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Taranrød LB, Kirkevold Ø, Pedersen I, Eriksen S. The transition of care from farm-based daycare for people with dementia: The perspective of next of kin. Int J Qual Stud Health Well-being 2023; 18:2228047. [PMID: 38016039 PMCID: PMC10291912 DOI: 10.1080/17482631.2023.2228047] [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: 11/11/2022] [Accepted: 06/18/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The aim of the present study was to explore the next of kin's experiences with the transition for people with dementia from a farm-based daycare (FDC) to another service in the municipality. METHODS The study has a qualitative, descriptive design. Eight semi-structured interviews with next of kin were conducted. The data were analysed in accordance with content analysis. RESULTS Through the analysis three main categories were developed: (1) Bearing the burden, (2) Being in transition, and (3) Feeling supported. The transition period was highly stressful for next of kin due to the exacerbation of their relatives' dementia symptoms. The next of kin focussed on optimizing the everyday lives of their relatives with dementia, even at the expense of their own well-being. Most participants experienced support from FDC, healthcare services and their informal network. CONCLUSIONS The study contributes important insights into the next of kin's experiences. Good quality service, close dialog, information, and support between the different part in the transition process, can be useful for the further development of services with good quality and to reduce the negative effects of care on next of kin.
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Affiliation(s)
- Liv Bjerknes Taranrød
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Centre for Age Related Functional Decline and Diseases (AFS) at Innlandet Hospital Trust, Hamar, Norway
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Ås, Norway, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Bachelor of Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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Layton N, Lalor A, Slatyer S, Lee DA, Bryant C, Watson M, Khushu A, Burton E, Oliveira D, Brusco NL, Jacinto A, Tiller E, Hill KD. Who cares for the carer? Codesigning a carer health and wellbeing clinic for older care partners of older people in Australia. Health Expect 2023; 26:2644-2654. [PMID: 37680165 PMCID: PMC10632619 DOI: 10.1111/hex.13863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 08/18/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023] Open
Abstract
INTRODUCTION Older carers or 'care partners' of older people experiencing care needs often provide essential support, at times while neglecting their own health and well-being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well-being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. METHODS Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus-based summaries, arriving at a preferred service model. FINDINGS This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well-being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. PUBLIC CONTRIBUTION This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions.
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Affiliation(s)
- Natasha Layton
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Aislinn Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
- Department of Occupational Therapy, School of Primary and Allied Health CareMonash UniversityMelbourneVictoriaAustralia
| | - Susan Slatyer
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Den‐Ching A Lee
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Christina Bryant
- Melbourne School of Psychological SciencesUniversity of MelbourneMelbourneVictoriaAustralia
| | - Moira Watson
- Centre for Healthy AgeingMurdoch UniversityMurdochWestern AustraliaAustralia
| | - Anjali Khushu
- Department of Geriatric MedicinePeninsula HealthFrankstonVictoriaAustralia
| | - Elissa Burton
- Curtin School of Allied HealthCurtin UniversityBentleyWestern AustraliaAustralia
- enAble Institute, Faculty of Health SciencesCurtin UniversityBentleyWestern AustraliaAustralia
| | - Déborah Oliveira
- Faculty of Nursing, Universidad Andrés BelloCampus Viña del MarViña del MarChile
- Millennium Institute for Care Research (MICARE)SantiagoChile
| | - Natasha L. Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
| | - Alessandro Jacinto
- Programa de Pós‐Graduação em Medicina Translacional, Faculty of Geriatric MedicineFederal University of São Paulo (UNIFESP)São PauloBrazil
| | - Elizabeth Tiller
- Department of Geriatrics (Falls Prevention Service)Peninsula HealthFrankstonVictoriaAustralia
| | - Keith D. Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research CentreMonash UniversityFrankstonVictoriaAustralia
- National Centre for Healthy AgeingMonash University and Peninsula HealthFrankstonVictoriaAustralia
