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Yiryuo L, Kpekura S, Osman W, Kukeba MW, Mumuni ND, Mwinbam MM, Dery A. Challenges and support experienced by family caregivers seeking antiretroviral therapy services for children living with HIV/AIDS: a phenomenological study in Ghana. BMJ Open 2024; 14:e081036. [PMID: 38760044 DOI: 10.1136/bmjopen-2023-081036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND Family caregivers of children living with HIV/AIDS in most cases are found to be overwhelmed and under-resourced, yet they are believed to be the primary source of support for children living with HIV/AIDS. Family caregivers experience different challenges that affect their children's antiretroviral therapy (ART) adherence. AIM This study explored the lived experiences of family caregivers of children living with HIV/AIDS who sought ART services for these children at the St Joseph's Hospital of Jirapa, Ghana. METHOD Using a qualitative phenomenology design and a semistructured in-depth interview guide and using purposive sampling, data were gathered from 13 family caregivers of children living with HIV/AIDS receiving ART treatment at St Joseph's Hospital, Jirapa following ethical approval. All interviews were audio-taped and transcribed verbatim. Reflexive thematic analysis was used to analyse the transcribed data. FINDINGS Six themes were generated: five challenges and one support. Family caregivers of children living with HIV/AIDS experienced: (1) Financial challenges, (2) Human-related challenges, (3) Challenges at HIV testing and counselling (HTC) centres, (4) Challenges with transportation, (5) Challenges in disclosing children's HIV status to them and (6) Support received from HTC and their family members. CONCLUSION AND RECOMMENDATION Family caregivers of children living with HIV/AIDS experience daunting challenges in their quest to care for their children. Governmental and non-governmental HIV/AIDS programme support should include small business skills training and acquisition including capital to help set up small-scale businesses for such caregivers to reduce their financial challenges. Access to ART at clinics closer to caregivers is also key to promoting adherence. Family and community support has been recognised as key to enhancing ART adherence. Education of caregivers on policy regarding disclosure of the HIV/AIDS status of children, the need to work to reduce the time spent by caregivers at HTC, and ensuring privacy by limiting access to HTCs to only caregivers and their children, are important to enhancing adherence.
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Affiliation(s)
- Lilian Yiryuo
- St. Joseph's Hospital, Ghana Health Service, Accra, Jirapa, Ghana
- Pediatrics, Ghana College of Nurses and Midwives, Accra, Ghana
| | - Stephen Kpekura
- General and Preventive Health Nursing, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Wahab Osman
- Department of Advance Nursing, University for Development Studies, Tamale, Northern Region, Ghana
| | - Margaret Wekem Kukeba
- Ghana College of Nurses and Midwives, Accra, Ghana
- Department of Maternal and Child Health Nursing, C K Tedam University of Technology and Applied Sciences, Navrongo, Ghana
| | - Najart Deborah Mumuni
- Ghana College of Nurses and Midwives, Accra, Ghana
- Ghana Health Service, Nadowli, Nadowli Upper West Region, Ghana
| | - Mavis Mallory Mwinbam
- Ghana College of Nurses and Midwives, Accra, Ghana
- Ghana Health Service, Accra, Nadowli Upper West Region, Ghana
| | - Anthony Dery
- NURSING, Seventh-Day Adventist Clinic, WA, GHANA, Ghana
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Monteiro BCDC, dos Santos TTBA, Nogueira MML, Dourado MCN. The relationship between burden and caregiver's sleep disturbances in dementia: a systematic review. Dement Neuropsychol 2023; 17:e20230030. [PMID: 38111593 PMCID: PMC10727027 DOI: 10.1590/1980-5764-dn-2023-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/27/2023] [Accepted: 09/24/2023] [Indexed: 12/20/2023] Open
Abstract
Caregivers of people living with dementia (PLwD) have a high burden degree that leads to health issues, including sleep. Objective This study aimed to analyze the impacts of the caregiving burden on caregiver's sleep disturbances. Methods This systematic review involved a qualitative analysis of publications on Web of Science and Pubmed/Medline databases published between February 2018 and August 2022. Results A total of 27 studies were identified and analyzed. Caregiver's sleep presents impairments in sleep latency, sleep fragmentation, sleep duration, subjective sleep quality, daytime dysfunction, and insomnia. Caregiver's distress and depressive symptoms have a dual relationship with sleep problems. Conclusion Sleep disturbances presented by caregivers are correlated with higher burden levels and lead to more vulnerability to psychiatric symptoms and health issues.
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Affiliation(s)
| | | | - Marcela Moreira Lima Nogueira
- Universidade Federal do Rio de Janeiro, Instituto de Psiquiatria, Centro de Doença de Alzheimer, Rio de Janeiro RJ, Brazil
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Yang Z, Sun F, Zhao L, Hu T, Lin X, Guo Y. Self-efficacy and well-being in the association between caregiver burden and sleep quality among caregivers of elderly patients having multiple chronic conditions in rural China: a serial multiple mediation analysis. BMC Nurs 2023; 22:424. [PMID: 37957638 PMCID: PMC10641968 DOI: 10.1186/s12912-023-01587-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Caregivers of elderly patients with multiple chronic conditions have heavy caregiver burden and poor sleep quality, which has an important impact on both caregivers and patients. This study aimed to examine among rural caregivers of elderly patients who have multiple chronic conditions in China, whether self-efficacy and well-being mediate the link between caregiver burden and sleep quality. METHODS The study recruited 325 caregivers of elderly patients having multiple chronic conditions in rural China. Several measures including the Caregiver Burden Inventory (CBI), Athens Insomnia Scale (AIS), General Self-Efficacy Scale (GSES) and Index of Well-Being (IWB) were utilized to collect data. Structural equation modeling was employed to study the relationships among caregiver burden, sleep quality, self-efficacy, as well as well-being. RESULTS Significant correlations were found between the measured variables (each p < 0.01). Self-efficacy and well-being acted as mediators in the link between caregiver burden and sleep quality, accounting for 10.94% and 15.63% of the total effect, respectively. In addition, self-efficacy and well-being had a serial multiple mediating effect in the association between caregiver burden and sleep quality, with this mediating pathway, explaining 9.93% of the total effect. CONCLUSIONS Caregivers of elderly patients having multiple chronic conditions in rural China experienced poor sleep quality due to the caregiver burden. Self-efficacy and well-being had serial mediating roles on the relationship between caregiver burden and sleep quality. Effective interventions should be developed to improve self-efficacy and well-being of caregivers, reduce their caregiver burden and, eventually, improve their sleep quality.
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Affiliation(s)
- Ziyue Yang
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Fengye Sun
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Lingrui Zhao
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Tingwei Hu
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Xin Lin
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China
| | - Yufang Guo
- School of Nursing and Rehabilitation, Shandong University, 44 Wen Hua Xi Road, Jinan, 250012, Shandong, China.
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Ramadasa U, Silva S, Udumulla U, Perera S, Lekamwasam S. Caregiver strain among patients of palliative care in Sri Lanka: validation of modified caregiver strain index - Sinhala version. BMC Palliat Care 2023; 22:172. [PMID: 37924086 PMCID: PMC10625189 DOI: 10.1186/s12904-023-01270-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 09/27/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Care givers of Palliated patients are at risk of adverse physical, psychosocial and emotional sequelae in varied nature. Efficient and valid assessment tools facilitate early detection to take corrective measures. The Modified Caregiver Strain Index (MCSI), composed of domains associated with caregiver strain is a simple and brief tool that can be used in both clinical and field settings. This study aimed to adapt and validate this in order to cater effective palliative care services in Sri Lanka. METHODS After cross-cultural adaptation, 200 primary caregivers in 3 teaching hospitals were recruited. The internal consistency, item-total correlations, of the 13-item S-MCSI were performed. The criterion validity was assessed by Pearson correlation between the total scores of S-MCSI, the Karnofky Performance Scale and the Barthel index. Construct validity was determined by the principal component analysis keeping the Varimax with Keiser normalization as the rotation method. The Kaiser-Meyer-Olkin test (KMO) and Bartlett's test of sphericity statistics were also performed to determine the adequacy of the sample and correlations between items, respectively. The number of factors was determined by the Scree plot, percentage of variance explained by each component and number of Eigen values over 01 (Kaiser-Guttman rule). RESULTS The total MCSI score ranged 0 to 26. The overall Cronbach's alpha of the 13-item questionnaire was 0.80 while item-total corrections ranged 0.34 to 0.62, exception of one item (0.11). Inverse correlations were demonstrated in total scores of MCSI and Karnofky Performance Scale (r =- 0.32, p < 0.001) and Barthel index (r =-0.34, P < 0.001). A Kaiser-Meyer-Olkin value of 0.79 (p < 0.001) for Bartlett's test indicated adequate sampling and nonlinearity of factors. The Scree plot showed a three-factor structure explaining 57% of the variation. Items regarding personal wellbeing of caregiver loaded together while the effects on the family loaded separately. Adjustment of personal concerns and family issues along with time alteration grouped as the third factor. CONCLUSIONS The study showed that the Sinhala version of MCSI has adequate psychometric properties and reliability to be used as a validated tool to estimate the caregiver burden within a short time period for any health care workers.
