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Hejazi S, Manzour R, Shahsavari A, Ghasemi S, Roshan-Nejad M. Experiences of family caregivers of individuals undergoing hemodialysis in Iran about caring during the COVID-19 pandemic: a qualitative study. BMC Nephrol 2024; 25:240. [PMID: 39075370 PMCID: PMC11285382 DOI: 10.1186/s12882-024-03677-w] [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: 01/14/2024] [Accepted: 07/17/2024] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND The Coronavirus disease 2019 (COVID-19) pandemic has significantly affected various aspects of public health. The virus poses a particular threat to individuals with kidney failure undergoing hemodialysis and their caregivers. The present study investigated the experience of family caregivers of individuals undergoing hemodialysis about caring during the COVID-19 pandemic in Iran. METHODS This qualitative study was conducted with 17 family caregivers of individuals undergoing hemodialysis in Bojnurd, Iran using inductive qualitative content analysis. The participants were selected using convenience and purposive sampling method with maximum variation. Semi-structured interviews were used in data collection based on the interview guide. The data were analyzed with MAXQDA10. RESULTS The results culminated in the identification of a main category of the COVID-19 care burden on caregivers and two generic categories including the COVID-19 Overt (financial/constraining) care burden (subcategories: Non-adherence to Health Protocols, COVID-19 Financial Costs, COVID-19 Restrictions and Hemodialysis Appointments, and Decreased Caregiver Support during the COVID-19 Era), and the COVID-19 Covert (emotional/psychological) Care Burden (subcategories: Caregiver's Loneliness in the Care, Stress of Contracting COVID-19, Psychological Consequences of individuals undergoing hemodialysis Staying at Home, The burden of other Individuals' Expectations of the Caregiver, and Physical and emotional pressure on the Caregiver). CONCLUSION Caregivers during the COVID-19 period have experienced both overt and covert care burden. The results of this study can contribute to understanding the experiences of caregivers of individuals with chronic diseases such as kidney failure, in critical conditions like the COVID-19 pandemic, by healthcare teams and devising strategies and programs to support them.
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Affiliation(s)
- Sima Hejazi
- Bojnurd School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Rezvaneh Manzour
- Bojnurd School of Nursing, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Arezoo Shahsavari
- Department of Medical Surgical Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad, Iran.
| | - Saeed Ghasemi
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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MacLeod A, Levesque J, Ward-Griffin C. Social Isolation of Older Adults, Family, and Formal Caregivers During the COVID-19 Pandemic: Stories and Solutions Through Participatory Action Research. Can J Aging 2024; 43:230-243. [PMID: 37721044 DOI: 10.1017/s071498082300048x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2023] Open
Abstract
This participatory action research (PAR) aimed to understand the health implications of guidelines impacting social isolation among frail community-dwelling older adults and their family and formal caregivers during the coronavirus disease (COVID-19) pandemic. Reflexive thematic analysis (RTA) of data collected from 10 policy/procedural documents revealed four themes: valuing principles, identifying problem(s), setting priorities, and making recommendations. Interviews with 31 participants from Peterborough, Ontario, also revealed four themes: sacrificing social health, diminishing physical health, draining mental health, and defining supports. Recommendations to decision makers were finalized at a knowledge exchange event involving participants and members of Age-friendly Peterborough. Key findings demonstrate the need for Canadian governments and health and social service agencies to enhance access to technology-based interventions, and educational and financial resources for caregivers. Meaningful communication and collaboration between older adults, caregivers, and decision makers are also needed to reduce the gap between policy and practice when addressing social isolation.
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Affiliation(s)
- Ann MacLeod
- Trent/Fleming School of Nursing, Peterborough, ON, Canada
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Albright L, Ko W, Buvanesh M, Haraldsson H, Polubriaginof F, Kuperman GJ, Levy M, Sterling MR, Dell N, Estrin D. Opportunities and Challenges for Augmented Reality in Family Caregiving: Qualitative Video Elicitation Study. JMIR Form Res 2024; 8:e56916. [PMID: 38814705 PMCID: PMC11176885 DOI: 10.2196/56916] [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: 01/31/2024] [Revised: 03/27/2024] [Accepted: 04/26/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Although family caregivers play a critical role in care delivery, research has shown that they face significant physical, emotional, and informational challenges. One promising avenue to address some of caregivers' unmet needs is via the design of digital technologies that support caregivers' complex portfolio of responsibilities. Augmented reality (AR) applications, specifically, offer new affordances to aid caregivers as they perform care tasks in the home. OBJECTIVE This study explored how AR might assist family caregivers with the delivery of home-based cancer care. The specific objectives were to shed light on challenges caregivers face where AR might help, investigate opportunities for AR to support caregivers, and understand the risks of AR exacerbating caregiver burdens. METHODS We conducted a qualitative video elicitation study with clinicians and caregivers. We created 3 video elicitations that offer ways in which AR might support caregivers as they perform often high-stakes, unfamiliar, and anxiety-inducing tasks in postsurgical cancer care: wound care, drain care, and rehabilitative exercise. The elicitations show functional AR applications built using Unity Technologies software and Microsoft Hololens2. Using elicitations enabled us to avoid rediscovering known usability issues with current AR technologies, allowing us to focus on high-level, substantive feedback on potential future roles for AR in caregiving. Moreover, it enabled nonintrusive exploration of the inherently sensitive in-home cancer care context. RESULTS We recruited 22 participants for our study: 15 clinicians (eg, oncologists and nurses) and 7 family caregivers. Our findings shed light on clinicians' and caregivers' perceptions of current information and communication challenges caregivers face as they perform important physical care tasks as part of cancer treatment plans. Most significant was the need to provide better and ongoing support for execution of caregiving tasks in situ, when and where the tasks need to be performed. Such support needs to be tailored to the specific needs of the patient, to the stress-impaired capacities of the caregiver, and to the time-constrained communication availability of clinicians. We uncover opportunities for AR technologies to potentially increase caregiver confidence and reduce anxiety by supporting the capture and review of images and videos and by improving communication with clinicians. However, our findings also suggest ways in which, if not deployed carefully, AR technologies might exacerbate caregivers' already significant burdens. CONCLUSIONS These findings can inform both the design of future AR devices, software, and applications and the design of caregiver support interventions based on already available technology and processes. Our study suggests that AR technologies and the affordances they provide (eg, tailored support, enhanced monitoring and task accuracy, and improved communications) should be considered as a part of an integrated care journey involving multiple stakeholders, changing information needs, and different communication channels that blend in-person and internet-based synchronous and asynchronous care, illness, and recovery.
