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Comer A, Roeder H, Jones A, Jawed A, Kramer N. The impact of sex and gender on burden for caregivers of stroke patients: A narrative review. J Stroke Cerebrovasc Dis 2024; 33:107854. [PMID: 39004239 DOI: 10.1016/j.jstrokecerebrovasdis.2024.107854] [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: 12/21/2023] [Revised: 07/03/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND When a patient is disabled after stroke, they require both emotional support and medical management and may require the assistance of a caregiver. Given the often-sudden onset of disability and the complex challenges related to caring for someone after stroke, caregivers can experience a heavy burden. Caregiver burden negatively affects quality of care, quality of life, and physical and psychological health. The impact of gender on caregiver burden has been in many other conditions; however, the association has not yet been thoroughly assessed in stroke. OBJECTIVE The aim of this paper is to define caregiver burden, discuss how it is assessed, discuss unique aspects of burden for stroke caregivers, and determine the impact of sex and gender on stroke caregiver role and burden. METHODS A narrative review was performed to synthesize the available literature and explore how the role of sex and gender impact caregiving for patients who have suffered stroke and whether sex and gender of the caregiver contribute to caregiver burden r. RESULTS Review of the available literature suggests that sex and gender significantly impact caregiving burden following stroke dipropionately affecting women. CONCLUSIONS Caregiving for patients who have suffered stroke is often provided by women both inside the home and when patients are within institutions. Women who serve as caregivers to stroke patients may be at higher risk of experiencing burden and its negative effects, including emotional strain, anxiety, and/or depression. More research is needed to determine the best ways to provide support for women who act as caregivers for stroke patients to mitigate caregiver burden.
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Affiliation(s)
- Amber Comer
- Indiana University, American Medical Association, United States; American Medical Association, United States.
| | | | - Anne Jones
- Indiana University School of Medicine, United States
| | - Areeba Jawed
- University of Michigan School of Medicine, United States
| | - Neha Kramer
- Rush University School of Medicine, United States
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Usubini AG, Bondesan A, Caroli D, Frigerio F, Grugni G, Castelnuovo G, Sartorio A. Psychological conditions of caregivers of adult subjects with Prader-Willi syndrome. Orphanet J Rare Dis 2024; 19:392. [PMID: 39438963 PMCID: PMC11498952 DOI: 10.1186/s13023-024-03385-6] [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: 07/25/2024] [Accepted: 09/24/2024] [Indexed: 10/25/2024] Open
Abstract
BACKGROUND Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder. Individuals with PWS face a range of cognitive, behavioral, and emotional challenges that require comprehensive and lifelong care, posing significant demands on their caregivers. The study is not only aimed to assess the psychological conditions of caregivers of adult subjects with PWS focusing on psychological distress and coping, but also to shed light on a crucial yet often overlooked aspect of healthcare. This study aims to compare the psychological well-being of individuals with PWS and their caregivers, providing valuable insights that can potentially improve the quality of care for these individuals. The sample recruited at the Division of Auxology, IRCCS Istituto Auxologico Italiano, was composed of 30 adult subjects with PWS (11 men and 19 women; mean age ± SD: 36.4 ± 10.31 years; mean Body Mass Index (BMI): 35.7 ± 8.92: kg/m2) and their caregivers (10 men and 20 women). To assess the psychological condition of caregivers, the Italian-validated versions of the Depression Anxiety and Stress Scale (DASS-21) and the Coping Orientation to the Problems Experiences (COPE) were used, while to assess the psychological well-being of individuals with PWS and their caregivers, the Italian validated version of the Psychological General Well-Being Index (PGWBI) was used. RESULTS Depression (p < 0.001), Stress (p = 0.050), and Total score (p = 0.009) of DASS 21 were higher in the caregivers of subjects with PWS than in the general population. PGWBI scores of caregivers were significantly lower than in individuals with PWS in Positive Well-being (p < 0.001), General Health (p = 0.006), Vitality (p = 0.004), and the total score (p = 0.006). The depression subscale of PGWBI was higher in caregivers than in subjects with PWS. Correlations between the subscales of COPE and the total score of PGWBI in caregivers revealed that the Avoidance subscale of COPE had a negative significant correlation with the total score of PGWBI (p = 0.003). CONCLUSIONS Our results highlighted several critical insights into the profound emotional and psychological challenges faced by the caregivers of individuals with PWS.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy.
| | - Adele Bondesan
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy
| | - Diana Caroli
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy
| | - Francesca Frigerio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy
| | - Graziano Grugni
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Psychology Research Laboratory, Milan, 20145, Italy
- Department of Psychology, Catholic University of Milan, Milan, 20123, Italy
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Experimental Laboratory for Auxo-Endocrinological Research, Piancavallo-Verbania, 28824, Italy
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Al-Hakeem H, Hickling A, Mallory KD, Lovell A, Bardikoff T, Provvidenza C, Lam B, Knapp B, Miller C, Scratch SE. Move&Connect-Caregivers: A virtual group intervention for caregivers of youth experiencing persisting symptoms after concussion. Dev Neurorehabil 2024; 27:217-227. [PMID: 39313848 DOI: 10.1080/17518423.2024.2398161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 08/23/2024] [Accepted: 08/26/2024] [Indexed: 09/25/2024]
Abstract
Caregivers play a critical role in supporting youth experiencing persisting symptoms after concussion (PSAC). However, there are limited empirically validated interventions tailored to the specific needs of caregivers, such as improving concussion knowledge and supporting psychosocial wellbeing. This study aims to describe the development of a virtual group intervention for caregivers of youth experiencing PSAC, Move&Connect-Caregivers (M&C-C), and examine its feasibility. Nine mothers participated across two M&C-C groups. Feasibility metrics and semi-structured interviews were collected and analyzed using descriptive and qualitative content analysis. Results suggest that M&C-C is a feasible intervention. By merging social support, concussion psychoeducation, and active skill building, M&C-C is meaningful for caregivers supporting their children experiencing PSAC.
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Affiliation(s)
- Hiba Al-Hakeem
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Andrea Hickling
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Kylie D Mallory
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrew Lovell
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Tess Bardikoff
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Christine Provvidenza
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Brendan Lam
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Brenda Knapp
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
| | - Carlin Miller
- Department of Psychology, University of Windsor, Windsor, Ontario, Canada
| | - Shannon E Scratch
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Department of Paediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Marega J, Bah HT. Burdening caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital, The Gambia. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1751-1760. [PMID: 38498148 DOI: 10.1007/s00127-024-02634-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/12/2024] [Indexed: 03/20/2024]
Abstract
PURPOSE Deinstitutionalization of persons living with mental illness has led to many patients residing in communities with family members and shifting the burden of care and caregiving from hospitals to homes. The aim of the study was to determine the burden on caregivers of patients with schizophrenia at Edward Francis Small Teaching Hospital (EFSTH). METHODS This was a descriptive cross-sectional study design with a sample consisting of 161 randomly selected caregivers of patients with schizophrenia. The GHQ-12 questionnaire was used to determine the general health status of the caregivers. The caregivers' burden was assessed using the Zarit Burden Scale. The data were collected using the researcher-administered method. The collected data were analyzed with IBM SPSS Version 20 using descriptive statistics, mean differences, and the general linear model (GLM). RESULTS The main findings of this study were that caregivers experienced a significantly high level of burden. Most of them experienced high levels of physical (70%), psychological (93.2%), social (78.3%) and financial (55.3%) burdens. Employment status, specifically unemployment status and belonging to the Wolof ethnic group, was a significant predictor of the level of financial burden on the caregivers. Similarly, the total score for social burden was also significantly greater among unemployed caregivers. Educational level was a significant predictor of the total score on the psychological and physical burden scale. CONCLUSION The caregivers of patients with schizophrenia at EFSTH are experiencing a high level of burden as a result of their caregiving role, which affects their health, and this calls for urgent intervention.
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Affiliation(s)
- Jarra Marega
- Department of Psychiatry, Edward Francis Small Teaching Hospital, C/O Edward Francis Small Teaching Hospital, No. 2 Marina Parade, Banjul, The Gambia
| | - Haddy Tunkara Bah
- Department of Nursing and Reproductive Health, University of The Gambia, C/O School of Medicine and Allied Health Sciences, Banjul, The Gambia.
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Shekhani SS. Daughters and daughters-in-law providing elderly care: a qualitative study from Karachi, Pakistan. BMC Geriatr 2024; 24:785. [PMID: 39322964 PMCID: PMC11423502 DOI: 10.1186/s12877-024-05295-5] [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: 09/12/2023] [Accepted: 08/09/2024] [Indexed: 09/27/2024] Open
Abstract
BACKGROUND AND CONTEXT Providing care to the elderly is an emerging area of interest due to the increase in elderly population not only in the developed world but also in low and middle income countries. In Pakistan a country with an overall population of over 200 million, the elderly population amounts to 11.3 million. Caregiving of the elderly tends to occur within the kinship motivated by sociocultural norms as well as absence of government support facilities. While quantitative literature exists in Pakistan describing the "caregiver's burden," an in-depth analysis into the experiences of familial caregivers is missing. METHODS The research used qualitative methods with the aim to explore the lived experiences of 7 daughters and 3 daughters-in-law, living in Karachi, Pakistan providing care to the elderly requiring assistance in at least two tasks of daily living. RESULTS Five themes were developed inductively through the phenomenological method. All participants were Muslim and belonged to the upper economic strata of the society. Findings reveal that obligations to care are dominant in kinship circles particularly among women. Participants highlighted the importance of elderly in the Pakistani society, especially due to the religious lens that considers them as blessings. Daughter caregivers spoke about caregiving of their parents as a form of role reversal, emphasizing also upon the life-long emotional bond that served as a strong motivator. On the other hand, for daughter-in-law caregivers, motivations to care also stemmed from social expectations and kinship obligations. All participants reported multiple difficulties during the caregiving experience, despite existence of paid formal help, with respect to balancing multiple role demands and the nature of caregiving that requires constant effort. Results also illustrate that despite the desire to care for the elderly within a collectivist and patrilocal society, participants experienced multiple physical and emotional effects. However, a few also reported an increase in self-mastery and self-worth. CONCLUSION This study reveals that despite increasing urbanization and more women working outside the home, providing care to the elderly appears to be centered within the kinship circle. The research makes important contributions to the ageing literature in Pakistan with relevance to other South Asian contexts.
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Munie BM, Birhan Z, Legas G, Asnakew S, Belete A, Beyene GM, Shiferaw K, Mulu AT, Kassie YT, Aytenew TM, Tedla A. Predictors of depression among caregivers of patients with severe mental illness in Northwest Ethiopia, 2023: an explanatory sequential mixed-method study. Front Psychiatry 2024; 15:1422104. [PMID: 39371906 PMCID: PMC11450481 DOI: 10.3389/fpsyt.2024.1422104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Accepted: 07/23/2024] [Indexed: 10/08/2024] Open
Abstract
Background Severe mental illness results in an enormous social and economic burden on affected individuals, their families, and communities, especially in developing countries, such as Ethiopia. Objective The aim of this study was to assess the level of depression among caregivers of patients with severe mental illness in Debre Tabor Town, Northwest Ethiopia in 2023. Methods This institution-based explanatory mixed study was conducted at Debre Tabor Compressive Specialized Hospitals between September 30 to October 30, 2023. A systematic random sampling technique was used to select 260 study participants, and a public health questionnaire was used to assess depression. Epicollect5 was used to collect data, which were then exported to the SPSS-25 for analysis. Variables with a p-value <0.25 were considered candidates for the multivariate logistic regression analysis. The odds ratios with a 95% confidence interval were used to determine the strength of the association. An in-depth interview was conducted with 11 participants, selected using purposive sampling. Results The prevalence of depression was 31.3% (95% CI = 29.7-38.6). The multivariate analysis showed that being female (AOD = 2.43, CI = 1.42-7.23), divorced/widowed (AOD = 1.8, CI = 1.32-6.34), poor social support (AOD = 2.2, CI = 1.9-5.87), and perceived stigma (AOD = 2.33, CI = 0.24-13.22) were positively associated with depression. The qualitative results suggest that being female, illiterate, severity of the illness, poor social support, and stigma were factors for depression. Conclusions and recommendations The prevalence of depression was high among caregivers of patients with severe mental illness. Female sex, being divorced or widowed, being illiterate, poor social support, and perceived stigma were the contributing factors. This implies that a greater focus on caregivers and the government increases mental health literacy and mental health community services.