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Affiliation(s)
- U Ramadasa
- Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Ratnapura, Sri Lanka
| | - S Silva
- Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
| | - U Udumulla
- Faculty of Medicine, Sabaragamuwa University of Sri Lanka, Ratnapura, Sri Lanka
| | - S Perera
- Ministry of Health, Nutrition and Indigenous Medicine, Colombo, Sri Lanka
| | - S Lekamwasam
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Jacob D, Muliira JK, Lazarus ER, Roslin H. Predictors of Quality of Life Among Omani Family Caregivers of Patients With Traumatic Brain Injury. Sultan Qaboos Univ Med J 2023; 23:463-471. [PMID: 38090238 PMCID: PMC10712391 DOI: 10.18295/squmj.5.2023.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to explore the quality of life (QoL) of Omani family caregivers (FCs) of patients with traumatic brain injury (TBI). After acute care, the burden of caring for patients with TBI is mainly shouldered by FCs. Methods This cross-sectional study was conducted at Khoula Hospital, Muscat, Oman. Patient data were collected at the time of discharge and 8 weeks post-discharge between April 2019 and December 2021. The SF-12 General Health Survey and Preparedness for Caregiving scale were used to measure the caregivers' QoL and preparedness, respectively. The Disability Rating and TBI Symptom scales were used to measure the patients' disability and symptoms, respectively. Results A total of 36 FCs and patients with TBI were recruited. Most caregivers were the parent (41.7%) or child (27.8%) of the patient with TBI. Overall, the caregivers had good physical QoL (PQoL) and mental health QoL (MHQoL) but low caregiving preparedness at the time of discharge. At 8 weeks post-discharge, there were significant improvements in caregiving preparedness (P <0.01) and patient disability (P <0.05) but a depreciation in caregivers' MHQoL (P <0.05), with no change in their PQoL. The caregiver's employment status and the severity of the patient's sleep and mood problems were modifiable predictors of the caregivers' PQoL. Caregiver's preparedness, the patient's inability to live independently, and the severity of the patient's mood and behavioural problems were predictors of caregivers' MHQoL. Conclusion Caring for patients with TBI negatively impacts the QoL of Omani FCs; this correlates with the physical, emotional, and mental health symptoms of the patient.
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Affiliation(s)
- Devakirubai Jacob
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Eilean R. Lazarus
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Hema Roslin
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
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Tona JT, Ash J, Brown E, Campagna C, Kostek K, Lawton E, Rieth A, Tomita M. Caregiver Burden, Stress, and Relationship Cohesion Among Self-Identified Caregivers of Children with Pediatric Acute-Onset Neuropsychiatric Syndrome. J Child Adolesc Psychopharmacol 2023; 33:378-386. [PMID: 37966363 PMCID: PMC10771873 DOI: 10.1089/cap.2023.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2023]
Abstract
Objective: Children with Pediatric Acute-onset Neuropsychiatric Syndrome (PANS) experience sudden onset neuropsychiatric symptoms after infection or other triggers. Symptoms range from mild to severe, potentially lasting days, weeks, months, or longer. Exacerbation-related functional decline presents in many aspects of daily life, generally accompanied by family stress and caregiver burden. We sought to investigate the relationship between severity of PANS symptoms and caregiver burden/stress and the relationship between severity of PANS symptoms and degree of caregiver/child cohesion. Methods: This cross-sectional online study surveyed caregivers recruited from PANS-related social media support sites. The Pediatric Acute Neuropsychiatric Symptom Scale - Parent Version (PNSS) measured current severity. Caregiver Burden Inventory (CBI) and Caregiver Self-Assessment Questionnaire (CSAQ) assessed caregiver burden/stress. Inclusion of Other in the Self (IOS) scale determined caregiver-perceived current and desired cohesion with their child(ren) with PANS. Results: Of the 216 respondents 79.6% exceeded CBI threshold indicating need for respite in adult care receiver populations. On the CSAQ, 72.9% expressed high distress, 80.5% reported feeling overwhelmed, and 58.1% reported crying spells, meeting cutoffs for support/respite used in adult care receiver populations. Most caregivers reported not having the desired degree of cohesion with their child on the IOS (85.5%). Parents of children with more severe PNSS symptoms fared significantly worse on all measures (CBI: H = 57.83; CSAQ: F = 29.26; IOS: H = 38.04; p < 0.001 for all). Content analysis of comments revealed five themes: (1) severe caregiver and/or family emotional distress and trauma; (2) caregivers wondering what happened to their child; (3) lack of awareness and support among health and education professionals; (4) relationship strain with family, friends, and significant others; and (5) financial and/or legal struggles because of their child's diagnosis. Conclusion: There is strong need for support and respite for children with PANS and their families. Long-term effects including posttraumatic stress symptoms among family members should be studied.
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Affiliation(s)
- Janice T. Tona
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Julie Ash
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Emily Brown
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Courtney Campagna
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Kellie Kostek
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Erin Lawton
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Andrea Rieth
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
| | - Machiko Tomita
- Rehabilitation Science Department, University at Buffalo, Buffalo, New York, USA
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Roslin H, Muliira JK, Lazarus ER, Jacob D, Al-Habsi W, Al-Musallami F. Caregiving Preparedness and Caregiver Burden in Omani Family Caregivers for Patients with Acquired Brain Injury. Sultan Qaboos Univ Med J 2023; 23:493-501. [PMID: 38090237 PMCID: PMC10712375 DOI: 10.18295/squmj.6.2023.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Revised: 03/19/2023] [Accepted: 04/19/2023] [Indexed: 12/18/2023] Open
Abstract
Objectives This study aimed to explore the caregiving preparedness and caregiver burden among Omani family caregivers (FCs) of patients with acquired brain injury (ABI). Methods This prospective observational study was conducted at the neurology clinic at Khoula Hospital, Muscat, Oman, from April 2019 to December 2021. Data were collected from 119 FCs and their patients at the time of discharge from the hospital and 16 weeks post-discharge during follow-up care. The questionnaire comprised the Zarit Burden Index, the Preparedness for Caregiving Scale, the Short-Form-12 Health Survey, and a patient symptom scale. Results The FCs were predominantly female (53.8%), and the mean age was 38.27 ± 9.11 years. Most patients had moderate to severe ABI (95.8%) due to stroke (56.3%) and trauma (30.3%). The most common patient symptoms were loss of muscle strength, speech problems, mood problems, memory loss, and change in behaviour. Most FCs were found to have low caregiving preparedness (58%) at discharge, and 19.1% were found to have a high level of caregiver burden at 16 weeks post-discharge. The length of time post-injury (P <0.01), symptom severity (P <0.01) and the FCs' physical and mental health status (P <0.01 each) were found to be significant predictors of caregiving preparedness, whereas caregiver preparedness (P <0.01), symptom severity (P <0.01), and caregivers' mental health (P = 0.028) were seen as the predictors of caregiver burden. Conclusion Omani FCs of patients with ABI tend to commence the caregiver role with inadequate preparation, and shortly after, a significant number suffer high caregiver burden. Interventions focusing on the caregiver's health and training in symptom management may improve the outcomes of FCs and patients.
