1
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Jiao YC, Chang J, Liu C, Zhou SY, Ji Y, Meng Y. Factors influencing the help-seeking behavior in patients with mild cognitive impairment: a qualitative study. BMC Health Serv Res 2023; 23:1345. [PMID: 38042819 PMCID: PMC10693691 DOI: 10.1186/s12913-023-10281-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 11/06/2023] [Indexed: 12/04/2023] Open
Abstract
BACKGROUND The early diagnosis and intervention of mild cognitive impairment (MCI) patients is expected to delay the progression of AD. Delayed treatment will lead to MCI patients missing the best intervention expectation. At present, the medical help-seeking behavior of this group is not optimistic. This study aimed to explore influencing factors of help-seeking behavior among patients with MCI in China based on the help-seeking behavior model. METHODS Twenty-two patients with MCI were recruited to participate in semi-structured interviews via purposeful sampling with a qualitative, descriptive design. Data were analyzed by qualitative content analysis. RESULTS The study revealed the main influencing factors of help-seeking behavior among MCI patients in China included perceived disease threat, symptom attribution, disease knowledge, use of cognitive compensation strategies, sense of foreseeable burden, social support, economic condition, and accessibility of medical service. CONCLUSIONS The help-seeking behavior of patients with MCI is affected by multiple factors. There are some key factors in different stages of the help-seeking process. Healthcare providers can utilize these factors to design targeted interventions for promoting early help-seeking of patients with MCI.
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Affiliation(s)
- Yu-Chen Jiao
- School of Nursing, Nanjing Medical University, Nanjing, China
- Department of Radiotherapy, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
| | - Jing Chang
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Chang Liu
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Shi-Yu Zhou
- School of Nursing, Nanjing Medical University, Nanjing, China
| | - Yan Ji
- School of Nursing, Nanjing Medical University, Nanjing, China.
| | - Yao Meng
- School of Nursing, Nanjing Medical University, Nanjing, China.
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2
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Nguyen T, Levkoff S, Nguyen H. 'He is just getting old, you know': the role of cultural and health beliefs in shaping the help-seeking process of family members caring for persons with dementia in Vietnam. ETHNICITY & HEALTH 2022; 27:1630-1651. [PMID: 33951992 DOI: 10.1080/13557858.2021.1922612] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES This study aims to examine the help-seeking process of family caregivers for persons with dementia (PWD) in Vietnam, and how health and cultural beliefs shape this process. DESIGN Twenty family caregivers of PWD at a geriatric hospital in Northern Vietnam were recruited. A total of 30 face-to-face, semi-structured interviews, including 10 follow-up interviews, were conducted. Structural coding was used first to guide data analysis through four structural codes consistent with the four stages of the help-seeking model: (1) disease and symptom experience; (2) explanatory models for symptom appraisal; (3) decision to seek help; and (4) contact with the sources of help. Then thematic coding was used for more detailed and data-driven initial codes to emerge from the data. RESULTS Cultural and health beliefs, particularly collectivist values, such as familism and filial piety, shaped each stage of Vietnamese family caregivers' help-seeking process. Caregivers experienced different PWD's symptoms and adopted a mixed explanatory model combining biomedical and folk beliefs to explain the causes of dementia. They highly valued independence, autonomy, devotion to their family, and self-sacrifice, making these values the driving force underlying their self-reliance regime in caregiving. Help-seeking was often delayed until caregivers considered the situation to be beyond their own capacity to manage independently. The family was always the primary informal source of support for caregivers, with additional help sought from friends, neighbors, and religious facilities. Health professionals, if available, were also an important formal source for medical advice. CONCLUSIONS The results highlight the importance of culture and health beliefs in shaping caregivers' help-seeking process, and advocate the needs of service development targeting not only Vietnamese family caregivers for PWD, but also caregivers sharing similar collectivist culture in different areas. Interventions and services that are consistent with their values of self-sacrifice, devotion to family, autonomy, and self-reliance are much needed.
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Affiliation(s)
- Trang Nguyen
- School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA
- University of Social Sciences and Humanities, Vietnam National University, Hanoi, Vietnam
| | - Sue Levkoff
- College of Social Work, University of South Carolina, Columbia, SC, USA
| | - Huong Nguyen
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
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3
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Stege AMR, Godinez J. Trusting in God: Religious and Spiritual Support in Mental Health Treatment Expectations in Mexico. JOURNAL OF RELIGION AND HEALTH 2022; 61:3655-3676. [PMID: 35441930 DOI: 10.1007/s10943-022-01554-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
Religious and spiritual practices have been identified as a main source of mental health support for Latinxs to improve overall health and well-being. This qualitative secondary data analysis sought to elucidate how Mexican patients and family members engaged in religious and spiritual practices to help alleviate patients' experiences of mental illness. Three main findings are discussed: (1) positive religious coping such as entrusting God with one's suffering, consejos (i.e., emotional support and advice giving), and positive social supports through religious communities; (2) negative religious coping such as harmful views of God as punishing; and (3) indigenous healing practices such as engagement with curanderos (medicine doctor) and limpias (i.e., herb-based cleanses). The authors discuss these findings in the context of tensions between culturally sanctioned healing and the perception of psychotherapeutic effectiveness reported by Mexican patients and their family members. The authors also provide future directions for incorporating patients' religious and spiritual practices into multiculturally competent treatment.
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Affiliation(s)
- Alyssa M Ramírez Stege
- University of Wisconsin-Madison, 335 Education Building, 1000 Bascom Mall, Madison, WI, 53706, USA.
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4
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Values and the experience of family care-giving: cultural values or shared family values? AGEING & SOCIETY 2022. [DOI: 10.1017/s0144686x2200006x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
The Sociocultural Stress and Coping Model focuses on the role of cultural values in shaping the stress and coping process for family care-givers of frail older adults. The literature suggested ethnic group-specific values as influences. The current study explored care-givers’ perceptions of values influencing caring to identify values not addressed in quantitative studies of cross-cultural care-giving. Seventeen family care-givers from Australian Aboriginal, Romanian-Australian, Pacific Island and white non-immigrant Australian backgrounds participated in semi-structured interviews about their care-giving experience and the role that values played in caring for a frail older adult. Thematic analysis of the interview transcripts led to identification of themes of cultural values of familism and care for frail older adults, religious values of filial piety and religious coping, love, reciprocity and responsibility/obligation. While cultural values influenced family care versus institutional care, religion was a more clearly identified source of values. Care-givers mostly shared values of love, reciprocity and responsibility/obligation rather than endorsing culture-specific values, with potential variations in expression between individualist and collectivist cultures. These findings suggest that the focus on cross-cultural differences may have missed core values shared across cultural groups and underestimated the influence of religion on care-giving values. Future research could focus on these perceptions of care-givers themselves rather than external perceptions of researchers and service providers.
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5
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Yap KH, Warren N, Allotey P, Reidpath D. Challenges for Diagnostic Clarity for Post-stroke Cognitive Impairment and Behavioural Issues in Middle-Income Countries: Case Studies From Malaysia. Front Neurol 2021; 12:628876. [PMID: 34149589 PMCID: PMC8206537 DOI: 10.3389/fneur.2021.628876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/03/2021] [Indexed: 11/29/2022] Open
Abstract
Following stroke, individuals require ongoing screening, diagnosis and monitoring for cognitive impairment. Services and policies around these vary widely between settings, and reports from many countries highlight persistent under-diagnosis of cognitive impairment in the months and years after stroke. Missed and delayed diagnosis of post-stroke cognitive impairment, including dementia, are important factors in shaping the experiences of people so affected and their family members, especially in low- and middle-income countries. Drawing upon ethnographic research conducted in Malaysia, this article draws upon three case studies to examine the continued health-seeking behaviour after the appearance of salient cognitive and behavioural symptoms that occurred after stroke. Findings highlight the challenges in getting formal diagnostic clarity for cognitive and behavioural symptoms in a rural setting within a middle-income country. No study participants sought help for memory or cognitive problems, partly due to limited lay awareness of cognitive impairment but more significantly due to health service factors. Despite their elevated risk for dementia, participants were not monitored for cognitive impairment during any follow-up care in various health facilities. Furthermore, caregivers' attempts to seek help when behavioural issues became untenable were met with multiple health system barriers. The journey was complicated by the meanings attached to the reactions towards cognitive symptoms at the community level. We suggest that strategies seek to increase the awareness of post-stroke cognitive and behavioural symptoms, and incorporate clear treatment pathways into the long-term care plans of community-dwelling stroke survivors.
