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Shi J, Jiang C. Exploring the associations between competence in dementia care and work attitudes among formal caregivers in nursing homes. J Clin Nurs 2024. [PMID: 38590040 DOI: 10.1111/jocn.17157] [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: 12/09/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 04/10/2024]
Abstract
AIMS Based on the two-factor model of caregiving appraisals, this study aims to (1) investigate the relationships between competence in dementia care and job satisfaction (work attitudes in positive aspect) and turnover intention (work attitudes in negative aspect) among formal caregivers in nursing homes, and (2) examine the mediating roles of positive aspects of caregiving (caregiving appraisals in positive aspect) and caregiving burden (caregiving appraisals in negative aspect) in the above associations. DESIGN A cross-sectional design was used. Structural equation modelling was employed to test the proposed model. STROBE checklist guides the reporting of this study. METHODS Using the multistage cluster sampling method, 407 formal caregivers were selected from 43 nursing homes across 7 districts/counties in China. RESULTS The proposed model shows a good model fit. Competence in dementia care shows significant positive associations with increased job satisfaction and decreased turnover intention among formal caregivers in nursing homes. Caregiving burden and positive aspects of caregiving mediate the relationships between competence in dementia care and both job satisfaction and turnover intention. Furthermore, the relationship between positive aspects of caregiving and job satisfaction is stronger than that with turnover intention, but the relationship between caregiving burden and turnover intention is not stronger than that with job satisfaction. CONCLUSIONS The results demonstrate that the two-factor model of caregiving appraisals effectively elucidates the associations and underlying mechanisms between competence in dementia care and formal caregivers' work attitudes. Specifically, two crucial conclusions are drawn: (1) competence in dementia care is associated with higher levels of job satisfaction and lower levels of turnover intention among formal caregivers in nursing homes; (2) caregiving burden and positive aspects of caregiving serve as parallel mediators in these associations. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Policymakers and nursing homes managers should implement a series of measures aimed at formal caregivers in nursing home. Specifically, allocating more resources to enhance the competence in dementia care of formal caregivers is crucial, given its significant association with elevated job satisfaction and reduced turnover intention. Besides, positive and negative caregiving appraisals emerge as proximal factors influencing work attitudes of formal caregivers. Therefore, intervention projects focused on formal caregivers in nursing home should target enhancing positive experiences and alleviating caregiving burden. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution.
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Affiliation(s)
- Jiaming Shi
- School of Public Administration, Southwestern University of Finance and Economics, Chengdu, Sichuan, China
| | - Chaoxin Jiang
- School of Social Development, East China Normal University, Shanghai, China
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Kim EA, Shin SS, Lee JA. Relationship Between Acculturation and Mental Health in Korean American Family Caregivers of Community-Dwelling Persons Living with Dementia. Clin Nurs Res 2024; 33:10547738241235695. [PMID: 38409746 PMCID: PMC11067392 DOI: 10.1177/10547738241235695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Despite the growing number of Korean American (KA) family caregivers for persons with dementia, little is known about how acculturation might affect caregiving stress in this population. Acculturation is a variable of considerable interest in caregiving research due to its significance in understanding the impact of cultural perceptions and expectations on the caregiving role and its relation to mental health outcomes. A cross-sectional descriptive study using baseline data from an ongoing randomized controlled trial of dementia caregiver intervention was performed to examine the association between acculturation and mental health outcomes among KA caregivers (n = 32) for persons with dementia. Self-report survey questionnaires including a bidirectional acculturation scale, Center for Epidemiologic Studies Depression Scale, the Perceived Stress Scale, and the Zarit Burden Interview were administered in person in English or Korean by trained bilingual community health workers. The primary independent variable, acculturation, was assessed using a 24-item inventory. It measured two sets of cultural orientation: Korean orientation and American orientation. The mean age was 67 years (SD = 11.8) and 87% were women. Half of the caregivers were spouses of persons with dementia, while the other half were offspring caregivers. In the multiple linear regression model, caregiver acculturation toward Korean cultural orientation had a significant and positive association with depressive symptoms (β = .62; SE = 0.25; p-value = .02) and perceived stress (β = .29; SE = 0.13; p-value = .03) after adjusting for age and self-efficacy. No significant effect of American cultural orientation was found for caregiver burden, perceived stress, or depressive symptoms. Our findings suggest that exploring the role of acculturation in caregiving and its relation to outcomes, particularly caregiver distress, may be valuable for future studies aiming to understand specific elements of cultural values and practices in the acculturation process related to mental health outcomes among immigrant Korean American caregivers.
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Affiliation(s)
- Eunbee A. Kim
- University of California, Irvine, Sue & Bill Gross School of Nursing, Irvine, California, USA
| | - Sanghyuk S. Shin
- University of California, Irvine, Sue & Bill Gross School of Nursing, Irvine, California, USA
| | - Jung-Ah Lee
- University of California, Irvine, Sue & Bill Gross School of Nursing, Irvine, California, USA
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Martis CS, Bhandary RP, Chandrababu R, Lakshmi R V, Bhandary PV, Noronha JA, Chakrabarty J, Tolson D, Devi ES. Caring burden and quality of life among the caregivers of people living with dementia - a cross-sectional study in Udupi district of Karnataka. Home Health Care Serv Q 2024:1-14. [PMID: 38190733 DOI: 10.1080/01621424.2023.2301417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2024]
Abstract
Dementia is a chronic disorder of the brain that affects cognitive performance. The caregivers of individuals with dementia experience a greater burden that affects their Quality of Life (QoL). This cross-sectional study conducted in India was designed to assess the caring burden and QoL among the caregivers of people with dementia, as well as to ascertain the relationship between QoL scores and burden. Our sample included 80 caregivers of people with dementia. Most of the caregivers (n = 59, 73.8%) had a higher level of caregiver burden. There was a negative correlation between caregiver burden scores and QoL. A higher level of caregiver stress and low QoL were experienced by caregivers of dementia patients. In developing countries like India, counseling, and education on home health care for people with dementia should be provided to reduce the burden and enhance the QoL of caregivers.
