PMID: 37584059 PMCID: PMC10424543 DOI: 10.1177/26323524231189525] [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: 04/17/2023] [Accepted: 07/05/2023] [Indexed: 08/17/2023] Open
Abstract
Background There have been international concerns raised that, during the COVID-19 pandemic, there was an absence of good palliative care resulting in poor end-of-life care experiences. To date, there have been few studies considering the pandemic's impact on people dying from non-COVID-19 causes and their families and friends. In particular, there has been very less empirical research in relation to end-of-life care for Indigenous, migrant and minoritised ethnic communities. Objectives To explore bereaved next-of-kin's views and experiences of end-of-life care under COVID-19 pandemic regulations. Design This qualitative study involved in-depth one-off interviews with 30 ethnically diverse next-of-kin who had a family member die in the first year of the pandemic in Aotearoa, New Zealand. Methods Interviews were conducted by ethnically matched interviewers/interviewees. A reflexive thematic analysis was used to explore and conceptualise their accounts. Results A key finding was that dying alone and contracting COVID-19 were seen as equally significant risks by bereaved families. Through this analysis, we identified five key themes: (1) compromised connection; (2) uncertain communication; (3) cultural safety; (4) supported grieving and (5) silver linings. Conclusion This article emphasises the importance of enabling safe and supported access for family/whanau to be with their family/wha-nau member at end-of-life. We identify a need for wider provision of bereavement support. We recommend that policy makers increase resourcing of palliative care services to ensure that patients and their families receive high-quality end-of-life care, both during and post this pandemic. Policy makers could also promote a culturally-diverse end-of-life care work force and the embedding of culturally-safety practices across a range of institutions where people die.
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Affiliation(s)
- Tessa Morgan
- Applied Social Science Group, Department of Public Health and Primary Care, The University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Joe Naden
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Yingmin Wang
- School of Foreign Studies and School of International Culture, South China Normal University, Guangzhou, China
| | - Brianna Smith
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Fanueli
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Martyarini Budi Setyawati
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathryn Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jackie Robinson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Natalie Anderson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Melissa Carey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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16
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McGarrigle CA, Ward M, Kenny RA. An investigation of what protective individual- and community-level factors are associated with life satisfaction in middle-aged and older family carers in Ireland. Front Public Health 2023; 11:1207523. [PMID: 37637804 PMCID: PMC10457003 DOI: 10.3389/fpubh.2023.1207523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/11/2023] [Indexed: 08/29/2023] Open
Abstract
Background Family care plays an essential role in providing care in society. However, caring can cause stress, and mental and physical responses to caring vary widely. Different outcomes for carers may reflect different approaches or adaptability to caring and their ability to maintain or recover their mental health and wellbeing following an adverse event (psychosocial resilience). We aim to identify factors that may promote psychosocial resilience, conceptualized as maintaining or recovering subjective wellbeing and operationalized as satisfaction with life, among carers. Methods Data were from 6 Waves (2009-2021) of The Irish Longitudinal Study on Aging (TILDA), a prospective biennial nationally representative longitudinal study of older adults aged ≥50 in Ireland. Family caregiving was assessed in Waves 3-6. Participants were asked if they cared for someone, their relationship to the recipient, and the number of hours per week that they provided care. We used growth mixture modeling to identify latent trajectories of satisfaction with life (SWL) before and after caring was initiated. Regression modeling was then used to identify protective factors (at the individual, family, and community levels) associated with resilient trajectories. Results Overall, 731 (12.2%) participants became carers during follow-up. We identified three trajectories in SWL in carers following initiation of caring, namely, Resilient-Stable (81%), Resilient-Recovery (12%), and Non-recovery (6%). Membership in Resilient-Stable and Resilient-Recovery trajectories was associated with fewer depressive symptoms (OR = 0.86, 95% CI 0.78, 0.94) and chronic conditions (OR = 0.21, 95% CI 0.06, 0.74), larger social networks (OR = 2.03, 95% CI 1.06, 3.86), more close friends and relatives (OR = 1.15, 95% CI 1.01, 1.32), and caring for someone other than a child (OR = 0.19, 95% CI 0.07, 0.51) compared to the Non-recovery group. Conclusion Becoming a family carer was associated with a decline in SWL over time in some carers. However, most carers either did not experience a decline in SWL or recovered their SWL over time. We found that both individual and community-level supports may be protective for carers' wellbeing. These results will inform the priorities for social and community-level services and support for older carers and contribute to the design of new projects and programs to meet these needs.
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Affiliation(s)
- Christine A. McGarrigle
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Mark Ward
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
- St James's Hospital, Mercer's Institute for Successful Ageing, Dublin, Ireland
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Lahiri A, Jha SS, Chakraborty A, Dey A, Dobe M. Home-Isolation Care in Newly COVID-19-Positive Elderly Patients: A Caregiver-Centric Explanatory Framework. Int J Public Health 2023; 68:1606060. [PMID: 37538233 PMCID: PMC10394230 DOI: 10.3389/ijph.2023.1606060] [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: 04/03/2023] [Accepted: 06/29/2023] [Indexed: 08/05/2023] Open
Abstract
Objectives: This community-based study aimed to identify the effect of different behavioral factors of family caregivers on the decision for home-isolation-based treatment of a new COVID-19-diagnosed elderly individual. It also explored the facilitators and barriers contributing to the decision-making process. Methods: A mixed-methods design was adopted to study the role of behavioral constructs such as risk tolerance, risk aversion, regret aversion, loss aversion, self-efficacy, and risk perception in healthcare-seeking decisions. By integrating the findings from the quantitative and qualitative parts, a framework was developed. Results: Self-efficacy, risk perception, and risk tolerance related to different issues were crucial factors behind the healthcare decision. However, regarding the various issues under consideration, risk perception followed by risk tolerance were the significant predictors for decision-making. Conclusion: To enhance appropriateness and equity in emergency healthcare-seeking, interventions should target risk tolerance and risk perception, taking into account the awareness levels of caregivers and the target population's risk and regret aversion. Such integrated approaches can improve the quality of care for elderly patients in home-based settings.
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Affiliation(s)
- Arista Lahiri
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Sweety Suman Jha
- Dr. B. C. Roy Multi-Speciality Medical Research Centre, Indian Institute of Technology Kharagpur, Kharagpur, West Bengal, India
| | - Arup Chakraborty
- Department of Community Medicine, Medical College and Hospital, Kolkata, West Bengal, India
| | - Abhijit Dey
- WHO-NTEP Technical Support Network, Swasthya Bhawan, Kolkata, West Bengal, India
| | - Madhumita Dobe
- Foundation for Actions and Innovations Towards Health Promotion (FAITH), Kolkata, West Bengal, India
- All India Institute of Hygiene and Public Health, Kolkata, West Bengal, India
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18
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Affiliation(s)
- Jon Glasby
- IMPACT, University of Birmingham, Birmingham, UK
| | | | - Liz Hanson
- NKA (Swedish Family Care Competence Unit) Kalmar, Sweden
- Linnaeus University, Sweden
| | - Mirella Minkman
- Vilans (Dutch Institute for Long Term Care), Utrecht, Netherlands
- School for Business and Society, Tilburg University, Tilburg, Netherlands
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Guedes DA, Gomes NP, Carvalho AADS. Subjective well-being in informal caregivers during the COVID-19 pandemic. Open Med (Wars) 2023; 18:20230739. [PMID: 37333446 PMCID: PMC10276610 DOI: 10.1515/med-2023-0739] [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: 01/10/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023] Open
Abstract
The study of subjective well-being (SWB) is important as it is related to the reduction of morbidity and mortality, with the maintenance of functionality and autonomy in the elderly population. The impact of the formative intervention on the SWB of informal caregivers (ICGs) during the pandemic crisis of COVID-19 was analyzed. This study is a quasi-experimental single-group, longitudinal study with a sample of 31 ICGs and their dependents. A form was used for data collection, and data processing was performed using IBM SPSS (Statistical Package for the Social Sciences), using descriptive statistics and inferential statistics. Of the total sample, the majority were female (90.3%). The difference between the mean of positive affection and negative affection at Moment 1 (M1) was -0.0581 ± 0.71590 and 0.04645 ± 0.53326 at Moment 2 (M2). The mean rank ordering of the difference between the two types of affection differed significantly between M2 and M1 (Wilcoxon: p < 0.000), with that of M2 being higher than M1 (16.93 > 2.50). The formative intervention, within the scope of community nursing, had a significant impact on increasing the SWB of the ICG in this sample. This study may contribute to improving the SWB of ICG and their dependents.
