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Evans E, Zengul A, Knight A, Willig A, Cherrington A, Mehta T, Thirumalai M. Stakeholders' Perspectives, Needs, and Barriers to Self-Management for People With Physical Disabilities Experiencing Chronic Conditions: Focus Group Study. JMIR Rehabil Assist Technol 2023; 10:e43309. [PMID: 38109170 PMCID: PMC10758937 DOI: 10.2196/43309] [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: 10/07/2022] [Revised: 09/28/2023] [Accepted: 10/19/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND While self-management programs have had significant improvements for individuals with chronic conditions, less is known about the impact of self-management programs for individuals with physical disabilities who experience chronic conditions, as no holistic self-management programs exist for this population. Similarly, there is limited knowledge of how other stakeholders, such as caregivers, health experts, and researchers, view self-management programs in the context of disability, chronic health conditions, and assistive technologies. OBJECTIVE This study aimed to obtain insight into how stakeholders perceive self-management relating to physical disability, chronic conditions, and assistive technologies. METHODS Nine focus groups were conducted by 2 trained facilitators using semistructured interview guides. Each guide contained questions relating to stakeholders' experiences, challenges with self-management programs, and perceptions of assistive technologies. Focus groups were audio recorded and transcribed. Thematic analysis was conducted on the focus group data. RESULTS A total of 47 individuals participated in the focus groups. By using a constructivist grounded approach and inductive data collection, three main themes emerged from the focus groups: (1) perspectives, (2) needs, and (3) barriers of stakeholders. Stakeholders emphasized the importance of physical activity, mental health, symptom management, medication management, participant centeredness, and chronic disease and disability education. Participants viewed technology as a beneficial aide to their daily self-management and expressed their desire to have peer-to-peer support in web-based self-management programs. Additional views of technology included the ability to access individualized, educational content and connect with other individuals who experience similar health conditions or struggle with caregiving duties. CONCLUSIONS The findings suggest that the development of any web-based self-management program should include mental health education and resources in addition to physical activity content and symptom management and be cost-effective. Beyond the inclusion of educational resources, stakeholders desired customization or patient centeredness in the program to meet the overall needs of individuals with physical disabilities and caregivers. The development of web-based self-management programs should be holistic in meeting the needs of all stakeholders. TRIAL REGISTRATION ClinicalTrials.gov NCT05481593; https://clinicaltrials.gov/study/NCT05481593.
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Affiliation(s)
- Eric Evans
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Ayse Zengul
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Amy Knight
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Amanda Willig
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Andrea Cherrington
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Tapan Mehta
- Department of Family and Community Medicine, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Mohanraj Thirumalai
- Department of Health Services Administration, School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, United States
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Martsolf GR, Kandrack R, Rodakowski J, Friedman EM, Beach S, Folb B, James AE. Work Performance Among Informal Caregivers: A Review of the Literature. J Aging Health 2019; 32:1017-1028. [DOI: 10.1177/0898264319895374] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objectives: To examine the association between informal caregiving and caregiver work performance. Method: A systematized review of the literature. Results: We found that caregiving has an adverse impact on work performance: caregivers experience substantial work disruptions and negative work performance outcomes, and these findings were consistent across measures. Our synthesis suggests that caregivers miss a significant amount of work and have reductions in productivity due to their caregiving responsibilities. However, significant methodological limitations with the reviewed studies make systematic interpretations and causal determinations challenging. Discussion: Examining the effect of caregiving on work performance is critical to better understand the full impact of caregiving, especially as demand for caregivers increases as the population ages. This comprehensive review suggests that caregiving has a significant negative impact on work performance, although methodological challenges remain in this area of science. These findings should inform both public policy development and workplace benefits design.
