1
|
Kim D, Russell BS, Park CL, Fendrich M. Emotion dysregulation and family functioning moderate family caregiving burden during the pandemic. Palliat Support Care 2024; 22:451-459. [PMID: 37997433 DOI: 10.1017/s1478951523001712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Since the onset of COVID-19 pandemic, additional risk factors affecting family caregivers' mental health have arisen. Therefore, personal stress coping strategies and family dynamics became important factors in reducing the impact of the pandemic on family caregivers' mental health. The present research aimed to estimate the association between COVID-19 stressors and family caregiving burden. Moreover, moderating effects of emotion dysregulation and family functioning on this association were investigated. METHODS This study analyzed data collected in April 2021 from 154 family caregivers (Mage = 38.79, SDage = 9.36, range = 22-64) recruited through Amazon's Mechanical Turk (MTurk). The impact of COVID-19 stressors on family caregiving burden was tested, and moderating impacts of emotion dysregulation and family functioning were also investigated. RESULTS Both COVID-19 stress exposure and stress appraisal were positively associated with family caregiving burden. Emotion dysregulation and problematic family functioning were also positively associated with family caregiving burden. A significant moderating effect of emotion dysregulation was found, such that family caregivers with higher emotion dysregulation were likely to feel more caregiving burden when they experienced more COVID-19 stressors. SIGNIFICANCE OF RESULTS The current research highlighted the role of emotion regulation in reducing the negative impact of COVID-19 stressors on family caregiving burden. The research also emphasizes the need for intervention programs to improve emotion regulation strategies to decrease family caregiving burden during the pandemic.
Collapse
Affiliation(s)
- Dahee Kim
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Beth S Russell
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, Hartford, Connecticut, USA
| |
Collapse
|
2
|
Xiang E, Rangel ML, Badr H. Social Connectedness and Perceived Stress Among Caregivers During the COVID-19 Pandemic: a Mixed-Methods Study. Int J Behav Med 2024; 31:380-392. [PMID: 37853272 DOI: 10.1007/s12529-023-10228-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2023] [Indexed: 10/20/2023]
Abstract
BACKGROUND The COVID-19 pandemic has created unprecedented stressors for caregivers due to social distancing requirements that simultaneously increased their responsibilities and reduced opportunities for social connection and support. This concurrent embedded mixed-methods study examined differences between caregivers and non-caregivers regarding the effects of social connectedness on perceived stress and explored challenges caregivers experienced related to social connectedness and perceived stress. METHOD A national online survey containing forced-choice and free-response questions was administered between April and June 2020. The survey was distributed via social media advertisements and a crowdsourcing platform to eligible adult residents in the United States (US) fluent in either English or Spanish. Multivariable regression and thematic analysis were used to analyze the quantitative and qualitative data. Mixed-methods integration occurred during the data analysis, interpretation, and reporting phases. RESULTS The study sample comprised 1540 US adults (1275 non-caregivers, 265 caregivers; 65% women; 36% racial/ethnic minorities). Relative to non-caregivers, caregivers had lower levels of social connectedness and higher levels of perceived stress. Social connectedness was also inversely related to perceived stress for non-caregivers (p < 0.001) and slightly but not significantly positively related to perceived stress for caregivers. Qualitative findings showed caregivers experienced a variety of stressors including fear of COVID-19 exposure to their care recipients, disruption to usual care routines, and difficulty accessing healthcare services that may have contributed to decrements in social connectedness and higher levels of perceived stress. CONCLUSION Findings suggest social connectedness may be beneficial for reducing perceived stress, but its impact can vary depending on individual circumstances. Overall, findings support the idea that caregivers are a particularly vulnerable sub-group of the population and may benefit from more targeted support and interventions.
Collapse
Affiliation(s)
- Ellen Xiang
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA
| | - Maria Lizette Rangel
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA
| | - Hoda Badr
- Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, USA.
| |
Collapse
|
3
|
Bender AA, Pier E, Moore M, Jungerman J, Davis A, Perkins MM. Barriers to Community Service Use Among Persons With Dementia and Their Care Partners: A Focus on Consumers of a Novel Statewide Dementia Care Program. J Appl Gerontol 2024; 43:612-622. [PMID: 38171532 DOI: 10.1177/07334648231223295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024] Open
Abstract
Although the importance of access to, and utilization of, home and community-based services (HCBS) is a well-documented aspect of informal care and the ability to age in place among people living with dementia, these resources are underutilized, especially in the initial stages of the disease. In 2017, the Georgia Memory Net was established as a novel private-public partnership to extend dementia screening, diagnosis, care planning, and direct HCBS connections for people with memory concerns throughout the State of Georgia. We aimed to identify barriers and facilitators to HCBS utilization following a dementia diagnosis and subsequent referral for services. Data were collected through in-depth interviews with 7 Georgia Memory Net patients and 19 care partners (unconnected dyads) and analyzed using thematic analysis. We found that even with a direct handoff, many people do not use HCBS and face barriers to accessing services. We offer several recommendations based on these findings.
Collapse
Affiliation(s)
| | - Ellyn Pier
- Spaulding Rehabilitation Hospital, Boston, MA, USA
| | | | | | | | - Molly M Perkins
- Emory University, Atlanta, GA, USA
- Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Atlanta, GA, USA
| |
Collapse
|
4
|
Kirkegaard A, Friedman EM, Edgington S, Kennedy D. Increased Care Provision and Caregiver Wellbeing: Moderation by Changes in Social Network Care Provision. J Gerontol B Psychol Sci Soc Sci 2024; 79:gbae015. [PMID: 38364364 PMCID: PMC10997277 DOI: 10.1093/geronb/gbae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Indexed: 02/18/2024] Open
Abstract
OBJECTIVES Previous research links increased care provision to worse wellbeing among family and friend caregivers, both before and during the coronavirus disease 2019 (COVID-19) pandemic. We expand on this by incorporating data on caregivers' social networks and exploring the relationships between own and network changes in care during the pandemic and caregiver wellbeing. METHODS We use nationally representative data from 1,876 family and friend caregivers in the first wave of our Care Network Connections over Time study (fielded 12/17/2020-1/4/2021) who had provided care continuously since before the COVID-19 pandemic began. Caregivers were asked about the amount of care that they and each member of their social networks were providing at the time of the survey relative to before the pandemic. We use multivariate regression models to examine the associations between five caregiver wellbeing outcomes and changes in care, and explore the moderating role of networks' changes in care. RESULTS Among caregivers who had provided care since prior to the pandemic, most increased (42.0%) or maintained the same (40.8%) care. Their networks also typically increased (33.4%) or maintained (46.5%) care. Increasing one's own care provision was associated with higher levels of anxiety, depression, loneliness, and emotional difficulty than maintaining stable care. Among those who increased care, these levels were highest when the network also increased or decreased care. DISCUSSION Increased care provision was most strongly associated with poor caregiver wellbeing in contexts where caregivers' social networks also changed care provisions. Supports for caregivers undertaking additional care tasks should take into account caregivers' networks.
Collapse
Affiliation(s)
| | - Esther M Friedman
- Institute for Social Research, University of Michigan at Ann Arbor, Ann Arbor, Michigan, USA
| | | | | |
Collapse
|
5
|
Liao X, Wang Z, Zeng Q, Zeng Y. Loneliness and social isolation among informal carers of individuals with dementia: A systematic review and meta-analysis. Int J Geriatr Psychiatry 2024; 39:e6101. [PMID: 38752797 DOI: 10.1002/gps.6101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/03/2024] [Indexed: 05/21/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis aimed to determine the prevalence of loneliness and social isolation among informal carers of individuals with dementia and to identify potential influencing factors. METHODS We conducted a comprehensive search across 10 electronic databases, including PubMed, Cochrane, Embase, Web of Science, PsycINFO, CINAHL, Scopus, Chinese Biomedical, China National Knowledge Internet, and WANFANG. Our search strategy covered the inception of the databases up to September 16, 2023, with an updated search conducted on March 8, 2024. Prevalence estimates of loneliness and social isolation, presented with 95% confidence intervals, were synthesized through meta-analysis. Subgroup analyses and meta-regression were employed to explore potential moderating variables and heterogeneity. RESULTS The study encompassed 27 research papers involving 11,134 informal carers from 17 different countries. The pooled prevalence of loneliness among informal carers of individuals with dementia was 50.8% (95% CI: 41.8%-59.8%), while the pooled prevalence of social isolation was 37.1% (95% CI: 26.7%-47.6%). Subgroup analyses and meta-regression indicated that various factors significantly influenced the prevalence of loneliness and social isolation. These factors included the caregiving setting, study design, the intensity of loneliness, geographical location (continent), data collection time, and the choice of assessment tools. CONCLUSIONS This study underscores the substantial prevalence of loneliness and social isolation among informal carers of individuals with dementia. It suggests that policymakers and healthcare providers should prioritize the development of targeted interventions and support systems to alleviate loneliness and social isolation within this vulnerable population.
Collapse
Affiliation(s)
- Xinqi Liao
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong Wang
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Qinglin Zeng
- Chengdu Fifth People's Hospital, Chengdu, Sichuan, China
| | - Yanli Zeng
- College of Nursing, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| |
Collapse
|
6
|
Chan JK, Marzuki AA, Vafa S, Thanaraju A, Yap J, Chan XW, Harris HA, Todi K, Schaefer A. A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain. BMC Psychol 2024; 12:237. [PMID: 38671542 PMCID: PMC11046828 DOI: 10.1186/s40359-024-01715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders. METHODS Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health. RESULTS Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst. CONCLUSIONS This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.