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Affiliation(s)
- Birhanu Mengist Munie
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Zelalem Birhan
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Getasew Legas
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Sintayehu Asnakew
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Amsalu Belete
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getnet Mihretie Beyene
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Kirubel Shiferaw
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Anemut Tilahun Mulu
- Department of Biochemistry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Yohannes Tesfahun Kassie
- Department of Emergency and Critical Care Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Tigabu Munye Aytenew
- Department of Nursing, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
| | - Assasahegn Tedla
- Department of Psychiatry, College of Health Sciences, Debre Tabor University, Debre Tabor, Ethiopia
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Kalu K, Shah GH, Ayangunna E, Shah B, Marshall N. The Role of Social Determinants of Health in Self-Reported Psychological Distress among United States Adults Post-COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:1219. [PMID: 39338102 PMCID: PMC11431397 DOI: 10.3390/ijerph21091219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 09/10/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024]
Abstract
Psychological distress, an emotional condition with symptoms of anxiety and depression, leads to impaired function, behavior, and personal traits. The current study examined the association between social determinants of health and the severity of psychological distress among adults in the United States after the COVID-19 pandemic. Using multinomial multivariable logistic regression, we analyzed data from 5106 (n = 5106) participants in the Health Information National Trends Survey (HINTS) 6. Compared to non-Hispanic Whites, African Americans (AOR = 0.62, CI = 0.42-0.93) had lower odds of reporting mild psychological distress rather than no stress. Other variables associated with a higher likelihood of reporting moderate to severe psychological distress, rather than no distress, are being in the 50-64 years age group (AOR = 2.77, CI = 1.45-5.28), divorced (AOR = 2.50, CI = 1.70-3.69), and widowed (AOR = 3.78, CI = 2.15-6.64). Respondents living in an urban area had lower odds of reporting moderate to severe psychological distress (AOR = 0.56, CI = 0.39-0.80) compared to those living in rural areas. Our findings identify several risk factors for psychological distress by sociodemographic characteristics such as age, race, marital status, and urban living, providing empirical evidence for interventions in behavioral health. These findings suggest there is an utmost need for a multi-sectoral approach to address the social determinants of health associated with psychological distress post-COVID-19 pandemic.
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Affiliation(s)
| | - Gulzar H. Shah
- Department of Health Policy and Community Health, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA 30458, USA; (K.K.); (E.A.); (B.S.); (N.M.)
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Simões LP, Souto T, Silva F, Ferreira MJ. The role of coping and positivity in shaping mental health among Portuguese informal caregivers. Geriatr Nurs 2024; 59:604-613. [PMID: 39178627 DOI: 10.1016/j.gerinurse.2024.07.038] [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: 01/31/2024] [Revised: 07/08/2024] [Accepted: 07/30/2024] [Indexed: 08/26/2024]
Abstract
The role of informal caregivers is increasingly relevant in the current sociodemographic context, with Portugal having an estimated 1.3 million caregivers. This study explores the relationship between coping strategies, Positive Life Orientation (PLO), and mental health among 133 Portuguese informal caregivers. Using a quantitative, cross-sectional methodology, results show a significant association between specific coping strategies, PLO, and variables related to distress and well-being. PLO and instrumental support positively predict well-being, while duration of care and self-blame and PLO positively predict depression, and positive reappraisal and positivity negatively predict depression. Religion, self-blame, and seeking emotional support are positively associated with anxiety, while religion, self-blame, and seeking emotional support positively predict stress, and positivity negatively predicts stress. PLO emerges as the strongest predictor of well-being. These findings underscore the importance of coping strategies and PLO in understanding informal caregivers' mental health, informing the development of personalized interventions tailored to their unique needs.
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Affiliation(s)
| | - Teresa Souto
- Faculty of Psychology, Sports and Education, Lusófona University, Porto, Portugal; HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal
| | - Frederico Silva
- Faculty of Psychology, Sports and Education, Lusófona University, Porto, Portugal
| | - Maria José Ferreira
- Faculty of Psychology, Sports and Education, Lusófona University, Porto, Portugal; HEI-Lab: Digital Human-Environment Interaction Lab, Lisbon, Portugal.
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Moreno G, Vicent L, Rosillo N, Delgado J, Cerro EPD, Bueno H. Do sex and gender aspects influence non-adherence to secondary prevention measures after myocardial infarction? Am J Prev Cardiol 2024; 19:100713. [PMID: 39224770 PMCID: PMC11367049 DOI: 10.1016/j.ajpc.2024.100713] [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: 03/09/2024] [Revised: 07/24/2024] [Accepted: 07/28/2024] [Indexed: 09/04/2024] Open
Abstract
Objective This study aimed to determine the prevalence of non-adherence to preventive interventions, its clinical consequences, and factors associated with non-adherence to secondary prevention measures, with a special emphasis on sex and gender. Methods Prospective observational study of patients hospitalized for acute myocardial infarction (AMI) in whom an evaluation of adherence to medication, Mediterranean diet, physical activity, and cardiac rehabilitation was performed after 6 and 12 months, with systematic assessment of predictors including patient-, disease-, psychological-, social-, and gender-related factors using self-administered questionnaires. Results Of 503 patients included, 101 (20,1%) were females. At one year, 85% of patients did not adhere to at least one of the recommendations with no differences between females and males. However, two factors more frequent in females, caregiver burden (adjusted OR, 1.45; 95%CI, 1.08-1.94) and depressive symptoms (adjusted OR, 1.40; 95%CI, 1.03-1.92) predicted non-adherence to all measures together. Chronic kidney disease (aOR, 3.24; 95%CI, 1.02-10.48) and being female (aOR, 2.21; 95%CI, 1.18-4.13) were associated with non-adherence to the Mediterranean diet; diabetes with organ damage (aOR, 12.06; 95%CI, 1.93-7.69) and older age (aOR, 0.96 per year; 95%CI, 0.93-0.99), among others, with physical activity; and higher body mass index with cardiac rehabilitation participation (aOR, 1.07; 95%CI, 1.002-1.14) and completion (aOR, 1.14; 95%CI, 1.03-1.26). Conclusion Adherence to all secondary prevention measures after AMI remains very low and is associated with several gender-related factors. Multidisciplinary intervention strategies targeting the most vulnerable patient groups, such as females or patients with diabetes, obesity, chronic kidney disease, or depression, are warranted.
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Affiliation(s)
- Guillermo Moreno
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Instituto de Investigación Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Lourdes Vicent
- Instituto de Investigación Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Servicio de Cardiología. Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - Nicolás Rosillo
- Instituto de Investigación Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Servicio de Cardiología. Hospital Universitario 12 de Octubre, Madrid, Spain
- Servicio de Medicina Preventiva, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Juan Delgado
- Servicio de Cardiología. Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
| | - Enrique Pacheco Del Cerro
- Departamento de Enfermería, Facultad de Enfermería, Fisioterapia y Podología, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Unidad de Procesos, Investigación, Innovación y Sistemas de Información, Dirección de Enfermería, Instituto de Investigación Sanitaria San Carlos (IDISSC), Hospital Clínico San Carlos, Madrid, Spain
| | - Héctor Bueno
- Instituto de Investigación Hospital 12 de Octubre (imas12), Hospital Universitario 12 de Octubre, Madrid, Spain
- Servicio de Cardiología. Hospital Universitario 12 de Octubre, Madrid, Spain
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
- Facultad de Medicina, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain
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Reji ES, Fredi F, Ismail RM, Bindu VM, Pereira P, Ramesh M, Syed J, Chalasani SH. Assessment of drug therapy satisfaction amongst the elderly: A patient reported outcomes measures approach. Geriatr Nurs 2024; 59:33-39. [PMID: 38981206 DOI: 10.1016/j.gerinurse.2024.06.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 06/20/2024] [Accepted: 06/27/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Understanding elderly experiences enhance healthcare outcomes and patient satisfaction. Recognizing caregivers' role and implementing supportive measures enhance care. OBJECTIVES Quantify drug satisfaction using patient-reported outcomes measures approach. Assess caregiver burden using short version of Burden Scale for Family Caregivers. METHODS Six-month cross-sectional study in Department of Geriatrics. Elderly (≥60), minimum one comorbidity, admitted for >48 h, and consenting to participate were enrolled. Patient satisfaction assessed using Treatment Satisfaction with Medicines Questionnaire (SATMED-Q). SPSS version 27 used to calculate odds ratio. RESULTS 282 participants enrolled. SATMED-Q score 47.41 ± 10.34, indicating overall satisfaction. Treatment satisfaction range 47.07 % to 100 %. Age [OR 0.964, 95 % CI 0.932-0.996 (p = 0.029)] and education [OR 1.500, 95 % CI 1.129-1.992 (p = 0.005)] influenced satisfaction. 268 [95.03 %] had caregivers, 14 [4.96 %] did not. Caregiver burden score 9.25 ± 9.11. CONCLUSION Insights obtained from assessing satisfaction and caregiver burden enables physicians to improve welfare of elderly and caregivers.
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Affiliation(s)
- Eileen Susa Reji
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Feba Fredi
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - R Muhammad Ismail
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - V M Bindu
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Pratibha Pereira
- Department of Geriatrics, JSS Medical College & Hospital, JSS Academy of Higher Education & Research, Mysuru - 15 Karnataka, India
| | - M Ramesh
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Jehath Syed
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India
| | - Sri Harsha Chalasani
- Department of Pharmacy Practice JSS College of Pharmacy JSS Academy of Higher Education & Research, Mysuru -15, Karnataka, India.
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11
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Haynes-Ferere A, Muirhead L, Hayes R, McCauley L. The growth and development of a novel distance accelerated bachelor of science in nursing program. J Prof Nurs 2024; 54:1-9. [PMID: 39266075 DOI: 10.1016/j.profnurs.2024.04.009] [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: 09/01/2023] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 09/14/2024]
Abstract
Severe nursing shortages threaten the sustainability of US health systems. Rural and underserved communities are disproportionately affected by staffing crises and associated facility closures, as well as health disparities. A major factor contributing to geographic gaps in care is the absence of nursing schools, nursing faculty, and locations for clinical rotations in many rural and underserved areas. Emory School of Nursing is helping to solve for these issues through the Distance Accelerated Bachelor of Science in Nursing (DABSN) program. The DABSN is establishing accelerated pipelines of nursing students into practice in locations where nursing education has historically been difficult or impossible to access. This innovative nursing education model allows students to enroll in a top-ranked nursing school while remaining in their home communities. Students complete synchronous didactic coursework with peers in every US time zone while performing clinical rotations in local healthcare facilities. This paper details the growth and development of the DABSN. It describes the challenges and opportunities we have navigated in implementing the program, along with information about its pedagogy, clinical placement practices, and student/faculty characteristics. We share program outcomes and conclude with recommendations for the future.
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Affiliation(s)
- Angela Haynes-Ferere
- Associate Clinical Professor, Program Director of Distance Accelerated Baccalaureate Nursing Program, Native American and Indigenous Studies Initiative at Emory (NAISI), Emory Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., NE, Atlanta, GA 30322, United States of America.
| | - Lisa Muirhead
- Professor, Clinical, Associate Dean for Equity and Inclusion, Admissions, & Student Affairs, Emory Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., NE, Atlanta, GA 30322, United States of America.
| | - Rose Hayes
- Director of Engagement, Emory Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., NE, Atlanta, GA 30322, United States of America.
| | - Linda McCauley
- Dean and Professor, Director of Engagement, Emory Nell Hodgson Woodruff School of Nursing, 1520 Clifton Rd., NE, Atlanta, GA 30322, United States of America.
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12
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Mastrogiannis AM, Steinway C, Santos TC, Chen J, Berens J, Davis T, Cornacchia M, Woodward J, Riddle I, Spicer B, Wright C, Lindquist LA, Jan S. Medicaid long-term services and supports and caregiving needs of caregivers of individuals with intellectual and developmental disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13289. [PMID: 39103738 DOI: 10.1111/jar.13289] [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: 08/12/2022] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 08/07/2024]
Abstract
BACKGROUND Long-term care services are funded primarily by Medicaid long-term services and support in the United States, where eligibility is based on care needs of the individual with intellectual and developmental disability alone. Impact of Medicaid waiver services on self-reported caregiver needs is not well understood. METHOD Caregivers (n = 405) of individuals with intellectual and developmental disabilities across four states (NY, OH, TX, and PA) completed an online survey. RESULTS Caregivers reported a moderate degree of burden and susceptibility of stress-induced health breakdown. Despite controlling for the activities of daily living of the care recipient, caregivers of individuals with Medicaid Waiver services reported greater difficulty managing medications (p = .013) and finding paid help (p < .001) than caregivers of individuals without services.
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Affiliation(s)
- Ariana M Mastrogiannis
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Caren Steinway
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Telmo C Santos
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
| | - Jack Chen
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
| | - John Berens
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Thomas Davis
- Division of General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Michelle Cornacchia
- Division of General Internal Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA
| | - Jason Woodward
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Ilka Riddle
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Brittany Spicer
- Division of Developmental and Behavioral Pediatrics, Cinncinati Children's Hospital and Medical Center, Cincinnati, Ohio, USA
| | - Charmaine Wright
- Division of Internal Medicine, Division of Pediatrics, Christiana Care, Wilmington, Delaware, USA
| | - Lee A Lindquist
- Division of Geriatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sophia Jan
- Department of Pediatrics, Northwell Health, New Hyde Park, New York, USA
- Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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13
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Baykal D, Bilgic B. The effects of progressive muscle relaxation exercise on dementia caregivers. Geriatr Nurs 2024; 59:491-497. [PMID: 39146639 DOI: 10.1016/j.gerinurse.2024.07.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/06/2024] [Accepted: 07/30/2024] [Indexed: 08/17/2024]
Abstract
While progressive muscle relaxation has demonstrated effectiveness in reducing anxiety, stress, and depression in general populations, its impact on caregivers of dementia patients remains understudied. This study investigated the effectiveness of Progressive Muscle Relaxation (PMR) in improving the well-being of dementia caregivers. Caregivers of individuals with dementia (n = 57) participated in a 3-month intervention, engaging in PMR thrice weekly. Participants completed assessments of depression, anxiety, stress, and caregiver burden at pre-test and post-intervention period. The intervention led to significant reductions in anxiety, stress, depression, and caregiver burden among participants. Female caregivers reported to have higher levels of anxiety and stress compared to males. Caregivers under financial stress showed high levels of distress and increased caregiver burden. These promising findings suggest the need for further research with larger, multicenter samples. Notably, PMR is a readily implementable intervention by nurses, requiring minimal equipment and offering a cost-effective approach to supporting caregiver well-being.