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Affiliation(s)
- Kwong Hsia Yap
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia
| | - Narelle Warren
- School of Social Sciences, Monash University, Clayton, VIC, Australia
| | - Pascale Allotey
- International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
| | - Daniel Reidpath
- Health Systems and Population Studies Division, icddr, b, Dhaka, Bangladesh
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Perceived Help-Seeking Difficulty, Barriers, Delay, and Burden in Carers of People with Suspected Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062956. [PMID: 33805808 PMCID: PMC7999253 DOI: 10.3390/ijerph18062956] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/07/2021] [Accepted: 03/09/2021] [Indexed: 11/20/2022]
Abstract
Because of an often complicated and difficult-to-access care system, help-seeking for people with suspected dementia can be stressful. Difficulty in help-seeking may contribute to carer burden, in addition to other known stressors in dementia care. This study examined the relationship between perceived help-seeking difficulty and carer burden, and the barriers contributing to perceived difficulty. We interviewed 110 carers accessing a community-based dementia assessment service for suspected dementia of a family member for their perceived difficulty, delays, and barriers in help-seeking, and carers burden in terms of role strain, self-criticism, and negative emotions. Linear regression models showed that perceived help-seeking difficulty is associated with carer self-criticism, while carer role strain and negative emotions are associated with symptom severity of the person with dementia but not help-seeking difficulty. Inadequate knowledge about symptoms, service accessibility, and affordability together explained more than half of the variance in perceived help-seeking difficulty (Nagelkerke R2 = 0.56). Public awareness about symptoms, support in navigating service, and financial support may reduce perceived difficulty in help-seeking, which in turn may reduce carer self-criticism during the early course of illness.
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7
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Giannouli V, Giannoulis K. Gazing at Medusa: Alzheimer's dementia through the lenses of spirituality and religion. Health Psychol Res 2020; 8:8833. [PMID: 32529092 PMCID: PMC7270639 DOI: 10.4081/hpr.2020.8833] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 04/07/2020] [Indexed: 02/03/2023] Open
Abstract
Although religious and spiritual issues regarding Alzheimer’s Dementia (AD) were not thoroughly investigated in the past, this review presents the most recent findings that can provide some scientific evidence about the experience and clinical usage of religious and spiritual beliefs from the perspective of the diagnosed patient, the caregiver-family members, and the health professional. Majority of the papers reviewed (50 out of 51) identified a positive influence of religiousness and spirituality. Thus, this review examines through a detailed analysis the possible pathways of the influence of these perceptions in cognitive, emotional, and behavioral aspects of AD. Findings support the paramount importance of religion and spirituality in coping with the diagnosis of this specific type of dementia. Future experimental research should consider these observed benefits with caution and include them in everyday life.
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8
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Lim S, Mohaimin S, Min D, Roberts T, Sohn YJ, Wong J, Sivanesathurai R, Kwon SC, Trinh-Shevrin C. Alzheimer's Disease and its Related Dementias among Asian Americans, Native Hawaiians, and Pacific Islanders: A Scoping Review. J Alzheimers Dis 2020; 77:523-537. [PMID: 32675416 PMCID: PMC8638681 DOI: 10.3233/jad-200509] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND The Asian American, Native Hawaiian, and Pacific Islander (AANHPI) aging population is rapidly growing and the burden of Alzheimer's disease and its related dementias (ADRD) will likely mirror this demographic growth. AANHPIs face significant barriers in obtaining timely ADRD diagnosis and services; yet little is known about ADRD in this population. OBJECTIVE The study objective is to conduct a systematic review on the published literature on ADRD among AANHPIs to identify gaps and priorities to inform future research and action plans. METHODS The systematic review was conducted following the PRISMA Protocol for Systematic Reviews. Co-author (TR), an experienced Medical Librarian, searched PubMed, EMBASE, PsycINFO, Cochrane Central of Clinical Trials, Ageline, and Web of Science for peer-reviewed articles describing ADRD among AANHPIs. The search was not limited by language or publication date. Each citation was reviewed by two trained independent reviewers. Conflicts were resolved through consensus. RESULTS The title/abstract and full texts of 1,447 unique articles were screened for inclusion, yielding 168 articles for analysis. Major research topics included prevalence, risk factors, comorbidities, interventions and outreach, knowledge and attitudes, caregiving, and detection tools. A limited number of studies reported on national data, on NHPI communities generally, and on efficacy of interventions targeting AANHPI communities. CONCLUSION To our knowledge, this is the first systematic review on ADRD among AANHPI populations. Our review provides a first step in mapping the extant literature on ADRD among this underserved and under-researched population and will serve as a guide for future research, policy, and intervention.
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Affiliation(s)
- Sahnah Lim
- Department of Population Health, New York University Grossman School of Medicine
| | - Sadia Mohaimin
- Department of Population Health, New York University Grossman School of Medicine
| | - Deborah Min
- Department of Population Health, New York University Grossman School of Medicine
| | - Timothy Roberts
- Health Science Library, New York University Grossman School of Medicine
| | - Young-Jin Sohn
- Department of Population Health, New York University Grossman School of Medicine
| | - Jazmine Wong
- Department of Population Health, New York University Grossman School of Medicine
| | | | - Simona C. Kwon
- Department of Population Health, New York University Grossman School of Medicine
| | - Chau Trinh-Shevrin
- Department of Population Health, New York University Grossman School of Medicine
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9
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Giroux D, Tremblay M, Latulippe K, Provencher V, Poulin V, Giguere A, Dubé V, Sévigny A, Guay M, Ethier S, Carignan M. Promoting Identification and Use of Aid Resources by Caregivers of Seniors: Co-Design of an Electronic Health Tool. JMIR Aging 2019; 2:e12314. [PMID: 31518284 PMCID: PMC6744817 DOI: 10.2196/12314] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 04/25/2019] [Accepted: 05/28/2019] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The importance of supporting caregivers is recognized in home care for older persons, and facilitating their help-seeking process is a way to meet that need. The use of electronic health (eHealth) is a potentially promising solution to facilitate caregivers' help-seeking process. OBJECTIVE The aim of this research was to develop, in partnership with community organizations, health and social service professionals and caregivers, an eHealth tool promoting the earlier identification of needs of older persons and an optimal use of available resources. METHODS To design the tool, 8 co-design sessions (CoDs) were conducted and 3 advisory committees were created (in 11 regions) in Quebec between May 2017 and May 2018. A variety of methods were used, including the sorting method, the use of personas, eHealth tool analysis, brainstorming, sketching, prototyping, and pretesting. RESULTS A total of 74 co-designers (women n=64 and men n=10) were recruited to participate in the CoDs or the advisory committees. This number allowed for the identification of needs to which the tool must respond and for the identification of its requirements (functionalities and content), as well as for the development of the information architecture. Throughout the study, adjustments were made to the planning of CoD, notably because certain steps required more sessions than expected. Among others, this was true for the identification of functionalities. CONCLUSIONS This study led to the development of an eHealth tool for caregivers of functionally dependent older persons to help them identify their needs and the resources available to meet them. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/11634.
