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Cao X, Tian Y, Chen H, Li S, Zhou J. The Global Research Trends on Intrinsic Capacity of Older Adults: A Bibliometric and Visual Analysis of Papers Published During 2015-2023. J Multidiscip Healthc 2024; 17:3323-3339. [PMID: 39010933 PMCID: PMC11249103 DOI: 10.2147/jmdh.s471324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Accepted: 07/04/2024] [Indexed: 07/17/2024] Open
Abstract
Objective The concept of intrinsic capacity (IC) revolves around healthy aging and active aging. Since the Introduction of the concept by the World Health Organization in 2015, a series of studies have been conducted by scholars from multiple fields. However, no bibliometric analysis has systematically investigated this issue. We aim to identify the current landscape and frontier trends of scientific achievements on IC in older adults through bibliometric approaches. Methods Quantitative analysis of publications relating to IC in older adults from 2015 to 2023 was interpreted and graphed through the Web of Science Core Collection database on December 5, 2023. A variety of quantitative variables was analyzed, including publication and citation counts, H-index, and journal citation reports. Co-authorship, citation, co-citation, and co-occurrence analyses were performed for countries/regions, institutions, authors, and keywords using the VOSviewer and CiteSpace. Results A total of 952 original and review articles in English were identified. The European countries possessed an absolute advantage in this field. The most contributive institution was the University of São Paulo. The most productive author is Cesari Matteo from France, followed by Qaisar Rizwan from the United Arab Emirates. However, a relatively low level of research cooperation existed between institutions and authors. Important topics mainly include the connotations, theoretical framework models, evaluation, screening tools, and application scenarios of IC. Among the promising hotspots, "biological aging", "ICOPE", "Covid-19", "prevention", "inflammation", "caf22", "prevalence", and "randomized controlled trial" displayed relatively latest average appearing year. Conclusion Global trends indicate a growing scientific output on IC in older adults, and developed countries are leading the way. There is still room for improvement in research team collaboration. The focus gradually shifts from theoretical research to empirical research. It is recommended to pay attention to the latest hot spots, such as "biological aging", "ICOPE implementation", "post-COVID-19 syndrome", and "biomarkers".
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Affiliation(s)
- Xia Cao
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Yusheng Tian
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Hui Chen
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Sihong Li
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
| | - Jiansong Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, The Second Xiangya Hospital of Central South University, Changsha, People's Republic of China
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Viphonephom P, Kounnavong S, Reinharz D. Decentralization and immunization program in a single-party state: the case of the Lao People's Democratic Republic. Trop Med Health 2024; 52:35. [PMID: 38715093 PMCID: PMC11075326 DOI: 10.1186/s41182-024-00601-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND The Lao People's Democratic Republic (Lao PDR), a lower-middle-income country, lags behind other Southeast Asian countries in immunization coverage for children under two years of age. The organization of health services is a key determinant of the functionality of immunization programs. However, this aspect, and in particular its decentralization component of the healthcare system, has never been studied. METHODS A case study in the Lao National Immunization Program was performed using a neo-institutional theory-based conceptual framework, highlighting the structure (rules, laws, resources, etc.) and interpretative schemes (dominant beliefs and ideas) that underlie the state of decentralization of the healthcare system that support the conduct of the immunization program. Twenty-two semi-structured interviews were conducted with representative actors from various government levels, external donors, and civil society, in four provinces. Data were complemented with information retrieved from relevant documents. RESULTS The Lao healthcare system has a deconcentrated form of decentralization. It has a largely centralized structure, albeit with certain measures promoting the decentralization of its immunization programs. The structure underlying the state of centralization of immunization services provided is coherent with a shared dominant interpretive scheme. However, the rapid economic, technical, and educational changes affecting the country suggest that the coherence between structure and interpretative schemes is bound to change. CONCLUSION Unprecedented opportunities to access quality higher education and the use of social networks are factors in Lao PDR that could affect the distribution of responsibilities of the different levels of government for public health programs such as the National Immunization Program.
