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Robertson MA, Petersen EE, Ross-White A, Camargo-Plazas P, Andrew M, Egan R. Residents' and spouses' experiences of loneliness and depression after separation due to long-term care placement: a qualitative systematic review. JBI Evid Synth 2024; 22:1536-1581. [PMID: 38632969 DOI: 10.11124/jbies-23-00334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
OBJECTIVE The objective of this review was to describe the experiences of loneliness and/or depression for residents and their spouses who have been separated by long-term care placement. INTRODUCTION Loneliness and depression have a pernicious influence on the overall health and well-being of older adults. Older adults' mental health is significantly affected by social relationships, including those between spouses. However, there is limited research pertaining to long-term care residents' and community-dwelling spouses' experiences of loneliness and/or depression after separation due to long-term care placement. INCLUSION CRITERIA This systematic review included studies that recruited community-dwelling spouses and long-term care residents over 50 years of age with living spouses from whom they are separated due to long-term care placement. Studies on the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in long-term care were included in this review. METHODS Ovid MEDLINE(R) was used for the initial search. A full search strategy was developed for Ovid MEDLINE(R), CINAHL (EBSCOhost), Embase (Ovid), and PsycINFO (Ovid). The review was conducted using the JBI methodology for reviews of qualitative research, with 2 independent reviewers performing study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence in the findings. RESULTS Eleven papers were included in this systematic review. Four synthesized findings were extracted from 10 categories and 42 findings: i) Loneliness and depression result from a lack of physical and social connection for separated long-term care residents and community-dwelling spouses; ii) Community-dwelling spouses feel unprepared and upset with spousal separation due to a lack of psychological support; iii) Behavioral strategies can prevent community-dwelling spouses and long-term care residents from developing loneliness and/or depression; and iv) Community-dwelling spouses have differing abilities to adapt and cope with feelings of loneliness and/or depression. CONCLUSION This review provides a comprehensive synthesis of the feelings of loneliness and/or depression in spouses who are separated due to long-term care placement. This review has demonstrated that there is a lack of literature inclusive of the voices and perspectives of all spouses affected by spousal separation in long-term care. The limitations of this review include the small number of included studies and the range of quality in included studies. Recommendations include additional research on the lived experience of spousal separation from the perspectives of long-term care residents and their community-dwelling spouses. Further, additional psychological support is needed for separated spouses, guided by the suggestions and experiences of long-term care residents and their community-dwelling spouses. REVIEW REGISTRATION PROSPERO CRD42022333014.
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Affiliation(s)
| | - Erika E Petersen
- Health Quality Programs, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
| | - Pilar Camargo-Plazas
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
- School of Nursing, Queen's University, Kingston, ON, Canada
| | - Melissa Andrew
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
| | - Rylan Egan
- Health Quality Programs, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Healthcare Quality: A JBI Centre of Excellence, Queen's University, Kingston, ON, Canada
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Bahadir-Yilmaz E. Nursing and midwifery students' perceptions of the elderly in nursing homes: a metaphor analysis. Psychogeriatrics 2024; 24:959-967. [PMID: 38877689 DOI: 10.1111/psyg.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2024] [Accepted: 06/04/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Nursing and midwifery students' perceptions and attitudes toward older adults affect their behaviours, career choices and/or the quality of care provided to older adults after graduation. This study aimed to evaluate the perceptions of second year nursing and midwifery students toward elderly people staying in nursing homes through metaphor analysis. METHODS This qualitative study has used the phenomenological approach. The sample of the study consisted of 128 nursing and midwifery students by purposive sampling method. Students were prompted to complete a sentence to express their perceptions about the elderly living in nursing homes: 'The elderly in the nursing home is similar to … because …' Participants were required to fill in their responses in two stages, providing metaphors in the first blank and reasons for their metaphors in the second blank. RESULTS The results indicated that five main themes and 12 sub-themes were obtained from student metaphors: (i) needing help in meeting their needs (need for care and need for love); (ii) the emotional burden of a life away from loved ones (loneliness, abandonment, and helplessness); (iii) exhaustion at the end of the road (end, loss, and unproductive); (iv) holding on to life again (friendship and beginning); and (v) post-traumatic growth (strong and experienced). CONCLUSION Students should question how to create opportunities and increase interaction for the elderly in the age of changing and developing technology before graduation and should be trained as professional individuals who are willing for this purpose.