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Affiliation(s)
- Dominique Giroux
- Department of Rehabilitation, Université Laval, Québec, QC, Canada.,Center of Excellence on Aging Quebec, Québec, QC, Canada
| | - Mélanie Tremblay
- Department of Teaching and Learning Studies, Université Laval, Québec, QC, Canada
| | - Karine Latulippe
- Department of Teaching and Learning Studies, Université Laval, Québec, QC, Canada
| | - Véronique Provencher
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center of Research on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Poulin
- Université du Québec in Trois-Rivières, Trois-Rivières, QC, Canada.,Interdisciplinary Center for Research in Rehabilitation and Social Integration, Université Laval, Québec, QC, Canada
| | - Anik Giguere
- Center of Excellence on Aging Quebec, Québec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Québec, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Research Centre of the University Hospital of Montreal, Montréal, QC, Canada
| | - Andrée Sévigny
- Center of Excellence on Aging Quebec, Québec, QC, Canada.,School of Social Work and Criminology, Université Laval, Québec, QC, Canada
| | - Manon Guay
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada.,Center of Research on Aging, Centre intégré universitaire de santé et de services sociaux de l'Estrie, Centre hospitalier universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Ethier
- Center of Excellence on Aging Quebec, Québec, QC, Canada.,School of Social Work and Criminology, Université Laval, Québec, QC, Canada
| | - Maude Carignan
- Center of Excellence on Aging Quebec, Québec, QC, Canada
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10
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Latulippe K, Guay M, Éthier S, Sévigny A, Dubé V, Provencher V, Poulin V, Giguere AM, Tremblay M, Carignan M, Giroux D. Supporting the Process of Help-Seeking by Caregivers of Functionally Dependent Older Persons Through Electronic Health: Protocol for a Multicenter Co-Design. JMIR Res Protoc 2019; 8:e11634. [PMID: 31025956 PMCID: PMC6658263 DOI: 10.2196/11634] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 11/14/2018] [Accepted: 01/23/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND It is often only when the initial signs of exhaustion appear that caregivers first may engage in help-seeking behavior, but it is difficult for them to know which is the most appropriate formal service in their situation. Electronic health (eHealth) can support caregivers in keeping the older person they are caring for at home, but few eHealth tools designed for supporting the process of help-seeking by caregivers of functionally impaired older persons have been developed using a co-design approach. OBJECTIVE This paper aims to describe the protocol of a project that tries to assist caregivers to target their needs and those of the older person they support early in their help-seeking process, and guide them effectively to the formal service most appropriate for their situation. This project aims to answer the following questions: (1) What type of tool can better support caregivers to identify their needs and those of the older person they are caring for and then refer them to an appropriate formal service? and (2) What information should be found in such a tool? METHODS This study presents a description of the process of an ongoing multicenter research project based on a co-design approach, which includes 3 phases (1) identification of caregivers' needs in terms of tools to support their help-seeking behavior, (2) development of a tool, and (3) evaluation of its usability. RESULTS The project began in January 2016 with the ethics application for the 3 phases of the project. For phase 1, recruitment began in December 2016 and ended in September 2017. Phase 2 began in the spring of 2017 and ended in June 2018. All the co-design sessions have been completed. Phase 3 of the project will begin in September 2018. CONCLUSIONS Although there are some challenges associated with this type of methodology, the methodology still remains relevant, as it involves future users in the development of a tool, which increases the chances that the tool will meet the users' needs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/11634.
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Affiliation(s)
- Karine Latulippe
- Department of Teaching and Learning Studies, Laval University, Quebec, QC, Canada
| | - Manon Guay
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Sophie Éthier
- School of Social Work and Criminology, Laval University, Quebec, QC, Canada.,Center of Excellence on Aging Quebec, Quebec, QC, Canada
| | - Andrée Sévigny
- School of Social Work and Criminology, Laval University, Quebec, QC, Canada.,Center of Excellence on Aging Quebec, Quebec, QC, Canada
| | - Véronique Dubé
- Faculty of Nursing, University of Montreal, Montreal, QC, Canada.,Research Center, University Hospital Center of Montreal, Montreal, QC, Canada
| | - Véronique Provencher
- School of Rehabilitation, University of Sherbrooke, Sherbrooke, QC, Canada.,Research Centre on Aging, Centre Intégré Universitaire de Santé et de Services Sociaux de l'Estrie-Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
| | - Valérie Poulin
- Université du Québec in Trois-Rivières, Trois-Rivières, QC, Canada.,Interdisciplinary Center for Research in Rehabilitation and Social Integration, Quebec, QC, Canada
| | - Anick Mc Giguere
- Center of Excellence on Aging Quebec, Quebec, QC, Canada.,Department of Family Medicine and Emergency Medicine, Laval University, Quebec, QC, Canada
| | - Mélanie Tremblay
- Department of Teaching and Learning Studies, Laval University, Quebec, QC, Canada
| | - Maude Carignan
- Center of Excellence on Aging Quebec, Quebec, QC, Canada
| | - Dominique Giroux
- Center of Excellence on Aging Quebec, Quebec, QC, Canada.,Department of Rehabilitation, Laval University, Quebec, QC, Canada
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11
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Bieber A, Nguyen N, Meyer G, Stephan A. Influences on the access to and use of formal community care by people with dementia and their informal caregivers: a scoping review. BMC Health Serv Res 2019; 19:88. [PMID: 30709345 PMCID: PMC6359781 DOI: 10.1186/s12913-018-3825-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 12/17/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND The literature describes the obstacles to sufficient care faced by people with dementia and their informal caregivers. Although factors influencing access and utilisation are frequently studied, the body of knowledge lacks an overview of aspects related to influence. The frequently used Behavioural Model of Health Care Use (BM) could be used to structure and explain these aspects. An adaptation of the BM emphasises psychosocial influences and appears to enrich the understanding of the use of long-term care for dementia. METHODS We conducted a scoping review with the aim of providing an overview of the aspects influencing the access to and utilisation of formal community care in dementia. Our search covered the PubMed, CINAHL, Social Science Citation Index and PsychInfo databases, as well as grey literature. Two researchers assessed the full texts for eligibility. A data extraction form was developed and tested. We analysed the main topics investigated by the studies and mapped and described the investigated psychosocial aspects according to the BM after narratively summarising the findings. We used the Mixed Method Appraisal Tool (MMAT) to critically appraise the included studies. RESULTS A total of 94 studies were included: n = 55 with quantitative designs, 35 with qualitative designs and four with mixed methods. The studies investigated different services, mainly focusing on health care services. One third of the studies provided information regarding the severity of dementia. The most frequently investigated main topics were ethnicity and attitudes towards services. Psychosocial aspects were frequently investigated, although few studies considered the perspectives of people with dementia. Approximately half of the studies reported a theoretical framework. The adapted BM facilitated the structuring and description of psychosocial aspects. However, this instrument did not address topics beyond the scope of psychosocial aspects, such as sociodemographic characteristics. CONCLUSIONS The access to and utilisation of formal community care for dementia can only be partly explained by individual influencing aspects. Therefore, a theoretical framework would likely help to describe this complex subject. Our findings indicate that the psychosocial categories of the adapted BM enriched the original BM, and that people with dementia should more often be included in healthcare service research to ensure a better understanding of the barriers to accessing formal community care.
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Affiliation(s)
- Anja Bieber
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Natalie Nguyen
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Gabriele Meyer
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Astrid Stephan
- Institute of Health and Nursing Sciences, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
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12
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Bonds K, Lyons KS. Formal Service Use by African American Individuals With Dementia and Their Caregivers: An Integrative Review. J Gerontol Nurs 2018; 44:33-39. [PMID: 29846740 DOI: 10.3928/00989134-20180509-06] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 03/23/2018] [Indexed: 11/20/2022]
Abstract
Dementia is a predominant problem in older adults, affecting African American individuals at higher rates than other ethnic groups; yet, African American older adults use fewer formal services. To identify factors influencing formal service use by African American individuals with dementia and their caregivers, an integrative review of the literature was performed using four databases from 1990 to July 2017. Fourteen articles (nine quantitative, five qualitative) describing formal service use were included in the review. Three main themes were identified: Formal Service Need, Expectations of Formal Service Providers, and Formal Service Use. Recommendations to improve formal service use are suggested. [Journal of Gerontological Nursing, 44(6), 33-39.].