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Affiliation(s)
- Clarita Shynal Martis
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Ramesh Chandrababu
- Department of Medical Surgical Nursing, Sri Ramachandra Faculty of Nursing, Sri Ramachandra Institute of Higher Education and Research, Porur, Chennai, India
| | - Vani Lakshmi R
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India
| | | | - Judith Angelitta Noronha
- Department of Obstetrics and gynaecological nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Jyothi Chakrabarty
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Debbie Tolson
- Alzheimer Scotland Centre for Policy and Practice, University of West of Scotland, Scotland, UK
| | - Elsa Sanatombi Devi
- Department of Medical Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
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Bielderman A, van Corven CTM, Koopmans RTCM, Leontjevas R, de Vugt ME, Bakker C, Gerritsen DL. Evaluation of the SPAN intervention for people living with young-onset dementia in the community and their family caregivers: a randomized controlled trial. Aging Ment Health 2024; 28:275-284. [PMID: 37776001 DOI: 10.1080/13607863.2023.2260335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 09/12/2023] [Indexed: 10/01/2023]
Abstract
OBJECTIVES To evaluate the effectiveness of the SPAN-intervention, a psychosocial intervention aiming at improving a sense of usefulness and engaging in meaningful activities, for community-dwelling people living with young-onset dementia (YOD) and their family caregivers. METHODS A cluster-randomized controlled trial with two parallel groups (SPAN-intervention vs. care as usual) with assessments at baseline and five-month follow-up was performed. Sixty-one persons living with YOD and their family caregivers were included (SPAN-intervention group: n = 35; care as usual group: n = 26). Outcomes included, for the person living with YOD, empowerment (operationalized by self-management abilities using the SMAS-30; primary outcome), quality of life, neuropsychiatric symptoms, disability, apathy; and, for the family caregiver, quality of life, emotional distress, sense of competence. Data were analyzed using linear mixed models. RESULTS We found no statistically significant effects of the SPAN-intervention on empowerment, nor on the secondary outcome measures for persons living with YOD or their family caregivers. CONCLUSION Although the SPAN-intervention may provide concrete opportunities to engage in activities and stimulate reciprocity, such as meaningful social activities, this study did not demonstrate intervention effects. Additional qualitative evaluations may provide more insight into the implementation process and experiences of people living with YOD and their family caregivers.This trial was registered at ClinicalTrials.gov (NCT02937883).
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Affiliation(s)
- Annemiek Bielderman
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Charlotte T M van Corven
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
| | - Raymond T C M Koopmans
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- De Waalboog 'Joachim en Anna', Center for Specialized Geriatric Care, Nijmegen, the Netherlands
| | - Ruslan Leontjevas
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Faculty of Psychology, Open University of The Netherlands, Heerlen, the Netherlands
| | - Marjolein E de Vugt
- Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht University, Maastricht, the Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Debby L Gerritsen
- Department of Primary and Community Care, Radboud University Medical Center, Radboud Institute for Health Sciences, Radboud Alzheimer Center, Nijmegen, The Netherlands
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Olavarría L, Caramelli P, Lema J, Andrade CBD, Pinto A, Azevedo LVDS, Thumala D, Vieira MCS, Rossetti AP, Generoso AB, Carmona KC, Sepúlveda-Loyola W, Pinto LAC, Barbosa MT, Slachevsky A. Impact of the Pandemic Time on the Mental Health of People with Dementia and Their Family Caregivers in Brazil and Chile: One-Year Follow-Up. J Alzheimers Dis 2024; 98:691-698. [PMID: 38427488 DOI: 10.3233/jad-231310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2024]
Abstract
Background Previous studies reported the negative impact of social isolation on mental health in people with dementia (PwD) and their caregivers, butlongitudinal studies seem scarcer. Objective To describe a one-year follow-up impact of the COVID-19 pandemic on PwD and their caregivers in both Brazil and Chile. Methods This study analyzed the impact of the pandemic on the psychological and physical health of PwD and their family caregivers after one year of follow-up in three outpatient clinics in Brazil (n = 68) and Chile (n = 61). Results In both countries, PwD reduced their functional capacity after one year of follow-up (p = 0.017 and p = 0.009; respectively) and caregivers reported worse physical and mental health (p = 0.028 and p = 0.039). Only in Chile, caregivers reported more sadness associated with care (p = 0.001), and reduced time sleeping (p = 0.07). Conclusions In conclusion, the COVID-19 pandemic appears to have had a long-lasting impact on PwD and their caregivers. However, it is essential to acknowledge that the inherent progression of dementia itself may also influence changes observed over a year.
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Affiliation(s)
- Loreto Olavarría
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Universidad de Chile, Santiago, Chile
- Psychiatry Department, Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibanez, Santiago, Chile
| | - Paulo Caramelli
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - José Lema
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
| | - Caíssa Bezerra de Andrade
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alejandra Pinto
- Neurology Department, Memory and Neuropsychiatric Center (CMYN), Memory Unit, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
| | - Lílian Viana Dos Santos Azevedo
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Daniela Thumala
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Department of Psychology, Faculty of Social Sciences, University of Chile, Santiago, Chile
| | | | | | | | - Karoline Carvalho Carmona
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ludmilla Aparecida Cardoso Pinto
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maira Tonidandel Barbosa
- Faculdade de Medicina, Behavioral and Cognitive Neurology Research Group, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Faculdade Ciências Médicas de Minas Gerais, Geriatric Medicine, Belo Horizonte, Brazil
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism (GERO), Santiago, Chile
- Physiopathology Department - Institute of Biomedical Sciences (ICBM), Neuroscience and East Neuroscience Departments, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Universidad de Chile, Santiago, Chile
- Neurology Department, Memory and Neuropsychiatric Center (CMYN), Memory Unit, Hospital del Salvador and Faculty of Medicine, Universidad de Chile, Santiago, Chile
- Departamento de Medicina, Servicio de Neurología, Clínica Alemana-Universidad del Desarrollo, Santiago, Chile
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Cremer S, de Man-van Ginkel JM, Zwakhalen SMG, Willems J, Metzelthin SF, Veenstra MY, Bleijlevens MHC. The struggle is real-A mixed qualitative methods synthesis of challenges in nursing care in activities of daily living. J Nurs Scholarsh 2023; 55:1092-1105. [PMID: 37278376 DOI: 10.1111/jnu.12921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Supporting care receivers in Activities of Daily Living (ADL), irrespective of diagnosis, setting, or cultural background, lies at the heart of fundamental nursing care. The pursuit of quality ADL care becomes increasingly challenging with the changing complexity of care needs. ADL care delivery is often undervalued and is considered a low-status task despite its crucial importance to care receivers. This study aims to synthesize challenges in ADL care irrespective of the care setting. METHODS In the mixed qualitative methods study, we used expert panel consultations, world café sessions, and a rapid literature review. For data analysis, we simultaneously analyzed the three data sets using inductive and deductive inquiry. RESULTS We identified four challenges and their corresponding subthemes. They are (1) Undervalued common-sense work versus complex, high-skilled care provision; (2) Limitations in professional reflective clinical decision-making; (3) Missed opportunities for shared ADL decisions; and (4) Meeting ADL care needs in a high-throughput system. CONCLUSION These challenges reveal the complexity of ADL care and how its paradoxical narrative relates to the conditions in which nursing professionals struggle to create opportunities, for reflective clinical reasoning and shared ADL decisions, by facing organizational and environmental barriers. CLINICAL RELEVANCE This study is relevant to nursing professionals, care organizations, policymakers, and researchers aiming to improve ADL care and provide insights into challenges in ADL care. This study forms the starting point for a changing narrative on ADL nursing care and subsequent quality improvements in the form of, for example, guidelines for nursing professionals.