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Affiliation(s)
- Hema Roslin
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | | | - Eilean R. Lazarus
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Devakirubai Jacob
- Department of Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman
| | - Warda Al-Habsi
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
| | - Fatma Al-Musallami
- Directorate General of Khoula Hospital, Ministry of Health, Muscat, Oman
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Vega-Silva EL, Barrón-Ortiz J, Aguilar-Mercado VV, Salas-Partida RE, Moreno-Tamayo K. [Quality of life and caregiver burden in caregivers with patients with complications from type 2 diabetes mellitus]. Rev Med Inst Mex Seguro Soc 2023; 61:440-448. [PMID: 37540582 PMCID: PMC10484553 DOI: 10.5281/zenodo.8200209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/03/2023] [Indexed: 08/06/2023]
Abstract
Background Chronic diseases with partial dependence, including type 2 diabetes mellitus, modify the way of life of the patient and his family, who adopt the role of caregiver having to reorganize, rethink their expectations and adapt their goals and objectives to the situation, this may generate a deterioration of the quality of life and an overload syndrome. Objective To identify the relationship between quality of life and caregiver overload in caregivers with patients with complications from type 2 diabetes mellitus assigned to the Family Medicine Unit No. 7. Material and methods Cross-sectional study, carried out with 138 caregivers with a patient with complications from type 2 diabetes mellitus. The sociodemographic profile instruments, the SF-36 health questionnaire, and the Zarit scale were used for data collection. The analysis was carried out through descriptive statistics and Spearman's correlation test, with a significance level of p≤0.05. Results It was identified that the health-related quality of life in caregivers with patients with complications from type 2 diabetes mellitus evaluated with the SF-36 questionnaire had a mean value of 74.8; with a score in the physical and mental components of 63.9 and 38.1 respectively. The best qualified dimensions were social function (84.9) and physical function, on the other hand, vitality obtained a lower qualification. It was observed that 5.05% of the caregivers present light overload and 5.05% intense overload. When performing the correlation between the global rating of the Zarit scale with the 8 dimensions of the SF-36 health questionnaire in caregivers of patients with complications of type 2 diabetes mellitus, a moderate negative correlation was observed between the dimensions of mental health, physical function, emotional role and vitality, as well as a weak negative correlation between the dimensions of social role and physical role. Conclusions The results show an inverse correlation between the caregiver's burden and the quality-of-life dimensions, that is, if one decreases, the other increases; It is important to carry out health promotion activities in this population to prevent caregiver overload.
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Affiliation(s)
- Erika Lorena Vega-Silva
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Servicio de Medicina Familiar. Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Jaqueline Barrón-Ortiz
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Servicio de Medicina Familiar. Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Virginia Verónica Aguilar-Mercado
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Coordinación Clínica de Educación e Investigación en Salud. Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Rosa Elena Salas-Partida
- Instituto Mexicano del Seguro Social, Unidad de Medicina Familiar No. 7, Dirección Médica. Aguascalientes, Aguascalientes, MéxicoInstituto Mexicano del Seguro SocialMéxico
| | - Karla Moreno-Tamayo
- Instituto Mexicano del Seguro Social, Centro Médico Nacional Siglo XXI, Unidad de Investigación Epidemiológica y en Servicios de Salud, Área Envejecimiento. Ciudad de México, MéxicoInstituto Mexicano del Seguro SocialMéxico
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Moreira VS, Chaves MLF, de Castilhos RM, Olchik MR. Caregiver burden related to feeding process in Alzheimer's disease. Dement Neuropsychol 2023; 17:e20220092. [PMID: 37533596 PMCID: PMC10392878 DOI: 10.1590/1980-5764-dn-2022-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 03/16/2023] [Accepted: 04/16/2023] [Indexed: 08/04/2023] Open
Abstract
Difficulties in the feeding process, such as aversive feeding behaviors and dysphagia, are common in patients with Alzheimer's disease (AD) and can often overload their caregivers. Although dysphagia is already established as a factor contributing to caregiver burden, the impact of aversive behaviors is less studied. Objectives Evaluate the relationship between the feeding process in individuals with AD and their caregiver's burden. Methods Dyads of individuals with AD and their caregivers were recruited for a cross-sectional study. The Edinburgh Feeding Evaluation in Dementia (EdFED) scale, the Zarit Burden Interview (ZBI), the mini-mental state examination (MMSE), the Functional Activities Questionnaire (FAQ), and the Functional Oral Intake scale (FOIS) were performed. Results We included 60 AD individuals-caregivers dyads. The median (IQR) age of caregivers was 57 (19-81) years, and the most were females (70%). The individuals with AD had a median MMSE of 12 (6-15), and the disease duration was 4 (2-6) years. The mean (SD) Zarit score was 20.95 (6.51). In the multivariate linear regression, the EdFED score (95% CI 0.368-1.465) and time as a caregiver (95% CI 0.133-1.355) were associated with the caregiver's burden. Conclusions Aversive behaviors were associated with the caregiver burden of individuals with AD, even with a short duration of the disease. These findings show the importance of education for caregivers regarding the feeding process, as these measures have great potential to minimize the caregiver's burden.
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Affiliation(s)
- Verônica Salazar Moreira
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Medicina, Ciências Médicas, Porto Alegre RS, Brazil
| | - Márcia Lorena Fagundes Chaves
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Medicina, Ciências Médicas, Porto Alegre RS, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Medicina, Departamento de Medicina Interna, Porto Alegre RS, Brazil
| | - Raphael Machado de Castilhos
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Medicina, Ciências Médicas, Porto Alegre RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil
| | - Maira Rozenfeld Olchik
- Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Medicina, Ciências Médicas, Porto Alegre RS, Brazil
- Hospital de Clínicas de Porto Alegre, Serviço de Neurologia, Porto Alegre RS, Brazil
- Universidade Federal do Rio Grande do Sul, Faculdade de Odontologia, Curso de Fonoaudiologia, Departamento de Cirurgia e Ortopedia, Porto Alegre RS, Brazil
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Pavarini SCI, Bregola AG, Luchesi BM, de Oliveira NA, Ottaviani AC. Sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers: a cross-sectional study. Dement Neuropsychol 2023; 17:e20220030. [PMID: 37223833 PMCID: PMC10202313 DOI: 10.1590/1980-5764-dn-2022-0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 07/04/2022] [Accepted: 09/01/2022] [Indexed: 05/25/2023] Open
Abstract
The task of caring can negatively affect the physical and mental health; therefore, it is important to understand which factors are associated with burden in older caregivers of older adults. Objective This study aimed to explore sociodemographic, clinical, and psychosocial factors associated with burden in older caregivers of older adults. Methods This is a cross-sectional study developed with 349 older caregivers who were registered at a Family Health Unit of a city in the state of São Paulo, Brazil. Household interviews were conducted and data were collected on the sociodemographic (profile, family income), clinical (self-reported pain, sleep, frailty), and psychosocial (burden, family functioning, depressive symptoms, stress) characteristics of the caregivers as well as dependence on activities of daily living and cognition in the care recipients. Results Women predominated in the sample (76.5%) and mean age was 69.5 years. The mean burden score was 18.06 points, with 47.9% above the cutoff of 16 points, denoting excessive burden. The bivariate model revealed associations between burden and financial insufficiency, family dysfunction, difficulty sleeping, pain, perceived stress, depressive symptoms, frailty, and multimorbidity among the caregivers as well as worse functional and cognitive performance in the care recipients. The controlled model revealed an association between burden and depressive symptoms (β=16.75; 95%CI 1.80-31.68). Conclusions We identified an association between burden and depressive symptoms, underscoring the need for the planning and implementation of specific actions directed at caregivers in order to minimize the impact on health and to improve the quality of life.