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Wang J, Liu W, Yu S, Li X, Ma Y, Zhao Q, Lü Y, Xiao M. Social Networks Effects on Spouse and Adult-Child Dementia Caregivers' Experiences: A Cross-Sectional Study. J Am Med Dir Assoc 2023; 24:1374-1380.e1. [PMID: 37236264 DOI: 10.1016/j.jamda.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVES A large body of literature addresses experiences of spouse and adult-children caregiver of individuals with dementia (IWDs) but has not examined the role and strength of social networks in associations between spouses and adult-children caregivers' experience. Based on the stress process model, we aimed to explore the strength levels of social networks and their association with spouses/adult-children caregivers for IWDs. DESIGN A cross-sectional study. SETTING AND PARTICIPANTS A questionnaire-based survey was conducted with a total of 146 family caregivers of IWDs (78 adult-child, and 68 spouses) in China. METHODS Data collection comprised 4 sections: (1) care-related stressors (dementia stage, neuropsychiatric symptoms); (2) caregiver context; (3) social network, using the Lubben Social Network Scale; and (4) caregiving experience, using the short-form Zarit Burden Interview and 9-item Positive Aspects of Caregiving Scale. Linear regression, mediation model analysis, and interactive analysis were performed to explore the mechanisms of associations between variables. RESULTS Spouses had weaker social network strength (β = -0.294, P = .001) and reported greater positive aspects of caregiving (β = 0.234, P = .003) than adult-children caregivers; no significant difference was found between them for caregiver burden. Mediation analysis suggests that associations between caregiver type and caregiver burden are indirect-only mediation effects of social networks (β = 0.140, 95% CI = 0.066-0.228). The social network strength suppressed the association between caregiver type and positive aspects of caregiving. The caregiver type/social network interaction statistically significantly (P = .025) affected the "positive aspects": a stronger social network was associated with more positive aspects of caregiving among the spouse subgroup (β = 0.341, P = .003). CONCLUSIONS AND IMPLICATIONS Social networks mediate responses to caregiving experiences among different care provider types and are vital intervention targets, especially for spousal caregivers. Our results can serve as references for identifying caregivers for clinical intervention.
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Affiliation(s)
- Jun Wang
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weichu Liu
- Department of Gynecology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Shiqi Yu
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuelian Li
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yingzhuo Ma
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
| | - Mingzhao Xiao
- Department of Urology, the First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
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Kirvalidze M, Abbadi A, Dahlberg L, Sacco LB, Morin L, Calderón-Larrañaga A. Effectiveness of interventions designed to mitigate the negative health outcomes of informal caregiving to older adults: an umbrella review of systematic reviews and meta-analyses. BMJ Open 2023; 13:e068646. [PMID: 37085312 PMCID: PMC10124259 DOI: 10.1136/bmjopen-2022-068646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES This umbrella review aimed to evaluate whether certain interventions can mitigate the negative health consequences of caregiving, which interventions are more effective than others depending on the circumstances, and how these interventions are experienced by caregivers themselves. DESIGN An umbrella review of systematic reviews was conducted. DATA SOURCES Quantitative (with or without meta-analyses), qualitative and mixed-methods systematic reviews were included. ELIGIBILITY CRITERIA Reviews were considered eligible if they met the following criteria: included primary studies targeting informal (ie, unpaid) caregivers of older people or persons presenting with ageing-related diseases; focused on support interventions and assessed their effectiveness (quantitative reviews) or their implementation and/or lived experience of the target population (qualitative reviews); included physical or mental health-related outcomes of informal caregivers. DATA EXTRACTION AND SYNTHESIS A total of 47 reviews were included, covering 619 distinct primary studies. Each potentially eligible review underwent critical appraisal and citation overlap assessment. Data were extracted independently by two reviewers and cross-checked. Quantitative review results were synthesised narratively and presented in tabular format, while qualitative findings were compiled using the mega-aggregation framework synthesis method. RESULTS The evidence regarding the effectiveness of interventions on physical and mental health outcomes was inconclusive. Quantitative reviews were highly discordant, whereas qualitative reviews only reported practical, emotional and relational benefits. Multicomponent and person-centred interventions seemed to yield highest effectiveness and acceptability. Heterogeneity among caregivers, care receivers and care contexts was often overlooked. Important issues related to the low quality of evidence and futile overproduction of similar reviews were identified. CONCLUSIONS Lack of robust evidence calls for better intervention research and evaluation practices. It may be warranted to avoid one-size-fits-all approaches to intervention design. Primary care and other existing resources should be leveraged to support interventions, possibly with increasing contributions from the non-profit sector. PROSPERO REGISTRATION NUMBER CRD42021252841; BMJ Open: doi:10.1136/bmjopen-2021-053117.
