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Zhou M, Wang M, Luo D, Sun C, Bian Q, Xu J, Lin Z. The mediating role of resilience between caregiver burden and hope among patients with inflammatory bowel disease. Nurs Open 2024; 11:e70001. [PMID: 39189092 PMCID: PMC11347936 DOI: 10.1002/nop2.70001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 02/09/2024] [Accepted: 08/04/2024] [Indexed: 08/28/2024] Open
Abstract
AIM To investigate whether resilience mediates the connection between caregiver burden and hope among caregivers of patients with inflammatory bowel disease (IBD). DESIGN A cross-sectional study. METHODS Two hundred patients with IBD were conveniently sampled from two tertiary hospitals in Jiangsu Province, China. The main instruments involved the Zarit Burden Interview, the 10-item Connor-Davidson resilience scale, and the Herth Hope Index. We conducted descriptive analysis and Pearson correlations using SPSS 25.0. The PROCESS v3.3 macro analysed the mediating effect. We report the results in line with the STROBE checklist. RESULTS Caregiver burden was significantly negatively connected with hope and resilience, whereas resilience positively correlated with hope. The mediation role of resilience was significant in the relationship between caregiver burden and hope, with mediating effects accounting for 47.86% of the overall effect. CONCLUSIONS Resilience partially mediates the association between caregiver burden and hope among patients with IBD. This finding highlights the protective role of resilience in undermining caregiver burden and strengthening hope. IMPLICATIONS FOR PRACTICE In clinical practice, healthcare providers should perform routine psychological assessments for caregivers of patients with IBD. Furthermore, resilience training should be incorporated into interventions to alleviate caregiver burden and enhance hope. PATIENT OR PUBLIC CONTRIBUTION None.
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Affiliation(s)
- Meijing Zhou
- Department of Endocrinology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Mi Wang
- Blood Purification Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dan Luo
- School of Nursing, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Caiyun Sun
- Department of Gastrointestinal Surgery, Zhongshan Hospital Affiliated to Fudan University, Shanghai, China
| | - Qiugui Bian
- Department of Gastroenterology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jingjing Xu
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zheng Lin
- Department of Nursing, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- School of Nursing, Nanjing Medical University, Nanjing, Jiangsu, China
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Young D, Weaver J, Christie L, Genders M, Simpson GK. Building resilience among families supporting relatives with ABI in rural NSW: testing the feasibility of telephone delivery of Strength2Strength program. Brain Inj 2024; 38:84-98. [PMID: 38328973 DOI: 10.1080/02699052.2024.2304877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 01/09/2024] [Indexed: 02/09/2024]
Abstract
BACKGROUND Strength2Strength (S2S) is a group psychoeducational program aiming to build resilience among families supporting relatives after traumatic injury. OBJECTIVE To test the feasibility, acceptability and outcomes of teleconference delivery of a 5 hour S2S program in rural New South Wales. METHODS A mixed methods design investigated the (i) convenience of telephone-based delivery; and (ii) acceptability of the program material (purpose-designed survey and the Narrative Evaluation of Intervention Interview). Program efficacy was measured with the Resilience Scale (RS) and Connor-Davidson Resilience Scale (CD-RISC); the Positive and Negative Affect Scale (PANAS); Depression, Anxiety and Stress Scale - 21 (DASS-21); Carer Assessment of Managing Index (CAMI); and Caregiver Burden Scale (CBS). Participant outcome data were collected at baseline, post program and 3 months follow-up. RESULTS 11 participants supporting adult relatives with severe brain injury completed the program. All participants and facilitators commented positively about the cost, ease of use and quality of the teleconference facility. Statistically significant gains were found between pre-program and follow-up scores on the RS, CD-RISC, PANAS-Positive, and CAMI, with statistically significant reductions found on the DASS-21 Depression Scale and CBS scores. CONCLUSION The study provides preliminary evidence for the efficacy of telephone-based delivery of S2S to family participants.
