Information use environments of African-American dementia caregivers over the course of cognitive-behavioral therapy for depression

A systematic review and thematic synthesis on the experiences of accessing and attending psychological therapy for informal carers of people living with dementia

BACKGROUND

Informal carers of people living with dementia are at a higher risk of experiencing mental health difficulties than the general population, yet many are not able to access timely psychological support and their psychological needs are often overlooked. It is therefore important to develop a greater understanding of carers' lived experiences in accessing and attending psychological therapy, to help tailor therapies to meet their individual needs. To our knowledge, this is the first thematic synthesis of qualitative literature on carers' experiences of accessing and taking part in psychological therapies.

METHODS

Three databases were systematically searched for qualitative literature, and 23 studies were included. Their quality was assessed and the data extracted was included in the thematic synthesis.

RESULTS

Findings were organised into five overarching themes: i) Mental health and relationship difficulties (context); ii) Overall positive experiences of therapy (including specific techniques, therapist factors and therapeutic relationship, social support); iii) Common changes experienced (e.g. increased awareness of one's emotions and needs, increased self-care and self-compassion); iv) Unhelpful experiences of therapy, suggestions and further needs; and v) Impact of wider societal contexts and events.

CONCLUSIONS

Given the predominantly positive experiences of therapy and mechanisms of change described, findings suggest that psychological therapies can be helpful for carers of people living with dementia. Additionally outlined are specific techniques to tailor therapy (regardless of approach) to best meet carers' needs, and suggestions for improvement. Future research should try to understand for whom and under what circumstances (e.g. wider contexts) psychosocial interventions become most effective in this population.

Qualitative Analysis of Faith Community Nurse-Led Cognitive-Behavioral and Spiritual Counseling for Dementia Caregivers

This article presents themes emerging from semistructured interviews with dementia family caregivers in rural communities who participated in an integrative, cognitive-behavioral and spiritual counseling intervention, and with faith community nurses (FCNs) who delivered the intervention. The primary objectives of the counseling intervention were to ameliorate dementia caregivers' depressive affect and the severity of their self-identified caregiving and self-care problems. The qualitative portion of the study was intended to elicit caregivers' and FCNs' perceptions of the benefits and drawbacks of the intervention. We conducted interviews with seven FCN/caregiver pairs 4 times during the 6-month counseling process, totaling 56 interviews. Themes emerging from the interviews included caregivers' perception of burden and care partners' problem behavior; formation of therapeutic alliance between FCNs and caregivers; problem-solving skills, tools, and resources; caregivers' use of problem-solving strategies; spirituality in caregiving and counseling processes; FCNs' prior professional experience; and caregiver and FCN time constraints.

Seeking information in circles: The application of Chatman’s life in the round theory to the information small world of Catholic clergy in northern Nigeria

This study explores Chatman’s proposition of the theory of life in the round that members of a small world who live in the round will not cross the boundaries of their world to seek information. The study tests Chatman’s proposition to find out whether it is applicable to the special population of Catholic clergy. The study was conducted with Catholic clergy from northern Nigeria. Findings show that these clergy are not likely to cross boundaries of their small worlds to seek information about their ministry or private lives. They prefer to seek such information within their circle of clergy. The findings align with Chatman’s conclusion that life lived in the round has a negative influence on information seeking. This study advances the understanding of Chatman’s theory of life in the round and positions religious status as a factor that is capable of influencing the information-seeking process.