Collapse
Affiliation(s)
- Jee Kei Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Sunway University Malaysia, Room: 4-4-11, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, 47500, Selangor, Malaysia.
| | - Aleya A Marzuki
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Samira Vafa
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Arjun Thanaraju
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Jie Yap
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Xiou Wen Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Hanis Atasha Harris
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Khushi Todi
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Alexandre Schaefer
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| |
Collapse
|
7
|
Ervin J, Fleitas Alfonzo L, Taouk Y, Maheen H, King T. Unpaid caregiving and mental health during the COVID-19 pandemic-A systematic review of the quantitative literature. PLoS One 2024; 19:e0297097. [PMID: 38635604 PMCID: PMC11025839 DOI: 10.1371/journal.pone.0297097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/19/2023] [Indexed: 04/20/2024] Open
Abstract
The COVID-19 pandemic imposed additional and specific challenges on the lives and wellbeing of informal unpaid carers. Addressing an important gap in the existing literature, this systematic review (prospectively registered with PROSPERO CRD42022376012) synthesises and evaluates the quantitative evidence examining the association between unpaid caregiving and mental health (compared to non-caring), during the pandemic. Five databases were searched (Medline, PsycInfo, EMBASE, Scopus, Web of Science) from Jan 1, 2020, to March 1, 2023. Population-based, peer-reviewed quantitative studies using any observational design were included, with screening, data extraction and quality assessment (amended NOS) independently conducted by two reviewers. Of the 3,073 records screened, 20 eligible studies (113,151 participants) were included. Overall quality of evidence was moderate. Narrative synthesis was complemented by Effect-direction and Albatross plots (given significant between-study heterogeneity precluded meta-analysis). Results indicate that the mental health of informal carers, already poorer pre-COVID compared to non-caregivers, was disproportionally impacted as a result of the pandemic and its associated public health containment measures. This review highlights the vulnerability of this group and should motivate political will and commensurate policies to ensure unpaid caregivers are better supported now, in the medium term, and crucially if, and when, another global public health emergency emerges.
Collapse
Affiliation(s)
- Jennifer Ervin
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ludmila Fleitas Alfonzo
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Yamna Taouk
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Humaira Maheen
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Tania King
- Centre for Health Policy, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
8
|
Parmar J, L’Heureux T, Lobchuk M, Penner J, Charles L, St. Amant O, Ward-Griffin C, Anderson S. Double-duty caregivers enduring COVID-19 pandemic to endemic: "It's just wearing me down". PLoS One 2024; 19:e0298584. [PMID: 38626216 PMCID: PMC11020535 DOI: 10.1371/journal.pone.0298584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/28/2024] [Indexed: 04/18/2024] Open
Abstract
The COVID-19 pandemic has considerably strained health care providers and family caregivers. Double-duty caregivers give unpaid care at home and are employed as care providers. This sequential mixed-method study, a survey followed by qualitative interviews, aimed to comprehensively understand the experiences of these Canadian double-duty caregivers amidst the pandemic and the transition to the endemic phase. The multi-section survey included standardized assessments such as the Double-duty Caregiver Scale and the State Anxiety Scale, along with demographic, employment-related, and care work questions. Data analysis employed descriptive and linear regression modeling statistics, and content analysis of the qualitative data. Out of the 415 respondents, the majority were female (92.5%) and married (77.3%), with 54.9% aged 35 to 54 years and 29.2% 55 to 64 years. 68.9% reported mental health decline over the past year, while 60.7% noted physical health deteriorated. 75.9% of participants self-rated their anxiety as moderate to high. The final regression model explained 36.8% of the variance in participants' anxiety levels. Factors contributing to lower anxiety included more personal supports, awareness of limits, younger age, and fewer weekly employment hours. Increased anxiety was linked to poorer self-rated health, and both perceptions and consequences of blurred boundaries. The eighteen interviewees highlighted the stress of managing additional work and home care during the pandemic. They highlighted the difficulty navigating systems and coordinating care. Double-duty caregivers form a significant portion of the healthcare workforce. Despite the spotlight on care and caregiving during the COVID-19 pandemic, the vital contributions and well-being of double-duty caregivers and family caregivers have remained unnoticed. Prioritizing their welfare is crucial for health systems as they make up the largest care workforce, particularly evident during the ongoing healthcare workforce shortage.
Collapse
Affiliation(s)
- Jasneet Parmar
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Tanya L’Heureux
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Michelle Lobchuk
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jamie Penner
- Helen Glass College of Nursing, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lesley Charles
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Oona St. Amant
- Daphne Cockwell School of Nursing, Toronto Metropolitan University, Toronto, Ontario, Canada
| | - Catherine Ward-Griffin
- Arthur Labatt Family School of Nursing, University of Western Ontario, London, Ontario, Canada
| | - Sharon Anderson
- Department of Family Medicine Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada
| |
Collapse
|
9
|
Çekici A, Yurttaş A. The Relationship Between Care Preparedness and Altruism Levels in Caregivers of Stroke Patients. J Neurosci Nurs 2024; 56:60-64. [PMID: 38085795 DOI: 10.1097/jnn.0000000000000745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
ABSTRACT BACKGROUND: Stroke care partners and caregivers experience emotional and physical burden, and 80% of stroke patients need support after discharge. This study examines the relationship between caregiver preparedness and altruism levels of stroke patients. METHODS: The population of this descriptive and correlational study consisted of the caregivers of stroke patients who were hospitalized at the stroke center of a hospital between January 2021 and August 2021. The sample was determined as 240 with the known sampling formula. The descriptive information form, the Preparedness for Caregiving Scale, and the Altruism Scale were used to collect the study data. RESULTS: The total mean score of the caregivers' preparedness to provide care was found to be 25.04 (7.36), and the mean total altruism score was 85.78 (9.20). The mean score of Donation, which is one of the subdimensions of the Altruism Scale, was 26.67 (4.08), and that of Helping Status was 59.10 (6.92). No statistically significant relationships were detected between caregivers' preparedness to provide care scores, Helping Status scores, Donation scores, and total altruism scores in this study ( P = .241, P = .245, and P = .129, respectively). CONCLUSION: No statistically significant relationships were detected between the preparedness and altruism levels of the caregivers of the stroke patients in this study.
Collapse
|
10
|
Kennedy DP, Friedman EM, Kirkegaard A, Edgington S, Shih R. Perceived loss of support to community caregivers during the COVID-19 pandemic in the United States. JOURNAL OF COMMUNITY PSYCHOLOGY 2024; 52:475-497. [PMID: 38329412 PMCID: PMC10977083 DOI: 10.1002/jcop.23107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/08/2024] [Indexed: 02/09/2024]
Abstract
Coronavirus disease (COVID-19) had a negative impact on the health and well-being of community caregivers. Few studies examine the pandemic's negative impact on the availability of social networks of caregivers. This article uses data collected during COVID-19 before vaccination to examine caregivers' reports of perceived lost and reduced network support. We assessed the personal networks of a nationally representative sample of 2214 community caregivers in the United States. We analyzed associations between caregiving factors and caregivers' perceptions of lost and reduced network support. Changes in care recipient living circumstances during COVID-19, longer-term caregiving, care recipient hearing/vision/mobility problems, caregiver travel/socializing restrictions, caregiver race/ethnicity, caregiver income, caregiver age, network connectivity, family relationships, and network members' age were associated with perceived lost/reduced support during the pandemic. Findings provide insights for the development of social network interventions to support caregivers and help them cultivate support networks resilient to public health crises.
Collapse
Affiliation(s)
- David P. Kennedy
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Esther M. Friedman
- Institute for Social Research, University of Michigan at Ann Arbor, 426 Thompson St, Ann Arbor, MI 48104
| | | | - Sarah Edgington
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
| | - Regina Shih
- RAND Corporation, 1776 Main St., M5S., Santa Monica, CA 90047-2138
- Emory University, 1518 Clifton Rd., Atlanta, GA
| |
Collapse
|
11
|
Poteat TC, Hall P, Brooks M, Horn J, Yang C, Pereira N, Adams MA. Caregiving During the COVID-19 Pandemic: A Cross-Sectional Study with Older Cisgender Sexual Minority Women in the United States. LGBT Health 2024; 11:219-228. [PMID: 37971831 PMCID: PMC11001953 DOI: 10.1089/lgbt.2023.0226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Purpose: This study describes prevalence of caregiving before and after the onset of the COVID-19 pandemic among racially diverse older cisgender sexual minority women, examines factors associated with caregiving, and assesses relationships between caregiving and health. Methods: A convenience sample of participants aged ≥50 years completed self-administered online surveys assessing sociodemographic characteristics, caregiver status, self-rated health, and depressive symptoms. Bivariate statistics compared response variables by race, caregiver status, and timing of caregiving relative to the pandemic. Results: Of 365 participants, 82.7% identified as lesbian or gay and 41.1% as Black/African American; 40% were caregivers before (n = 32), during (n = 34), or both before and during (n = 80) the pandemic. A greater proportion of caregivers lived with a partner (45.9% vs. 35.6%, p = 0.06), were unemployed (37.7% vs. 29.7%, p = 0.07), and had high school or lower education (11.6% vs. 5%, p = 0.09). No differences were found in self-rated health by caregiver status; however, a higher proportion of Black (vs. White) caregivers reported good to excellent physical health (77.9% vs. 62.9%, p = 0.05). Caregivers more frequently reported depressive symptoms (28.1% vs. 17.8%, p = 0.03). Caregivers both before and during the pandemic had lower educational attainment than those who provided care only before or only during the pandemic (p = 0.04). Conclusion: Caregiving was common among older sexual minority women during the pandemic and experiences varied by race and other social factors. Consideration of these intersecting experiences is important for fully understanding caregiver experiences during COVID-19. Overall, caregiving was associated with depressive symptoms, underscoring the importance of psychosocial support for all caregivers.
