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Zhang H, Li S, Dai W, Wang H. The effect of reverse intergenerational support on the happiness of Chinese older adults: A moderating effect analysis based on role conflict. Front Psychol 2023; 13:1080772. [PMID: 36704675 PMCID: PMC9871921 DOI: 10.3389/fpsyg.2022.1080772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Intergenerational support is bidirectional, and reverse intergenerational support refers to parents providing financial support, time support, and spiritual support to their offspring. The emergence of reverse intergenerational support has created role conflicts among different groups of older adults. Based on survey data from 3,170 elderly people in eight sample provinces in China, this paper empirically investigates the relationship between reverse intergenerational support and the happiness of the elderly in contemporary China and the moderating effect of role conflict in it, using an ordered logit model. It was found that, first, reverse economic support reduces the happiness of the elderly, and reverse time support and reverse spiritual support can significantly enhance the happiness of the elderly. Second, in the presence of role conflict, the effect of reverse time support and reverse spiritual support on the enhancement of older adults' happiness was suppressed; in the presence of role enhancement, the effect of reverse economic support on the reduction of older adults' happiness was mitigated. The above findings provide new empirical evidence for understanding the relationship between reverse intergenerational support and the happiness of the elderly, which is prevalent in contemporary China, and offer new insights for enhancing happiness.
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Affiliation(s)
- Hongfeng Zhang
- School of Economics, Guizhou University of Finance and Economics, Guiyang, Guizhou, China,School of Economics and Trade Management, Changzhou Institute of Light Industry Technology, Changzhou, China
| | - Shunyi Li
- School of Economics, Guizhou University of Finance and Economics, Guiyang, Guizhou, China
| | - Wenwen Dai
- School of Economics and Trade Management, Changzhou Institute of Light Industry Technology, Changzhou, China,*Correspondence: Wenwen Dai,
| | - Hanning Wang
- School of Economics, Guizhou University of Finance and Economics, Guiyang, Guizhou, China,School of Big Data Application and Economics, Guizhou University of Finance and Economics, Guiyang, Guizhou, China
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2
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Li C, Han Q, Hu J, Han Z, Yang H. Impact of intergenerational support and medical expenditures on depression: Evidence from rural older adults in China. Front Public Health 2022; 10:840864. [PMID: 35937247 PMCID: PMC9354659 DOI: 10.3389/fpubh.2022.840864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 06/27/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Globally, depression has become a major health issue among older adults, who experience poor physical health and high medical expenditures. In Asian countries, older adults are greatly dependent on their children. This study assessed the impact of different types of intergenerational support and medical expenditures on depression among older adults in rural China. Method A three-phase balanced panel was constructed based on data from 1,838 rural older adults with comparable scores on the Center for Epidemiologic Studies Depression Scale (CES-D) from the China Family Panel Studies in 2012, 2016, and 2018. A fixed-effects model was used to analyze the impact of intergenerational support and medical expenditures on CES-D score and of intergenerational support on medical expenditures. The propensity score-matching model was used to test the regression results' robustness. Results The findings were as follows. First, different types of intergenerational support had a heterogeneous impact on depression among rural older adults. Emotional support had a significantly negative impact on CES-D score, although too much care-based support had a positive impact on CES-D score. Low-level economic support had no significant effect on CES-D score. Second, medical expenditures impacted depression; among these, non-inpatient medical expenditure had a significant and positive impact on CES-D score. Third, CES-D scores among rural older adults were associated with chronic diseases and per capita family income. Fourth, care-based support was associated with reduced non-inpatient medical expenditures, and the sub-sample regression results indicated that the impact was significant for older adults with no chronic diseases and those younger than 75 years. Conclusion Intergenerational emotional support and non-inpatient medical expenditures directly affected rural older adults' CES-D scores. The mediating role of medical expenditures between intergenerational support and CES-D score was not significant. Measures should be taken to encourage intergenerational emotional support and reduce the pressure on children's economic and care-based support. Further, the medical insurance reimbursement policy, as formal support, should be improved to alleviate depression among rural older adults when children's support is limited.
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Affiliation(s)
- Congrong Li
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
- *Correspondence: Congrong Li
| | - Qing Han
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Jinrong Hu
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Zeyu Han
- School of Public Administration, Xi'an University of Architecture and Technology, Xi'an, China
| | - Hongjuan Yang
- Institute of Sociology, Shaanxi Academy of Social Sciences, Xi'an, China
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3
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Majellano EC, Clark VL, Foster JM, Gibson PG, McDonald VM. "It's like being on a roller coaster": the burden of caring for people with severe asthma. ERJ Open Res 2021; 7:00812-2020. [PMID: 33855063 PMCID: PMC8039902 DOI: 10.1183/23120541.00812-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 01/12/2021] [Indexed: 12/30/2022] Open
Abstract
Introduction Family carers and significant others play a fundamental role in the well-being of people with severe asthma. This study aimed to investigate the challenges faced by family carers/significant others of people with severe asthma, to understand if there is an unmet need and to explore coping strategies. Methods Carers of people with severe asthma were invited to participate in a face-to-face or telephone interview. Semi-structured interviews were conducted until reaching data saturation of themes. The 20 interviews were recorded and transcribed, and analysis of data followed an inductive thematic approach. Results We report three overarching emergent themes: 1) “Caring role impacts”, which centred around the negative and positive impacts of caring on carers' well-being; 2) “Unmet needs”, which encapsulated the support needs participants desired and were categorised into unmet information, biopsychosocial needs and carers' involvement in decision-making; and 3) “Coping strategies”, which were central to the range of tools and positive approaches in dealing with caring demands. Discussion Caring for someone with severe asthma can be burdensome and may negatively affect the physical and psychosocial health of the carer. Various coping strategies are used to manage the demands of these caring roles. Carers of people with severe asthma expressed a need for informational, biopsychosocial and involvement in care decision-making support. Tailored support services that are sensitive to their needs may improve their quality of life and encourage healthcare providers to value and acknowledge the important contribution that carers make. Caring for someone with severe asthma can be burdensome, affecting the physical and psychosocial health of the supportive person negatively. Tailored support services may improve their quality of life.https://bit.ly/2KA9PWS
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Affiliation(s)
- Eleanor C Majellano
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia
| | - Vanessa L Clark
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia
| | - Juliet M Foster
- Woolcock Institute of Medical Research and The University of Sydney, Sydney, NSW, Australia
| | - Peter G Gibson
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council Centre for Research Excellence in Severe Asthma and The Priority Research Centre for Health Lungs, The University of Newcastle, Newcastle, NSW, Australia.,School of Nursing and Midwifery, The University of Newcastle, Newcastle, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, NSW, Australia
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4
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Do caregivers who connect online have better outcomes? A systematic review of online peer-support interventions for caregivers of people with stroke, dementia, traumatic brain injury, Parkinson’s disease and multiple sclerosis. BRAIN IMPAIR 2021. [DOI: 10.1017/brimp.2021.5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
AbstractBackground and Objectives:This systematic review aimed to identify and appraise the evidence for online peer-support interventions for caregivers of stroke survivors (with and without aphasia), and people with dementia, traumatic brain injury (TBI), Parkinson’s disease and multiple sclerosis.Research Design and Methods:Systematic review conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Five databases were systematically searched up until September 2020: EMBASE, PubMed, CINAHL, Scopus and Web of Science. Two reviewers independently screened titles, abstracts and full-text articles. The methodological quality of included studies was assessed using Physiotherapy Evidence Database (PEDro) and Mixed-Methods Appraisal Tool (MMAT) scales. Interventions were described using the Template for Intervention Description and Replication (TIDieR) checklist.Results:A total of 3026 records were identified from database searches. Following screening, 18 studies reporting 17 interventions were included in this review. Most studies (n = 13) reported interventions for caregivers of people with dementia. All studies incorporated an element of peer support as part of the intervention, however, most interventions (n = 15) comprised both psychosocial and educational elements. Statistically significant changes were reported for 11 interventions in one or more of the following domains: caregiver knowledge, mental health, stress, depression, distress, burden, self-efficacy, mastery, helplessness and perceived support. Qualitative outcomes included perceived reductions in stress and increased emotional and informational support.Discussion and Implications:Positive changes in caregiver outcomes were identified in response to multi-component online interventions (i.e., peer support in addition to education). Peer support was often poorly described, limiting the conclusions that could be drawn about the intervention components which result in better outcomes. Online interventions may provide an accessible and effective means of supporting caregivers.