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Affiliation(s)
- Denise Young
- Mid Western Brain Injury Rehabilitation Program, Bathurst Health Service, Bathurst, Australia
| | - Jerre Weaver
- Inpatient Mental Health Unit, Bathurst Health Service, Bathurst, Australia
| | - Lauren Christie
- Allied Health Research Unit, St Vincent's Health Network, Sydney, Australia
- Nursing Research Institute, St Vincent's Health Network, St Vincent's Hospital Melbourne and Australian Catholic University, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Michelle Genders
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Grahame K Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, University of Sydney, Sydney, Australia
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Ikin Anderson M, Gopinath B, Fiona Jones K, Morey P, Simpson GK. Testing the stability of a family resilience model at 2 and 5 years after traumatic brain injury or spinal cord injury: A longitudinal study. Ann Phys Rehabil Med 2023; 66:101734. [PMID: 37030248 DOI: 10.1016/j.rehab.2023.101734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 10/06/2022] [Accepted: 12/10/2022] [Indexed: 04/10/2023]
Abstract
BACKGROUND Recent studies have tested models of resilience and caregiver adjustment in individuals with traumatic brain injury (TBI) or spinal cord injury (SCI). Few studies have examined the role of adaptive variables over time. OBJECTIVE Conduct a longitudinal study to test a model of caregiver resilience with caregiver outcomes at 2- and 5-years post-injury. METHOD Caregivers of relatives with TBI or SCI were surveyed at 2 years (Time 1) and 5 years (Time 2) post-injury. Stability of the resilience model across the 2 time-points was tested using structural equation modeling with multi-group analysis. Measures included resilience related variables (Connor-Davidson Resilience Scale, General Self-Efficacy Scale, Herth Hope Scale, Social Support Survey) and outcome variables (Caregiver Burden Scale, General Health Questionnaire-28, Medical Outcome Study Short Form -36 [SF-36] and Positive and Negative Affect Scale). RESULTS In total, 100 caregivers were surveyed at both 2 and 5 years (TBI =77, SCI =23). Scores for resilience (Time 1, 75.9 SD 10.6; Time 2, 71.5 SD 12.6) and self-efficacy (Time 1, 32.51 SD 3.85; Time 2, 31.66 SD 4.28) showed significant minor declines, with other variables remaining stable. The resilience model for the pooled responses (Time 1+ Time 2) demonstrated a good fit (Goodness of Fit Index [GFI] = 0.971; Incremental Fit Index [IFI] = 0.986; Tucker-Lewis Index [TLI] = 0.971; Comparative Fit Index [CFI] = 0.985 and Root Mean Square Error of Approximation [RMSEA] = 0.051). Multi-group analysis then compared Time 1 to Time 2 responses and found that a variant (compared to invariant) model best fitted the data, with social support having stronger associations with mental health and positive affect at Time 2 than Time 1. Hope reduced from Time 1 to Time 2. CONCLUSIONS The model suggests that resilience-related variables can play an important role in positive caregiver adjustment over time.
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Affiliation(s)
| | - Bamini Gopinath
- Macquarie University Hearing, Macquarie University, North Ryde, NSW, Australia
| | - Kate Fiona Jones
- Institute for Ethics and Society, The University of Notre Dame, Sydney, NSW Australia; Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia
| | - Peter Morey
- School of Nursing and Health, Avondale University, Sydney, NSW, Australia
| | - Grahame Kenneth Simpson
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney, NSW, Australia
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Rasmussen MS, Howe EI, Andelic N, Soberg HL. Associations between protective resources and family functioning after traumatic brain injury: A cross-sectional study using a structural equation modeling approach. NeuroRehabilitation 2023; 52:47-58. [PMID: 36617761 PMCID: PMC9912729 DOI: 10.3233/nre-220131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/13/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND A strength-based approach in the rehabilitation after traumatic brain injury (TBI) is recommended for patients and their families. However, further exploration of the complexity of individual and family factors is needed. OBJECTIVE To explore the associations between individual protective resources in patients and family members and the overall family functioning using a strength-based approach. METHODS Secondary analysis of data collected at baseline in a randomized controlled trial. Structural equation modeling with two latent constructs and six observed variables was performed. Outcome measures included the Resilience Scale for Adults, the Mental Component Summary (SF-36), the General Self-Efficacy Scale, and the Family Adaptability and Cohesion Evaluation Scale-IV. RESULTS Hundred and twenty-two participants (60 patients, 62 family members) with a mean age of 43 years were included at a median of 11 months post-injury. The final model demonstrated a strong covariance (coefficient = 0.61) between the latent Protective construct and Family functioning. Model-fit statistics indicated an acceptable fit to the data. CONCLUSION Higher levels of protective resources (resilience, self-efficacy, and mental HRQL) were positively associated with family functioning. These resources should be further assessed in patients and their families, to identify factors that can be strengthened through TBI rehabilitation intervention.
