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Khouban-Shargh R, Mirhosseini S, Ghasempour S, Basirinezhad MH, Abbasi A. Stress management training program to address caregiver burden and perceived stress among family caregivers of patients undergoing hemodialysis: a randomized controlled trial study. BMC Nephrol 2024; 25:350. [PMID: 39402480 PMCID: PMC11476389 DOI: 10.1186/s12882-024-03795-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 10/07/2024] [Indexed: 10/19/2024] Open
Abstract
BACKGROUND The objective of the current study was to assess the effectiveness of stress management training, grounded in Lazarus and Folkman's stress management model, on reducing caregiving burden and perceived stress among family caregivers of patients on hemodialysis. METHODS This two-group clinical trial study was conducted in parallel design among 60 family caregivers of patients on hemodialysis in 2023. The participants were divided into two groups of training and control using a random quadruple block allocation method. The intervention took place over two months, in six online group sessions of 35-45 min. Zarit Burden Inventory (ZBI) and Cohen's Perceived Stress Scale (PSS-14) were used to collect information before and two weeks after the intervention. The study data were analyzed using and analysis of covariance (ANCOVA), pair, and independent t-tests at a significance level of 0.05. RESULTS At baseline, the two groups exhibited homogeneity in terms of mean scores for caregiving burden (Training group = 50.8 ± 4.9; Control group = 49.1 ± 6.0; P = 0.264) and perceived stress (Training group = 32.8 ± 4.7; Control group = 31.5 ± 2.4; P = 0.192). Nevertheless, following the intervention, there was a significant decrease in caregiving burden (Training group = 45.9 ± 4.1; Control group = 49.0 ± 5.8; P = 0.017) and perceived stress (Training group = 28.0 ± 4.4; Control group = 30.7 ± 3.5; P = 0.01) scores within the training group compared to the control group. CONCLUSION Based on the findings of the current study, given that family caregivers of patients on hemodialysis encounter psychological distress and contend with the negative aspects of care, it is advisable to implement psycho-educational interventions, such as stress management training. Incorporating these interventions into the care plan for hemodialysis could help mitigate these adverse consequences and provide valuable support for family caregivers. TRIAL REGISTRATION Iranian Registry of Clinical Trials (IRCT), IRCT20180728040617N6. Registered on 17/04/2023.
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Affiliation(s)
- Ramisa Khouban-Shargh
- Center for Health Related Social and Behavioral Sciences Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Seyedmohammad Mirhosseini
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Saeed Ghasempour
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Hasan Basirinezhad
- Department of Epidemiology and Biostatistics, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Abbasi
- Department of Nursing, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran.
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Wang Z, Yu S, Liu Y, Han Y, Zhao W, Zhang W. Effectiveness of family centred interventions for family caregivers: A systematic review and meta-analysis of randomized controlled trials. J Clin Nurs 2024; 33:1958-1975. [PMID: 38439168 DOI: 10.1111/jocn.17091] [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: 07/16/2023] [Revised: 01/11/2024] [Accepted: 02/19/2024] [Indexed: 03/06/2024]
Abstract
AIMS AND OBJECTIVES To examine the effectiveness of family-centred interventions among family caregivers. BACKGROUND Family-centred interventions are an emerging form of intervention that can be effective at improving physical and mental health outcomes for patients and family caregivers. To date, no reviews have examined the effectiveness of family-centred interventions for family caregivers. DESIGN A systematic review, including a meta-analysis, was conducted according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA 2020) checklist. METHODS Seven English and two Chinese electronic databases were compressively searched from the outset to March 2023. Two researchers independently reviewed the abstracts and full texts, extracted the data and assessed the risk of bias independently by using the Cochrane 'Risk of bias assessment tool'. RESULTS This systematic review and meta-analysis included 20 articles. The results of the meta-analysis showed that family-centred interventions could significantly improve caregiver burden (p=0.003), quality of life (p = 0.007), depression (p = 0.0002), and stress (p < 0.0001) but not anxiety or family functioning. According to our subgroup analysis, the family-centred empowerment model (p = 0.009) was superior to the other family intervention (p=0.004) in reducing caregiver burden. Family-centred interventions are more effective at reducing the burden of caregiving on family caregivers of adolescent patients (SMD=-0.79, 95% CI[-1.22,-0.36], p = 0.0003) than on adult patients (SMD=-0.37, 95% CI [-0.61,-0.12], p = 0.004). CONCLUSIONS Family-centred interventions could enhance family caregivers' burden, quality of life, stress and depression but had no significant impact on anxiety or family functioning. RELEVANCE TO CLINICAL PRACTICE Family-centred interventions have the potential to improve the health status and caregiving burden of family caregivers. Rigorous and high-quality evidence is needed to confirm the long-term effects of these interventions on family caregivers. TRIAL REGISTRATION DETAILS The protocol has been registered in the PROSPERO international prospective register of systematic reviews (Protocol registration ID: CRD42023453607).