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Affiliation(s)
- Daniela Alves Guedes
- Grouping of Health Centres Tâmega I, Baixo Tâmega, Marão Várzea Personalised Health Care Unit, Amarante, Portugal
| | | | - Amâncio António de Sousa Carvalho
- Department of Health School, University of Trás-os-Montes e Alto Douro/Nursing School, Vila Real, Portugal
- CIEC – Research Centre on Child Studies, University of Minho, Braga, Portugal
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Hajek A, Grupp K, Aarabi G, Gyasi RM, Freak-Poli R, Kretzler B, König HH. Long-term care need, loneliness, and perceived social isolation during the COVID-19 pandemic: evidence from the German Ageing Survey. Aging Clin Exp Res 2023; 35:1377-1384. [PMID: 37099237 PMCID: PMC10130804 DOI: 10.1007/s40520-023-02411-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 04/12/2023] [Indexed: 04/27/2023]
Abstract
BACKGROUND There is a complete lack of studies focusing on the association between care degree (reflecting the long-term care need) and loneliness or social isolation in Germany. AIMS To investigate the association between care degree and loneliness as well as perceived social isolation during the COVID-19 pandemic. METHODS We used data from the nationally representative German Ageing Survey, which covers community-dwelling middle-aged and older individuals aged 40 years or over. We used wave 8 of the German Ageing Survey (analytical sample: n = 4334 individuals, mean age was 68.9 years, SD: 10.2 years; range 46-100 years). To assess loneliness, the De Jong Gierveld instrument was used. To assess perceived social isolation, the Bude and Lantermann instrument was used. Moreover, the level of care was used as a key independent variable (absence of care degree (0); care degree 1-5). RESULTS After adjusting for various covariates, regressions showed that there were no significant differences between individuals without a care degree and individuals with a care degree of 1 or 2 in terms of loneliness and perceived social isolation. In contrast, individuals with a care degree of 3 or 4 had higher loneliness (β = 0.23, p = 0.034) and higher perceived social isolation scores (β = 0.38, p < 0.01) compared to individuals without a care degree. DISCUSSION/CONCLUSIONS Care degrees of 3 or 4 are associated with higher levels of both loneliness and perceived social isolation. Longitudinal studies are required to confirm this association.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany.
| | - Katharina Grupp
- Division of Plastic, Reconstructive and Aesthetic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ghazal Aarabi
- Department of Periodontics, Preventive and Restorative Dentistry, Center for Dental and Oral Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Razak Mohammed Gyasi
- African Population and Health Research Center, Nairobi, Kenya
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia
- School of Clinical Sciences at Monash Health, Monash University, Melbourne, VIC, 3004, Australia
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Martinistr. 52, 20246, Hamburg, Germany
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Ward A, Buffalo L, McDonald C, L'Heureux T, Charles L, Pollard C, Tian PG, Anderson S, Parmar J. Supporting First Nations Family Caregivers and Providers: Family Caregivers', Health and Community Providers', and Leaders' Recommendations. Diseases 2023; 11:diseases11020065. [PMID: 37218878 DOI: 10.3390/diseases11020065] [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: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Family caregivers and care providers are increasingly becoming more distressed and reaching a breaking point within current systems of care. First Nations family caregivers and the health and community providers employed in First Nations communities have to cope with colonial, discriminatory practices that have caused intergenerational trauma and a myriad of siloed, disconnected, and difficult-to-navigate federal-, provincial/territorial-, and community-level policies and programs. Indigenous participants in Alberta's Health Advisory Councils described Indigenous family caregivers as having more difficulty accessing support than other Alberta caregivers. In this article, we report on family caregivers', providers', and leaders' recommendations to support First Nations family caregivers and the health and community providers employed in First Nations. We used participatory action research methods in which we drew on Etuaptmumk (the understanding that being in the world is the gift of multiple perspectives) and that Indigenous and non-Indigenous views are complementary. Participants were from two First Nation communities in Alberta and included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). Participants advised that family caregivers needed four types of support: (1) recognize the family caregivers' role and work; (2) enhance navigation and timely access to services, (3) improve home care support and respite, and (4) provide culturally safe care. Participants had four recommendations to support providers: (1) support community providers' health and wellbeing; (2) recruit and retain health and community providers; (3) improve orientation for new providers; and (4) offer providers a comprehensive grounding in cultural awareness. While creating a program or department for family caregivers may be tempting to address caregivers' immediate needs, improving the health of First Nations family caregivers requires a population-based public health approach that focuses on meaningful holistic system change to support family caregivers.
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Affiliation(s)
- Amber Ward
- Faculty of Medicine, University of Victoria, Victoria, BC V6T 1Z3, Canada
| | | | | | - Tanya L'Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, Regina, SK S4S 0A2, Canada
| | - Peter G Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
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22
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Gaspar T, Raimundo M, de Sousa SB, Barata M, Cabrita T. Relationship between Burden, Quality of Life and Difficulties of Informal Primary Caregivers in the Context of the COVID-19 Pandemic: Analysis of the Contributions of Public Policies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:5205. [PMID: 36982114 PMCID: PMC10048817 DOI: 10.3390/ijerph20065205] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/06/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
The study aimed to characterize and understand the difficulties experienced by informal caregivers from a bio-psychosocial and environmental perspective, taking into account the socio-demographic and health characteristics of the informal caregiver and the person cared for, quality of life, perceived burden, social support, and the impact of the COVID-19 pandemic on the informal caregiver and the person cared for. The participants were 371 informal primary caregivers, 80.9% female, aged between 25 and 85 years, mean 53.17 (SD = 11.45) years. Only 16.4% of the informal caregivers benefited from monitoring and training for informal caregiver skills; 34.8% received information on the rights of the person being cared for; 7.8% received advice or guidance on the rights and duties of the informal caregiver; 11.9% of the caregivers benefited from psychological support; and 5.7% participated in self-help groups. A convenience sample was used, and data were collected via an online questionnaire. The main findings show that the major difficulties experienced by caregivers are related to social constraints, the demands of caring, and the reactions of the person cared for. The results reveal that the burden of the main informal caregivers is explained by the level of education, quality of life, level of dependence of the person cared for, level of difficulties, and social support. The COVID-19 pandemic impacted caregiving by increasing the perceived difficulty of accessing support services, such as consultations, services, and support; causing distress feelings in the caregiver, such as, anxiety and worry; increasing the needs and symptoms of the person cared for; and increasing the degree of isolation, for both, the informal caregiver and the person cared for.
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Affiliation(s)
- Tania Gaspar
- SPIC, Hei-Lab, Lusófona University, 1749-024 Lisbon, Portugal
- ISAMB, Medicine Faculty, Lisbon University, 1649-026 Lisbon, Portugal
| | - Marta Raimundo
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Sofia Borges de Sousa
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Marta Barata
- SPIC, Psychology and Life Sciences School, Lusófona University, 1749-024 Lisbon, Portugal
- Aventura Social Associação, 1649-026 Lisbon, Portugal
| | - Tulia Cabrita
- CLISSIS, Psychology Institute, Lusiada University, 1349-001 Lisbon, Portugal
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23
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Alreshidi SM, Rayani AM, Alhumaid AF. Diet Quality as a Mediator in the Relationship Between Perceived Stress and Depression Among Family Caregivers of Patients with Chronic Illness in Saudi Arabia. Int J Psychiatry Med 2023:912174231162749. [PMID: 36871959 DOI: 10.1177/00912174231162749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVE The aim of this research was to investigate the correlation between caregivers' perceived stress and depression and examine the mediating role of quality of diet on this relationship. METHODS A cross-sectional survey was performed in Medical City from January to August 2022 in the Kingdom of Saudi Arabia. Utilizing the Stress Scale, Anxiety and Depression, the Health Promoting Lifestyle Profile-II questionnaire, and the Patient Health Questionnaire-9, researchers assessed levels of perceived stress, diet quality, and depression. The bootstrap approach and the SPSS PROCESS macro were used to assess the importance of the mediation effect. The target population was family caregivers of patients with chronic illness at Medical City in Saudi Arabia. The researcher conveniently sampled 127 patients, with 119 responding, a response rate of 93.7%. A significant correlation between depression and perceived stress was observed (β = 0.438, p < 0.001). Diet quality mediated the relationship between depression and perceived stress (β = -0.187, p = 0.018). The importance of the indirect effect of perceived stress through diet quality was supported by the outcomes of the non-parametric bootstrapping method (95% bootstrap CI = 0.010, 0.080). The findings revealed that the indirect influence of diet quality explained 15.8% of the overall variation in depression. CONCLUSIONS These findings help clarify the mediating effects of diet quality on the relationship between perceived stress and depression.