Collapse
Affiliation(s)
- Tonia C. Poteat
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Porsha Hall
- ZAMI NOBLA: National Organization of Black Lesbians on Aging, Atlanta, Georgia, USA
| | - Madeline Brooks
- Department of Epidemiology, Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Jennifer Horn
- Family Caregiver Support Center, Pikes Peak Area Agency on Aging, Colorado Springs, Colorado, USA
| | - Chloe Yang
- Department of Health Behavior, Gillings School of Public Health, Chapel Hill, North Carolina, USA
| | - Nastacia Pereira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Mary Anne Adams
- ZAMI NOBLA: National Organization of Black Lesbians on Aging, Atlanta, Georgia, USA
| |
Collapse
|
12
|
Sun JJ, Hsiao CT, Liu TY. Caregiving experiences of primary family caregivers caring for family members affected by COVID-19 during home isolation: A phenomenology study. Nurs Health Sci 2024; 26:e13091. [PMID: 38356113 DOI: 10.1111/nhs.13091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 12/16/2023] [Accepted: 01/07/2024] [Indexed: 02/16/2024]
Abstract
During home isolation due to the coronavirus disease, family caregivers assumed the responsibility of caring for infected family members; however, the full extent of the difficulties and challenges they encountered remains unclear. This study applied a descriptive phenomenology approach, using semi-structured, one-on-one, in-depth interviews to explore the experiences of 16 primary family caregivers during home isolation amid the coronavirus disease. The key themes identified were as follows: (1) protecting family, comprising anxiety over preventing infection and bearing the responsibility of caregiving and a concern about the diagnosis; (2) seeking stability, encompassing the impact of epidemic control policies on daily routines, strategies to overcome obstacles caused by quarantine measures, and gathering resources and receiving support; and (3) reflections on life, including favoring love over discrimination, rediscovering oneself, cherishing family, and acknowledging personal growth and dedication. This study highlights that family members who took on caregiving roles due to obstacles or health risks faced significant pressure to protect their family members during isolation and actively sought professional consultation and acquired caregiving skills to enhance their confidence and adaptability.
Collapse
Affiliation(s)
- Jia-Jing Sun
- School of Nursing, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Nursing, Taipei City Hospital, Taipei, Taiwan
| | | | - Tsui-Yao Liu
- Department of Nursing, Taipei City Hospital, Taipei, Taiwan
| |
Collapse
|
13
|
Ngamasana EL, Zarwell M, Eberly L, Gunn LH. Difference in the physical and mental health of informal caregivers pre- and post-COVID-19 National Emergency Declaration in the United States. SSM Popul Health 2024; 25:101609. [PMID: 38313872 PMCID: PMC10837638 DOI: 10.1016/j.ssmph.2024.101609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024] Open
Abstract
Background The burden of informal caregiving represents a chronic stressor for the informal caregivers (ICs). The study investigates differences in the physical and mental health of ICs and that of non-informal caregivers before and during COVID-19. Methods We used data from the 2019/2020 Behavioral Risk Factor Surveillance System (BRFSS) to investigate differences in the rates of days of poor physical and mental health among ICs compared to non-informal caregivers before and after the COVID-19 National Emergency Declaration (NED). A propensity score model simulated a pseudo experimental design, comparing ICs ("treated") with non-informal caregivers ("control"). A difference-in-difference regression model estimated the incidence rate ratios for days of poor physical and mental health as a function of IC status and time of care provision. Results A total of 44,583 respondents were identified with valid responses on informal caregiving status and key sociodemographic characteristics. Of those, 6.24% (n = 3073) were ICs, matched against 15,365 non-informal caregivers. In the matched sample (n = 18,848), the incidence rate for days of poor physical health among ICs was 17% (p = 0.003) higher compared to non-informal caregivers. The incidence rate for days of poor physical health was 23% (p < 0.001) lower in the post-NED compared to the pre-NED periods. The incidence rate for days of poor mental health was 44% (p < 0.001) higher among ICs compared to non-informal caregivers and 22% higher among respondents who took the survey post-NED compared to those who answered during the pre-NED period. No statistically significant differences were found between the two groups in their incidence rates for days of poor physical and mental health from the pre-to the post-NED period. Conclusion These findings suggest a need to balance between the benefits conferred by public health restrictions versus the mental health burden that may result among certain groups, including ICs, who experience higher negative mental health outcomes.
Collapse
Affiliation(s)
- Emery Lady Ngamasana
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Meagan Zarwell
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Lori Eberly
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Laura H Gunn
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
- School of Data Science, University of North Carolina at Charlotte, Charlotte, NC, USA
- Department of Primary Care and Public Health, Imperial College London, London, UK
| |
Collapse
|
14
|
Pokoski OM, Crain H, DiGuiseppi C, Furnier SM, Moody EJ, Nadler C, Pazol K, Sanders J, Wiggins LD, Durkin MS. Economic impacts of the COVID-19 pandemic on families of children with autism and other developmental disabilities. Front Psychiatry 2024; 15:1342504. [PMID: 38419902 PMCID: PMC10899320 DOI: 10.3389/fpsyt.2024.1342504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/26/2024] [Indexed: 03/02/2024] Open
Abstract
Background To control the spread of the coronavirus disease (COVID-19), many jurisdictions throughout the world enacted public health measures that had vast socio-economic implications. In emergency situations, families of children with developmental disabilities (DDs), including autism, may experience increased difficulty accessing therapies, economic hardship, and caregiver stress, with the potential to exacerbate autism symptoms. Yet, limited research exists on the economic impacts of the COVID-19 pandemic on families of children with autism or another DD compared to families of children from the general population. Objectives To assess impact of the COVID-19 pandemic related to parental employment and economic difficulties in families of children with autism, another DD, and in the general population, considering potential modification by socioeconomic disadvantage before the pandemic and levels of child behavioral and emotional problems. Methods The Study to Explore Early Development (SEED) is a multi-site, multi-phase, case-control study of young children with autism or another DD as compared to a population comparison group (POP). During January-July 2021, a COVID-19 Impact Assessment Questionnaire was sent to eligible participants (n=1,789) who had enrolled in SEED Phase 3 from September 2017-March 2020. Parents completed a questionnaire on impacts of the pandemic in 2020 and completed the Child Behavior Checklist (CBCL) to measure behavioral and emotional health of their child during this time. Multiple logistic regression models were built for employment reduction, increased remote work, difficulty paying bills, or fear of losing their home. Covariates include group status (autism, DD, POP), household income at enrollment, child's race and ethnicity, and binary CBCL Total Problems T-score (<60 vs. ≥60). Unadjusted and adjusted odds ratios (aOR) and 95% confidence intervals (CI) were calculated. Results The study included 274 children with autism, 368 children with another DD, and 385 POP children. The mean age of 6.1 years (standard deviation, 0.8) at the COVID-19 Impact Assessment did not differ between study groups. Parents of children with autism were less likely to transition to remote work (aOR [95% CI] = 0.6 [0.4, 1.0]) and more likely to report difficulty paying bills during the pandemic (1.8 [1.2, 2.9]) relative to parents of POP children. Lower income was associated with greater employment reduction, difficulty paying bills, and fear of losing their home, but inversely associated with transitioning to remote work. Parents of non-Hispanic (NH) Black children experienced greater employment reduction compared to parents of NH White children (1.9 [1.1, 3.0]). Parents from racial and ethnic minority groups were more likely to experience difficulty paying bills and fear losing their home, relative to NH White parents. Caregivers of children with CBCL scores in the clinical range were more likely to fear losing their home (2.1 [1.3, 3.4]). Conclusion These findings suggest that families of children with autism, families of lower socio-economic status, and families of racial and ethnic minority groups experienced fewer work flexibilities and greater financial distress during the pandemic. Future research can be used to assess if these impacts are sustained over time.