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Affiliation(s)
- Ziqi Wang
- School of Nursing, Jilin University, Changchun, China
| | - Shuanghan Yu
- School of Nursing, Jilin University, Changchun, China
| | - Yantong Liu
- School of Nursing, Jilin University, Changchun, China
| | - Yujie Han
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhao
- School of Nursing, Jilin University, Changchun, China
| | - Wei Zhang
- School of Nursing, Jilin University, Changchun, China
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Jeong YJ, Kim HS, Kang HG. Development and Evaluation of a Mobile Application to Prevent Recurrent Stroke by Enhancing Self-management on Health Outcomes for Stroke Survivors. Comput Inform Nurs 2024; 42:53-62. [PMID: 37580022 DOI: 10.1097/cin.0000000000001050] [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: 08/16/2023]
Abstract
This study aimed to develop a Mobile Application to Prevent Recurrent Stroke to prevent recurrent stroke by enhancing self-management and to evaluate its effects on stroke survivors' health outcomes. The Mobile Application to Prevent Recurrent Stroke was developed based on social cognitive theory and the model in order of analysis, design, development, implementation, and evaluation process. The Mobile Application to Prevent Recurrent Stroke consisted of health management contents such as information about stroke, its associated risk factors, and required skills to conduct self-management with tailored support and counseling. A quasi-experimental preintervention and postintervention design was used involving a total of 54 stroke survivors. The experimental group (n = 27) was provided the Mobile Application to Prevent Recurrent Stroke for 8 weeks, whereas the control group (n = 27) received an education booklet. The result revealed that medication adherence ( P = .002), healthy eating habit ( P < .001), physical activity ( P < .001), and affected-side grip strength ( P = .002) in the experimental group were significantly better than those in the control group. The systolic blood pressure ( P = .020), diastolic blood pressure ( P < .001), body mass index ( P < .001), and waist circumference ( P < .001) in the experimental group were significantly lower than those in the control group. Stroke survivors can easily use this Mobile Application to Prevent Recurrent Stroke to improve self-management. Nurses can provide tailored care based on the lifelogging data of stroke survivors to prevent recurrent stroke.
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Affiliation(s)
- Young Ju Jeong
- Author Affiliations: Department of Nursing, Wonkwang Health Science University, Iksan (Dr Jeong); and College of Nursing, Research Institute of Nursing Science, Jeonbuk National University (Dr Kim), and Department of Neurology, Research Institute of Clinical Medicine (Dr Kang), Jeonbuk National University and Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Hayati M, Bagherzadeh R, Mahmudpour M, Heidari F, Vahedparast H. Effect of teaching health-promoting behaviors on the care burden of family caregivers of hemodialysis patients: a four-group clinical trial. BMC Nurs 2023; 22:436. [PMID: 37978371 PMCID: PMC10655433 DOI: 10.1186/s12912-023-01604-2] [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: 08/24/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
INTRODUCTION Chronic kidney disease could have a profound effect on the life of patients and family caregivers. The caregivers' care burden increases as the disease progresses. Interventions reducing care burden should be investigated. Educational interventions could affect family caregivers' care burden among hemodialysis patients. However, most studies and interventions have focused on caregivers. Therefore, this study aims to compare the effect of teaching Health-promoting behaviors on the care burden of family caregivers of hemodialysis patients. MATERIALS AND METHODS This trial was conducted using a pretest-posttest design and follow-up after one month. Hemodialysis patients and their family caregivers were selected using convenience sampling method. In total, 124 patient-caregiver pairs were divided into four groups of patient-centered education, caregiver-centered education, Patient and caregiver education and control by block randomization (15 blocks of 8 members and 1 block of 4 members) (n = 31 pairs per group). The intervention (teaching health-promoting behaviors) was performed in 8 sessions using the teach-back method, except for the control. The data were collected by patient and caregiver demographic forms and Novak and Guest care burden inventory as well as following the treatment regimen in three stages (before, immediately after and one month after the intervention). Demographic variables were compared among the four groups using ANOVA, Kruskal-Wallis and Chi-square test. The intragroup comparison of the main variables was made using the repeated measures ANOVA with modified LSD post hoc test. The intergroup comparison was made by one-way ANOVA with LSD post hoc test. RESULTS Out of 124 caregivers participating in the study, 68 (54.8%) were female. Also, out of 124 patients participating in the study, 86 (69.4%) were male. The mean age of the caregivers and patients was 39.2 ± 11.31 and 54.23 ± 14.20 years old, respectively. There was a statistically significant difference in the mean total care burden scores of the pre-test and post-test between the four groups (p < 0.001). The total care burden decreased in patient-centered, caregiver-centered and Patient and caregiver education groups. However, this reduction in the caregiver-centered and Patient and caregiver education groups was significantly higher than the patient-centered education group (p < 0.001). CONCLUSION The results revealed teaching health-promoting behaviors reduced care burden. Moreover, caregiver-centered approach could reduce care burden more than patient-centered approach. Therefore, this could be used as a supportive method to improve the health of patients and caregivers. TRIAL REGISTRATION NUMBER (TRN) IRCT20090522001930N4. DATE OF REGISTRATION 2021-11-12.