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13
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Kenning C, Daker-White G, Blakemore A, Panagioti M, Waheed W. Barriers and facilitators in accessing dementia care by ethnic minority groups: a meta-synthesis of qualitative studies. BMC Psychiatry 2017; 17:316. [PMID: 28854922 PMCID: PMC5577676 DOI: 10.1186/s12888-017-1474-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 08/22/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND It is estimated that there are about 25,000 people from UK ethnic minority groups with dementia. It is clear that there is an increasing need to improve access to dementia services for all ethnic groups to ensure that everyone has access to the same potential health benefits. The aim was to systematically review qualitative studies and to perform a meta-synthesis around barriers and facilitators to accessing care for dementia in ethnic minorities. METHODS Databases were searched to capture studies on barriers and facilitators to accessing care for dementia in ethnic minorities. Analysis followed the guidelines for meta-ethnography. All interpretations of data as presented by the authors of the included papers were extracted and grouped into new themes. RESULTS Six hundred and eighty four papers were identified and screened. Twenty eight studies were included in the meta-synthesis. The analysis developed a number of themes and these were incorporated into two overarching themes: 'inadequacies' and 'cultural habitus'. CONCLUSIONS The two overarching themes lend themselves to interventions at a service level and a community level which need to happen in synergy. TRIAL REGISTRATION The review was registered with PROSPERO: CRD42016049326 .
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Affiliation(s)
- Cassandra Kenning
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL, UK.
| | - Gavin Daker-White
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Amy Blakemore
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Maria Panagioti
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
| | - Waquas Waheed
- 0000000121662407grid.5379.8Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, The University of Manchester, 5th floor, Williamson Building, Oxford Road, Manchester, M13 9PL UK
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Lian Y, Xiao LD, Zeng F, Wu X, Wang Z, Ren H. The Experiences of People with Dementia and Their Caregivers in Dementia Diagnosis. J Alzheimers Dis 2017; 59:1203-1211. [PMID: 28731450 DOI: 10.3233/jad-170370] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Yan Lian
- School of Nursing, Third Military Medical University, Chongqing, China
- Department of Prevention Medicine, Daping Hospital, Third Military Medical University, Chongqing, China
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
| | - Lily Dongxia Xiao
- School of Nursing and Midwifery, Flinders University, Adelaide, Australia
| | - Fan Zeng
- Department of Neurology, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Xianmu Wu
- Daping Community Medical Service Centre, Chongqing, China
| | - Zhen Wang
- Department of Prevention Medicine, Daping Hospital, Third Military Medical University, Chongqing, China
| | - Hui Ren
- School of Nursing, Third Military Medical University, Chongqing, China
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15
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Lee VYW, Seah WY, Kang AWC, Khoo EYH, Mooppil N, Griva K. Managing multiple chronic conditions in Singapore - Exploring the perspectives and experiences of family caregivers of patients with diabetes and end stage renal disease on haemodialysis. Psychol Health 2016; 31:1220-36. [PMID: 27356152 DOI: 10.1080/08870446.2016.1203921] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Diabetes mellitus (DM) is the commonest cause of end stage renal disease (ESRD). Despite increasing DM-ESRD prevalence and high dependency on care, there is a lack of literature on DM-ESRD caregivers. We sought to explore the perspectives and experiences of caregivers of patients with DM undergoing haemodialysis in Singapore. DESIGN This study employed an exploratory, qualitative design comprising in-depth interviews with caregivers of DM-ESRD patients. METHODS Semi-structured interviews were conducted with a sample of 20 family caregivers (54.2 ± 12.6 years; 75% female) of DM-ESRD patients. Data were analysed using Thematic Analysis. RESULTS Key caregiving challenges identified were managing diet, care recipients' emotions and mobility dependence. Patients' emotional reactions caused interpersonal conflicts and hindered treatment management. Difficulties in dietary management were linked to patients' erratic appetite, caregivers' lack/poor understanding of the dietary guidelines and caregivers' low perceived competence. Limited resources in terms of social support and finances were also noted. Physical and psychological well-being and employment were adversely affected by caregiving role. CONCLUSION This study highlights distinctive aspects of the DM-ESRD caregiving experience, which impact on caregivers' health and challenge care. Disease management programmes should be expanded to support caregivers in dealing with multimorbidity.
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Affiliation(s)
- Vanessa Y W Lee
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Wei Ying Seah
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Augustine W C Kang
- a Department of Psychology , National University of Singapore , Singapore , Singapore
| | - Eric Y H Khoo
- b Department of Medicine , Yong Loo Lin School of Medicine , National University of Singapore , Singapore , Singapore
| | | | - Konstadina Griva
- a Department of Psychology , National University of Singapore , Singapore , Singapore.,d Health Services Research Group , City University London , London , UK
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Wallhagen MI, Yamamoto-Mitani N. The Meaning of Family Caregiving in Japan and the United States: A Qualitative Comparative Study. J Transcult Nurs 2016; 17:65-73. [PMID: 16410438 DOI: 10.1177/1043659605281979] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
This study explores how cultural values affect the meaning and experiences of daughter (or daughter-in-law) caregivers of elderly persons with dementia by comparing caregivers in the United States and Japan. Nine American and seven Japanese caregivers were interviewed twice at 6-month intervals. Interviews were audiotaped and analyzed using constant-comparative techniques. Data suggest that moral obligation to care and intense loss are two universal themes of caregiving. However the experiences and perceptions of the role of caregivers from these two cultures differed in select ways that were captured within three categories: reasons for caregiving, caregiving as a career, and caregiving as a life phase or detour. Findings suggest that American caregivers may need greater anticipatory socialization regarding the caregiving role, whereas Japanese caregivers may benefit from assistance in accepting needed services.
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17
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Care Needs and Caregivers: Associations and Effects of Living Arrangements on Caregiving to Older Adults in India. AGEING INTERNATIONAL 2016; 41:193-213. [PMID: 27340308 PMCID: PMC4877410 DOI: 10.1007/s12126-016-9243-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
As the ageing phenomenon continues in India, we explore the care needs of older adults and identify caregivers for specific care needs across living arrangements. Using the United Nations Population Fund (UNFPA) conducted Building Knowledge Base on Population Ageing in India (BKPAI 2011) data comprising 9850 older adults, we employed statistical methods to analyze the data, find associations and used binary logistic regression to model the adjusted and unadjusted effects of living arrangements on caregiving to older adults for specific care needs. Care-requiring situations considered were acute sickness, sickness requiring hospitalization, chronic morbidity, functional disability represented by ADL and IADL limitations, and locomotor disability. Results indicate that living arrangements of older adults were significantly associated with health, functional status and disability as well as caregiving patterns. Our results suggest that co-residence with children and all others was beneficial to older adults in obtaining care from a family caregiver for their hospitalization and chronic morbidity needs while living with spouse or living with a partner was advantageous for older adults in receiving care for their ADL limitations and during hospitalizations. Mean number of children was also significantly associated with the availability of a caregiver during hospitalization, locomotor disability, chronic morbidity and acute sickness. The study also highlights a little known phenomenon, that there was familial help available to older adults who lived alone. Notably, non-family sources of caregiving were steadily becoming visible (as high as 8–10 % of the caregiving component) especially among older adults living alone.