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Affiliation(s)
- Svenja Cremer
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Janneke M de Man-van Ginkel
- Department of Gerontology and Geriatrics, Nursing Science, Leiden University Medical Centre, Leiden, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jules Willems
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Silke F Metzelthin
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Marja Y Veenstra
- Department of Psychiatry & Neuropsychology, Alzheimer Center Limburg
- School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
- Burgerkracht Limburg, Sittard, The Netherlands
| | - Michel H C Bleijlevens
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
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Moon HE, Rote SM, Sears J, Schepens Niemiec SL. Racial Differences in the Dementia Caregiving Experience During the COVID-19 Pandemic: Findings From the National Health and Aging Trends Study (NHATS). J Gerontol B Psychol Sci Soc Sci 2022; 77:e203-e215. [PMID: 35869747 PMCID: PMC9384524 DOI: 10.1093/geronb/gbac098] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Given racial disparities in both dementia and coronavirus disease 2019 (COVID-19), non-Hispanic Black (Black) dementia caregivers (CGs) may be at greater risk for care burden during the COVID-19 pandemic than non-Hispanic White (White) CGs. This study investigates the impact of dementia care provision on CGs' quality of life by race using the 2020 National Health and Aging Trends Study Family Members and Friends COVID-19 data (FF). METHODS This study features a secondary analysis of FF data (2020-2021), including 216 Black and 1,204 White CGs. We used ANOVA to determine differences in caregiving stressors (i.e., changes in providing help with activities of daily living [ADL], instrumental ADL [IADL], and emotional support). Ordinary least square regression was used to investigate the moderating effects of dementia care on the associations of race with perceived well-being, care burden, and self-reported health and to conduct subgroups analyses of Black and White dementia CGs. RESULTS Black dementia CGs provided significantly more help with ADL before and during the COVID-19 pandemic than Black nondementia, White dementia, and White nondementia CGs. Dementia care status did not moderate the associations between race and CG outcomes. For Black dementia CGs, changes in objective stressors (assistance with ADL and IADL) were associated with care burden and well-being. For White CGs, the provision of emotional support was associated with care burden and well-being. DISCUSSION This study highlights that increased caregiving demands during the pandemic amplified racial differences in CG stress. Findings suggest that outreach to reduce CG stress and burden is critical for Black dementia CGs.
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Affiliation(s)
- Heehyul E Moon
- Kent School of Social Work & Family Science, University of Louisville, Kentucky, USA
| | - Sunshine M Rote
- Kent School of Social Work & Family Science, University of Louisville, Kentucky, USA
| | - Jeanelle Sears
- Department of Human Services, Bowling Green State University, Ohio, USA
| | - Stacey L Schepens Niemiec
- Chan Division of Occupational Science and Occupational Therapy, University of Southern California, California, USA
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Xu L, Chen Z, Zhang AY. Impact of older adults' oral health on caregiving stress of their family caregivers in the United States: The mediating effect of functional ability. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e5470-e5481. [PMID: 35950685 DOI: 10.1111/hsc.13971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 05/09/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
Extensive studies have explored the factors affecting caregiving stress, but how oral health of care recipients (CRs) associates with caregiving stress and the mechanism behind it are not well-known. Guided by Stress Process Theory, this study addressed such research gaps. Caregiver services dataset came from the 13th National Survey of Older Americans Act Participants in the United States (N = 1289). Caregiving stress included physical, emotional, and financial stress. The oral health of CRs was self-rated by a single item. The functional ability of CRs was assessed by activities of daily living (ADLs) and instrumental activities of daily living (IADLs). PROCESS 3.4 for SPSS 26.0 was used to conduct the mediation analyses. Results from the study showed that caregivers reported slightly high levels of physical (M = 3.06, SD = 1.33, Range = 1-5), emotional (M = 3.43, SD = 1.28, Range = 1-5), and financial (M = 2.83, SD = 1.43, Range = 1-5) stress. The results from hierarchical linear regression revealed that poor oral health of CRs was significantly associated with higher levels of physical (B = 0.11, p < 0.001), emotional (B = 0.09, p < 0.01), and financial (B = 0.12, p < 0.001) stress, respectively. The functional ability of CRs mediated such relationships between the oral health of CRs and the caregiving stress of their family caregivers. Findings from this study enrich our theoretical and practical understanding of caregiving stress in aged care and offer programs and policy implications of oral and physical healthcare for community-dwelling older adults.
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Affiliation(s)
- Ling Xu
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Zhirui Chen
- School of Social Work, University of Texas at Arlington, Arlington, Texas, USA
| | - Anna Yan Zhang
- Postdoctoral Fellow, Faculty of Social Sciences, the University of Hong Kong, Hong Kong, China
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9
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Relations of neuropsychiatric symptoms with disease stage, sex, and daily function in mild cognitive impairment and dementia due to Alzheimer's disease: A cross-sectional study. J Psychosom Res 2022; 161:110994. [PMID: 35939891 DOI: 10.1016/j.jpsychores.2022.110994] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 07/18/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To reveal the relations between neuropsychiatric symptoms (NPS), stages of cognitive impairment, sex, and daily function in patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease (AD). METHODS A cross-sectional study was conducted from 2014 to 2021 on 1154 patients. Cognitive function, disease severity, NPS, and daily function were evaluated by Mini-mental State Examination, Clinical Dementia Rating Scale, Neuropsychiatric Inventory, and Activities of Daily Living (ADL) respectively. Multivariate logistic regression and linear regression were used to explore the correlations between NPS, disease stage, sex and ADL. RESULTS Affective disturbance displayed the highest prevalence from MCI (52.7%) to severe dementia due to AD (98.2%). Multivariate logistic regression revealed that aberrant motor behavior displayed higher prevalence between groups from MCI to severe dementia due to AD (OR = 4.710, P < 0.001; OR = 3.141, P < 0.001; OR = 2.722, P = 0.002, respectively). In patients with dementia due to AD, hallucination and depression were more prevalent in female (OR = 1.730, P = 0.001; OR = 2.376, P < 0.001, respectively) while male presented higher prevalence in apathy (OR = 0.608, P = 0.002). Linear regression analysis showed that delusion and sleep disturbance were significantly associated with basic ADL across all dementia due to AD stages (delusion: mild: β = 0.113, P = 0.015; moderate: β = 0.159, P = 0.019; severe: β = 0.317, P = 0.018; sleep disturbance: mild: β = 0.164, P < 0.001; moderate: β = 0.167, P = 0.013; severe: β = 0.308, P = 0.025) while anxiety was correlated with instrumental ADL from MCI to moderate dementia due to AD (MCI: β = 0.119, P = 0.006; mild: β = 0.149, P < 0.001; moderate: β = 0.130, P = 0.042). CONCLUSION Different subitems of NPS are strongly correlated with sex, stage of cognitive impairment, and ADL.