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Affiliation(s)
- Mehrdad Hayati
- Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Razieh Bagherzadeh
- Department of Midwifery, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mehdi Mahmudpour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Fatemeh Heidari
- Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hakimeh Vahedparast
- Department of Nursing, Nursing and Midwifery Faculty, Bushehr University of Medical Sciences, Bushehr, Iran.
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Purgato M, Prina E, Ceccarelli C, Cadorin C, Abdulmalik JO, Amaddeo F, Arcari L, Churchill R, Jordans MJ, Lund C, Papola D, Uphoff E, van Ginneken N, Tol WA, Barbui C. Primary-level and community worker interventions for the prevention of mental disorders and the promotion of well-being in low- and middle-income countries. Cochrane Database Syst Rev 2023; 10:CD014722. [PMID: 37873968 PMCID: PMC10594594 DOI: 10.1002/14651858.cd014722.pub2] [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] [Indexed: 10/25/2023]
Abstract
BACKGROUND There is a significant research gap in the field of universal, selective, and indicated prevention interventions for mental health promotion and the prevention of mental disorders. Barriers to closing the research gap include scarcity of skilled human resources, large inequities in resource distribution and utilization, and stigma. OBJECTIVES To assess the effectiveness of delivery by primary workers of interventions for the promotion of mental health and universal prevention, and for the selective and indicated prevention of mental disorders or symptoms of mental illness in low- and middle-income countries (LMICs). To examine the impact of intervention delivery by primary workers on resource use and costs. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, CINAHL, Global Index Medicus, PsycInfo, WHO ICTRP, and ClinicalTrials.gov from inception to 29 November 2021. SELECTION CRITERIA Randomized controlled trials (RCTs) of primary-level and/or community health worker interventions for promoting mental health and/or preventing mental disorders versus any control conditions in adults and children in LMICs. DATA COLLECTION AND ANALYSIS Standardized mean differences (SMD) or mean differences (MD) were used for continuous outcomes, and risk ratios (RR) for dichotomous data, using a random-effects model. We analyzed data at 0 to 1, 1 to 6, and 7 to 24 months post-intervention. For SMDs, 0.20 to 0.49 represented small, 0.50 to 0.79 moderate, and ≥ 0.80 large clinical effects. We evaluated the risk of bias (RoB) using Cochrane RoB2. MAIN RESULTS Description of studies We identified 113 studies with 32,992 participants (97 RCTs, 19,570 participants in meta-analyses) for inclusion. Nineteen RCTs were conducted in low-income countries, 27 in low-middle-income countries, 2 in middle-income countries, 58 in upper-middle-income countries and 7 in mixed settings. Eighty-three RCTs included adults and 30 RCTs included children. Cadres of primary-level workers employed primary care health workers (38 studies), community workers (71 studies), both (2 studies), and not reported (2 studies). Interventions were universal prevention/promotion in 22 studies, selective in 36, and indicated prevention in 55 RCTs. Risk of bias The most common concerns over risk of bias were performance bias, attrition bias, and reporting bias. Intervention effects 'Probably', 'may', or 'uncertain' indicates 'moderate-', 'low-', or 'very low-'certainty evidence. *Certainty of the evidence (using GRADE) was assessed at 0 to 1 month post-intervention as specified in the review protocol. In the abstract, we did not report results for outcomes for which evidence was missing or very uncertain. Adults Promotion/universal prevention, compared to usual care: - probably slightly reduced anxiety symptoms (MD -0.14, 95% confidence interval (CI) -0.27 to -0.01; 1 trial, 158 participants) - may slightly reduce distress/PTSD symptoms (SMD -0.24, 95% CI -0.41 to -0.08; 4 trials, 722 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD -0.69, 95% CI -1.08 to -0.30; 4 trials, 223 participants) Indicated prevention, compared to usual care: - may reduce adverse events (1 trial, 547 participants) - probably slightly reduced functional impairment (SMD -0.12, 95% CI -0.39 to -0.15; 4 trials, 663 participants) Children Promotion/universal prevention, compared to usual care: - may improve the quality of life (SMD -0.25, 95% CI -0.39 to -0.11; 2 trials, 803 participants) - may reduce adverse events (1 trial, 694 participants) - may slightly reduce depressive symptoms (MD -3.04, 95% CI -6 to -0.08; 1 trial, 160 participants) - may slightly reduce anxiety symptoms (MD -2.27, 95% CI -3.13 to -1.41; 1 trial, 183 participants) Selective prevention, compared to usual care: - probably slightly reduced depressive symptoms (SMD 0, 95% CI -0.16 to -0.15; 2 trials, 638 participants) - may slightly reduce anxiety symptoms (MD 4.50, 95% CI -12.05 to 21.05; 1 trial, 28 participants) - probably slightly reduced distress/PTSD symptoms (MD -2.14, 95% CI -3.77 to -0.51; 1 trial, 159 participants) Indicated prevention, compared to usual care: - decreased slightly functional impairment (SMD -0.29, 95% CI -0.47 to -0.10; 2 trials, 448 participants) - decreased slightly depressive symptoms (SMD -0.18, 95% CI -0.32 to -0.04; 4 trials, 771 participants) - may slightly reduce distress/PTSD symptoms (SMD 0.24, 95% CI -1.28 to 1.76; 2 trials, 448 participants). AUTHORS' CONCLUSIONS The evidence indicated that prevention interventions delivered through primary workers - a form of task-shifting - may improve mental health outcomes. Certainty in the evidence was influenced by the risk of bias and by substantial levels of heterogeneity. A supportive network of infrastructure and research would enhance and reinforce this delivery modality across LMICs.
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Affiliation(s)
- Marianna Purgato
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Prina
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Caterina Ceccarelli
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Camilla Cadorin
- Department of Neurosciences, Biomedicine and Movement Sciences, Verona, Italy
| | | | - Francesco Amaddeo
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | | | - Rachel Churchill
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Mark Jd Jordans
- Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Crick Lund
- King's Global Health Institute, Centre for Global Mental Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Davide Papola
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
| | - Eleonora Uphoff
- Cochrane Common Mental Disorders, Centre for Reviews and Dissemination, University of York, York, UK
| | - Nadja van Ginneken
- Department of Primary Care and Mental Health, University of Liverpool, Liverpool, UK
| | - Wietse Anton Tol
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Corrado Barbui
- Department of Neurosciences, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
- Cochrane Global Mental Health, University of Verona, Verona, Italy
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Vasli P, Hosseini M, Nasiri M, Bakhtiari N. Family-centered empowerment approach to optimize phosphate management among hemodialysis patients: an experimental study. BMC Nephrol 2023; 24:259. [PMID: 37661281 PMCID: PMC10476304 DOI: 10.1186/s12882-023-03311-1] [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: 12/05/2022] [Accepted: 08/26/2023] [Indexed: 09/05/2023] Open
Abstract
BACKGROUND This study aimed to investigate the effect of a family-centered empowerment program on hyperphosphatemia management. METHOD This experimental study was performed on 80 randomly selected eligible patients with hyperphosphatemia undergoing hemodialysis. Patients were assigned randomly to two groups of family-centered empowerment program (FCEPG) and control group (CG) by coin toss (40 people per group). Data collection tools were the researcher-made Phosphate Control Knowledge Scale, the researcher-made Adherence to Dietary Restriction of Phosphorus Intake Scale, the eight-item Morisky Medication Adherence Scale, and serum phosphorus measurements. Data were collected before the intervention, one month, and three months after the intervention. Patients in FCEPG participated in a family-centered empowerment program. The statistical significance level was considered to be 0.05. RESULTS Inter-group comparisons showed no significant difference between FCEPG and CG in terms of the mean score of knowledge of phosphate control, adherence to dietary restriction of phosphorus intake, adherence to medication, and the mean serum phosphorus level before the empowerment program, but showed significant differences between them in these respects at one month after the program and three months after the program (p < 0.05). Intra-group comparisons showed a significant difference in FCEPG between the mean and standard deviation of all four variables before the empowerment program and the corresponding values one month and three months after the program (P < 0.05). CONCLUSION The findings of this study can be used in various fields of healthcare in the hospital and community.
