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Safa A, Adib-Hajbaghery M, Rezaei M. A model for older adults' coping with the death of their child: a grounded theory study. BMC Psychiatry 2024; 24:150. [PMID: 38383337 PMCID: PMC10882903 DOI: 10.1186/s12888-024-05597-3] [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: 06/20/2023] [Accepted: 02/07/2024] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Losing a child at an old age while also facing health problems and physical limitations can have significant negative impacts on parents' lives such as anxiety, depression, and impairment in social functions. The process of coping with the death of a child is particularly unknown among older adults. Therefore, this study aimed to explore how older adults cope with the death of their child. METHOD This qualitative study was conducted in 2020-2021, using Corbin and Strauss (2015) approach to the grounded theory method. The sampling began purposefully and continued theoretically until theoretical saturation was achieved. Semi-structured interviews were conducted to collect data from Iranian older adults who had experienced the death of their child. To ensure data trustworthiness, the Guba and Lincoln (1985) criteria were utilized. A qualitative data analysis software, MAXQDA2020, was used to manage the data. FINDINGS The results of this study were obtained from 27 participants. The main concern of older adults was the fear of their lives collapsing following the death of their child. Participants utilized three main strategies to address their concerns: attempting to rebuild themselves, connecting to a higher power, and searching for positivity amidst grief. The central category that emerged from the analysis was "improving physical, mental, and spiritual capacities," resulting in personal growth and improved social relationships. CONCLUSIONS Through the use of the three aforementioned strategies, older adults were able to overcome their primary concern of the fear of their lives collapsing following the death of their child. Further development of the theory is suggested in order to design a model that can facilitate older adults' coping with this difficult life event.
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Affiliation(s)
- Azade Safa
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mahboubeh Rezaei
- Trauma Nursing Research Center, Kashan University of Medical Sciences, Kashan, Iran
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Shamsikhani S, Ahmadi F, Kazemnejad A, Vaismoradi M. Design and psychometric properties of the family support for older people questionnaire. Front Public Health 2023; 11:1068839. [PMID: 36817922 PMCID: PMC9932903 DOI: 10.3389/fpubh.2023.1068839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/04/2023] [Indexed: 02/05/2023] Open
Abstract
Background and objectives The population of older people is increasing across the world. Older people need care and support from their families to be able to live independently. This study aimed to design and evaluate the psychometric properties of the family support for older people (FSOP) questionnaire. Methods In this instrument development study using a mixed-methods design, the psychometric properties of the FSOP questionnaire in terms of validity and reliability were evaluated. Results The FSOP questionnaire consisted of 50 items in six domains. It was shown to have appropriate qualitative and quantitative validities (score > 1.5). The indicators of content validity (CVR > 0.62, ICVI ≥ 0.80, and SCVI > 0.94) and confirmatory factor analysis (indexes of χ2/df = 2.50, CFI = 0.96, GFI = 0.97, AGFI = 0.96, NNFI = 0.96, PNFI = 0.89, TLI = 0.96, and RMSEA = 0.06) were satisfactory. Cronbach's alpha coefficient for reliability was 0.94, indicating an optimal score. Conclusions Healthcare providers and family caregivers are suggested to use the FSOP questionnaire for improving the quality of life of older people at home.