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Affiliation(s)
- Sofia Cristina Iost Pavarini
- Universidade Federal de São Carlos, Departamento de Gerontologia, São Carlos SP, Brazil
- Universidade Federal de São Carlos, Programa de Graduação em Enfermagem, São Carlos SP, Brazil
| | | | - Bruna Moretti Luchesi
- Universidade Federal do Mato Grosso do Sul, Programa de Graduação em Enfermagem,Três Lagoas MS, Brazil
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Mihan R, Mousavi SB, Khodaie Ardakani MR, Rezaei H, Hosseinzadeh S, Nazeri Astaneh A, Alikhani R. Comparison of Caregivers' Burden among Family Members of Patients with Severe Mental Disorders and Patients with Substance Use Disorder. Iran J Psychiatry 2023; 18:183-190. [PMID: 37383957 PMCID: PMC10293690 DOI: 10.18502/ijps.v18i2.12369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 10/31/2021] [Accepted: 12/09/2021] [Indexed: 06/30/2023]
Abstract
Objective: The burden on caregivers of patients with severe mental disorders is significantly higher than the care burden of patients with other medical conditions. Substance use disorder is also one of the most common psychiatric disorders that has negative effects on people's quality of life. This study was designed to investigate caregiver burden in severe mental disorders versus substance use disorder. Method : First-degree relatives of patients admitted to the Razi Psychiatric Hospital of Tehran with a diagnosis of schizophrenia, bipolar disorder type1, schizoaffective disorder, or substance use disorder entered this study. They completed the sociodemographic questionnaire for patients and caregivers and the Zarit burden interview for caregivers. Results: Our study shows that caregiver burden in substance use disorder has no significant difference with that in severe mental disorders (P > 0.05). In both groups, the highest spectrum of burden was moderate to severe. To find caregiver burden related factors, a general linear regression model with multiple predictor variables was fitted. In this model, caregivers' burden was significantly higher in patients with comorbidity (P = 0.007), poor compliance (P < 0.001), and in female caregivers (P = 0.013). Conclusion: Statistically speaking, the caregiver burden in substance use disorders is as severe as other mental disorders. The considerable burden on both groups necessitates serious efforts to minimize its negative effects.
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Affiliation(s)
- Ronak Mihan
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seiedeh Bentolhoda Mousavi
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Hamed Rezaei
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Samaneh Hosseinzadeh
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Nazeri Astaneh
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Rosa Alikhani
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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12
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Viny M, Trevino AY, Bouldin ED, Kalvesmaki A, Roghani A, Pugh MJ. Caregiver burden and COVID-19: How epilepsy caregivers experienced the pandemic. Epilepsy Behav 2023; 141:109151. [PMID: 36907084 PMCID: PMC9968611 DOI: 10.1016/j.yebeh.2023.109151] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 02/17/2023] [Accepted: 02/19/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Caregivers of adults with epilepsy face unique challenges, yet most studies focus on the impact of epilepsy on those living with the condition, rather than the impact on caregivers. Our objective was to evaluate whether caregivers' pandemic-related changes and experiences - namely those related to their health, healthcare access, and well-being - were associated with their caregiving burden. METHODS Caregivers of adults with epilepsy (n = 261) were recruited through Qualtrics Panels to participate in an online survey examining health, well-being, COVID-19 experiences, and caregiver burden from October-December, 2020. The burden was measured using the Zarit 12-item measure; the clinically significant burden was defined as a score greater than 16. Adjustments were made to account for burden scores related to exposures of interest. Chi-square tests, t-tests, and generalized linear regression models were used to compare cross-sectional associations between COVID-19 experiences and burden. RESULTS Over half (57.9%) of caregivers had clinically significant caregiver burden. Most reported increased anxiety (65%), stress (64%), and sense of social isolation (58%) during the pandemic. Many caregivers reported that their sense of control over their life (44%) and their use of healthcare changed (88%) due to COVID-19. In adjusted models, caregivers who reported increased anger, increased anxiety, decreased sense of control, or changes in healthcare utilization during COVID-19 had about twice the odds of having clinically significant caregiver burden compared to caregivers who did not report changes. DISCUSSION Changes experienced by caregivers of adults with epilepsy during the pandemic were strongly associated with clinically significant levels of caregiver burden. These findings demonstrate the link between mass-level events, such as a pandemic, the burden caregivers of adults with epilepsy may carry, and subsequent psychological outcomes. CONCLUSION Caregivers of adults with epilepsy may need support to reduce the negative impact of COVID-19-related experiences and should be connected to healthcare and resources that can help alleviate their burden.
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Affiliation(s)
- Mikayla Viny
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.
| | - Amira Y Trevino
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Department of Educational Psychology, University of Utah College of Education, Salt Lake City, UT, United States.
| | - Erin D Bouldin
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.
| | - Andrea Kalvesmaki
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States.
| | - Ali Roghani
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States.
| | - Mary Jo Pugh
- Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States; Informatics, Decision-Enhancement, and Analytic Sciences Center, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, UT, United States.
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13
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Steiger KG, Boehmer KR, Klanderman MC, Mookadam A, Koneru SS, Montori VM, Mookadam M. Who Is Most Burdened in Health Care? An Analysis of Responses to the ICAN Discussion Aid. J Am Board Fam Med 2023; 36:277-288. [PMID: 36948538 DOI: 10.3122/jabfm.2022.220251r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 10/27/2022] [Accepted: 11/01/2022] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To create a model based on patients' characteristics that can predict the number of burdens reported using the ICAN Discussion Aid, to target use of this tool to patients likeliest to benefit. PATIENTS AND METHODS Six hundred thirty-five patients (aged ≥18 years) completed the ICAN Discussion Aid at a Scottsdale, Arizona, family medicine clinic. Patient characteristics were gathered from their health records. Regression trees with Poisson splitting criteria were used to model the data. RESULTS Our model suggests the patients with the most burdens had major depressive disorder, with twice as many overall burdens (personal plus health care burdens) than patients without depression. Patients with depression who were younger than 38 years had the highest number of personal burdens. A body mass index (BMI) of 26 or greater was associated with increased health care burden versus a BMI below 26. CONCLUSION The number of burdens a patient will report on the ICAN Discussion Aid can be approximated based on certain patient characteristics. Adults with major depression, a BMI of 26 or greater, and younger age may have greater reported burdens on ICAN, but this finding needs to be validated in independent samples.
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Affiliation(s)
- Kyle G Steiger
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Kasey R Boehmer
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Molly C Klanderman
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Aamena Mookadam
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Sethu Sandeep Koneru
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Victor M Montori
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM)
| | - Martina Mookadam
- From the Mayo Clinic Alix School of Medicine, Mayo Clinic College of Medicine and Science, Scottsdale (KGS); Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, Minnesota (KRB, VMM); Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota (KRB); Department of Quantitative Health Sciences, Mayo Clinic, Scottsdale, Arizona (MCK); Mayo Clinic, Scottsdale, Arizona (AM, SSK); Department of Family Medicine, Mayo Clinic, Scottsdale, Arizona (MM); Arizona State University, Tempe (AM).
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Freytes IM, Schmitzberger MK, Rivera-Rivera N, Lopez J, Motta-Valencia K, Wu SS, Orozco T, Hale-Gallardo J, Eliazar-Macke N, LeLaurin JH, Uphold CR. Study protocol of a telephone problem-solving intervention for Spanish-speaking caregivers of veterans post-stroke: an 8-session investigator-blinded, two-arm parallel (intervention vs usual care), randomized clinical trial. BMC Prim Care 2023; 24:73. [PMID: 36932321 PMCID: PMC10022053 DOI: 10.1186/s12875-022-01929-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/25/2022] [Indexed: 03/18/2023]
Abstract
BACKGROUND Stroke is one of the leading causes of death and the main cause of long-term disability in the United States. The significant risk factors of stroke among Hispanics are well-documented. The majority of stroke survivors return home following a stroke and are cared for by family caregivers. Due to the abrupt nature of strokes, caregivers experience unexpected changes and demands that oftentimes lead to caregiver burden and depression. Given the significant risk factors for stroke in Hispanics and the influence of culture in family norms and family management, we developed a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers. This study tests the impact of a telephone and online problem-solving intervention for Spanish-speaking stroke caregivers on caregiver outcomes. METHODS The design is a two-arm parallel randomized clinical trial with repeated measures. We will enroll 290 caregivers from 3 Veterans Affairs (VA) medical centers. Participants randomized into the intervention arm receive a problem-solving intervention that uses telephone and online education and care management tools on the previously developed and nationally available RESCUE en Español Caregiver website. In the usual care group, participants receive the information and/or support caregivers of veterans with stroke normally receive through existing VA resources (e.g., stroke-related information and support). The primary outcome is change in caregiver's depressive symptoms at 1- and 12-weeks post-intervention. Secondary outcomes include changes in stroke caregivers' burden, self-efficacy, problem-solving, and health-related quality of life (HRQOL) and veterans' functional abilities. We will also determine the budgetary impact, the acceptability of the intervention and participation barriers and facilitators for Spanish-speaking stroke caregivers. DISCUSSION This is an ongoing study. It is the first known randomized controlled trial testing the effect of a telephone and online problem-solving intervention in Spanish for caregivers of veterans post-stroke. If successful, findings will support an evidence-based model that can be transported into clinical practice to improve the quality of caregiving post-stroke. TRIAL REGISTRATION ClinicalTrials.gov: NCT03142841- Spanish Intervention for Caregivers of Veterans with Stroke (RESCUE Español). Registered on February 23, 2018. Protocol version 8. 08.11.2022.