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Affiliation(s)
- Salman M Alreshidi
- College of Nursing, 37850University of King Saud, Riyadh City, Saudi Arabia
| | - Ahmad M Rayani
- College of Nursing, 37850University of King Saud, Riyadh City, Saudi Arabia
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24
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Costi C, Hollingsworth B, O'Sullivan V, Zucchelli E. Does caring for others affect our mental health? Evidence from the COVID-19 pandemic. Soc Sci Med 2023; 321:115721. [PMID: 36827903 PMCID: PMC9872568 DOI: 10.1016/j.socscimed.2023.115721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/14/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Despite a growing literature about the mental health effects of COVID-19, less is known about the psychological costs of providing informal care during the pandemic. We examined longitudinal data from the UK's Understanding Society Survey, including eight COVID surveys, to estimate fixed effects difference-in-differences models combined with matching, to explore the causal effects of COVID-19 among informal carers. While matching accounts for selection on observables into caregiving, multiple period difference-in-differences specifications allow investigation of heterogeneous mental health effects of COVID-19 by timing and duration of informal care. The estimates suggest that while mental health fluctuated following the imposition of social restrictions, informal carers who started caregiving during the pandemic show the largest mental health deterioration, especially during lockdowns. Policies to mitigate the psychological burden of caregiving might be more effective if targeted at those starting to provide care for the first time.
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Affiliation(s)
- Chiara Costi
- Department of Economics, Lancaster University Management School (LUMS), Lancaster University, UK.
| | | | | | - Eugenio Zucchelli
- Madrid Institute for Advanced Study (MIAS) and Department of Economic Analysis, Universidad Autónoma de Madrid (UAM), Spain; IZA, Germany; Lancaster University, UK
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25
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Corallo F, Maresca G, Bonanno L, Lo Buono V, De Caro J, Bonanno C, Formica C, Quartarone A, De Cola MC. Importance of telemedicine in mild cognitive impairment and Alzheimer disease patients population during admission to emergency departments with COVID-19. Medicine (Baltimore) 2023; 102:e32934. [PMID: 36827032 PMCID: PMC9949366 DOI: 10.1097/md.0000000000032934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In March 2020, the World Health Organization declared a global pandemic due to the new coronavirus SARS-CoV-2, and several governments have planned a national quarantine to control the spread of the virus. Acute psychological effects during hospitalization in frail elderly individuals with special needs, such as patients with dementia, have been little studied. The greatest distress manifested by these kinds of patients was isolation from their families during hospitalization. Thus, structured video call interventions were carried out to family caregivers of patients diagnosed with dementia during their hospitalization in the COVID-19 ward. The purpose of this quasi-experimental study was to assess changes in cognitive and behavioral symptoms in both patients and caregivers. All study participants underwent psychological assessments. Specifically, the psychological well-being states of patients and their caregivers were measured at admission (T0) and discharge (T1) using psychometric tests and clinical scales. Each participant received an electronic device to access video calls in addition meetings were scheduled with the psychologist and medical team to keep caregivers updated on the health status of their relatives. A psychological support and cognitive rehabilitation service was also provided. Significant differences were found in all clinical variables of the caregiver group. Results showed a significant relationship in the quality of life score between the patient and caregiver groups. The results of this study has highlighted the importance of maintaining significantly effective relationships during the hospitalization period of patients admitted to COVID wards.
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Affiliation(s)
| | - Giuseppa Maresca
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
- * Correspondence: Giuseppa Maresca: IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy (e-mail: )
| | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
| | | | - Jolanda De Caro
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
| | - Carmen Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, Messina, Sicily, Italy
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26
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Acquati C, Head KJ, Rand KL, Alwine JS, Short DN, Cohee AA, Champion VL, Draucker CB. Psychosocial Experiences, Challenges, and Recommendations for Care Delivery among Partners of Breast Cancer Survivors: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2786. [PMID: 36833489 PMCID: PMC9956235 DOI: 10.3390/ijerph20042786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 01/28/2023] [Accepted: 01/30/2023] [Indexed: 06/18/2023]
Abstract
For women diagnosed with breast cancer, partners are consistently identified as the primary support person. Despite growing consensus about the psychosocial experience and unmet needs of cancer caregivers, limited evidence exists about strategies to offer partner-centered care across the cancer continuum. This study describes challenges endured by partners of breast cancer survivors (BCS), strategies implemented to manage these experiences, and recommendations for healthcare providers to inform targeted psychosocial care. Using convenience sampling, 22 partners of female BCS were recruited and completed semi-structured interviews. Conventional content analysis was used to code and synthesize findings. Participants described undergoing five experiences in their role as romantic partners: (a) assuming the role of caregiver, (b) becoming healthcare advocates for BCS, (c) connecting emotionally with the partner, (d) managing their own painful emotions, and (e) connecting with others for support. Experience-specific coping strategies and recommendations were identified. Romantic partners face multiple transitions across the cancer care continuum, which warrant investigation to sustain their well-being and active participation in illness management. Psychosocial interventions for this group will benefit from flexible implementation and attention to care delivery, mental health, and supportive/social needs.
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Affiliation(s)
- Chiara Acquati
- Graduate College of Social Work, University of Houston, Houston, TX 77004, USA
- Tilman J. Fertitta Family College of Medicine, University of Houston, Houston, TX 77004, USA
- Department of Health Disparities Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Katharine J. Head
- Department of Communication Studies, School of Liberal Arts, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | - Kevin L. Rand
- School of Science, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA
| | | | | | - Andrea A. Cohee
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
| | - Victoria L. Champion
- School of Nursing, Indiana University, Indianapolis, IN 46202, USA
- Melvin and Bren Simon Comprehensive Cancer Center, Indiana University, Indianapolis, IN 46202, USA
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Chew EYH, Ong ZL, Glass GF, Chan EY. '24/7' Caregiving: A Qualitative Analysis of an Emerging Phenomenon of Interest in Caregiving. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17046. [PMID: 36554924 PMCID: PMC9779682 DOI: 10.3390/ijerph192417046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The COVID-19 pandemic has exacerbated the difficulties faced by caregivers who have to provide continuous '24/7' care to persons with dementia with minimal formal and informal support. While caregivers have reported heightened levels of caregiving distress and burden during the pandemic, there remains a dearth of research pertaining to their lived experiences of providing continuous care with little respite and the corresponding physical, psychosocial and emotional impacts of caregiving '24/7'. The present study uses data obtained from interviews with dementia caregivers (N = seven) that were collected as part of a larger study on Carer Matters, a hospital-based holistic caregiver support program held during COVID-19, to conduct a secondary thematic analysis. The findings revealed three themes that defined the shared experiences of '24/7' caregivers: (1) A World Overturned, which refers to the increase in caregiving intensity and burden due to the pandemic; (2) Burning on Both Ends, which refers to the impossible balance between caregiving and their personal lives; and (3) At Wits' End, which refers to an overwhelming sense of hopelessness and helplessness over their caregiving situation. These findings highlight the challenges and unsustainability of '24/7' caregiving and the detrimental impact that round-the-clock care wields on caregivers' physical and mental well-being. Implications and recommendations are discussed in accordance with the cultural particularities of the study's Asian context (Singapore), with calls for greater caregiver support to be better integrated into society and the community, especially at the neighborhood and grassroots level, to alleviate caregiving burden and safeguard their well-being.