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Giebel C, Challis D, Worden A, Jolley D, Bhui KS, Lambat A, Purandare N. Perceptions of self-defined memory problems vary in south Asian minority older people who consult a GP and those who do not: a mixed-method pilot study. Int J Geriatr Psychiatry 2016. [PMID: 26217913 DOI: 10.1002/gps.4337] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE South Asian older adults access services for mental health problems and dementia less than other older people in the UK, unlike for physical health problems. This pilot study investigated how South Asians with self-defined memory problems, with and without GP consultation, construe the symptoms, causes, consequences and treatment of the condition. METHODS Participants were recruited through community centres, their networks and memory clinics in Greater Manchester. The newly developed Barts Explanatory Model Inventory for Dementia (BEMI-D) was administered to 33 (18 M, 15 F) older South Asians aged 65 or above with memory problems in English, Gujarati or Urdu. Furthermore, cognition, executive function and depression were assessed. RESULTS Perceptions of dementia varied by GP consultation for memory problems. A greater proportion of older adults without a consultation considered memory problems to be given by God, saw acceptance of fate as an alternative treatment and did not identify medical support as appropriate. Forgetfulness and loss of social meaning were identified as symptoms of dementia more by those with a consultation. Higher levels of diabetes, heart disease and depression were found in those without a consultation. CONCLUSIONS Differences in perceptions may influence the decision about consulting a GP. Similarly, consultation for memory problems appears linked to extent physical health problems and mental health consultation (depression). These variations reported on a small scale in this pilot study suggest the need to explore the impact of perceptions on rates of GP consultation, so as to improve timely diagnosis and access to appropriate services.
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Affiliation(s)
- Clarissa Giebel
- Personal Social Services Research Unit, The University of Manchester, UK
| | - David Challis
- Personal Social Services Research Unit, The University of Manchester, UK.,Manchester Mental Health and Social Care Trust, UK
| | - Angela Worden
- Personal Social Services Research Unit, The University of Manchester, UK
| | - David Jolley
- Personal Social Services Research Unit, The University of Manchester, UK
| | - Kamaldeep Singh Bhui
- Centre for Psychiatry, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | | | - Nitin Purandare
- University of Exeter, UK.,Manchester Mental Health and Social Care Trust, UK
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19
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MacKenzie MA, Buck HG, Meghani SH, Riegel B. Unique Correlates of Heart Failure and Cancer Caregiver Satisfaction With Hospice Care. J Pain Symptom Manage 2016; 51:71-8. [PMID: 26384557 DOI: 10.1016/j.jpainsymman.2015.09.001] [Citation(s) in RCA: 10] [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] [Received: 07/09/2014] [Revised: 09/01/2015] [Accepted: 09/03/2015] [Indexed: 01/19/2023]
Abstract
CONTEXT Heart failure patients, along with their informal caregivers are increasingly enrolling in hospice care. Caregiver satisfaction with hospice care is a key quality indicator. The role that diagnosis plays in shaping satisfaction is unclear. OBJECTIVES Our aim was to identify unique correlates of caregiver satisfaction in heart failure and cancer caregivers and explore whether the identified correlates differ between the two diagnosis groups. METHODS This was a retrospective cohort study of national data collected in 2011 by the National Hospice and Palliative Care Organization using the 61-item Family Evaluation of Hospice Care survey. We used complete Family Evaluation of Hospice Care responses of adult heart failure (n = 7324) and cancer (n = 23,871) caregivers. Multiple logistic regression was used to examine the relationship between possible correlates and caregiver satisfaction. Correlates examined included caregiver and patient demographics, patient clinical characteristics, and hospice characteristics. RESULTS Caregiver-reported patient dyspnea was associated with global and symptom management satisfaction in the heart failure cohort, whereas caregiver race was associated with global and symptom management satisfaction in the cancer cohort. Nursing home placement was associated with lower satisfaction odds in both cancer and heart failure cohorts, but heart failure patients were twice as likely as cancer patients to receive care in a nursing home. CONCLUSION This study generated hypotheses about unique factors related to caregiver satisfaction among two diagnosis cohorts that require further study, particularly the impact of race on satisfaction in the cancer cohort and the management of dyspnea in heart failure hospice patients.
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Affiliation(s)
| | - Harleah G Buck
- The Pennsylvania State University College of Nursing, Pennsylvania, USA
| | - Salimah H Meghani
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Barbara Riegel
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Werner P, Goldstein D, Karpas DS, Chan L, Lai C. Help-seeking for dementia: a systematic review of the literature. Alzheimer Dis Assoc Disord 2015; 28:299-310. [PMID: 25321607 DOI: 10.1097/wad.0000000000000065] [Citation(s) in RCA: 69] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Help-seeking (HS) for dementia presents a great challenge, especially because a timely and appropriate HS process might be associated with better outcomes for the person with dementia, their caregivers, and society. A clear understanding of the HS concept and its measurement in the area of dementia might improve the effectiveness of the process. AIMS The aims of our systematic review were: (1) to systematically obtain and evaluate the relevant literature on HS and dementia; and (2) to summarize current research findings and draw conclusions for future research and clinical care in this area. METHOD A systematic review of the literature on HS and dementia was conducted up till June 2013. RESULTS From the 478 retrieved articles, 48 were included in the review. Conceptually, the studies examined professional and nonprofessional sources of help; showed preference for seeking help from close relatives followed by primary health caregivers; and identified inadequate knowledge and stigmatic beliefs as the main barriers to HS. The majority of the studies did not rely on a theoretical framework. CONCLUSIONS Although the body of literature in the area of HS and dementia is growing, several conceptual and methodological limitations still have to be resolved to advance knowledge in the area.
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Affiliation(s)
- Perla Werner
- *Department of Community Mental Health †Center for Research and Study of Aging, University of Haifa, Haifa, Israel ‡Ho Cheung Shuk Yuen Charitable Foundation, Hong Kong §Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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21
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Pagán-Ortiz ME, Cortés DE, Rudloff N, Weitzman P, Levkoff S. Use of an online community to provide support to caregivers of people with dementia. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2014; 57:694-709. [PMID: 24689359 PMCID: PMC4127129 DOI: 10.1080/01634372.2014.901998] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
One challenge faced by many family members caring for persons with dementia is lack of information about how to take care of others and themselves. This is especially important for persons from ethnic minority groups, because linguistically and culturally appropriate information is often not available. In response to these needs, we developed a web site for Spanish-speaking caregivers. Cuidatecuidador.com provides bilingual information on dementia and caregiver issues. Content was developed and then evaluated by caregivers residing in 3 countries. Findings suggest trends that exposure to information may be related to a higher sense of mastery and a reduction of depressive symptomatology.
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22
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Regan JL. Ethnic minority, young onset, rare dementia type, depression: A case study of a Muslim male accessing UK dementia health and social care services. DEMENTIA 2014; 15:702-20. [PMID: 24858552 DOI: 10.1177/1471301214534423] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A case study comprised of formal interviews, formal observations and informal discussions investigated the motivations and experiences accessing dementia care health and social care services for a Muslim, Pakistani male with dementia. Motivations derived from 'desperation' and an inability to access support from family or religious community. Experiences of accessing services were mostly negative. Dementia services were ill-informed about how to support persons with young onset dementia, with pre-existing mental health conditions, from an ethnic minority. Education and training to remove barriers to all dementia care services is required for persons with dementia, their families and within dementia services and religious communities.
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Affiliation(s)
- Jemma L Regan
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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23
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Rote S, Angel JL, Markides K. Health of elderly Mexican American adults and family caregiver distress. Res Aging 2014; 37:306-31. [PMID: 25651573 DOI: 10.1177/0164027514531028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Using newly available data on family caregivers from a large epidemiological study of elderly Mexican-origin adults (Hispanic Established Population for the Epidemiologic Study of the Elderly [HEPESE], 2010/2011), we identify which types of impairment (functional, psychological, and cognitive) in the elderly individual are associated with family caregiver depressive symptoms. Results from ordinary least squares regressions using 626 caregiver-care recipient dyads demonstrate that more severe mobility limitations (Performance-Oriented Mobility Assessment), social disability (instrumental activities of daily living), neuropsychiatric disturbances related to cognitive decline (Neuropsychiatric Inventory), and depressive symptoms in the elderly subject are positively associated with caregiver psychological distress. Perceived social stress partially accounts for these associations. We also identify certain segments of this caregiver population that are especially vulnerable to burden when caring for a family member with high levels of impairment, namely female and low-income caregivers. These vulnerabilities should be the focus of intervention efforts to reduce stress and improve the emotional and psychological well-being of Mexican-origin caregivers.