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de Voogd X, Willems DL, Torensma M, Onwuteaka-Philipsen BD, Suurmond JL. Dignity of informal caregivers of migrant patients in the last phase of life: a qualitative study. BMC Palliat Care 2021; 20:26. [PMID: 33541334 PMCID: PMC7863486 DOI: 10.1186/s12904-021-00721-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 01/20/2021] [Indexed: 11/17/2022] Open
Abstract
Background A key aim of palliative care is to improve the quality of life of patients and their families. To help ensure quality of life for the families of patients with migrant backgrounds, this study sought insights into the dignity of informal caregivers in migrant communities. This could improve understanding of family-centered care for migrant patients. Methods Twenty semi-structured interviews with informal caregivers of Turkish, Moroccan, or Surinamese background living in the Netherlands were analyzed thematically. Results The dignity of the patient and that of their informal caregivers were found to be strongly interrelated. Most important for the dignity of caregivers was ensuring good care for their patients and preserving the patients’ dignity. Ensuring good care involved advocating for good and dignified care and for satisfaction of a patient’s wishes. For many informal caregivers, it also included delivering care to the patient by themselves or together with other family members, despite having to give up part of their own lives. Providing care themselves was part of maintaining a good relationship with the patient; the care was to cater to the patient’s preferences and help preserve the patient’s dignity, and it could be accompanied by valuable aspects such as times for good conversations. Positive interaction between an informal caregiver and a patient positively influenced the informal caregiver’s dignity. Informal caregiver and patient dignity were often compromised simultaneously; when informal caregivers felt healthcare professionals were undermining a patient’s dignity, their own dignity suffered. According to informal caregivers, healthcare professionals can help them preserve dignity by taking seriously their advice about the patient, keeping them informed about the prognosis of the disease and of the patient, and dealing respectfully with differences in values at the end of life. Conclusion The dignity of migrant patients’ informal caregivers in the last phase of a patient’s life is closely entwined with ensuring good care and dignity for the patient. Healthcare professionals can strengthen the dignity of informal caregivers by supporting their caregiving role. Supplementary Information The online version contains supplementary material available at 10.1186/s12904-021-00721-6.
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Affiliation(s)
- X de Voogd
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands. .,Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands.
| | - D L Willems
- Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands.,Department of Ethics, Law and Humanities, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,Expertise Centre for Palliative Care, Amsterdam UMC, Boelelaan 1117, Postbus 7057, 1007 MB, Amsterdam, Netherlands
| | - M Torensma
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands
| | - B D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands.,Expertise Centre for Palliative Care, Amsterdam UMC, Boelelaan 1117, Postbus 7057, 1007 MB, Amsterdam, Netherlands
| | - J L Suurmond
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, Netherlands.,Amsterdam Public Health Research Institute, Van Boechorstraat 7, Postbus 7057, 1007 MB, Amsterdam, Netherlands
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6
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Abstract
BACKGROUND Caregivers have different experiences in the patient care process during which the role of providing care is fulfilled. AIM The aim of this study was to provide data on the feelings, thoughts and experiences of the caregivers of patients with schizophrenia. METHOD In this study, the phenomenological method was used. RESULTS The results of this study revealed the following themes: meaning of schizophrenia, the meaning of being caregiver, life before being caregiver, feeling of patients' relatives, difficult areas while providing care, coping situations and metaphors produced by the caregivers. CONCLUSION The results obtained from the study revealed that the caregivers of patients with schizophrenia need information about the mental illness and have a higher emotional burden. PRACTICE IMPLICATIONS Nurses should listen to caregivers' experiences, inquire about the experience of caregivers regarding patient care and advise caregivers on how to take care of their patients.
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Affiliation(s)
- Kerime Bademli
- Psychiatric Nursing Department, Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - Neslihan Lök
- Psychiatric Nursing Department, Faculty of Nursing, Selcuk University, Konya, Turkey
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7
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Houben F, Ghysels R, Mennen D, Bosmans R, Nuyts E, Spooren A. A tool for measuring burden in activities and participation of clients with acquired brain injury: the FINAH-instrument. Brain Inj 2020; 34:1245-1252. [PMID: 32755421 DOI: 10.1080/02699052.2020.1802658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PRIMARY OBJECTIVE The objective of this study was to design an instrument to screen for burden in the daily life of both the client with acquired brain injury (ABI) and their nonprofessional caregiver. RESEARCH DESIGN Exploratory research Methods and Procedures: Based on a survey amongst stakeholder organizations, the FINAH-instrument is designed as a digital self-assessment questionnaire, based on ICF-framework. A test survey of the FINAH instrument is conducted on both clients, nonprofessional caregivers and healthcare professionals. MAIN OUTCOMES AND RESULTS The relative burden per item for clients and nonprofessional caregivers is most prominent in the domains of fatigue, cognitive and emotional consequences, self-care and mobility. The estimation of burden for clients and nonprofessional caregiver by healthcare professionals showed an overall 65% correct estimation by the healthcare professional. 19% of the items showed underestimation of burden, while 16% showed overestimation. CONCLUSIONS These results show that FINAH can ameliorate the estimation of the health care professional on the self-assessed burden of clients and nonprofessional caregivers, thus substantiating a more client-centred approach.
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Affiliation(s)
- Frederik Houben
- Department of Healthcare, PXL University College , Hasselt, Belgium
| | - Rudi Ghysels
- Department of Healthcare, PXL University College , Hasselt, Belgium
| | - Danny Mennen
- Department of Neurology, Adelante Centre of Expertise in Rehabilitation and Audiology , Hoensbroek, The Netherlands
| | - Roel Bosmans
- Department of Technology, PXL University College , Hasselt, Belgium
| | - Erik Nuyts
- Department of Healthcare, PXL University College , Hasselt, Belgium.,Faculty of Architecture and Arts, Hasselt University , Hasselt, Belgium
| | - Annemie Spooren
- Department of Healthcare, PXL University College , Hasselt, Belgium.,Faculty of Rehabilitation Sciences, Hasselt University , Hasselt, Belgium
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8
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Wasley D, Eden S. Predicting psychological distress of informal carers of individuals with major depression or bipolar disorder. Int J Ment Health Nurs 2018; 27:358-367. [PMID: 28317329 DOI: 10.1111/inm.12329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 11/26/2022]
Abstract
Caring for someone with a mental illness is associated with high levels of burden and psychological distress. Understanding these factors could be important to prevent the development of physical and mental health problems in carers. The purpose of the present study was to determine the contribution of coping styles and social support in predicting the psychological distress reported by informal carers (IC) of individuals with major depression or bipolar disorder. IC (n = 72) of adults with a diagnosed depressive illness were recruited from mental health organizations within the community setting. Carers completed the General Health Questionnaire, Brief COPE, and Social Support Questionnaire. Multiple linear regression analysis revealed that 63% of the variance in psychological distress could be accounted for by adaptive and maladaptive coping styles and perceived quantity and satisfaction with social support. Satisfaction with social support (β = -0.508, P < 0.001) and maladaptive coping (β = 0.369; P < 0.001) were significant predictors of psychological distress. These findings suggest that interventions should consider coping styles, specifically the interaction between maladaptive behaviours and enhancement of quality of support, to assist carers to manage psychological distress, especially earlier in the caring role.
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Affiliation(s)
- David Wasley
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
| | - Samantha Eden
- Cardiff School of Sport, Cardiff Metropolitan University, Cardiff, UK
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9
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Persons with disability, social deprivation and an emergency medical admission. Ir J Med Sci 2018; 187:593-600. [PMID: 29340944 DOI: 10.1007/s11845-018-1736-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 01/02/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND The community level of disability and social deprivation may result in an emergency hospitalisation; we have examined the annual admission incidence rate for emergency medical conditions in relation to the community prevalence of such factors. METHODS All emergency medical admissions (96,305 episodes in 50,612 patients) within the institution's catchment area were examined between 2002 and 2016. The frequency of disability, level of full-time carers and unemployment for the 74 electoral divisions of the catchment area was regressed against admission rates; incidence rate ratios (IRR) were calculated using truncated Poisson regression. RESULTS Disability was present in 12.1% of the catchment area population (95% CI = 9.7-15.0). The annual admission incidence rates/1000 population across disability quintiles for the more affluent areas increased from Q1 7.6 (95% CI = 7.4-7.8) to Q5 27.3 (95% CI = 27.0-27.5) and for the more deprived area from Q1 16.6 (95% CI = 16.4, 16.8) to and Q5 40.4 (95% CI = 40.1-40.7). Disability status influenced the overall admission IRR (compared with Q1/Q3) for Q4/Q5 1.11 (95% CI = 1.09-1.13) showing an increased rate of hospitalisation for the more deprived areas. Community disability levels interacted with local area unemployment and frequency of full-time carers; as they increased, a linear relationship between disability and the admission rate incidence was demonstrated. CONCLUSION Local catchment area disability prevalence rates in addition to social deprivation factors are an important determinant of the annual incidence rate of emergency medical admissions.