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Affiliation(s)
- Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Noushin Bakhtiari
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Tabata-Kelly M, Ruan M, Dey T, Sheu C, Kerr E, Kaafarani H, Ornstein KA, Kelley A, Gray TF, Salim A, Joseph B, Cooper Z. Postdischarge Caregiver Burden Among Family Caregivers of Older Trauma Patients. JAMA Surg 2023; 158:945-952. [PMID: 37405733 PMCID: PMC10323760 DOI: 10.1001/jamasurg.2023.2500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/30/2023] [Indexed: 07/06/2023]
Abstract
Importance Caregiver burden, characterized by psychological distress and physical morbidity, affects more than 50 million family caregivers of older adults in the United States. Risk factors for caregiver burden among caregivers of older trauma patients have not been well characterized. Objective To characterize postdischarge caregiver burden among caregivers of older trauma patients and identify targets that can inform interventions to improve their experience. Design, Setting, and Participants This study used a repeated cross-sectional design. Participants were family caregivers for adults 65 years or older with traumatic injury who were discharged from 1 of 2 level I trauma centers. Telephone interviews were conducted at 1 month and 3 months postdischarge with family caregivers (identified by the patient as family or friends who provided unpaid care). Admissions occurred between December 2019 and May 2021, and data were analyzed from June 2021 to May 2022. Exposure Hospital admission for geriatric trauma. Main Outcome and Measures High caregiver burden was defined by a score of 17 or higher on the 12-item Zarit Burden Interview. Caregiver self-efficacy and preparedness for caregiving were assessed via the Revised Scale for Caregiving Self-Efficacy and Preparedness for Caregiving Scale, respectively. Associations between caregiver self-efficacy, preparedness for caregiving, and caregiver burden were tested via mixed-effect logistic regression. Results There were 154 family caregivers enrolled in the study. Their mean (SD) age was 60.6 (13.0) years (range, 18-92 years), 108 of 154 were female (70.6%). The proportion of caregivers experiencing high burden (Zarit Burden Interview score ≥17) was unchanged over time (1 month, 38 caregivers [30.9%]; 3 months, 37 caregivers [31.4%]). Participants with lower caregiver self-efficacy and preparedness for caregiving were more likely to experience greater caregiver burden (odds ratio [OR], 7.79; 95% CI, 2.54-23.82; P < .001; and OR, 5.76; 95% CI, 1.86-17.88; P = .003, respectively). Conclusion and Relevance This study found that nearly a third of family caregivers of older trauma patients experience high caregiver burden up to 3 months after the patients' discharge. Targeted interventions to increase caregiver self-efficacy and preparedness may reduce caregiver burden in geriatric trauma.
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Affiliation(s)
- Masami Tabata-Kelly
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
- The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts
| | - Mengyuan Ruan
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
| | - Tanujit Dey
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
| | - Christina Sheu
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
| | - Emma Kerr
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
| | - Haytham Kaafarani
- Division of Trauma & Emergency Surgery, Department of Surgery, Massachusetts General Hospital, Boston
| | | | - Amy Kelley
- Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Tamryn F. Gray
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Institute, Boston, Massachusetts
| | - Ali Salim
- Department of Surgery, Brigham and Woman’s Hospital, Boston, Massachusetts
| | - Bellal Joseph
- Department of Surgery, University of Arizona, Tucson
| | - Zara Cooper
- Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts
- Department of Surgery, Brigham and Woman’s Hospital, Boston, Massachusetts
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Bayrak B, Ozkan CG, Demirbag BC. The effects of nursing interventions on the level of anxiety and care burden of the caregivers of bedridden patients. Niger J Clin Pract 2023; 26:253-259. [PMID: 37056096 DOI: 10.4103/njcp.njcp_1352_21] [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: 04/15/2023]
Abstract
Background Taking care of bedridden patients at home is a very difficult task for caregivers. In this care process, caregivers can be supported with the interventions given by the nurses at home. Aim This study mainly aimed to compare the anxiety and care burden levels of caregivers of bedridden patients at home after nursing interventions which a personal care handbook, regular home visits, and telephone counseling. Subject and Methods To proceed with this study, 51 caregivers have included in this study between January 1 and July 21, 2018. The Barthel Index for Activities of Daily Living (BIADL) was used to measure levels of independence in patient's activities, State and Trait Anxiety Scale (SAI and TAI) was used to measure the anxiety levels, and Burden Interview (BI) care burden problems of caregivers who participated in the study. Also, Sociodemographic Characteristics Form was used for demographic data of patients and caregivers. Results The analysis of the responses showed the proportions of the caregivers who had lower SAI- TAI and BI scores after taking nursing intervention at home. The state anxiety level of caregivers (pre-test: Mean; 54.06+-7.97; post-test: Mean; 38.43+-6.41) and the trait anxiety level of the caregivers (pre-test: Mean; 51.45+-5.94; post-test: Mean; 41.59+-7.05) and the burden level of caregivers (pre-test: Mean; 75.75+-11.41; post-test: Mean; 57.69+-13.39) was determined. The differences between the pre and post-test mean scores of SAI, TAI, and BI were statistically significant (P < 0.05). Conclusions Our study highlights that the burden and anxiety levels of the caregivers had lower post-test levels than the pre-test levels.