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Affiliation(s)
- Esther Yin Hui Chew
- Nursing Research Unit, Nursing Service, Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore 308443, Singapore
| | - Zhi Lei Ong
- Nursing Research Unit, Nursing Service, Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore 308443, Singapore
| | - George Frederick Glass
- Nursing Research Unit, Nursing Service, Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore 308443, Singapore
| | - Ee-Yuee Chan
- Nursing Research Unit, Nursing Service, Centre for Healthcare Innovation, Tan Tock Seng Hospital, Singapore 308443, Singapore
- Geriatric Education and Research Institute (GERI), Singapore 768024, Singapore
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28
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Liu CH, Chen YJ, Chen JS, Fan CW, Hsieh MT, Lin CY, Pakpour AH. Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19. BMC Geriatr 2022; 22:958. [PMID: 36514006 PMCID: PMC9745281 DOI: 10.1186/s12877-022-03675-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Caregivers have faced unprecedented circumstances throughout the COVID-19 pandemic, but previous research only minimally addresses the caregivers' burden. Therefore, this study aimed to investigate the relationship between caregiver burden, psychological stress, satisfaction with support, and fear of COVID-19 in caregivers of patients with stroke during the pandemic. METHODS A cross-sectional survey study with total of 171 caregivers of patients with stroke in a community hospital in Taiwan. All participants completed the Zarit Burden Interview, Depression, Anxiety, Stress Scale (DASS-21), satisfaction of support survey, and Fear of COVID-19 Scale. Pearson correlations were used to examine the bivariate correlations between study variables. Then, with the control of demographic confounders, a multiple linear regression model was applied with significant variables to construct and explain caregiver burden. RESULTS The proposed model significantly explained the caregiver burden of caregivers of patients with stroke. Specifically, the caregiver burden was negatively correlated with satisfaction with family support, but positively with psychological distress and the fear of COVID-19. CONCLUSIONS Caregivers of patients with stroke will suffer a greater burden if they have lower satisfaction with family support, experienced higher psychological distress, and perceived more fear of the COVID-19 pandemic. Health professionals must address these concerns, support caregivers, and enhance available resources.
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Affiliation(s)
- Chieh-hsiu Liu
- grid.416911.a0000 0004 0639 1727Department of Family Medicine, Taoyuan General Hospital, Ministry of Health and Welfare, Taoyuan, Taiwan
| | - Yi-Jung Chen
- grid.64523.360000 0004 0532 3255Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701 Taiwan
| | - Jung-Sheng Chen
- grid.414686.90000 0004 1797 2180Department of Medical Research, E-Da Hospital, Kaohsiung, 82445 Taiwan
| | - Chia-Wei Fan
- Department of Occupational Therapy, AdventHealth University, Orlando, Florida USA
| | - Meng-Tsang Hsieh
- grid.414686.90000 0004 1797 2180Stroke Center and Department of Neurology, E-Da Hospital, Kaohsiung, 82445 Taiwan ,grid.411447.30000 0004 0637 1806School of Medicine, College of Medicine, I-Shou University, Kaohsiung, 82445 Taiwan ,grid.64523.360000 0004 0532 3255Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, 70101 Taiwan
| | - Chung-Ying Lin
- grid.64523.360000 0004 0532 3255Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 701 Taiwan ,grid.64523.360000 0004 0532 3255Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan ,grid.64523.360000 0004 0532 3255Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Amir H. Pakpour
- grid.118888.00000 0004 0414 7587Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Carer distress among community living older adults with complex needs in the pre- and post-COVID-19 era: a national population study. Sci Rep 2022; 12:19697. [PMID: 36385630 PMCID: PMC9668208 DOI: 10.1038/s41598-022-24073-0] [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: 06/17/2022] [Accepted: 11/09/2022] [Indexed: 11/18/2022] Open
Abstract
Carer distress is one important negative impact of caregiving and likely exacerbated by the novel coronavirus disease 2019 (COVID-19) pandemic, yet little population-based epidemiological information exists. Using national data from repeated standardized comprehensive geriatric needs assessments, this study aims to: describe the pattern of caregiver distress among those providing informal care to community-living adults aged ≥ 65 years with complex needs in New Zealand over time; estimate the COVID-19 effect on this temporal pattern; and, investigate relationships between participants' sociodemographic and selected health measures on caregiver distress. Fractional polynomial regression and multivariable multilevel mixed-effects models were employed. Overall, 231,277 assessments from 144,358 participants were analysed. At first assessment, average age was 82.0 years (range 65-107 years), and 85,676 (59.4%) were female. Carer distress prevalence increased from 35.1% on 5 July 2012 to a peak of 48.5% on 21 March 2020, when the New Zealand Government announced a national lock-down. However, the population attributional fraction associated with the COVID-19 period was small, estimated at 0.56% (95% CI 0.35%, 0.77%). Carer distress is common and has rapidly increased in recent years. While significant, the COVID-19 impact has been relatively small. Policies and services providing efficacious on-going strategies to support caregivers deserves specific attention.
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30
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Bergmann M, Hecher MV, Sommer E. The impact of the COVID-19 pandemic on the provision of instrumental help by older people across Europe. FRONTIERS IN SOCIOLOGY 2022; 7:1007107. [PMID: 36439079 PMCID: PMC9682231 DOI: 10.3389/fsoc.2022.1007107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/18/2022] [Indexed: 06/16/2023]
Abstract
The outbreak of the COVID-19 pandemic in early 2020 introduced new challenges to social cohesion across Europe. Epidemiological control measures instituted in almost all European countries have impacted the possibility to provide help to others. In addition, individual characteristics contributed to whether individuals were able and willing to provide help to or receive help from others. Against this background, we focus on how private support networks of individuals aged 50 years and older across Europe were directly or indirectly affected by the COVID-19 pandemic. The focus of the paper is on the supply side. While the older population has been mainly perceived as recipients of instrumental help in the COVID-19 pandemic, the paper examines the patterns of providing instrumental help to others by the older generations and their changes during the pandemic. Has the provision of instrumental help increased or decreased in the course of the COVID-19 crisis? Have the groups of recipients changed during the pandemic? What were key determinants for helping others in 2021 as compared to the first phase of the pandemic 1 year before? And how did this differ across countries with different degrees of affectedness by COVID-19? To answer these questions, we analyzed representative data from the Survey of Health, Aging and Retirement in Europe (SHARE) and, in particular, the two waves of the SHARE Corona Survey, fielded in 27 European countries and Israel in 2020 and 2021. Results based on data from more than 45,000 respondents aged 50+ showed that help from children to parents has strongly increased in the first phase of the pandemic, while the opposite (parents helping their children) has decreased-especially in countries that have been hit hardest by the pandemic in 2020. This changed with the continuing crisis. Instrumental help provided to non-kin that was common in Western Europe in the first phase of the pandemic, yielding an optimistic view of increasing solidarity after the outbreak of COVID-19, strongly decreased 1 year later. Our findings provide a contribution to comparative research on micro- and macro-determinants that are crucial for the understanding of intergenerational support in times of crisis.
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Affiliation(s)
- Michael Bergmann
- Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Munich, Germany
- Chair for the Economics of Aging, Technical University of Munich, Munich, Germany
| | - Magdalena Viktoria Hecher
- Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Munich, Germany
| | - Elena Sommer
- Munich Center for the Economics of Aging (MEA), Max Planck Institute for Social Law and Social Policy, Munich, Germany
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Hvalič-Touzery S, Trkman M, Dolničar V. Caregiving Situation as a Predictor of Subjective Caregiver Burden: Informal Caregivers of Older Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14496. [PMID: 36361373 PMCID: PMC9655837 DOI: 10.3390/ijerph192114496] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/26/2022] [Accepted: 11/03/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to investigate how a caregiving situation's characteristics predict the subjective burden of care in times of COVID-19. The study was conducted in April and May 2021 via an online access panel. The sample (n = 612) was determined using a screening test that enabled us to focus on a Slovenian population of informal caregivers aged 40+ caring for a person aged 65+ for at least four hours/week on average. Our findings reveal that the subjective burden of care was high among informal caregivers during COVID-19. Multiple regression analysis showed that the provision of activities of daily living, care duration, average hours of care per week, formal care status, and recipients' health problems related to dementia or other memory problems significantly predicted the subjective burden of caregivers. These findings call for better recognition of the role of informal caregivers. The time and effort devoted to informal care should be supported by legislation and social security.
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Hoogendijk EO, Schuster NA, van Tilburg TG, Schaap LA, Suanet B, De Breij S, Kok AA, Van Schoor NM, Timmermans EJ, de Jongh RT, Visser M, Huisman M. Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults. BMJ Open 2022. [PMID: 36323473 DOI: 10.1136/bmjopen-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
OBJECTIVES The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning. DESIGN Cross-sectional study. SETTING The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands. PARTICIPANTS Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic. PRIMARY OUTCOME MEASURES A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness). RESULTS The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile. CONCLUSIONS Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.
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Affiliation(s)
- Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Noah A Schuster
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Theo G van Tilburg
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bianca Suanet
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sascha De Breij
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Almar Al Kok
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Natasja M Van Schoor
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Renate T de Jongh
- Department of Internal Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Hoogendijk EO, Schuster NA, van Tilburg TG, Schaap LA, Suanet B, De Breij S, Kok AA, Van Schoor NM, Timmermans EJ, de Jongh RT, Visser M, Huisman M. Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults. BMJ Open 2022; 12:e061745. [PMID: 36323473 PMCID: PMC9638742 DOI: 10.1136/bmjopen-2022-061745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning. DESIGN Cross-sectional study. SETTING The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands. PARTICIPANTS Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic. PRIMARY OUTCOME MEASURES A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness). RESULTS The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile. CONCLUSIONS Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.