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Affiliation(s)
- Mariam Kirvalidze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Ahmad Abbadi
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Lena Dahlberg
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Lawrence B Sacco
- Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Lucas Morin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Inserm CIC 1431, University Hospital of Besançon, Besançon, France
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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von Saenger I, Dahlberg L, Augustsson E, Fritzell J, Lennartsson C. Will your child take care of you in your old age? Unequal caregiving received by older parents from adult children in Sweden. Eur J Ageing 2023; 20:8. [PMID: 37012453 PMCID: PMC10070562 DOI: 10.1007/s10433-023-00755-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
Intergenerational family care provided to older parents by adult children is growing and differs based on gender and socioeconomic status. Few studies consider these elements in relation to both the parent and their adult child, and little is known about the number of care tasks received even though those providing intensive levels of care are at risk of experiencing adverse consequences in their lives. This study uses data from the nationally representative 2011 Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD) and includes child-specific information from parents aged 76 years and above. Analyses used ordinal logistic regression and are presented as average marginal effects and predictive margins. Results show that parents in need of care report that one-third of all adult children in the sample provide care to three out of five of them. The care is most often non-intensive, yet nearly one in ten of all children provide more intensive care of two or more tasks. When adjusting for dyad characteristics as well as geographic proximity, results show adult-child gender differences where parents receive more care from manual-working-class daughters than manual-working-class sons. Overall, manual-working-class daughters are most commonly reported as carers among adult children, and they are particularly overrepresented in providing intensive care. We conclude that gender and socioeconomic inequalities exist among care receivers' adult children, even in a strong welfare state such as Sweden. Knowledge about levels and patterns of intergenerational care have important implications for how to reduce unequal caregiving.
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Affiliation(s)
- Isabelle von Saenger
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Lena Dahlberg
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Erika Augustsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Johan Fritzell
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Carin Lennartsson
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden
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Lee DCA, Burton E, Slatyer S, Jacinto A, Oliveira D, Bryant C, Khushu A, Tiller E, Lalor A, Watson M, Layton N, Brusco N, Hill KD. Understanding the Role, Quality of Life and Strategies Used by Older Carers of Older People to Maintain Their Own Health and Well-Being: A National Australian Survey. Clin Interv Aging 2022; 17:1549-1567. [PMID: 36304174 PMCID: PMC9594879 DOI: 10.2147/cia.s384202] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/05/2022] [Indexed: 11/23/2022] Open
Abstract
Introduction Carers play a critical role in supporting older people with health problems to remain living at home. This study aimed to understand the role and quality of life of older carers of older people and identify strategies used to manage their own health and well-being. Methods Older carers (aged ≥50 years) of older people (aged ≥65 years) in Australia participated in a cross-sectional survey focused on carer roles, self-rated health, information and activities used to maintain their carer role and health, barriers to accessing health care, and assessment of quality of life (QoL) using the Dementia Quality of Life Scale for Older Family Carers. Multiple regression analysis examined relationships between variables and the QoL outcome. Results The survey was completed by 189 older carers (mean age: 68 years; SD = 9.3). Most were female (83.5%), 80.2% providing care daily and 47.8% provided ≥six hours care daily. Almost half (45.1%) self-reported their health as average or below. Despite rating ensuring personal health as very important (mean importance 8/10), only 46.3% reported receiving support from their general practitioner for their carer role. The most common barrier to accessing care for themselves was “not having enough time”. Factors independently associated with poorer carer QoL were living with the care-recipient, caring for someone with depression/anxiety and poor care-recipient health. Factors independently associated with higher carer QoL were placing high importance on personal health, receiving assistance from a specialist clinic as a carer, and older age. Conclusion Older carers of older people provide high levels of care and experience reduced quality of life. Innovative approaches that provide integrated care and support for older carers to promote their QoL are urgently needed.