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Affiliation(s)
- Grant R. Martsolf
- RAND Corporation, Pittsburgh, PA, USA
- University of Pittsburgh, PA, USA
| | - Ryan Kandrack
- RAND Corporation, Pittsburgh, PA, USA
- The University of North Carolina at Chapel Hill, USA
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Graff MJ, Vernooij-Dassen MJ, Zajec J, Olde-Rikkert MG, Hoefnagels WH, Dekker J. How can occupational therapy improve the daily performance and communication of an older patient with dementia and his primary caregiver? DEMENTIA 2016. [DOI: 10.1177/1471301206069918] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To enhance insight into the process of occupational therapy (OT) and the changes after OT, in an older patient with mild dementia and his primary caregiver. Design and setting: Case study: content analysis of an OT patient record. Intervention: System-based OT at home using a guideline focusing on both patient's performance in daily activities and caregiver's cognition on patient behaviour and caregiver role and focusing on adaptation of the physical environment. Measures: Triangulation of results of qualitative content analysis and quantitative description using the following measures: Brief Cognitive Rating Scale (BCRS), Assessment of Motor and Process Skills (AMPS), Interview of Deterioration in Daily Activities in Dementia (IDDD), Canadian Occupational Performance Measurement (COPM), Dementia Quality of Life Instrument (DQOL), Sense of Competence Scale (SCQ) and the Mastery Scale. Results: The global categories derived from content analysis were: daily performance and communication. The specific categories were the patient with dementia, his or her caregiver and the occupational therapist. Important themes derived from content analysis were: patient's capacity for pleasure, autonomy and appreciation in performing daily activities and caregiver's competence. Patient's changes reported after OT: more initiative, autonomy and pleasure in performing daily activities, increase of quality of life; caregiver's changes reported after OT: improved communication and supervision skills, changed cognition on patient behaviour and caregiver role, improved sense of competence. The quantitative results showed an improved daily performance (e.g. initiative, motor and process skills, need for assistance) and quality of life of the patient and improved sense of competence, quality of life and mastery of the situation of the caregiver after OT intervention. Thus the results of the qualitative content analysis were supported by the quantitative results. Additionally, based on the results of the content analysis an exploratory and system-based model has been developed connecting OT diagnosis and OT treatment at home for patients with dementia and their primary caregivers. Conclusion: This case study provides information on how occupational therapy can improve the daily performance, communication, sense of competence and quality of life of an older patient with dementia and his or her primary caregiver. A combination of education, setting feasible goals, using adaptations in physical environment, training compensatory skills, training supervision skills, and changing dysfunctional cognitions on patient behaviour and caregiver role seemed to be successful. A randomized controlled trial must provide information on the effects of OT at home for older patients with dementia and their primary caregivers.
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Karp DA, Watts-Roy D. Bearing Responsibility: How Caregivers to the Mentally Ill Assess Their Obligations. Health (London) 2016. [DOI: 10.1177/136345939900300408] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Based on 50 in-depth interviews, this article describes how family caregivers to a spouse, parent, child, or sibling suffering from depression, manic-depression, or schizophrenia negotiate their involvement with the ill person. The central research question asks: ‘what features of the situation do family members take into account as they try to operationalize boundaries of obligation between themselves and the mentally ill person in their lives?’ Data analysis of the joint experience of caregivers and family members reveals four interpretive junctures that mark transitions in the way caregivers assess their obligations. They are: hoping and learning, revising expectations, assessing responsibility, and preserving oneself. These categories capture clear regularities in the way respondents re-interpret their obligations to care over time. Our analysis suggests the need for a research agenda that looks more closely at how negotiations between caregivers and sick family members are mediated by their gender and status within the family.
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Rasu RS, Cline SK, Shaw JW, Hayes O, Agbor Bawa W, Cifaldi MA. Impact of JIA on parents' work absences. Rheumatology (Oxford) 2014; 54:1177-85. [PMID: 25504895 DOI: 10.1093/rheumatology/keu414] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Children with JIA have long-term morbidity and require extensive parental assistance. This study aimed to evaluate the impact of having a child with JIA on parents' missed work time, which can lead to decreased work productivity. METHODS The Truven Health MarketScan Commercial Database (2000-9) was accessed to identify a cohort of parents having a child with newly diagnosed JIA. For comparison, a cohort of parents having no children with JIA was identified and matched with the preceding cohort. Parents' work absences were analysed using descriptive statistics and multivariable regression. Estimates were weighted to be generalizable to the US employer-sponsored insurance population. RESULTS The study identified 108 parents having a child with newly diagnosed JIA (mean age 42.5 years), representing an estimated 3335 (weighted) parents nationally. Most of them were from the South (45%), male (71%) and employed in the transportation and utilities industry (58%). The demographic characteristics of the control cohort of parents were generally similar. Children with JIA (mean age 10.6 years) represented an estimated 3528 cases nationally. The mean number of reported missed work-time hours was 281.81 (s.e. 40.50) in a 9 year period for parents having a child with JIA compared with other parents 183.36 (28.55). Work-time loss was significantly related to having a child with JIA, sex and geographical region of residence. Parents having a child with JIA were 2.78 times more likely to report work-time loss [odds ratio (OR) 2.78 (95% CI 1.47, 5.26)] than those having no children with JIA. CONCLUSION Parents having a child with JIA report significant work-time loss compared with parents with no children having JIA, particularly during the year following the child's diagnosis.