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Doebler S, Ryan A, Shortall S, Maguire A. Informal care-giving and mental ill-health - differential relationships by workload, gender, age and area-remoteness in a UK region. HEALTH & SOCIAL CARE IN THE COMMUNITY 2017; 25:987-999. [PMID: 27753162 DOI: 10.1111/hsc.12395] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/06/2016] [Indexed: 05/06/2023]
Abstract
Informal care-giving can be a demanding role which has been shown to impact on physical, psychological and social well-being. Methodological weaknesses including small sample sizes and subjective measures of mental health have led to inconclusive evidence about the relationship between informal care-giving and mental ill-health. This paper reports on a study carried out in a UK region which investigated the relationship between informal care-giving and mental ill-health. The analysis was conducted by linking three data sets, the Northern Ireland Longitudinal Study, the Northern Ireland Enhanced Prescribing Database and the Proximity to Service Index from the Northern Ireland Statistics and Research Agency. Our analysis used both a subjective measure of mental ill-health, i.e. a question asked in the 2011 Census, and an objective measure, whether the respondents had been prescribed antidepressants by a General Practitioner between 2010 and 2012. We applied binary logistic multilevel modelling to these two responses to test whether, and for what sub-groups of the population, informal care-giving was related to mental ill-health. The results showed that informal care-giving per se was not related to mental ill-health, although there was a strong relationship between the intensity of the care-giving role and mental ill-health. Females under 50, who provided over 19 hours of care, were not employed or worked part-time and who provided care in both 2001 and 2011 were at a statistically significantly elevated risk of mental ill-health. Caregivers in remote areas with limited access to shops and services were also at a significantly increased risk as evidenced by prescription rates for antidepressants. With community care policies aimed at supporting people to remain at home, the paper highlights the need for further research in order to target resources appropriately.
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Affiliation(s)
- Stefanie Doebler
- School of Natural and Built Environment, Queen's University Belfast, Belfast, UK
| | - Assumpta Ryan
- School of Nursing, University of Ulster, Londonderry, UK
| | - Sally Shortall
- School of Sociology, Social Policy and Social Work, Queen's University Belfast, Belfast, UK
| | - Aideen Maguire
- School of Medicine, Dentistry and Biomedical Sciences, Centre for Public Health, Queen's University Belfast, Royal Victoria Hospital, Belfast, UK
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11
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Saletti-Cuesta L, Tutton E, Langstaff D, Willett K. Understanding informal carers' experiences of caring for older people with a hip fracture: a systematic review of qualitative studies. Disabil Rehabil 2016; 40:740-750. [PMID: 27976920 DOI: 10.1080/09638288.2016.1262467] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE This systematic review aimed to reconceptualize experiences from a variety of papers to provide direction for research, policy and practice. METHOD Meta-ethnography was used to inform the review, and 21 studies were included. FINDINGS The analysis identified a core theme of "engaging in care: struggling through", as carers, who wanted to be involved in caring, learnt to live with the intense and stressful impact of caring and changes to their life. The core theme is represented through three themes (1) Helping another to live, (2) Adapting ways of living and (3) Negotiating the unknown. CONCLUSIONS The discussion identified a focus on carers of people suffering from a hip fracture, the willingness of informal carers to engage in caring and the intense experience of adapting to changes in relationships and dependency alongside a steep experiential learning curve. Tensions exist in negotiations with complex health care systems as carers do not feel their expertise is valued and struggle to find and understand information. Implications for Rehabilitation Including relatives/carers in the umbrella of care within a family-centred approach. Involving relatives/carers within shared decision-making about care requirements and rehabilitation goals. Utilizing forms of experiential learning to help the development of relatives/carers skills in relation to their role as carer. Providing opportunities for carers to explore ways of sustaining their own health through self-compassion.
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Affiliation(s)
- Lorena Saletti-Cuesta
- a Culture and Society Research and Study Centre, National Scientific and Technical Research Council. (CIECS-CONICET-UNC), Córdoba , Argentina
| | - Elizabeth Tutton
- b Kadoorie Critical Care Research and Education Centre, Oxford University Hospitals, NHS Foundation Trust , Oxford , UK.,c Royal College of Nursing Research Institute, Warwick Medical School, University of Warwick , Warwick , UK
| | - Debbie Langstaff
- d Trauma Unit , John Radcliffe Hospital, Oxford University Hospital, NHS Foundation Trust , Oxford , UK
| | - Keith Willett
- b Kadoorie Critical Care Research and Education Centre, Oxford University Hospitals, NHS Foundation Trust , Oxford , UK.,e Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Science , University of Oxford , Oxford , UK
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12
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Brennan A, Warren N, Peterson V, Hollander Y, Boscarato K, Lee S. Collaboration in crisis: Carer perspectives on police and mental health professional's responses to mental health crises. Int J Ment Health Nurs 2016; 25:452-61. [PMID: 27339118 DOI: 10.1111/inm.12233] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 04/05/2016] [Accepted: 04/06/2016] [Indexed: 11/27/2022]
Abstract
For many situations involving a mental health crisis, carers (e.g. family or friends) are present and either attempt to help the person overcome the crisis or request assistance from professional services (e.g. mental health or police). Comparatively, little research has explored how carers experience the crisis, the professional response and how the nature of the response, in turn, impacts carers. The current study was conducted to explore these issues during individual interviews with nine carers who had previous contact with police and mental health services during a crisis response. Collected data described the definition and perceived impact of a mental health crisis for carers, how carers had experienced a crisis response from police and mental health services, and how the professional response had impacted on carers. Of importance was the finding that carers were often themselves traumatized by witnessing or being involved in the crisis, however, were rarely offered direct education or support to help them cope or prevent future crises. A number of carers described a reluctance to request assistance from professional services due to previous poor experiences. This highlighted the importance of implementing strategies to deliver more timely, respectful, specialist and collaborative crisis responses to improve carer and consumer outcomes.
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Affiliation(s)
- Alice Brennan
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Narelle Warren
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia.,School of Social Sciences, Monash University, Melbourne, Victoria, Australia
| | - Violeta Peterson
- Department of Psychiatry, The Alfred and Central Clinical School Monash University, Melbourne, Victoria, Australia
| | - Yitzchak Hollander
- Department of Psychiatry, The Alfred and Central Clinical School Monash University, Melbourne, Victoria, Australia.,Department of Psychology, Faculty of Health, Arts and Design, Swinburne University, Melbourne, Victoria, Australia
| | - Kara Boscarato
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Stuart Lee
- Monash Alfred Psychiatry Research Centre, The Alfred and Central Clinical School Monash University, Melbourne, Victoria, Australia.
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13
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Macmillan TH. Hospital discharge: lost opportunities to promote or maintain older people’s mental health. QUALITY IN AGEING AND OLDER ADULTS 2016. [DOI: 10.1108/qaoa-06-2015-0029] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to explore the impact of hospital discharge on the wider wellbeing of older people, drawing out implications this can have on mental health.
Design/methodology/approach
This paper is based on research from the Healthwatch England Special Inquiry into hospital discharge. The paper focuses on the experiences of 1,300 older people, with the majority of the research being undertaken by the local Healthwatch network. The 58 local Healthwatch who submitted evidence on the experiences of older people as part of the inquiry were autonomous in how they were able to carry out the research, with results being analysed through use of a qualitative framework.
Findings
Older people often felt they were not ready for discharge due to not feeling involved in planning of their discharge, being discharged without the information they need and having difficulties accessing aftercare support. This paper examines the impact these issues can have on the mental health and wellbeing of older people, their carers and specifically patients with dementia both during and after discharge from hospital. Through examination of these issues the discharge process can be viewed from the perspective of the individual, and start to conceptualise where the hospital discharge process could further support older people’s mental health and wellbeing.