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Affiliation(s)
- Emiel O Hoogendijk
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Noah A Schuster
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Theo G van Tilburg
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Laura A Schaap
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bianca Suanet
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sascha De Breij
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Almar Al Kok
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Natasja M Van Schoor
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Erik J Timmermans
- Julius Center for Health Sciences and Primary Care, Utrecht University Medical Center, Utrecht, The Netherlands
| | - Renate T de Jongh
- Department of Internal Medicine, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Martijn Huisman
- Department of Epidemiology & Data Science, Amsterdam Public Health research institute, Amsterdam UMC, Location VUmc, Amsterdam, The Netherlands
- Department of Sociology, Faculty of Social Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Does the provision of informal care matter for caregivers' mental health? Evidence from China. Geriatr Nurs 2022; 48:14-23. [PMID: 36095887 DOI: 10.1016/j.gerinurse.2022.08.006] [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: 05/26/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 12/14/2022]
Abstract
This paper investigates the causal effect of informal care on the mental health of caregivers and disentangles the mechanisms of such effect. Using 2011-2018 CHARLS data, the fixed effects and instrumental variable approaches was conducted to address fundamental endogeneity problems. This study found that there was no impact of informal caregiving on caregivers' mental health in general. However, the intensity of caregiving was shown to negatively impair mental health. The impact of informal caregiving varied by kinship, cultural context, and residential area. Participation in social and exercise activities and life satisfaction mediated the association between the provision of informal care and caregivers' mental health. Long-term care insurance and the provision of formal care substantially modified the negative impacts of informal caregiving.
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Zwar L, König HH, Hajek A. Conspiracy mentality among informal caregivers as a risk factor for caregiver burden, mental health, perceived loneliness and social isolation during the COVID-19 pandemic: findings of a representative online study from Germany. Qual Life Res 2022; 31:3139-3151. [PMID: 35789451 PMCID: PMC9255449 DOI: 10.1007/s11136-022-03177-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/17/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to analyze if and how conspiracy mentality is associated with mental health, burden and perceived social isolation and loneliness of informal caregivers of older individuals with care needs. METHODS A quantitative, cross-sectional study was conducted. Participants had to be at least 40 years of age and were drawn randomly from the German online panel forsa.omninet and questioned between the 4th and 19th of March 2021. A sample of 489 informal caregivers (relatives and non-relatives supporting individuals aged ≥ 60 years) was questioned. Conspiracy mentality, depressive symptoms, loneliness and social exclusion were measured with validated instruments (e.g., The Conspiracy Mentality Questionnaire). Questions referred to the last three months prior to assessment. Multiple linear regression analyses, adjusted for sociodemographic, economic and health factors and indicators of the pandemic, were conducted. RESULTS Findings indicate a significant positive association between conspiracy mentality and caregiver burden, loneliness, social exclusion, and depressive symptoms. No gender differences were found for any outcome. CONCLUSIONS The results indicate that conspiracy mentality could be a risk factor for mental health, perceived social isolation and loneliness, and contribute to increased caregiver burden among informal caregivers of older care recipients during the COVID-19 pandemic. Accordingly, informal caregivers could benefit from actions focused on reducing conspiracy mentality during a health crisis, which could improve psychosocial health and wellbeing in this vulnerable group.
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Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
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Chyu J, Cantu P, Mehta N, Markides K. Caregiving for People With Dementia or Cognitive Impairment During the COVID-19 Pandemic: A Review. Gerontol Geriatr Med 2022; 8:23337214221132369. [PMID: 36299916 PMCID: PMC9585366 DOI: 10.1177/23337214221132369] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic has been a major source of stress for informal caregivers
for people with dementia. Studies show the unique challenges caregivers face,
such as social isolation, extended work hours, and adherence to public health
guidelines. We conducted a narrative review of factors impacting well-being of
informal caregivers of older adults with dementia during the COVID-19 pandemic.
Sixty-four papers were identified as published between June 2020 and December
2021. All studies were conducted in the U.S. or other Western countries and were
cross-sectional and conducted prior to COVID-19 vaccines. Articles highlighted
increasing burdens such as financial and physical stress, as well as worsened
psychological well-being from anxiety and depression. Protective factors such as
social support and telehealth interventions also emerged. Limitations include
lack of longitudinal information to identify broader themes on caregiving during
the pandemic. Studies not only identified new, pandemic-related risk factors,
but also a heightened effect of pre-existing risk factors (e.g., income, living
situation) on caregiver burden.
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Affiliation(s)
- Joanna Chyu
- University of Texas Medical Branch,
Galveston, USA
| | - Philip Cantu
- University of Texas Medical Branch,
Galveston, USA
| | - Neil Mehta
- University of Texas Medical Branch,
Galveston, USA
| | - Kyriakos Markides
- University of Texas Medical Branch,
Galveston, USA,Kyriakos Markides, School for Public and
Population Health, University of Texas Medical Branch, Galveston, TX 77551, USA.
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Egan KJ, Hodgson W, Imperatore G, Dunlop MD, Maguire R, Kirk A. Supporting Physical Activity for Informal Caregivers during and beyond COVID-19: Exploring the Feasibility, Usability and Acceptability of a Digital Health Smartphone Application, 'CareFit'. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12506. [PMID: 36231803 PMCID: PMC9565999 DOI: 10.3390/ijerph191912506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 06/16/2023]
Abstract
The COVID-19 pandemic has exposed how our global societies rely upon the care and support of informal (unpaid) caregivers: in the UK alone, there are an estimated 6.5 million informal carers. The caring role is not just precarious, it is often associated with high levels of stress, poor/deteriorating health and crisis points (hospitalisations, worsening of health). Fittingly, there has been much research in recent years focusing on mental health supports. A lesser explored area is physical health and physical activity. To address this, we conducted a real-world feasibility, usability and acceptability study of a novel codesigned digital health app for caregivers to improve levels of physical activity. Our study was designed to test the prototype app use for three weeks, following participants across questionnaires/in app data/qualitative data. Our findings (from 27 caregivers) highlights key knowledge gaps around physical activity-national guidelines were not reaching populations studies and behavioural change techniques hold promise to help support caregivers in the longer term. Our collective results support the acceptability, usability and feasibility of the Carefit app and warrant further investigation.
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Affiliation(s)
- Kieren J. Egan
- Department of Computer and Information Science, University of Strathclyde, Glasgow G1 1XQ, UK
| | - William Hodgson
- Physical Activity for Health Group, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Gennaro Imperatore
- Department of Computer and Information Science, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Mark D. Dunlop
- Department of Computer and Information Science, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Roma Maguire
- Department of Computer and Information Science, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Alison Kirk
- Physical Activity for Health Group, University of Strathclyde, Glasgow G1 1XQ, UK
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Afshari P, Beheshti-Nasab M, Maraghi E, Sadeghi S, Sanjari N, Zarea K. Home care in COVID-19 patients with the home-quarantined condition: A study from Iran. Front Public Health 2022; 10:952618. [PMID: 36148335 PMCID: PMC9485635 DOI: 10.3389/fpubh.2022.952618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 08/01/2022] [Indexed: 01/24/2023] Open
Abstract
Objectives During the COVID-19 home-quarantines, home care services may act as an auxiliary component of health care system, which reduces the burden on the formal health care system. This study aimed to investigate the status of informal home care provided for home quarantined patients with COVID-19 in southwest Iran. Methods This descriptive study was conducted on 288 patients with COVID-19 in Ahvaz (southwest Iran). Inclusion criteria included a known case of COVID-19, willingness to participate in the study, recommendation of home quarantine from a health center, having a smartphone, and fluency in reading and writing in Persian, and the exclusion criterion was a history of COVID-19 longer than 3 months. The data collection method was structured interviews based on a questionnaire (face-to-face-telephone calls-video call). SPSS software was used for the analysis of data. Results 45.5% of the participants in the study were women with a mean age of 37.82 (10.48%) and 55.5% were men with a mean age of 36.12 (11.93%). Findings showed that in most cases, the spouse (61.4) is responsible for the care of the patient, and in other cases, parents are responsible for this duty. 57.3% of the patients stated that they themselves had to leave home to provide for necessities of life, and 37.2% stated that they were in charge of cooking. 47.9% of the patients evaluated the quality of quality of care provided at home as good. Most of patients and caregivers referred to hospital for getting information (35.8% patients and 34% caregivers). Most of patients recovered from diseases (60.8%) and 39.2% were hospitalized. Although 43.9% of men and 33.6% of women were hospitalized and a there was a significant difference between men and women (P < 0.04). Conclusion During COVID-19 pandemic home care to reduce the burden on the health system are very important. We must also know that this type of care requires informed and planned support and sufficient community education. The health care system needs to put self-care and family care among its top priorities. The focus should be on educational and mental support of informal caregivers along with measures that protect their relatives from COVID-19.