Collapse
Affiliation(s)
- Olivia M. Pokoski
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Hayley Crain
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| | - Carolyn DiGuiseppi
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Aurora, CO, United States
| | - Sarah M. Furnier
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
| | - Eric J. Moody
- Wyoming Institute for Disabilities, University of Wyoming, Laramie, WY, United States
| | - Cy Nadler
- Division of Developmental and Behavioral Health, Children’s Mercy Kansas City, Kansas City, MO, United States
| | - Karen Pazol
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Jessica Sanders
- Department of Pediatrics and Department of Neurology, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lisa D. Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Maureen S. Durkin
- Department of Population Health Sciences, University of Wisconsin-Madison, Madison, WI, United States
- Waisman Center, University of Wisconsin-Madison, Madison, WI, United States
- Department of Pediatrics, University of Wisconsin-Madison, Madison, WI, United States
| |
Collapse
|
15
|
Ünsal C, Yalım E, Gündoğmuş I. The Determinants of COVID-19-Related Stress Among Caregivers of Individuals at High Risk During the Pandemic. Cureus 2024; 16:e54538. [PMID: 38516466 PMCID: PMC10956550 DOI: 10.7759/cureus.54538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND Informal caregivers offer a range of support-physical, emotional, and social-to individuals under their care, thereby exposing themselves to potential mental health risks. During the outbreak of COVID-19, caregivers have emerged as a demographic particularly vulnerable to mental health issues owing to their caregiving roles. The aim of the study is to identify the determinants influencing COVID-19-related stress among caregivers of individuals at elevated risk of coronavirus infection. MATERIALS AND METHODS A cross-sectional study was undertaken, utilizing a sample of 1,556 participants who were enlisted via social media and an online survey questionnaire. Participants provided sociodemographic data and completed both the Depression Anxiety Stress Scale (DASS-21) and the COVID-19 Stress Scale (CSS) to assess their mental health status. RESULTS The mean age of the participants was 30.76±6.97 years. Of these, 42.35% (n = 659) resided with individuals at high risk for COVID-19, and 72.75% were female. Statistically significant differences were observed in DASS-21 subscale scores as well as in CSS scores for contamination, socioeconomic consequences, traumatic stress, perceived danger, compulsive checking, xenophobia, and total scores between those living and not living with COVID-19 high-risk individuals. Factors such as residing with a COVID-19 high-risk individual, education level, and DASS-21 subscale scores were identified as significant predictors of CSS scores. CONCLUSION The study reveals those caregivers for individuals at high risk for COVID-19 experience elevated levels of depression, anxiety, stress, and COVID-19-related stress. Factors such as living with a high-risk individual, educational level, and mental health status were significant predictors of COVID-19-related stress. Further research is needed to evaluate the mental well-being of caregivers and to develop effective interventions.
Collapse
Affiliation(s)
- Cansu Ünsal
- Psychiatry, Silifke State Hospital, Mersin, TUR
| | - Esra Yalım
- Psychiatry, Çankırı State Hospital, Çankırı, TUR
| | | |
Collapse
|
16
|
Mauldin L, Defelice C. The Invisible Frontline: Experiences of Spousal Caregivers During COVID-19. J Appl Gerontol 2024; 43:160-169. [PMID: 37922207 DOI: 10.1177/07334648231205414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2023] Open
Abstract
Spousal caregivers are a largely invisible population of unpaid long-term care providers in the United States. This paper examines their experiences during the COVID-19 pandemic by drawing on data from 96 virtual and phone interviews with 44 spousal caregivers cohabitating with an ill partner across 22 states between June and December 2020. Findings show caregivers 1) adjusted care practices related to food and supply deliveries, socializing online, and infection control; 2) experienced impacts on care, including the loss of home health aides and reduced outpatient care; and 3) experienced emotional distress due to isolation, increased care demands, and resulting heightened anxiety and stress. These findings indicate specific types of ongoing resources caregivers may continue to need as the pandemic wanes, such as access to online support, a more robust infrastructure for food delivery, and planning for an increased projected shortage of home health aides.
Collapse
|
17
|
Chiang M, Markoulakis R, Levitt A. Impact of the COVID-19 pandemic on perceived changes in responsibilities for adult caregivers who support children and youth in Ontario, Canada. BJPsych Open 2024; 10:e35. [PMID: 38265051 PMCID: PMC10897706 DOI: 10.1192/bjo.2023.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 11/22/2023] [Accepted: 11/23/2023] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic has created long-lasting changes in caregiving responsibilities, including but not limited to increased demands, loss of support, worsening mental and physical health, and increased financial worries. There is currently limited evidence regarding factors associated with perceived changes in caregiving responsibilities. AIMS This observational study aimed to investigate factors (sociodemographic characteristics of caregivers and mental health and/or addiction concerns of the caregiver and their youth) that predict perceived negative changes in caregiving responsibilities among adult caregivers (aged 18+ years) of children and youth (aged 0-25 years) in Ontario, Canada, during the COVID-19 pandemic. METHOD Data were collected from 1381 caregivers of children and youth between January and March of 2022 through a representative cross-sectional survey completed online. Logistic regression was conducted to determine predictors contributing to perceived negative changes in caregiving responsibilities. RESULTS Among the sociodemographic characteristics, only ethnicity significantly predicted outcome. Higher caregiver strain (odds ratio [OR] = 10.567, 95% CI = 6.614-16.882, P < 0.001), worsened personal mental health (OR = 1.945, 95% CI = 1.474-2.567, P < 0.001), a greater number of children/youth cared for per caregiver (OR = 1.368, 95% CI = 1.180-1.587, P < 0.001), dissatisfaction with the availability of social supports (OR = 1.768, 95% CI = 1.297-2.409, P < 0.001) and negative changes in mental well-being in at least one child/youth (OR = 2.277, 95% CI = 1.660-3.123, P < 0.001) predicted negative changes in caregiving responsibilities. CONCLUSION These results support further exploration of the implications of negative perceptions of caregiving responsibilities and what processes might be implemented to improve these perceptions and the outcomes.
Collapse
Affiliation(s)
- Madeline Chiang
- Sunnybrook Research Institute, Toronto, Ontario, Canada; and College of Science, University of Notre Dame, South Bend, Indiana, USA
| | - Roula Markoulakis
- Sunnybrook Research Institute, Toronto, Ontario, Canada; and Department of Occupational Science and Occupational Therapy, University of Toronto, Ontario, Canada
| | - Anthony Levitt
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Family Navigation Project, Sunnybrook Research Institute, Toronto, Ontario, Canada; Hurvitz Brain Sciences Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; and Department of Psychiatry, University of Toronto, Ontario, Canada
| |
Collapse
|
18
|
Elayan S, Bei E, Ferraris G, Fisher O, Zarzycki M, Angelini V, Ansmann L, Buskens E, Hagedoorn M, von Kutzleben M, Lamura G, Looijmans A, Sanderman R, Vilchinsky N, Morrison V. Cohort profile: The ENTWINE iCohort study, a multinational longitudinal web-based study of informal care. PLoS One 2024; 19:e0294106. [PMID: 38236932 PMCID: PMC10796045 DOI: 10.1371/journal.pone.0294106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 10/25/2023] [Indexed: 01/22/2024] Open
Abstract
Informal care is a key pillar of long-term care provision across Europe and will likely play an even greater role in the future. Thus, research that enhances our understanding of caregiving experiences becomes increasingly relevant. The ENTWINE iCohort Study examines the personal, psychological, social, economic, and geographic factors that shape caregiving experiences. Here, we present the baseline cohort of the study and describe its design, recruitment methods, data collection procedures, measures, and early baseline findings. The study was conducted in nine countries: Germany, Greece, Ireland, Israel, Italy, the Netherlands, Poland, Sweden, and the United Kingdom. The study comprised a web-based longitudinal survey (baseline + 6-month follow-up) and optional weekly diary assessments conducted separately with caregivers and care recipients. From 14 August 2020 to 31 August 2021, 1872 caregivers and 402 care recipients were enrolled at baseline. Participants were recruited via Facebook and, to a lesser extent, via the study website or caregiver/patient organisations. Caregiver participants were predominantly female (87%) and primary caregivers (82%), with a median age of 55 years. A large proportion (80%) held at least post-secondary education, and two-thirds were married/partnered. Over half of the caregivers were employed (53%) and caring for a person with multiple chronic conditions (56%), and nearly three-quarters were caring for either a parent (42%) or a spouse/partner (32%). About three-quarters of care recipient participants were female (77%), not employed (74%), and had at least post-secondary education (77%), with a median age of 55 years. Over half of the care recipients were married/partnered (59%), receiving care primarily from their spouses/partners (61%), and diagnosed with multiple chronic conditions (57%). This study examining numerous potential influences on caregiving experiences provides an opportunity to better understand the multidimensional nature of these experiences. Such data could have implications for developing caregiving services and policies, and for future informal care research.