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Affiliation(s)
- Liam Albright
- Department of Information Science, Cornell University, New York, NY, United States
| | - Woojin Ko
- Department of Computer Science, Cornell Tech, New York, NY, United States
| | - Meyhaa Buvanesh
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | | | - Fernanda Polubriaginof
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Gilad J Kuperman
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Michelle Levy
- Digital Informatics and Technology Solutions (DigITS), Memorial Sloan Kettering Cancer Center, New York, NY, United States
| | - Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medicine, New York, NY, United States
| | - Nicola Dell
- Department of Information Science, Jacobs Technion-Cornell Institute, Cornell Tech, New York, NY, United States
| | - Deborah Estrin
- Department of Computer Science, Cornell Tech, New York, NY, United States
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Attieh S, Kilpatrick K, Chênevert D, Pomey MP, Loiselle CG. Measuring Team Functioning During the COVID-19 Pandemic: Perspectives of Cancer Care Team Members. J Multidiscip Healthc 2024; 17:2623-2633. [PMID: 38828266 PMCID: PMC11141571 DOI: 10.2147/jmdh.s448985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 04/24/2024] [Indexed: 06/05/2024] Open
Abstract
Background In a public health crisis such as COVID-19, cancer teams face significant challenges including acute work disruptions, rapid shifts in clinical practice, and burnout. Within this context, it is crucial to explore team functioning from the perspectives of multiple stakeholders. Objective This quantitative pilot study aimed to 1) measure perceptions of multi-stakeholders on key indicators of team functioning (Team Effectiveness, TE, and Team Relational Coordination, TRC) during COVID-19 and its transition, and 2) document whether patient perceptions of TE/TRC are significantly associated with their cancer care experiences. Methods A descriptive design with repeated measures was used. Through convenience sampling, participants were recruited from two outpatient cancer clinics at a large university-affiliated hospital, in Montréal, Qc, Canada. Sixty-six participants (ie, 13 healthcare professionals, 40 patients, 6 informal caregivers, and 7 volunteers) completed e-measures at T1 (years 2021-2022) and n = 44 at T2 (year 2023). Results At T1, participants reported high perceptions of Team Effectiveness (scale 1 to 6) M = 4.47; SD = 0.7 (Mdn = 4.54; IQR: 4.06-5) and Relational Coordination (scale 1 to 5) M = 3.77; SD = 0.77 (Mdn = 3.81; IQR: 3.12-4.38) with no significant differences in perceptions across the four groups. At T2, no significant changes in TE/TRC perceptions were found. At both time points, patient perceptions of TE/TRC were significantly correlated with positive cancer care experiences (Spearman rank correlation rs ranging from 0.69 and 0.83; p < 0.01). Conclusion To our knowledge, this is the first study documenting perceptions of cancer team functioning amidst the pandemic as reported by multiple stakeholders. Significant relationships between patient perceptions of TE/TRC and their cancer care experiences underscore the importance of including patients' views in team functioning processes. Future work should rely on larger sample sizes to further explore key elements of optimal team functioning.
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Affiliation(s)
- Samar Attieh
- Department of Experimental Medicine, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Kelley Kilpatrick
- Susan E. French Chair in Nursing Research and Innovative Practice, Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - Denis Chênevert
- Department of Human Resources Management, HEC Montréal, Montréal, QC, Canada
| | - Marie-Pascale Pomey
- Research Centre of the University of Montreal Hospital Centre, Montréal, QC, Canada
- Centre d’excellence sur le partenariat avec les patients et le public, Montréal, QC, Canada
- Department of Health Policy, Management and Evaluation, School of Public Health, University of Montréal, Montréal, QC, Canada
| | - Carmen G Loiselle
- Ingram School of Nursing, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
- Department of Oncology, Faculty of Medicine and Health Sciences, McGill University, Montréal, Canada
- Segal Cancer Center, Jewish General Hospital, Montréal, Canada
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Velarde-García JF, Ortego-Maté C, Sarabia-Cobo C, Delgado Uria A, Fernández-Peña R. Impact of the Pandemic on Dementia Care and Caregivers: A Qualitative Study. Clin Nurs Res 2024; 33:240-252. [PMID: 38623695 DOI: 10.1177/10547738241246023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
Physical distancing measures to limit contagion in the COVID-19 pandemic made it difficult to care for older persons with dementia. Non-essential home visits were prevented and family caregivers took over most of their care. The aim of our study was to describe the lived experience of peoples living with dementia caregivers during the pandemic regarding the care provided and the person cared for. A qualitative phenomenological design was used. Participants were recruited using purposeful sampling. Informants were selected from primary healthcare centers, day centers, and a community mental health unit. The study participants comprised 21 caregivers. Semi-structured in-depth interviews by telephone were used, and field notes were collected from the researchers. A thematic analysis was conducted. The criteria used to control trustworthiness were credibility, transferability, dependability, and confirmability. Three main themes and six related sub-themes were identified: (1) care for the person with dementia during the pandemic, including lockdown, associated with difficulties in coping with restrictions, deterioration in health, and the impact of the closure of health and social resources; (2) health and social care provided to people with dementia after the disruptions and the care received from primary care prior to hospital or residential admission; and (3) the caregiver's perspective on the effects of the psycho-emotional impact, and coping strategies adopted in caring. Interventions for people with dementia should be planned in order to prevent the worsening of their health and cognitive status, while also developing programs to prevent stress and alleviate caregiver burden in case of health crises.
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Affiliation(s)
- Juan Francisco Velarde-García
- Department of Nursing, Red Cross College of Nursing, Universidad Autónoma de Madrid, Spain
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos, Madrid, Spain
- Research Nursing Group of Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Carmen Ortego-Maté
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
| | - Carmen Sarabia-Cobo
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
| | | | - Rosario Fernández-Peña
- Faculty of Nursing, Universidad de Cantabria, Santander, Spain
- Nursing Research Group, IDIVAL, Santander, Spain
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Mauldin L, Defelice C. The Invisible Frontline: Experiences of Spousal Caregivers During COVID-19. J Appl Gerontol 2024; 43:160-169. [PMID: 37922207 DOI: 10.1177/07334648231205414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Spousal caregivers are a largely invisible population of unpaid long-term care providers in the United States. This paper examines their experiences during the COVID-19 pandemic by drawing on data from 96 virtual and phone interviews with 44 spousal caregivers cohabitating with an ill partner across 22 states between June and December 2020. Findings show caregivers 1) adjusted care practices related to food and supply deliveries, socializing online, and infection control; 2) experienced impacts on care, including the loss of home health aides and reduced outpatient care; and 3) experienced emotional distress due to isolation, increased care demands, and resulting heightened anxiety and stress. These findings indicate specific types of ongoing resources caregivers may continue to need as the pandemic wanes, such as access to online support, a more robust infrastructure for food delivery, and planning for an increased projected shortage of home health aides.
