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Risch AK, Mund M, Wilz G. The Caregiver Thoughts Scale: An Instrument to Assess Functional and Dysfunctional Thoughts about Caregiving. Clin Gerontol 2022:1-14. [PMID: 36528807 DOI: 10.1080/07317115.2022.2153775] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Caregivers' care-related thoughts critically effect their well-being. Currently, there is a lack of validated measures to systematically assess caregivers' functional and dysfunctional thoughts. We therefore aimed to develop a measure of caregivers' thoughts that assesses not only their dysfunctional but also their functional thoughts in multiple domains. METHODS A pool of potential questionnaire items was generated from therapy sessions with caregivers and was rated by experts. A sample of 322 main family caregivers (Mage = 63.9 years) of a person with dementia then completed a set of 28 items about their care-related thoughts and a number of related measures at three measurement points. Items were then aggregated via a formative measurement approach based on theoretical considerations. Correlational analyses were used to examine the construct validity of the subscale scores. RESULTS The final 28-item scale assesses caregiving thoughts in four distinct domains: dysfunctional caregiving standards, self-care, dysfunctional assumptions about dementia, and acceptance. The correlational analyses demonstrated the subscales' construct validity, by showing that scale scores are meaningfully related to theoretically relevant constructs. CONCLUSIONS The Caregiving Thoughts Scale is a promising measure of caregivers' thoughts in four important domains. CLINICAL IMPLICATIONS The scale can be applied in clinical research settings.
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Affiliation(s)
- Anne Katrin Risch
- Institute of Psychology, Department of Counseling and Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
| | - Marcus Mund
- Institute of Psychology, Department of Personality Psychology and Psychological Assessment, University of Klagenfurt, Klagenfurt, Austria
| | - Gabriele Wilz
- Institute of Psychology, Department of Counseling and Clinical Psychology, Friedrich Schiller University Jena, Jena, Germany
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Lynch A, Raziano V, Feehan K, Thompson E, Massey P, Turchi R. Unmet Needs of Male Caregivers of Children and Youth with Special Health Care Needs. Matern Child Health J 2021; 25:1992-2001. [PMID: 34652597 DOI: 10.1007/s10995-021-03248-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2021] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The caregiving experiences and unique health needs of male caregivers of children and youth with special health care needs (CYSHCN) are not well described. This study seeks to understand potential unmet health needs and attitudes toward supportive resources from the perspective of a sample of male caregivers of CYSHCN. METHODS This mixed-methods study recruited a convenience sample of 30 men with CYSHCN who receive care for a chronic medical condition from primary care medical homes in Pennsylvania. We conducted semi-structured interviews (SSI), administered quantitative surveys to caregivers, and produced a thematic analysis. The SSI explored the health needs of male caregivers, assessed attitudes toward and preferences regarding supportive resources, and garnered their advice to other caregivers regarding parenting and health care system navigation. RESULTS Participants' median age is 41 years (IQR: 33, 44), and most (80%) reside full time with their CYSHCN. Most male caregivers deprioritized their own emotional, mental, and physical health needs to support the needs of their families. Many male caregivers articulated interest in seeking emotionally supportive resources (not time-intensive). They advised other male caregivers to remain involved in the medical care and wellbeing of their CYSCHN and to openly seek and receive emotional support despite the daily challenges they face. CONCLUSIONS FOR PRACTICE Male caregivers of CYSHCN experience intense daily stress and express the need for emotionally supportive resources. Programs designed to facilitate such support may benefit from flexible formats (time and location) and involve male caregivers of CYSHCN as both facilitators and participants.