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Affiliation(s)
- Rafia S Rasu
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Stephanie K Cline
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - James W Shaw
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Oscar Hayes
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Walter Agbor Bawa
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
| | - Mary A Cifaldi
- School of Pharmacy, University of Kansas, Lawrence, KS, Global Health Economics and Outcomes Research, AbbVie, North Chicago, IL and School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO, USA
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6
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C. Arévalo-Flechas L, Acton G, I. Escamilla M, N. Bonner P, L. Lewis S. Latino Alzheimer's caregivers: what is important to them? JOURNAL OF MANAGERIAL PSYCHOLOGY 2014. [DOI: 10.1108/jmp-11-2012-0357] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Parker MW, Call VRA, Dunkle R, Vaitkus M. “Out of Sight” But Not “Out of Mind”: Parent Contact and Worry Among Senior Ranking Male Officers in the Military Who Live Long Distances From Parents. MILITARY PSYCHOLOGY 2009. [DOI: 10.1207/s15327876mp1404_3] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- M. W. Parker
- School of Social Work, University of Alabama, and Center for Aging and Department of Geriatrics and Gerontology, University of Alabama at Birmingham
| | | | - Ruth Dunkle
- School of Social Work, University of Michigan
| | - Mark Vaitkus
- U.S. Army Physical Fitness Research Institute, U.S. Army War College
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8
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Giovannetti ER, Wolff JL, Frick KD, Boult C. Construct validity of the Work Productivity and Activity Impairment questionnaire across informal caregivers of chronically ill older patients. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2009; 12:1011-7. [PMID: 19402853 PMCID: PMC3040443 DOI: 10.1111/j.1524-4733.2009.00542.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES To assess the validity of the Work Productivity and Activity Impairment questionnaire as adapted for caregiving (WPAI:CG) to measure productivity loss (hours missed from work, impairment while at work, and impairment in regular activities) due to unpaid caregiving for medically complex older adults. METHODS The WPAI:CG was administered along with the Caregiver Strain Index (CSI) and Center for Epidemiologic Studies Depression Scale (CESD) to a caregiving population (N = 308) enrolled with their older, medically complex care-recipient in a cluster-randomized controlled study. Correlation coefficients were calculated between each productivity variable derived from the WPAI:CG and CSI/CESD scores. Nonparametric tests for trend across ordered groups were carried out to examine the relationship between each productivity variable and the intensity of the caregiving. RESULTS Significant positive correlations were found between work productivity loss and caregiving-related strain (r = 0.45) and depression (r = 0.30). Measures of productivity loss were also highly associated with caregiving intensity (P < 0.05) and care-recipient medical care use (P < 0.05). The average employed caregiver reported 1.5 hours absence from work in the previous week and 18.5% reduced productivity while at work due to caregiving. Employed and nonemployed caregivers reported 27.2% reduced productivity in regular activities in the previous week. CONCLUSION The results indicate high convergent validity of the WPAI:CG questionnaire. This measure could facilitate research on the cost-effectiveness of caregiver-workplace interventions and provide employers and policy experts with a more accurate and comprehensive estimate of caregiving-related costs incurred by employers and society.