Research limitations/implications
This paper examines these issues in detail through case studies collected regarding older people, and exposes the impact poor discharge can have on physical and mental wellbeing for older patients. The paper presents a number of issues which have implications for policy and practice in both health and social care, and the integration of the two services.
Originality/value
This is the first Special Inquiry conducted by Healthwatch England in conjunction with the local Healthwatch network and presents a large scale piece of research led by the experiences of older people.
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Abstract
With demographic trends predicting an increase in the number of older people and a reduction in the number of family carers (Royal Commission on Long Term Care, 1999), it is likely that admission to nursing homes will continue to increase. Although it might be expected that entry to a nursing home, with an anticipated reduction in 24-hour care, would result in a reduction in stress for carers, evidence to date does not support this expectation. Study findings indicate that this experience is associated with guilt, anger, despair, resentment and general psychological distress (Kellett, 1999; Ryan and Scullion, 2000a; Nolan and Dellasega, 2000; Davies, 2001). Therefore, although the physical burden of caring is relieved following nursing home placement, the emotional turmoil often continues, and is exacerbated by the circumstances surrounding the decision to end home care. Although there is evidence to suggest that, following placement, families are often expected to relinquish their dependent older relative to the bureaucracy of the institution, this is not always in the best interest of the resident, the family or the nursing home staff. This paper examines recent literature on the transition from home care to nursing home care and highlights the need for greater collaboration between families and nursing home staff.
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Affiliation(s)
- Assumpta Ryan
- University of Ulster, Coleraine, Co. Londonderry, Northern Ireland
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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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16
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Brereton L, Carroll C, Barnston S. Interventions for adult family carers of people who have had a stroke: a systematic review. Clin Rehabil 2016; 21:867-84. [DOI: 10.1177/0269215507078313] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: A systematic review of the effectiveness of interventions for adult family carers of people with stroke, and an exploratory examination of the relationship between the conceptual basis of these interventions and their effectiveness. Data sources: Seventeen electronic databases and grey literature sources were searched, including ASSIA, BNI, Cochrane Library, CINAHL, EMBASE, MEDLINE, PsycINFO, Social Science Citation Index and the Science Citation Index, HMIC and the National Research Register. Authors of unpublished material were contacted for data and additional publications. Reference and citation tracking was performed on included publications. Review methods: Inclusion criteria: randomized controlled trials of interventions aimed primarily at adult family carers of people post stroke; carers were the primary sample; primary outcomes reported were for carers. Two independent reviewers screened titles and abstracts to identify publications and extract data. Quality assessment was performed to weight study findings. Results: Eight papers were found reporting on six complex, generally heterogeneous, interventions: caregiver training; education and counselling; social problem-solving partnerships, delivered principally by telephone; a psycho-educational telephone support group; a nurse-led support and education programme; and a support programme, delivered either to groups in hospital or individuals during home visits. Half of the interventions were based on stress-coping theories; the remainder did not identify a conceptual basis for the intervention. Conclusions: Some benefits were reported for all interventions, although trials were generally of low quality, preventing firm conclusions being drawn. The presence of a conceptual basis for interventions does not appear to influence effectiveness.
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Affiliation(s)
- Louise Brereton
- Faculty of Health & Wellbeing, Sheffield Hallam University, Sheffield
| | - Christopher Carroll
- Information Resources, School of Health and Related Research (ScHARR), University of Sheffield,
| | - Sue Barnston
- Sheffield Teaching Hospital NHS Foundation Trust, Stroke Unit, Royal Hallamshire Hospital, Sheffield, UK
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17
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Adams KB, Smyth KA, McClendon MJ. Psychosocial Resources as Moderators of the Impact of Spousal Dementia Caregiving on Depression. J Appl Gerontol 2016. [DOI: 10.1177/0733464805278812] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study examines the relationship of personal mastery and perceived emotional support to depressive symptoms for spousal dementia caregivers (CGs) and noncaregiver (NCG) spouses. Although it is well known that caring for a spouse with dementia is stressful and that personal mastery and emotional support may reduce stress, the authors hypothesize that these resources are more important for reducing stress in the difficult situation of dementia care than in everyday life for older persons. In bivariate comparisons, CG levels of perceived support and mastery were lower and depression was higher than for NCGs. Consistent with prior research, a hierarchical multiple regression with combined data shows that CG status was a significant predictor of depressive symptoms. A significant interaction of CG status with personal mastery indicates greater impact of mastery on depression among CGs than among NCGs. This unique finding strongly supports interventions focusing on enhancement of mastery among spousal CGs.
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Affiliation(s)
- Kathryn Betts Adams
- Case Western Reserve University, University Hospitals of Cleveland Memory and Aging Center,
| | - Kathleen A. Smyth
- Case Western Reserve University, University Hospitals of Cleveland Memory and Aging Center,
| | - McKee J. McClendon
- Case Western Reserve University, University Hospitals of Cleveland Memory and Aging Center,
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18
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Balfe M, Maguire R, Hanly P, Butow P, O'Sullivan E, Timmons A, Gooberman-Hill R, Sharp L. Distress in long-term head and neck cancer carers: a qualitative study of carers' perspectives. J Clin Nurs 2016; 25:2317-27. [DOI: 10.1111/jocn.13242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2016] [Indexed: 11/30/2022]
Affiliation(s)
- Myles Balfe
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
| | | | - Paul Hanly
- National College of Ireland; Dublin Ireland
| | - Phyllis Butow
- Centre for Medical Psychology; University of Sydney; Sydney NSW Australia
| | | | - Aileen Timmons
- National Cancer Registry of Ireland; Cork Airport Business Park; Cork Ireland
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19
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Olasoji M, Maude P, McCauley K. A Journey of Discovery: Experiences of Carers of People with Mental Illness Seeking Diagnosis and Treatment for Their Relative. Issues Ment Health Nurs 2016; 37:219-28. [PMID: 27055123 DOI: 10.3109/01612840.2015.1135492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study explores the experiences of informal carers of people with mental illness in an Australian mental health service. A qualitative descriptive approach was used with data collected via focus group interviews with a purposive sample of 19 carers. Data analysis revealed two major themes: (a) "Something is not right" and (b) "Now we have a diagnosis." The carers noticed that there was something wrong with their relative before they received a diagnosis but were often hesitant to engage Mental Health services. Carers have trouble understanding if the problems they are witnessing are part of normal development, contemporary culture, or are symptoms of mental illness. Fear of stigma remains a barrier to accessing services and early diagnosis. Findings suggest a need to target support for informal carers in the period prior to and leading to the establishment of a mental health diagnosis.
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Affiliation(s)
- Michael Olasoji
- a Monash University/The Alfred , School of Nursing and Midwifery , Melbourne , Australia
| | - Phil Maude
- b RMIT University, School of Health Sciences , Melbourne , Australia.,c University of Tasmania, School of Health Sciences , Hobart , Tasmania
| | - Kay McCauley
- a Monash University/The Alfred , School of Nursing and Midwifery , Melbourne , Australia
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20
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Theron L. The support needs of South African educators affected by HIV and AIDS. AJAR-AFRICAN JOURNAL OF AIDS RESEARCH 2015; 8:231-42. [PMID: 25875574 DOI: 10.2989/ajar.2009.8.2.11.863] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
In a qualitative study of 77 South African educators, participants were asked to explain how they are affected by HIV and AIDS and how they would best like to be supported in response to this. The term 'affected' refers to educators who have colleagues, learners or loved ones who are HIV-positive or who have died from HIV-related illnesses, or those who teach children orphaned by AIDS or learners who are vulnerable because of a parent's or caregiver's HIV status. Their responses endorse current theory regarding support for educators in the context of the epidemic, but their needs for support also include forms of 'ecosystemic compassion': that is, a longing for the school management, learners' parents, learners, and colleagues to have compassion for their HIV-related predicaments. Because the latter need was pronounced among those educators caring for an ill HIV-positive loved one, this study introduces the importance of researchers' and stakeholders' sensitivity to the possibility of differentiated support, according to how educators are affected by HIV. Many of the participants' calls for support were at odds with policyfacilitated demands on educators to function as pillars of support to vulnerable learners and communities in the age of HIV and AIDS. The findings provide a caveat with regard to educators who require support-notwithstanding the expectation that they function as ecosystemic agents of support. Finally, the educators' calls for support should be tempered by resilience theory, which suggests that while it is important to support HIV-affected educators, the choice of supports should not stymie educators' agency or discourage educators' active participation in the support process.