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Affiliation(s)
- Dilek Baykal
- Department of Nursing, Faculty of Health Sciences, Istanbul Atlas University, Istanbul, , Türkiye.
| | - Basar Bilgic
- Istanbul University, Istanbul Faculty of Medicine, Department of Neurology, Behavioral Neurology and Movement Disorders Unit, Istanbul, , Türkiye
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14
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Di Gessa G, Deindl C. Determinants of trajectories of informal caregiving in later life: evidence from England. Eur J Ageing 2024; 21:24. [PMID: 39215804 PMCID: PMC11365911 DOI: 10.1007/s10433-024-00818-w] [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] [Accepted: 08/05/2024] [Indexed: 09/04/2024] Open
Abstract
Although the long-term consequences of informal care provision have been well investigated, few studies have examined the trajectories of informal care provision among older people and the socioeconomic, demographic, health, and family characteristics associated with them. We use data from four waves of the English Longitudinal Study of Ageing, with 6561 respondents followed for 6 years (2012/3-2018/9). We used group-based trajectory modelling to group people's provision of care over time into a finite number of distinct trajectories of caregiving. Using multinomial logistic regressions, we then investigated the characteristics associated with these trajectories. Four distinct trajectories of caregiving were identified: "stable intensive", "increasing intensive", "decreasing", and "stable no care". Results suggest that although there are socioeconomic, demographic, and health differences across the trajectories of caregiving (with younger women in good health and poorer socioeconomic status more likely to care intensively throughout), family characteristics are their main drivers. Respondents who live alone, with no children, and no parents alive are more likely to never provide care, whereas those with older parents and who live with adults in poor health are more likely to provide stable intensive care. Also, changes in family characteristics (e.g. death of parents, widowhood, or deterioration of the partner's health) are associated with trajectories representing increases or decreases in caregiving over time. Overall, trajectories of informal caregiving undertaken by older people are varied and these patterns are mostly associated with both the availability and health of family members, suggesting that need factors represent the most immediate reason for caregiving commitments.
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Affiliation(s)
- Giorgio Di Gessa
- Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, London, WC1E 7HB, UK.
| | - Christian Deindl
- Department of Social Sciences, TU Dortmund University, Dortmund, Germany
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15
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Gulino V, Brunasso L, Avallone C, Costa V, Adorno AA, Lombardo MC, Tumbiolo S, Iacopino DG, Maugeri R. Caregivers' Perspective and Burden of the End-of-Life Phase of Patients with Glioblastoma: A Multicenter Retrospective Study. World Neurosurg 2024:S1878-8750(24)01482-7. [PMID: 39214291 DOI: 10.1016/j.wneu.2024.08.114] [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: 07/02/2024] [Revised: 08/21/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Glioblastoma is the most common aggressive primary brain tumor in adults. Changes in cognition, personality, and behavior of patients as well as side effects of treatments cause unique challenges for providing care and may impact caregiver burden in different ways. METHODS This retrospective study included 45 patients with a diagnosis of glioblastoma treated between January 2022 and June 2023 in 2 neurosurgical departments. We investigated the quality of life and the experiences of patients with glioblastoma and caregivers in the end-of-life phase using a validated questionnaire consisting of 38 questions related to the caregiver's view of the patient's terminal phase and another 26 questions regarding caregiver's experiences and emotions during the last 3 months of the patient's life. RESULTS Fatigue, reduced consciousness, and sadness were the most common patient symptoms reported by their caregivers. The reported quality of life of caregivers was low and in accordance with the quality of life that they attributed to the patient. Symptoms of burnout and feelings of insufficient information emphasize the urgent need for psychological support and training dedicated to caregivers. CONCLUSIONS The end-of-life phases of patients with glioblastoma represent a critical factor that significantly affects not only the patient but also the caregiver's burden, caregiving tasks, and time. A multidisciplinary support program is needed to address and improve caregivers' burden.
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Affiliation(s)
- Vincenzo Gulino
- Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy
| | - Lara Brunasso
- Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy.
| | - Chiara Avallone
- Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy
| | - Vanessa Costa
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | | | | | - Silvana Tumbiolo
- Department of Neurosurgery, Villa Sofia Hospital, Palermo, Italy
| | - Domenico Gerardo Iacopino
- Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy
| | - Rosario Maugeri
- Neurosurgical Clinic, AOUP "Paolo Giaccone", Post Graduate Residency Program in Neurologic Surgery, Department of Experimental Biomedicine and Clinical Neurosciences, School of Medicine, University of Palermo, Palermo, Italy
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16
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Cheng JC, Yang CF, Chou CC, Shu YM, Liu PC, Lo KW, Chen CW. The lived experience of mothers caring for school-age children with Pompe disease: A qualitative study. J Pediatr Nurs 2024; 79:24-31. [PMID: 39190967 DOI: 10.1016/j.pedn.2024.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 08/06/2024] [Accepted: 08/06/2024] [Indexed: 08/29/2024]
Abstract
PURPOSE To explore the lived experiences of mothers caring for school-age children with Pompe disease. DESIGN AND METHODS A qualitative study using a descriptive phenomenology approach. Semi-structured interviews were conducted from October to December 2022 with 10 mothers of school-age children diagnosed with Pompe disease, which were identified through the Taiwan Pompe Disease Association. Colaizzi's phenomenological method was employed for data analysis. RESULTS The study identified five themes in the caregiving experiences of mothers: 1. unwavering parenting beliefs; 2. child-centric approach; 3. focus on peer relationships and coping strategies; 4. integration of learning, treatment, and rehabilitation; and 5. embracing and navigating life's challenges. Mothers balanced education, treatment, and rehabilitation for their children with Pompe disease, offering perspectives into the caregiving experience. CONCLUSIONS This study highlights the complex experiences of mothers caring for children with Pompe disease, emphasizing the importance of comprehensive support. PRACTICE IMPLICATIONS Insights into the perspectives of mothers can aid health-care professionals in understanding the challenges faced by families with children diagnosed with Pompe disease and can enable the development of strategies for providing comprehensive psychological support to improve mental health outcomes for these children and their families. Increased awareness among health-care professionals and in the society leads to an informed and empathetic approach to addressing the unique challenges faced by children with Pompe disease and their families.
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Affiliation(s)
- Ju-Chun Cheng
- Department of Nursing, Cathay General Hospital Hsinchu, Hsinchu, Taiwan
| | - Chia-Feng Yang
- Department of Pediatrics, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Cheng-Chen Chou
- Institute of Community Health Care, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Ying-Mei Shu
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Pei-Ching Liu
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Kao-Wen Lo
- Department of Nursing, Chang Gung University of Science and Technology, Taoyuan, Taiwan.
| | - Chi-Wen Chen
- Department of Nursing, College of Nursing, National Yang Ming Chiao Tung University, Taipei, Taiwan.
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17
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Al-Awad F. Perceived Burden and Quality of Life in Caregivers of Patients with Schizophrenia in Saudi Arabia's Eastern Province: A Cross-sectional Study. Clin Pract Epidemiol Ment Health 2024; 20:e17450179314013. [PMID: 39355198 PMCID: PMC11443458 DOI: 10.2174/0117450179314013240417105321] [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: 03/02/2024] [Revised: 03/26/2024] [Accepted: 03/28/2024] [Indexed: 10/03/2024]
Abstract
Background and Aims Family Caregivers (FCGs) of patients with schizophrenia (PwS) may face unanticipated sources of stress and responsibility, which can negatively impact their quality of life (QoL). This study aimed to assess FCGs' QoL and the impact of clinical characteristics of patients and sociodemographic factors on their QoL. Patients and Methods A cross-sectional questionnaire-based study surveyed 340 FCGs from outpatient clinics of PwS in two large psychiatric hospitals in Saudi Arabia's eastern province using a convenience sampling approach. We used the Adult Carer Quality of Life (AC-QoL) scale, which has eight subscales and 40 items, to assess QoL. AC-QoL is translated into Arabic in this study. Results The study included 216 FCGs, with 127 (58.8%) being men, 117 (54.2%) being over 45 years old, 91 (42.1%) being a sibling of a PwS, and 82 (38%) being a parent of a PwS. The mean score in our sample was 78.2 ± 21.24 out of 120, indicating mid-range QoL. Lower QoL was associated with more time spent in caregiving per day, a lower educational level of FCG, and recent admission of PwS to an inpatient unit. Conclusion PwS FCGs have a mid-range QoL. FCGs reported a moderate financial burden and low levels of support from healthcare professionals. FCG's QoL and stress can be reduced through healthcare providers, participation in a community support group, and addressing an FCG's in an individual setting.
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Affiliation(s)
- Feras Al-Awad
- Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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18
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Hayes A, Courey L, Kells M, Hyndman D, Dempsey M, Murphy M. Caregivers of individuals with borderline personality disorder: The relationship between leading caregiver interventions and psychological distress/positive mental well-being. FAMILY PROCESS 2024. [PMID: 39091082 DOI: 10.1111/famp.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 04/15/2024] [Accepted: 07/08/2024] [Indexed: 08/04/2024]
Abstract
Burden and psychological distress are higher in informal caregivers (ICs) of people with severe emotional and behavior dysregulation who have been given a diagnosis of borderline personality disorder (BPD) compared with non-caregivers. The current cross-sectional study examines the difference in outcomes of ICs of people with BPD who have received the intervention Family Connections (FC) and who also led interventions for other caregivers (caregiver-leaders) compared with those who have attended FC but not led caregiver interventions (non-leader-FC participants). The sample for this research is from a larger study (Hayes et al., 2023, Borderline Personality Disorder and Emotion Dysregulation, 10, 31). Data for 347 participants who self-reported receiving FC and completed the McLean Screening Instrument for BPD-Carer Version, the Brief COPE, the Multidimensional Scale of Perceived Social Support, the Kessler Psychological Distress scale, the WHO-5 Well-being Index, and the Coronavirus Anxiety Scale were analyzed. The results found that being a caregiver-leader was associated with higher positive mental well-being and lower psychological distress compared with non-leader-FC participants. Being a caregiver-leader was also associated with significantly greater use of the coping strategy of positive reframing and lower use of behavioral disengagement and self-blame than non-leader-FC participants. The study provides preliminary evidence that for those who have received FC, becoming an intervention leader is associated with better outcomes than caregivers who do not become leaders and provides support for caregiver-led rollout of FC across services.
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Affiliation(s)
- Aoife Hayes
- School of Applied Psychology, University College Cork, Cork, Ireland
- Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, Cork, Ireland
| | - Lynn Courey
- The Sashbear Foundation, Toronto, Ontario, Canada
| | - Mary Kells
- Mental Health Services, Cork Kerry Community Healthcare, Health Service Executive, Cork, Ireland
| | | | - Maria Dempsey
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Mike Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
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Ogunjesa B, Gao X, Raj M. Factors Influencing Caregivers' Use of Respite Care Services: Secondary Analysis of the National Study of Caregiving. J Appl Gerontol 2024; 43:1100-1110. [PMID: 38298084 DOI: 10.1177/07334648241229574] [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: 02/02/2024] Open
Abstract
This study examines when and why unpaid caregivers use respite services. We conducted a secondary analysis of the 2017 National Study of Caregiving (NSOC) Wave III, a U.S. nationally representative sample comprising 2652 unpaid caregivers. We found that unpaid caregivers reporting financial, physical, and emotional difficulties in caregiving were more likely to use respite care services than those not reporting these challenges. White, non-Hispanic caregivers reporting that they received support from their social networks (families/friends) were more likely to use respite care services than non-White and/or Hispanic caregivers receiving such support. Non-White and/or Hispanic caregivers who belonged to or attended support groups were more likely to use respite care support than those without social group affiliation. Respite care is underutilized in the U.S. despite its value and efficacy in supporting caregivers' mental and physical well-being. Policies are necessary to increase availability and access to respite services for diverse unpaid caregivers.
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Affiliation(s)
- Babatope Ogunjesa
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Xiaotian Gao
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
| | - Minakshi Raj
- College of Applied Health Sciences, University of Illinois Urbana Champaign, Champaign, IL, USA
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20
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Du X, Gao S, Zhao X, Chen X. The effect of cognitive reappraisal on emotion recognition in mothers of children with special needs. Acta Psychol (Amst) 2024; 248:104401. [PMID: 39003991 DOI: 10.1016/j.actpsy.2024.104401] [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: 02/19/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024] Open
Abstract
Intrinsic family dynamics are an important factor in the development of children with special needs, and mothers' emotion regulation ability influences children's development to some extent. This study examined the intrinsic mechanism of cognitive reappraisal of emotion regulation strategies affecting the emotion recognition ability of mothers of children with special needs. Results indicated that mothers of children with special needs recognized negative emotions significantly faster than typically developing child mothers. After receiving cognitive reappraisal emotion regulation strategies, they significantly improved emotional recognition of surprise and reduced attention bias towards anger. Overall, mothers of children with special needs may have obvious attention bias towards negative emotions, and cognitive reappraisal can target negative emotions to help them to better improve emotional resilience.