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Affiliation(s)
- I Magaly Freytes
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA.
- Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA.
| | - Magda K Schmitzberger
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Naiomi Rivera-Rivera
- Research Service, VA Caribbean Healthcare System, 10 Casia St, San Juan, PR, 00921, USA
| | - Janet Lopez
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Keryl Motta-Valencia
- Physical Medicine and Rehabilitation Service, VA Caribbean Healthcare System, 10 Casia St, San Juan, PR, 00921, USA
| | - Samuel S Wu
- College of Medicine, Department of Biostatistics, University of Florida, CTRB Room 5243, 2004 Mowry Road, Gainesville, FL, 32610, USA
| | - Tatiana Orozco
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Jennifer Hale-Gallardo
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Nathaniel Eliazar-Macke
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Jennifer H LeLaurin
- Research Service, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
| | - Constance R Uphold
- Geriatric Research Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Rd #151B, Gainesville, FL, 32608, USA
- College of Medicine, Department of Aging and Geriatric Research, University of Florida, 2004 Mowry Rd, Gainesville, FL, 32603, USA
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15
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Mukherjee R, Bhattacharyya B, Mukherjee A, Das G, Das S, Biswas A. Health status of persons with dementia and caregivers' burden during the second wave of COVID-19 pandemic: an Indian study. Dement Neuropsychol 2022; 16:284-291. [PMID: 36619844 PMCID: PMC9762382 DOI: 10.1590/1980-5764-dn-2021-0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 01/11/2022] [Accepted: 01/25/2022] [Indexed: 01/11/2023] Open
Abstract
Due to the disruption of normal flow of treatment during the restrictions related to the coronavirus disease 2019 (COVID-19) pandemic, the health status of persons with dementia (PwD) and their caregivers' burden might worsen. Objective The article aims to find out the health status of PwD and caregivers' burden during the peak of second wave of COVID-19 and make a comparison with the preceding trough phase. Methods The study was conducted with 53 PwD and their caregivers in two phases. On their visit to the hospital during the unlock phase (phase 1), data were collected for CDR from PwD, and NPI-Q and ZBI from their caregivers. During the peak of second wave (phase 2), data were collected for NPI-Q, ZBI, and DASS-21 through telephonic communication, and statistical analyses were performed on the collected data. Results Significantly higher caregiver burden (p=0.001) and neuropsychiatric symptoms (NPSs) [both in severity (p=0.019) and distress (p=0.013)] were observed among the respondents during the peak of second wave of the pandemic as compared to the preceding trough phase. Positive correlations were observed between the caregiver burden and depression, anxiety, and stress of the caregivers (p<0.001) and between the severity of dementia in PwD and caregiver burden (p<0.001) for both the first and second phases. Positive correlation was also observed between the severity of dementia in PwD and depression (p=0.042) and stress (p=0.023) of caregivers. Conclusions Significant increase in the burden and distress was observed among caregivers due to increased NPSs of PwD during the second wave of COVID-19 pandemic.
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Affiliation(s)
- Ruchira Mukherjee
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Bidisha Bhattacharyya
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Adreesh Mukherjee
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Goutam Das
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
| | - Sujata Das
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
- Rabindranath Tagore International Institute of Cardiac Sciences,
Department of Neuropsychology, Kolkata, India
| | - Atanu Biswas
- Bangur Institute of Neurosciences, Institute of Post Graduate
Medical Education & Research, Department of Neurology, Kolkata, India
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16
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Bertelli S, Ferrara P, Di Modica S, Bergamelli E, Gambini O, D'Agostino A, Destrebecq A, Terzoni S. Adaptation and validation of the Caregiver Burden Inventory in eating disorders. J Eat Disord 2022; 10:34. [PMID: 35255998 PMCID: PMC8903570 DOI: 10.1186/s40337-022-00560-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Accepted: 02/27/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Living with people diagnosed with a mental disorder is known to increase the risk of developing high levels of so-called "caregiver burden" in informal caregivers. In-depth analysis of this phenomenon and specific assessment tools for caregivers of patients diagnosed with Eating Disorders (EDs) are lacking. In this study, we aimed to evaluate the psychometric properties of the Caregiver Burden Inventory in EDs and employ this adapted tool in this category of caregivers. METHODS A cross-sectional study was conducted in the Eating Disorders outpatient unit of an Italian University hospital. Face and content validity were investigated by calculating standard Content Validity Indices (CVI-I and CVI-S) after administering the Inventory to 6 expert nurses with at least 5 years of experience in mental health services assisting people diagnosed with Eating Disorders. Internal consistency was evaluated with Cronbach's α coefficient for the overall scale and subscales. An exploratory factor analysis (EFA) was performed to explore latent constructs. The adapted CBI was then administered to 62 informal caregivers of ED patients. RESULTS The EFA yielded a 5-factor structure. The CVI-S was 97.2%; the Cronbach α coefficient was 0,90 (> 0.74 in each subscale). The median burden level in the experimental population was 40.0 [range = 21 to 54], in a theoretical range from 0 (no burden) to 96 (highest level of burden). CONCLUSION The Caregiver Burden Inventory appears to be a valid and reliable instrument to assess caregiver burden in individuals diagnosed with Eating Disorders. Further research is needed to evaluate this tool's efficiency in improving individually tailored interventions on families.
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Affiliation(s)
- Sara Bertelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Paolo Ferrara
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Sharon Di Modica
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
| | - Emilio Bergamelli
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
| | - Orsola Gambini
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.,CRC "Aldo Ravelli" for Neurotechnology and Experimental Brain Therapeutics, University of Milan Medical School, Milan, Italy
| | - Armando D'Agostino
- Department of Mental Health and Addiction, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy. .,Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
| | - Anne Destrebecq
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy.,Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Stefano Terzoni
- Bachelor School of Nursing, ASST Santi Paolo e Carlo, San Paolo Hospital, Milan, Italy
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Isac C, Lee P, Arulappan J. Older adults with chronic illness - Caregiver burden in the Asian context: A systematic review. Patient Educ Couns 2021; 104:2912-2921. [PMID: 33958255 DOI: 10.1016/j.pec.2021.04.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 03/14/2021] [Accepted: 04/21/2021] [Indexed: 05/25/2023]
Abstract
INTRODUCTION Upsurge in life expectancy, filial responsibility of caring, and healthcare advances have increased the older adult population in Asia. The last decade has witnessed nuclear families' proliferation in Asia, leaving family caregivers with more accountability and responsibility. This review explores the pattern of caregiver burden among caregivers of older adults with chronic illness in Asia. METHODS PRISMA guidelines serves as the framework for this systematic review. Studies from selected databases assessed caregivers' physical state, psychological dysfunction, and or burden as an outcome measure. The Newcastle - Ottawa Quality Assessment Scale appraised the quality of the selected studies. RESULTS The review included 12 research articles. Caregivers consistently report mild to a moderate burden. Care recipient with functional dependency, comorbidities, memory, and sleep impairments, escalate caregiver burden. Caregiver variables intensifying burden were advancing age, male gender, spouse as a care recipient, longer care provision duration, and no assistance. CONCLUSION Optimal levels of emotional well-being, significant family/social support, and self-preparedness among caregivers are grounds for their empowerment. PRACTICAL IMPLICATIONS A paradigm shift from 'caregiver burden' to 'caregiver resilience' is advocated. Routine screening, preventive measures (skill-building and psychosocial empowerment), and restorative services (respite care and problem-based home visiting) for caregivers are forecasted.