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Affiliation(s)
- Linda Theron
- a School of Education Sciences, Faculty of Humanities , North-West University , Vaal Triangle Campus, PO Box 1174 , 1900 , Vanderbijlpark , South Africa
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21
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Abstract
Primary carers provide much of the day-to-day care for community-dwelling people living with dementia (PWD). Maintaining that contribution will require a more in-depth understanding of the primary carer role and the support needs that flow from that role. This study explored patterns of formal and informal support utilisation by people caring for a PWD in a rural-regional context. In-depth semi-structured interviews were conducted with 18 rural primary carers of a PWD and thematically analysed. Participant primary carers' almost total commitment to, and absorption in their role and their assumption of ultimate responsibility for the PWD's wellbeing meant that external social context, such as rurality, became less relevant. Carer networks effectively contracted to those key individuals who were central to supporting them in their caring task. External sources of support were tightly managed with strong boundaries around the provision of direct care to the PWD largely excluding all but professional providers. Primary carers are generally categorised along with other family and friends as informal care. However, in assuming primary responsible for the care and wellbeing for the PWD they effectively become the key care provider, suggesting that it would be productive in both research and practice to treat primary carers as key members of a care partnership alongside professional carers, rather than as adjuncts to formal care and/or another client.
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22
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Ugur O, Elcigil A, Arslan D, Sonmez A. Responsibilities and Difficulties of Caregivers of Cancer Patients in Home Care. Asian Pac J Cancer Prev 2014; 15:725-9. [DOI: 10.7314/apjcp.2014.15.2.725] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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23
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Livingston PM, Osborne RH, Botti M, Mihalopoulos C, McGuigan S, Heckel L, Gunn K, Chirgwin J, Ashley DM, Williams M. Efficacy and cost-effectiveness of an outcall program to reduce carer burden and depression among carers of cancer patients [PROTECT]: rationale and design of a randomized controlled trial. BMC Health Serv Res 2014; 14:5. [PMID: 24393305 PMCID: PMC3893402 DOI: 10.1186/1472-6963-14-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2013] [Accepted: 12/27/2013] [Indexed: 11/23/2022] Open
Abstract
Background Carers provide extended and often unrecognized support to people with cancer. The aim of this study is to test the hypothesis that excessive carer burden is modifiable through a telephone outcall intervention that includes supportive care, information and referral to appropriate psycho-social services. Secondary aims include estimation of changes in psychological health and quality of life. The study will determine whether the intervention reduces unmet needs among patient dyads. A formal economic program will also be conducted. Methods/Design This study is a single-blind, multi-centre, randomized controlled trial to determine the efficacy and cost-efficacy of a telephone outcall program among carers of newly diagnosed cancer patients. A total of 230 carer/patient dyads will be recruited into the study; following written consent, carers will be randomly allocated to either the outcall intervention program (n = 115) or to a minimal outcall / attention control service (n = 115). Carer assessments will occur at baseline, at one and six months post-intervention. The primary outcome is change in carer burden; the secondary outcomes are change in carer depression, quality of life, health literacy and unmet needs. The trial patients will be assessed at baseline and one month post-intervention to determine depression levels and unmet needs. The economic analysis will include perspectives of both the health care sector and broader society and comprise a cost-consequences analysis where all outcomes will be compared to costs. Discussion This study will contribute to our understanding on the potential impact of a telephone outcall program on carer burden and provide new evidence on an approach for improving the wellbeing of carers. Trial registration Australian New Zealand Clinical Trials Registry ACTRN: 12613000731796.
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Affiliation(s)
- Patricia M Livingston
- Faculty of Health, Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia.
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24
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Olson R. A time-sovereignty approach to understanding carers of cancer patients' experiences and support preferences. Eur J Cancer Care (Engl) 2013; 23:239-48. [DOI: 10.1111/ecc.12121] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R.E. Olson
- School of Science and Health; University of Western Sydney; Penrith NSW Australia
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25
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McDougall C, Buchanan A, Peterson S. Understanding primary carers' occupational adaptation and engagement. Aust Occup Ther J 2013; 61:83-91. [DOI: 10.1111/1440-1630.12076] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Carmel McDougall
- School of Occupational Therapy and Social Work; Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
| | - Angus Buchanan
- School of Occupational Therapy and Social Work; Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
| | - Sunila Peterson
- School of Occupational Therapy and Social Work; Curtin Health Innovation Research Institute; Curtin University; Perth Western Australia Australia
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26
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Bee TS, Allison W. The Effects of Parkinson's Disease on Caregivers and People with Parkinson's Disease: A Literature Review. PROCEEDINGS OF SINGAPORE HEALTHCARE 2013. [DOI: 10.1177/201010581302200306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Parkinson's disease (PD) is a complex, slowly progressive, neurodegenerative, neurological condition characterised by a wide range of motor problems such as movement disorders, issues with gait and balance, and difficulty with swallowing and speech. In addition, sufferers also experience non-motor symptoms such as disorder of sleep, postural hypotension, mood alterations, lethargy, and cognitive dysfunction. As PD progresses to an advanced stage, people experience periods of debilitating physical and neurological problems and their caregivers face increasing complexity of care. Many people with PD require the support of a caregiver to attend to activities of daily living. This paper will review the literature on the effects of Parkinson's disease on both the patient and caregiver. Findings highlight the progressive nature of the disease affecting both functional and affective domains, and the need for caregiver support to enable the delivery of quality of care to this group throughout the disease trajectory.
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Affiliation(s)
- Tan Siok Bee
- Nursing Division, Singapore General Hospital, Singapore
| | - Williams Allison
- School of Nursing and Midwifery, Faculty of Medicine, Nursing and Health Sciences, Monash University, Australia
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27
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Correa G, Domènech M. Care networking: a study of technical mediations in a home telecare service. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2013; 10:3072-88. [PMID: 23880730 PMCID: PMC3734477 DOI: 10.3390/ijerph10073072] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/22/2013] [Revised: 07/05/2013] [Accepted: 07/09/2013] [Indexed: 11/16/2022]
Abstract
This article examines the processes of technical mediation within familial care networks based on a study of home telecare targeted at older people. Supported by contributions from the actor-network theory as part of the social psychology of science and technology, these processes of technical mediation are analyzed using a qualitative approach. The data were gathered through six focus groups and four in-depth interviews; the participants in the study included users, relatives and formal carers. Thematic analysis techniques encompassing the information were used, revealing the effects on the patterns of caring relationships. The results show the interplay between presence-absence made possible by the devices; the two-way direction of care between the older people and the artifacts; and the process of sustaining care using the technology. We conclude that care should be seen as a socio-technical network where technology plays an active role in sustaining family relationships.
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Affiliation(s)
- Gonzalo Correa
- Departament de Psicologia Social, Universitat Autònoma de Barcelona, Barcelona 8014, Spain.
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28
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Asuquo EF, Etowa JB, Adejumo P. Assessing the Relationship between Caregivers Burden and Availability of Support for Family Caregivers’ of HIV/AIDS Patients in Calabar, South East Nigeria. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/wja.2013.34043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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29
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Epiphaniou E, Hamilton D, Bridger S, Robinson V, Rob G, Beynon T, Higginson I, Harding R. Adjusting to the caregiving role: the importance of coping and support. Int J Palliat Nurs 2012; 18:541-5. [DOI: 10.12968/ijpn.2012.18.11.541] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Eleni Epiphaniou
- Queen Mary University of London, Barts & The London School of Medicine and Dentistry, Centre for Primary Care and Public Health, Blizard Institute, Yvonne Carter Building, 58 Turner Street, London, E1 2AB
| | | | | | | | - George Rob
- Palliative Care, Guy's and St Thomas’ NHS Foundation Trust
| | - Teresa Beynon
- Palliative Care, Guy's and St Thomas’ NHS Foundation Trust
| | | | - Richard Harding
- Palliative Care, Cicely Saunders Institute, King's College London
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30
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Punpanich W, Gorbach PM, Detels R. Impact of paediatric human immunodeficiency virus infection on children's and caregivers' daily functioning and well-being: a qualitative study. Child Care Health Dev 2012; 38:714-22. [PMID: 21851376 PMCID: PMC3392445 DOI: 10.1111/j.1365-2214.2011.01301.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) infection impacts not only upon the physical health of affected children, but also their psychosocial functions, family relationships and economical status. Caregivers are confronted with complex challenges related to the physical, emotional and financial demands of raising these children. The purpose of this study was to enhance our understanding of the impact of HIV disease on both children's and caregivers' well-being, using a qualitative inquiry approach. METHODS A total of 35 primary caregivers of HIV-infected children participated in in-depth interviews. The issues discussed included the major negative impacts on children's daily functioning and well-being, and the perceived caregiver/parental burden. Participants included parents (40%), grandparents (22.8%), other relatives (e.g. uncles, aunts) (34.3%) and one foster parent (2.8%). RESULTS Qualitative analysis revealed that the major negative impacts of HIV/AIDS included physical symptoms, school performance and relationship changes. The major negative impacts on caregivers' well-being included acceptance of the diagnosis, dealing with the financial burden and keeping the diagnosis private. CONCLUSIONS Approaches are needed to address these challenges by enhancing families' coping skills and building supportive networks.