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Affiliation(s)
- Sunshine Rote
- Sealy Center on Aging, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Jacqueline L Angel
- LBJ School of Public Affairs and Department of Sociology, The University of Texas at Austin, Austin, TX, USA
| | - Kyriakos Markides
- Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
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24
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Pioneers in migration, pioneering in dementia: first generation immigrants in a European metropolitan memory clinic. Acta Neurol Belg 2013; 113:435-40. [PMID: 23975562 DOI: 10.1007/s13760-013-0245-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2013] [Accepted: 08/08/2013] [Indexed: 10/26/2022]
Abstract
By reviewing the clinical files of 1,058 consecutive newly admitted outpatients of a Brussels-based memory clinic between 2005 and 2012, this study aims to document the demographic and clinical characteristics of European and non-European first generation immigrants. They accounted for 18.6% of the patients, of which 8.6% came from outside Europe (mostly from Morocco, Turkey and the Democratic Republic of Congo). Immigrants with AD tended to be younger, and there was a higher proportion of males among non-European ethnic minorities. There was a higher proportion of Parkinson-related cognitive disorders and Lewy Body disease among European immigrants, whereas non-Europeans had more often a psychiatric diagnosis. Even after correction for education, non-European immigrants had lower MMSE scores, and they did report longer delays between first symptoms and diagnosis, although this last difference was not statistically significant. These results suggest that non-European immigrants with cognitive problems consult later.
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25
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Understanding Chinese–Canadian pathways to a diagnosis of dementia through a critical-constructionist lens. J Aging Stud 2012. [DOI: 10.1016/j.jaging.2011.07.002] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Karim S, Minhas HM, Bhattacharya S, Sein K, Nayar B, Morris J, Nizami A, Minhas F, Burns A. The symptomatology of Alzheimer's disease: a cross-cultural study. Int J Geriatr Psychiatry 2011; 26:415-22. [PMID: 21412847 DOI: 10.1002/gps.2544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 04/16/2010] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This paper presents the results of a trans-cultural study looking at the possible differences in the symptomatology of Alzheimer's disease (AD) in people from Manchester, UK and Rawalpindi, Pakistan. METHODS Two groups of people with AD (45 in each group) were recruited at the two sites. The participants and their carers were interviewed to investigate possible differences in demographics and symptomatology including cognition, depression, personality change and every day activities. The instrument used included the Mini Mental State Examination (MMSE), Geriatric Depression Scale (GDS), Cornell Scale for Depression in Dementia (CSDD), The Brooks and McKinlay Personality Inventory and Informant Questionnaire on Cognitive Decline in the Elderly (IQ CODE). RESULTS The data analysis showed that compared to people from Manchester the Pakistanis had lower literacy levels but similar cognitive deficits when MMSE scores were adjusted for education. They were however more depressed; they had a different profile of personality change since the onset of illness and their reported changes in activities of daily living were more severe. CONCLUSION The study has shown a number of possible cultural differences in affective symptoms, personality changes and every day activities. It highlights the need for developing mental health services for older people in Pakistan and making UK services more accessible for this growing community. Further research on service and care needs along with developing culturally sensitive instruments for assessing cognition, psychiatric symptoms, personality changes and daily activities is needed.
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Affiliation(s)
- Salman Karim
- Psychiatry Research Group, University of Manchester, Manchester, UK.
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Sayegh P, Knight BG. The effects of familism and cultural justification on the mental and physical health of family caregivers. J Gerontol B Psychol Sci Soc Sci 2011; 66:3-14. [PMID: 20797972 PMCID: PMC3031310 DOI: 10.1093/geronb/gbq061] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2010] [Accepted: 07/26/2010] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES We aimed to examine the effects of 2 factors of familism (Familial Obligations and Expected Support from the Family) and Cultural Justification on caregivers' mental and physical health as mediated by coping style. METHODS We used a probability sample of 95 African American and 65 White family caregivers for people with dementia to test hypotheses based on the updated sociocultural stress and coping model using path analysis. Main outcome measures included depressive symptomatology, various psychological symptoms, and subjective physical health. RESULTS Both Familial Obligations and Cultural Justification had an indirect effect on poor mental health and subjective physical health via avoidant coping. Expected Support from the Family had no effect on caregivers' health outcomes. DISCUSSION These findings suggest that feelings of obligation may be accounting for a significant proportion of the negative effects of familism on caregivers' mental and subjective physical health. Expectations of familial social support may be relatively inconsequential in this process.
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Affiliation(s)
- Philip Sayegh
- Department of Psychology, University of Southern California, Los Angeles, CA 90089-1061, USA.
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28
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Lee SE, Diwan S, Yeo G. Causal attributions of dementia among Korean American immigrants. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2010; 53:743-59. [PMID: 20972929 DOI: 10.1080/01634372.2010.515290] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
To better understand conceptualizations of dementia, this study explored causal attributions of dementia among 209 Korean Americans, using a self-administered questionnaire in Korean. Findings show that Korean Americans endorsed various causal attributions. Factor analysis yielded 3 dimensions of their attributions including psychological, physical/environmental, and cognitive/social. Bivariate analyses showed that younger age and higher education were related to more physical/environmental attributions, and younger age was related to more cognitive/social attributions. The study provides an understanding of causal attributions of dementia that practitioners need to understand to provide culturally competent practice and highlights a need to customize public education messages by specific ethnic groups.
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Affiliation(s)
- Sang E Lee
- School of Social Work, San Jose State University, San Jose, California 95192–0124, USA.
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Chen H, Levkoff SE. The Multiverse of Inquiry: Introduction to the Special Issue on "Dementia Care and Chinese Culture". AGEING INTERNATIONAL 2010; 35:85-95. [PMID: 22068037 DOI: 10.1007/s12126-010-9061-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Hongtu Chen
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
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Napoles AM, Chadiha L, Eversley R, Moreno-John G. Reviews: developing culturally sensitive dementia caregiver interventions: are we there yet? Am J Alzheimers Dis Other Demen 2010; 25:389-406. [PMID: 20508244 DOI: 10.1177/1533317510370957] [Citation(s) in RCA: 149] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Despite evidence of ethnic differences in family caregivers' experiences, the extent to which caregiver interventions are culturally tailored to address these differences is unknown. A systematic review of literature published from 1980 to 2009 identified: differences in caregiving experiences of African American, Latino, and Chinese American caregivers; psychosocial support interventions in these groups; and cultural tailoring of interventions. Ethnic differences in caregiving occurred at multiple levels (intrapersonal, interpersonal, environmental) and in multiple domains (psychosocial health, life satisfaction, caregiving appraisals, spirituality, coping, self-efficacy, physical functioning, social support, filial responsibility, familism, views toward elders, use of formal services and health care). Only 18 of 47 intervention articles reported outcomes by caregiver ethnicity. Only 11 reported cultural tailoring; 8 were from the Resources for Enhancing Alzheimer's Caregiver Health (REACH) initiative. Cultural tailoring addressed familism, language, literacy, protecting elders, and logistical barriers. Results suggest that more caregiver intervention studies evaluating systematically the benefits of cultural tailoring are needed.
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Affiliation(s)
- Anna M Napoles
- Center for Aging in Diverse Communities, Division of General Internal Medicine, Department of Medicine, University of California San Francisco (UCSF), San Francisco, CA 94118, USA.