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Kastl A, Rauner YN, Mayer-Huber S, Oestreich C, Benstetter F, Fettke U. Stakeholder needs assessment for developing ageing in place solutions - a qualitative study. BMC Geriatr 2024; 24:104. [PMID: 38287254 PMCID: PMC10823612 DOI: 10.1186/s12877-024-04722-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 01/18/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Ageing in place is a common desire among older adults and people in need of care. Accessible housing and ambient assisted living (AAL) technologies can help to live independently at home. However, they cannot replace the human support network of informal caregivers, healthcare professionals and social workers. The needs of these stakeholders should be considered and analysed in order to develop user-friendly and acceptable (digital) solutions for ageing in place while supporting human support networks in fulfilling their roles. This paper presents the first step for a comprehensive multi-level needs analysis within the framework of an user-centered design thinking approach. METHODS Guideline-based interviews were conducted with healthcare professionals, social workers and an informal caregiver to collect data about the needs of older adults as well as people in need of care, and their human support networks. RESULTS The call for more information that is easier to find is a common desire of the three groups. There is agreement on system-based communication and orientation problems, the existence of physical and psychological stress exacerbated by a lack of human resources, the desire for personalised care, the need to feel safe and supported in emergencies, and the need for advice and help with administrative tasks. Overall, the needs of one group are closely linked to those of the other. CONCLUSION Stakeholder selection and diversity are decisive for findings about ageing in place. The overlaps between the stakeholders' needs offer chances and challenges at the same time for the development of user-friendly, acceptable (digital) solutions and products that support ageing in place.
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Affiliation(s)
- Andrea Kastl
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany.
| | - Yvonne Nadine Rauner
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany
| | - Sandra Mayer-Huber
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany
| | - Claudia Oestreich
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany
| | - Franz Benstetter
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany
| | - Ulrike Fettke
- Technical University of Applied Sciences Rosenheim, Hochschulstraße 1, Rosenheim, 83024, Germany
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Thapa P, Lama S, Rai G, Sapkota N, Pradhan N, Thapa R, Uprety P, Basnet M. Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal. PLoS One 2024; 19:e0295395. [PMID: 38181040 PMCID: PMC10769026 DOI: 10.1371/journal.pone.0295395] [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: 07/15/2023] [Accepted: 11/19/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal. METHODS A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS). Thirteen caregivers of COVID-19 positive patients were purposively selected from April to June, 2022. Face-to-face interviews were conducted at a caregiver residential facility using the interview schedule developed by the department for the purpose of data collection after obtaining ethical clearance from the Institutional review committee of BPKIHS. Data were audio recorded and manually analyzed. RESULTS Among the 13 caregivers, six were male and seven were female. The findings were categorized into five domains: challenges encountered, changes in physical and mental health, changes in roles and responsibilities, positive experiences, and strategies to ease caregiving tasks. Major challenges included financial burdens, communication problems, stigmatization, Insecurity, substandard accommodation, and visitor restrictions. Caregivers reported negative emotions, unmet physical health needs, and shifts in family and occupational roles. Despite these challenges, caregivers attempted to cope positively and acknowledged the efforts of healthcare personnel and other family members. Suggestions for improving caregiving included providing essential medical and basic services within the hospital, enhancing accommodation facilities, establishing proper communication channels, and allowing visitations. CONCLUSIONS Caregivers of COVID-19 patients face significant challenges during the caregiving process. Enhancing hospital services, promoting effective communication, fostering positive attitudes, and ensuring a safe environment can facilitate caregiving tasks.
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Affiliation(s)
- Prekshya Thapa
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sami Lama
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gayatri Rai
- Hospital Matron, Nursing Service Administration, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nidesh Sapkota
- Department of Psychiatry, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Nirmala Pradhan
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Roshni Thapa
- Department of Community Health Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Pratik Uprety
- Medical Doctor, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhur Basnet
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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Tacchini-Jacquier N, Monnay S, Bonvin E, Dubuis J, Verloo H. Relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave: a PREMs study in Valais Hospital, Switzerland. BMC Health Serv Res 2023; 23:1008. [PMID: 37726727 PMCID: PMC10510254 DOI: 10.1186/s12913-023-10013-9] [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: 01/19/2023] [Accepted: 09/08/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND During the COVID-19 pandemic, most countries introduced temporary visiting restrictions on the relatives of acute care hospital patients, whether or not they were infected with SARS-CoV-2. This affected relatives' psychological and emotional states and how closely they could be involved in their loved one's hospitalization. STUDY AIMS Investigate relatives' experiences of visiting restrictions during the COVID-19 pandemic's first wave and the support offered by Valais Hospital's healthcare staff. METHODS Relatives and patients who had been discharged between February 28 and May 13, 2020, were asked to complete a patient-reported experience measures (PREMs) questionnaire, whether or not they had been infected by SARS-CoV-2. Relatives were asked about how visiting restrictions had affected them, their perceptions of the severity of the COVID-19 pandemic, the quality of communication concerning their loved ones' health status during their hospitalization, and the information received from healthcare staff. Descriptive and inferential statistics were computed. RESULTS Of 866 PREMs questionnaires returned, 818 were analyzable, and 543 relatives had experienced visiting restrictions to their loved ones: 92 relatives (87%) of COVID-19 patients and 451 relatives (66%) of non-infected patients, with heterogenous effects on their psychological and affective status. Overall, whether or not relatives were subjected to visiting restrictions, they perceived themselves to be well treated, well informed, and that communication with hospital healthcare staff was satisfactory. However, relatives subjected to visiting restrictions reported significantly lower scores on the quality of communication than other relatives. The relatives of patients in gynecology/obstetrics and internal medicine wards were significantly more affected by visiting restrictions than were the relatives of patients in other wards. Numerous relatives subjected to visiting restrictions reported regular communication with their loved ones or with healthcare staff, at least once a day (n = 179), either via videoconferences using FaceTime®, WhatsApp®, Zoom®, or Skype® or via mobile phone text messages. CONCLUSION Visiting restrictions affected relatives differently depending on the wards their loved ones were hospitalized. Healthcare institutions should investigate the utility of visiting restrictions on patients, how they affect relatives, and how to improve personalized patient-relative communications. Future research should attempt to develop reliable, validated measurement instruments of relatives' experiences of acute-care visiting restrictions during pandemics.