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Affiliation(s)
- Phonevilay Viphonephom
- Department of Social and Preventive Medicine, Laval University, Quebec City, QC, Canada.
| | - Sengchanh Kounnavong
- Lao Tropical and Public Health Institute (Lao TPHI), Ministry of Health, Vientiane, Lao PDR
| | - Daniel Reinharz
- Department of Social and Preventive Medicine, Laval University, Quebec City, QC, Canada
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Xu X, Li Y, Mi H. Life expectancy, long-term care demand and dynamic financing mechanism simulation: an empirical study of Zhejiang Pilot, China. BMC Health Serv Res 2024; 24:469. [PMID: 38622660 PMCID: PMC11017606 DOI: 10.1186/s12913-024-10875-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 03/18/2024] [Indexed: 04/17/2024] Open
Abstract
BACKGROUND China has piloted Long-Term Care Insurance (LTCI) to address increasing care demand. However, many cities neglected adjusting LTCI premiums since the pilot, risking the long-term sustainability of LTCI. Therefore, using Zhejiang Province as a case, this study simulated mortality-adjusted long-term care demand and the balance of LTCI funds through dynamic financing mechanism under diverse life expectancy and disability scenarios. METHODS Three-parameter log-quadratic model was used to estimate the mortality from 1990 to 2020. Mortality with predicted interval from 2020 to 2080 was projected by Lee-Carter method extended with rotation. Cohort-component projection model was used to simulate the number of older population with different degrees of disability. Disability data of the older people is sourced from China Health and Retirement Longitudinal Study 2018. The balance of LTCI fund was simulated by dynamic financing actuarial model. RESULTS Life expectancy of Zhejiang for male (female) is from 80.46 (84.66) years in 2020 to 89.39 [86.61, 91.74] (91.24 [88.90, 93.25]) years in 2080. The number of long-term care demand with severe disability in Zhejiang demonstrates an increasing trend from 285 [276, 295] thousand in 2023 to 1027 [634, 1657] thousand in 2080 under predicted mean of life expectancy. LTCI fund in Zhejiang will become accumulated surplus from 2024 to 2080 when annual premium growth rate is 5.25% [4.20%, 6.25%] under various disability scenarios, which is much higher than the annual growth of unit cost of long-term care services (2.25%). The accumulated balance of LTCI fund is sensitive with life expectancy. CONCLUSIONS Dynamic growth of LTCI premium is essential in dealing with current deficit around 2050 and realizing Zhejiang's LTCI sustainability in the long-run. The importance of dynamic monitoring disability and mortality information is emphasized to respond immediately to the increase of premiums. LTCI should strike a balance between expanding coverage and controlling financing scale. This study provides implications for developing countries to establish or pilot LTCI schemes.
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Affiliation(s)
- Xueying Xu
- School of International Studies, Zhejiang University, Hangzhou, China
| | - Yichao Li
- School of Public Affairs, Zhejiang University, Hangzhou, China.
| | - Hong Mi
- School of Public Affairs, Zhejiang University, Hangzhou, China
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Li Q, Chen Y, Zhang Y, Liu X. Evaluation of China's long-term care insurance policies. Front Public Health 2024; 12:1252817. [PMID: 38605882 PMCID: PMC11007106 DOI: 10.3389/fpubh.2024.1252817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 03/12/2024] [Indexed: 04/13/2024] Open
Abstract
Introduction In response to the increasing demand for long-term care services for older people, the Chinese government has launched a pilot program for long-term care insurance (LTCI) since 2016. The objective of this study is to evaluate the performance and effectiveness of this program in China and provide recommendations for the future development and expansion of the LTCI system. Methods We developed a comprehensive evaluation framework to assess these LTCI policies implemented in all 49 pilot cities in China. Results Based on our evaluation, the average assessment score for the LTCI program across all pilot cities was 71.8 points, with scores ranging from 57.5 to 92.5 points in these cities. Furthermore, most of the pilot cities achieved higher scores in the fact-based assessment compared to the value-based assessment. Discussion The results suggested that the overall pilot effect regarding LTCI was favorable, but there were significant regional disparities. Moreover, in most of pilot cities, current LTCI policies were designed to alleviate both the financial burden and the burden of caring for people with disabilities that families faced. However, some challenges still remained, such as the lack of community and home-based care services, the need to expand the coverage of insurance, and the importance of diversifying funding sources.