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Affiliation(s)
- Xue Du
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China; Research Center for Brain and cognitive science, Chongqing Normal University, Chongqing, China.
| | - Shuanghong Gao
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China; Research Center for Brain and cognitive science, Chongqing Normal University, Chongqing, China
| | - Xuefei Zhao
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China; Research Center for Brain and cognitive science, Chongqing Normal University, Chongqing, China
| | - Xiaoyi Chen
- Key Laboratory of Applied Psychology, Chongqing Normal University, Chongqing, China; Research Center for Brain and cognitive science, Chongqing Normal University, Chongqing, China
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21
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Papadopoulos A, Tsapara A, Gryparis A, Tafiadis D, Trimmis N, Plotas P, Skapinakis P, Tzoufi M, Siafaka V. A Prospective Study of the Family Quality of Life, Illness Perceptions, and Coping in Mothers of Children Newly Diagnosed with Autism Spectrum Disorder and Communication Difficulties. Eur J Investig Health Psychol Educ 2024; 14:2187-2204. [PMID: 39194940 DOI: 10.3390/ejihpe14080146] [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: 05/03/2024] [Revised: 07/12/2024] [Accepted: 07/30/2024] [Indexed: 08/29/2024] Open
Abstract
(1) Background: This study assesses the impact of mothers' illness perceptions about autism spectrum disorder and their coping strategies on the family's quality of life during the initial period following diagnosis and one year afterward. (2) Method: The sample consisted of 53 mothers of children newly diagnosed with autism spectrum disorder and having communication difficulties who completed the following: the Beach Center Family Quality of Life Scale, the Brief Illness Perception Questionnaire, and the Brief-COPE. (3) Results: The findings revealed a moderate family quality of life in the initial assessment and a lack of a statistically significant change one year later. Notably, statistically significant changes were observed in coping strategies, as in the second assessment, and the score in denial and self-blame decreased. Pearson and Eta analyses indicated several correlations between socio-demographic characteristics, illness perceptions, coping strategies, and family quality of life. Multiple regression analysis showed that positive reframing was positively associated with total family quality of life in the initial period following diagnosis and one year afterward, while self-blame was associated with poorer quality of life in the time after diagnosis. Furthermore, the belief about the controllability of the disorder was correlated with better family quality of life one year after the diagnosis. (4) Conclusions: Illness perceptions and coping can be considered as predictors of family quality of life outcomes one year after the diagnosis of autism spectrum disorder. The focus of interventions, apart from controlling the disorder's symptoms, should aim to strengthen specific strategies and weaken others.
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Affiliation(s)
- Angelos Papadopoulos
- School of Humanities and Social Sciences, University of Patras, 26504 Patras, Greece
- General Children's Hospital of Patras "Karamandaneio", 26331 Patras, Greece
| | - Angeliki Tsapara
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Alexandros Gryparis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
| | - Dionysios Tafiadis
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
| | - Nikolaos Trimmis
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Panagiotis Plotas
- Department of Speech and Language Therapy, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
- Laboratory of Primary Health Care, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece
| | - Petros Skapinakis
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Meropi Tzoufi
- Faculty of Medicine, School of Health Sciences, University of Ioannina, 45110 Ioannina, Greece
| | - Vassiliki Siafaka
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, 4th Km National Road Ioannina-Athens, 45500 Ioannina, Greece
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Marwi A, Bali IA, Almurashi A, Alharbi EH, Alnkhli IJ, Moneer Alqerafi N. The Social and Financial Burden on Families of Type 1 Diabetic Pediatric Patients in Madinah Region, Saudi Arabia. Cureus 2024; 16:e66427. [PMID: 39246901 PMCID: PMC11380156 DOI: 10.7759/cureus.66427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2024] [Indexed: 09/10/2024] Open
Abstract
INTRODUCTION Caregivers and families play an essential role in managing and caring for type 1 diabetes mellitus (T1DM) pediatric patients. However, caregiving is usually associated with social and financial burdens. This study assesses the burden and underlying social and financial factors among Saudi caregivers of pediatric patients with T1DM. METHODS A cross-sectional study was conducted among caregivers and families of T1DM pediatric patients attending the Diabetic Center at King Fahad Hospital (KFH) and the Diabetic Center at King Salman Bin Abdulaziz Medical City (KSAMC) in Al-Madinah City, Kingdom of Saudi Arabia (KSA) from January 2024 to June 2024. The data collection was done using the Zarit Burden Questionnaire and the Caregiver Care Cost Assessment Questionnaire. RESULTS The study surveyed 376 participants, primarily females (N = 285, 75.8%) and married (N = 317, 84.3%), with a majority aged between 18 and 47 years (N = 322, 85.6%). The burden experienced by families with T1DM pediatric patients was moderate, with a mean total burden level score of 27.8 ± 16.3. For those employed, most reported working as usual (N = 107, 81.1%), with most spending less than two hours on care weekly (N = 76, 57.6%). A significant association was found between the financial impact of caregiving on saving, spending, and general financial stress and social burden (p < 0.01). CONCLUSION The findings show a moderate burden faced by caretakers of T1DM pediatric patients, with a strong correlation between the financial impact of caregiving on saving, spending, and general financial stress and burden level. The findings also highlight the significant impact of caregiving on the financial stress and lifestyle changes that caregivers endure.
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Affiliation(s)
- Abdulaziz Marwi
- Preventive Medicine, Public Health Administration, Ministry of Health, Madinah, SAU
| | - Ibrahim A Bali
- Pediatric Endocrinology, King Salman Bin Abdulaziz Medical City, Madinah, SAU
| | | | - Eman H Alharbi
- Pediatric Medicine, King Salman Bin Abdulaziz Medical City, Madinah, SAU
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Cohen S, Salamin V, Perroud N, Dieben K, Ducasse D, Durpoix A, Guenot F, Tissot H, Kramer U, Speranza M. Group intervention for family members of people with borderline personality disorder based on Dialectical Behavior Therapy: Implementation of the Family Connections® program in France and Switzerland. Borderline Personal Disord Emot Dysregul 2024; 11:16. [PMID: 39039536 PMCID: PMC11265349 DOI: 10.1186/s40479-024-00254-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 05/23/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Families and significant others of people with borderline personality disorder (BPD) show increased levels of psychological distress. Family Connections®, a 12-week group intervention based on the principles of Dialectical Behavior Therapy, was designed to provide families with both information about the disorder and emotion regulation skills. It has been progressively implemented in French-speaking European countries. METHODS We conducted an observational, multicenter study in France and Switzerland. In total, 149 participants of the Family Connections program were included among five centers. Burden, depression, coping, and emotion regulation were assessed before and after the intervention. RESULTS One-way repeated measures MANOVA showed that the burden, depressive symptoms, emotion regulation and coping all changed significantly after the intervention (p < 0.001, partial η2 = 0.297). T-tests showed that the burden significantly decreased after the intervention (p < 0.0001, d = -0.48), as did depressive symptoms (p < 0.0001, d = -0.36) and difficulties in emotion regulation (p < 0.0001, d =-0.32) whereas coping improved (p < 0.0001, d = 0.53). Two-way mixed ANOVA showed that burden reduction was stronger among female than male participants (p = 0.048, η2 = 0.027). Before the intervention, the burden was higher for female than male participants (p < 0.001). An initial linear regression showed the burden reduction to be associated with a decrease in the resignation of the participants (β = 0.19, p = 0.047). A second linear regression showed the burden reduction to be associated with the intensity of the relatives' symptoms at baseline (β = 0.22, p = 0.008) and improvement of emotional clarity of the participants (β = 0.25, p = 0.006). CONCLUSION This Dialectical Behavior Therapy-Based psychoeducational intervention is an appropriate way to support French-speaking European families of people with BPD.
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Affiliation(s)
- Satchel Cohen
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
| | | | - Nader Perroud
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Karen Dieben
- Department of Psychiatric Specialties for Emotion Regulation Disorders, Geneva University Hospitals, 1201, Geneva, Switzerland
| | - Déborah Ducasse
- CHU de Montpellier, Service Urgences Et Post-Urgences Psychiatriques (Lapeyronie), Centre de Thérapies Troubles de L'humeur Et Émotionnels/Borderline (La Colombière), IGF, Univ. Montpellier, CNRS, Inserm, Montpellier, France
| | - Amaury Durpoix
- Strasbourg University Hospital, 67000, Strasbourg, France
| | | | - Hervé Tissot
- Center for Family Studies, University Institute of Psychotherapy, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
- Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Ueli Kramer
- Lausanne University Hospital Institute of Psychotherapy/General Psychiatry, 1003, Lausanne, Switzerland
| | - Mario Speranza
- Child and Adolescent Psychiatry Care Unit, Versailles Hospital, Le Chesnay, France.
- Paris-Saclay University, UVSQ, Inserm, Centre for Research in Epidemiology and Population Health UMR 1018, Team "Developmental Psychiatry and Trajectories", 78000, Versailles, France.
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Sun YJ, Song J, Li XP, Wang XH, Wu YX, Huang JJ, Wang SB, Teng YY. Knowledge of Alzheimer's disease and associated factors among adults in Zhuhai, China: a cross-sectional analysis. BMC Public Health 2024; 24:1769. [PMID: 38961390 PMCID: PMC11220978 DOI: 10.1186/s12889-024-19289-w] [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: 12/20/2023] [Accepted: 06/27/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND This study aimed to assess the public knowledge regarding Alzheimer's Disease (AD) in Zhuhai, China, focusing on identifying knowledge gaps and the influence of demographic and health factors. METHODS A cross-sectional study was conducted in Zhuhai, China, from October to November 2022. A total of 1986 residents from 18 communities were selected employing stratified multi-stage equi-proportional sampling. Questionnaires covering general information and the Alzheimer's Disease Knowledge Scale (ADKS) were investigated face-to-face. Ordinal multiclass logistic regression was applied to assess the relationship between AD awareness and demographic and health characteristics. RESULTS The average ADKS score was 18.5 (SD = 3.36) in Zhuhai. The lowest awareness rates were observed in the "Symptoms" and "Caregiving" subdomains of ADKS, with rates of 51.01% and 43.78%, respectively. The correct rates for the 30 ADKS questions ranged from 16.62 to 92.6%, showing a bimodal pattern with clusters around 80% and 20%. Women (OR = 1.203, 95% CI: 1.009-1.435), individuals aged 60 years or older (OR = 2.073, 95% CI: 1.467-2.932), those living in urban areas (OR = 1.361, 95% CI: 1.117-1.662), higher average monthly household income per capita (OR = 1.641, 95% CI: 1.297-2.082), and without any neurological or mental disorders (OR = 1.810, 95% CI: 1.323-2.478) were more likely to have higher levels of awareness about Alzheimer's disease. CONCLUSIONS Adults in Zhuhai show a limited knowledge of AD, particularly in the 'Symptoms' and 'Caregiving' subdomains. Upcoming health campaigns must focus on bridging the knowledge gaps in different subdomains of AD, especially among subgroups with lower awareness, as identified in our study.
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Affiliation(s)
- Ya-Jun Sun
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Jie Song
- Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xu-Ping Li
- Xiangya School of Public Health, Central South University, No.172 Tongzipo Road, Yuelu District, Changsha City, Hunan Province, 410006, China
| | - Xiao-Hui Wang
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Yi-Xuan Wu
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Jia-Ju Huang
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China
| | - Shi-Bin Wang
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, Guangdong province, 510080, China.
| | - Yong-Yong Teng
- The Third People's Hospital of Zhuhai, Zhuhai Center for Chronic Disease Prevention and Control, Zhuhai, Guangdong province, 519000, China.
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Albani EN, Toska A, Togas C, Rigatos S, Vus V, Fradelos EC, Tzenalis A, Saridi M. Burden of Caregivers of Patients with Chronic Diseases in Primary Health Care: A Cross-Sectional Study in Greece. NURSING REPORTS 2024; 14:1633-1646. [PMID: 39051358 PMCID: PMC11270267 DOI: 10.3390/nursrep14030122] [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: 06/02/2024] [Revised: 06/26/2024] [Accepted: 06/26/2024] [Indexed: 07/27/2024] Open
Abstract
BACKGROUND In the world of elderly people and people with chronic diseases, caregivers give a solution to caring at home. This study aimed to evaluate the burden of caregivers of patients with chronic diseases in primary health care and identify possible demographic and other determinants of it. METHODS This was a cross-sectional study with a convenience sample, which was conducted in two health centers. The sample comprised 291 caregivers who visited the aforementioned health centers in Patra, Greece. A composite questionnaire was utilized: the first part included demographic data and care-related information and the second included the Zarit Burden Interview and the Depression, Anxiety, and Stress Scale-21 (DASS-21). RESULTS The highest mean score in the DASS was recorded in the depression subscale and the lowest in the stress subscale. Concerning the Zarit Burden Interview, the highest mean score was recorded in the personal strain subscale and the lowest in the management of care subscale. The highest correlation was recorded between role strain and anxiety and the lowest was between management of care and stress. Similarly, the total score in the Zarit Burden Interview correlated significantly (in a positive direction) with depression, anxiety, and stress. CONCLUSIONS Most of the caregivers of patients with chronic diseases in primary health care experienced a moderate to severe burden (especially in the dimension of personal strain) and moderate depression. The experienced burden was positively associated with depression, anxiety, and stress. There were significant differences in the caregivers' burden according to several demographic and care-related characteristics.