Collapse
Affiliation(s)
- Saif Elayan
- Faculty of Economics and Business, Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - Eva Bei
- Faculty of Social Sciences, Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Oliver Fisher
- Department of Economics and Social Sciences, Università Politecnica delle Marche, Ancona, Italy
| | - Mikołaj Zarzycki
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - Viola Angelini
- Faculty of Economics and Business, Department of Economics, Econometrics and Finance, University of Groningen, Groningen, The Netherlands
| | - Lena Ansmann
- Department of Health Services Research, Division of Organizational Health Services Research, University of Oldenburg, Oldenburg, Germany
- Faculty of Medicine, Institute of Medical Sociology, Health Services Research and Rehabilitation Science (IMVR), University of Cologne, Cologne, Germany
| | - Erik Buskens
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Milena von Kutzleben
- Department of Health Services Research, Division of Organizational Health Services Research, University of Oldenburg, Oldenburg, Germany
| | - Giovanni Lamura
- IRCCS INRCA-National Institute of Health and Science on Ageing, Centre for Socio-Economic Research on Ageing, Ancona, Italy
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Robbert Sanderman
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Noa Vilchinsky
- Faculty of Social Sciences, Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
| | - Val Morrison
- School of Human and Behavioural Sciences, Bangor University, Bangor, United Kingdom
| |
Collapse
|
19
|
Chen B, Zhu H, Fu H, Han Q, Chen L. A qualitative study on the willingness and influencing factors of master of geriatric nursing specialist postgraduates to volunteer for home respite care for disabled elderly families. BMC Nurs 2024; 23:49. [PMID: 38233888 PMCID: PMC10792901 DOI: 10.1186/s12912-024-01710-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/03/2024] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND As China's population ages, the demand for care for the disabled elderly is increasing, and family caregivers find it challenging to meet the comprehensive care needs of the disabled elderly. Through home respite services, families of the disabled elderly can receive help and support from specialized nursing professionals to ease the burden on family caregivers and provide high-quality services. This study explores the willingness and influencing factors of Master of Geriatric Nursing Specialist postgraduates in China to volunteer to provide home respite services for disabled elderly individuals. METHODS A qualitative study based on Grounded Theory used Strauss and Corbin's programmatic version. A purposive sampling method was employed to conduct semi-structured interviews with 12 Master of Geriatric Nursing Specialist postgraduates from a tertiary hospital in Changsha, Hunan Province, China. RESULTS The willingness of Master of Geriatric Nursing Specialist postgraduates to volunteer to provide home respite services for the disabled elderly was established as a core category, which was influenced by three main categories: personal factors, service object factors, and social factors, and nine categories formed from 39 initial concepts were included under the main category. CONCLUSIONS Influenced by China's traditional cultural background, Master of Geriatric Nursing Specialist postgraduates in China have shown high motivation in volunteering to provide home respite services for the families of the disabled elderly but have been challenged by several challenges from China's healthcare environment and education system. Relevant departments need to adopt a series of policies and measures to increase volunteers' willingness to participate in respite care and promote its development.
Collapse
Affiliation(s)
- Bihui Chen
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
| | - Haili Zhu
- Nursing Department of Hunan Provincial Hospital of Integrated Traditional Chinese and Western Medicine, 58 Lushan Road, Changsha City, Hunan Province, China.
| | - Han Fu
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
| | - Qiannan Han
- Changsha Hospital of Traditional Chinese Medicine, No. 22, Xingsha Avenue, Changsha County, Changsha City, Hunan Province, China
| | - Lei Chen
- College of Nursing, Hunan University of Chinese Medicine, No.300, Xueshi Road, Hanpu Science and Education Park, Yuelu District, Changsha City, Hunan Province, China
| |
Collapse
|
20
|
Thapa P, Lama S, Rai G, Sapkota N, Pradhan N, Thapa R, Uprety P, Basnet M. Family caregiver experience of caring COVID-19 patients admitted in COVID-19 hospital of a tertiary care hospital in Nepal. PLoS One 2024; 19:e0295395. [PMID: 38181040 PMCID: PMC10769026 DOI: 10.1371/journal.pone.0295395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 11/19/2023] [Indexed: 01/07/2024] Open
Abstract
BACKGROUND Informal caregivers played a significant role in caring for COVID-19 patients during hospitalization in Nepal. This study aimed to understand the experiences of family caregivers attending to their relatives in a COVID-19 hospital in Nepal. METHODS A descriptive phenomenological approach was adopted to understand the caregiver's experience in supporting their relatives admitted to the COVID-19 hospital of the BP Koirala Institute of Health Sciences (BPKIHS). Thirteen caregivers of COVID-19 positive patients were purposively selected from April to June, 2022. Face-to-face interviews were conducted at a caregiver residential facility using the interview schedule developed by the department for the purpose of data collection after obtaining ethical clearance from the Institutional review committee of BPKIHS. Data were audio recorded and manually analyzed. RESULTS Among the 13 caregivers, six were male and seven were female. The findings were categorized into five domains: challenges encountered, changes in physical and mental health, changes in roles and responsibilities, positive experiences, and strategies to ease caregiving tasks. Major challenges included financial burdens, communication problems, stigmatization, Insecurity, substandard accommodation, and visitor restrictions. Caregivers reported negative emotions, unmet physical health needs, and shifts in family and occupational roles. Despite these challenges, caregivers attempted to cope positively and acknowledged the efforts of healthcare personnel and other family members. Suggestions for improving caregiving included providing essential medical and basic services within the hospital, enhancing accommodation facilities, establishing proper communication channels, and allowing visitations. CONCLUSIONS Caregivers of COVID-19 patients face significant challenges during the caregiving process. Enhancing hospital services, promoting effective communication, fostering positive attitudes, and ensuring a safe environment can facilitate caregiving tasks.
Collapse
Affiliation(s)
- Prekshya Thapa
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sami Lama
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Gayatri Rai
- Hospital Matron, Nursing Service Administration, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nidesh Sapkota
- Department of Psychiatry, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Nirmala Pradhan
- Department of Psychiatric Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Roshni Thapa
- Department of Community Health Nursing, College of Nursing, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Pratik Uprety
- Medical Doctor, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Madhur Basnet
- Department of Psychiatry, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| |
Collapse
|
21
|
Robinson-Lane SG, Leggett AN, Johnson FU, Leonard N, Carmichael AG, Oxford G, Miah T, Wright JJ, Blok AC, Iwashyna TJ, Gonzalez R. Caregiving in the COVID-19 pandemic: Family adaptations following an intensive care unit hospitalisation. J Clin Nurs 2024; 33:203-214. [PMID: 36262026 PMCID: PMC9874809 DOI: 10.1111/jocn.16560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 09/21/2022] [Accepted: 09/29/2022] [Indexed: 01/29/2023]
Abstract
AIM AND OBJECTIVE To identify how family caregivers adapt to the caregiving role following a relative's COVID-19-related intensive care unit (ICU) hospitalisation. BACKGROUND Family caregiving is often associated with poor health amongst caregivers which may limit their capacity to effectively support patients. Though severe COVID-19 infection has necessitated increasing numbers of persons who require caregiver support, little is known about these caregivers, the persons they are caring for, or the strategies used to effectively adjust to the caregiving role. DESIGN A qualitative descriptive study design was adopted, and findings are reported using COREQ. METHODS A secondary analysis of transcripts from semi-structured interviews conducted with recently discharged ICU patients who had COVID-19 (n = 16) and their family caregivers (n = 16) was completed using thematic analysis. MAXQDA 2020 and Miro were used to organise data and complete coding. Analysis involved a structured process of open and closed coding to identify and confirm themes that elucidated adaptation to family caregiving. RESULTS Six themes highlight how family caregivers adapt to the caregiving role following an ICU COVID-19-related hospitalisation including (1) engaging the support of family and friends, (2) increased responsibilities to accommodate caregiving, (3) managing emotions, (4) managing infection control, (5) addressing patient independence and (6) engaging support services. These themes were found to be congruent with the Roy adaptation model. CONCLUSIONS Family caregiving is a stressful transition following a patient's acute hospitalisation. Effective adaptation requires flexibility and sufficient support, beginning with the care team who can adequately prepare the family for the anticipated challenges of recovery. RELEVANCE TO CLINICAL PRACTICE Clinical teams may improve post-hospitalisation care outcomes of patients by preparing families to effectively adjust to the caregiver role-particularly in identifying sufficient support resources. PATIENT OR PUBLIC CONTRIBUTION Participation of patients/caregivers in this study was limited to the data provided through participant interviews.
Collapse
Affiliation(s)
- Sheria G. Robinson-Lane
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Amanda N. Leggett
- Department of Psychiatry, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Florence U. Johnson
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
| | - Natalie Leonard
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Alicia G. Carmichael
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Grace Oxford
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Tanbirul Miah
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Johnny J. Wright
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| | - Amanda C. Blok
- Department of Systems, Populations, and Leadership, University of Michigan School of Nursing, Ann Arbor, Michigan, USA
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Theodore J. Iwashyna
- VA Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Richard Gonzalez
- BioSocial Methods Collaborative, Research Center for Group Dynamics, University of Michigan Institute for Social Research, Ann Arbor, Michigan, USA
| |
Collapse
|
22
|
Mage S, Benton D, Gonzalez A, Zaragoza G, Wilber K, Tucker-Seeley R, Meyer K. "I Lay Awake at Night": Latino Family Caregivers' Experiences Covering Out-of-Pocket Costs When Caring for Someone Living With Dementia. THE GERONTOLOGIST 2024; 64:gnad011. [PMID: 36786288 PMCID: PMC10733120 DOI: 10.1093/geront/gnad011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Indexed: 02/15/2023] Open
Abstract
BACKGROUND AND OBJECTIVES The financial burden of caregiving has received less research attention than physical and emotional costs. This is especially true for underserved ethnic minorities. Financial strain affects mental and physical health and is unequally distributed across caregivers of different races and ethnicities. Although caregivers overall spend, on average, one quarter of their income on caregiving, Latino caregivers, the focus of this study, spend nearly half. RESEARCH DESIGN AND METHODS To better understand this disparity, we conducted 11 qualitative interviews with 14 Latino caregivers of persons living with dementia located in either California or Texas. Interview transcripts were thematically coded, guided by a material-psychosocial-behavioral conceptual model of financial strain. RESULTS We identified 3 themes: daily needs and costs, psychological distress caused by financial issues, and stressful barriers to accessing family and societal support. Furthermore, interviews revealed how Latino culture may influence spending patterns and management of costs. Findings suggest that preference by Latino families to care for a family member in the home may be met with a financial disadvantage due to the high out-of-pocket costs of care. DISCUSSION AND IMPLICATIONS A better understanding of the factors contributing to high costs for Latino caregivers and how these costs affect caregivers will inform approaches at both the individual and policy levels and develop culturally relevant interventions to help Latino families to lower caregiving costs. This is especially important as the number of Latinos living with dementia is expected to increase over the next 4 decades and effective interventions are lacking.