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Affiliation(s)
- Qiang Li
- College of Economics and Management, Shandong Agricultural University, Tai’an, China
| | - Yiwen Chen
- College of Economics and Management, Shandong Agricultural University, Tai’an, China
| | - Yongmei Zhang
- College of Economics and Management, Shandong Agricultural University, Tai’an, China
- School of Economics and Management, Shandong Agricultural Engineering University, Jinan, China
| | - Xue Liu
- College of Economics and Management, Shandong Agricultural University, Tai’an, China
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Macdonald M, Weeks LE, Langman E, Roach S, MacNeil MX, Caruso J, Tricco AC, Pham B, Straus SE, Mishra S, Isaranuwatchai W, Cormack GV, Grossman MR, Yakubovich AR, Mojbafan A, Ignaczak M, Leid C, Watt J, Stevens S, Khan T, Curran JA, Moody E, Rodrigues R. Recent innovations in long-term care coverage and financing: a rapid scoping review. BMJ Open 2024; 14:e077309. [PMID: 38388500 PMCID: PMC10884182 DOI: 10.1136/bmjopen-2023-077309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 01/29/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVES To identify, chart and analyse the literature on recent initiatives to improve long-term care (LTC) coverage, financial protection and financial sustainability for persons aged 60 and older. DESIGN Rapid scoping review. DATA SOURCES Four databases and four sources of grey literature were searched for reports published between 2017 and 2022. After using a supervised machine learning tool to rank titles and abstracts, two reviewers independently screened sources against inclusion criteria. ELIGIBILITY CRITERIA Studies published from 2017-2022 in any language that captured recent LTC initiatives for people aged 60 and older, involved evaluation and directly addressed financing were included. DATA EXTRACTION AND ANALYSIS Data were extracted using a form designed to answer the review questions and analysed using descriptive qualitative content analysis, with data categorised according to a prespecified framework to capture the outcomes of interest. RESULTS Of 24 reports, 22 were published in peer-reviewed journals, and two were grey literature sources. Study designs included quasi-experimental study, policy analysis or comparison, qualitative description, comparative case study, cross-sectional study, systematic literature review, economic evaluation and survey. Studies addressed coverage based on the level of disability, income, rural/urban residence, employment and citizenship. Studies also addressed financial protection, including out-of-pocket (OOP) expenditures, copayments and risk of poverty related to costs of care. The reports addressed challenges to financial sustainability such as lack of service coordination and system integration, insufficient economic development and inadequate funding models. CONCLUSIONS Initiatives where LTC insurance is mandatory and accompanied by commensurate funding are situated to facilitate ageing in place. Efforts to expand population coverage are common across the initiatives, with the potential for wider economic benefits. Initiatives that enable older people to access the services needed while avoiding OOP-induced poverty contribute to improved health and well-being. Preserving health in older people longer may alleviate downstream costs and contribute to financial sustainability.
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Affiliation(s)
- Marilyn Macdonald
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lori E Weeks
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Erin Langman
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sheri Roach
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Morgan X MacNeil
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Julie Caruso
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Andrea C Tricco
- St. Michael's Hospital Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, Epidemiology Division, University of Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Ba' Pham
- University of Toronto, Toronto, Ontario, Canada
| | - Sharon E Straus
- St. Michael's Hospital Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Sujata Mishra
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Wanrudee Isaranuwatchai
- Health Intervention and Technology Assessment Program, Mueang Nonthaburi, Nonthaburi, Thailand
- Unity Health Toronto, Toronto, Ontario, Canada
| | - Gordon V Cormack
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Maura R Grossman
- David R. Cheriton School of Computer Science, University of Waterloo, Waterloo, Ontario, Canada
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
- Osgoode Hall Law School, York University, Toronto, Ontario, Canada
| | - Alexa R Yakubovich
- St. Michael's Hospital Li Ka Shing Knowledge Institute, Unity Health Toronto, Toronto, Ontario, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Affiliate Scientist, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Arezoo Mojbafan
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Melissa Ignaczak
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Caron Leid
- SPOR Evidence Alliance, Toronto, Ontario, Canada
| | | | - Susan Stevens
- Senior Director Continuing Care, Nova Scotia Health, Halifax, Nova Scotia, Canada
| | - Tayaba Khan
- SPOR Evidence Alliance, Toronto, Ontario, Canada
| | - Janet A Curran
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Elaine Moody
- School of Nursing, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Ricardo Rodrigues
- ISEG Lisbon School of Economics and Management, Universidade de Lisboa, Lisboa, Portugal
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Yang S, Guo D, Bi S, Chen Y. The effect of long-term care insurance on healthcare utilization of middle-aged and older adults: evidence from China health and retirement longitudinal study. Int J Equity Health 2023; 22:228. [PMID: 37904167 PMCID: PMC10617164 DOI: 10.1186/s12939-023-02042-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/19/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND As global ageing continues to increase and many countries face challenges from the growing demand for long-term care. Drawing on the experiences of developed countries, developing countries have explored their own suitable long-term care insurance and have shown strong potential for development and research prospects. However, due to their late start, relevant research is underrepresented in the global research network and still needs to be supplemented. The present study hopes to examine the effect of long-term care insurance on healthcare utilization among the middle-aged and elderly from an empirical perspective, using China as an example. METHODS Panel data from wave 3 (2015) and wave 4 (2018) of the nationally-representative China health and retirement longitudinal study were selected to obtain a sample of 661 processing participants and 16,065 control participants after matching the policy implementation time in the first pilot cities, and quantitative analysis was conducted using difference-in-differences propensity score matching estimator method to assess the net effect of long-term care insurance on health care utilization among the middle-aged and elderly adults. RESULTS In the matched frequency-weighted regression difference-in-differences estimator results, long-term care insurance had a negative effect on the number and costs of annual hospitalizations at the 5% significance level (key variable values of - 0.0568101 and - 1236.309, respectively) and a non-significant effect on outpatient service utilization (P > 0.05). Further exploration of the heterogeneous effect of it revealed that implementation had a more significant negative effect on hospitalization utilization for middle-aged and older people in the East and for those with higher levels of education or attended care. CONCLUSION Long-term care insurance has played a role in controlling hospitalization costs but has not yet achieved the expected effect in controlling outpatient costs. The policy effects in terms of regional distribution and education level and care situation have been variable. The treatment plan of long-term care insurance needs to be improved, the supply of resources for long-term care services should be increased, and the promotion of long-term care insurance and health science should be given attention.