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Affiliation(s)
- N Tacchini-Jacquier
- Development of Nursing Practices Unit, Valais Hospital, 86, Avenue du Grand-Champsec, CH-1951, Sion, Switzerland
| | - S Monnay
- Social Affairs and Human Resources Specialist, Valais Hospital, 86, Avenue du Grand-Champsec, CH-1951, Sion, Switzerland
| | - E Bonvin
- Valais Hospital, 86, Avenue Grand-Champsec, CH-1951, Sion, Switzerland
| | - J Dubuis
- Valais Family Caregivers' Association, 19, Avenue de Tourbillon, CH-1950, Sion, Switzerland
| | - H Verloo
- Valais Hospital, HES-SO Valais/Wallis, 5, Chemin de L'Agasse, CH-1950, Sion, Valais, Switzerland.
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Marx Y, Bauer A, Unverzagt S, Stark U, Frese T. Instruments in general practice to identify and to measure (over)burden due to informal care for caring relatives: a scoping review protocol. BMJ Open 2023; 13:e067934. [PMID: 37380204 PMCID: PMC10410812 DOI: 10.1136/bmjopen-2022-067934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 06/06/2023] [Indexed: 06/30/2023] Open
Abstract
INTRODUCTION Family caregivers provide by far the largest share of long-term, unpaid care for their primarily elderly and chronically ill relatives or friends. This is associated with a higher risk of psychological and physical overload for the caregivers due to the persistently high time, financial and emotional burden.Recognising the effects of persistent burden on caring relatives at an early stage significantly contributes to the appropriate coordination of available resources and mediation of individual support to maintain a functional caring relationship without excessive demands. General practitioners are usually responsible for the early detection of burden arising from informal care and the coordination of adequate measures. The objective of this review is to give an overview of instruments to identify and measure (over)burden of caring relatives in German general practice and to describe their characteristics. METHODS AND ANALYSIS We used the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist in addition to the Joanna Briggs Institute Reviewer's Manual to describe the aims and methods of the planned scoping reviews. This protocol has been registered with Open Science Framework (OSF), https://osf.io/9ce2k. Two reviewers will run the search to identify studies in four databases (PubMed, LIVIVO, the Cochrane Library and CINAHL) in June and July 2023. Abstracts, titles and full-text publications will be screened to extract data from each included study using a data extraction form. Additionally, an overview of all studies including main study characteristics and detailed information on identification instruments will be given to map the different instruments and tools and to clarify statements concerning their use and practicability in general practice. ETHICS AND DISSEMINATION Ethical approval or consent to participate is not required, as data in this study consists of published studies and not individual data from human or animal participants. Dissemination will consist of publications, presentations and other knowledge translation activities.
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Affiliation(s)
- Yvonne Marx
- Medical Faculty, Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Alexander Bauer
- Medical Faculty, Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Susanne Unverzagt
- Medical Faculty, Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Undine Stark
- Medical Faculty, Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), Germany
| | - Thomas Frese
- Medical Faculty, Institute of General Practice and Family Medicine, Center of Health Sciences, Martin Luther University Halle Wittenberg, Halle (Saale), 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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Dymchuk E, Mirhashemi B, Chamberlain S, Beeber A, Hoben M. The impact of COVID-19 on relationships between family/friend caregivers and care staff in continuing care facilities: a qualitative descriptive analysis. BMC Nurs 2023; 22:121. [PMID: 37059999 PMCID: PMC10102683 DOI: 10.1186/s12912-023-01289-7] [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: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic and related public health measures added a new dynamic to the relationship between caregivers and care staff in congregate care settings. While both caregivers and staff play an important role in resident quality of life and care, it is common for conflict to exist between them. These issues were amplified by pandemic restrictions, impacting not only caregivers and care staff, but also residents. While research has explored the relationship between caregivers and care staff in long-term care and assisted living homes, much of the research has focused on the caregiver perspective. Our objective was to explore the impact of COVID-19-related public health measures on caregiver-staff relationships from the perspective of staff in long-term care and assisted living homes. METHODS We conducted 9 focus groups and 2 semi-structured interviews via videoconference. RESULTS We identified four themes related to caregiver-staff relationships: (1) pressure from caregivers, (2) caregiver-staff conflict, (3) support from caregivers, and (4) staff supporting caregivers. CONCLUSIONS The COVID-19 pandemic disrupted long-standing relationships between caregivers and care staff, negatively impacting care staff, caregivers, and residents. However, staff also reported encouraging examples of successful collaboration and support from caregivers. Learning from these promising practices will be critical to improving preparedness for future public health crises, as well as quality of resident care and life in general.
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Affiliation(s)
- Emily Dymchuk
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Bita Mirhashemi
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie Chamberlain
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Anna Beeber
- School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada.
- School of Health Policy and Management, Faculty of Health, York University, Room 301E Stong College 4700 Keele Street, Toronto, ON, M3J 1P3, Canada.