Collapse
Affiliation(s)
- Susanna Mage
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Donna Benton
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Alexander Gonzalez
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | | | - Kate Wilber
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
| | - Reginald Tucker-Seeley
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA
- ZERO—The End of Prostate Cancer, Alexandria, Virginia, USA
| | - Kylie Meyer
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
23
|
Nxumalo CT, Tokwe L, Ngcobo SJ, Gam NP, Mchunu GG, Makhado L. Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study. Int J Qual Stud Health Well-being 2023; 18:2247622. [PMID: 37639491 PMCID: PMC10464539 DOI: 10.1080/17482631.2023.2247622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 08/09/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context. PURPOSE To explore the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. METHODS A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee-reference number: BREC00003228/2021. RESULTS Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19. DISCUSSION AND CONCLUSION Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.
Collapse
Affiliation(s)
- Celenkosini Thembelenkosini Nxumalo
- Academic Development Unit, Faculty of Health Sciences, Durban University of Technology, Ritson Campus, Durban, South Africa
- Department of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Lwandile Tokwe
- School of Nursing, Faculty of Community and Health Sciences, University of Western Cape, Cape Town, South Africa
| | - Silingene Joyce Ngcobo
- Department of Nursing, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Nkululeko Phalson Gam
- Centre for quality Promotion and Assurance, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Gugu Gladness Mchunu
- Executive Dean, Faculty of Health Sciences, Durban University of Technology, Ritson Campus, Durban, South Africa
| | - Lufuno Makhado
- Executive Dean, School of Public Health, University of Venda, Thohoyandou, South Africa
| |
Collapse
|
24
|
Han SH. Revisiting the caregiver stress process: Does family caregiving really lead to worse mental health outcomes? ADVANCES IN LIFE COURSE RESEARCH 2023; 58:100579. [PMID: 38054877 DOI: 10.1016/j.alcr.2023.100579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/16/2023] [Accepted: 10/20/2023] [Indexed: 12/07/2023]
Abstract
While the act of caregiving is often characterized as a stressful experience detrimental to mental health, recent studies are challenging this view by reporting robust health and well-being benefits linked to family caregiving. The current study attempted to provide an explanation of this apparent paradox by focusing on the role played by family health problems in the association between being a caregiver and mental health. Framed within the life course perspective and focusing on caregiving provided to aging mothers, the current study aimed 1) to demonstrate how the linkage between caregiving and depression reported in earlier studies may be misleading and 2) to further investigate whether caregiving to an aging mother may lead to any mental health benefits. Using longitudinal data drawn from the nationally representative US Health and Retirement Study, I follow adult children 50 and older who had a living mother during the observation period (N = 4812; 18,442 person-wave observations). A series of within-between random effects models were estimated to explicate how health conditions of aging mothers (i.e., disability and dementia) and caregiving transitions of adult children were associated with changes in depressive symptoms of adult children. Findings demonstrated that caregiving transitions were unrelated to depressive symptoms among adult children once the model controlled for the confounding effects of having their mother experience disability and dementia. Further, caregiving behavior was found to buffer the direct detrimental effect of maternal disability on adult children's depressive symptoms. This study adds to the growing body of research that cautions against characterizing caregiving as a chronic stressor detrimental to mental health and further echoes earlier calls for a more balanced portrayal of caregiving in policy reports and research literature.
Collapse
Affiliation(s)
- Sae Hwang Han
- Department of Human Development and Family Sciences, University of Texas at Austin, USA; Population Research Center, University of Texas at Austin, USA; Center on Aging and Population Sciences, University of Texas at Austin, USA.
| |
Collapse
|
25
|
Lee CD, Kim H, Cooper R, Beach SR. Changes in Caregiver Burden in Older Adults' Caregivers During the COVID-19 Outbreak. OTJR-OCCUPATION PARTICIPATION AND HEALTH 2023:15394492231214961. [PMID: 38006242 DOI: 10.1177/15394492231214961] [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: 11/26/2023]
Abstract
This study investigated the changes in caregiver burden during the coronavirus disease 2019 (COVID-19) pandemic. The study sample included 827 caregivers for older adults (65+) from the National Health and Aging Trends Study (NHATS) COVID-19 data set. We used paired t-tests to analyze data. The caregivers' assistance in basic and instrumental activities of daily living for care recipients, as well as the amount of time they provided, increased significantly (all ps < .001) during the pandemic compared with before. Approximately, 40% of caregivers reported changes in the amount of assistance they provided during the pandemic. Financial, emotional, and physical difficulties among caregivers have increased, with emotional difficulties being the most frequently reported. The majority of caregivers reported not utilizing any social services during the pandemic. The pandemic may have heightened the caregiver burden. It is important to ensure that caregivers have access to and utilize social services in a physically and psychologically safe manner.
Collapse
Affiliation(s)
- Chang Dae Lee
- U.S. Department of Veterans Affairs Pittsburgh Healthcare System, PA, USA
- University of Pittsburgh, PA, USA
| | - Hansol Kim
- National Rehabilitation Research & Training Center on Family Support, University of Pittsburgh, PA, USA
| | - Rosemarie Cooper
- U.S. Department of Veterans Affairs Pittsburgh Healthcare System, PA, USA
- University of Pittsburgh, PA, USA
| | - Scott R Beach
- National Rehabilitation Research & Training Center on Family Support, University of Pittsburgh, PA, USA
- University Center for Social and Urban Research, University of Pittsburgh, PA, USA
| |
Collapse
|
26
|
Leggett AN, Robinson-Lane SG, Oxford G, Leonard N, Carmichael AG, Baker E, Paratore J, Blok AC, Prescott HC, Iwashyna TJ, Gonzalez R. Barriers to and Facilitators of Family Caregiving of Patients With COVID-19 Early in the Pandemic. Am J Crit Care 2023; 32:431-439. [PMID: 37907378 DOI: 10.4037/ajcc2023364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Abstract
BACKGROUND In 2020, many family members were thrust into the role of caregiving for a relative with COVID-19 with little preparation, training, or understanding of the disease and its symptoms. OBJECTIVES To explore the barriers to and facilitators of caregiving experienced by family caregivers of patients with COVID-19 who had been in intensive care in the pandemic's earliest months. METHODS In-depth qualitative interviews were conducted by web conference with 16 adults recovering at home after intubation for COVID-19 in an intensive care unit at a major academic medical center and their primary caregivers from March to August 2020 (N = 32). Thematic qualitative analysis was done using Watkins' rigorous and accelerated data reduction technique with MAXQDA software. RESULTS Seven themes emerged regarding factors that facilitated or posed barriers to care: other health conditions that increased complexity of care, interactions and experiences in the health care system, COVID-19's proliferation into other areas of life, the psychological well-being of the patient-caregiver dyad, experience of support from the dyad's network, the role of caregiving in the dyad, and contextual circumstances of the dyad. The themes often included both barriers and facilitators, depending on the experience of the dyad (eg, feeling encouraged vs fatigued by their support network). CONCLUSIONS Understanding how patients with COVID-19 and their caregivers experience illness management across the recovery journey can help clarify the COVID-19 care-giving process and identify intervention targets to improve overall health and well-being of the care dyad.