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Affiliation(s)
- W. Punpanich
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA,Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University, Pathum Thani, Thailand
| | - P. M. Gorbach
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA
| | - R. Detels
- Department of Epidemiology, UCLA School of Public Health, Los Angeles, CA, USA
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31
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Tan SB, Williams AF, Morris ME. Experiences of caregivers of people with Parkinson’s disease in Singapore: a qualitative analysis. J Clin Nurs 2012; 21:2235-46. [DOI: 10.1111/j.1365-2702.2012.04146.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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32
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Conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease. Prim Health Care Res Dev 2012; 14:40-51. [PMID: 22785223 DOI: 10.1017/s146342361200031x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
AIM To describe conceptions of daily life in women living with a man suffering from chronic obstructive pulmonary disease (COPD) in different stages. BACKGROUND The spouse is often the primary caregiver to someone with COPD, and thus also affected by the consequences of the disease. No previous studies have been found focusing on conceptions of daily life in women living with a man suffering from COPD in different stages. METHODS A phenomenographic study was conducted. Data were collected in 2008-2009 through semi-structured interviews with 21 women living with men suffering from COPD in different stages. FINDINGS Four main descriptive categories were found: unchanged life situation where no support was needed; socially restricted life and changed roles; changes in health; and changes in the couple's relationship where support was needed. The categories are described in relation to the woman herself, in relation to the man, and in relation to others. No support was needed from society or health care when the men had mild COPD and the women experienced no change in their daily life. As the disease progressed, the women's responsibilities increased and their role changed from being a spouse to being an informal carer. Social contacts became limited, and they began to feel isolated. The women prioritized their spouse's health and well-being and compromised their own health. They experienced lack of support from health professionals and from the municipality.
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O'Brien MR, Whitehead B, Jack BA, Mitchell JD. The need for support services for family carers of people with motor neurone disease (MND): views of current and former family caregivers a qualitative study. Disabil Rehabil 2012; 34:247-56. [PMID: 22087569 DOI: 10.3109/09638288.2011.605511] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE Family carers provide the majority of home-based care for people with motor neurone disease (MND). Carers' need for, and use of, support services are not fully understood; this study aimed to explore, from a qualitative perspective, the views of current and former family carers of people with MND. METHODS A qualitative study was undertaken in Northwest England, using narrative interviews with current (18) and former (10) carers of a family member with MND. An optional longitudinal element involving diary completion was offered to the current carers. Data were analyzed using a thematic framework approach. RESULTS Carer's needs vary, but encompass the provision of information and training, availability of respite care, counselling, and access to trained paid-for carers. CONCLUSIONS There is need for a range of support services to be made available from which carers can select those most appropriate for them. Some support services are not always available for carers of this client group. There is a need for carers to access greater manual handling and training for physical care. Without sufficient support, carer burden can be overwhelming which may impact on the place of care of the patient and ultimately has implications for health and social care services.
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Affiliation(s)
- Mary R O'Brien
- Evidence-based Practice Research Centre, Faculty of Health, Edge Hill University, Ormskirk, Lancashire, UK.
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34
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Cumming TB, Cadilhac DA, Rubin G, Crafti N, Pearce DC. Psychological Distress and Social Support in Informal Caregivers of Stroke Survivors. BRAIN IMPAIR 2012. [DOI: 10.1375/brim.9.2.152] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground: A high degree of burden is often experienced by informal caregivers of stroke survivors. However, little is known about the long-term impact of the caregiving role. This study sought to examine the relationship between social support and the psychological effects experienced by long-term caregivers of stroke survivors. Methods: The design was a prospective, multicentre, hospital-based stroke cohort study with 3 years of follow-up. Caregivers of participating stroke survivors completed questionnaires either through face-to-face interview or over the telephone. Primary outcome measures were the Medical Outcome Study (MOS) Social Support Survey and the Irritability, Depression, and Anxiety (IDA) Scale, and the association between them was investigated using multivariate logistic regression. Results: 174/217 (80%) stroke survivors participated at 3 years, involving 116 informal caregivers (mean age 66.9 years, 71% female). Increasing social support was correlated with lower levels of depression, anxiety and inward irritability in caregivers. Social support was independently associated with anxiety (OR 0.55, 95% CI 0.35–0.85; p = .007) and inward irritability (OR 0.47, 95% CI 0.29–0.77; p = .002). Furthermore, social support was significantly associated with carer strain, as assessed by the Caregiver Strain Index. Conclusions: The amount of social support available to long-term caregivers of stroke survivors may be an important factor in lowering psychological burden in these caregivers.
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Olson RE. Managing hope, denial or temporal anomie? Informal cancer carers’ accounts of spouses’ cancer diagnoses. Soc Sci Med 2011; 73:904-11. [DOI: 10.1016/j.socscimed.2010.12.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2010] [Revised: 12/06/2010] [Accepted: 12/09/2010] [Indexed: 10/18/2022]
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Zegwaard MI, Aartsen MJ, Cuijpers P, Grypdonck MH. Review: a conceptual model of perceived burden of informal caregivers for older persons with a severe functional psychiatric syndrome and concomitant problematic behaviour. J Clin Nurs 2011; 20:2233-58. [PMID: 21332854 DOI: 10.1111/j.1365-2702.2010.03524.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIMS AND OBJECTIVES This literature review aims to delineate the determinants of perceived burden by informal caregivers and provide insight into the interrelatedness between these determinants. BACKGROUND Despite the attention given to the various determinants of perceived burden, their interrelatedness has not been unravelled. Insight into this interrelatedness is mandatory for the development of successful, complex, multivariate interventions to reduce perceived burden of informal caregivers. DESIGN; Systematic review. METHOD Four electronic databases, CINAHL, Embase psychiatry, Medline, Psychinfo and reference lists of selected articles, were searched. Publications between January 1985-2008 were included if they concerned mental illness, burden and care giving. Articles were selected according to predefined inclusion and exclusion criteria. RESULTS The results of mostly descriptive, cross-sectional and univariate research and the more process-oriented results coming from qualitative burden research are organised in a process orientated conceptual scheme or model adapted from the stress-theoretical framework by Lazarus and Folkman. The model indicates that perceived burden must be understood through the individual appraisal of stressors and the availability and use of internal and external resources. Perceived burden is the outcome of multiple, clinically overlapping psychiatric problems, problematic behaviour and functional disabilities. CONCLUSIONS So far, intervention programs to reduce perceived burden of informal caregivers have not devoted much attention to the interrelatedness of the origins of burden. The conceptual model provides an overview of the various determinants of perceived burden and a clear picture of the possible interrelatedness appears. This overview of the most important sources of burden helps to develop a complex, multivariate intervention that is comprehensive, long-term, individually tailored and has the flexibility to meet the dynamics of burden over time. RELEVANCE TO CLINICAL PRACTICE Use of the conceptual model is crucial to professional nursing and the quality of support of informal caregivers.