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Affiliation(s)
- Chandrani Isac
- Lecturer, Adult Health & Critical Care, College of Nursing, Sultan Qaboos University, Muscat, Oman.
| | - Premila Lee
- Professor, Medical Surgical Department, College of Nursing, Christian Medical College, Vellore, India
| | - Judie Arulappan
- Assistant Professor, Maternity & Child Health, College of Nursing, Sultan Qaboos University, Muscat, Oman
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18
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Hejazi SS, Hosseini M, Ebadi A, Alavi Majd H. Development and Psychometric Evaluation of " Caregiver Burden Questionnaire for Family Caregivers of Patients Undergoing Hemodialysis": A Protocol for A Sequential Exploratory Mixed-Method Study. Iran J Psychiatry 2021; 16:471-479. [PMID: 35082860 PMCID: PMC8725188 DOI: 10.18502/ijps.v16i4.7235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 10/29/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
Objective: Caregiver burden is defined as the physical, financial, mental, and social problems stemmed from providing care for one of the family members who is involved with a medical problem. The precise measurement of caregiver burden is crucial, and it is essential to have an appropriate and specific tool for measuring caregiver burden. This study will be carried out using sequential exploratory mixed-method design with the aim of development and psychometric evaluation of a questionnaire for caregiver burden in family caregivers of hemodialysis patients. Method : The study will be done in 2 phases: 1. qualitative study and literature review, and 2. designing and psychometric evaluation of the questionnaire. In the qualitative phase, family caregivers of hemodialysis patients, patients, nurses, physicians, and social workers will be selected using the maximum variation purposive sampling method. Data will be gathered through semi-structured interviews using a combination of the questions derived from the model and open-ended questions and will be analyzed using directed content analysis. The literature review will be carried out based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses to improve the reporting of the systematic review. After developing the primary item pool, in the quantitative phase, the psychometric properties of the questionnaire will be evaluated. In this regard, face, content, and construct validity (exploratory factor analysis), internal consistency (Alpha's Cronbach), reliability (test-retest), responsiveness, interpretability, and feasibility of the questionnaire will be assessed. Results: The primary questionnaire will be developed based on the qualitative and systematic literature review; then, its psychometric properties will be assessed in the second phase. The result section will consist of the findings of these two phases. Conclusion: It seems that a specific questionnaire could be a facilitator of identifying and measuring the actual caregiver burden.
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Affiliation(s)
- Sima Sadat Hejazi
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meimanat Hosseini
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Abbas Ebadi
- Behavioral Sciences Research Center, Life Style Institute, Faculty of Nursing, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Hamid Alavi Majd
- Department of Biostatistics, Faculty of Paramedicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Dalirirad H, Najafi T, Seyedfatemi N. Effect of an Educational Support Programme on Caregiver Burden Among the Family Members of Patients Undergoing Coronary Artery Bypass Graft Surgery. Sultan Qaboos Univ Med J 2021; 21:e266-e274. [PMID: 34221475 PMCID: PMC8219316 DOI: 10.18295/squmj.2021.21.02.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/26/2020] [Accepted: 08/19/2020] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The family caregivers of patients undergoing coronary artery bypass graft (CABG) surgery experience considerable physical and emotional distress. This study aimed to investigate the effect of an educational support programme on caregiver burden among the family caregivers of patients undergoing CABG surgery in Iran. METHODS This non-randomised controlled clinical trial was conducted from January to April 2017 at a cardiovascular centre in Tehran, Iran. A total of 80 family caregivers of patients undergoing CABG surgery were sequentially selected and non-randomly assigned to intervention and control groups. The control group received routine care, whereas the intervention group received additional education sessions at baseline, prior to surgery, the day after surgery and before discharge. Caregiver burden was compared at baseline and six weeks post-discharge using the Persian-language versions of the Caregiver Burden Inventory (CBI) and Katz Index of Independence in Activities of Daily Living (IADL). RESULTS A significant difference was observed between family caregivers in the control and intervention groups with regards to pre-post differences in mean CBI scores (+1.67 ± 19.23 versus +17.45 ± 9.83; P <0.001), with an effect size of -1.14. In addition, there was a significant increase in mean post-discharge IADL scores among CABG patients in the intervention group compared to the control group (4.42 ± 1.05 versus 3.07 ± 1.09; P <0.001). CONCLUSION An educational support programme significantly reduced caregiver burden among the family members of patients undergoing CABG surgery in Iran. As such, in addition to routine care, healthcare providers should provide educational support to this population to help mitigate caregiver burden.
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Affiliation(s)
- Helen Dalirirad
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Tahereh Najafi
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Naima Seyedfatemi
- Department of Emergency & Critical Care Nursing, School of Nursing & Midwifery, Iran University of Medical Sciences, Tehran, Iran
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De Luca R, Torrisi M, Bramanti A, Maggio MG, Anchesi S, Andaloro A, Caliri S, De Cola MC, Calabrò RS. A multidisciplinary Telehealth approach for community dwelling older adults. Geriatr Nurs 2021; 42:635-642. [PMID: 33823421 DOI: 10.1016/j.gerinurse.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 03/16/2021] [Accepted: 03/18/2021] [Indexed: 01/03/2023]
Abstract
Telemedicine may be used for the continuity of care in several chronic conditions. Sixty frail old people were enrolled along with their primary caregivers, and randomly divided into two groups: 30 of them received a multi-specialist telemedicine care, whilst the other 30 were treated in their usual territory care. All of the patients were evaluated through a clinical and psychometric battery at baseline (T0), after 6 months (T1), and at the end of the study (T2). It was found that telemedicine was more effective than the traditional approach in mood improvement (p < 0.001), behaviour (p < 0.01) and ADL/IADL (p < 0.01/0.04), as well as nutritional status. These changes increased over time (from T0 to T1), the caregivers' burden decreased, and system usability was rated as good. Telemedicine could be considered an important tool to improve the psychological health and quality of the life of older frail patients living at home.
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Affiliation(s)
- Rosaria De Luca
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Michele Torrisi
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Alessia Bramanti
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Maria Grazia Maggio
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Smeralda Anchesi
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Adriana Andaloro
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Santina Caliri
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Maria Cristina De Cola
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy
| | - Rocco Salvatore Calabrò
- Rocco Salvatore Calabrò, IRCCS Centro Neurolesi "Bonino-Pulejo", S.S. 113, Contrada Casazza, 98124 Messina, Italy.
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García-Torres F, Jacek Jabłoński M, Gómez Solís Á, Moriana JA, Jaén-Moreno MJ, Moreno-Díaz MJ, Aranda E. Social support as predictor of anxiety and depression in cancer caregivers six months after cancer diagnosis: A longitudinal study. J Clin Nurs 2020; 29:996-1002. [PMID: 31793095 DOI: 10.1111/jocn.15123] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Revised: 11/20/2019] [Accepted: 11/21/2019] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To establish the predictive utility of specific social support domains for emotional well-being in cancer caregivers, six months after their partner's cancer diagnosis. BACKGROUND In cancer caregivers, social support has been consistently related to anxiety and depression. There is little information, however, about the predictive utility of specific social support domains for psychological well-being in the first six months after a partner's cancer diagnosis. DESIGN Longitudinal research study. METHODS Sixty-seven caregivers of recently diagnosed cancer patients were recruited from the Reina Sofia University Hospital in Cordoba (Spain). Participants completed a set of questionnaires including the Berlin Social Support Scale (BSSS), the Hospital Anxiety and Depression Scale (HADS) and a socio-demographic questionnaire. Data were collected at two time points: T1 (30-45 days after diagnosis) and T2 (180-200 days after). TRIPOD checklist was used. RESULTS Most of the caregivers were female (65%) and the partner of the patient (58%), with an average age of 51.63 years (SD = 13.25). Statistical differences were observed between the two assessment points for the social support domains of perceived emotional support, satisfaction with support and protective buffering. Logistic regression analysis showed that less physical and sports activity, more support seeking and less informational support received at T1 predicted anxiety at T2, while less perceived available support predicted depression. CONCLUSIONS Accurate information and support from other members of the community and the promotion of physical and sports routines for cancer caregivers may help to alleviate symptoms of anxiety and depression in the first months after a partner's cancer diagnosis. RELEVANCE TO CLINICAL PRACTICE Clinicians must pay attention to the social support needs and physical activity of caregivers in the first days after diagnosis, in order to prevent anxiety and depression.