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Affiliation(s)
- Poorandokht Afshari
- Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Beheshti-Nasab
- Nursing and Midwifery Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Maraghi
- Department of Biostatistics and Epidemiology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Simin Sadeghi
- Imam Khomeini Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | | | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Brugiavini A, Di Novi C, Orso CE. Visiting parents in times of COVID-19: The impact of parent-adult child contacts on the psychological health of the elderly. ECONOMICS AND HUMAN BIOLOGY 2022; 46:101152. [PMID: 35700656 PMCID: PMC9172389 DOI: 10.1016/j.ehb.2022.101152] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/20/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Using the 8th wave of the SHARE and the SHARE Corona Survey, we investigated whether the disruption of parent-adult child contacts due to social distancing restrictions increased the symptoms of depression among old age individuals during the first wave of the COVID-19 pandemic. We model the relationship between the disruption of parent-adult child contacts and the mental health of the elderly using a recursive simultaneous equation model for binary variables. Our findings show that the likelihood of disruption of parent-adult child contacts was higher with adult children who do not live with or close to their parents (i.e., in the same household or in the same building) for whom contact disruption increases about 15 %. The duration of restrictions to movement and lockdowns also has a positive and significant effect on parent-child contact disruption: an additional week of lockdown significantly increases the probability of parent-child contact disruption, by about 1.5 %. The interventions deemed essential to reduce the spread of the pandemic, such as the "stay-at-home" order, necessarily disrupted personal parent-child contacts and the social processes that facilitate psychological well-being, increasing the probability of suffering from a deepening depressed mood by about 17 % for elderly parents.
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Affiliation(s)
- Agar Brugiavini
- Department of Economics, Ca' Foscari University of Venice, Italy
| | - Cinzia Di Novi
- European Commission, Joint Research Centre (JRC), Ispra, Italy.
| | - Cristina Elisa Orso
- Department of Law, Economics, and Cultures, Insubria University, Como, Italy
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Anderson S, Parmar J, L’Heureux T, Dobbs B, Charles L, Tian PGJ. Family Caregiving during the COVID-19 Pandemic in Canada: A Mediation Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148636. [PMID: 35886490 PMCID: PMC9317413 DOI: 10.3390/ijerph19148636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/10/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022]
Abstract
Family caregiving is a public health issue because of caregivers’ significant contribution to the health and social care systems, as well as the substantial impact that giving and receiving care has on the health and quality of life of care receivers and caregivers. While there have been many studies that associate caregivers’ care work, financial difficulty, navigation, and other caregiving factors with family caregivers’ psychological distress, we were interested not only in the factors related to family caregiver anxiety but also in hypothesizing how those effects occur. In this study, we used Andrew Hayes’ PROCESS moderation analysis to explore the link between caregiver frailty, weekly care hours, and perceptions of financial difficulty, social support, and anxiety. In this analysis, we included 474 caregivers with relatively complete data on all of the variables. In regression analysis after controlling for gender and age, social loneliness (β = 0.245), frailty (β = 0.199), financial difficulty (β = 0.196), care time (β = 0.143), and navigation confidence (β = 0.131) were all significant. We then used PROCESS Model 6 to determine the significance of the direct, indirect, and total effects through the serial mediation model. The model pathway from frailty to care time to financial difficulty to social loneliness to anxiety was significant. The proportions of family caregivers who were moderately frail, anxious, and experiencing social loneliness after eighteen months of the COVID-19 pandemic found in this survey should be of concern to policymakers and healthcare providers.
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Affiliation(s)
- Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Correspondence:
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
| | - Tanya L’Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
| | - Bonnie Dobbs
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
- Medically At-Risk Driver Centre, University of Alberta, Edmonton, AB T5G 2T4, Canada
- Alberta Health Services, Edmonton, AB T5G 0B7, Canada
| | - Peter George J. Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T5G 2T4, Canada; (J.P.); (T.L.); (B.D.); (L.C.); (P.G.J.T.)
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Testing the informal care model: intrapersonal change in care provision intensity during the first lockdown of the COVID-19 pandemic. Eur J Ageing 2022; 19:1287-1300. [PMID: 36692758 PMCID: PMC9213212 DOI: 10.1007/s10433-022-00713-2] [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] [Accepted: 05/23/2022] [Indexed: 01/26/2023] Open
Abstract
Informal care, meaning taking health-related care of people in their own social network, is a topic that gets more and more attention in social science research because the pressure on people to provide informal care is rising due to ageing societies and policy changes. The Informal Care Model developed by Broese van Groenou and de Boer (Eur J Ageing 13(3):271-279, 2016) provides a theoretical foundation to understand under what conditions a person provides informal care. We test this theoretical model by applying it to intrapersonal changes in informal care provision during the first COVID-19 lockdown in the Netherlands in Spring 2020. Data from the LISS panel from two time points, March 2020 and data from July over the period of April/May 2020, were analysed with multinominal multilevel regression analysis (N = 1270 care situations of 1014 caregivers). Our results showed that the individual determinants (Do I have to?, Do I want to?, and especially Can I?) discussed in the Informal Care Model (apart from a series of control variables) are contributing substantially to the understanding of intrapersonal changes in care provision during the first lockdown and by that, we found empirical support for the theoretical model. We conclude that on top of its original purpose to explain between-individual differences in informal caregiving using static indicators, the Informal Care Model is also useful to explain intrapersonal changes in informal caregiving using dynamic indicators.
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Grycuk E, Chen Y, Almirall‐Sanchez A, Higgins D, Galvin M, Kane J, Kinchin I, Lawlor B, Rogan C, Russell G, O'Sullivan R, Leroi I, on the behalf of the CLIC Caregiver study group. Care burden, loneliness, and social isolation in caregivers of people with physical and brain health conditions in English-speaking regions: Before and during the COVID-19 pandemic. Int J Geriatr Psychiatry 2022; 37:10.1002/gps.5734. [PMID: 35574817 PMCID: PMC9324775 DOI: 10.1002/gps.5734] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 04/27/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Public health restrictions due to the COVID-19 (SARS CoV-2) pandemic have disproportionately affected informal caregivers of people living with long term health conditions. We aimed to explore levels of care burden, loneliness, and social isolation among caregivers of people with enduring physical and brain health conditions in English-speaking regions worldwide, by investigating outcomes before and during the COVID-19 pandemic. METHODS A cross-sectional anonymous online survey data from 2287 English-speaking caregivers of people with long term health conditions from four English-speaking regions (UK, Ireland, USA, New Zealand) included measures of care burden, loneliness, and social isolation, reported before and during the COVID-19 pandemic. Analyses were descriptive, followed by an ordinal regression model for predictors of burden. RESULTS Compared to pre-pandemic levels, all caregivers experienced a significant increase in burden, loneliness, and isolation. Caregivers of people with both brain health and physical conditions were the most burdened and had the highest levels of loneliness and isolation compared to caregivers of people with either a brain health or physical condition only. The increase in care burden among caregivers of people with brain health challenges was associated with caregiver's gender, moderate and severe emotional loneliness, magnitude and frequency of isolation during the pandemic, and care circumstances (cohabitation with the care recipient, restrictions on the ability to provide care). CONCLUSIONS Health and social care interventions should target caregivers' care circumstances and psychological outcomes, particularly in women, accounting for the significant additional burden of care, loneliness, and isolation resulting from pandemic-related restrictions.