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Affiliation(s)
- Emel Bahadir-Yilmaz
- Faculty of Health Sciences, Department of Psychiatric Nursing, Giresun University, Giresun, Turkey
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Bökberg C, Lindhardt T, Björkman E, Ahlström G. Caring and Health of Close Family Members of Frail Older Persons Recently Discharged from Acute Hospital Care: A Comparative Cross-Sectional Study. NURSING REPORTS 2024; 14:901-912. [PMID: 38651481 PMCID: PMC11036298 DOI: 10.3390/nursrep14020069] [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: 02/22/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/25/2024] Open
Abstract
Multimorbidity in older people is strongly linked to the need for acute hospital care, and caregiving activities usually become more complex after patients are discharged from hospital. This may negatively impact the health of close family members, although this has not been comprehensively investigated. This study aimed to explore the general and mental health of close family members caring for frail older (>65) persons recently discharged from acute hospital care, making assessments in terms of gender, relationship to the older person, and aspects of caring. A comparative cross-sectional study was conducted involving 360 close family members caring for frail older persons recently discharged from hospital. The statistical analyses included subgroup comparisons and associations to caring were examined. Half of the family members reported that their general and mental health was poor, with spouses reporting the poorest health. Female participants had significantly more severe anxiety, while males had significantly more severe depression. Providing care for more than six hours per week was associated with poor general health (OR 2.31) and depression (OR 2.59). Feelings of powerless were associated with poor general health (OR 2.63), anxiety (6.95), and depression (3.29). This knowledge may provide healthcare professionals with better tools in order to individualise support, preventing family members from exceeding their resources during these demanding periods.
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Affiliation(s)
- Christina Bökberg
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
| | - Tove Lindhardt
- Research Unit for Clinical Nursing, Department of Internal Medicine, Copenhagen University Hospital Herlev and Gentofte, Herlev Ringvej 75, 2730 Herlev, Denmark;
| | - Eva Björkman
- Department of Care Science, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden;
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
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Staats K, Jeppestøl K, Søvde BE, Brenne BA, Tarberg AS. End-of-life care at home: Dignity of family caregivers. Nurs Ethics 2024:9697330241241773. [PMID: 38587469 DOI: 10.1177/09697330241241773] [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: 04/09/2024]
Abstract
BACKGROUND Healthcare services are increasingly being shifted to home settings for patients nearing end-of-life. Consequently, the burden on family caregivers is significant. Their vulnerable situation remains poorly understood and there is little information available regarding their experiences of dignity. AIM This study seeks to understand the experiences of family caregivers related to dignity and loss of dignity, aiming to provide a deeper insight into their situation when caring for a home-dwelling family member nearing end-of-life. RESEARCH DESIGN AND PARTICIPANTS This exploratory study consists of a second analysis combining data from two primary studies, including 24 family caregivers of a family member nearing end-of-life, and is founded upon Gadamer's philosophical hermeneutics. ETHICAL CONSIDERATIONS Approval was obtained from the Norwegian Agency for Shared Services in Education and Research and was based on voluntary participation, informed consent, and confidentiality. RESULTS The following three main themes were identified: Having a meaningful existence within the living environment, being seen and valued as a family caregiver in relation with others and suffering in a space of loneliness. These contextual, relational, and existential perspectives were found to be closely interrelated. CONCLUSION AND FINAL CONSIDERATIONS The dignity of family caregivers was closely tied to being seen as unique individuals, not merely caregivers, thereby requiring healthcare professionals (HCPs) to understand their personal needs. This study highlights the emotional distress and loneliness family caregivers feel in their dual role within the healthcare system, thereby calling for HCPs to adopt an attitude of gentleness and recognition to impart dignity-preserving care in homecare practices.
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Robertson MA, Petersen EE, Ross-White A, Egan R. Experience of loneliness and depression due to spousal separation in long-term care residents and their spouses: a qualitative systematic review protocol. JBI Evid Synth 2023; 21:1672-1678. [PMID: 36999375 DOI: 10.11124/jbies-22-00270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE The objective of this review is to describe the experience of loneliness and/or depression due to spousal separation when one or both spouses are admitted into a long-term care facility. INTRODUCTION Loneliness and depression are important concerns for the health and well-being of older adults separated from their spouses due to long-term care placement. Social relationships, specifically spousal relationships, have a significant impact on the mental health of older adults. However, there is limited research on the experience or effect of spousal separation on long-term care residents' and their spouses' experience of loneliness and/or depression. INCLUSION CRITERIA This review will include long-term care residents and their spouses who are over the age of 50 and have a spouse they are separated from due to long-term care placement. Studies will be included in this review if they explore the experiences of loneliness and/or depression due to spousal separation with one or both spouses living in a long-term care facility. METHODS This review will be conducted in line with the JBI methodology for systematic reviews of qualitative evidence. MEDLINE was used for the initial search. A full search strategy was then developed for MEDLINE, CINAHL, Embase, and PsycINFO. The JBI approach to study selection, critical appraisal, data extraction, data synthesis, and assessment of confidence will be used. Two reviewers will pilot test the screening criteria and data extraction protocol. REVIEW REGISTRATION PROSPERO CRD42022333014.