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Affiliation(s)
- Den-Ching A Lee
- School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Victoria, 3199, Australia,Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,Correspondence: Den-Ching A Lee, School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Moorooduc Highway, Frankston, Victoria, 3199, Australia, Tel +613 9904 4662, Email
| | - Elissa Burton
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, 6102, Australia,enAble Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, 6102, Australia
| | - Susan Slatyer
- Centre for Healthy Ageing, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Alessandro Jacinto
- Faculty of Geriatric Medicine, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Déborah Oliveira
- Medical School, Faculty Postgraduate Department of Psychiatry, Federal University of Sao Paulo – UNIFESP, Sao Paulo-SP, Brazil
| | - Christina Bryant
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Anjali Khushu
- Department of Geriatrics (Falls Prevention Service), Peninsula Health, Frankston, Victoria, 3199, Australia
| | - Elizabeth Tiller
- Department of Geriatrics (Falls Prevention Service), Peninsula Health, Frankston, Victoria, 3199, Australia
| | - Aislinn Lalor
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,Department of Occupational Therapy, Monash University, Melbourne, Victoria, 3199, Australia
| | - Moira Watson
- Centre for Healthy Ageing, Murdoch University, Murdoch, Western Australia, 6150, Australia
| | - Natasha Layton
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia
| | - Natasha Brusco
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia
| | - Keith D Hill
- Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Victoria, 3199, Australia,National Centre for Healthy Ageing, Monash University and Peninsula Health, Frankston, Victoria, 3199, Australia
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Wang J, Li X, Liu W, Yang B, Zhao Q, Lü Y, Xiao M. The positive aspects of caregiving in dementia: A scoping review and bibliometric analysis. Front Public Health 2022; 10:985391. [PMID: 36187613 PMCID: PMC9515975 DOI: 10.3389/fpubh.2022.985391] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Accepted: 08/12/2022] [Indexed: 01/25/2023] Open
Abstract
Purpose The increasing incidence of dementia and home-based care exposes family caregivers to a variety of challenges as they endure strong stressors underlying the caregiver role. Despite growing publications on positive aspects of caregiving in dementia, few studies have identified the extent, nature, and gaps in the existing literature based on a holistic view. The aim was to identify key issues and a holistic view of literature regarding positive aspects of caregiving in dementia. Methods A scoping review was conducted underlying a five-stage framework by Arksey and O'Malley. Five databases, including PubMed, CINAHL, PsycINFO, Embase, and Web of Science, were searched, and references were listed accordingly. Data were extracted by two researchers, comprising article characteristics, forms of positive aspects of caregiving and measurements, theories, forms of dementia and family caregiver, and keywords. Descriptive statistics and narrative synthesis were performed to analyze data. Network analysis of keywords and authors was conducted using VOSviewer software. Word cloud analysis of titles was examined by NVivo. Results The review included 230 articles, most of which have been published in the last decade (62.61%). Most articles (40.00%) were contributed by the United States. Cross-sectional studies (41.30%) ranked first, followed by qualitative studies (13.48%). Over a quarter of the literature (28.26%) focused on Alzheimer's care, and nearly 90% included all forms of family caregivers. The Positive Aspects of Caregiving Scale and stress coping theory were most frequently cited. Four clusters dominated by Casey D, Quinn C, Joling KJ, and Teahan A were identified in the network of co-authorship. Six themes were identified: current situations of caregiver experiences, antecedents, consequences, measurement development, effects of interventions, and the concept of positive aspects of caregiving. These were in line with network analysis of keywords and word cloud analysis of titles. Conclusions Positive aspects of caregiving in dementia have been widely concerned, but most of them are based on the theory of the negative stress process and are limited to current situations and influencing factors. Building theories focus on the positive aspects of caregiving, subsequently developing a comprehensive measurement and effective interventions, should be further studied.
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Affiliation(s)
- Jun Wang
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xuelian Li
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Weichu Liu
- Department of Gynecology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Bing Yang
- Department of Nursing, Stomatological Hospital of Chongqing Medical University, Chongqing, China
| | - Qinghua Zhao
- Department of Nursing, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yang Lü
- Department of Geriatrics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mingzhao Xiao
- Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China,*Correspondence: Mingzhao Xiao
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