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Affiliation(s)
- Soheila Shamsikhani
- Shazand School of Nursing, Arak University of Medical Sciences, Arak, Iran,Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,*Correspondence: Fazlollah Ahmadi ✉
| | - Anoshirvan Kazemnejad
- Biostatistical Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway,Faculty of Science and Health, Charles Sturt University, Orange, NSW, Australia
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Mardanpour M, Rezaei J, Vaisi Raygani AA, Abdi A, Salari N, Khaledi-Paveh B, Mohammadi MM. The Effect of Family-Centered and Peer-Centered Education on the Sleep Quality of Hemodialysis Patients: A Randomized Clinical Trial. SAGE Open Nurs 2023; 9:23779608231178614. [PMID: 37273547 PMCID: PMC10233576 DOI: 10.1177/23779608231178614] [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: 02/02/2023] [Revised: 04/07/2023] [Accepted: 05/06/2023] [Indexed: 06/06/2023] Open
Abstract
Introduction Sleep disorders in hemodialysis patients are of high prevalence affecting the lives of these patients. Objective The present study was conducted to investigate the effect of family-centered and peer-centered education on the sleep quality of hemodialysis patients. Methods In this controlled clinical trial, 90 patients were randomly assigned to three groups (control, family-centered, and peer-centered). All three groups completed Pittsburgh Sleep Quality Index before the intervention. The intervention included five training sessions conducted by the researcher according to the patients' needs to improve their sleep quality. Routine ward interventions were performed for the control group. At the end of the study, the Pittsburgh Sleep Quality Index was completed by all three groups once again. Data were collected and analyzed using SPSS version 24 software and statistical tests. Results No significant difference was found between the two intervention and control groups regarding demographic variables and variables related to sleep quality before the intervention (p < .05). However, based on the results of the Wilcoxon test, there was a statistically significant difference between the mean rank of sleep quality in the intervention and control groups after the intervention (p-value = .008), indicating that sleep hygiene education was effective in the two intervention groups. Conclusion According to the findings, the mean rank of sleep quality in the two intervention groups was significant after the training, indicating the effectiveness of family-centered and peer-centered education. Accordingly, medical healthcare managers, policymakers, and planners, including nurses, are recommended to employ these convenient, safe, and cost-free training methods and provide better sleep quality and more comfort to patients by spending a short period of time for training.
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Affiliation(s)
- Maryam Mardanpour
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Jahangir Rezaei
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ali Akbar Vaisi Raygani
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Abdi
- School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behnam Khaledi-Paveh
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Rahimi F, Shakibazadeh E, Ashoorkhani M, Foroughan M. Barriers to home care for older adults from perspectives of Iranian informal caregivers: a qualitative study. BMJ Open 2022; 12:e065547. [PMID: 36600370 PMCID: PMC9730353 DOI: 10.1136/bmjopen-2022-065547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE A longer life expectancy increases the number of older adults who require long-term care. The presence of a caregiver at home prevents the placement of older adults in care facilities. Identifying the caregivers' viewpoints around the care clarifies key factors in providing quality care.This study aimed to assess barriers to home care from the perspective of Iranian informal caregivers of older adults. DESIGN This was a qualitative study with content analysis. Semistructured interviews were conducted via telephone in Persian with informal caregivers of older adults using open-ended questions. SETTING Social and health organisations in southern Tehran, Iran. PARTICIPANTS Seventeen informal caregivers were selected on purpose. Participants were eligible to participate in the study if they were 18 years or older, and had at least 1 month of care experience for a minimum of 6 hours per week. RESULTS Barriers to home care for older adults from informal caregivers' points of view were categorised into three domains: (1) Individual barriers include the physical, mental and social burden of care as well as personal characteristics of the caregiver; (2) interpersonal barriers include psychobehavioural characteristics of the older adult and misbehaviour of people around the caregiver and (3) care system barriers include inefficient institutional/organisational infrastructure, moral issues and inefficiency in public policy. CONCLUSIONS Our study showed multiple individual, interpersonal and care system barriers to home care for older adults. Specific contextual challenges among Iranian caregivers, such as their attitudes and beliefs, as well as a lack of social and healthcare support for families, hindered the quality of care. TRIAL REGISTRATION NUMBER IRCT20201012048999N1.