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Affiliation(s)
- Mari S. Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I. Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Helene L. Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Met - Oslo Metropolitan University, Oslo, Norway
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Matérne M, Simpson G, Jarl G, Appelros P, Arvidsson-Lindvall M. Contribution of participation and resilience to quality of life among persons living with stroke in Sweden: a qualitative study. Int J Qual Stud Health Well-being 2022; 17:2119676. [PMID: 36062839 PMCID: PMC9467624 DOI: 10.1080/17482631.2022.2119676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Resilience contributes to positive adaptation after many health conditions, but little is known about its contribution to long-term recovery after stroke. This study investigated the lived experience of resilience and participation and their relationship to quality of life after stroke in Sweden. MATERIAL AND METHOD Semi-structured telephone interviews were conducted with 19 informants (10 male, 9 female), aged from 44-89 years and between 1 and 19 years post-stroke. Stroke severity ranged from mild (n = 8), moderate (n = 9) to severe (n = 2). Interviews were analysed using content analysis. RESULTS The analysis resulted in an overarching theme; Life with stroke has been adapted to but not accepted, built on five subthemes: 1) Adapting and adjusting life, 2) Meaningful values in life, 3) Inner resources, 4) Support and treatment from social relations, and 5) Support and treatment from external resources. CONCLUSION Participants described a tension between adapting and accepting life after stroke. Resilience was a useful framework, highlighting the contribution of inner, social and societal resources to recovery and quality of life, both directly and as enhanced through increased participation. Important factors for adaptation are meaningful values in life, individual strategies for adaptation and support from both social relationship and the society.
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Affiliation(s)
- Marie Matérne
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden
| | - Grahame Simpson
- John Walsh Centre of Rehabilitation Research, University of Sydney, Sydney, Australia
- Brain Injury Rehabilitation Research Group, Ingham Institute for Applied Medical Research, Sydney, Australia
| | - Gustav Jarl
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
- Department of Prosthetics and Orthotics, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Peter Appelros
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
| | - Mialinn Arvidsson-Lindvall
- University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden
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Guan CQ, Meng W, Morett LM, Fraundorf SH. Mapping Pitch Accents to Memory Representations in Spoken Discourse Among Chinese Learners of English: Effects of L2 Proficiency and Working Memory. Front Psychol 2022; 13:870152. [PMID: 35664143 PMCID: PMC9161639 DOI: 10.3389/fpsyg.2022.870152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/09/2022] [Indexed: 11/14/2022] Open
Abstract
We examined L2 learners' interpretation of pitch accent cues in discourse memory and how these effects vary with proficiency and working memory (WM). One hundred sixty-eight L1-Chinese participants learning L2-English listened to recorded discourses containing pairs of contrastive alternatives and then took a later recognition memory test. Their language proficiency and WM were measured through standard tests and the participants were categorized into low, medium, advanced, and high advanced language proficiency groups. We analyzed recognition memory task performance using signal detection theory to tease apart response bias (an overall tendency to affirm memory probes) from sensitivity (the ability to discern whether a specific probe statement is true). The results showed a benefit of contrastive L + H* pitch accents in rejecting probes referring to items unmentioned in a discourse, but not contrastive alternatives themselves. More proficient participants also showed more accurate memory for the discourses overall, as well as a reduced overall bias to affirm the presented statements as true. Meanwhile, that the benefit of L + H* accents in rejecting either contrast probes or unmentioned probes was modulated for people with greater working memory. Participants with higher WM were quite sure that it did not exist in the memory trace as this part of discourse wasn't mentioned. The results support a contrast-uncertainty hypothesis, in which comprehenders recall the contrast set but fail to distinguish which is the correct item. Further, these effects were influenced by proficiency and by working memory, suggesting they reflect incomplete mapping between pitch accent and discourse representation.