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Hackett K, Giovannetti T. Capturing Cognitive Aging in Vivo: Application of a Neuropsychological Framework for Emerging Digital Tools. JMIR Aging 2022; 5:e38130. [PMID: 36069747 PMCID: PMC9494215 DOI: 10.2196/38130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/19/2022] [Accepted: 07/31/2022] [Indexed: 11/13/2022] Open
Abstract
As the global burden of dementia continues to plague our healthcare systems, efficient, objective, and sensitive tools to detect neurodegenerative disease and capture meaningful changes in everyday cognition are increasingly needed. Emerging digital tools present a promising option to address many drawbacks of current approaches, with contexts of use that include early detection, risk stratification, prognosis, and outcome measurement. However, conceptual models to guide hypotheses and interpretation of results from digital tools are lacking and are needed to sort and organize the large amount of continuous data from a variety of sensors. In this viewpoint, we propose a neuropsychological framework for use alongside a key emerging approach—digital phenotyping. The Variability in Everyday Behavior (VIBE) model is rooted in established trends from the neuropsychology, neurology, rehabilitation psychology, cognitive neuroscience, and computer science literature and links patterns of intraindividual variability, cognitive abilities, and everyday functioning across clinical stages from healthy to dementia. Based on the VIBE model, we present testable hypotheses to guide the design and interpretation of digital phenotyping studies that capture everyday cognition in vivo. We conclude with methodological considerations and future directions regarding the application of the digital phenotyping approach to improve the efficiency, accessibility, accuracy, and ecological validity of cognitive assessment in older adults.
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Affiliation(s)
- Katherine Hackett
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, United States
| | - Tania Giovannetti
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, United States
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11
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Turró-Garriga O, Viñas-Díez V, Zacarias-Pons L, Conde-Sala JL, Garre-Olmo J. Longitudinal effect of dementia carers' sense of coherence on burden. Int J Geriatr Psychiatry 2022; 37. [PMID: 35932155 DOI: 10.1002/gps.5784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 07/11/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND A sense of coherence (SOC) could help us better understand why there are individuals who cope better than others in similar situations. The study aimed to assess the effect of SOC on the course of burden reports in relatives of persons with dementia. METHODS This was a prospective cohort study of 156 dementia carers. The SOC was assessed by the Orientation to Life Questionnaire (OLQ-13), burden by Burden Interview, and personal and contextual characteristics were collected via ad hoc questions. The main dementia symptoms, including functional difficulties (Disability Assessment for Dementia), neuropsychiatric symptoms (Neuropsychiatric Inventory), and cognitive impairment (Mini-Mental State Examination), were also assessed. A general linear model was adjusted to determine the effect of SOC and other covariates on burden throughout the follow-up. Burden differences between baseline and 12 and 24 months were analysed, and the baseline OLQ-13 score was grouped by quartiles. RESULTS The global burden reported increased after 24 months (F = 9.98; df = 2; p < 0.001), but not equally for all carers; daughters reported the greatest increase. SOC, functional disability, and neuropsychiatric disorders showed a significant effect on burden, but time did not. Carers with higher SOC at baseline tend to remain with lower burden levels, whereas carers with low SOC reported higher burden at each visit. CONCLUSIONS This study reports evidence of the effect of SOC on burden at baseline, 12 and 24 months of follow-up. Burden scores differ by carers' SOC; those with higher SOC showed lower burden levels, whereas the low-SOC group reported a greater burden at each visit.
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Affiliation(s)
- Oriol Turró-Garriga
- Research Institute, Fundació Salut Empordà, Figueres, Catalonia
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
- Registry of Dementia of Girona (ReDeGi), Institut d'Assistència Sanitària, Salt, Catalonia
| | - Vanesa Viñas-Díez
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
| | - Lluís Zacarias-Pons
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
| | - Josep-Lluís Conde-Sala
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
- Faculty of Psychology, University of Barcelona, Barcelona, Catalonia
| | - Josep Garre-Olmo
- Aging, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGI], Salt, Catalonia
- Registry of Dementia of Girona (ReDeGi), Institut d'Assistència Sanitària, Salt, Catalonia
- Serra Hunter Fellow, Department of Nursing, University of Girona, Girona, Catalonia
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12
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Hsu WC, Huang NC, Li DC, Hu SC. The long-term effects of dual caregiving on the caregivers' well-being among middle-aged and older adults in Taiwan. Aging Ment Health 2022:1-8. [PMID: 35585725 DOI: 10.1080/13607863.2022.2076205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES As life expectancy is prolonged, older people may face increased burdens related to supporting multi-generational family members. This study is aimed toward examining the effects of such an emerging type of informal care on the well-being of caregivers. METHODS Participants aged 50 and over from the Taiwan Longitudinal Study on Aging (1996-2007, n = 4,217) were analyzed. We categorized caregiving status according to different care recipients: 1) older adults only, 2) grandchildren only, 3) both older adults and grandchildren (dual caregiving), and 4) non-caregivers. Well-being was measured based on depressive symptoms and degree of life satisfaction. Generalized Estimation Equation models were used to examine the association between types of caregiving and the caregivers' state of well-being. RESULTS After adjusting for all covariates, caregivers of older adults had significantly more depressive symptoms and less life satisfaction than non-caregivers, especially when caregiving for adults with ADL problems. In contrast, caregivers of grandchildren were not significantly affect either depression or life satisfaction as compared with non-caregivers. Interestingly, caregiving for both older adults and grandchildren had no significant effect on depression but positively affected the degree of life satisfaction. CONCLUSION Our findings highlight that simultaneously taking care of both older adults and grandchildren can buffer negative feelings in caregivers or even improve their mental health.