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Affiliation(s)
- Francisco García-Torres
- Department of Psychology, University of Cordoba, Cordoba, Spain / IMIBIC Health Research Institute / Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - Marcin Jacek Jabłoński
- Institute of Psychology, Faculty of Philosophy, Jesuit University Ignatianum in Krakow, Poland
| | | | - Juan Antonio Moriana
- Department of Psychology, University of Cordoba, Cordoba, Spain / IMIBIC Health Research Institute / Reina Sofía University Hospital of Cordoba, Cordoba, Spain
| | - Maria José Jaén-Moreno
- IMIBIC Health Research Institute / Department of Social Health Sciences, Radiology and Physical Medicine/ University of Córdoba, Córdoba, Spain
| | - Maria José Moreno-Díaz
- Department of Social Health Sciences, Radiology and Physical Medicine / University of Córdoba, Córdoba, Spain
| | - Enrique Aranda
- Medical Oncology Department, Reina Sofía University Hospital, Córdoba, Spain
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Zoladl M, Afroughi S, Nooryan K, Kharamin S, Haghgoo A, Parandvar Y. Applying Collaborative Care Model on Intensive Caregiver Burden and Resilient Family Caregivers of Patients with Mental Disorders: A Randomized Controlled Trial. Iran J Psychiatry 2020; 15:17-26. [PMID: 32377211 PMCID: PMC7193235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective: Psychological education for families in the form of a model is one of the effective approaches in managing problems caused by mental health problems. The present study aimed to determine the effect of using the participatory care model on the caregiver burden and resilience of home caregivers of patients with mental disorders. Method : In this clinical trial, 66 households with psychiatric patients hospitalized at Shahid Rajaee Psychiatric Hospital in Yasuj during 2014-2015 were selected and assigned into 2 groups of experimental and intervention based on convenience and simple random sampling. The data of this study were gathered by Novak & Guest (1989) Caregiver burden and Sixbey (2005) Resilience Questionnaire before and after intervention. Participatory care model was performed for 12 ninety-minute sessions in the intervention group. No intervention was provided to the control group during the study period. SPSS software (version 21) was used to run the descriptive and inferential statistics. Results: Chi-squared test showed that the caregiver burden was significantly lower in the experimental group than in the control group after the intervention (P = 0.0001). Following the intervention, increased resilience and all its components were observed in the experimental group compared to the control group. According to the independent t test and Mann-Whitney U, the 2 groups were considerably different (P < 0.05). Conclusion: The application of the participatory care model efficiently increased resilience and decreased the intensity of the caregiver burden on the home caregivers of patients suffering from mental disorders.
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Affiliation(s)
- Mohammad Zoladl
- School of Nursing and Midwifery, Yasuj University of Medical Sciences, Yasouj, Iran
| | - Solaiman Afroughi
- Department of Biostatistics and Epidemiology, School of Health and Social Determinants of Health Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Khairollah Nooryan
- School of Nursing and Midwifery, Yasuj University of Medical Sciences, Yasouj, Iran
| | - Shirali Kharamin
- Department of Psychology, School of Medicine, Yasouj University of Medical Sciences, Yasuj, Iran
| | - Amin Haghgoo
- School of Nursing and Midwifery, Yasuj University of Medical Sciences, Yasouj, Iran.,Corresponding Author: Address: Yasuj University of Medical Sciences, Martyr Dr. Jalil, Yasuj, Iran. Postal Code:7951994799. Tel: +98-07633235140, Fax: +98-07633235140,
| | - Yaghoub Parandvar
- School of Nursing and Midwifery, Yasuj University of Medical Sciences, Yasouj, Iran
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Burke T, Wilson O'Raghallaigh J, Maguire S, Galvin M, Heverin M, Hardiman O, Pender N. Group interventions for amyotrophic lateral sclerosis caregivers in Ireland: a randomised controlled trial protocol. BMJ Open 2019; 9:e030684. [PMID: 31542756 PMCID: PMC6756338 DOI: 10.1136/bmjopen-2019-030684] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Amyotrophic lateral sclerosis (ALS) is a rapid and fatal motor disease marked by progressive physical impairment due to muscle weakness and wasting. It is multidimensional with many patients presenting with cognitive and/or behavioural impairment. Caregivers of patients with ALS, commonly non-paid immediate family members, often take primary responsibility for the complex care needs of patients in non-medicalised setting, and many as a consequence experience caregiver burden, anxiety, and/or depression. METHODS AND ANALYSIS This randomised controlled trial (RCT) will use randomisation to allocate n=75 caregivers of patients with ALS from the national ALS clinic into three groups with an equal distribution. The RCT consists of two intervention groups and a wait list control (treatment as usual [TAU]) group. The intervention arms of the trial consist of a 'mindfulness-based stress reduction' and 'building better caregivers' manualised group-based intervention, with 9 and 6 weekly sessions, respectively. The TAU group will have access to intervention at the end of the trial period. Primary outcomes are self-report questionnaires on anxiety and depression symptoms, with caregiver burden and quality of life considered secondary outcomes. Assessment will commence at baseline, immediately following the intervention period, and after a period of 12 weeks to assess the effectiveness and efficacy of participating in an intervention. Patient cognitive and behavioural data will also be considered. Means of treatment and control groups at Time 0 and 1 will be analysed using mixed model multivariate analysis of variance followed by analysis of variance, and treatment effect-sizes will be calculated. This RCT protocol is pre-results and has been registered with an international database resulting in an International Standard Randomised Controlled Trials Number (ISRCTN53226941). ETHICS AND DISSEMINATION Ethics approval was obtained from the Beaumont Hospital Medical Research Ethics Committee. Results of the main trial will be submitted for publication in a peer-reviewed journal.
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Affiliation(s)
- Tom Burke
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland
| | | | - Sinead Maguire
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Miriam Galvin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland
| | - Mark Heverin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland
- Department of Neurology, Beaumont Hospital, Dublin, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, University of Dublin Trinity College, Dublin, Ireland
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Abstract
There is growing recognition that caring for a patient with schizophrenia often results in high levels of perceived burden and poorer overall mental health for caregivers. A quantitative cross-sectional design and standardized instruments were used to collect data from 355 primary caregivers of adults in outpatient care with schizophrenia in China. Structural equation modeling was used to examine the association between caregiver burden and mental health among primary caregivers and whether this association is influenced by personality, coping style, and family functioning, based on a diathesis-stress perspective. Goodness-of-fit indices (χ2 /df = 1.406, GFI = 0.919, CFI = 0.957, etc.) confirmed that the modified model fit the data well. In line with the diathesis-stress model, and with this study's hypotheses, we found that caregiver burden was significantly related to mental health outcomes directly. The final model showed that personality traits, coping style, and family function influenced the relationship between caregiver burden and mental health. The neuroticism personality traits have a direct effect on caregiver burden and family functioning in this sample. Coping style had a direct effect on the caregiver burden, and family functioning had a direct effect on the caregiver burden. Our final model about primary caregivers can be applied clinically to predict mental health outcomes from caregiver burden.