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Affiliation(s)
- Fatemeh Rahimi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Shakibazadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Ashoorkhani
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahshid Foroughan
- Department of Aging, Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Science, Tehran, Iran
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Giang NH, Vinh NT, Phuong HT, Thang NT, Oanh TTM. Household financial burden associated with healthcare for older people in Viet Nam: a cross-sectional survey. Health Res Policy Syst 2022; 20:112. [PMID: 36443746 PMCID: PMC9706832 DOI: 10.1186/s12961-022-00913-3] [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: 09/16/2022] [Accepted: 09/16/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Population ageing and the associated increase in the healthcare needs of older people are putting pressure on the healthcare system in Viet Nam. The country prioritizes healthcare for older people and has developed financial protection policies to mitigate financial hardship due to out-of-pocket health expenditures (OOPHEs) borne by their households. This study examines the level and determinants of the financial burden of OOPHE among households with people aged ≥ 60 years in Viet Nam. METHODS A cross-sectional household survey was conducted among a sample of 1536 older people living in 1477 households in three provinces representing the North, Central and South regions of Viet Nam during 2019-2020. The financial outcomes were catastrophic health expenditure (CHE), using WHO's definition, and financial distress due to OOPHE. Multivariate binary logistic regression analysis was employed to determine the factors associated with these outcomes. RESULTS OOPHE for older household members accounted for 86.3% of total household health expenditure. Of households with older people, 8.6% (127) faced CHE, and 12.2% (181) experienced financial distress due to OOPHE. Households were at a higher risk of incurring financial burdens related to health expenditures if they had fewer household members; included only older people; were in rural or remote, mountainous areas; and had older members with noncommunicable diseases. There was no significant association between health insurance coverage and financial burden. However, when older people sought tertiary care or private care, the possibility of a household facing CHE increased. Regardless of the type and level of care, health service utilization by older people results in a higher likelihood of a household encountering financial distress. CONCLUSIONS This study reveals that OOPHE for older people can impose substantial financial burdens on households, leading them to face CHE and financial distress. This study provides evidence to justify reforming financial protection policies and introducing policy interventions targeted at better protecting older people and their households from the financial consequences of OOPHE. There is also the need to strengthen the grassroots health facilities to provide primary care closer to home at lower costs, particularly for the management of noncommunicable diseases.
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Affiliation(s)
- Nguyen Hoang Giang
- grid.492361.b0000 0004 0642 7152Health Strategy and Policy Institute, Lane 196, Ho Tung Mau Street, Mai Dich Ward, Cau Giay District, Hanoi, Viet Nam
| | - Nguyen The Vinh
- grid.492361.b0000 0004 0642 7152Health Strategy and Policy Institute, Lane 196, Ho Tung Mau Street, Mai Dich Ward, Cau Giay District, Hanoi, Viet Nam
| | - Hoang Thi Phuong
- grid.492361.b0000 0004 0642 7152Health Strategy and Policy Institute, Lane 196, Ho Tung Mau Street, Mai Dich Ward, Cau Giay District, Hanoi, Viet Nam
| | - Nguyen Thi Thang
- grid.492361.b0000 0004 0642 7152Health Strategy and Policy Institute, Lane 196, Ho Tung Mau Street, Mai Dich Ward, Cau Giay District, Hanoi, Viet Nam
| | - Tran Thi Mai Oanh
- grid.492361.b0000 0004 0642 7152Health Strategy and Policy Institute, Lane 196, Ho Tung Mau Street, Mai Dich Ward, Cau Giay District, Hanoi, Viet Nam
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Lotfalinezhad E, Nadrian H, Kousha A, Andersen-Ranberg K, Asghari Jafarabadi M, Sohrabi A, Hashemiparast M, Honarvar MR, Freeman S. Design, implementation and evaluation of informal home care support intervention program for lonely older adults in the community: Protocol for a feasibility study. PLoS One 2022; 17:e0273924. [PMID: 36044533 PMCID: PMC9432751 DOI: 10.1371/journal.pone.0273924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 07/23/2022] [Indexed: 11/19/2022] Open
Abstract
Background Providing lonely older adults with informal home care services is important to improving their health and quality of life. The study aims to evaluate the feasibility of design, implementation and evaluation of an informal home care support intervention program (HoSIP) for community-dwelling lonely older adults in Gorgan, Iran. Method/design This feasibility study is a mixed-method with a concurrent nested design. Lonely older adults will be enrolled as the HoSIP intervention group and will receive 12-weeks of informal home care service by peer supporters. The purpose of this feasibility study is to determine the recruitment capability and resulting sample characteristics, data collection procedure and outcome measures, the acceptability and suitability of the intervention and study procedures, the resource and ability to manage the study and intervention, and preliminary evaluation of participant response to intervention. Primary outcomes including participant feelings of loneliness, quality of life, general health, social network, social support, and self-care ability, will be assessed at baseline and post-intervention for the intervention and control groups. Semi-structured interviews will be conducted immediately after the intervention using content qualitative approach to describe participants’ experiences with HoSIP. Discussion Through this study we will examine the feasibility of delivering informal home care services to community-dwelling lonely older adults in a developing country through employing a concurrent nested mixed-method design. Trial registration IRCT20190503043455N