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13
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Awosoga OA, Odole AC, Onyeso OK, Doan J, Nord C, Nwosu IB, Steinke C, Ojo JO, Ekediegwu EC, Murphy S. Well-being of professional older adults' caregivers in Alberta's assisted living and long-term care facilities: a cross-sectional study. BMC Geriatr 2023; 23:85. [PMID: 36755216 PMCID: PMC9908505 DOI: 10.1186/s12877-023-03801-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND For the care need of older adults, long-term care (LTC) and assisted living (AL) facilities are expanding in Alberta, but little is known about the caregivers' well-being. The purpose of the study was to investigate the physical health conditions, mental and emotional health (MEH), health behaviour, stress levels, quality of life (QOL), and turnover and absenteeism (TAA) among professional caregivers in Alberta's LTC and AL facilities. METHODS This cross-sectional survey involved 933 conveniently selected caregivers working in Alberta's LTC and AL facilities. Standardised questions were selected from the Canadian Community Health Survey, Patient Health Questionnaire-9, and Short Form-36 QOL survey revalidated and administered to the participants. The new questionnaire was used to assess the caregivers' general health condition (GHC), physical health, health behaviour, stress level, QOL, and TAA. Data were analysed using descriptive statistics, Cronbach alpha, Pearson's correlation, one-way analysis of variance, and multiple linear regression. RESULTS Of 1385 surveys sent to 39 facilities, 933 valid responses were received (response rate = 67.4%). The majority of the caregivers were females (90.8%) who were ≥ 35 years (73.6%), worked between 20 to 40 h weekly (67.3%), and were satisfied with their GHC (68.1%). The Registered Nurses had better GHC (mean difference [MD] = 0.18, p = 0.004) and higher TAA than the Health Care Aides (MD = 0.24, p = 0.005). There were correlations between caregivers' TAA and each of MEH (r = 0.398), QOL (r = 0.308), and stress (r = 0.251); p < 0.001. The most significant predictors of TAA were the propensity to quit a workplace or the profession, illness, job stress, and work-related injury, F (5, 551) = 76.62, p < 0.001, adjusted R2 = 0.998. CONCLUSION Reducing the caregivers' job stressors such as work overload, inflexible schedule, and poor remuneration, and improving their quality of life, health behaviour, and mental, emotional, and physical health conditions may increase their job satisfaction and reduce turnover and absenteeism.
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Affiliation(s)
- Oluwagbohunmi A. Awosoga
- grid.47609.3c0000 0000 9471 0214Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB Canada
| | - Adesola Christiana Odole
- grid.9582.60000 0004 1794 5983Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo Nigeria
| | - Ogochukwu Kelechi Onyeso
- Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB, Canada. .,Emerging Researchers and Professionals in Ageing-African Network, Abuja, Nigeria.
| | - Jon Doan
- grid.47609.3c0000 0000 9471 0214Faculty of Art and Sciences, University of Lethbridge, Lethbridge, AB Canada
| | - Christina Nord
- grid.47609.3c0000 0000 9471 0214Faculty of Art and Sciences, University of Lethbridge, Lethbridge, AB Canada
| | - Ifeoma Blessing Nwosu
- grid.412207.20000 0001 0117 5863Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra Nigeria
| | - Claudia Steinke
- grid.47609.3c0000 0000 9471 0214Faculty of Health Sciences, University of Lethbridge, Lethbridge, AB Canada
| | - Joshua O. Ojo
- grid.9582.60000 0004 1794 5983Department of Physiotherapy, Faculty of Clinical Sciences, College of Medicine, University of Ibadan, Ibadan, Oyo Nigeria
| | - Ezinne Chika Ekediegwu
- Emerging Researchers and Professionals in Ageing-African Network, Abuja, Nigeria ,grid.412207.20000 0001 0117 5863Department of Medical Rehabilitation, Faculty of Health Sciences and Technology, College of Health Sciences, Nnamdi Azikiwe University, Awka, Anambra Nigeria
| | - Sheli Murphy
- Rural Health, Professional Practice, Research and Libraries, Covenant Care, Edmonton, AB Canada
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14
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Hoben M, Baumbusch J, B. Hogan D, Gruneir A, A. Chamberlain S, Corbett K, E. Griffith L, McGrail KM, E. Amuah J, E. Lane N, J. Maxwell C. Caregivers' Concerns About Assisted Living Residents' Mental Health During the COVID-19 Pandemic: A Cross-Sectional Survey Study. JOURNAL OF FAMILY NURSING 2023; 29:28-42. [PMID: 36124925 PMCID: PMC9490393 DOI: 10.1177/10748407221124159] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Family or friend caregivers' concerns about assisted living (AL) residents' mental health are reflective of poor resident and caregiver mental health. COVID-19-related visiting restrictions increased caregiver concerns, but research on these issues in AL is limited. Using web-based surveys with 673 caregivers of AL residents in Western Canada, we assessed the prevalence and correlates of moderate to severe caregiver concerns about residents' depressed mood, loneliness, and anxiety in the 3 months before and after the start of the COVID-19 pandemic. Caregiver concerns doubled after the start of the pandemic (resident depressed mood: 23%-50%, loneliness: 29%-62%, anxiety: 24%-47%). Generalized linear mixed models identified various modifiable risk factors for caregiver concerns (e.g., caregivers' perception that residents lacked access to counseling services or not feeling well informed about and involved in resident care). These modifiable factors can be targeted in efforts to prevent or mitigate caregiver concerns and resident mental health issues.
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Affiliation(s)
- Matthias Hoben
- York University, Toronto, Ontario, Canada
- University of Alberta, Edmonton, Canada
| | | | | | - Andrea Gruneir
- University of Alberta, Edmonton, Canada
- ICES, Toronto, Ontario, Canada
| | | | | | | | | | | | - Natasha E. Lane
- The University of British Columbia, Vancouver, Canada
- ICES, Toronto, Ontario, Canada
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15
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Fragkiadaki S, Kontaxopoulou D, Stanitsa E, Angelopoulou E, Pavlou D, Šemrov D, Colnar S, Lustrek M, Blažica B, Vučica I, Matković R, Vukojevic K, Jelicic A, Guzzi PH, Martinović V, Medina AP, Piccoli G, Menon M, Kozetinac S, Miljković M, Kiskini C, Kokorotsikos T, Zilidou V, Radević I, Papatriantafyllou J, Thireos E, Tsouros A, Dimovski V, Papageorgiou SG. How Well Did the Healthcare System Respond to the Healthcare Needs of Older People with and without Dementia during the COVID-19 Pandemic? The Perception of Healthcare Providers and Older People from the SI4CARE Project in the ADRION Region. Geriatrics (Basel) 2023; 8:geriatrics8010021. [PMID: 36826363 PMCID: PMC9957093 DOI: 10.3390/geriatrics8010021] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/23/2023] [Accepted: 01/28/2023] [Indexed: 02/05/2023] Open
Abstract
One major challenge during the COVID-19 pandemic was the limited accessibility to healthcare facilities, especially for the older population. The aim of the current study was the exploration of the extent to which the healthcare systems responded to the healthcare needs of the older people with or without cognitive impairment and their caregivers in the Adrion/Ionian region. Data were collected through e-questionnaires regarding the adequacy of the healthcare system and were anonymously administered to older individuals and stakeholder providers in the following countries: Slovenia, Italy (Calabria), Croatia, Bosnia and Herzegovina, Greece, Montenegro, and Serbia. Overall, 722 older people and 267 healthcare stakeholders participated in the study. During the COVID-19 pandemic, both healthcare stakeholders and the older population claimed that the healthcare needs of the older people and their caregivers increased dramatically in all countries, especially in Italy (Calabria), Croatia and BiH. According to our results, countries from the Adrion/Ionian regions faced significant challenges to adjust to the special needs of the older people during the COVID-19 pandemic, which was possibly due to limited accessibility opportunities to healthcare facilities. These results highlight the need for the development of alternative ways of providing medical assistance and supervision when in-person care is not possible.