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Affiliation(s)
- Eleni N. Albani
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (E.N.A.); (S.R.); (A.T.)
| | - Aikaterini Toska
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece; (A.T.); (M.S.)
| | - Constantinos Togas
- Department of Psychology, Panteion University of Social and Political Sciences, 17671 Athens, Greece;
| | - Spyridon Rigatos
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (E.N.A.); (S.R.); (A.T.)
| | - Viktor Vus
- Institute for Social and Political Psychology, National Academy of Educational Science of Ukraine, 04070 Kyiv, Ukraine;
| | - Evangelos C. Fradelos
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece; (A.T.); (M.S.)
| | - Anastasios Tzenalis
- Department of Nursing, School of Health Rehabilitation Sciences, University of Patras, 26504 Patras, Greece; (E.N.A.); (S.R.); (A.T.)
| | - Maria Saridi
- Department of Nursing, School of Health Sciences, University of Thessaly, 41500 Larissa, Greece; (A.T.); (M.S.)
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Wang T, Lund B, Dow M. Do Hospitals Satisfy Our Healthcare Information Needs for Rare Diseases?: Comparison of Healthcare Information Provided by Hospitals with Information Needs of Family Caregivers. HEALTH COMMUNICATION 2024; 39:1628-1637. [PMID: 37340548 DOI: 10.1080/10410236.2023.2228010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
This study uses a cross-sectional online survey approach to investigate the gap between healthcare information provided by hospitals and family caregivers' information needs and the relationship between demographic factors and information satisfaction. The results indicate that family caregivers have diverse healthcare information needs for daily care, but the information provided by hospitals could not satisfy these information needs most of the time. Family caregivers' information satisfaction was unrelated to various demographic factors, such as age, race, education level, and annual household income. Family caregivers who were male and spent less time searching for rare disease related information and whose children received a rare disease clinical diagnosis and spent more days in hospitals after birth expressed higher information satisfaction. Based on the findings, this study recommends strengthening continuing education of physicians about rare diseases to increase diagnosis and conducting information literacy assessments of family caregivers to better meet their information needs about daily care.
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Affiliation(s)
- Ting Wang
- School of Library and Information Management, Emporia State University
| | - Brady Lund
- College of Information, University of North Texas
| | - Mirah Dow
- School of Library and Information Management, Emporia State University
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Pacheco Barzallo D, Schnyder A, Zanini C, Gemperli A. Gender Differences in Family Caregiving. Do female caregivers do more or undertake different tasks? BMC Health Serv Res 2024; 24:730. [PMID: 38877542 PMCID: PMC11177503 DOI: 10.1186/s12913-024-11191-w] [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: 04/17/2024] [Accepted: 06/10/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Two out of three family caregivers are female. However, current trends show that men are more likely to undertake caregiving duties, yet female caregivers report a higher burden. This paper analyzed data from long-term family caregivers to determine whether, under similar circumstances, gender differences in caregiving persist. We examined whether the observed gender gap affects caregivers' satisfaction with their health and quality of life. METHODS We analyze cross-sectional data from family caregivers of persons with spinal cord injury (SCI) in Switzerland. The data provides comprehensive information about the time and type of weekly tasks family caregivers undertake. To determine differences in caregiving related to gender, we balanced the characteristics of the caregiver and the cared-for person using a propensity score kernel matching. With the balanced sample, we estimated how the observed differences in caregiving varied across cohorts using a Poisson regression. RESULTS Under similar circumstances, male and female caregivers invest similar time in caregiving. This result holds for 21 caregiving tasks, except for household chores, where women spent, on average, four more hours per week than male caregivers. Despite these differences, female caregivers report a quality of life and satisfaction with their health that is similar to that of male caregivers. CONCLUSION Gender differences in caregiving narrow over time, except for household chores, where female caregivers continue to spend significantly more hours than male caregivers. Measures designed for family caregivers must consider these gender differences, as the support needs of female caregivers can differ greatly from those of male caregivers.
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Affiliation(s)
- Diana Pacheco Barzallo
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland.
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, Nottwil, 6207, Switzerland.
- Center for Rehabilitation in Global Health Systems, WHO Collaborating Center, University of Lucerne, Frohburgstrasse 3, Lucerne, 6002, Switzerland.
| | - Aline Schnyder
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
| | - Claudia Zanini
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, Nottwil, 6207, Switzerland
| | - Armin Gemperli
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, Lucerne, 6005, Switzerland
- Center for Primary and Community Care, Frohburgstrasse 3, 6002, Lucerne, Switzerland
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Kabir ZN, Tyrrell M, Konradsen H, Craftman Å, Joshi N, Gupta MK, Sharma S, Bhardwaj P. mHealth based intervention by social care professionals to support family caregivers to persons with dementia living at home in Sweden (Caregiver Connect): a randomized controlled trial. BMC Geriatr 2024; 24:519. [PMID: 38877412 PMCID: PMC11177475 DOI: 10.1186/s12877-024-05106-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: 09/21/2023] [Accepted: 05/24/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND The majority of persons with dementia in Sweden reside in their own homes with support from family members. Approximately, 12% of persons with dementia have immigrant background. Within the next 20 years, the number of persons with dementia who are non-ethnic Swedes is said to double. Family caregivers with immigrant backgrounds are noted to receive less support in the community than ethnic Swedes and rate their health status lower than ethnic Swedish peers. The Swedish National Board of Health and Welfare have highlighted the importance of follow-up support for family caregivers with immigrant backgrounds as there is a recognized gap in research and available information tailored to meet the needs of this group. PURPOSE OF THE STUDY The purpose of the study is to test effectiveness of an mHealth based intervention through which community social workers can improve caregiving competence of non-European immigrant family caregivers of people with dementia living at home in Sweden. The overarching aim is to reduce caregiver burden and depressive symptoms, and improve quality of life. METHODS A randomized controlled trial (RCT) including wait list control group will be performed consisting of an intervention group (A, n = 44) and a wait list control group (B, n = 44), totaling a sample size of 88. On completion of the 10-weeks long intervention in the intervention group, the intervention will be delivered to group B. Effect of the intervention will be analyzed between and within groups over time. The content of the educational component of the intervention is inspired by the iSupport manual developed by the World Health Organization. The contents, in the form of a booklet, aims to equip the family caregivers with structured information on understanding dementia as a condition and its management at home, including self-care guidance designed specifically for family caregivers themselves. DISCUSSION Similar telephone-delivered intervention studies targeted for family caregivers to persons with dementia are ongoing in Malaysia and will start in India using the same booklet adapted to the local context. These studies will provide evidence on the effectiveness of using digital technologies to deliver support to those who may not be reached or adequately served by the traditional healthcare system. TRIAL REGISTRATION ISRCTN registry, Registration number ISRCTN64235563.
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Affiliation(s)
- Zarina Nahar Kabir
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden.
| | - Marie Tyrrell
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
- Department of Nursing, Sophiahemmet University, Valhallavägen 91, Stockholm, 11428, Sweden
| | - Hanne Konradsen
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
| | - Åsa Craftman
- Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Alfred Nobels Allé 23, Huddinge, 141 52, Sweden
| | - Nitin Joshi
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Manoj Kumar Gupta
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
| | - Suresh Sharma
- College of Nursing, All India Institute of Medical Sciences (AIIMS), Jodhpur, 342005, India
| | - Pankaj Bhardwaj
- School of Public Health, Department of Community Medicine and Family Medicine, All India Institute of Medical Sciences, Jodhpur, 342005, India
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Luo Y, Zhao D, Pan X, Lingling Z. Household Environments and Cognitive Decline Among Middle-Aged and Older Adults in China: Exploring Gender, Age, and Residential Variations. Int J Aging Hum Dev 2024:914150241260824. [PMID: 38859750 DOI: 10.1177/00914150241260824] [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: 06/12/2024]
Abstract
This study examined the relationship between household environments and trajectories of cognitive function among middle-aged and older adults in China and its urban/rural, gender, and age variations. We estimated multi-level linear growth curve models using a representative sample of 16,111 respondents aged 45 years and over from the China Health and Retirement Longitudinal Study (2011-2018). Older people who lived with a spouse, but not with children, and those with higher living expenditures, better housing quality, and indoor clean fuels for cooking had a slower cognitive decline. Living arrangement more strongly predicted men's cognitive decline, while living expenditure, solid fuel use, and housing quality significantly predicted only women's cognitive decline. Only for older adults and rural residents, those living alone had significantly faster cognitive decline than those living with a spouse only. These findings underscore the importance of improving the living conditions of older adults to help alleviate their cognitive decline.
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Affiliation(s)
- Ye Luo
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Dandan Zhao
- Department of Sociology, Anthropology and Criminal Justice, Clemson University, Clemson, SC, USA
| | - Xi Pan
- Department of Sociology, Texas State University, San Marcos, TX, USA
| | - Zhang Lingling
- Department of Nursing, University of Massachusetts Boston, Boston, MA, USA
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Ribera-Asensi O, Pérez-Marín M, Valero-Moreno S. Family bonds and personal factors in caregiver burden in patients at the end of life. FAMILY PROCESS 2024. [PMID: 38840320 DOI: 10.1111/famp.13026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 05/04/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
Family caregivers are defined as those who assume substantial responsibilities for the care of an ill loved one without formal health care training. This study aims to analyze the predictors of physical and emotional burden in caregivers of palliative patients using qualitative comparative analysis methodologies (QCA) and taking into account patient and caregiver personal and relational variables. A total of 125 caregivers of patients at the end of life were assessed using an ad hoc emotional and physical burden questionnaire and patient and caregiver personal and relational variables were recorded. Results indicate moderately high levels of both emotional and physical burden. Differences in burden are found only as a function of kinship. Emotional burden is positively associated with the use of physical health medication in the caregiver and kinship; meanwhile, physical burden is positively associated with time since diagnosis, patient functional independence, and economic problems. For the QCA models, several pathways predict the observed variance in the emotional and physical burden of family caregivers of patients at the end of life, based on patient, caregiver, and relationship variables. In conclusion, it is relevant to design intervention programs focused on patient-caregiver relationship to prevent the development of emotional and physical burden.
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Affiliation(s)
- Olga Ribera-Asensi
- Hospital Clínico Universitario de Valencia, Valencia, Valencia, Spain
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de Valencia, Valencia, 46010, Valencia, Spain
| | - Marián Pérez-Marín
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de Valencia, Valencia, 46010, Valencia, Spain
| | - Selene Valero-Moreno
- Department of Personality, Assessment and Psychological Treatments, Faculty of Psychology and Speech Therapy, Universitat de Valencia, Valencia, 46010, Valencia, Spain
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Younas A, Zeb H, Durante A, Vellone E. Sex based differences in depression, anxiety, and quality of life and predictors of quality of life among South Asian individuals with chronic obstructive pulmonary disease: A Bayesian analysis. Soc Sci Med 2024; 351:116989. [PMID: 38788430 DOI: 10.1016/j.socscimed.2024.116989] [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: 02/26/2024] [Revised: 04/19/2024] [Accepted: 05/15/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND COPD can affect both men and women leading to deteriorating impact on general well-being, personal, and family life and decreased quality of life. Anxiety, depression, and self-care behaviours can affect the quality of life of individuals with COPD. There is a dearth of sex-based comparative analyses of anxiety, depression, quality of life, and predictors of quality of life among South Asian individuals with COPD. PURPOSE To identify the sex-based differences in depression, anxiety, and quality of life and the predictors of quality of life among South Asian individuals with COPD. METHODS A cross-sectional survey of 294 men and 114 women with COPD was conducted in Khyber Pakhtunkhwa, Pakistan. Hospital Anxiety and Depression scale, World Health Organization Quality of Life-brief version, Self-Care of Chronic Obstructive Pulmonary Disease Inventory, the Self-Care Self-Efficacy in COPD Scale were used for data collection. Bayesian independent sample t-test was used to compare mean differences in depression, anxiety, and quality of life among men and women. Two regression models were examined to determine if age, years of living with COPD, anxiety, depression, self-care self-efficacy, self-care monitoring, management, and maintenance were predictors of quality of life among men and women. FINDINGS Bayesian analysis showed anecdotal evidence that women had higher levels of depression, but lower levels of anxiety compared to men. Anecdotal evidence indicated that the physical quality of life of men was better than women, but strong evidence that their social relationship and environmental quality of life was better than women. Years of living with COPD, anxiety, depression, self-care self-efficacy, self-care management, self-care monitoring, and self-care maintenance were stronger predictors of women's quality of life. Anxiety and depression only predicted men's psychological quality of life, but predicted women's psychological, social relationships, and environmental quality of life. CONCLUSIONS The findings contribute to literature highlighting sex-based differences in anxiety, depression, and quality of life among South Asian men and women with COPD. Men generally reported higher levels of quality of life than women across all domains. Women's social relationships and environmental quality of life were greatly impacted by anxiety and depression. Quality of life interventions for women should be targeted at improving their social relationships and environmental satisfaction and addressing anxiety and depression.