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Affiliation(s)
- Elham Lotfalinezhad
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Haidar Nadrian
- Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- * E-mail:
| | - Ahmad Kousha
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Karen Andersen-Ranberg
- Department of Clinical Research, Consultant Physician, Dept. of Geriatrics, Odense University Hospital, University of Southern Denmark, Odense, Denmark
| | - Mohamed Asghari Jafarabadi
- Cabrini Research, Cabrini Health, Malvern, Victoria, Australia
- School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ahmad Sohrabi
- Cancer Control Research Center, Cancer Control Foundation, Iran University of Medical Sciences, Tehran, Iran
| | - Mina Hashemiparast
- Department of Health Education & Promotion, School of Public Health, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mohammad Reza Honarvar
- Health Management and Social Development Research Center, Golestan University of Medical Sciences, Gorgan, Iran
| | - Shannon Freeman
- Faculty of Nursing, University of Northern British Columbia, Prince George, Canada
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Effectiveness of Supportive Educative Programs on the Care Burden of Informal Caregivers and Perceived Social Support of the Older Adults: a Quasi-experimental Study. AGEING INTERNATIONAL 2022. [DOI: 10.1007/s12126-022-09501-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Shamsikhani S, Ahmadi F, Kazemnejad A, Vaismoradi M. Meaning of Respect for Older People in Family Relationships. Geriatrics (Basel) 2022; 7:geriatrics7030057. [PMID: 35645280 PMCID: PMC9149946 DOI: 10.3390/geriatrics7030057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Older people have various physical and mental health needs and often receive help from their family members to perform their daily life activities. This research aimed to explore the meaning of respect for older people in family relationships. Methods: A qualitative study using a content analysis approach was conducted. Semi-structured interviews were performed with sixteen older people and four family members. Results: Three main categories were developed: “respect for personal interests”, “kind and sincere respect” and “respect for autonomy”. Understanding of the meaning of respect for older people was influenced by special expectations from family members in terms of meeting personal needs, consideration of preferences and interests and empowerment and support to help preserve older people’s independence and autonomy. Conclusions: Family members should be informed and educated with regard to their expected roles in family relationships, and should consider respect as an important factor affecting older people’s well-being.
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Affiliation(s)
- Soheila Shamsikhani
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran;
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran;
- Correspondence: ; Tel.: +98-21-8288-3553
| | - Anoshirvan Kazemnejad
- Biostatistics Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14155-4838, Iran;
| | - Mojtaba Vaismoradi
- Faculty of Nursing and Health Sciences, Nord University, 8049 Bodø, Norway;
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Needs Detection for Carers of Family Members with Dementia. Healthcare (Basel) 2021; 10:healthcare10010045. [PMID: 35052209 PMCID: PMC8775551 DOI: 10.3390/healthcare10010045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 11/29/2022] Open
Abstract
Aim: To determine the perceived needs of carers of non-institutionalized family members that suffer from dementia. Methods: Two-steps qualitative study by focus groups of relatives in three centres of different characteristics from the Girona Health Region (step 1) and two in-depth interviews with significant professionals in dementia care (step 2). The analysis was performed based on the interpretation of the transcribed data and the bottom-up coding of categories and themes. The information was triangulated and coding was agreed upon. Results: There were three groups, 26 main carers of community-dwelling relatives with dementia in step 1 and two in-depth interviews with dementia-specialised healthcare and social care professionals in step 2. The demands were categorised according to three main themes: whether they were addressed to the members of care services for more direct and close care, to the agencies for a better joint working and less fragmented system, or to society for better comprehension and social recognition. We emphasize the need for a consultation-liaison reference figure throughout the process both for aspects of greater efficiency in the management of resources and for greater empowerment of carers.
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