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Affiliation(s)
- Stella Fragkiadaki
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dionysia Kontaxopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Evangelia Stanitsa
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Efthalia Angelopoulou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Dimosthenis Pavlou
- School of Topography and Geoinformatics, University of West Attica, Ag. Spyridonos Str., 12243 Aigalew, Greece
| | - Darja Šemrov
- Faculty of Civic and Geodetic Engineering, University of Ljubljana Jamova cesta 2, 1000 Ljubljana, Slovenia
| | - Simon Colnar
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Mitja Lustrek
- Department of Intelligent Systems, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Bojan Blažica
- Computer Systems Department, Jožef Stefan Institute, Jamova cesta 39, 1000 Ljubljana, Slovenia
| | - Inga Vučica
- Department of Gerontology, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Roberta Matković
- Department for Research Data Collecting and Analysis, Teaching Institute for Public Health of Split and Dalmatian County, Vukovarska 46, 21000 Split, Croatia
| | - Katarina Vukojevic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Ana Jelicic
- Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Šoltanska ul. 2, 21000 Split, Croatia
| | - Pietro Hiram Guzzi
- Municipality of Miglierina, Street B. Telesio 88040, Italy and University of Catanzaro, viale Europa, 88100 Catanzaro, Italy
| | - Vlatka Martinović
- Faculty of Medicine, University Hospital Mostar, 88000 Mostar, Bosnia and Herzegovina
| | - Amina Pekmez Medina
- Health Insurance and Reinsurance Fund of Federation of Bosnia and Herzegovina, Trg Heroja 14, 71000 Sarajevo, Bosnia and Herzegovina
| | - Guido Piccoli
- ALOT, SI4CARE-TEAM Street Cipro, 16, 25124 Brescia, Italy
| | | | - Srdjan Kozetinac
- Special Hospital Merkur, Cara Dusana 3, 36210 Vrnjaka Banja, Serbia
| | | | - Chrysanthi Kiskini
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Themis Kokorotsikos
- Department of European Union, Projects of Regional Development Fund of Central Macedonia, Vas. Olgas 198, 54 655, Thessaloniki, Greece
| | - Vasiliki Zilidou
- Lab of Medical Physics & Digital Innovation, and Thessaloniki Active & Healthy Ageing Living Lab, School of Medicine, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Ivan Radević
- Faculty of Economics, University of Montenegro, 37 Bulevar Jovana Tomaševića, 81000 Podgorica, Montenegro
| | - John Papatriantafyllou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
| | - Eleftherios Thireos
- National Health System, Athens Medical Society, Meandrou 23, 115 28 Athens, Greece
| | - Agis Tsouros
- Department of Global Health, Boston University School of Public Health, 715 Albany Street, Boston, MA 02118, USA
| | - Vlado Dimovski
- School of Economics and Business, University of Ljubljana Kardeljeva ploščad 17, 1000 Ljubljana, Slovenia
| | - Sokratis G. Papageorgiou
- 1st Department of Neurology, Aiginition University Hospital, Vasilissis Sofias Street 72-74, 11528 Athens, Greece
- Correspondence:
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16
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Manzari ZS, Rafiei H, Ghaderi MS, Abedi F, Mafi MH. Relationship between Resilience and Caregiver Burden Among Home Caregivers of COVID-19 Patients. Home Healthc Now 2023; 41:42-48. [PMID: 36607209 PMCID: PMC9812295 DOI: 10.1097/nhh.0000000000001133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
This study examined caregiver burden among home caregivers of COVID-19 patients and its relationship to resilience. This cross-sectional correlational study was conducted in Mashhad, Iran, in 2020. The sample consisted of 220 family caregivers of COVID-19 patients. The data collection tools included: demographic characteristics, Novak and Guest Caregiver Burden Inventory, and Connor-Davidson Resilience Scale. Data were analyzed with descriptive statistics and correlation test in SPSS v25. The mean score of caregiver burden was 76.85±16.25. In total, 4.5% experienced mild caregiver burden, 31.4% moderate caregiver burden, 50.9% severe caregiver burden, and 13.2% very severe caregiver burden. The mean score of resilience was 62.98±14.06. A significant and inverse relationship was observed between caregiver burden and resilience (p < 0.05, r = -0.46). Family caregivers of COVID-19 patients experienced a significant level of caregiver burden, and it was lower in caregivers with higher levels of resilience. Further studies are recommended in this regard. The use of procedure and training that can improve the resilience of caregivers is recommended to nurses, especially home care nurses.
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17
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Baik D, Coats H, Baker C. Experiences of Older Family Care Partners of Persons With Heart Failure 1 Year After the Onset of the COVID-19 Pandemic: A Qualitative Study. J Gerontol Nurs 2022; 48:47-52. [PMID: 36169290 PMCID: PMC10990474 DOI: 10.3928/00989134-20220908-07] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has negatively affected the health and well-being of family care partners of older adults with heart failure (HF-FCPs). The purpose of the current study was to examine the caregiving experiences and coping strategies of older HF-FCPs during the ongoing pandemic. Qualitative telephone interviews were conducted with 13 HF-FCPs (aged ≥65 years) from January to April 2021. Three themes emerged: (1) Impact on Physical, Mental, and Social Health; (2) Limitations of Using Health Care Services; and (3) Coping Strategies. During the pandemic, HF-FCPs had increased caregiving burden due to managing their own age-related health and providing care to their family member with heart failure. After 1 year of COVID-19, they adjusted by increasing use of telecommunication platforms and following prevention and protection strategies. During the ongoing pandemic, emotional and social support, respite care, and digital health support for older HF-FCPs would be beneficial for improving their physical, mental, and social health. [Journal of Gerontological Nursing, 48(10), 47-52.].