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Affiliation(s)
- Wenjun Yu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, GuangZhou, China
- College of Education, JingGangShan University, Ji'An, China
| | - Jia Chen
- Education Center of Master of Social Work, JingGangShan University, Ji'An, China
| | - Jize Hu
- College of Psychology and Sociology, ShenZhen University, ShenZhen, China
| | - JingChu Hu
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, GuangZhou, China
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25
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Park MH, Smith SC, Hendriks AAJ, Black N. Caregiver burden and quality of life two years after attendance at a memory clinic. Int J Geriatr Psychiatry 2018. [PMID: 30556183 DOI: 10.1002/gps.5053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 12/09/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES We aimed to describe 1) the burden and HRQL of informal caregivers of new patients attending a memory assessment service (MAS), 2) changes in these outcomes over two years and 3) satisfaction with services. METHODS Informal caregivers of patients attending one of 73 MASs throughout England completed questionnaires at the patient's first appointment, and 6 and 12 months later. Participants from 30 of these MASs were also followed up at 24 months. Questionnaires covered caregivers' sociodemographic characteristics, Zarit Burden Interview, EQ-5D-3L and satisfaction with services. We used multivariable linear regression to assess relationships between burden, HRQL and caregiver and patient characteristics. RESULTS Of 1020 caregivers at baseline, 569 were followed up at 6 months, 452 at 12 months and 187 at 24 months. There was a small increase in caregiver burden over two years (effect size 0.30 SD). These changes were not associated with most caregiver or patient characteristics, except socioeconomic deprivation which was associated with larger increases in burden at two years. Caregivers' HRQL was weakly associated with burden and showed a small reduction over time (0.2 SD). Most caregivers were satisfied with services but caregivers who were not satisfied with the services they received reported greater increases in burden. CONCLUSIONS Increases in caregiver burden and reductions in HRQL appear to be small over the first two years after attending a MAS. However, the longer-term impact on caregivers and those they care for needs investigating, as do strategies to reduce their burden.
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Affiliation(s)
- Min Hae Park
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Sarah C Smith
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - A A Jolijn Hendriks
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Nick Black
- Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
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Shukla R, Thakur E, Bradford A, Hou JK. Caregiver Burden in Adults With Inflammatory Bowel Disease. Clin Gastroenterol Hepatol 2018; 16:7-15. [PMID: 28529169 DOI: 10.1016/j.cgh.2017.05.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/01/2017] [Accepted: 05/09/2017] [Indexed: 02/07/2023]
Abstract
Inflammatory bowel disease (IBD) is a chronic condition that has a relapsing and remitting disease course. There is high degree of inpatient and outpatient health care utilization by IBD patients along with a great deal of psychosocial stress associated with the condition. Patients frequently rely on family, friends, and other informal caregivers to provide medical, instrumental, and emotional support. The role of caregiving for adult IBD patients can lead to significant caregiver burden. At present, there are limited data on the existence of caregiver burden in adult IBD patients. Moreover, there are no specific measures for evaluating caregiver burden and there are no interventions targeting caregiver burden in adults with IBD. This review outlines the limited available data on caregiver burden in IBD, explores caregiver burden in other chronic conditions, and proposes applications of these data for creating screening and assessment tools and interventions for caregiver burden in IBD.
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Affiliation(s)
- Richa Shukla
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
| | - Elyse Thakur
- Menninger Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Houston VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; VA South Central Mental Illness Research, Education and Clinical Center, Houston, Texas
| | - Andrea Bradford
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Menninger Department of Psychiatry and Behavioral Sciences, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas
| | - Jason K Hou
- Section of Gastroenterology and Hepatology, Department of Medicine, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas; Houston VA Health Services Research & Development Center of Excellence, Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, Texas.
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Pilon MH, Poulin S, Fortin MP, Houde M, Verret L, Bouchard RW, Laforce R. Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study. Neurology (ECronicon) 2016; 2:278-286. [PMID: 27747317 PMCID: PMC5065347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Few studies have explored the rate of cognitive decline and caregiver burden within the context of a specialized memory clinic. When this was done, the focus was largely on functional decline related to Alzheimer's disease (AD). Our goal was to compare the longitudinal decline of AD patients to those with Vascular Dementia (VaD) on Mini-Mental State Examination (MMSE). We further explored the differential impact on caregiver burden. We retrospectively studied 237 charts from patients seen at our Memory Clinic between 2006 and 2012. The data was collected over 17 years. Cohorts were formed by excluding conditions other than AD and VaD, and including patients who had been assessed at least twice with the MMSE (AD: n = 83; mean age: 67.7 yo; VaD: n = 32; mean age: 73.3yo). A small group of 36 caregivers was surveyed by phone to explore caregiver burden. Results indicated that the natural history of MMSE changes in AD patients differed significantly from that of patients with VaD (F = 10.41, p<0.0014), with AD patients showing more cognitive decline over time. Sadness, stress/anxiety, fatigue, and sleep disorders were reported as the main preoccupations by caregivers and its impact was rated as 'severe' in 50% of cases. Altogether, this study provides further insight into the natural history of cognitive decline in AD and VaD. Future studies should explore the progression of dementing disorders in larger cohorts using prospective methodological designs.
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Affiliation(s)
| | - Stéphane Poulin
- Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
| | - Marie-Pierre Fortin
- Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
| | - Michèle Houde
- Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
| | - Louis Verret
- Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
| | - Rémi W Bouchard
- Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
| | - Robert Laforce
- Faculté de médecine, Université Laval, Canada; Clinique Interdisciplinaire de Mémoire, Département. des sciences neurologiques, CHU de Québec, Canada
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Mashayekhi F, Pilevarzadeh M, Rafati F. THE ASSESSMENT OF CAREGIVER BURDEN IN CAREGIVERS OF HEMODIALYSIS PATIENTS. Mater Sociomed 2015; 27:333-6. [PMID: 26622201 PMCID: PMC4639350 DOI: 10.5455/msm.2015.27.333-336] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 09/15/2015] [Indexed: 11/26/2022] Open
Abstract
Background: Chronic renal failure is among the chronic disease which due to persistence of the disease and long treatment process has various effects on the physiological, psychological, functional ability, lifestyle changes, and independence status of the patient and his family. This may result in the burden feeling in caregivers. According to the importance of the subject, this study is to assess the level of caregiver burden in caregivers of hemodialysis patients. Methods: This is a cross-sectional analytical descriptive study that was conducted in 2014 on the caregivers of hemodialysis patients. Research instruments were consisted of two parts: demographic data check list and caregiver burden questionnaire. Data were analyzed by SPSS statistical software and Pearson correlation coefficient tests. A p value of less than 0.05 was considered statistically significant. Results: In this study, 72.5% of caregivers reported moderate to severe levels of caregiver burden. A significant relationship was observed between gender of the patient with caregiver burden score of (p=0.031) and type of the income with caregiver burden score of (p=0.000). Caregivers of male patients and patients with inadequate income had a higher caregiver burden score. Conclusions: Our results showed that more than half of the caregivers of hemodialysis patients had moderate to severe levels of caregiver burden, therefore it is worthy that health officials and nurses pay special attention to this issue by communicating with these patients and their caregivers.
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Abstract
BACKGROUND Dementia is an irreversible illness. The caregiver is expected to assume increased responsibility as the condition of the person with dementia declines. It is important to explore the factors constituting caregiver burden on the informal caregivers of people with dementia. AIMS The purpose of this article is to identify the factors constituting caregiver burden on the informal caregivers of people with dementia living in the community. METHODS A systematic review of the four databases, including PubMed, PsycINFO, CINAHL and the Cochrane Library, was carried out to access relevant articles published between 2003 and 2012. Twenty-one articles met the inclusion criteria of this study. RESULTS Behavioural problems or psychological symptoms were the primary factor of the person with dementia that is associated with caregiver burden. Caregiver socio-demographical factors and psychological factors were the two primary factors of the caregiver burden. LIMITATIONS Several results of this study were based on studies that had their own limitations. Furthermore, the concept of caregiver 'burden' was not clearly defined in some of the studies; instead, the term was broadly defined. CONCLUSION Factors of caregiver burden in regard to people with dementia living in the community were clarified in this review study. By identifying all of the factors, healthcare professionals can deliver appropriate assistance to relieve caregiver burden and improve the quality of caregiving for people with dementia. IMPLICATIONS FOR NURSING AND HEALTH POLICY It is important to identify the factors of the burden on the caregivers of people with dementia living in the community to prevent early nursing home placement, deterioration of caregiver's health and reduce the adverse health outcomes for care recipients. A health-related policy should be formulated to help informal caregivers receive more professional assistance. Training opportunities should be provided for family caregivers to reduce the impact of caregiving on the delivery of effective care.
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Affiliation(s)
- C-Y Chiao
- School of Nursing, Chung Shan Medical University, Chung Shan Medical University Hospital, Asia University, Taichung City, Taiwan
| | - H-S Wu
- School of Nursing, Asia University, Taichung City, Taiwan
| | - C-Y Hsiao
- School of Nursing, Chung Shan Medical University, Chung Shan Medical University Hospital, Asia University, Taichung City, Taiwan
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