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Affiliation(s)
- Ahtisham Younas
- Memorial University of Newfoundland, Canada; Swat College of Nursing, Swat, Pakistan.
| | - Hussan Zeb
- Swat College of Nursing, Swat, Pakistan; Tor Vergata University of Rome, Italy
| | - Angela Durante
- Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy; Health Science Interdisciplinary Center, Scuola Superiore Sant'Anna, Pisa, Italy
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Cappon D, den Boer T, Yu W, LaGanke N, Fox R, Brozgol M, Hausdorff JM, Manor B, Pascual-Leone A. An Educational Program for Remote Training and Supervision of Home-Based Transcranial Electrical Stimulation: Feasibility and Preliminary Effectiveness. Neuromodulation 2024; 27:636-644. [PMID: 37552152 PMCID: PMC10850429 DOI: 10.1016/j.neurom.2023.04.477] [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: 09/08/2022] [Revised: 03/14/2023] [Accepted: 04/03/2023] [Indexed: 08/09/2023]
Abstract
OBJECTIVES There has been recent interest in the administration of transcranial electrical stimulation (tES) by a caregiver, family member, or patient themselves while in their own homes (HB-tES). The need to properly train individuals in the administration of HB-tES is essential, and the lack of a uniform training approach across studies has come to light. The primary aim of this paper is to present the HB-tES training and supervision program, a tele-supervised, instructional, and evaluation program to teach laypersons how to administer HB-tES to a participant and to provide a standardized framework for remote monitoring of participants by teaching staff. The secondary aim is to present early pilot data on the feasibility and effectiveness of the training portion of the program based on its implementation in 379 sessions between two pilot clinical trials. MATERIALS AND METHODS The program includes instructional materials, standardized tele-supervised hands-on practice sessions, and a system for remote supervision of participants by teaching staff. Nine laypersons completed the training program. Data on the feasibility and effectiveness of the program were collected. RESULTS No adverse events were reported during the training or any of the HB-tES sessions after the training. All laypersons successfully completed the training. The nine laypersons reported being satisfied with the training program and confident in their tES administration capabilities. This was consistent with laypersons requiring technical assistance from teaching staff very infrequently during the 379 completed sessions. The average adherence rate between all administrators was >98%, with seven of nine administrators having 100% adherence to the scheduled sessions. CONCLUSIONS These findings indicate that the HB-tES program is effective and is associated with participant satisfaction. SIGNIFICANCE We hope that the remote nature of this training program will facilitate increased accessibility to HB-tES research for participants of different demographics and locations. This program, designed for easy adaptation to different HB-tES research applications and devices, also is accessible online. The adoption of this program is expected to facilitate uniformity of study methods among future HB-tES studies and thereby accelerate the pace of tES intervention discovery.
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Affiliation(s)
- Davide Cappon
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA.
| | - Tim den Boer
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA
| | - Wanting Yu
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA
| | - Nicole LaGanke
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA
| | - Rachel Fox
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife, Boston, MA, USA
| | - Marina Brozgol
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jeffrey M Hausdorff
- Center for the Study of Movement, Cognition, and Mobility, Neurological Institute, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sagol School of Neuroscience, and Department of Physical Therapy, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Rush Alzheimer's Disease Center and Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA
| | - Brad Manor
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Hinda and Arthur Marcus Institute for Aging Research at Hebrew SeniorLife, Boston, MA, USA; Deanna and Sidney Wolk Center for Memory Health at Hebrew SeniorLife, Boston, MA, USA; Department of Neurology, Harvard Medical School, Boston, MA, USA
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Roscoe RA. Narrating the Sociocultural Experience and Management of Stigma Related to Military Caregiving. HEALTH COMMUNICATION 2024:1-12. [PMID: 38818796 DOI: 10.1080/10410236.2024.2360177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
Despite accelerating the recovery and rehabilitation of wounded veterans and saving the U.S. substantial sums in avoided long-term care costs, military caregivers (MCs) are an underserved community lacking resources and support. On top of managing a variety of emotional, physical, relational, and occupational challenges, MCs experience stigma. Indeed, caregiving can be a stigmatized task, especially for military-affiliated individuals who may be expected to adhere to cultural norms of personal sacrifice and resilience in the face of adversity. The current study uses narrative inquiry to better understand the unique experiences and characteristics of MCs providing care for veterans experiencing posttraumatic stress. Specifically, this study examined MCs' narratives to uncover the sociocultural experience and management of stigma related to military caregiving. Interviews with 15 military caregivers of veterans experiencing PTS demonstrated that military caregivers experienced stigma for 1) staying in the relationship, 2) enabling the veteran, 3) mismanaging the condition, and 4) flaking on plans and relationships. In response to stigma, MCs often challenged stigma through strategies of denial or evasion of responsibility. This study contributes to communication scholarship by introducing co-stigma management and further interrogating processes related to stigma management communication. In addition, the results can inform Veteran Affairs (VA) healthcare, caregiver assistance programs, health practices, and support-seeking behaviors.
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Affiliation(s)
- Rikki A Roscoe
- Department of Communication Studies, University of Kansas
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Treder MS, Lee S, Tsvetanov KA. Introduction to Large Language Models (LLMs) for dementia care and research. FRONTIERS IN DEMENTIA 2024; 3:1385303. [PMID: 39081594 PMCID: PMC11285660 DOI: 10.3389/frdem.2024.1385303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/23/2024] [Indexed: 08/02/2024]
Abstract
Introduction Dementia is a progressive neurodegenerative disorder that affects cognitive abilities including memory, reasoning, and communication skills, leading to gradual decline in daily activities and social engagement. In light of the recent advent of Large Language Models (LLMs) such as ChatGPT, this paper aims to thoroughly analyse their potential applications and usefulness in dementia care and research. Method To this end, we offer an introduction into LLMs, outlining the key features, capabilities, limitations, potential risks, and practical considerations for deployment as easy-to-use software (e.g., smartphone apps). We then explore various domains related to dementia, identifying opportunities for LLMs to enhance understanding, diagnostics, and treatment, with a broader emphasis on improving patient care. For each domain, the specific contributions of LLMs are examined, such as their ability to engage users in meaningful conversations, deliver personalized support, and offer cognitive enrichment. Potential benefits encompass improved social interaction, enhanced cognitive functioning, increased emotional well-being, and reduced caregiver burden. The deployment of LLMs in caregiving frameworks also raises a number of concerns and considerations. These include privacy and safety concerns, the need for empirical validation, user-centered design, adaptation to the user's unique needs, and the integration of multimodal inputs to create more immersive and personalized experiences. Additionally, ethical guidelines and privacy protocols must be established to ensure responsible and ethical deployment of LLMs. Results We report the results on a questionnaire filled in by people with dementia (PwD) and their supporters wherein we surveyed the usefulness of different application scenarios of LLMs as well as the features that LLM-powered apps should have. Both PwD and supporters were largely positive regarding the prospect of LLMs in care, although concerns were raised regarding bias, data privacy and transparency. Discussion Overall, this review corroborates the promising utilization of LLMs to positively impact dementia care by boosting cognitive abilities, enriching social interaction, and supporting caregivers. The findings underscore the importance of further research and development in this field to fully harness the benefits of LLMs and maximize their potential for improving the lives of individuals living with dementia.
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Affiliation(s)
- Matthias S. Treder
- School of Computer Science & Informatics, Cardiff University, Cardiff, United Kingdom
| | - Sojin Lee
- Olive AI Limited, London, United Kingdom
| | - Kamen A. Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
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Carroll D, Wales M, Rintell LS, Hojlo M, Gonzalez-Heydrich J, Berbert L, Fitzpatrick M, D'Angelo E, Reed MP. Burden Experienced by Primary Caregivers of Children With Psychotic Disorders and at Clinical High Risk for Psychosis. J Am Psychiatr Nurses Assoc 2024; 30:518-531. [PMID: 36475411 DOI: 10.1177/10783903221141883] [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: 12/13/2022]
Abstract
BACKGROUND Despite the existing research exploring caregiver burden in adult psychosis, few studies have examined the experience of providing care to children diagnosed with psychotic disorders (PDs) and those identified as having clinical high risk for psychosis (CHR-P). AIM This study measured the level of burden in caregivers of children with PD and CHR-P and examined associated risk factors, including social support, caregiver-child relationship, severity of illness, and frequency of psychiatric hospitalizations. METHODS A total of 56 caregivers completed validated measures and provided demographic information. Measures included the Zarit Burden Interview, the Multidimensional Scale of Perceived Social Support, the Behavior Assessment System for Children, Third Edition, Parenting Relationship Questionnaire-Child and Adolescent Form (BASC-3 PRQ-CA), and the Clinical Global Impression-Severity scale. RESULTS The majority of caregivers were women (86%), mothers (84%), White (63%), married (66%), working full-time (50%), college-educated (79%), and whose mean age was 45.7 years (SD = 8.09). Nearly half of the caregivers (45%) reported a high level of caregiver burden, 39% rated their burden in the mild to moderate range, and 16% reported little to no burden. There was no significant difference in mean burden between PD and CHR-P groups. Higher caregiver burden was associated with lower levels of social support (r = -.408, p = .002), lower levels of parenting confidence (r = -.514, p < .001), higher levels of relational frustration (r = .612, p < .001), and higher severity of illness (r = .316 p = .025). CONCLUSIONS These findings underscore the critical unmet need for support for caregivers of children with PD and CHR-P. Applications to clinical practice are discussed.
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Affiliation(s)
- Devon Carroll
- Devon Carroll, PMHNP-BC, MSN, Boston Children's Hospital, Boston, MA, USA; University of Rhode Island, Providence, RI, USA
| | - Meghan Wales
- Meghan Wales, RN, BA, Boston Children's Hospital, Boston, MA, USA
| | | | - Margaret Hojlo
- Margaret Hojlo, BA, Boston Children's Hospital, Boston, MA, USA
| | - Joseph Gonzalez-Heydrich
- Joseph Gonzalez-Heydrich, MD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Laura Berbert
- Laura Berbert, MS, Boston Children's Hospital, Boston, MA, USA
| | - Molly Fitzpatrick
- Molly Fitzpatrick, MA, Boston Children's Hospital, Boston, MA, USA; William James College, Newton, MA, USA
| | - Eugene D'Angelo
- Eugene D'Angelo, PhD, Boston Children's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Mary P Reed
- Mary P. Reed, PhD, RN, ANP, CNRN, NEA-BC, Boston Children's Hospital, Boston, Massachusetts, USA
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Li W, Manuel DG, Isenberg SR, Tanuseputro P. Using Exploratory Structural Equation Modeling to Examine Caregiver Distress and Its Contributors. J Am Med Dir Assoc 2024; 25:817-825.e5. [PMID: 38341185 DOI: 10.1016/j.jamda.2023.12.019] [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: 08/30/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To develop and test the direct and indirect associations between caregiver distress and its many contributing factors and covariates. DESIGN Analysis using data from a national, cross-sectional survey of Canadian caregivers. SETTING AND PARTICIPANTS A total of 6502 respondents of the 2012 General Social Survey-Caregiving and Care-receiving who self-identified as a caregiver. METHODS We used exploratory structural equation modeling to achieve our aims. Based on literature review, we hypothesized a structural model of 5 caregiving factors that contribute to distress: caregiving burden, caregiving network and support, disruptions of family and social life, positive emotional experiences, and caregiving history. Survey items hypothesized to measure each latent factor were modeled using exploratory factor analysis (EFA). After establishing a well-fit EFA model, structural equation modeling was performed to examine the relationships between caregiving factors and caregiver distress while controlling for covariates such as caregiver's and care-recipient's sociodemographic characteristics and kinship. RESULTS EFA established a well-fit model that represented caregiver distress and its 5 contributing factors as hypothesized. Although all 5 had significant effects on caregiver distress, disruptions of family and social life contributed the most (β = 0.462), almost 3 times that of caregiving burden (β = 0.162). Positive emotional experiences also substantially reduced distress (β = -0.310). CONCLUSIONS AND IMPLICATIONS Understanding the multifaceted nature of caregiver distress is crucial for developing effective strategies to support caregivers. In addition to reducing caregiving burden, having flexible resources and policies to minimize disruptions to caregivers' families (eg, flexible work policies; family-oriented education, training, and counseling) and enhance the positive aspects of caregiving may more effectively reduce distress.
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Affiliation(s)
- Wenshan Li
- Ottawa Hospital Research Institute, Clinical Epidemiology, Ottawa, Ontario, Canada; ICES uOttawa, Ottawa, Ontario, Canada.
| | - Douglas G Manuel
- Ottawa Hospital Research Institute, Clinical Epidemiology, Ottawa, Ontario, Canada; ICES uOttawa, Ottawa, Ontario, Canada; Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Sarina R Isenberg
- Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Peter Tanuseputro
- ICES uOttawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada
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Gessa GD, Deindl C. Determinants of Trajectories of Informal Caregiving in later life. Evidence from England. RESEARCH SQUARE 2024:rs.3.rs-4027872. [PMID: 38746327 PMCID: PMC11092806 DOI: 10.21203/rs.3.rs-4027872/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Although long-term consequences of informal care provision are well investigated, fewer studies have examined trajectories of informal care provision among older people and the socioeconomic, demographic, health, and family characteristics associated with them. We use data from four waves of the English Longitudinal Study of Ageing, with 6,561 respondents followed for 6 years (2012/3 to 2018/9). We used group-based trajectory modelling to group people's provision of care over time into a finite number of distinct trajectories of caregiving. Using multinomial logistic regressions, we then investigated characteristics associated with these trajectories. Four distinct trajectories were identified representing "stable intensive", "increasing intensive", "decreasing", and "stable no care". Results suggest that, although there are socioeconomic, demographic, and health differences across the trajectories of caregiving (with younger women in good health and poorer socioeconomic status more likely to care intensively throughout), family characteristics are their main drivers. Respondents who live alone, with no children, and no parents alive are more likely to never provide care, whereas those with older parents and who live with adults in poor health are more likely to provide stable intensive care. Also, changes in family characteristics (e.g. death of parents, widowhood, or deterioration of the partner's health) are associated with trajectories representing increases or decreases of caregiving over time. Overall, trajectories of informal caregiving undertaken by older people are varied and these patterns are mostly associated with both the availability and health of family members, suggesting that the needs factors represent the most immediate reason for caregiving commitments.