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Wiegelmann H, Wolf-Ostermann K, Brannath W, Arzideh F, Dreyer J, Thyrian R, Schirra-Weirich L, Verhaert L. Sociodemographic aspects and health care-related outcomes: a latent class analysis of informal dementia care dyads. BMC Health Serv Res 2021; 21:727. [PMID: 34301241 PMCID: PMC8299572 DOI: 10.1186/s12913-021-06708-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 10/26/2020] [Accepted: 06/28/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Studies revealed the importance to assess dementia care dyads, composed of persons with dementia and their primary informal caregivers, in a differentiated way and to tailor support services to particular living and care circumstances. Therefore, this study aims first to identify classes of dementia care dyads that differ according to sociodemographic, care-related and dementia-specific characteristics and second, to compare these classes with regard to healthcare-related outcomes. METHODS We used data from the cross-sectional German DemNet-D study (n = 551) and conducted a latent class analysis to investigate different classes of dementia care dyads. In addition, we compared these classes with regard to the use of health care services, caregiver burden (BIZA-D), general health of the informal caregiver (EQ-VAS) as well as quality of life (QoL-AD) and social participation (SACA) of the person with dementia. Furthermore, we compared the stability of the home-based care arrangements. RESULTS Six different classes of dementia care dyads were identified, based on best Bayesian Information Criterion (BIC), significant likelihood ratio test (p < 0.001), high entropy (0.87) and substantive interpretability. Classes were labelled as "adult child parent relationship & younger informal caregiver", "adult child parent relationship & middle aged informal caregiver", "non family relationship & younger informal caregiver", "couple & male informal caregiver of older age", "couple & female informal caregiver of older age", "couple & younger informal caregiver". The classes showed significant differences regarding health care service use. Caregiver burden, quality of life of the person with dementia and stability of the care arrangement differed also significantly between the classes. CONCLUSION Based on a latent class analysis this study indicates differences between classes of informal dementia care dyads. The findings may give direction for better tailoring of support services to particular circumstances to improve healthcare-related outcomes of persons with dementia and informal caregivers.
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Affiliation(s)
- Henrik Wiegelmann
- grid.7704.40000 0001 2297 4381Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
| | - Karin Wolf-Ostermann
- grid.7704.40000 0001 2297 4381Institute for Public Health and Nursing Research, Health Sciences Bremen, University of Bremen, Grazer Straße 4, 28359 Bremen, Germany
| | - Werner Brannath
- grid.7704.40000 0001 2297 4381Competence Centre for Clinical Trials, University of Bremen and Clinic Bremen-Mitte, Bremen, Germany
| | - Farhad Arzideh
- grid.7704.40000 0001 2297 4381Competence Centre for Clinical Trials, University of Bremen and Clinic Bremen-Mitte, Bremen, Germany
| | - Jan Dreyer
- grid.424247.30000 0004 0438 0426German Centre for Neurodegenerative Diseases (DZNE), Site Witten, Germany
| | - Rene Thyrian
- grid.424247.30000 0004 0438 0426German Centre for Neurodegenerative Diseases (DZNE), Site Witten, Germany
| | - Liane Schirra-Weirich
- grid.466086.a0000 0001 1010 8830Department of Social Services, Centre for Participation Research, Catholic University of Applied Sciences of North Rhine-Westphalia, Cologne, Germany
| | - Lisa Verhaert
- grid.466086.a0000 0001 1010 8830Department of Social Services, Centre for Participation Research, Catholic University of Applied Sciences of North Rhine-Westphalia, Cologne, Germany
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Klein OA, Boekholt M, Afrin D, Dornquast C, Dreier-Wolfgramm A, Keller A, Michalowsky B, Zwingmann I, Teipel S, Thyrian JR, Kilimann I, Hoffmann W. Effectiveness of a digitally supported care management programme to reduce unmet needs of family caregivers of people with dementia: study protocol for a cluster randomised controlled trial (GAIN). Trials 2021; 22:401. [PMID: 34134744 PMCID: PMC8206900 DOI: 10.1186/s13063-021-05290-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 11/24/2020] [Accepted: 04/23/2021] [Indexed: 11/28/2022] Open
Abstract
Background Up to two-thirds of dementia care is provided by family caregivers who often experience high burden, little support and adverse health outcomes. Enabling and supporting family caregivers to provide care at home prevents early institutionalisation of the person with dementia and alleviates the economic burden of dementia in the long term. General practitioners (GPs), as the first point of contact, have a key role in identifying and managing burden and care needs of family caregivers. However, in routine care, this opportunity is often limited by time constraints and even if caregiver needs are recognised, detailed information about regionally available support and advice on healthcare services is often lacking. Methods This is a cluster randomised, controlled trial investigating the clinical use and cost-effectiveness of a digitally supported care management programme for caregivers of people with dementia (PwD). Five hundred family caregivers will be