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18
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Lane NE, Hoben M, Amuah JE, Hogan DB, Baumbusch J, Gruneir A, Chamberlain SA, Griffith LE, McGrail KM, Corbett K, Maxwell CJ. Prevalence and correlates of anxiety and depression in caregivers to assisted living residents during COVID-19: a cross-sectional study. BMC Geriatr 2022; 22:662. [PMID: 35962356 PMCID: PMC9372518 DOI: 10.1186/s12877-022-03294-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/12/2022] [Indexed: 12/30/2022] Open
Abstract
Background Family and friend caregivers play significant roles in advocating for and ensuring quality health and social care of residents in Assisted Living (AL) homes. However, little is known about how the COVID-19 pandemic and related visitor restrictions affected their health and mental well-being. We examined the prevalence and correlates of anxiety and depressive symptoms among caregivers of AL residents during the initial wave of COVID-19 in two Canadian provinces. Methods A cross-sectional web-based survey was conducted among family/friend caregivers of AL residents in Alberta and British Columbia (Oct 28, 2020—Mar 31, 2021) to collect data on their sociodemographic, health and caregiving characteristics, as well as concerns about residents’ health and social care before and during the first wave of the pandemic. A clinically significant anxiety disorder and depressive symptoms were assessed with the GAD-7 and CES-D10 instruments, respectively. Separate multivariable (modified) Poisson regression models identified caregiver correlates of each mental health condition. Results Among the 673 caregivers completing the survey (81% for Alberta residents), most were women (77%), white (90%) and aged ≥ 55 years (81%). Clinically significant anxiety and depression were present in 28.6% and 38.8% of caregivers respectively. Both personal stressors (comorbidity level, income reduction, low social support) and caregiving stressors exacerbated by the pandemic were independently associated with caregiver anxiety and depression. The latter included increased concern about the care recipients’ depression (adjusted risk ratio [adjRR] = 1.84, 95% confidence interval [CI] 1.19–2.85 for caregiver anxiety and adjRR = 1.75, 95% CI 1.26–2.44 for caregiver depressive symptoms) and reported intention to withdraw the resident from AL because of COVID-19 (adjRR = 1.24, 95%CI 0.95–1.63 for caregiver anxiety and adjRR = 1.37, 95%CI 1.13–1.67 for caregiver depressive symptoms). Conclusions Caregivers of residents in AL homes reported significant personal and caregiving-related stressors during the initial wave of COVID-19 that were independently associated with an increased likelihood of experiencing clinically significant anxiety and depressive symptoms. Healthcare providers and AL staff should be aware of the prevalence and varied correlates of caregivers’ mental health during public health crises so that appropriate screening and support may identified and implemented. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03294-y.
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Affiliation(s)
- Natasha E Lane
- ICES, Toronto, ON, Canada.,Department of Internal Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Matthias Hoben
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Joseph E Amuah
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jennifer Baumbusch
- School of Nursing, University of British Columbia, Vancouver, BC, Canada
| | - Andrea Gruneir
- ICES, Toronto, ON, Canada.,Department of Family Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Stephanie A Chamberlain
- Department of Family Medicine, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Lauren E Griffith
- Department of Health Research Methods, Evidence and Impact, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Kimberlyn M McGrail
- School of Population and Public Health, Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC, Canada
| | - Kyle Corbett
- Faculty of Nursing, College of Health Sciences, University of Alberta, Edmonton, AB, Canada
| | - Colleen J Maxwell
- ICES, Toronto, ON, Canada. .,School of Pharmacy, University of Waterloo, ON, N2L 3G1, Waterloo, Canada. .,School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
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19
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Tsuboi M, Sawano T, Ozaki A, Nonaka S, Kohayakawa Y, Kondo H, Tsubokura M. Comparison of mortality patterns after the Fukushima Daiichi Nuclear Power Plant radiation disaster and during the COVID-19 pandemic. JOURNAL OF RADIOLOGICAL PROTECTION : OFFICIAL JOURNAL OF THE SOCIETY FOR RADIOLOGICAL PROTECTION 2022; 42:031502. [PMID: 35764063 DOI: 10.1088/1361-6498/ac7c9b] [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: 04/01/2022] [Accepted: 06/28/2022] [Indexed: 06/15/2023]
Abstract
The initial health impact caused by radiation disasters can be broadly classified into direct and indirect effects. Though no direct health hazards caused by radiation, such as acute radiation injury, were observed following the Fukushima Daiichi nuclear power plant accident, indirect deaths have been reported, including those caused by initial emergency evacuation and relocation, medical disruption, and psychological and social health effects. However, these indirect health effects have not been prioritised for addressal. We evaluated the radiation disaster experience with that of the coronavirus disease (COVID-19) pandemic that emerged while facing the challenges from the radiation disaster. Most of the health effects of COVID-19 are directly associated with infection, but indirect health effects of various scales and entities have been reported. The two disasters have similarities in terms of the strain on community healthcare and the large number of deaths. Adapting the measures implemented in the acute to subacute phases of the COVID-19 disaster to radiation disasters may help improve management following future radiation disasters. Based on the experience and findings during the COVID-19 pandemic, the pattern of deaths in radiation disasters can be divided into five major groups: direct deaths, and four indirect patterns of deaths due to a deteriorating supply-demand balance (a hospital-level problem), collapse of the healthcare system (a community-level problem), death due to neglect alongside underlying disease, and diseases other than direct invasion. From the similarities between the two disasters, three main issues should be prioritised as initial emergency evacuation measures in a radiation disaster: emergency exposure medicine, the establishment of a medical system, and protection of death with dignity. The validity of these priority issues needs to be verified in future research.