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Affiliation(s)
- B Bayrak
- Department of Fundamentals of Nursing, Faculty of Health Sciences, Ordu University, Ordu, Turkey
| | - C G Ozkan
- Department of Fundamentals of Nursing, Faculty of Health Sciences, Manisa Celal Bayar University, Manisa, Turkey
| | - B C Demirbag
- Department of Public Health Nursing, Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
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Söylemez BA, Özgül E, Küçükgüçlü Ö, Yener G. Telehealth applications used for self-efficacy levels of family caregivers for individuals with dementia: A systematic review and Meta-analysis. Geriatr Nurs 2023; 49:178-192. [PMID: 36565592 DOI: 10.1016/j.gerinurse.2022.12.001] [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: 09/02/2022] [Revised: 12/01/2022] [Accepted: 12/01/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND The effectiveness of telehealth applications for family caregivers of individuals with dementia remains unclear. The aim of this study is to investigate how telehealth-based interventions applied for family caregivers of individuals with dementia affect their self-efficacy levels, caregiving burden, stress, depression, and quality of life. MATERIALS AND METHODS This was a systematic review. Screening took place between April 30 and May 5, 2022, for the scope of the past 10 years (January 2012/May 2022). The related studies were screened over ten (10) databases and search engines both in English and Turkish, including CINAHL, Cochrane Library, MEDLINE, PsycINFO, PubMed and Web of Science, ULAKBIM, Turkish Medline, Türkiye Klinikleri, and YOK National Thesis Center. Keywords included in various medical topic titles identified upon consultation with literature review experts from a library. Methodological quality of the studies was evaluated using Critical Appraisal Checklists developed by the Joanna Briggs Institute for experimental and quasi-experimental studies. The data were synthesized by meta-analysis. RESULTS Two hundred and twelve (212) records were accessed in the databases. Of that, 12 studies (covering 1,013 caregivers) were selected for the meta-analysis. Statistically, the self-efficacy mean score was significantly higher in the intervention group than the control group after the intervention (SMD: 1.08, Z= 3.12, p= 0.002). The effectiveness of telehealth-based applications for caregivers' caregiving burden, stress, depression and quality of life -- except for self-efficacy - was evaluated. The results of the intervention and control groups were similar after the intervention (SMD: -0.17, Z= 0.82, p= 0.41; MD: -0.60, Z= 0.49, p= 0.63, SMD: -0.04, Z= 0.13, p= 0.98; SMD: 0.15, Z= 0.47, p= 0.64, respectively). CONCLUSIONS This systematic review and meta-analysis showed that telehealth applications were effective in elevating the self-efficacy levels of caregivers of individuals with dementia. However, no statistically significant difference was observed in terms of caregiving burden, stress, depression, or quality of life for caregivers.
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Affiliation(s)
- Burcu Akpınar Söylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Ecem Özgül
- Department of Internal Medicine Nursing, Faculty of Health Sciences, Izmir University of Economics, İzmir, Turkey.