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Affiliation(s)
| | - Jennifer L. Wolff
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
| | - Kevin D. Frick
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
| | - Chad Boult
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Johns Hopkins School of Medicine, Baltimore, MD
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9
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Lewis SL, Miner-Williams D, Novian A, Escamilla MI, Blackwell PH, Kretzschmar JH, Arévalo-Flechas LC, Bonner PN. A stress-busting program for family caregivers. Rehabil Nurs 2009; 34:151-9. [PMID: 19583056 DOI: 10.1002/j.2048-7940.2009.tb00271.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Aging baby boomers, longer life spans, and rising levels of Alzheimer's disease and related dementias (ADRD) will result in a caregiver crisis in the near future. The ways in which caregivers deal with stresses related to caregiving will be critical to both their own well-being and their ability to care for others. The purpose of this article is to describe the Stress-Busting Program (SBP) for family caregivers and its effectiveness. The essential components of the SBP are education, stress management, problem solving, and support delivered in a group setting for 9 weeks. Results of the SBP indicate that throughout the program, caregivers experienced significant improvements in general health, vitality, social function, and mental health scores and decreases in anxiety, anger/hostility, depression, perceived stress, and caregiver burden. The SBP is a cost-effective health-promotion strategy for caregivers who have substantial ongoing stress.
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Affiliation(s)
- Sharon L Lewis
- School of Nursing and Medicine, University of Texas Health Science Center at San Antonio, USA.
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10
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McGrath WL, Mueller MM, Brown C, Teitelman J, Watts J. Caregivers of Persons with Alzheimer'S Disease. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2009. [DOI: 10.1080/j148v18n02_04] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Kurtz ME, Kurtz JC, Given CW, Given B. A randomized, controlled trial of a patient/caregiver symptom control intervention: effects on depressive symptomatology of caregivers of cancer patients. J Pain Symptom Manage 2005; 30:112-22. [PMID: 16125026 PMCID: PMC1805478 DOI: 10.1016/j.jpainsymman.2005.02.008] [Citation(s) in RCA: 89] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2005] [Indexed: 11/30/2022]
Abstract
In this study, we investigated whether a clinical nursing intervention focusing on teaching family caregivers and their cancer patients skills to better manage the patients' symptoms would reduce caregiver depressive symptomatology. Two hundred thirty-seven patient/caregiver dyads were recruited for the study. These dyads were randomized into either the 10-contact, 20-week experimental intervention group (n=118), which focused on assisting the patient and caregiver in managing patient symptoms and reducing emotional distress, or to a conventional care control group (n=119). A longitudinal random effects regression analysis did not indicate that the clinical nursing intervention was effective in decreasing caregiver depression over the 20-week course of the study. The relationship of the intervention to caregiver depressive symptomatology seems to be a complex one. We recommend further research to explore whether a lengthened intervention and/or delayed follow-up might reveal delayed positive effects of such interventions.
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Affiliation(s)
- Margot E Kurtz
- Department of Family and Community Medicine, Michigan State University, East Lansing, Michigan 48824, USA
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Rosswurm MA, Larrabee JH, Nunley BL. Improving geriatric care knowledge, competency, and resourcefulness of home care nurses and aides. HOME HEALTHCARE NURSE 2003; 21:300-6. [PMID: 12792411 DOI: 10.1097/00004045-200305000-00006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Home care nurses aides have opportunities to support families caring for frail elders; however, most lack specialized geriatric knowledge, competence, and resourcefulness skills essential to caring for vulnerable elders and assisting their families. This study compares the pretest and posttest intervention scores of a geriatric care continuing education program for nurses and aides. Specific participant outcomes include increased geriatric knowledge, competency, and resourcefulness.
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Affiliation(s)
- Mary Ann Rosswurm
- Geriatric Nursing and Evidence-Based Practice, West Virginia University School of Nursing, USA.
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13
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Rosswurm MA, Larrabee JH, Zhang J. Training family caregivers of dependent elderly adults through on-site and telecommunications programs. J Gerontol Nurs 2002; 28:27-38. [PMID: 12168715 DOI: 10.3928/0098-9134-20020701-07] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Mary Ann Rosswurm
- West Virginia University School of Nursing, Cincinnati, Ohio 45247, USA
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14
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Silver HJ, Wellman NS. Family caregiver training is needed to improve outcomes for older adults using home care technologies. JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION 2002; 102:831-6. [PMID: 12067050 DOI: 10.1016/s0002-8223(02)90185-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Family caregivers, although uncompensated, provide daily care for more than 75% of the older adults who are dependent on home care technologies such as home enteral nutrition. The high complication rates and poor outcomes seen in older adults suggest that being an effective caregiver requires specialized training in home care technologies, and dietitians need to be more actively involved in discharge planning and follow-up home care. The level of knowledge and skill mastery required for technology-dependent care, along with the chronic, intensive nature of family caregiving and the disruptions in caregivers' daily lives, lead to negative emotional and physical consequences that may interfere with caregivers' ability to do caregiving well. Recognizing that care recipients and caregivers are underserved populations, dietitians should develop their professional competencies and expand their roles in technology-dependent home care. Dietitians can thereby contribute to better outcomes for both family caregivers and older home care recipients.