randomised at GP offices, specialist practices and memory clinics, with about n=250 participants per arm. Participants are eligible if they are the primary family caregiver of a PwD, are at least 18 years of age and provide informed consent. Participants in the intervention group will receive an individualised care management plan, which will be carried out by qualified study nurses in collaboration with the treating GP. All participants will receive a baseline assessment and a 6-months follow-up assessment. Participants in the wait-list control group will receive usual care. Starting at the 6 months’ follow-up, the former controls will also receive an individualised management plan. Primary outcomes are the number of unmet needs (incl. the Camberwell Assessment of Need for the Elderly, CANE) and health-related quality of life (EQ-5D-5L) at 6 months. Secondary outcomes include caregiver burden (Zarit Burden Interview, ZBI), social support (Lubben Social Network Scale, LSNS), the use of medical and non-medical services (Questionnaire for the Use of Medical and Non-Medical Services, FIMA) and resource utilisation (Resource Utilisation in Dementia, RUD). The primary analysis will be based on intention-to-treat. Between- and within-group analyses and a cost-effectiveness analysis will be conducted to estimate the effect of the tablet PC-based care management programme. This trial is funded by the German Federal Joint Committee (G-BA) Innovation Fund. Discussion The findings of this trial will be useful in informing and improving current healthcare system structures and processes to support family dementia caregivers within routine care practices. Trial registration ClinicalTrials.gov NCT04037501. Registered on 30 July 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13063-021-05290-w.
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Affiliation(s)
- Olga A Klein
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Rostock, Germany.
| | - Melanie Boekholt
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Dilshad Afrin
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Christina Dornquast
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Adina Dreier-Wolfgramm
- Hamburg University of Applied Sciences (HAW), Faculty of Business and Social Sciences, Department of Nursing and Management, Hamburg, Germany
| | - Armin Keller
- Institute of Medical Psychology and Medical Sociology, Medical Faculty, University of Rostock, Rostock, Germany
| | - Bernhard Michalowsky
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany
| | - Ina Zwingmann
- European University of Applied Sciences (EU FH), Rostock, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Rostock, Germany.,Department for Psychosomatic and Psychotherapeutical Medicine, University Hospital Rostock, Rostock, Germany
| | - Jochen René Thyrian
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Rostock, Germany.,Department for Psychosomatic and Psychotherapeutical Medicine, University Hospital Rostock, Rostock, Germany
| | - Wolfgang Hoffmann
- German Center for Neurodegenerative Diseases (DZNE), site Rostock/Greifswald, Greifswald, Germany.,Institute for Community Medicine, Section Epidemiology and Community Health, University Medicine Greifswald, Greifswald, Germany
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Hoyle JN, Laditka JN, Laditka SB. Mental health risks of parents of children with developmental disabilities: A nationally representative study in the United States. Disabil Health J 2020; 14:101020. [PMID: 33187876 DOI: 10.1016/j.dhjo.2020.101020] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 05/09/2020] [Revised: 10/03/2020] [Accepted: 10/24/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Caring for a child with a developmental disability may affect parents' mental health. There are few longitudinal or nationally representative studies, none on new mental health problems. Studies have few young children, and few adult children. OBJECTIVE/HYPOTHESES We hypothesized that parents of children with developmental disability would be more likely to develop mental health problems than other parents. METHODS We used the Panel Study of Income Dynamics (PSID, 1997-2017) and its Child Development Supplements, defining developmental disability by diagnoses such as autism spectrum disorder or intellectual disability, and requiring additional evidence of lasting impairment. We linked children's and parents' data spanning 20 years, including 44,264 mental health measurements for 4024 parents of 7030 children. Discrete-time hazard analysis controlled for child and parent characteristics. RESULTS About 9.4% of children had developmental disability. Parents of children with developmental disability were more likely to develop mental health problems than other parents. The odds of developing anxiety or depression were higher when an adult child with developmental disability lived independently, nearly 3 times higher for mothers (OR 2.89, CI 2.33-3.59) and more than twice as large for fathers (OR 2.35, CI 1.70-3.26). Compared to fathers whose children did not have developmental disability and challenging behaviors, the odds of psychological distress were over 7 times larger (odds ratio, OR 7.18, 95% confidence interval, CI, 5.37-9.61) for those whose children had developmental disability and challenging behaviors. CONCLUSIONS Parents of children with developmental disability may benefit from increased emotional support, respite, and interventions addressing challenging behaviors.