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Foster K. 'I wanted to learn how to heal my heart': family carer experiences of receiving an emotional support service in the Well Ways programme. Int J Ment Health Nurs 2011; 20:56-62. [PMID: 21199245 DOI: 10.1111/j.1447-0349.2010.00710.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Family carers of people with mental illness provide an immense contribution to society in caring for mental health consumers. However, carers can experience substantial burdens and poor health outcomes themselves. Recognition of their needs for education and support has led to the development of a range of family education programmes. Throughout Australia, the Mental Illness Fellowship Australia offers the Well Ways programme, a group-based, family-to-family, education programme that provides information and aims to increase carers' capacity to care effectively for themselves, their families, and the mental health consumers. This paper describes a qualitative evaluation of an emotional support service piloted in a Well Ways programme in rural Queensland, Australia. The pilot service comprised individual emotional support offered to family carers attending the weekly Well Ways group education programme. Six of eight family carers who received the emotional support engaged in semistructured interviews exploring their experience of receiving the support. Three themes emerged from their experience: dealing with difficult times, connecting through shared experience, and exploring different options. Family carers found the emotional support beneficial, and reported that it enhanced their capacity to manage their own well-being, as well as their caregiving roles.
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Affiliation(s)
- Kim Foster
- Sydney Nursing School, University of Sydney, New South Wales, Australia.
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Tan SB, Williams AF, Morris ME, Tan EK. Health-Related Quality of Life of Caregivers of People with Parkinson's Disease in Singapore. PROCEEDINGS OF SINGAPORE HEALTHCARE 2010. [DOI: 10.1177/201010581001900404] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: To investigate the health-related quality of life (HRQoL) of caregivers for people with Parkinson's disease (PD) living in Singapore. Methods: A face-to-face survey was conducted with a cross-section of caregivers for people with PD. The caregivers were recruited from a PD clinic at an acute tertiary hospital in Singapore and from the members of the Singapore Parkinson's Disease Society. HRQoL was quantified using the SF-36v2® Health Survey, an internationally validated multi-purpose short-form health survey. Results: Ninety-four caregivers completed the survey (a response rate of 57.3%). The respondents were all above 21 years old, with most falling in the 51 and >61 years age range. Seventy-four of the respondents (78.7%) were female. As a whole, the caregivers scored lower in all 6 health domains compared to the general population (adjusted for age, gender and ethnic group) in Singapore. The were significant differences for the “Role Physical” and the “Role Emotional” domains, at 3.9 and 3.3 respectively. Caregivers had a much lower mental component summary (-2.4) when compared to the physical component summary (-1.6). Conclusion: It is important to identify the factors that influence the HRQoL of caregivers so that policies can be developed to lower the burden of PD on caregivers. Assessing the well-being of caregivers may help to identify individuals at risk. The well-being of caregivers has the potential to influence quality of life of people with PD.
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Affiliation(s)
- Siok Bee Tan
- Nursing Division, Singapore General Hospital, Singapore
- Melbourne School of Health Sciences, The University of Melbourne, Australia
| | - Allison F Williams
- Melbourne School of Health Sciences, The University of Melbourne, Australia
| | - Meg E Morris
- Melbourne School of Health Sciences, The University of Melbourne, Australia
| | - Eng King Tan
- Department of Neurology, National Neuroscience Institute (Singapore General Hospital Campus), Singapore
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Clarke D, Winsor J. Perceptions and needs of parents during a young adult's first psychiatric hospitalization: "we're all on this little island and we're going to drown real soon". Issues Ment Health Nurs 2010; 31:242-7. [PMID: 20218767 DOI: 10.3109/01612840903383992] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
A young person's first psychiatric hospitalization can present a crisis for the family. This initial contact with the mental health care system and health care providers, whether positive or negative, has the potential to set the foundation for all future interactions. The purpose of this study was to examine the impact of a young person's first hospitalization on his or her parents and to determine the parents' perspectives on their own emotional and practical support needs. Ten parents (nine mothers and one father) of a young person aged 18 to 25 were recruited through local support groups and by snowball sampling. Based on Aguilera and Messick's (1986) crisis theory, participants were asked about their perception of the event, coping methods they used, and support systems they engaged while their adult child was hospitalized. Six themes were identified: feeling relief about receiving a diagnosis; shock and disbelief associated with the diagnosis of a mental illness; isolation associated with the stigma of mental illness; feeling excluded during the discharge process; and grieving for the loss associated with an altered future. The results revealed that participants received their support from family, friends, and support groups and did not find mental health care providers to be helpful or supportive. The participants provided recommendations for those who work with families experiencing the crisis of a first psychiatric hospitalization.
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Affiliation(s)
- Diana Clarke
- University of Manitoba, School of Nursing, 214 Helen Glass Centre,Winnipeg, Manitoba, R3T 2N2, Canada. diana
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Gent C, McGarry J, Pinnington L. Motor neurone disease: Carers' experiences, behaviour and coping methods. ACTA ACUST UNITED AC 2009. [DOI: 10.12968/bjnn.2009.5.12.45651] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Carol Gent
- Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus
| | - Julie McGarry
- graduate entry nursing, School of Nursing, Midwifery and Physiotherapy, University of Nottingham, Melbourne House, 96 Osmaston Road, Derby, DE1 2RD
| | - Lorraine Pinnington
- University of Nottingham, Division of Rehabilitation Medicine, School of Graduate Entry Medicine and Health, Royal Derby Hospital, Uttoxeter Road, Derby, DE22 3NE
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Rocha SMM, Nogueira ML, Cesario M. Social support and networks in health promotion of older people: a case study in Brazil. Int J Older People Nurs 2009; 4:288-98. [DOI: 10.1111/j.1748-3743.2009.00177.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Salin S, Kaunonen M, Astedt-Kurki P. Informal carers of older family members: how they manage and what support they receive from respite care. J Clin Nurs 2009; 18:492-501. [PMID: 19191998 DOI: 10.1111/j.1365-2702.2008.02550.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIMS To describe informal carers' coping strategies and their experiences of the support provided by respite care. BACKGROUND The target set in the Finnish national old age policy strategy is that 90% of the population over 75 should be able to live at home. A major source of support for older people and their families is respite care in an institution. DESIGN Survey. METHODS The data were collected among informal carers who regularly use respite care services (n = 143). Two structured questionnaires were used: the Carers' Assessment of Managing Index (Nolan et al. 1995) and an index developed by the researchers. RESULTS Informal carers who provided care for younger individuals or people who needed less help had a better quality of life. Spouse carers and older informal carers were less satisfied with their quality of life than younger carers. Periods of respite care had a major influence on informal carers' quality of life: 93% said they felt invigorated. Care periods remained rather isolated episodes in the lives of the older patients in that there was hardly any discussion at the institution about the family's situation, the objectives of respite care, or about how the informal carer was coping. Altogether, 47% of the nurses remained fairly distant. The most useful coping strategies involved creating alternative perspectives in the caring relationship. CONCLUSIONS The results strengthen the knowledge base of informal caregiving by showing how caregivers cope and what kind of support they need in their demanding caring role. RELEVANCE TO CLINICAL PRACTICE Respite care nurses should invest greater effort in supporting informal carers. The service should be developed as an integral part of home care for older people. Nurses and informal carers should see each other as partners who share a common goal, i.e. the well-being of the entire family.
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Affiliation(s)
- Sirpa Salin
- Department of Nursing Science, University of Tampere, Finland.
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The Experience of Spouses as Informal Caregivers for Recipients of Hematopoietic Stem Cell Transplants. Cancer Nurs 2009; 32:E15-23. [DOI: 10.1097/ncc.0b013e31819962e0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Huang XY, Ma WF, Shih HH, Li HF. Roles and functions of community mental health nurses caring for people with schizophrenia in Taiwan. J Clin Nurs 2009; 17:3030-40. [PMID: 19012770 DOI: 10.1111/j.1365-2702.2008.02426.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES The study aimed to understand the nursing roles and functions of public health nurses and home health nurses in Taiwan and the factors that affect nursing roles and functions of nurses that provide community mental health home visiting services. BACKGROUND Although community nurses provide more psychiatric home visiting services than other psychiatric professionals, little research on their roles and functions has been conducted. DESIGN Nursing roles and functions were developed through use of grounded theory method of Strauss and Corbin. METHODS Data were collected using semi-structured face-to-face in-depth interviews and unstructured non-participant observations. The constant comparative analysis continued during the open, axial and selective coding process until data saturation occurred. Participants were selected using theoretical sampling. Final sample size in this study comprised a total of 29 community nurses (18 public health nurses and 11 home health nurses) who provided community mental health home visiting. Public health nurses conducted a total of 16 (eight carers and eight clients) services and home health nurses conducted 16 (eight carers and eight clients) services. RESULTS Fourteen nursing roles were identified. These roles included assessor, supporter, educator, consultant, counselor, negotiator, harmoniser, collaborator, advocate, placement coordinator, resource provider, care provider, case manager and case finder. Moreover, several factors that affect nursing roles and functions in the community mental health home visiting service in Taiwan were also identified. CONCLUSION This is the first study to identify the role of public health and home health nurses caring for people with schizophrenia in the community in Taiwan. RELEVANCE TO CLINICAL PRACTICE The recommendations based on the findings of this research can be used as a guide to improve the delivery of psychiatric home visiting services to community-dwelling clients with schizophrenia and their carers.