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Nautiyal A, Bagchi S, Bansal SB. Gender and kidney transplantation. FRONTIERS IN NEPHROLOGY 2024; 4:1360856. [PMID: 38711923 PMCID: PMC11070561 DOI: 10.3389/fneph.2024.1360856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2023] [Accepted: 04/09/2024] [Indexed: 05/08/2024]
Abstract
Kidney transplantation provides the best form of kidney replacement therapy with improvement in quality of life and longevity. However, disparity exists in its availability, utilisation and outcomes, not only due to donor availability or financial constraints but also arising from the influence of biological sex and its sociocultural attribute i.e., Gender. Women make up the majority of kidney donors but are less likely to be counselled regarding transpantation, be waitlisted or receive living/deceased donor kidney. Biological differences also contribute to differences in kidney transplantation among the sexes. Women are more likely to be sensitised owing to pregnancy, especially in multiparous individuals, complicating donor compatibility. A heightened immune system in women, evidenced by more autoimmune illnesses, increases the risk of allograft rejection and loss. Differences in the pharmacokinetics of transplant drugs owing to biological variances could also contribute to variability in outcomes. Transgender medicine is also increasingly becoming a relevant topic of study, providing greater challenges in the form of hormonal manipulations and anatomic changes. It is thus important to determine and study transplantation and its nuances in this backdrop to be able to provide relevant sex and gender-specific interventions and design better practices for optimum kidney transplant utilisation and outcomes.
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Affiliation(s)
- Arushi Nautiyal
- Department of Nephrology, Jaipur Golden Hospital, New Delhi, India
| | - Soumita Bagchi
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
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Govil D, Sahoo H, Chowdhury B, James KS. A qualitative perspective of working women care providers and care receivers on eldercare: a study from India. BMC Geriatr 2024; 24:345. [PMID: 38627618 PMCID: PMC11021006 DOI: 10.1186/s12877-024-04782-z] [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: 12/29/2022] [Accepted: 02/05/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND The paper aims to explore the elderly caregiving process in India from the perspective of both elderly as well as working women care providers, along with the challenges faced and the coping strategies adopted by them during the process. METHODS In-depth interviews with 48 participants (care providers and care receivers) from 25 multi-generational households were conducted in the slums of Mumbai and analysed using QSR-NVivo-10. RESULTS Working women care providers supported the needs of the dependent elderly along with performing household chores and paid work. However, the way the care was perceived and demanded, was not often same as delivered by the care providers. Care provider suffered silently with poor social, physical and emotional welling in absence of support system and lack of time. Sometimes, physically exhausted care providers unknowingly resorted to elderly abuse and neglect. At the same time, a bidirectional flow of support from elderly also existed in the form of childcare, household chores and financial support. Though caregiving overstrained the care providers, strong family ties, acknowledgement of the contributions of the elderly during their young days, and the desire to set a precedent for the young generation did not let them step back from their duties. The main coping mechanism for both care receivers and providers was largely centred around the notion of acceptance of their situation. CONCLUSION Conversations between generations can help in enhancing family ties and reduce conflicts. The support of family and community can also ease the burden of caregiving.
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Affiliation(s)
- Dipti Govil
- International Institute for Population Sciences, Mumbai, India.
| | - Harihar Sahoo
- International Institute for Population Sciences, Mumbai, India
| | - Biswabandita Chowdhury
- S.P. Mandali's Prin. L. N. Welingkar Institute of Management Development & Research, Mumbai, India
| | - K S James
- International Institute for Population Sciences, Mumbai, India
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Schefter Z, Smith AM. Exploring downstream effects of gender roles in healthcare decision-making and relationships within systems: A cross-sectional analysis of openness to treatment in pediatric headache. J Psychosom Res 2024; 179:111611. [PMID: 38430793 DOI: 10.1016/j.jpsychores.2024.111611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 03/05/2024]
Abstract
OBJECTIVE Socio-culturally defined identity factors present significant and often understudied influences on the experience, management, and treatment of chronic pain. For instance, there exist societal narratives about how males and females are expected to experience and express pain. Such gender roles may impact youth and caregiver openness to individual multidisciplinary treatments for pediatric headache. METHODS In this cross-sectional study, participants (N = 1087 youth/caregiver dyads, Mage = 14.5 years, 71% female, 97% cisgender, 77% White) completed a series of questionnaires, including Openness to Headache Treatment (OHT), upon presenting for initial multidisciplinary evaluation of chronic headache. Pearson correlations, independent samples t-tests and hierarchical regressions were used to analyze potential gender differences in youth and caregiver openness, as well as its relationships with pain-related and psychological factors. RESULTS Overall, female youth and their caregivers were more open to headache treatment, broadly and for individual interventions, when compared to male counterparts. Caregiver distress related to their child's headaches (i.e., fear and avoidance) was significantly correlated with openness in female youth and their caregivers, but not males. CONCLUSION Gendered patterns in healthcare decision-making in youth and caregivers provide insight on individual, societal, and systemic gender bias.
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Affiliation(s)
- Zoë Schefter
- Boston Children's Hospital, Department of Anesthesiology, Perioperative & Pain Medicine, Division of Pain Medicine, USA
| | - Allison M Smith
- Boston Children's Hospital, Department of Anesthesiology, Perioperative & Pain Medicine, Division of Pain Medicine, USA; Harvard Medical School, Department of Psychiatry, Division of Psychology, USA.
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Ko W, Jeong H. Association between children with attention-deficit hyperactivity disorder and parental mental health: Data from the 2011-2020 Korea National Health and Nutrition Examination Survey. J Affect Disord 2024; 350:544-549. [PMID: 38242216 DOI: 10.1016/j.jad.2024.01.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 10/18/2023] [Accepted: 01/11/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND The aim of this study was to investigate whether children's attention-deficit hyperactivity disorder (ADHD) is associated with parental mental health, using data from the Korean National Health and Nutrition Examination Survey (KNHANES). METHODS This cross-sectional study included 14,428 samples from KNHANES of parents with children younger than 19 years between 2011 and 2020. Mental health problems, measured as perceived stress, depressive symptoms, and suicidality, were assessed. Sociodemographic and health-related characteristics were collected as potential confounding factors. The association between children with ADHD and parental mental health problems was expressed as odds ratio and 95 % confidence interval with multivariate logistic regression using PROC SURVEYLOGISTIC. RESULTS Among the 14,428 participants, 202 (1.4 %) were classified as parents of children with ADHD. Mothers of children with ADHD reported higher perceived stress (aOR = 1.67, 95 % CI 1.09-2.56), depressive symptoms (aOR = 2.93, 95 % CI 1.59-5.40), and suicidality (aOR = 2.63, 95 % CI 1.29-5.38) than those of children without ADHD after adjusting for parents' age, gender, and parental education level, employment status, cohabitation status, drinking, smoking, and number of children. However, fathers' mental health problems were not significantly associated with having a child with ADHD. LIMITATION Because it was conducted the analysis using cross-sectional data, findings on causality are unclear. CONCLUSIONS The current findings suggest that parenting children with ADHD is associated with parental mental health problems. Parents of children with ADHD, especially mothers, need community support and public health attention to help alleviate their mental health problems.
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Affiliation(s)
- Woolim Ko
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyunsuk Jeong
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Poteat TC, Hall P, Brooks M, Horn J, Yang C, Pereira N, Adams MA. Caregiving During the COVID-19 Pandemic: A Cross-Sectional Study with Older Cisgender Sexual Minority Women in the United States. LGBT Health 2024; 11:219-228. [PMID: 37971831 PMCID: PMC11001953 DOI: 10.1089/lgbt.2023.0226] [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: 11/19/2023] Open
Abstract
Purpose: This study describes prevalence of caregiving before and after the onset of the COVID-19 pandemic among racially diverse older cisgender sexual minority women, examines factors associated with caregiving, and assesses relationships between caregiving and health. Methods: A convenience sample of participants aged ≥50 years completed self-administered online surveys assessing sociodemographic characteristics, caregiver status, self-rated health, and depressive symptoms. Bivariate statistics compared response variables by race, caregiver status, and timing of caregiving relative to the pandemic. Results: Of 365 participants, 82.7% identified as lesbian or gay and 41.1% as Black/African American; 40% were caregivers before (n = 32), during (n = 34), or both before and during (n = 80) the pandemic. A greater proportion of caregivers lived with a partner (45.9% vs. 35.6%, p = 0.06), were unemployed (37.7% vs. 29.7%, p = 0.07), and had high school or lower education (11.6% vs. 5%, p = 0.09). No differences were found in self-rated health by caregiver status; however, a higher proportion of Black (vs. White) caregivers reported good to excellent physical health (77.9% vs. 62.9%, p = 0.05). Caregivers more frequently reported depressive symptoms (28.1% vs. 17.8%, p = 0.03). Caregivers both before and during the pandemic had lower educational attainment than those who provided care only before or only during the pandemic (p = 0.04). Conclusion: Caregiving was common among older sexual minority women during the pandemic and experiences varied by race and other social factors. Consideration of these intersecting experiences is important for fully understanding caregiver experiences during COVID-19. Overall, caregiving was associated with depressive symptoms, underscoring the importance of psychosocial support for all caregivers.
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Affiliation(s)
- Tonia C. Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Porsha Hall
- ZAMI NOBLA: National Organization of Black Lesbians on Aging, Atlanta, Georgia, USA
| | - Madeline Brooks
- Department of Epidemiology, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer Horn
- Family Caregiver Support Center, Pikes Peak Area Agency on Aging, Colorado Springs, Colorado, USA
| | - Chloe Yang
- Department of Health Behavior, Gillings School of Public Health, Chapel Hill, North Carolina, USA
| | - Nastacia Pereira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Mary Anne Adams
- ZAMI NOBLA: National Organization of Black Lesbians on Aging, Atlanta, Georgia, USA
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Im H, George N, Swan LET. Gendered Health Outcome Among Somali Refugee Youth in Displacement: A Role of Social Support and Religious Belief. J Immigr Minor Health 2024; 26:341-350. [PMID: 37733168 DOI: 10.1007/s10903-023-01546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 09/22/2023]
Abstract
This study examines the factors influencing physical health status, specifically focusing on the gender differences in risk and promotive factors affecting health outcomes among Somali refugee youth displaced in Nairobi, Kenya (n = 227). A survey was used to assess participants' physical health along with psychosocial factors, somatic symptoms, and demographic characteristics. The study shows that religious belief and somatic symptoms among the total sample were significant predictors in influencing the outcome of physical health. A moderated mediation analysis and logistic regression analyses also revealed gender differences in associated factors as well as health status; female participants reported higher somatic symptoms, associated with a decline in physical health, whereas the protective effect of social support and religious belief promote was found only among male counterparts. Future studies and interventions would be benefited from a gender-specific approach to health promotion and coping mechanisms in this population.
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Affiliation(s)
- Hyojin Im
- Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, USA.
| | - Nicole George
- Virginia Commonwealth University, 1000 Floyd Ave., 3rd Floor, Richmond, USA
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, USA
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Figueiredo Da Mata FA, Oliveira D, Mateus E, Franzon ACA, Godoy C, Salcher-Konrad M, De-Poli C, Comas-Herrera A, Ferri CP, Lorenz-Dant K. Accessing Dementia Care in Brazil: An Analysis of Case Vignettes. DEMENTIA 2024; 23:378-397. [PMID: 37191076 DOI: 10.1177/14713012231176305] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Despite the rapid increase in the number of people living with dementia in Brazil, dementia care is limited. This study describes how people living with dementia and their carers access care, treatment, and support, and identifies what characteristics are likely to enable or prevent access. RESEARCH DESIGN AND METHODS We created 10 vignettes to illustrate fictitious but realistic scenarios involving people living with dementia in Brazil. The vignettes explore a combination of socioeconomic and demographic variables. They were completed using an in-depth desk review of the dementia care landscape in Brazil; a Strengths, Opportunities, Weaknesses, and Threats (SWOT) analysis of the desk review; and expert knowledge. The analysis focused on identifying common sources of service provision, barriers of access to care and support, and specific issues experienced by some population groups. FINDINGS Access to a dementia diagnosis, care, and support for people living with dementia in Brazil is limited. Demographic and socio-economic circumstances play a role in determining the type of services to which a person might have access. Poor knowledge about dementia, lack of capacity in the health system, and lack of formal long-term care support are among the identified barriers to accessing timely diagnosis, care, and support in the country. DISCUSSION AND IMPLICATIONS Understanding the barriers and facilitators of access to diagnosis, treatment, and support for people with dementia and families with different demographic and socioeconomic characteristics is crucial for designing dementia policies that are context-specific and responsive to the care needs of different socioeconomic groups in Brazil.