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Affiliation(s)
- Songhao Yang
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Research Centre for Rural Health Service, Wuhan, 430030, China
| | - Dandan Guo
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Research Centre for Rural Health Service, Wuhan, 430030, China
| | - Shengxian Bi
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
- Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Research Centre for Rural Health Service, Wuhan, 430030, China
| | - Yingchun Chen
- Department of Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
- Key Research Institute of Humanities & Social Sciences of Hubei Provincial Department of Education, Research Centre for Rural Health Service, Wuhan, 430030, China.
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Shi HY, Yeh SCJ, Chou HC, Wang WC. Long-term care insurance purchase decisions of registered nurses: Deep learning versus logistic regression models. Health Policy 2023; 129:104709. [PMID: 36725380 DOI: 10.1016/j.healthpol.2023.104709] [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: 06/26/2022] [Revised: 10/03/2022] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The purpose of this study was to use a deep learning model and a traditional statistical regression model to predict the long-term care insurance decisions of registered nurses. METHODS We Prospectively surveyed 1,373 registered nurses with a minimum of 2 years of full-time working experience at a large medical center in Taiwan: 615 who already owned long-term care insurance (LTCI), 332 who had no intention to purchase LTCI (group 1), and 426 who intended to purchase LTCI (group 2). RESULTS After inverse probability of treatment weighting (IPTW), no statistically significant differences were identified in the study characteristics of the two groups. All the performance indices for the deep neural network (DNN) model were significantly higher than those of the multiple logistic regression (MLR) model (P<0.001). The strongest predictor of an individual's long-term care insurance decision was their risk propensity score, followed by their caregiving responsibilities, whether they live with older adult relatives, their experiences of catastrophic illness, and their openness to experience. CONCLUSIONS The DNN model is useful for predicting long-term care insurance decisions. Its prediction accuracy can be increased through training with temporal data collected from registered nurses. Future research can explore designs for two-level or multilevel models that explain the contextual effects of the risk factors on long-term care insurance decisions.