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Herrera AP, Snipes SA, King DW, Torres-Vigil I, Goldberg DS, Weinberg AD. Disparate inclusion of older adults in clinical trials: priorities and opportunities for policy and practice change. Am J Public Health 2010; 100 Suppl 1:S105-12. [PMID: 20147682 PMCID: PMC2837461 DOI: 10.2105/ajph.2009.162982] [Citation(s) in RCA: 206] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2009] [Indexed: 11/04/2022]
Abstract
Older adults are vastly underrepresented in clinical trials in spite of shouldering a disproportionate burden of disease and consumption of prescription drugs and therapies, restricting treatments' generalizability, efficacy, and safety. Eliminating Disparities in Clinical Trials, a national initiative comprising a stakeholder network of researchers, community advocates, policymakers, and federal representatives, undertook a critical analysis of older adults' structural barriers to clinical trial participation. We present practice and policy change recommendations emerging from this process and their rationale, which spanned multiple themes: (1) decision making with cognitively impaired patients; (2) pharmacokinetic differences and physiological age; (3) health literacy, communication, and aging; (4) geriatric training; (5) federal monitoring and accountability; (6) clinical trial costs; and (7) cumulative effects of aging and ethnicity.
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Sun F, Roff LL, Klemmack D, Burgio LD. The influences of gender and religiousness on Alzheimer disease caregivers' use of informal support and formal services. J Aging Health 2009; 20:937-53. [PMID: 18936242 DOI: 10.1177/0898264308324652] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective. This study explored how male and female family caregivers of Alzheimer's disease (AD) patients differ in their use of formal services and informal support and how religiousness may affect such differences. Methods. Data were from a sample of 720 family caregivers of AD patients who participated in the Resources for Enhancing Alzheimer's Caregiver Heath (REACH I) study sites in Birmingham, Boston, Memphis, and Philadelphia. Results. Female caregivers were less likely to use in-home services than males (M = 0.83 vs. M = 1.06, p < .01) but reported more use of transportation services (21.6% vs. 12.7%, p < .01) and more use of informal support (M = 13.9 vs. M = 10.7, p < .01). Mediation tests suggested that three measures of religiousness helped explain the relationship between gender and use of formal services and informal support. Discussion. These findings highlight the necessity to assess AD caregivers' religiousness to better understand their circumstances.
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Affiliation(s)
- Fei Sun
- Socila Work Department, Arizona State University, #3251, 4701 W. Thunderbird Road, Glendale, AZ 85306-4908, USA.
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Wilkins VM, Bruce ML, Sirey JA. Caregiving tasks and training interest of family caregivers of medically ill homebound older adults. J Aging Health 2009; 21:528-42. [PMID: 19252141 DOI: 10.1177/0898264309332838] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE This study assessed the caregiving activities and training interests of family caregivers of medically ill older adults without dementia who receive home health care. METHODS Participants were 101 family caregivers of patients from the Training in the Assessment of Depression (TRIAD) study. Caregivers were assessed using a sociodemographic questionnaire and measures of caregiver tasks and training interest. RESULTS Family caregivers provided a variety of caregiving tasks and their interest in training was independent of current provision of tasks. Black caregivers expressed greater overall interest in receiving training than did White caregivers, as did younger caregivers compared to same-generation caregivers. DISCUSSION Family caregivers in this study evidenced both a range of care provision and clear interest in improving caregiving skills through training. Research efforts should focus on meeting the specific training needs of family caregivers and determining the impact training can have on patient health outcomes.
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Affiliation(s)
- Victoria M Wilkins
- Department of Psychiatry, Weill Medical College of Cornell University, 21 Bloomingdale Road, White Plains, NY 10605, USA.
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Danner DD, Smith CD, Jessa P, Hudson J. African Americans with memory loss: findings from a community clinic in Lexington, Kentucky. Nurs Clin North Am 2008; 43:437-47, ix-x. [PMID: 18674674 DOI: 10.1016/j.cnur.2008.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Kentucky's African-American Dementia Outreach Partnership (AADOP) has shown that African-American patients seek dementia care if a clinic is conveniently located and families are educated about the distinction between normal aging and signs of disease. The early identification of dementia allows African Americans access to pharmaceutic treatments that work best early in the course of the disease and provides the opportunity for the patient to plan future care. In the AADOP model, a conveniently located clinic and access to the patient's home were first steps in achieving equality of care. The trust that was built in the community through collaboration with African-American churches has allowed patients and their families to receive help with memory problems and to feel comfortable in seeking help for other medical problems. Maintaining this involvement and responsiveness to the community over the long term is the next challenge for the program.
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Affiliation(s)
- Deborah D Danner
- Sanders-Brown Center on Aging, Alzheimer's Disease Center, University of Kentucky, Lexington, KY 40536-0230, USA.
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Abstract
AIM This paper is a report of a study designed to explore the caregiving experiences of Korean Americans. BACKGROUND Increasing numbers of older people in the Asian population place important long-term care demands on Asian caregivers, yet minimal attention has been given to the issue of caregiving in this group. The current study attempts to fill the gap by describing Korean American caregivers' unique caregiving experiences from their perspectives. METHOD A qualitative research design using a focus group approach was employed to discuss caregiving experiences in a cultural context. Data were collected over an 8-month period in 2005. Twenty-four informants, mostly women, at varying points surrounding caregiving participated in a focus group interview. Each focus group lasted about 1 (1/2)-2 hours. Thematic analysis was conducted by two bilingual researchers. FINDINGS Three key themes were identified: the caregiver role - competing priorities and beliefs, the extent and impact of caregiving, and the need for education and culturally-tailored support systems. Ten subthemes were identified within the three major themes: (1) facing double challenges; (2) changing attitudes about filial piety (Hyo); (3) providing care; (4) feeling out of control; (5) going through changing family dynamics; (6) being connected vs. providing connection; (7) paying back; (8) learning by themselves; (9) recognizing differences and (10) reconsidering geriatric care systems. CONCLUSION The caregiving experiences described by Korean American families point to the need to identify and develop more focused outreach programmes as well as more culturally appropriate support services for this rapidly increasing population.
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Affiliation(s)
- Hae-Ra Han
- Johns Hopkins University School of Nursing, Baltimore, Maryland, USA.
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Expert Strategies: Nurses Providing Care for their Elderly Parents. AGEING INTERNATIONAL 2008. [DOI: 10.1007/s12126-008-9012-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Wilks SE, Vonk ME. Private prayer among Alzheimer's caregivers: mediating burden and resiliency. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2008; 50:113-131. [PMID: 18510194 DOI: 10.1300/j083v50n3_09] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This study examined whether the coping method of private prayer served as a protective factor of resiliency among a sample (N = 304) of Alzheimer's caregivers. Participants in caregiver support groups completed questionnaires that assessed a number of constructs, including caregiving burden; prayer frequency; use of private prayer as a means of coping; and perceived resiliency. The sample averaged a moderate level of burden and a great extent of prayer usage. Caregiving burden had positively affected the extent of prayer usage and negatively influenced perceived resiliency. Findings from hierarchical regression analysis showed that caregiving burden and private prayer significantly influenced variation in perceived resiliency scores. Results from a regression equation series and path analysis provided support for prayer as a mediator between burden and perceived resiliency. Implications for social work practice and education are discussed.
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Affiliation(s)
- Scott E Wilks
- LSU School of Social Work, 203 HP Long Fieldhouse, Baton Rogue, LA 70803, USA.
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Gerdner LA, Tripp-Reimer T, Simpson HC. Hard lives, God's help, and struggling through: caregiving in Arkansas Delta. J Cross Cult Gerontol 2007; 22:355-74. [PMID: 17899348 DOI: 10.1007/s10823-007-9047-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2005] [Accepted: 08/27/2007] [Indexed: 10/22/2022]
Abstract
The purpose of this ethnographic study was to describe the experience of African American adults providing in-home care for a family member with chronic confusion living in the Arkansas Delta. We conducted this study over fourteen months in two rural Delta counties using participant observation and in-depth interviews. The majority of caregivers were adult daughters. Nearly half attributed chronic confusion to a difficult life and emotional stress or "worry;" a third believed it to be a natural component of "old age." Caregivers tended to view their work as an expression of love and devotion that was accompanied by emotional stress and personal sacrifice. While just under half of the caregivers had no other family members willing or available to assist with the physical care of the elder, the majority were able to turn to family members for emotional support. Further they identified strong religious beliefs as the primary force that sustained them in the caregiving role. The centrality of spirituality, faith/religion was noted in nearly all aspects of life. Faith in God was seen as continuing to be an important aspect of the care recipients' lives as well. Recipients' spiritual needs were addressed by accompanying the care recipient to church services and reading Bible passages to them on a regular basis. Selective community services (i.e., adult day care, home health services) were used that supported efforts at maintaining the family caregiver role. Findings are discussed within the context of historical and sociopolitical factors of the geographic region.