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Affiliation(s)
- Jessica N Hoyle
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
| | - James N Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
| | - Sarah B Laditka
- Department of Public Health Sciences, University of North Carolina at Charlotte, 9201 University City Boulevard, Charlotte, NC, 28223, USA.
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Eaton J, Madsen-Wilkerson N. Portrait of a Caregiver: Ethnodrama Development and Its Influence on Caregiver Well-Being. Gerontologist 2020; 60:1169-1178. [PMID: 31647553 DOI: 10.1093/geront/gnz137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 06/17/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The majority of long-term care needs are placed upon family members who often receive minimal support. In this study, we collaborate with family caregivers to create an ethnodrama about their experience and assess outcomes of participation, including caregiver well-being. METHODS Participants met over 4 months to discuss their roles as informal caregivers. Discussions were analyzed in a two-phase process and themes were developed into a script. Member checks included script review and revisions, culminating in viewing a professional performance of the play followed by a post-performance discussion and reflection. Data were gathered at six timepoints to assess caregiver well-being and longitudinal analysis was used to assess change during the course of the intervention. RESULTS Twenty-two caregivers completed intervention activities. Participant reactions to the process evolved overtime, from an initial hesitance about what individuals had to offer leading to an acknowledgement of feeling heard and a desire to help others. Caregivers had high levels of burden and positive perceptions towards caregiving. Those with high levels of self-rated health had the lowest levels of burden and the most positive perceptions of caregiving. DISCUSSION AND IMPLICATIONS Developing an ethnodrama in partnership with caregivers is a unique and feasible method of caregiver support, mentoring, reflexivity, and meaning making. Promoting caregiver health early in the caregiving trajectory has the potential of reducing burden and elevating positivity towards caregiving.
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Affiliation(s)
- Jacqueline Eaton
- College of Nursing, University of Utah, Salt Lake City.,Utah Caregiver Support Program, Utah Division of Aging & Adult Services, Salt Lake City
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Kim G, Allen RS, Wang SY, Park S, Perkins EA, Parmelee P. The Relation Between Multiple Informal Caregiving Roles and Subjective Physical and Mental Health Status Among Older Adults: Do Racial/Ethnic Differences Exist? Gerontologist 2020; 59:499-508. [PMID: 29373738 DOI: 10.1093/geront/gnx196] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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: 01/18/2017] [Accepted: 11/14/2017] [Indexed: 01/21/2023] Open
Abstract
PURPOSE OF THE STUDY The present study examined whether race/ethnicity moderated the relation between type of caregiving role (none, one, or multiple care recipients) and subjective physical and mental health among older adults. DESIGN AND METHODS The sample was drawn from the 2009 California Health Interview Survey. Racially/ethnically diverse adults aged 55 and older (n = 24,241) were categorized into 3 groups by caregiving roles: noncaregivers (n = 18,626; referent), caregivers with a single caregiving role (n = 4,023), and caregivers with multiple caregiving roles (n = 1,772). A 2-way analysis of covariance was conducted to test main and interaction effects. RESULTS After adjustment for covariates, noncaregivers reported significantly worse self-rated health and lower psychological distress than caregivers with any type of role. The interaction between race/ethnicity and caregiving roles was significant only for self-rated health (p < .05). Blacks with multiple caregiving roles had poorer self-rated health than those with a single caregiving role and better self-rated health than noncaregivers, whereas other racial/ethnic groups with multiple caregiving roles had better self-rated health compared to both noncaregivers and those with a single caregiving role. Our sensitivity analysis showed that controlling caregiving-related variables present only among caregivers eliminated the differences in self-rated health between the two types of caregivers. IMPLICATIONS Findings suggest that caregivers report better self-rated health than noncaregivers and that the relation of multiple caregiving roles with self-rated health differs by race/ethnicity, with blacks differing from other racial/ethnic groups. This implies that caregivers experience gain, or are selected into the role of caregiving by virtue of having good health.