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Affiliation(s)
- Wan-Chen Hsu
- Department of Public Health, College of Medicine, National Cheng Kung, Tainan, Taiwan
| | - Nuan-Ching Huang
- Healthy City Research Center, Innovation Headquarters, National Cheng Kung, Tainan, Taiwan
| | - Der-Chiang Li
- Department of Industrial and Information Management, National Cheng Kung, Tainan, Taiwan
| | - Susan C Hu
- Department of Public Health, College of Medicine, National Cheng Kung, Tainan, Taiwan.,Healthy City Research Center, Innovation Headquarters, National Cheng Kung, Tainan, Taiwan
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13
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Cantu PA, Aranda MP. Neuropsychiatric symptoms and caregiver relationship quality for older Mexican Americans. Aging Ment Health 2022; 27:896-903. [PMID: 35266850 PMCID: PMC9463394 DOI: 10.1080/13607863.2022.2048358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES Caregivers play a key role in supporting older Mexican Americans, who are less likely to enter nursing facilities than other racial/ethnic groups in the US. However, there is little research on how Neuropsychiatric symptoms (NPS) affect relationship quality between caregivers and care recipients. METHOD Using data from the 2015 wave of the Hispanic Established Populations for Epidemiologic Studies of the Elderly (H-EPESE) (n = 416) study of older (age 85+) Mexican Americans, we examined relationship quality and NPS with ordered logistic regression. Relationship quality was measured using positive (enjoyment, appreciation) and negative (nerves, argue) assessments. NPS were categorized into hyperactivity, affective, and psychosis symptoms. RESULTS Hyperactivity symptoms were associated with appreciation, arguing, and nerves. Psychosis symptoms were associated with arguing and nerves. Spousal caregivers were more likely to report arguing and nerves and less likely to report feeling appreciated. Enjoyment assessments were not associated with NPS. CONCLUSION Relationship quality is related to behavioral changes in late life. Mexican American caregivers negatively evaluate their relationships, not in response to care tasks per se, but when the older person exhibits behavioral problems. The relationship between NPS and negative relationship assessments may be due to unanticipated behavior changes in late life and stigma around psychiatric symptomatology.
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Affiliation(s)
- Phillip A. Cantu
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - María P. Aranda
- Suzanne Dworak-Peck School of Social Work, Edward R. Roybal Institute on Aging, University of Southern California, Los Angeles, CA, USA
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14
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Muslemani S, Gagnon C, Gallais B. Instrumental activities of daily living in adults with the DM1 childhood phenotype: going beyond motor impairments. Neuromuscul Disord 2022; 32:313-320. [DOI: 10.1016/j.nmd.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 02/05/2022] [Accepted: 02/09/2022] [Indexed: 10/19/2022]
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15
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Calderón-Rubio E, Oltra-Cucarella J, Bonete-López B, Iñesta C, Sitges-Maciá E. Regression-Based Normative Data for Independent and Cognitively Active Spanish Older Adults: Free and Cued Selective Reminding Test, Rey-Osterrieth Complex Figure Test and Judgement of Line Orientation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:12977. [PMID: 34948588 PMCID: PMC8701853 DOI: 10.3390/ijerph182412977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/02/2021] [Accepted: 12/07/2021] [Indexed: 11/21/2022]
Abstract
The aim of this work was to develop normative data for neuropsychological tests for the assessment of independent and cognitively active Spanish older adults over 55 years of age. METHODS regression-based normative data were calculated from a sample of 103 nondepressed independent community-dwelling adults aged 55 or older (66% women). The raw data for the Free and Cued Selective Reminding Test (FCSRT), the Rey-Osterrieth Complex Figure Test (ROCF) and the Judgement of Line Orientation Test (JLO) were regressed on age, sex and education. The model predicting the FCSRT delayed-recall (FCSRT-Del) scores also included the FCSRT immediate-recall (FCSRT-Imm) scores. The model predicting the ROCF immediate-recall (ROCF-Imm) scores included the ROCF copy-trial (ROCF-C) scores, and the model predicting the ROCF delayed-recall (ROCF-Del) scores included both the ROCF-C and the ROCF-Imm scores. In order to identify low scores, z-scores were used to determine the discrepancy between the observed and the predicted scores. The base rates of the low scores for both the SABIEX normative data and the published normative data obtained from the general population were compared. RESULTS the effects of the different sociodemographic variables (age, sex and education) varied throughout the neuropsychological measures. Despite finding similar proportions of low scores between the normative data sets, the agreement was irrelevant or only fair-to-good. CONCLUSIONS the normative data obtained from the general population might not be sensitive enough to identify low scores in cognitively active older adults, incorrectly classifying them as cognitively normal compared to the less active population.
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Affiliation(s)
- Eva Calderón-Rubio
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
| | - Javier Oltra-Cucarella
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Beatriz Bonete-López
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
| | - Clara Iñesta
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
| | - Esther Sitges-Maciá
- SABIEX, Universidad Miguel Hernández de Elche, Avda. de la Universidad, 03207 Elche, Spain; (E.C.-R.); (B.B.-L.); (C.I.); (E.S.-M.)
- Department of Health Psychology, Miguel Hernández University of Elche, 03202 Elche, Spain
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16
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Li J, Gao G, Zeng Y, Wu Y, Zhu X, Xu H. Perceived social support in Chinese family caregivers of patients with dementia. Int J Nurs Pract 2021; 28:e12945. [PMID: 33870622 DOI: 10.1111/ijn.12945] [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: 01/06/2020] [Revised: 03/01/2021] [Accepted: 03/20/2021] [Indexed: 11/30/2022]
Abstract
AIM This study aimed to describe levels of social support and explore the factors predictive of social support for Chinese family caregivers of patients with dementia. BACKGROUND Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented, which need to be further clarified to provide a basis for creating effective social support strategies. METHODS This was a cross-sectional study with 91 participants who completed a demographic questionnaire and the Social Support Rating Scale from 2015 to 2016. RESULTS Chinese family caregivers of patients with dementia received moderate social support. Caregivers' subjective support domain scores and support utilization domain scores were significantly lower than those of the normal Chinese population, whereas caregivers' total social support scores were higher than those of the normal Chinese population. Family caregivers' monthly household income, educational level and place of residence were predictors of their own social support. CONCLUSION Social support in Chinese caregivers of patients with dementia needs to be improved, especially the subjective support and support utilization. Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. SUMMARY STATEMENT What is already known about this topic? Social support is important for family caregivers of patients with dementia. Social support levels and their predictive factors in Chinese dementia caregivers have not been well documented. What this paper adds? Caregivers' subjective support and support utilization were significantly lower than the normal Chinese population; caregivers' total social support was significantly higher than the normal Chinese population. The best predictors of caregivers' social support were the monthly household income, educational level and place of residence of the caregivers. The implications of this paper: Healthcare professionals should pay special attention to caregivers with a lower monthly household income and educational level and caregivers who lived in the suburban area. Future research is needed to create effective nursing regimes, paying attention to caregivers with a lower educational level and caregivers who lived in the suburban area.