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Affiliation(s)
- Heidi J Silver
- National Policy and Resource Center on Nutrition and Aging, Florida International University, Miami 33199, USA.
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15
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Silver HJ, Wellman NS. Nutrition education may reduce burden in family caregivers of older adults. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2002; 34 Suppl 1:S53-S58. [PMID: 12047830 DOI: 10.1016/s1499-4046(06)60312-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The chronic, demanding nature of family caregiving for frail older adults creates a high degree of stress for caregivers, called caregiver burden. Caregiver burden compromises caregivers' emotional and physical health and health-promoting behaviors. Deterioration in caregivers' health and nutritional status may put caregivers at risk for chronic disease, diminish the ability of caregivers to provide care, and impair the quality of life experienced by caregivers and care recipients. Nutrition education may help reduce caregiver stress and maintain caregivers' health and well-being. Mediating caregiver stress may allow family caregivers to meet their societal role, which has intensified because of health care cost containment.
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Affiliation(s)
- Heidi J Silver
- National Policy and Resource Center on Nutrition and Aging, Florida International University, Miami, Florida 33199, USA.
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Lai CK, Wong FL, Liu KH. A training workshop on late-stage dementia care for family caregivers. Am J Alzheimers Dis Other Demen 2001; 16:361-8. [PMID: 11765861 PMCID: PMC10833672 DOI: 10.1177/153331750101600607] [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: 11/17/2022]
Abstract
Training workshops have been considered a useful intervention in helping family caregivers of people with dementia to cope with the stress of caregiving. However, there are no reports in the literature with regard to training and support of families specifically looking after individuals who are in the late stage of dementia. This paper reports the experience and evaluation of a training workshop aimed at preparing family caregivers for late-stage dementia care. Eighty-eight percent of the participants completed the client satisfaction questionnaire. The results from the questionnaire gave a very positive response, showing 90.9 percent of respondents were satisfied with the workshop, and 77.3 percent of respondents indicated that their caregiving needs were met. Eleven participants who attended this workshop joined a focus group feedback session. The Kruskal-Wallis test found no significant differences between the overall profile of the participants and that of the focus group in terms of age, gender, educational background, whether they were primary caregivers, for whom they cared (e.g., parents or spouse), or whether the care recipient stayed at home or in a nursing home. Findings from the focus group session provide a somewhat different picture from that of the questionnaire. Three focus group participants provided more critical comments of the workshop. Although the majority of the focus group agreed that the workshop had been useful, they disagreed on whether it is necessary to discuss psychosocial issues in this workshop. Findings from the focus group have enabled the project team to reflect on their design and operation of the workshop and provided valuable insight for future development as well as for further study.
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Affiliation(s)
- C K Lai
- Department of Nursing and Health Sciences, Hong Kong Polytechnic University, SAR, China
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Weaver AJ, Flannelly LT, Flannelly KJ. A review of research on religious and spiritual variables in two primary gerontological nursing journals: 1991 to 1997. J Gerontol Nurs 2001; 27:47-54. [PMID: 11820556 DOI: 10.3928/0098-9134-20010901-09] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
All articles published between 1991 and 1997 in the Journal of Gerontological Nursing and Geriatric Nursing were classified as qualitative research, quantitative research, or non-research. Of the 784 articles reviewed, 5.1% mentioned religion or spirituality. Research articles (7.7%) were more likely than non-research articles (2.8%) to address religion and spirituality. No statistical difference was found between the percentage of qualitative (10.7%) and quantitative (6.8%) studies addressing religious and spiritual factors. The percentage of quantitative studies including religious and spiritual variables was found to be higher than that found by systematic reviews of the research literature in various health professions.