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Affiliation(s)
- Linda A Gerdner
- Stanford Geriatric Education Center, Stanford University, Palo Alto, CA 94304, USA.
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Magai C, Consedine NS, Adjei BA, Hershman D, Neugut A. Psychosocial influences on suboptimal adjuvant breast cancer treatment adherence among African American women: implications for education and intervention. HEALTH EDUCATION & BEHAVIOR 2007; 35:835-54. [PMID: 17909222 DOI: 10.1177/1090198107303281] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Despite lower incidence, African American women are at increased risk of dying from breast cancer relative to their European American counterparts. Although there are key differences in both screening behavior and tumor characteristics, an additional part of this mortality difference may lie in the fact that African American women receive suboptimal adjuvant chemotherapy and may receive suboptimal hormonal therapy, therapies that are known to increase survival. The authors consider ethnic differences in the psychosocial factors that have been shown to relate to poor screening adherence and consider how they may influence adherence to breast cancer adjuvant treatment, thus the receipt of suboptimal adjuvant chemo or hormonal therapy. To this end, they review ethnic differences in cognitive, emotional, and social network variables. Psychosocial variables should be included in research designed to understand cancer disparities as well interventions that can be tailored to culturally diverse populations to improve treatment adherence.
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Affiliation(s)
- Carol Magai
- Department of Psychology, Long Island University, Brooklyn, New York 11201, USA.
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Scharlach AE, Kellam R, Ong N, Baskin A, Goldstein C, Fox PJ. Cultural attitudes and caregiver service use: lessons from focus groups with racially and ethnically diverse family caregivers. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2006; 47:133-56. [PMID: 16901881 DOI: 10.1300/j083v47n01_09] [Citation(s) in RCA: 109] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Focus groups were conducted with caregivers from eight racial-specific or ethnic-specific populations (African Americans, Chinese, Filipinos, Hispanics, Koreans, Native Americans, Russians, and Vietnamese), to examine cultural variations in caregiving experiences, care-related values and beliefs, care practices, and factors contributing to decisions about the use of caregiver support services. Analysis of focus group transcripts revealed three cross-cutting constructs: familism, group identity, and attitudinal and structural barriers to service use. We discuss these findings in terms of their implications for existing knowledge regarding family responsibility, resource utilization, and program development for racially and ethnically diverse family caregivers.
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Affiliation(s)
- Andrew E Scharlach
- Center for the Advanced Study of Aging Services, School of Social Welfare, University of California-Berkeley, CA 94720-7400, USA.
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Ayalon L, Young MA. Racial group differences in help-seeking behaviors. The Journal of Social Psychology 2005; 145:391-403. [PMID: 16050338 DOI: 10.3200/socp.145.4.391-404] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The authors evaluated variations in help-seeking behaviors among Blacks and Whites and the role of cognitive-affective variables as mediators of these variations. Participants were 70 Black and 66 White community college students who completed the SCL-90-R (L. R. Derogatis, 1977, 1994), the Revised Multidimensional Health Locus of Control (T. Bekhuis et al., 1995), the Symptom Interpretation Questionnaire (J. M. Robbins & L. J. Kirmayer, 1991), and a measure of help-seeking behaviors and demographic information. Relative to White college students, Black college students significantly less frequently used psychological or social services and significantly more frequently used religious services. The authors accounted for group differences in religious help-seeking behaviors by beliefs in the power of God and by normalizing symptom attributions. The cognitive-affective variables that were studied did not account for differences in psychological help-seeking behaviors. The authors inferred that to better meet the needs of Black college students, collaboration between mental health services and religious services would likely be beneficial.
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Affiliation(s)
- Liat Ayalon
- Institute of Psychology, Illinois Institute of Technology, Chicago, USA.
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Sörensen S, Pinquart M. Racial and ethnic differences in the relationship of caregiving stressors, resources, and sociodemographic variables to caregiver depression and perceived physical health. Aging Ment Health 2005; 9:482-95. [PMID: 16024408 DOI: 10.1080/13607860500142796] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Racial and ethnic differences in the association of stressors, resources, and sociodemographic characteristics with depressive symptoms and perceived physical health were investigated. Data from 653 White non-Hispanic caregivers, 278 African American, and 218 Hispanic Alzheimer's caregivers (209 males, 940 females) who were assessed at the baseline data collection of the REACH study, a multisite trial of caregiver interventions, was obtained. Multiple sample analysis, which allows testing whether a pattern of relationships is invariant across different samples, was used. Results support the hypothesis that, despite significant differences in resources and stressors, the predictors of depression and health are relatively uniform across groups. Ethnic differences were found for the effect of age, income, gender, and care receiver's self-care impairments on caregiver depression. For perceived physical health, there were ethnic differences for the effect of income, gender, and type of caregiver relationships.
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Affiliation(s)
- Silvia Sörensen
- Program Geriatrics and Neuropsychiatry, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, NY 14642-8409, USA.
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Pinquart M, Sörensen S. Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a meta-analysis. THE GERONTOLOGIST 2005; 45:90-106. [PMID: 15695420 DOI: 10.1093/geront/45.1.90] [Citation(s) in RCA: 441] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE We investigated ethnic differences in caregiver background variables, objective stressors, filial obligations beliefs, psychological and social resources, coping processes, and psychological and physical health. DESIGN AND METHODS We used a meta-analysis to integrate the results of 116 empirical studies. RESULTS Ethnic minority caregivers had a lower socioeconomic status, were younger, were less likely to be a spouse, and more likely to receive informal support. They provided more care than White caregivers and had stronger filial obligations beliefs than White caregivers. Asian-American caregivers, but not African-American and Hispanic caregivers, used less formal support than non-Hispanic White caregivers. Whereas African-American caregivers had lower levels of caregiver burden and depression than White caregivers, we found that Hispanic and Asian-American caregivers were more depressed than their White non-Hispanic peers. However, all groups of ethnic minority caregivers reported worse physical health than Whites. Observed ethnic differences in burden and depression were influenced by study characteristics, such as the type of illness of the care recipient and the representativeness of the sample. IMPLICATIONS The results suggest that more specific theories are needed to explain differential effects of ethnic minority groups of caregivers. Intervention needs vary, in part, between ethnic groups of caregivers.
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Affiliation(s)
- Martin Pinquart
- Department of Developmental Psychology, Friedrich Schiller University, Am Steiger 3 Haus 1, D-07743 Jena, Germany.
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Dementia care-giving in black and Asian populations: reviewing and refining the research agenda. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2005. [DOI: 10.1002/casp.830] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Weitzman PF, Weitzman EA. Promoting communication with older adults: protocols for resolving interpersonal conflicts and for enhancing interactions with doctors. Clin Psychol Rev 2003; 23:523-35. [PMID: 12788108 DOI: 10.1016/s0272-7358(02)00209-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this paper, we review the importance of effective communication in older adulthood, and ideas for promoting it. We focus on theoretical and applied work in two communicative encounters that have particular relevance for older adult health, i.e., interpersonal conflict and visits with a healthcare provider. Little applied work has aimed to adapt training protocols for older adults in these two areas. We will present training protocols we have developed in constructive conflict resolution for older adults, and on enhancing doctor-patient communication. We present these protocols to stimulate ideas on the part of the reader on how to further develop and refine training efforts for older adults in effective communication.
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