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Affiliation(s)
- Jufang Li
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Gexin Gao
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yawei Zeng
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Yuping Wu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Xiaoling Zhu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
| | - Hongbo Xu
- School of Nursing, Wenzhou Medical University, Wenzhou, Wenzhou, China
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17
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Burch K, Burch BD. Activities of Daily Living Performance in Persons With Dementia: Comparing Care Partners' and Clinicians' Appraisal and Associated Factors. Alzheimer Dis Assoc Disord 2021; 35:153-159. [PMID: 33230012 DOI: 10.1097/wad.0000000000000424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/25/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Persons living with dementia require assistance in making day-to-day and health care decisions. Health care professionals select treatments based on the care partner (CP) report of the person's function; however, the accuracy of CPs' appraisal has received limited exploration. METHODS Retrospective analyses of observational, programmatic data were performed across 161 dyads (CPs and persons with dementia) participating in an evidence-based, community-level dementia intervention program. We examined the differences in the appraisal of activities of daily living performance by CPs versus occupational therapists specialized in dementia treatment and investigated factors related to this discrepancy. RESULTS The discrepancy in the assessment of function is common between CPs and clinicians. CPs tend to overestimate the abilities of persons with dementia. Appraisal discrepancy was most strongly associated with (1) sex of the person with dementia, (2) timing of assessment performance, (3) number of behavioral symptoms of the person with dementia, and (4) cognitive abilities of the person with dementia. DISCUSSION Many factors influence the ability of CPs to appraise the function of persons with dementia. The inaccurate appraisal could result in insufficient daily assistance for, or even unnecessary health care utilization, of the person with dementia. Timeliness of intervention is crucial as their health status may change quickly.
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Affiliation(s)
- Kari Burch
- Memory Care Home Solutions, St. Louis, MO
| | - Brent D Burch
- Department of Mathematics & Statistics, Northern Arizona University, Flagstaff, AZ
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18
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Rodríguez-González AM, Rodríguez-Míguez E, Claveria A. Determinants of caregiving burden among informal caregivers of adult care recipients with chronic illness. J Clin Nurs 2021; 30:1335-1346. [PMID: 33528913 DOI: 10.1111/jocn.15683] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 12/26/2020] [Accepted: 01/22/2021] [Indexed: 01/05/2023]
Abstract
AIMS AND OBJECTIVES This study examined the predictors of caregiver burden based on patient and caregiver characteristics in a sample of Spanish caregivers looking after adult patients with chronic disease. The effect of task type and patient-caregiver interaction is also analysed. BACKGROUND Specific predictors of caregiver burden have been widely examined in the literature. Few studies, however, jointly analyse a wide range of factors, including the effect of task type and patient-caregiver interaction. DESIGN Correlational study. METHODS One hundred and thirty five informal caregivers for 148 care recipients were recruited from primary health care centres. The caregivers responded to the short version of the Zarit Burden Interview (ZBI), the DEPendency index-6 Dimensions (DEP-6D), and reported how long they spent on caregiving on a daily basis. Sociodemographic and health characteristics were also recorded. Linear and logistic regression models were used to evaluate factors associated with ZBI scores and the likelihood of being severely burdened, respectively. This research complies with STROBE guidelines for observational studies. RESULTS Severe burden was present in 62% of the caregivers. Regression analysis shows that burden severity increases significantly with the level of dependence when the latter is measured either by DEP-6D or by time spent on basic activities. Care related to incontinence and mobility has the greatest effect on burden, which is aggravated when the patient has behavioural problems. Poor caregiver health or not being retired also contributes to burden levels. CONCLUSIONS These results establish that caregiver burden is related to characteristics of both the caregiver and the care recipient as well as to their interaction. RELEVANCE TO CLINICAL PRACTICE The findings indicate that the socio-sanitary attention focused on reducing caregiver burden must address the caregiver and patient as a dyad. Identifying the dependence level and the patient's aggressive behaviour can be a good predictor of caregiver burden.
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Affiliation(s)
- Ana-María Rodríguez-González
- University of Vigo, Vigo, Spain.,Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Cantabrian Health Service, Primary Care, Puente San Miguel, Spain
| | - Eva Rodríguez-Míguez
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Department of Applied Economics, University of Vigo, Vigo, Spain.,Group of Research in Empirical Economics (GRiEE, ECOBAS), Vigo, Spain
| | - Ana Claveria
- Instituto de Investigación Sanitaria Galicia Sur, Vigo, Spain.,Quality and Research Unit, EOXI Vigo, Galician Health Service, Vigo, Spain
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19
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Amato C, Burridge G, Basic D, Huynh D, Gibbons E, Ní Chróinín D, Liu KPY. Assistance provided in daily tasks and difficulty experienced by caregivers for people living with dementia. Aust Occup Ther J 2021; 68:236-245. [PMID: 33533025 DOI: 10.1111/1440-1630.12720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/05/2021] [Accepted: 01/10/2021] [Indexed: 12/31/2022]
Abstract
INTRODUCTION There is a growing body of research that addresses caregivers for people living with dementia. However, there is limited research looking at the perceptions of caregivers in specific daily tasks. To address this gap, this study investigated the assistance caregivers provided and the difficulty they faced when completing daily tasks for people with dementia and, additionally, how these experiences might relate to their perceived burden. METHODS Sixty-two caregivers for people living with dementia completed the study. Data were collected, through a survey, on the level of assistance caregivers provided, and the difficulties they experienced. The Zarit Burden Scale was used to measure the level of perceived burden. Descriptive statistics and Spearman's correlation coefficient were used to report the results and the relationship between the perceived burden, the level of assistance provided, and the difficulty experienced. RESULTS The activities of daily living that caregivers provided the most assistance for was dressing and showering. Most instrumental activities of daily living required maximal to total assistance. Overall, the caregivers did not experience a high level of difficulty with assisting with these daily tasks in comparison to the level of assistance provided. The caregiver burden was associated significantly with the difficulties experienced in dressing, toileting, and showering (rho = 0.30-0.75), most instrumental activities of daily living (rho = 0.29-0.47), but not with the level of assistance provided. CONCLUSION Caregivers are assisting in many daily tasks. Their level of difficulty is relatively low in comparison to the level of assistance they provide. Significant correlations were found between the difficulties experienced and the burden scale. There is a need for occupational therapists to address the specific daily tasks and the concerns experienced by caregivers and to provide them with adequate support to improve the quality of care for people with dementia.