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Affiliation(s)
- Motohiro Tsuboi
- Department of Emergency and Critical Care Medicine, Japanese Red Cross Saitama Hospital, Saitama, Japan
- Department of International Cooperation for Disaster Medicine, International Research Institute of Disaster Science (IRIDeS), Tohoku University, Miyagi, Japan
| | - Toyoaki Sawano
- Department of Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Japan
- Department of Radiation Health Management, Fukushima Medical University, Fukushima City, Japan
| | - Akihiko Ozaki
- Department of Breast Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki City, Japan
- Department of Ggastrointestinal Tract Surgery, Fkushima Medical University School of Medicine, Fukushima City, Japan
| | - Saori Nonaka
- Research Center for Community Health, Minamisoma Municipal General Hospital, Fukushima, Japan
| | | | - Hisayoshi Kondo
- DMAT Secretariat, National Hospital Organization Headquarters, Tokyo, Japan
| | - Masaharu Tsubokura
- Department of Radiation Health Management, Fukushima Medical University, Fukushima City, Japan
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Laranjeira C, Dixe MA, Martinho R, Rijo R, Querido A. Building Bridges for "Palliative Care-in-Place": Development of a mHealth Intervention for Informal Home Care. Front Psychol 2022; 13:862347. [PMID: 35401349 PMCID: PMC8993184 DOI: 10.3389/fpsyg.2022.862347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 03/09/2022] [Indexed: 12/12/2022] Open
Abstract
Background In Palliative Care (PC), family and close people are an essential part of provision of care. They assume highly complex tasks for which they are not prepared, with considerable physical, psychological, social and economic impact. Informal Caregivers (ICs) often falter in the final stage of life and develop distress, enhancing emotional burden and complicated grief. The lack of available and accessible in-person counselling resources is often reported by ICs. Online resources can promote early access to help and support for patient-IC dyads in palliative care. The primary aim of this research is to co-design, develop and test the feasibility of the Help2Care-PAL mHealth app that addresses the needs of ICs of palliative patients cared for at home. This Digital Health Intervention (DHI) in palliative care will be used for education, symptom management, communication and decision-making, to enhance Quality of Life (QoL) of patients and ICs, fostering anticipatory grief and the reach and efficiency of services. Methods This study will use an iterative co-design process and convergent mixed-methods design, following the MORECare consensus for developing a complex intervention. Construction of the DHI will follow four main phases: (I) a needs assessment (a cross-sectional survey, individual interviews with ICs and focus groups with professionals with community palliative care experience); (II) design and co-production of mHealth materials and interventions to support ICs; (III) the development of a mHealth app; and (IV) usability and feasibility of the mHealth app. The Help2Care-PAL platform seeks to build resources from the perspectives and needs of both family dyads and nursing professionals working in the field of community palliative care. User-centeredness will be ensured by the active participation of patient-IC dyads and professionals of the palliative care community. Discussion This mixed-method study will offer new insights on needs and expectations of patient-IC dyads and nurses in community palliative care regarding caregiving preparedness and online health resources. Through the implementation of an adaptive digital tool, we aim to improve access to palliative care family support, which is highly linked with the wellbeing of patients and especially new ICs.
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Affiliation(s)
- Carlos Laranjeira
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,Research in Education and Community Intervention (RECI I&D), Piaget Institute, Viseu, Portugal
| | - Maria Anjos Dixe
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal
| | - Ricardo Martinho
- Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal.,Technology and Management School of Polytechnic of Leiria, Leiria, Portugal
| | - Rui Rijo
- Technology and Management School of Polytechnic of Leiria, Leiria, Portugal
| | - Ana Querido
- School of Health Sciences of Polytechnic of Leiria, Leiria, Portugal.,Centre for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, Leiria, Portugal.,Center for Health Technology and Services Research (CINTESIS), University of Porto, Porto, Portugal
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Merrilees J, Robinson-Teran J, Allawala M, Dulaney S, Rosenbloom M, Lum HD, Sawyer RJ, Possin KL, Bernstein A. Responding to the needs of persons living with dementia and their caregivers during the COVID-19 pandemic: Lessons from the Care Ecosystem. Innov Aging 2022; 6:igac007. [PMID: 35434383 PMCID: PMC9007551 DOI: 10.1093/geroni/igac007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background and Objectives
The COVID-19 pandemic created challenges for persons with dementia, their caregivers, and programs that support them. The Care Ecosystem (CE) is a model of dementia care designed to support people with dementia and their family caregiver dyads through on-going contact with a care team navigator (CTN) and an expert clinical team. CTNs provide support, education and resources and help dyads manage dementia-related concerns as they evolve over the course of the disease. We aimed to understand how the Care Ecosystem responded to the needs of dyads during the initial three months of the COVID-19 pandemic.
Research Design and Methods
We conducted a survey and qualitative interviews with staff members from four established Care Ecosystem programs located in four different states to explore 1) challenges dyads voiced during the pandemic, 2) CE staff approaches to addressing the needs of dyads and 3) programmatic challenges faced and lessons learned.
Findings
Nine staff members from four Care Ecosystem programs with an active collective caseload of 379 dyads were interviewed. Themes were identified that included dyad concerns regarding fear of illness, changing attitudes towards long term care, decreased availability of services and resources, and impacts on patient and caregiver health and well-being. Programmatic challenges included maintaining effective communication with dyads and program staff, technological readiness, workflow restructuring and program sustainability.
Discussion and Implications
Approaches in supporting people with dementia and their caregivers should demonstrate flexibility, responsivity, and creativity and these findings provide insight for understanding how dementia care programs can be positioned to offer continuous support for this vulnerable population.
Translational Significance
During the pandemic, persons with dementia and their caregivers reported concerns relating to viral exposure, functional and behavioral decline of the person with dementia, difficulty accessing resources, changing attitudes towards long term care and experiences of loneliness and isolation. The Care Ecosystem, a supportive dementia care model, faced challenges relating to program sustainability and workflow. Telephone-based and scheduled contacts with dyads, along with strong organizational and community partnerships were factors in supporting dyads. Results from this study inform programs on ways to support persons with dementia and their caregivers during unexpected events that threaten public health and safety.
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Affiliation(s)
- Jennifer Merrilees
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Joanne Robinson-Teran
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Mahnoor Allawala
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Sarah Dulaney
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
| | - Michael Rosenbloom
- Center for Memory and Aging, HealthPartners Institute, Saint Paul, Minnesota, USA
| | - Hillary D Lum
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA
- VA Eastern Colorado Geriatrics Research Education and Clinical Center, Rocky Mountain Regional VA Medical Center, Aurora, Colorado, USA
| | - Robert John Sawyer
- Cognitive Disorders and Brain Health Program, Ochsner Health, New Orleans, Louisiana, USA
| | - Katherine L Possin
- Memory and Aging Center, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
| | - Alissa Bernstein
- Department of Humanities and Social Sciences, Philip R. Lee Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
- Global Brain Health Institute, University of California San Francisco, San Francisco, California, USA
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