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Affiliation(s)
- Emilia Grycuk
- Department of PsychiatrySchool of MedicineTrinity College DublinDublinIreland
| | - Yaohua Chen
- Global Brain Health InstituteTrinity College DublinDublinIreland,Lille CHU Univ. Lille, Inserm, CHU Lille, Lille Neurosciences & CognitionUMR‐S1172Degenerative and Vascular Cognitive DisordersLilleFrance
| | | | - Dawn Higgins
- Global Brain Health InstituteTrinity College DublinDublinIreland,Department of PsychologyMaynooth UniversityMaynoothIreland
| | - Miriam Galvin
- Global Brain Health InstituteTrinity College DublinDublinIreland,Academic Unit of NeurologyTrinity College DublinDublinIreland
| | - Joseph Kane
- Centre for Public HealthQueen's University BelfastBelfastUK
| | - Irina Kinchin
- Global Brain Health InstituteTrinity College DublinDublinIreland,Center for Health Policy and ManagementTrinity College DublinDublinIreland,University of Technology SydneyUltimoNew South WalesAustralia
| | - Brian Lawlor
- Global Brain Health InstituteTrinity College DublinDublinIreland
| | - Carol Rogan
- Dementia Research Network IrelandSchool of MedicineTrinity College DublinDublinIreland
| | - Gregor Russell
- Yorkshire and Humber NIHR Clinical Research NetworkNorthern IrelandUK
| | - Roger O'Sullivan
- Institute of Public HealthBelfastIreland,Ulster UniversityColeraineUK
| | - Iracema Leroi
- Department of PsychiatrySchool of MedicineTrinity College DublinDublinIreland,Global Brain Health InstituteTrinity College DublinDublinIreland
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Medina-Perucha L, López-Jiménez T, Holst AS, Jacques-Aviñó C, Munrós-Feliu J, Martínez-Bueno C, Valls-Llobet C, Pinzón-Sanabria D, Vicente-Hernández MM, Berenguera A. Self-Reported Menstrual Alterations During the COVID-19 Syndemic in Spain: A Cross-Sectional Study. Int J Womens Health 2022; 14:529-544. [PMID: 35444473 PMCID: PMC9013667 DOI: 10.2147/ijwh.s354655] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/18/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Available evidence suggests that there might be an association between the stressors experienced during the COVID-19 syndemic and changes in menstrual patterns. The aim of this study was to assess self-reported menstrual alterations during the COVID-19 syndemic among women and people who menstruate aged 18-55 in Spain. Materials and Methods A cross-sectional online survey-based study was conducted (March-July 2021). Descriptive statistics were calculated and multivariate logistic regression models were constructed. This study was conducted as part of the "Equity and Menstrual Health in Spain" research project. Results Among participants (N=17,455), 39.4% reported menstrual alterations since the start of the syndemic. Participants self-reporting long COVID-19 presented higher odds of menstrual alterations (aOR: 1.34, 95% CI, 1.15-1.57). In participants with no history of COVID-19, the risk for self-reported menstrual alterations was significantly higher based on employment situation, among participants experiencing financial issues (eg, financial issues always/many times <12 months: aOR: 1.68, 95% CI, 1.48-1.90), poorer self-perceived health (eg, poor: aOR: 2.00, 95% CI, 1.31-3.07), and those diagnosed with polycystic ovary syndrome (aOR: 1.13, 95% CI, 1.02-1.26). Among participants with a self-reported COVID-19 diagnosis, factors that significantly increased the odds for menstrual alterations were experiencing financial strains (eg, financial issues always/many times <12 months: aOR: 1.53, 95% CI, 1.09-2.14), poorer self-perceived health (eg, poor: aOR: 3.09, 95% CI, 1.01-9.52). Overall, factors that decreased the odds of reporting menstrual alterations included age >25, being a carer, not having a gynecological condition and using hormonal contraception. Discussion and conclusions Findings suggest an impact of the COVID-19 syndemic on menstrual patterns. Social inequities in reporting menstrual alterations were identified. While the risk of reporting menstrual alterations was higher among participants with long COVID-19, evidence is not conclusive. Further research on menstrual health in the context of COVID-19 is needed, also to inform policy and practice.
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Affiliation(s)
- Laura Medina-Perucha
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Tomàs López-Jiménez
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Anna Sofie Holst
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Constanza Jacques-Aviñó
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain
| | - Jordina Munrós-Feliu
- Atenció a la Salut Sexual i Reproductiva (ASSIR) Muntanya/La Mina, Institut Català de la Salut, Barcelona, Spain.,Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain
| | - Cristina Martínez-Bueno
- Sexual and Reproductive Health Care Research Group (GRASSIR), Barcelona, Spain.,Servei d'Atenció a la Salut Sexual i Reproductiva (ASSIR), Direcció Assistencial d'Atenció Primària, Institut Català de la Salut, Barcelona, Spain
| | | | | | | | - Anna Berenguera
- Fundació Institut Universitari per a la recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.,Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Barcelona, Spain.,Departament d'Infermeria, Universitat de Girona, Girona, Spain
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Understanding the Economic Value and Impacts on Informal Carers of People Living with Mental Health Conditions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052858. [PMID: 35270554 PMCID: PMC8910204 DOI: 10.3390/ijerph19052858] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/21/2022] [Accepted: 02/24/2022] [Indexed: 01/18/2023]
Abstract
Informal carers play a vital role in supporting people living with mental health conditions, but comparatively little is known about the economic value of caring. This study undertook an online survey of adult informal carers supporting adults with mental health conditions to better understand the impacts of caring on carer quality of life, levels of loneliness, finances and employment, as well as estimate the economic value of time spent caring. In total, 712 carers participated in the multi-national survey between August 2019 and April 2020. A total of 17% were male, with a mean age of 53, and 68% supported a child living with a mental health condition. A total of 56% of care recipients were male, with a mean age of 37. Adverse impacts on quality of life, loneliness and personal finances were greatest in carers living with care recipients. Overall mean weekly hours of care were 43.42, rising to 65.41 for carers living with care recipients. Mean weekly costs of care per carer ranged from €660 to €2223 depending on living arrangements. Annual costs ranged between €34,960 and €125,412, depending on living arrangements and valuation method. Informal care costs are substantial, and policy makers should consider investing more in carer support, especially for carers living with care recipients.
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A Brain-Computer Interface for Teleoperation of a Semiautonomous Mobile Robotic Assistive System Using SLAM. JOURNAL OF ROBOTICS 2022. [DOI: 10.1155/2022/6178917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The proposed assistive hybrid brain-computer interface (BCI) semiautonomous mobile robotic arm demonstrates a design that is (1) adaptable by observing environmental changes with sensors and deploying alternate solutions and (2) versatile by receiving commands from the user’s brainwave signals through a noninvasive electroencephalogram cap. Composed of three integrated subsystems, a hybrid BCI controller, an omnidirectional mobile base, and a robotic arm, the proposed robot has commands mapped to the user’s brainwaves related to a set of specific physical or mental tasks. The implementation of sensors and the camera systems enable both the mobile base and the arm to be semiautonomous. The mobile base’s SLAM algorithm has obstacle avoidance capability and path planning to assist the robot maneuver safely. The robot arm calculates and deploys the necessary joint movement to pick up or drop off a desired object selected by the user via a brainwave controlled cursor on a camera feed. Validation, testing, and implementation of the subsystems were conducted using Gazebo. Communication between the BCI controller and the subsystems is tested independently. A loop of prerecorded brainwave data related to each specific task is used to ensure that the mobile base command is executed; the same prerecorded file is used to move the robot arm cursor and initiate a pick-up or drop-off action. A final system test is conducted where the BCI controller input moves the cursor and selects a goal point. Successful virtual demonstrations of the assistive robotic arm show the feasibility of restoring movement capability and autonomy for a disabled user.
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Degraded Psychophysiological Status in Caregivers and Human Resources Staff during a COVID-19 Peak Unveiled by Psychological and HRV Testing at Workplace. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031710. [PMID: 35162733 PMCID: PMC8835268 DOI: 10.3390/ijerph19031710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 12/04/2022]
Abstract
During COVID-19 pandemic peaks, healthcare professionals are a frontline workforce that deals with death on an almost daily basis and experiences a marked increase in workload. Returning home is also associated with fear of contaminating or be contaminated. An obvious consequence is stress accumulation and associated risks, especially in caregivers in mobility and possibly in human resource teams managing mobility. Here, during the second pandemic peak, we designed a 15-min testing procedure at the workplace, combining HADS and Brief COPE questionnaires with heart rate variability (HRV) recordings to evaluate psychophysiological status in four groups: caregivers in mobility (MOB); human resources teams managing mobility (ADM); caregivers without mobility (N-MOB); and university researchers teaching online (RES). Anxiety, depression, coping strategies, vagally-mediated heart rate regulation, and nonlinear dynamics (entropy) in cardiac autonomic control were quantified. Anxiety reached remarkably high levels in both MOB and ADM, which was reflected in vagal and nonlinear HRV markers. ADM maintained a better problem-solving capacity. MOB and N-MOB exhibited degraded problem-solving capacity. Multivariate approaches show how combining psychological and physiological markers helps draw highly group-specific psychophysiological profiles. Entropy in HRV and problem-solving capacity were highly relevant for that. Combining HADS and Brief COPE questionnaires with HRV testing at the workplace may provide highly relevant cues to manage mobility during crises as well as prevent health risks, absenteeism, and more generally malfunction incidents at hospitals.