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Affiliation(s)
- Carmen Amato
- Liverpool Hospital, South Western Sydney Local Health District, NSW, Australia
| | - Gemma Burridge
- Liverpool Hospital, South Western Sydney Local Health District, NSW, Australia
| | - David Basic
- Liverpool Hospital, South Western Sydney Local Health District, NSW, Australia
| | - Danielle Huynh
- School of Health Sciences, Translational Health Research Institute, Western Sydney University, NSW, Australia
| | - Emma Gibbons
- School of Health Sciences, Translational Health Research Institute, Western Sydney University, NSW, Australia
| | | | - Karen P Y Liu
- School of Health Sciences, Translational Health Research Institute, Western Sydney University, NSW, Australia
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20
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Caregiving intensity and caregiver burden among caregivers of people with dementia: The moderating roles of social support. Arch Gerontol Geriatr 2021; 94:104334. [PMID: 33516077 DOI: 10.1016/j.archger.2020.104334] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 12/03/2020] [Accepted: 12/27/2020] [Indexed: 12/25/2022]
Abstract
Using the Pearlin stress process model, the present study aimed to test if there was an association between caregiving intensity and caregiver burden, to analyze what type of association existed, and to test if different indicators of social support moderated such association among caregivers of people with dementia. Data from the baseline assessment of the Resources for Enhancing Alzheimer's Caregiver Health (REACH II) (N = 637) were used. Caregiver burden (12-item Zarit caregiver burden scale), caregiving intensity (caregiving hours), and social support (Lubben social network, received support, satisfaction with support, and negative interactions) were the main measurements. Separate multivariate regression models were conducted with Stata 16. The results showed that the relationship between caregiving hours and caregiver burden was a nonlinear inversed U shape after controlling all of the socio-demographic variables. Further analyses showed that when caregiving hours reached 14 hours per day, the levels of burden were the highest. In addition, received support, satisfaction with support, and social network significantly buffered the relationship between caregiving hours and caregiver burden when they were examined separately. However, only social network played a significant buffering role when examining the four social support indicators simultaneously. These findings suggest the need for programs and practices that emphasize the importance of identifying, gaining, and strengthening positive aspect of social support, especially in how to broaden a caregiver's social network while caring for a family member with dementia.
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21
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Shaw CA, Williams KN, Perkhounkova Y, Hein M, Coleman CK. Effects of a Video-based Intervention on Caregiver Confidence for Managing Dementia Care Challenges: Findings from the FamTechCare Clinical Trial. Clin Gerontol 2020; 43:508-517. [PMID: 32072866 PMCID: PMC7434650 DOI: 10.1080/07317115.2020.1729917] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVES The Supporting Family Caregivers with Technology trial tested the FamTechCare video support intervention against telephone support. Dementia caregivers' video-recorded challenging care encounters and an interdisciplinary team provided tailored feedback. This paper reports on the effects of the intervention on caregiver confidence in managing priority challenges, a secondary outcome of this non-blinded parallel randomized controlled trial. METHODS Caregiver/person living with dementia dyads were randomized to the experimental FamTechCare video support (n = 43) or attention control telephone support (n = 41) groups. Caregivers providing in-home care to a person living with mild or more severe dementia were eligible. Caregivers identified three priority challenges using the Caregiver Target Problems Questionnaire and rated the frequency and severity of each challenge and their confidence managing the challenge at baseline and 3-months. Challenges were classified using the FamTechCare Technology-supported Dementia Care Typology. Effects on confidence were compared between groups using the Wilcoxon rank-sum test and within groups using the Wilcoxon signed-rank test. RESULTS Caregiver priority challenges included managing dementia behaviors, understanding disease expectations, and performing activity of daily living care. Improvements were observed across the three categories in both groups; however, not all changes were statistically significant. No significant differences were identified between groups. CONCLUSION Caregivers in the FamTechCare group reported benefit across all priority challenges including managing dementia behaviors, understanding disease expectations, and performing activity of daily living care. CLINICAL IMPLICATIONS Innovative technology provides new opportunities to support family caregivers in dementia home care. Video-recording can be used to enhance support for family caregivers facing care challenges.
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Affiliation(s)
- Clarissa A Shaw
- College of Nursing, University of Iowa , Iowa City, Iowa, USA
| | | | | | - Maria Hein
- College of Nursing, University of Iowa , Iowa City, Iowa, USA
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22
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Kurauchi G, Endo M, Odaira K, Ono R, Koseki A, Goto M, Sato Y, Kon S, Watanabe N, Sugawara N, Kimura E, Takada H. Caregiver Burden and Related Factors Among Caregivers of Patients with Myotonic Dystrophy Type 1. J Neuromuscul Dis 2020; 6:527-536. [PMID: 31640106 DOI: 10.3233/jnd-190386] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Multi-systemic symptoms of varying severity in myotonic dystrophy type 1 (DM1) may pose difficulties in caregiving. However, the factors which affect their care burden are yet to be sufficiently understood. OBJECTIVE We investigated care burden and its correlates among caregivers of patients with DM1. METHODS General demographic information was obtained from patients with DM1, as well as Barthel index (ADL), body mass index, and genetic information. Patients completed SF-36v2 (health-related quality of life), CES-D (depressive symptoms), and ESS (daytime sleepiness) questionnaires. Caregivers reported their perception of patient's status through these questionnaires, and completed Zarit Caregiver Burden Interview (ZBI). Correlation analysis of these variables were performed, and regression analysis was utilized to assess the relationship between caregiver burden and other variables. RESULTS Forty-three patient-caregiver dyads participated. Mean ZBI score was 20.7±17.4, and 32.6% reported a significant care burden. ZBI correlated with caregiver-reported CES-D, but not with patient-reported CES-D. Both patient-reported and caregiver-reported physical QoL of patients correlated with patient ADL. Multiple regression analysis revealed that the combination of caregiver-reported CES-D, caregiver-reported mental QoL, and genetic characteristics predicted caregiver burden. CONCLUSIONS Caregiver burden was felt although patients were relatively well-functioning. Patients' and caregivers' assessment of patients' physical condition were similar. However, they did not agree on the evaluation of the patients' psychological state. Cognitive characteristic of the patients and the caregivers' perception of the patients' state may have affected the results. Future DM1 care strategies need to work on improvement of patient-caregiver communication and provide support for the caregiver's psychological health.