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Affiliation(s)
- Connie Qun Guan
- School of Foreign Studies, Beijing Language and Culture University, Beijing, China
- Department of Psychology, Carnegie Mellon University, Pittsburgh, PA, United States
| | - Wanjin Meng
- China National Institute of Education Sciences, Beijing, China
| | - Laura M. Morett
- Department of Educational Studies in Psychology, Research Methodology, and Counseling, University of Alabama, Tuscaloosa, AL, United States
| | - Scott H. Fraundorf
- Department of Psychology and Learning Research and Development Center, University of Pittsburgh, Pittsburgh, PA, United States
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Jaracz K, Grabowska-Fudala B, Kleka P, Tomczak M, Smelkowska A, Pawlicka A, Górna K. Development and Psychometric Properties of the Caregiver Burden Scale in Polish Caregivers of Stroke Patients. Psychol Res Behav Manag 2022; 15:665-675. [PMID: 35321032 PMCID: PMC8937617 DOI: 10.2147/prbm.s348972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 02/11/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose Most stroke patients require long-term care of their family members. Excessive care burden entails several negative consequences; therefore, the severity of the burden should be periodically assessed. For this purpose, valid multidimensional measures are needed. Our study, which is a part of a larger research project, aims to translate and evaluate the psychometric properties of the Polish Caregiver Burden Scale (CBS) in relation to construct validity and internal consistency in caregivers of the patients after stroke. Patients and Methods The sample of this cross-sectional observational study consisted of 366 informal caregivers to consecutive first-ever stroke survivors. The five-factor Polish CBS and the Hospital Anxiety and Depression Scale (HADS) were administered during the home visits at three to six months after patients’ hospitalisation. Exploratory (EFA), confirmatory (CFA) factor analyses and a net analysis were performed to investigate the internal structure and a factorial construct validity of the CBS. Correlation analyses between the CBS and the HADS were carried out to examine convergent validity. Cronbach’s alpha and item-total correlation were applied to assess internal consistency. Results Three out of five factors identified by EFA were similar to the original indices of the CBS, while the remaining two deviated from the original structure of the CBS. The CFA five-factor model represented an acceptable fit (confirmatory fit index, CFI = 0.96, root mean square error, RMSEA = 0.04) but only after a modification. All subscale scores of the CBS were positively correlated with the HADS, supporting the convergent validity. Cronbach’s alpha coefficients for the overall scale (0.92) and all subscales (0.72–0.87) except one (0.69) and item-total correlation results indicated good internal consistency. Conclusion The Polish version of the CBS showed acceptable internal consistency and good convergent validity. Factorial validity and structural integrity were partially supported. The interrelationships between the CBS subdomains, their partial mutual contamination, and the scale’s non-orthogonal structure should be considered when interpreting the results of further studies using this version of the scale.
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Affiliation(s)
- Krystyna Jaracz
- Department of Neurological Nursing, Poznan University of Medical Sciences, Poznań, Poland
- Correspondence: Krystyna Jaracz, Department of Neurological Nursing, Poznan University of Medical Sciences, Poznań, Poland, Tel + 48 618612267, Email
| | | | - Paweł Kleka
- Faculty of Psychology and Cognitive Sciences, Adam Mickiewicz University, Poznań, Poland
| | - Maciej Tomczak
- Department of Psychology, Poznan University of Physical Education, Poznań, Poland
| | - Anna Smelkowska
- Department of Neurological Nursing, Poznan University of Medical Sciences, Poznań, Poland
| | | | - Krystyna Górna
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznań, Poland
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