Collapse
Affiliation(s)
- Amanda N Leggett
- Amanda N. Leggett is an assistant professor in the Institute of Gerontology at Wayne State University, Detroit, Michigan, and an adjunct assistant professor, Department of Psychiatry, School of Medicine, University of Michigan Ann Arbor
| | - Sheria G Robinson-Lane
- Sheria G. Robinson-Lane is an assistant professor, Department of Systems, Populations, and Leadership, School of Nursing, University of Michigan Ann Arbor
| | - Grace Oxford
- Grace Oxford is a research assistant, Biosocial Methods Collaborative, University of Michigan Ann Arbor
| | - Natalie Leonard
- Natalie Leonard is a research technician, Research Center for Group Dynamics, Institute for Social Research, University of Michigan Ann Arbor
| | - Alicia G Carmichael
- Alicia G. Carmichael is a research process manager, Research Center for Group Dynamics, Institute for Social Research, University of Michigan Ann Arbor
| | - Elaina Baker
- Elaina Baker is a research assistant, Department of Psychiatry, School of Medicine, University of Michigan Ann Arbor
| | - Janeann Paratore
- Janeann Paratore is a research assistant, Biosocial Methods Collaborative, University of Michigan Ann Arbor
| | - Amanda C Blok
- Amanda C. Blok is a research assistant professor, Department of Systems, Populations and Leadership, School of Nursing, University of Michigan and a research health scientist, VA Center for Clinical Management Research, Ann Arbor VA Healthcare System, Ann Arbor, Michigan
| | - Hallie C Prescott
- Hallie C. Prescott is an associate professor, Pulmonary and Critical Care, Department of Internal Medicine, School of Medicine, University of Michigan and a research investigator, VA Center for Clinical Management Research, Ann Arbor VA Healthcare System
| | - Theodore J Iwashyna
- Theodore J. Iwashyna is the Bloomberg Distinguished Professor of Social Science and Justice in Medicine and professor of medicine, Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard Gonzalez
- Richard Gonzalez is the Amos N. Tversky Professor, Psychology and Statistics and director, Research Center for Group Dynamics, University of Michigan
| |
Collapse
|
27
|
Zwar L, König HH, Hajek A. Mental health, social integration and support of informal caregivers during the second wave of the COVID-19 pandemic: A population-based representative study from Germany. Arch Gerontol Geriatr 2023; 114:105085. [PMID: 37311371 PMCID: PMC10238121 DOI: 10.1016/j.archger.2023.105085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The study analyzed mental health, social integration and social support of informal caregivers of individuals aged ≥60 years compared to non-caregivers during the second wave of the COVID-19 pandemic. METHODS A quantitative, cross-sectional study was conducted with a sample drawn randomly from the nationally representative online panel forsa.omninet in Germany between March 4th and 19th 2021. In total, 3022 adults aged ≥40 years from Germany were questioned, including 489 adults providing informal care for adults aged ≥60 years between December 2020 and March 2021. Depressive (PHQ-9) and anxiety symptoms (GAD-7), loneliness (De Jong Gierveld Scale), social exclusion (Bude & Lantermann Scale) and social network support (Lubben's Social Network Scale) were measured. Adjusted OLS regression analyses and additional moderator analyses (moderators: perceived restrictions and danger of infection due to the COVID-19 pandemic) were conducted. RESULTS Significant higher levels of depressive and anxiety symptoms and more social support were found among informal caregivers compared to non-caregivers. Loneliness and social exclusion did not differ between both groups. Perceived restrictions by the pandemic significantly moderated the association between informal caregiving and social support - social support was stronger among caregivers with higher levels of perceived restrictions by the pandemic. CONCLUSION Informal caregivers are faced with worse mental health than non-caregivers during the pandemic, although their social support was stronger, in particular in dependence of higher levels of perceived restrictions by the pandemic. Thus, results indicate a need for an informal-care-specific policy and more professional support for informal caregivers during a health crisis.
Collapse
Affiliation(s)
- Larissa Zwar
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| |
Collapse
|
28
|
Utz RL, Caserta M, Iacob E, Sparks C, Stark L, Terrill A, Thompson A, Wong B. Maximizing the Benefit of Respite for Dementia Caregivers: A Study Protocol Describing the Development & Evaluation of the Time for Living & Caring (TLC) Intervention. OBM INTEGRATIVE AND COMPLIMENTARY MEDICINE 2023; 8:040. [PMID: 38313766 PMCID: PMC10838170 DOI: 10.21926/obm.icm.2304040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Dementia caregivers are susceptible to adverse physical and mental health outcomes, given the often prolonged and challenging care and support they provide to family members with Alzheimer's Disease and Related Dementias (ADRD). This report describes a community-engaged implementation of a novel behavioral intervention - an "app" (interactive website) called TLC (Time for Living and Caring) that coaches caregivers on how to maximize the benefits associated with respite time. The rationale and features of the TLC intervention and the full research protocol used to develop and then evaluate its feasibility, acceptability, and initial efficacy are described here.
Collapse
Affiliation(s)
- Rebecca L. Utz
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Michael Caserta
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
| | - Eli Iacob
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
| | - Catharine Sparks
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Louisa Stark
- University of Utah, School of Medicine, 27 S. Mario Capecchi Dr, Salt Lake City, UT, USA
| | - Alexandra Terrill
- University of Utah, College of Health, 15 N 2030 East, Salt Lake City, UT, USA
| | - Amber Thompson
- University of Utah, College of Social and Behavioral Sciences, 260 South Central Campus Drive, Salt Lake City, UT, USA
| | - Bob Wong
- University of Utah, College of Nursing, 10 S. 2000 E., Salt Lake City, UT, USA
| |
Collapse
|
29
|
Parenteau AM, Boyer CJ, Campos LJ, Carranza AF, Deer LK, Hartman DT, Bidwell JT, Hostinar CE. A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience. Dev Psychopathol 2023; 35:1821-1842. [PMID: 36097815 PMCID: PMC10008755 DOI: 10.1017/s0954579422000499] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Social and economic inequality are chronic stressors that continually erode the mental and physical health of marginalized groups, undermining overall societal resilience. In this comprehensive review, we synthesize evidence of greater increases in mental health symptoms during the COVID-19 pandemic among socially or economically marginalized groups in the United States, including (a) people who are low income or experiencing homelessness, (b) racial and ethnic minorities, (c) women and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) communities, (d) immigrants and migrants, (e) children and people with a history of childhood adversity, and (f) the socially isolated and lonely. Based on this evidence, we propose that reducing social and economic inequality would promote population mental health and societal resilience to future crises. Specifically, we propose concrete, actionable recommendations for policy, intervention, and practice that would bolster five "pillars" of societal resilience: (1) economic safety and equity, (2) accessible healthcare, including mental health services, (3) combating racial injustice and promoting respect for diversity, equity, and inclusion, (4) child and family protection services, and (5) social cohesion. Although the recent pandemic exposed and accentuated steep inequalities within our society, efforts to rebuild offer the opportunity to re-envision societal resilience and policy to reduce multiple forms of inequality for our collective benefit.
Collapse
Affiliation(s)
- Anna M. Parenteau
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | - Chase J. Boyer
- Department of Human Ecology, University of California-Davis
| | | | | | - LillyBelle K. Deer
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| | | | - Julie T. Bidwell
- Betty Irene Moore School of Nursing, University of California-Davis
| | - Camelia E. Hostinar
- Psychology Department, University of California-Davis
- Center for Poverty and Inequality Research, University of California-Davis
| |
Collapse
|
30
|
Truskinovsky Y, Wiemers EE. Paid care among older adults with long-term care needs declined in the first year of COVID-19 while families stepped in. HEALTH AFFAIRS SCHOLAR 2023; 1:qxad040. [PMID: 38756748 PMCID: PMC10986229 DOI: 10.1093/haschl/qxad040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 08/04/2023] [Accepted: 10/02/2023] [Indexed: 05/18/2024]
Abstract
Separate strands of research have documented impacts of the COVID-19 pandemic in nursing homes and among paid and family caregivers, yet there is little evidence connecting changes in the residential decisions of older adults with the provision of paid and family care, limiting our ability to identify potential substitutions and gaps in care. Using the 2020 wave of the Health and Retirement Study linked to county-level COVID-19 mortality rates, we found that, among older adults with long-term care needs, higher county-level mortality rates were associated with a decline in nursing home residence and an increase in co-residence with adult children. These changes were coupled with a decline in the likelihood of receiving paid care and in the number of paid caregivers and an increase in the hours of unpaid care received. This analysis documents a reduction in nursing home residence and paid care during the first year of the pandemic and shows that families filled some of the resulting care gaps. Policymaking around long-term care should consider whether declines in the use of paid care are permanent and how they will affect the health of older Americans and their caregivers over the next decade.
Collapse
Affiliation(s)
- Yulya Truskinovsky
- Department of Economics, Wayne State University, Detroit, MI 48202, United States
| | - Emily E Wiemers
- Department of Public Administration and International Affairs, Syracuse University,Syracuse, NY, 13244, United States
| |
Collapse
|
31
|
Iyer SS, Ngo V, Humber MB, Chen P, Pallaki M, Dolinar T, Brodrick MFB, Gould CE, Trivedi RB. Caregiver Experience of Tele-dementia Care for Older Veterans. J Gen Intern Med 2023; 38:2960-2969. [PMID: 37131102 PMCID: PMC10153773 DOI: 10.1007/s11606-023-08188-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 03/22/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND For the 5 million persons living with dementia (PLWD) in the USA, telemedicine may improve access to specialty care from their homes. OBJECTIVE To elicit informal caregiver perceptions of tele-dementia care provided during COVID-19. DESIGN Qualitative, observational study using grounded theory. PARTICIPANTS Informal caregivers aged 18 + who cared for an older adult who received tele-dementia services at two major VA healthcare systems participated in 30-60-min semi-structured telephone interviews. INTERVENTIONS Interviews were designed using Fortney's Access to Care model. MAIN MEASURES Thirty caregivers (mean age = 67, SD = 12, 87% women) were interviewed. KEY RESULTS Five major themes were (1) Tele-dementia care avoids routine disruption and pre-visit stress; (2) Transportation barriers to in-person visits include not only travel logistics but navigating the sequelae of dementia and comorbid medical conditions. These include cognitive, behavioral, physical, and emotional challenges such as balance issues, incontinence, and agitation in traffic; (3) Tele-dementia care saves time and money and improves access to specialists; (4) Tele-dementia facilitated communication between caregiver and provider without hindering communication between PLWD and provider; and (5) Caregivers described ideal future dementia care as a combination of virtual and in-person modalities with in-home help, financial and medical support, and dementia-sensitive caregiver access. Caregivers interviewed saved 2.6 h ± 1.5 h (range: 0.5 to 6 h) of travel time. Multiple caregivers described disruption of routines as difficult in PLWD and appreciated the limited preparation and immediate return to routine post telemedicine visit as positives. CONCLUSIONS Caregivers found tele-dementia care convenient, comfortable, stress reducing, timesaving, and highly satisfactory. Caregivers would prefer a combination of in-person and telemedicine visits, with an opportunity to communicate with providers privately. This intervention prioritizes care for older Veterans with dementia who have high care needs and are at higher risk for hospitalization than their same age counterparts without dementia.