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Affiliation(s)
- Go Kurauchi
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Makiko Endo
- Clinical Research Unit, National Center Hospital, National Center of Neurology and Psychiatry, Ogawahigashi-cho, Kodaira, Tokyo, Japan
| | - Kaori Odaira
- Regional Medical Liaison Office, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Ryohei Ono
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Atsushi Koseki
- Section for Development and Disability Training, National Hospital Organization, Hanamaki Hospital, Suwa, Hanamaki, Iwate, Japan
| | - Momoko Goto
- Section for Development and Disability Training, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Yumi Sato
- Department of Rehabilitation, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Seiko Kon
- Department of Neurology, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
| | - Norio Watanabe
- School of Public Health, Graduate School of Medicine, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, Japan
| | - Norio Sugawara
- Department of Psychiatry, Dokkyo Medical University, Kitakobayashi, Mibu-machi, Shimotsuga-gun, Tochigi, Japan
| | - En Kimura
- Department of Clinical Research Support, Translational Medical Center, National Center of Neurology and Psychiatry, Ogawahigashi-cho, Kodaira, Tokyo, Japan
| | - Hiroto Takada
- Department of Neurology, National Hospital Organization, Aomori Hospital, Megasawa-Hirano, Namioka, Aomori, Japan
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Yi Y, Ding L, Wen H, Wu J, Makimoto K, Liao X. Is Barthel Index Suitable for Assessing Activities of Daily Living in Patients With Dementia? Front Psychiatry 2020; 11:282. [PMID: 32457659 PMCID: PMC7225343 DOI: 10.3389/fpsyt.2020.00282] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/23/2020] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVES To evaluate application of the Barthel Index (BI) in assessing basic activities of daily living (ADL) of patients with dementia using Rasch analysis. DESIGN A multi-country cross-sectional study. SETTING AND PARTICIPANTS Nineteen long-term care facilities located in China, Japan, South Korea, and Thailand. A total of 644 patients with dementia were included. METHODS Unidimensionality, global and item fit, local dependence, person-item targeting, threshold disordering, and differential item functioning (DIF) were examined. Negative correlations between scores for DIF items and Neuropsychiatric Inventory Nursing Home version (NPI-NH) were evaluated. RESULTS Item reliability (1.0) and person reliability (.88) were acceptable. The Rasch dimension explained 72.9% of the variance (Eigenvalue = 27), while the first contrast explained 6.6% (Eigenvalue = 2.4). The "mobility" was misfitting to the Rasch model (infit mean square = 1.86). The overall difficulty of the BI exceeded patients' ability (person location = -2.27 logits). The "stairs climbing" and "mobility" showed narrow category thresholds (< 1.4 logits). The location of "controlling bladder" and "toilet use" overlapped. Removing "stairs climbing", collapsing categories with narrow threshold widths in "mobility", and combining "controlling bowel" and "controlling bladder" into one item, improved unidimensionality, and item fit of the scale. Only three items ("grooming", "dressing", and "toilet use") were free from DIF across countries. The scores for "feeding" were negatively related to scores for "disinhibition" (r = -0.46, P < 0.01), and scores for "controlling bowel" were negatively related to scores for "disinhibition" (r = -0.44, P < 0.01), "agitation" (r = -0.32, P < 0.05), and "aggression" (r = -0.27, P < 0.01) in Japanese samples. CONCLUSIONS AND IMPLICATIONS The performance of the BI for assessing patients with dementia might be compromised by misfit items, person-item mistargeting, measurement gaps, redundant items, narrow threshold width, and item bias. Mobility ability might not be helpful for determining capability of basic ADL in the patients. Comparisons of BI scores between countries should be undertaken with caution due to item bias. Neuropsychiatric symptoms might interact with basic ADL abilities of the patients. We will not suggest using the instrument in patients with dementia, without future refining to improve its performance.
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Affiliation(s)
- Yayan Yi
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Lin Ding
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Huangliang Wen
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jialan Wu
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Kiyoko Makimoto
- Department of Nursing, School of Nursing and Rehabilitation, Konan Women's University, Kobe, Japan
| | - Xiaoyan Liao
- Department of Nursing, Zengcheng Branch, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Snyder SA, Vitaliano PP. Caregiver Psychological Distress: Longitudinal Relationships With Physical Activity and Diet. Am J Alzheimers Dis Other Demen 2020; 35:1533317520904554. [PMID: 32066252 PMCID: PMC10624019 DOI: 10.1177/1533317520904554] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Given limited longitudinal research with caregivers (CGs, n = 122) of spouses with Alzheimer disease, and demographically matched noncaregivers (NCGs, n = 117), we compared these groups on psychological distress (anxiety, depression), burden, and health behaviors over 2 years. Analyses examined group differences in relationships of micronutrient recommended daily allowances (RDAs) and physical activity considering hours of care, psychological distress, and burden. Participants were measured and assessed on whether they met micronutrient intake and physical activity totaled over an average week. Regression analyses showed a total effect whereby NCGs had greater increases in meeting micronutrient allowances (RDAs) than CGs (b = 10.91, standard error [SE] = 4.74, 95% confidence interval [CI]: 1.56-20.26). Additionally, over time, NCGs had greater increases in physical activity, which was mediated by hours of care (b = 0.149, SE = 0.060, 95% CI: 0.034-0.270). These results suggest CGs may lack proper nutrients, and care hours may influence their health behaviors.
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Affiliation(s)
- Shane A. Snyder
- Department of Psychology, The University of Texas at Arlington, Arlington, TX, USA
| | - Peter P. Vitaliano
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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25
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Saffari M, Chen H. Mediating effect of spiritual coping strategies on caregiving burden and mental health in caregivers of Iranian patients with dementia. SOCIAL HEALTH AND BEHAVIOR 2019. [DOI: 10.4103/shb.shb_39_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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