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Affiliation(s)
- Giyeon Kim
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Rebecca S Allen
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Department of Psychology, The University of Alabama, Tuscaloosa
| | - Sylvia Y Wang
- Department of Psychology, The University of Alabama, Tuscaloosa
| | - Soohyun Park
- Department of Psychology, The University of Alabama, Tuscaloosa
| | | | - Patricia Parmelee
- Alabama Research Institute on Aging, The University of Alabama, Tuscaloosa.,Department of Psychology, The University of Alabama, Tuscaloosa
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Fairfax A, Brehaut J, Colman I, Sikora L, Kazakova A, Chakraborty P, Potter BK; Canadian Inherited Metabolic Diseases Research Network. A systematic review of the association between coping strategies and quality of life among caregivers of children with chronic illness and/or disability. BMC Pediatr 2019; 19:215. [PMID: 31262261 DOI: 10.1186/s12887-019-1587-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 06/17/2019] [Indexed: 12/02/2022] Open
Abstract
Background Parents of children with chronic illness have reported decreased psychological and physical quality of life (QoL) relative to parents of children without such illness, which may be associated with the extent of complexity involved in the caregiving role. Given that coping strategies have been reported to influence QoL, our goal was to synthesize existing research about the association between coping strategies and QoL in caregivers of children with chronic illness. We were particularly interested in whether coping strategies may mediate the association between caregiving complexity and QoL, or may modify the association. Methods We developed an electronic search strategy to identify relevant citations in Medline, EMBASE, PsycINFO and CINAHL. Two reviewers independently assessed retrieved citations against pre-specified inclusion criteria in two stages of screening. One reviewer abstracted data on study characteristics, methods to address confounding, measurement tools, risk of bias, and results with respect to associations of interest. A second reviewer validated extracted data. We summarized results narratively. Results 2602 citations were screened and 185 full-text articles reviewed. The 11 articles that met inclusion criteria addressed 5 diseases and included a total of 2155 caregivers. Ten of the 11 included studies were cross-sectional. We identified some evidence that coping was associated with QoL: in three studies, coping strategies considered to be adaptive were positively associated with psychological QoL while in one study, maladaptive strategies were negatively associated with psychological QoL. Only two studies considered coping as a potential mediating variable in the association between caregiving complexity and parental QoL, with inconsistent findings and challenges in interpreting cross-sectional associations. No studies considered coping as a moderating variable. The variability among instruments used to measure key constructs, particularly coping strategies, made it difficult to synthesize results. Conclusions We found that coping strategies may be associated with psychological QoL among parents of children with chronic illness. We also identified important research gaps related to the consistent and clear measurement of coping strategies and their prospective association with QoL. Understanding how coping strategies are associated with QoL is important to inform the development of interventions to support families of children with chronic illness. Electronic supplementary material The online version of this article (10.1186/s12887-019-1587-3) contains supplementary material, which is available to authorized users.