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Daly M. COVID-19, Social Policy and Care: A Complex Set of Processes and Outcomes. FRONTIERS IN SOCIOLOGY 2022; 6:808239. [PMID: 35127890 PMCID: PMC8812826 DOI: 10.3389/fsoc.2021.808239] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 12/20/2021] [Indexed: 06/02/2023]
Abstract
This article looks at the 2020 period of COVID-19 and especially the first months through the lens of public policy support for care in Europe. It covers the policy responses to both care for young children and frail, ill or disabled adults and develops an understanding of care as welfare-related activity focused on practices and resources oriented to meeting care-related need. The article's over-arching research question centres around how European countries responded to the 2020 pandemic, especially in regard to the types of care need that were recognized, the resources committed, the actors/agency that were supported or taken for granted and the values underpinning the responses. What we find from the review is that, while care assumed a strong place in public rhetoric, this was not reflected in greater public resourcing of care for young children or long-term care. Instead, care for children was refamilialized and long-term care was under-resourced and relegated to a secondary position; both were in many ways rendered further dependent on the private agency of individuals. In sum, the pandemic spearheaded some reversion to old practices and the opportunity to invest in care as a human need, a basis of rights and entitlements and a valued activity was not availed of.
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Messina A, Lattanzi M, Albanese E, Fiordelli M. Caregivers of people with dementia and mental health during COVID-19: findings from a cross-sectional study. BMC Geriatr 2022; 22:56. [PMID: 35034607 PMCID: PMC8761089 DOI: 10.1186/s12877-022-02752-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 01/04/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND There is sparse evidence on the impact on vulnerable populations of the COVID-19 pandemic. The aim of our study was to explore burden and mental wellbeing (including depressive, anxiety, and stress symptoms) in caregivers of people with dementia during the first wave of the pandemic in Italy and southern Switzerland, two bordering regions severely hit by the COVID-19 pandemic. METHODS We conducted an online cross-sectional survey with family carers of people with dementia between May and June 2020. We registered socio-demographic characteristics, and information about the relationship with the care recipient, dementia subtype, care inputs from others, and the need of care of the person with dementia. We measured caregiver burden with the Zarit Burden Interview (ZBI), psychological distress with the Depression, Anxiety and Stress Scale (DASS-21), and perceived isolation with the 3-item UCLA Loneliness Scale (UCLALS3). RESULTS Caregivers (N =571) reported moderate to severe care-related burden (mean=54.30; SD=18.33), moderate anxiety symptoms (mean=10.04; SD=6.93), mild depressive symptoms (mean=11.79; SD=6.12) and mild stress (mean=12.95; SD=5.53), and 72.3% of participants reported to feel lonely. All scores were significantly more severe in Swiss compared to Italian caregivers (all p values<0.001). CONCLUSIONS We found that caregivers' burden, anxiety symptoms, depression and perceived loneliness were marked during the first wave of the COVID-19 pandemic, in two severely hit bordering countries. Regional differences in the impact of the epidemic on caregivers could be due to contextual, societal, and cultural circumstances. As the pandemic endures, support to caregivers of people with dementia should be proportionate and tailored to needs and adapted to contextual factors.
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Affiliation(s)
- Anna Messina
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
| | - Martina Lattanzi
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Emiliano Albanese
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
| | - Maddalena Fiordelli
- Institute of Public Health, Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland
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Tannous J, Pan A, Bako A, Potter T, Jones SL, Janjan N, Smith ML, Seshadri S, Ory MG, Vahidy FS. COVID‐19 associated disruptions in routine health care of people with mild cognitive impairment or dementia. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2022; 14:e12323. [PMID: 35664890 PMCID: PMC9157405 DOI: 10.1002/dad2.12323] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 11/30/2022]
Abstract
Introduction We report the COVID‐19 pandemic's impact on health‐care use disruption among people with mild cognitive impairment or Alzheimer's disease and related dementia (MCI/ADRD). Methods We compared the pandemic‐period health‐care use between MCI/ADRD and matched non‐MCI/ADRD patients. Using 4‐year pre‐pandemic data, we modeled three health‐care use types (inpatient, outpatient, emergency encounters) to predict pandemic‐period use, disaggregated for lockdown and post‐lockdown periods. Observed health‐care use was compared to the predicted. Proportional differences (confidence intervals) are reported. Results Both MCI/ADRD and non‐MCI/ADRD patients (n = 5479 each) experienced pandemic‐related health‐care use disruptions, which were significantly larger for the MCI/ADRD group for outpatient, –13.2% (–16.2%, –10.2%), and inpatient encounters, –12.8% (–18.4%, –7.3%). Large health‐care disruptions during lockdown were similar for both groups. However, post‐lockdown outpatient, –14.4% (–17.3%, –11.5%), and inpatient, –15.2% (–21.0%, –9.5%), disruptions were significantly greater for MCI/ADRD patients. Conclusion MCI/ADRD patients experienced greater and sustained pandemic‐related health‐care use disruptions, highlighting the need for robust strategies to sustain their essential health care during pandemic‐like catastrophes.
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Affiliation(s)
- Jonika Tannous
- Center for Outcomes Research Houston Methodist Houston Texas USA
| | - Alan Pan
- Center for Outcomes Research Houston Methodist Houston Texas USA
| | - Abdulaziz Bako
- Center for Outcomes Research Houston Methodist Houston Texas USA
| | - Thomas Potter
- Center for Outcomes Research Houston Methodist Houston Texas USA
| | - Stephen L. Jones
- Center for Outcomes Research Houston Methodist Houston Texas USA
- Houston Methodist Academic Institute Houston Methodist Houston Texas USA
- Weill Cornell Medical College Cornell University New York New York USA
| | | | - Matthew Lee Smith
- Center for Population Health and Aging Texas A&M University College Station Texas USA
- School of Public Health Texas A&M Health Science Center College Station Texas USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases University of Texas Health Science Center San Antonio Texas USA
| | - Marcia G. Ory
- Center for Population Health and Aging Texas A&M University College Station Texas USA
- School of Public Health Texas A&M Health Science Center College Station Texas USA
| | - Farhaan S. Vahidy
- Center for Outcomes Research Houston Methodist Houston Texas USA
- Houston Methodist Academic Institute Houston Methodist Houston Texas USA
- Weill Cornell Medical College Cornell University New York New York USA
- Houston Methodist Neurological Institute Houston Texas USA
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Otobe Y, Kimura Y, Suzuki M, Koyama S, Kojima I, Yamada M. Factors Associated with Increased Caregiver Burden of Informal Caregivers during the COVID-19 Pandemic in Japan. J Nutr Health Aging 2022; 26:157-160. [PMID: 35166308 PMCID: PMC8783575 DOI: 10.1007/s12603-022-1730-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
This study's objective was to explore the association between various factors and the increased caregiver burden of informal caregivers during the COVID-19 pandemic. On February, 2021, 700 informal caregivers completed an online survey. We assessed the change in caregiver burden during the COVID-19 pandemic. Among all caregiver participants, 287 (41.0%) complained of an increased caregiver burden due to the COVID-19 pandemic. The factors associated with increased caregiver burden were depressive symptoms in caregivers [odds ratio (OR), 2.20; 95% confidence interval (CI), 1.50-3.23], dementia (OR, 2.48; 95%CI, 1.07-5.73) and low Barthel Index scores (OR, 2.01; 95%CI, 1.39-2.90) in care receivers, care days (OR, 1.09; 95%CI, 1.01-1.17) and times (OR, 1.06; 95%CI, 1.01-1.10), and use of home care service (OR, 1.46; 95%CI, 1.01-2.10) and visiting care service (OR, 1.71; 95%CI, 1.20-2.45). These findings suggest we need to pay attention to the physical and mental health of both the care receivers and caregivers.
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Affiliation(s)
- Y Otobe
- Yuhei Otobe, Graduate School of Comprehensive Human Sciences, University of Tsukuba, Tokyo, Japan, 3-29-1 Otsuka, Bunkyo-ku, Tokyo, 112-0012, Japan, Tel: +81-29-853-2111, E-mail:
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