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Affiliation(s)
| | - Déborah Oliveira
- Faculty of Nursing, Universidad Andrés Bello, Santiago, Chile
- Millennium Institute for Care Research (MICARE), Santiago, Chile
| | - Elaine Mateus
- Federação Brasileira das Associações de Alzheimer (FEBRAz), São Paulo, Brazil
- Applied Linguistics, Department of Modern Languages, Universidade Estadual de Londrina (UEL), São Paulo, Brazil
| | | | - Carolina Godoy
- Department of Psychiatry, Medical School, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Maximilian Salcher-Konrad
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Chiara De-Poli
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Adelina Comas-Herrera
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Cleusa P Ferri
- Department of Psychiatry, Medical School, Universidade Federal de São Paulo, São Paulo, Brazil
- Health Technology Assessment Unit, Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
| | - Klara Lorenz-Dant
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
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Kitselman A K, Bédard-Matteau J, Rousseau S, Tabrizchi R, Daneshtalab N. Sex differences in vascular endothelial function related to acute and long COVID-19. Vascul Pharmacol 2024; 154:107250. [PMID: 38043758 DOI: 10.1016/j.vph.2023.107250] [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: 09/13/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has been at the forefront of health sciences research since its emergence in China in 2019 that quickly led to a global pandemic. As a result of this research, and the large numbers of infected patients globally, there were rapid enhancements made in our understanding of Coronavirus disease 2019 (COVID-19) pathology, including its role in the development of uncontrolled immune responses and its link to the development of endotheliitis and endothelial dysfunction. There were also some noted differences in the rate and severity of infection between males and females with acute COVID. Some individuals infected with SARS-CoV-2 also experience long-COVID, an important hallmark symptom of this being Myalgic Encephalomyelitis-Chronic Fatigue Syndrome (ME-CFS), also experienced differently between males and females. The purpose of this review is to discuss the impact of sex on the vasculature during acute and long COVID-19, present any link between ME-CFS and endothelial dysfunction, and provide evidence for the relationship between ME-CFS and the immune system. We also will delineate biological sex differences observed in other post viral infections and, assess if sex differences exist in how the immune system responds to viral infection causing ME-CFS.
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Affiliation(s)
- Kayla Kitselman A
- Faculty of Medicine, Division of Biomedical Sciences at Memorial University of Newfoundland and Labrador, Canada
| | - Jérôme Bédard-Matteau
- Faculty of Medicine, Department of Pharmacology and Therapeutics, McGill University, Québec, Canada; Meakins-Christie Laboratories, RI-MUHC, Block EOffice EM3.2244Lab E03.21371001 Decarie Blvd., Montreal, QC H4A 3J1, Canada
| | - Simon Rousseau
- Faculty of Medicine, Department of Pharmacology and Therapeutics, McGill University, Québec, Canada; Faculty of Medicine, Department of Experimental Medicine, McGill University, Québec, Canada; Meakins-Christie Laboratories, RI-MUHC, Block EOffice EM3.2244Lab E03.21371001 Decarie Blvd., Montreal, QC H4A 3J1, Canada
| | - Reza Tabrizchi
- Faculty of Medicine, Division of Biomedical Sciences at Memorial University of Newfoundland and Labrador, Canada
| | - Noriko Daneshtalab
- School of Pharmacy at Memorial University of Newfoundland and Labrador, Canada.
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Johnson K, Hartwig K, Maisano K, Crusan A, Biggs J, DiSpirito K. Caregivers' perspectives of community acceptance before and after surgical treatment for their child's disability. Child Care Health Dev 2024; 50:e13232. [PMID: 38356401 DOI: 10.1111/cch.13232] [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: 09/12/2023] [Revised: 12/13/2023] [Accepted: 01/25/2024] [Indexed: 02/16/2024]
Abstract
In Tanzania, about 600 000 youth between 5 and 24 years old have a disability. Individuals with disabilities face numerous obstacles due to social stigma. The aim of this formative evaluation is to assess how caregivers of children with correctable disabilities (e.g., cleft lip/palate, club foot, and burn scar contractures) in Tanzania perceive their community's acceptance of their child before and after surgical treatment. Semi-structured interviews were conducted with 80 caregivers of children with disabilities treated at Kafika House in Arusha, Tanzania. The constant comparative method identified themes regarding the caregivers' feelings on their child's functional abilities and experiences of stigma in their community. Caregiver perceptions of stigma before and after surgical treatment were categorized and quantified as 'positive', 'neutral' and 'negative'. Thematic analysis of the 80 interviews resulted in five major themes: (1) stigma and acceptance (pre-treatment) and (2) post-treatment; (3) functional abilities (pre-treatment) and (4) post-treatment; and (5) emotional impact (pre- and post-treatment). These themes indicate caregivers and their children experience a range of emotional impacts before and after treatment, more severe stigma before treatment, and overall better social, emotional and functional status after treatment. Frequency analysis of caregiver experiences indicated that stigma experienced by children and their families decreased from 75% before surgical treatment to 2.5% after surgery. Surgical intervention and rehabilitation of physical disabilities mitigated experiences of social stigma for both children and their caregivers. Findings support the need for expanded treatment of correctable disabilities, larger investments in community-based rehabilitation programmes and further interventions to support stigmatized parents and their children.
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Affiliation(s)
- Kali Johnson
- St. Catherine University, Henrietta Schmoll School of Health Sciences, St. Paul, Minnesota, USA
| | - Kari Hartwig
- St. Catherine University, Henrietta Schmoll School of Health Sciences, St. Paul, Minnesota, USA
| | - Kristen Maisano
- St. Catherine University, Henrietta Schmoll School of Health Sciences, St. Paul, Minnesota, USA
| | - Ambria Crusan
- St. Catherine University, Henrietta Schmoll School of Health Sciences, St. Paul, Minnesota, USA
| | - Jennifer Biggs
- St. Catherine University, Henrietta Schmoll School of Health Sciences, St. Paul, Minnesota, USA
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47
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Narasimhan M, Hargreaves JR, Logie CH, Abdool-Karim Q, Aujla M, Hopkins J, Cover J, Sentumbwe-Mugisa O, Maleche A, Gilmore K. Self-care interventions for women's health and well-being. Nat Med 2024; 30:660-669. [PMID: 38454127 DOI: 10.1038/s41591-024-02844-8] [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: 11/17/2023] [Accepted: 01/31/2024] [Indexed: 03/09/2024]
Abstract
The human right to health is universal and non-exclusionary, supporting health in full, and for all. Despite advances in health systems globally, 3.6 billion people lack access to essential health services. Women and girls are disadvantaged when it comes to benefiting from quality health services, owing to social norms, unequal power in relationships, lack of consideration beyond their reproductive roles and poverty. Self-care interventions, including medicines and diagnostics, which offer an additional option to facility-based care, can improve the autonomy and agency of women in managing their own health. However, tackling challenges such as stigma is essential to avoid scenarios in which self-care interventions provide more choice for those who already benefit from access to quality healthcare, and leave behind those with the greatest need. This Perspective explores the opportunities that self-care interventions offer to advance the health and well-being of women with an approach grounded in human rights, gender equality and equity.
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Affiliation(s)
- Manjulaa Narasimhan
- Department of Sexual and Reproductive Health and Research, including the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland.
| | - James R Hargreaves
- Center for Evaluation, London School of Hygiene and Tropical Medicine, London, UK
| | - Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | | | - Mandip Aujla
- Department of Sexual and Reproductive Health and Research, World Health Organization, Geneva, Switzerland
| | | | - Jane Cover
- Sexual and Reproductive Health Program, PATH, Seattle, WA, USA
| | | | - Allan Maleche
- Kenya Legal & Ethical Issues Network on HIV and AIDS (KELIN), Nairobi, Kenya
| | - Kate Gilmore
- Department of International Development, London School of Economics and Political Science, London, UK
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48
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Zha P, Zhang C, Qureshi R, Cai G, Huang L, Liu Y. Psychometric evaluation of the Chinese version of new fear of the coronavirus questionnaire. Medicine (Baltimore) 2024; 103:e37282. [PMID: 38428903 PMCID: PMC10906590 DOI: 10.1097/md.0000000000037282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 01/25/2024] [Indexed: 03/03/2024] Open
Abstract
The fear of COVID-19 significantly impacting the health of people globally. This study translated newly developed measurement tool New Fear of the Coronavirus Questionnaire (New_FCQ) into Chinese language and evaluated the psychometric properties of the Chinese version of New_FCQ among Chinese population. A total of 522 participants were included in the study. Internal consistency, construct validity, criterion validity, and concurrent validity of the Chinese version of New_FCQ were assessed in this study. The Chinese version of New_FCQ had excellent internal consistency (α = 0.97) and exploratory factor analysis demonstrated one-dimensional structure of the Chinese version of New_FCQ. The preliminary criterion validity revealed statistically significant differences in the fear of COVID-19 scores based on age and education level (P = .002 and P = .03, respectively). The good concurrent validity also established with the Chinese version Fear of COVID-19 Scale(P < .001). Psychometric proportions of the Chinese version of New_FCQ were established, which exhibited sufficient validity and reliability among Chinese population.
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Affiliation(s)
- PeiJia Zha
- Division of Nursing Science, School of Nursing, Rutgers, the State University of New Jersey, Newark, NJ
| | | | - Rubab Qureshi
- Division of Nursing Science, School of Nursing, Rutgers, the State University of New Jersey, Newark, NJ
| | - GuiGui Cai
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
| | - LiHong Huang
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
| | - Yang Liu
- Department of Nursing, School of Medicine, Xiamen University, Xiamen, China
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49
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Oleas Rodríguez DA, Yong Peña C, Garza Olivares X, Teixeira Filho FS, Lucero Córdova JE, Salas Naranjo AJ. Emotional Coping Strategies for Informal Caregivers of Hospitalized Patients: A Study of Distress and Overload. Psychol Res Behav Manag 2024; 17:725-734. [PMID: 38410381 PMCID: PMC10895987 DOI: 10.2147/prbm.s443200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/08/2024] [Indexed: 02/28/2024] Open
Abstract
Purpose Informal caregivers constitute a vulnerable population group that has forsaken their activities and life projects with the sole purpose of caring for a dependent individual without receiving any form of compensation in return. Emotionally, this population has been neglected by both the state and family members, exacerbating distress levels among them. The objective is to analyze the impact of emotional coping strategies on the experiences of distress and emotional burden among adult informal caregivers tending to hospitalized individuals. Sample and Methods The role of emotional coping strategies in caregiver burden and psychological distress was examined in 460 informal adult caregivers from Guayaquil, Ecuador, who participated in an online survey. The instruments used included the Depression, Anxiety, and Stress Scale (DASS 21), the Zarit Burden Inventory (ZBI), and the Emotional Coping Questionnaire (Cuestionario de Afrontamiento Emocional). The analysis involved a multiple regression to iteratively select variables, aiming to build a simpler and more explanatory model. Results Employing multiple regression analysis with a stepwise model selection procedure, it was found that 16.5% of the variance in depression, 19.5% of the variance in anxiety, 19.8% of the variance in stress, and 32% of the variance in burden were predicted by specific coping strategies. Additionally, the impact of burden was estimated by the participants' gender, with greater burden observed among males due to societal role expectations. Conclusion This study underscores the importance of emotional coping in the experience of informal caregivers and suggests that psychological interventions should focus on developing adaptive strategies to manage the stress and emotional burden associated with caregiving.
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Affiliation(s)
| | | | - Xochitl Garza Olivares
- Department of Clinical and Health Psychology, Tecnológico de Monterrey, Monterrey, NL, México
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50
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Lloyd SL, Caban-Holt A, Starks TD, Clark JC, Byrd GS. Assessing Gender Differences on the Impact of COVID-19 on the Medical and Social Needs of Dementia Caregivers. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2024; 67:207-222. [PMID: 37578097 DOI: 10.1080/01634372.2023.2244556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 07/25/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
Our analyses aimed to assess health status and critical needs of caregivers of persons with dementia (PWD) during the COVID-19 pandemic by gender. Between March 2021 and August 2021, respondents (n = 267) were recruited from an Alzheimer's disease (AD) listserv at an US academic center to complete a questionnaire to capture sociodemographic data, caregiving characteristics, health status, status of COVID-19 testing, and COVID-19 preventative practices during the pandemic. Women caregivers reported needing assistance with caregiving responsibilities, whereas men caregivers needed assistance with health and social resources. More men caregivers also reported psychological distress compared to women caregivers. Our findings indicated significant differences in the resources needed and psychological distress of women and men who cared for PWD during the COVID-19 pandemic. The development of recommendations and resources with both men and women caregivers in mind may be beneficial to support informal caregivers during emergency situations.
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Affiliation(s)
- Shawnta L Lloyd
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Allison Caban-Holt
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Takiyah D Starks
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Jarrel C Clark
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
| | - Goldie S Byrd
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston Salem, North Carolina, USA
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