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Hua AY, Wells JL, Haase CM, Chen KH, Rosen HJ, Miller BL, Levenson RW. Evaluating Patient Brain and Behavior Pathways to Caregiver Health in Neurodegenerative Diseases. Dement Geriatr Cogn Disord 2019; 47:42-54. [PMID: 30630168 PMCID: PMC6568322 DOI: 10.1159/000495345] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [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: 08/23/2018] [Accepted: 11/12/2018] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Caregivers of patients with neurodegenerative diseases are at heightened risk for serious health problems, but health differences between individual caregivers abound. AIMS To determine whether atrophy in patient brains could be used to identify caregivers at heightened risk for health problems and which patient variables mediate this relationship. METHODS In 162 patient-caregiver dyads, we assessed patient atrophy using structural MRI, caregiver health, and patient behavior and cognitive symptoms. RESULTS Patient atrophy in the right insula and medial frontal gyrus was associated with worse caregiver health; this relationship was partially mediated by patient neuropsychiatric symptoms, and assessing atrophy in these regions improved predictions of poor caregiver health above and beyond patient behavioral symptoms. CONCLUSIONS This study shows the value of patients' brain data in identifying caregivers at risk for becoming sick themselves.
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Affiliation(s)
- Alice Y. Hua
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Jenna L. Wells
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Claudia M. Haase
- School of Education and Social Policy, Northwestern University, Evanston, IL, USA
| | - Kuan-Hua Chen
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
| | - Howard J. Rosen
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco, CA, USA
| | - Robert W. Levenson
- Department of Psychology, University of California, Berkeley, Berkeley, CA, USA
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10
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Karg N, Graessel E, Randzio O, Pendergrass A. Dementia as a predictor of care-related quality of life in informal caregivers: a cross-sectional study to investigate differences in health-related outcomes between dementia and non-dementia caregivers. BMC Geriatr 2018; 18:189. [PMID: 30139354 PMCID: PMC6108112 DOI: 10.1186/s12877-018-0885-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 08/16/2018] [Indexed: 11/17/2022] Open
Abstract
Background The objectives of this study with a large sample of informal caregivers (CG) were a) to compare health-related outcomes of CGs caring for a patient with dementia and those caring for a relative with another chronic disease and b) to check whether dementia is a predictor of CG’s care-related quality of life (QoL) in CarerQoL-7D. Methods This cross-sectional study involved self-reported data from 386 informal CGs who applied for an initial grade or upgrade of the care level of the care recipient at the Medical Service of Compulsory Health Insurance Funds of Bavaria (Germany). By obtaining data this way, systematic biases often associated with the acquisition of CGs were prevented. Bivariate and multiple analyses were conducted using a univariate covariance model (ANCOVA). Results Bivariate analyses showed significantly higher levels of subjective burden and lower QoL in the dementia group. No significant differences were found in terms of physical health and depressiveness, though there was a tendency suggesting higher levels of depressiveness in dementia CGs. Multiple analysis explaining QoL by dementia status after controlling for CG’s sex, age and employment status revealed a significant effect of dementia, suggesting caregiving for a dementia patient was associated with lower QoL. Conclusions Results of the study suggest that caring for a relative with dementia is associated with poorer health, i.e. greater levels of subjective burden and depressiveness, and predicts lower QoL in CGs. These findings emphasize the importance of specific interventions aiming to support informal CGs of dementia patients.
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Affiliation(s)
- Nina Karg
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany.
| | - Elmar Graessel
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
| | - Ottilie Randzio
- Medical Service of Compulsory Health Insurance Funds (MDK) of Bavaria, Haidenauplatz 1, D-81667, Munich, Germany
| | - Anna Pendergrass
- Department of Psychiatry and Psychotherapy, Center for Health Service Research in Medicine, Friedrich-Alexander-University Erlangen-Nuremberg, Schwabachanlage 6, D-91054, Erlangen, Germany
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11
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Tilford JM, Payakachat N, Kuhlthau KA, Pyne JM, Kovacs E, Bellando J, Williams DK, Brouwer WB, Frye RE. Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects. J Autism Dev Disord 2015; 45:3613-23. [PMID: 26126749 DOI: 10.1007/s10803-015-2507-5] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles.
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