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Affiliation(s)
- A J Weaver
- The HealthCare Chaplaincy, New York, New York 10022-1505, USA
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Abstract
Men are important providers of care to older adults who are functionally impaired in the home setting. Some results from research studies suggest that the male caregiver may provide different types of care and have different responses to caregiving than female caregivers. This article provides an overview of research related to the role of the male caregiver and discusses implications for supportive interventions. The need for more research related to the needs of the male caregivers and the value of traditional interventions for this group are addressed.
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Affiliation(s)
- S C Houde
- University of Massachusetts, Lowell, Department of Nursing, 01854, USA
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Abstract
'Finding a balance point' is a process used by caregivers to achieve or preserve equilibrium in caregiving while facing competing needs. This paper describes different patterns of 'finding a balance point'. Interviews with 15 family caregivers receiving home nursing services and 14 family caregivers of hospitalized and discharged frail elders were analysed using constant comparison. Sources of competing needs and the strategies used to find a balance point were identified by participants. Findings suggest that caregivers in a stable situation maintain a balance point, caregivers experiencing major family change try to regain a balance point, and caregivers experiencing the transition from hospital to home work at establishing a balance point. These findings can sensitize nurses to family caregivers' needs and conditions.
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Affiliation(s)
- Y I Shyu
- Graduate Institute of Nursing, Chang Gung University, Kwei-Shan, Tao-Yuan, Taiwan, Republic of China.
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Kennedy J, Walls C, Owens-Nicholson D. A national profile of primary and secondary household caregivers: estimates from the 1992 and 1993 surveys on income and program participation. Home Health Care Serv Q 1999; 17:39-58. [PMID: 10539580 DOI: 10.1300/j027v17n04_04] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
According to the 1992 and 1993 Surveys of Income and Program Participation (SIPP), an estimated 4,538,000 adults in the U.S. serve as primary assistants for one or more household members with disabilities. Another 530,000 serve as secondary assistants. Spouses are the main source of primary ADL and IADL assistance, while adult children and other family members are the main source of secondary assistance. Primary household assistants tend to be older and female, while secondary assistants tend to be younger and male. Primary assistants are more likely than the general adult population to rate their health as fair or poor, describe themselves as work disabled, and be limited in or need assistance with ADLs. Secondary assistants report slightly higher rates of work disability than the general population, but similar rates of ADL limitation and health status. Both assistance groups are more likely than the general adult population to have annual family incomes which fall below the federal poverty line, and working-age (aged 18-64) assistants are much less likely to work full time.
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Affiliation(s)
- J Kennedy
- Department of Community Health, University of Illinois at Urbana-Champaign, USA.
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Larsen LS. Effectiveness of a Counseling Intervention to Assist Family Caregivers of Chronically Ill Relatives. J Psychosoc Nurs Ment Health Serv 1998; 36:26-32. [PMID: 9726083 DOI: 10.3928/0279-3695-19980801-15] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. Caregivers need information about community services, as well as ways to improve their ability to manage their relative's care. 2. Nurses can help ease a caregiver through the emotionally painful process of placing a relative in a nursing home by clarifying concerns and offering support and guidance. 3. Individual counseling is an effective intervention to assist family caregivers because the nurse can focus on the diverse needs and specific goals of each caregiver.
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Affiliation(s)
- L S Larsen
- Southeastern Louisiana University School of Nursing, Baton Rouge 70809, USA
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Abstract
This exploratory study describes caregiving experiences of elderly family members as perceived by eight Mexican American women caregivers and characterizes the ideas that some Mexican Americans have about elder care. A qualitative approach, using open-ended questions, revealed a cultural picture that reflected a very rich cultural heritage. This picture includes the importance of the family's responsibility to care for its elder members and describes family commitments that reach beyond obligation. It also portrays a complex system of cultural beliefs and values that are based on Mexican American tradition. The themes of reciprocity and point of reckoning emerged as two descriptive characteristics of the Mexican American family in the southwestern United States that form the basis for the restructuring of a woman's responsibilities during middle age. This study indicated that the bicultural lens through which the caregiver views the world may differ markedly from that of the elderly family member.
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Affiliation(s)
- M Clark
- University of Texas School of Nursing, Galveston, USA
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