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Görsev Yener
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
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Bártolo A, Sousa H, Ribeiro O, Figueiredo D. Effectiveness of psychosocial interventions on the burden and quality of life of informal caregivers of hemodialysis patients: a systematic review. Disabil Rehabil 2022; 44:8176-8187. [PMID: 34913777 DOI: 10.1080/09638288.2021.2013961] [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: 01/19/2023]
Abstract
PURPOSE To systematically review the effectiveness of psychosocial interventions developed for informal caregivers of hemodialysis patients. METHODS Relevant studies were identified through five electronic databases: PubMed, Scopus, Web of Science, ProQuest, and the CENTRAL. Randomized controlled trials (RCTs) and quasi-experimental studies describing interventions for informal caregivers of adult in-center hemodialysis patients (≥18 years old) were included and independently appraised by two reviewers using the Joanna Briggs Institute Statistics Assessment and Review Instruments critical appraisal checklists. RESULTS Eleven articles evaluating eight intervention programs were included in this review, covering a total of 729 informal caregivers. Most studies implemented educational or psycho-educational interventions (n = 6). Psycho-educational interventions designed to promote caregivers' ability to care and to cope with the caregiving role had positive effects on burden and/or quality of life. Psychological interventions also had large effects on reducing the burden over time. CONCLUSIONS There are still few interventions available to caregivers of hemodialysis patients. Psychosocial interventions showed great potential in improving the caregiver burden and quality of life. Further research with rigorous designs is needed to achieve stronger evidence on the extent of the current findings. TRIAL REGISTRATION NUMBER CRD42021247916.Implications for rehabilitationPatients with end-stage renal disease (ESRD) undergoing in-center hemodialysis often require emotional and/or practical support from family members or friends.Research has consistently shown that informal caregivers of hemodialysis patients may experience significant burden and a negative impact on their quality of life as a result of their caregiving role during the disease trajectory.This review evidenced that intervention programs involving education and psychological strategies had large positive effects on reducing caregiver burden and improving quality of life.The findings provide valuable evidence to recommend the inclusion of psychosocial programs to family caregivers as part of comprehensive renal care.
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Affiliation(s)
- Ana Bártolo
- Center for Health Technology and Services Research (CINTESIS.UA), Piaget Institute - ISEIT/Viseu, Viseu, Portugal
| | - Helena Sousa
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Oscar Ribeiro
- Department of Education and Psychology, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
| | - Daniela Figueiredo
- School of Health Sciences, Center for Health Technology and Services Research (CINTESIS.UA), University of Aveiro (Campus Universitário de Santiago), Aveiro, Portugal
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11
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Ahlstedt Karlsson S, Henoch I, Olofsson Bagge R, Wallengren C. An intervention mapping-based support program that empowers patients with endocrine therapy management. EVALUATION AND PROGRAM PLANNING 2022; 92:102071. [PMID: 35307615 DOI: 10.1016/j.evalprogplan.2022.102071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 06/10/2021] [Accepted: 03/13/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND For women diagnosed with hormone-receptor-positive breast cancer, endocrine therapy (ET) is recommended. Patients experience diverse side effects, and difficulties in managing these side effects have been identified as obstacles for treatment continuation. The aim of this study was to describe the development of a support program for patients prescribed ET. METHODS Intervention mapping (IM) a comprehensive theory-based approach was used in the support program development. A participatory design was used and four advisory groups was formed including both patients and healthcare professionals. RESULTS This study employed the systematic stages of IM to develop a theory-based support program with the goal to empower patients prescribed ET to manage ETrelated symptoms and problems, and to illuminate the healthcare structure. The needs assessment identified three performance objectives: (1) Patients have knowledge of and understand their symptoms and their management strategies. (2) Patients have the knowledge and confidence to express their care needs and to ask for guidance from healthcare professionals. (3) Patients are active in and lead their healthcare process. CONCLUSION This is a systematic developed model, built upon aspects of ET both from a patient´ perspective as well as from healthcare professionals' perspectives.
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Affiliation(s)
- Susanne Ahlstedt Karlsson
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, University of Gothenburg, Gothenburg, Sweden.