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Affiliation(s)
- Xuan-Yi Huang
- School of Nursing and Nursing Department, China Medical University and Hospital, Taichung, Taiwan.
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Ryan AA, McCann S, McKenna H. Impact of community care in enabling older people with complex needs to remain at home. Int J Older People Nurs 2009; 4:22-32. [PMID: 20925798 DOI: 10.1111/j.1748-3743.2008.00152.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Aim. This aim of the study was to explore the impact of community care in enabling older people with complex needs to remain at home. Background. Changing demographic trends and successive government policies have led to an increase in the number of older people with complex needs residing in the community. Design. A qualitative approach using semi-structured interviews was used to collect data from older people (n = 17) and carers (n = 14). Method. Social workers were asked to identify community dwelling older people (65+ years) with multiple needs requiring interventions from a range of health and social care practitioners. Results. Community care enabled older people with complex needs who would otherwise have required residential or nursing home care to remain in their own homes. This was the expressed wish of both the older people and carers interviewed. Conclusions. The provision of high-quality community care for older people is a globally significant challenge and one that requires creative solutions, both at a local and strategic level. Relevance to clinical practice. Nurses and other health and social care professionals need to understand the significance of 'home' for older people and take steps to ensure that additional and appropriate resources are targeted towards community care.
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Affiliation(s)
- Assumpta Ann Ryan
- Lecturer, School of Nursing and Institute for Nursing Research, University of Ulster, Coleraine, Co. Londonderry, Northern IrelandLecturer in Psychology, University of Ulster, Londonderry, Northern IrelandDean of Faculty of Life and Health Sciences, University of Ulster, Cromore Road, Coleraine, Co. Londonderry, Northern Ireland
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Dibsdall L, Rugg S. Carers' Perspectives on their Needs and Local Authority Occupational Therapy Practice. Br J Occup Ther 2008. [DOI: 10.1177/030802260807100704] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Unpaid family carers are the main providers of care for older people in the community. Local authority occupational therapists are required by law to assess the needs of such carers in their work, targeting their interventions to support carers' roles. This small qualitative study identified the perceived needs of nine family carers of adults with physical disabilities in one English county, exploring the extent to which these needs were met by local authority occupational therapists. Data were collected from semi-structured qualitative interviews with nine family carers. These interviews were transcribed verbatim and analysed using elements of grounded theory methodology. Six varied categories of carers' needs emerged. Occupational therapists met the participants' needs for practical assistance and information, but not for respite or financial assistance. Regarding support network issues, the participants reported poorly integrated community services and little initial awareness of occupational therapy. Once seen by an occupational therapist, however, they wished to remain ‘on file’ to gain instant access to a valued source of support. The recommendations made include the generation of family carer targeted occupational therapy information resources, ongoing therapist liaison to raise general practitioners' familiarity with local service provision and additional research.
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Affiliation(s)
- Lisa Dibsdall
- Amesbury Community Team, Department of Community Services, Amesbury, Wiltshire
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Papastavrou E, Kalokerinou A, Papacostas SS, Tsangari H, Sourtzi P. Caring for a relative with dementia: family caregiver burden. J Adv Nurs 2007; 58:446-57. [PMID: 17442030 DOI: 10.1111/j.1365-2648.2007.04250.x] [Citation(s) in RCA: 277] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM This paper is a report of part of a study to investigate the burden experienced by families giving care to a relative with dementia, the consequences of care for the mental health of the primary caregiver and the strategies families use to cope with the care giving stressors. BACKGROUND The cost of caring for people with dementia is enormous, both monetary and psychological. Partners, relatives and friends who take care of patients experience emotional, physical and financial stress, and care giving demands are central to decisions on patient institutionalization. METHOD A volunteer sample of 172 caregiver/care recipient dyads participated in the study in Cyprus in 2004-2005. All patients were suffering from probable Alzheimer's type dementia and were recruited from neurology clinics. Data were collected using the Memory and Behaviour Problem Checklist, Burden Interview, Center for Epidemiological Studies-Depression scale and Ways of Coping Questionnaire. FINDINGS The results showed that 68.02% of caregivers were highly burdened and 65% exhibited depressive symptoms. Burden was related to patient psychopathology and caregiver sex, income and level of education. There was no statistically significant difference in level of burden or depression when patients lived in the community or in institutions. High scores in the burden scale were associated with use of emotional-focused coping strategies, while less burdened relatives used more problem-solving approaches to care-giving demands. CONCLUSION Caregivers, especially women, need individualized, specific training in how to understand and manage the behaviour of relatives with dementia and how to cope with their own feelings.
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Affiliation(s)
- Evridiki Papastavrou
- School of Health Sciences, Department of Nursing, Cyprus University of Technology, Cyprus.
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Henriksson A, Andershed B. A support group programme for relatives during the late palliative phase. Int J Palliat Nurs 2007; 13:175-83. [PMID: 17551421 DOI: 10.12968/ijpn.2007.13.4.23484] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study describes an intervention where relatives were invited to take part in a support group programme during the late palliative phase of their family member. The purpose was to describe their experiences of the support group programme and the subsequent impact on their lives as relatives of a terminally ill person. Qualitative interviews were chosen as the data collection method. The analysis was inspired by the phenomenological method as described by Giorgi (1989). The relatives' experiences were categorised into six key constituents: confirmation; insight into the gravity of the illness; sense of belonging created by similar experiences; participation in the care system; being able to rest; and strength to provide support for the patient. These six constituents resulted in a sense of safety in relation to the patient, the illness, the nursing staff and the care unit. The study's findings show that interventions of this kind may be integral to the relatives' ability to handle their situation when caring for a terminally ill family member.
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Ekwall AK, Sivberg B, Hallberg IR. Older caregivers? coping strategies and sense of coherence in relation to quality of life. J Adv Nurs 2007; 57:584-96. [PMID: 17346317 DOI: 10.1111/j.1365-2648.2006.03994.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIM This paper reports a study to investigate coping strategies and sense of coherence in relation to gender, the extent of care, caregiving activities and health-related quality of life in a population-based sample of caregivers aged 75 and over. BACKGROUND Caring for another person can be stressful both emotionally, and caregiver burden may affect quality of life in a negative way for the carer. Caregivers' experience of burden may depend on for example, the behaviour of the person cared for, their own health and their sense of coherence. Older people take a great part of caregiving responsibility and thus understanding of their strain and coping is required. METHODS A postal survey was carried out in 2001 with 171 informal caregivers, aged 75 or older. The response rate was 47%. The questionnaire included the Short-Form 12, Carer's Assessment of Managing Index, and Sense of Coherence instrument. RESULTS Almost 70% of caregivers provided help every day. Higher health-related quality of life was predicted by using self-sustaining coping strategies and by high sense of coherence. Poor economic situation and demanding social and practical support predicted low scores. CONCLUSION These findings could help identify those at risk of low quality of life due to caregiving, dysfunctional coping or lack of information about care. Early intervention, including education about alternative coping strategies and practical information, might allow caregivers better possibilities to continue caring with less negative effects on their lives.
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Abstract
Increasingly, Australian government policy advances an expectation that consumer and carer participation will be present in all aspects of mental health service delivery. A review of the literature suggests that consumers and carers actively seek the opportunity to participate but are frequently hampered by barriers. However, government policy documents tend to discuss consumers and carers with regards to participation as though their needs and desires are essentially similar. This paper presents the findings of a qualitative research project involving in-depth interviews with carers and mental health nurses. The issue of conflict between the issues for consumers and carers emerged as a major theme. This issue is explored and discussed in light of the goals of current mental health policy. It is concluded that conflicting agendas are apparent and must be addressed if genuine participation in service delivery is possible for both consumers and carers.
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Affiliation(s)
- Val Goodwin
- Centre for Psychiatric Nursing Research and Practice, School of Nursing, University of Melbourne, Melbourne, Victoria, Australia
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