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Affiliation(s)
- Hon-Yi Shi
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan; Graduate Institute of Technological and Vocational Education, National Pingtung University of Science and Technology, Pingtung, Taiwan; Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
| | - Shu-Chuan Jennifer Yeh
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Hsueh-Chih Chou
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan; Department of Nursing, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Wen Chun Wang
- Institute of Health Care Management and Department of Business Management, National Sun Yat-sen University, No.70 Lian Hai Road, Kaohsiung 80424, Taiwan
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Liu Z, Sun W, Chen H, Zhuang J, Wu B, Xu H, Li P, Chen X, Li J, Yin Y. Caregiver burden and its associated factors among family caregivers of persons with dementia in Shanghai, China: a cross-sectional study. BMJ Open 2022; 12:e057817. [PMID: 35613751 PMCID: PMC9174806 DOI: 10.1136/bmjopen-2021-057817] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE To assess the level of caregiver burden and factors associated with it among family caregivers of persons with dementia (PWD) living in communities of Shanghai, China. DESIGN Cross-sectional study. SETTING Communities in Hongkou District of Shanghai, China. PARTICIPANTS A random sample of 109 older adults with dementia and their primary family caregivers. MAIN OUTCOME MEASURE Caregiver burden measured by the Caregiver Burden Inventory (CBI), and the Caregivers' depressive symptom measured by the simplified Chinese version of Self-rating Depression Scale was the outcome variable of the study. The independent variables, including the cognitive function (measured by Montreal Cognitive Assessment (MoCA), sleep quality assessed by the Pittsburgh Sleep Quality Index, abilities of daily life assessed by the Activities of Daily Living Scale, and behavioural and psychological symptoms assessed by the Neuropsychiatric Inventory of PWDs, the community service utilisation (measured by the Community Service Utilisation Measurement), perceived social support (assessed by three questions), positive aspects of caregiving (PAC) (assessed by the PAC) of dementia caregivers, were analysed. Multivariate linear regression was employed to determine the factors related to caregiver burden. RESULTS The average level of CBI was 65.92±16.74. The score of MoCA, PAC and perceived social support of caregivers were negatively associated with caregiver burden (β=-0.84, p<0.001, β=-3.61, p=0.03 and β=-1.22, p=0.001, respectively). Community service utilisation was positively associated (β=3.46, p<0.001) with caregiver burden. Perceived social support by the caregiver moderated the relationship between caregiver burden and caregivers' depression symptoms. CONCLUSION Dementia caregivers experienced a high level of caregiver burden. The cognitive function of PWD, PAC, social support and community service utilisation were factors associated with caregiver burden. Strengthening social support, providing more high-quality home care services, promoting PAC are imperative to reduce caregiver burden.
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Affiliation(s)
- Zhijian Liu
- School of Nursing, Naval Medical University, Shanghai, China
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
| | - Wenjing Sun
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
| | - Honglin Chen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
- School of Social Development and Public Policy, Fudan University, Shanghai, China
| | - Jianhua Zhuang
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
| | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York City, New York, USA
| | - Hanzhang Xu
- School of Nursing, Duke University, Durham, North Carolina, USA
- School of Medicine, Duke University, Durham, North Carolina, USA
| | - Peng Li
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
| | - Xiaohan Chen
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
| | - Juan Li
- Huashan Hospital affiliated to Fudan University, Shanghai, China
| | - You Yin
- Department of Neurology, Second Affiliated Hospital of Naval Medical University (Changzheng Hospital), Shanghai, China
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Wang L, Zhou Y, Fang X, Qu G. Care burden on family caregivers of patients with dementia and affecting factors in China: A systematic review. Front Psychiatry 2022; 13:1004552. [PMID: 36545040 PMCID: PMC9760850 DOI: 10.3389/fpsyt.2022.1004552] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 11/14/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Dementia is a chronic and progressive illness characterized by severe impairment and high dependencies. Under the influence of Chinese traditional culture, 80% of patients with dementia are watched over at home by family caregivers as primary caregivers. However, long-term care brings formidable burdens to them and reduces the quality of their life. It is necessary to find out the influencing factors of caregivers' burden. METHODS A scoping search was conducted on eight electronic databases from 1 January 2010 to 14 June 2022: PubMed, Embase, the Cochrane Library, Web of Science, China National Knowledge Infrastructure, China VIP Database, China Biomedical Literature Database, and Wanfang Data Knowledge Service Platform. Research articles included in this review discussed the factors affecting Chinese dementia family caregivers' care burden or stress, and the level of care burden was evaluated by a standardized care burden scale. RESULTS A total of 1,888 related articles were found and 23 cross-sectional studies were eventually included. After quality assessment, 12 were of good quality and 11 were of fair quality. A total of 32 factors were identified that were associated with caregiver burden, and the results were grouped into three categories: patient, caregiver, and society. The severity of disease, poor self-care ability, neuropsychiatric symptoms, care time, number of helpers, poor health status, economic stress, poor psychological status, social support, and age were reported in many previous studies. CONCLUSION In this review, the factors that affect the caregiver burden for people with dementia were clarified. By identifying these factors, hospitals, decision-makers, and communities can carry out special projects for these populations, provide appropriate assistance, or design corresponding intervention measures to reduce the caregiver burden and improve the quality of care for patients with dementia. SYSTEMATIC REVIEW REGISTRATION [https://www.crd.york.ac.uk/PROSPERO/], identifier [CRD42022347816].
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Affiliation(s)
- Lan Wang
- School of Nursing, Weifang Medical University, Weifang, China
| | - Yang Zhou
- School of Nursing, Weifang Medical University, Weifang, China
| | | | - Guiyu Qu
- School of Nursing, Weifang Medical University, Weifang, China
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