| | - Ingela Henoch
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, University of Gothenburg, Gothenburg, Sweden
| | - Roger Olofsson Bagge
- Department of Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden; Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Catarina Wallengren
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, University of Gothenburg, Gothenburg, Sweden
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Wu CY, Liu JS, Chen CH, Huang CT, Yu TM, Chuang YW, Huang ST, Hsu CC, Wu MJ. Early Comprehensive Kidney Care in Dialysis-Requiring Acute Kidney Injury Survivors: A Populational Study. Front Med (Lausanne) 2022; 9:847462. [PMID: 35530035 PMCID: PMC9072865 DOI: 10.3389/fmed.2022.847462] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundFor patients with Acute Kidney Injury (AKI), a strong and graded relationship exists between AKI severity and mortality. One of the most severe entities of AKI is Dialysis-Requiring Acute Kidney Injury (D-AKI), which is associated with high rates of mortality and end-stage renal disease (ESRD). For this high-risk population group, there is a lack of evidence regarding optimal post-AKI care. We propose that post-AKI care through the combined efforts of the nephrologist and the multidisciplinary care team may improve outcomes. Our aim here is to study for survivors of dialysis-requiring acute kidney injury, the effects of implementing early comprehensive kidney care.MethodsThis is a retrospective longitudinal cohort study of Taiwanese through analyzing the National Health Insurance Research Database (NHIRD). We included patients with acute dialysis during hospitalization from January 1, 2015 to December 31, 2018. Propensity match was done at 1:1, including estimated glomerular filtration rate (eGFR) based on CKD-EPI which was performed due to large initial disparities between these two cohorts.ResultsAfter the propensity match, each cohort had 4,988 patients. The mean eGFR based on CKD-EPI was 27.5 ml/min/1.73 m2, and the mean follow-up period was 1.4 years.The hazard ratio for chronic dialysis or ESRD was 0.55 (95% CI, 0.49–0.62; p < 0.001). The hazard ratio for all-cause mortality was 0.79 (95% CI, 0.57–0.88; p < 0.001). Both outcomes favored early comprehensive kidney care.ConclusionsFor survivors of dialysis-requiring acute kidney injury, early comprehensive kidney care significantly lowered risks of chronic dialysis and all-cause mortality.
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Affiliation(s)
- Chun-Yi Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Nursing, Asia University, Taichung, Taiwan
| | - Jia-Sin Liu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Cheng-Hsu Chen
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Post-baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Department of Life Science, Tunghai University, Taichung, Taiwan
| | - Chun-Te Huang
- Department of Internal Medicine and Critical Care Medicine, Nephrology and Critical Care Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tung-Min Yu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ya-Wen Chuang
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Post-baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
| | - Shih-Ting Huang
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Health Services Administration, China Medical University, Taichung, Taiwan
- Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Miaoli, Taiwan
- *Correspondence: Chih-Cheng Hsu
| | - Ming-Ju Wu
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Post-baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- RongHsing Research Center for Translational Medicine, College of Life Sciences, National Chung Hsing University, Taichung, Taiwan
- Ph.D. Program in Translational Medicine, National Chung Hsing University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, China Medical University, Taichung, Taiwan
- Ming-Ju Wu
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Hovadick AC, Jardim VR, Paúl C, Pagano A, Reis I, Torres H. Interventions to improve the well-being of family caregivers of patients on hemodialysis and peritoneal dialysis: a systematic review. PeerJ 2021; 9:e11713. [PMID: 34322322 PMCID: PMC8300494 DOI: 10.7717/peerj.11713] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/10/2021] [Indexed: 01/23/2023] Open
Abstract
Background The family caregivers of patients on hemodialysis (HD) and peritoneal dialysis (PD) typically experience higher burden than the general population because of the nature of tasks these caregivers need to carry out as a part of homecare. This fact influences both the caregivers’ quality of life and the quality of their care toward the patient. Thus, this study aimed to review the effectiveness and limitations of interventions in improving the well-being of family caregivers of patients on HD and PD. Methodology A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses and the Cochrane Handbook for Systematic Reviews of Interventions (version 5.1.0). The Cochrane Library, Cumulative Index to Nursing and Allied Health Literature, Embase, MEDLINE, VHL Regional Portal, Scopus, and Web of Science databases were searched queried for randomized controlled trials that developed interventions aimed at improving the well-being of family caregivers of patients undergoing HD and/or PD from 2009 to 2020. The study protocol was registered at the International Prospective Register of Systematic Reviews (registration no. CRD42020151161). Results Six studies met the inclusion criteria, all of which addressed caregivers of patients undergoing HD. All interventions reported in the included studies were carried out in group sessions, which addressed topics such as patient assistance and care, treatment complications, coping strategies, caregiver self-care practices, problem solving, and self-efficacy. The studies found significant improvement in the caregiver’s well-being. Conclusions Group session interventions are effective in improving the well-being of family caregivers of patients undergoing HD. In regard to PD, there is insufficient evidence to make recommendations for caregivers of patients with this treatment.
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Affiliation(s)
- Ana Carolina Hovadick
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Viviane Rodrigues Jardim
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Constança Paúl
- Instituto de Ciências Biomédicas Abel Salazar, Universidade de Porto, Porto, Portugal
| | - Adriana Pagano
- Faculdade de Letras, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ilka Reis
- Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Heloisa Torres
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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