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Affiliation(s)
- Madison A Robertson
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Erika E Petersen
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
| | - Amanda Ross-White
- Bracken Health Science Library, Queen's University, Kingston, ON, Canada
- Queen's Collaboration for Health Care Quality, Queen's University, Kingston, ON, Canada
| | - Rylan Egan
- Health Quality Programs, School of Nursing, Queen's University, Kingston, ON, Canada
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Luo Y, Ran H, Deng Y, Li H, Zhang M, Zhao L. Paid caregivers' experiences of falls prevention and care in China's senior care facilities: A phenomenological study. Front Public Health 2023; 11:973827. [PMID: 36875422 PMCID: PMC9978790 DOI: 10.3389/fpubh.2023.973827] [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: 06/20/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Background In China, as population aging accelerates, senior care facilities have gradually become a mainstream option. According to the World Health Organization (WHO), the annual rate of falls has increased from 30 to 50% in senior care facilities. A study found that older adults who live in senior care facilities are three times more likely to fall than those who live in the community. The quality of care is highly related to the occurrence of falls. Therefore, exploring paid caregivers' experiences is very important to prevent falls in senior care facilities. Objective The aim of this study was to explore paid caregivers' experiences of fall prevention and care in China's senior care facilities. Furthermore, we discussed the situation and provided suggestions. Design This is a phenomenological study using face-to-face, in-depth, semi-structured interviews. Setting The study was conducted at four senior care facilities in Changsha, Hunan, China. Participants Fourteen paid caregivers in four senior care facilities, including nursing assistants and senior nurses, participated in this study. Methods A purposive sample method was used to select 14 nursing assistants and senior nurses from four different senior care facilities in Changsha from March to April 2022. Every participant individually completed a face-to-face, in-depth, semi-structured interview. Based on the phenomenological research methodology, the thematic analysis method and the Colaizzi analysis method were used for data analysis and theme extraction. Results Based on interview data, a total of seven themes were distilled: (1) paid caregivers' professional requirements; (2) paid caregivers' attitude toward falls; (3) paid caregivers' fall training and education; (4) paid caregivers' knowledge about falls; (5) paid caregivers' fall risk assessment; (6) paid caregivers' fall prevention; and (7) paid caregivers' fall treatment. Conclusion In China's senior care facilities, paid caregivers to need to be responsible and pay appropriate attention to older adults. First, senior nurses and nursing assistants need to enhance communication and cooperation. Second, they must learn about deficiencies in fall risk assessment and try their best to improve their capability. Third, they must adopt appropriate education methods to improve fall prevention capability. Finally, the protection of privacy should be taken seriously.
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Affiliation(s)
- Yuan Luo
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Haiye Ran
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Yuqian Deng
- Xiang Ya Nursing School, Central South University, Changsha, Hunan, China
| | - Huan Li
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Mengxi Zhang
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
| | - Liping Zhao
- Xiang Ya Second Hospital of Central South University, Changsha, Hunan, China
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Duggleby W, O'Rourke HM, Baxter P, Nekolaichuk C, Thompson G, Peacock S, Ghosh S, Holroyd-Leduc J, McAiney C, Dubé V, Swindle J, Pagnucco-Renaud M, Sana S. Building a new life: a qualitative study of how family carers deal with significant changes. BMC Geriatr 2022; 22:551. [PMID: 35778694 PMCID: PMC9248114 DOI: 10.1186/s12877-022-03236-8] [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: 03/30/2022] [Accepted: 06/17/2022] [Indexed: 11/18/2022] Open
Abstract
Background Family carers of persons living with dementia who are residing in long term care (LTC), often experience significant changes in their roles and relationships which affects mental and physical health. Research has focused on describing the carers’ experience, but not on how they deal with these changes or their perceptions of support needs. The purpose of this study was to explore how family carers of persons living with dementia residing in LTC deal with significant changes and to understand how best to support these carers. Methods Eight face-to-face audio-recorded focus group interviews were conducted with 45 participants from September 2019 to January 2020, as part of a larger study aimed at guiding the adaptation of an online toolkit to support family carers of persons living with dementia residing in LTC. Applied thematic analysis was used to analyze the focus group data. Findings/results Carers dealt with the significant changes they experienced through the process of “building a new life” consisting of two sub-processes: a) building new relationships (with their family member, LTC staff and others outside of LTC), and b) finding space for themselves (sharing of care and finding balance). Understanding dementia, support from others (staff, family and friends), connecting with resources, and being included in care decisions helped carers build a new life. Conclusion The process of building a new life describes the ways that family carers deal with the life-altering changes they experienced when a family member is admitted to LTC. Carers may be supported in building their new life, by providing them with information about dementia and how to relate to staff and their family member living with dementia. The quality of care being provided and the LTC environment may also play an important role in how carers deal with the significant changes they experience.
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Affiliation(s)
- Wendy Duggleby
- Faculty of Nursing University of Alberta, 4-141 ECHA, 11405 87th Ave, Edmonton, AB, T6G 1C9, Canada.
| | - Hannah M O'Rourke
- Faculty of Nursing University of Alberta, 4-141 ECHA, 11405 87th Ave, Edmonton, AB, T6G 1C9, Canada
| | - Pamela Baxter
- Faculty of Health Sciences, McMaster University, 1280 Main St. W, Hamilton, ON, L8S4K1, Canada
| | - Cheryl Nekolaichuk
- Department of Oncology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6L 0A3, Canada
| | - Genevieve Thompson
- College of Nursing, University of Manitoba, 89 Curry Place, Winnipeg, MB, R3T 2N2, Canada
| | - Shelley Peacock
- College of Nursing, University of Saskatchewan, 104 Clinic Place, Saskatoon, SK, S7N 2Z4, Canada
| | - Sunita Ghosh
- Alberta Health Services-Cancer Control Alberta, Department of Medical Oncology, University of Alberta, 11560 University Ave, Edmonton, AB, T6G 1Z2, Canada
| | - Jayna Holroyd-Leduc
- Department of Medicine, Cumming School of Medicine, University of Calgary, 1403 29th Street NW, Calgary, AB, T2N 4W4, Canada
| | - Carrie McAiney
- Schlegel Research Chair in Dementia, Schlegel-UW Research Institute for Aging, Waterloo, Canada.,School of Public Health and Health Systems, University of Waterloo, 200 University Ave, W, Waterloo, ON, N2L 3G1, Canada
| | - Véronique Dubé
- Chairholder Marguerite-d'Youville Research Chair, Faculty of Nursing, University of Montreal, P.O. Box 6128, Centre-ville Station, Montreal, QC, H3C 3J7, Canada
| | - Jennifer Swindle
- Faculty of Nursing, University of Alberta, Level 3 ECHA, 11405 87 Avenue, Edmonton, Alberta, T6G 1C9, Canada
| | - Madeleine Pagnucco-Renaud
- Faculty of Nursing University of Alberta, 4-005A, ECHA, 11405 87th Ave, Edmonton, AB, T6G 1C9, Canada
| | - Samina Sana
- Faculty of Nursing, School of Public Health, University of Alberta, Edmonton, Canada
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Leino HM, Hurmerinta L, Sandberg B, Menzfeld M. No place like home - Or is there? Extended transformational potential of nursing homes during vital conjunctures. J Clin Nurs 2022; 32:2854-2866. [PMID: 35679129 DOI: 10.1111/jocn.16402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/16/2022] [Accepted: 05/23/2022] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES The purpose of this study is to explore how the concept of 'feeling at home' manifests in nursing home environments and influences the transformational potential of such homes-servicescapes where customers experience vital conjunctures. BACKGROUND Recent research on places highlights the potential of service venues as places that can promote well-being. Nursing homes bridge the concepts of 'home' and a service with transformational aspirations. Moving to a nursing home can be regarded as a vital conjuncture, yet despite the resultant mixed emotions, nursing homes can generate positive changes and meaningful relations. DESIGN; METHODS: A qualitative field study with ethnographic features was conducted in two Finnish nursing homes. The data consist of observations and 64 semi-structured interviews. COREQ guidelines were followed. RESULTS 'Feeling at home' is built on: (1) artefacts and surroundings, (2) functions and activities and (3) relationality and atmosphere. A home-like experience related to each category is important in enabling customers to feel at home, thus assisting in dealing with the vital conjuncture, but the transformative power of nursing homes is linked most closely to respectful, kind attendance of the others and a positive atmosphere. CONCLUSIONS The roles of nurses and a homely servicescape are essential in dealing with residents' vital conjunctures, whether those residents employ resistance or adjustment coping methods. Positive transformations that evoke residents' re-balancing and well-being are enabled in nursing homes that support residents' important relationships, identity, safety and self-efficacy. This positive transformation also aids family members with their associated vital conjunctures, thus multiplying the service's transformational potential. PATIENT OR PUBLIC CONTRIBUTION Service users and caregivers were involved in the design and conduct of the data in this study. RELEVANCE TO CLINICAL PRACTICE Creating a homely atmosphere in nursing homes fosters not only residents' but also family members' re-balancing and well-being.
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Affiliation(s)
- Henna M Leino
- Department of Marketing and International Business, University of Turku, Turku, Finland
| | - Leila Hurmerinta
- Department of Marketing and International Business, University of Turku, Turku, Finland
| | - Birgitta Sandberg
- Department of Marketing and International Business, University of Turku, Turku, Finland
| | - Mira Menzfeld
- Department of Religious Studies, University of Zurich, Zurich, Switzerland
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