Collapse
Affiliation(s)
- Sowmya S Iyer
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA.
- Division of Primary Care and Population Health, Geriatrics Section, Stanford University School of Medicine, Palo Alto, CA, USA.
| | - Victoria Ngo
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
- Elizabeth Dole Center of Excellence for Veteran and Caregiver Research, Health Services Research & Development, U.S. Department of Veteran Affairs, Palo Alto, CA, USA
- Department of Health Policy, Freeman Spogli Institute & Stanford University School of Medicine, Palo Alto, CA, USA
| | - Marika Blair Humber
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Peijun Chen
- Geriatric Research, Education, and Clinical Center, VA Northeast Ohio Health Care System, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Muralidhar Pallaki
- Geriatric Research, Education, and Clinical Center, VA Northeast Ohio Health Care System, Cleveland, OH, USA
- Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Teresa Dolinar
- Geriatric Research, Education, and Clinical Center, VA Northeast Ohio Health Care System, Cleveland, OH, USA
| | | | - Christine E Gould
- Geriatric Research, Education, and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry & Behavioral Sciences, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Ranak B Trivedi
- Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA, USA
- Division of Public Mental Health and Population Sciences, Department of Psychiatry and Behavioral Sciences, Stanford University, San Francisco, CA, USA
| |
Collapse
|
32
|
Soysal P, Veronese N, Smith L, Chen Y, Akpinar Soylemez B, Coin A, Religa D, Välimäki T, Alves M, Shenkin SD. The Impact of the COVID-19 Pandemic on the Psychological Well-Being of Caregivers of People with Dementia or Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Geriatrics (Basel) 2023; 8:97. [PMID: 37887970 PMCID: PMC10606547 DOI: 10.3390/geriatrics8050097] [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: 08/10/2023] [Revised: 09/21/2023] [Accepted: 09/25/2023] [Indexed: 10/28/2023] Open
Abstract
The aim of this systematic review was to investigate the effects of the COVID-19 lockdown on the psychological well-being of caregivers of people with dementia or mild cognitive impairment (PwD/MCI). Electronic databases were searched from inception to August 2022 for observational studies investigating the COVID-19 lockdown and psychological well-being of caregivers of PwD/MCI. Summary estimates of standardized mean differences (SMD) in psychological well-being scores pre- versus during COVID-19 were calculated using a random-effects model. Fifteen studies including 1702 caregivers (65.7% female, mean age 60.40 ± 12.9 years) with PwD/MCI were evaluated. Five studies found no change in psychological well-being parameters, including depression, anxiety, distress, caregiver burden, and quality of life. Ten studies found a worsening in at least one parameter: depression (six studies, n = 1368; SMD = 0.40; 95%CI: 0.09-0.71; p = 0.01, I2 = 86.8%), anxiety (seven studies, n = 1569; SMD = 1.35; 95%CI: 0.05-2.65; I2 = 99.2%), caregiver distress (six studies, n = 1320, SMD = 3.190; 95%CI: 1.42-4.95; p < 0.0001; I2 = 99.4%), and caregiver burden (four studies, n = 852, SMD = 0.34; 95%CI: 0.13-0.56; p = 0.001; I2 = 54.1%) (p < 0.05). There was an increase in depression, anxiety, caregiver burden, and distress in caregivers of PwD/MCI during the lockdown in the COVID pandemic. This could have longer term consequences, and it is essential that caregivers' psychological well-being is assessed and supported, to benefit both themselves and those for whom they care.
Collapse
Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, 90133 Palermo, Italy
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Yaohua Chen
- Department of Geriatrics, Lille Neurosciences & Cognition, University of Lille, 59000 Lille, France
| | - Burcu Akpinar Soylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir 35210, Turkey
| | - Alessandra Coin
- Geriatrics Division, Department of Medicine, University of Padua, 35122 Padua, Italy
| | - Dorota Religa
- Division for Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institute, 14152 Stockholm, Sweden
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, 70211 Kuopio, Finland
| | - Mariana Alves
- Serviço de Medicina III, Hospital Pulido Valente, CHLN, Alameda das Linhas de Torres, 117, 1769-001 Lisbon, Portugal
| | - Susan D. Shenkin
- Ageing and Health Research Group, Usher Institute, University of Edinburgh, Edinburgh EH16 4SB, UK
| |
Collapse
|
33
|
Nyondo-Mipando AL, Nyirenda D, Suwedi-Kapesa L, Chirwa M, Mwapasa V. "Why take the patient back home?": Exploring the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001601. [PMID: 37756270 PMCID: PMC10529612 DOI: 10.1371/journal.pgph.0001601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
The Corona Virus Disease 2019 (COVID-19) pandemic continues to have serious health and socio-economic consequences. In Malawi, COVID-19 cases are managed at home, with hospital admission reserved for severe cases. This study described the lived experiences of caregivers of COVID-19-infected individuals in Blantyre, Malawi. This descriptive qualitative study was conducted from January to June 2021 in Blantyre, Malawi, among caregivers of confirmed SARS-COV-2 cases enrolled in the SARS-CoV-2 study and aimed to explore infections, transmission dynamics, and household impact. We conducted 37 in-depth interviews with caregivers of SARS-COV-2 cases who were purposively sampled. We captured data using telephonic interviews, digitally recorded, transcribed verbatim, managed using NVivo, and analysed it using a thematic approach guided by the theory of caregiving dynamics. Caregivers stated that the economic status of a family largely influenced caregiving roles and abilities because it determined the resources that a household could access or not. Caregivers expressed being committed to their role despite being ill-prepared to manage a COVID-19 patient at home, in addition to fears about the contagious nature of COVID-19. They prioritised their patients' health by ensuring that they were present to offer nutritional and medical treatment. Caregivers highlighted challenges faced in the implementation of preventive measures because of financial limitations and cultural factors. They further expressed fear resulting from the increase in death rates, and the lack of proper information challenged their expectation of having their patients healed. Caregivers stated that they managed their role by sharing responsibilities, getting better at it with time, and getting support from religious institutions and social networks. Caring for confirmed cases of COVID-19 demanded commitment from the caregivers while ensuring that the transmission of the virus was minimised. There is a need to support households in isolation with the right information on how to manage their patients and streamline social support for the ultra-poor.
Collapse
Affiliation(s)
- Alinane Linda Nyondo-Mipando
- Department of Health Systems and Policy, School of Global and Public Health Kamuzu University Health Sciences, Blantyre, Malawi
| | | | - Leticia Suwedi-Kapesa
- Department of Health Systems and Policy, School of Global and Public Health Kamuzu University Health Sciences, Blantyre, Malawi
- Public Health Institute of Malawi, Lilongwe, Malawi
| | - Marumbo Chirwa
- Department of Health Systems and Policy, School of Global and Public Health Kamuzu University Health Sciences, Blantyre, Malawi
| | - Victor Mwapasa
- Department of Public Health, School of Global and Public Health Kamuzu University Health Sciences, Blantyre, Malawi
| |
Collapse
|
34
|
Shahbaz R, Williams A, Sethi B, Wahoush O. Commonalities and Differences in the Experiences of Visible Minority Transnational Carer-Employees: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6800. [PMID: 37754659 PMCID: PMC10531478 DOI: 10.3390/ijerph20186800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/10/2023] [Accepted: 09/19/2023] [Indexed: 09/28/2023]
Abstract
This qualitative study explored the commonalities and differences among the experiences of visible minority Transnational Carer-Employees (TCEs) before and after COVID-19. TCEs are immigrants who live and work in the country of settlement while providing caregiving across international borders. Purposive and snowball sampling resulted in the participation of 29 TCEs of Pakistani, Syrian, African, and South American origin living in London, Ontario. Thematic analysis of the dataset using the ATLAS.ti software, Version 23.2.1., generated three themes: (1) feelings associated with transnational care; (2) employment experiences of TCEs; and (3) coping strategies for well-being. The results of the secondary analysis conducted herein suggested that there are more similarities than differences across the four cohorts. Many participants felt a sense of satisfaction at being able to fulfill their care obligations; however, a different outlook was observed among some Syrian and African origin respondents, who disclosed that managing care and work is overwhelming. Most TCEs also reported facing limited job options because of language barriers. While various interviewees experienced a lack of paid work and reduced income after COVID-19, a distinct perspective was noted from African descent TCEs as they expressed facing increased work demands after the pandemic. Participants additionally revealed four common coping strategies such as keeping busy, praying, family support, and staying active. Study implications include the promotion of Carer-Friendly Workplace Policies (CFWPs) that can facilitate the welfare of unpaid caregivers. This research is important as it may inform policymakers to create opportunities that may not only foster economic stability of TCEs and the Canadian economy, but also contribute towards a more equitable society.
Collapse
Affiliation(s)
- Reemal Shahbaz
- Faculty of Health Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Allison Williams
- Faculty of Sciences, McMaster University, Hamilton, ON L8S 4L8, Canada;
| | - Bharati Sethi
- Department of Political Studies, Trent University, Peterborough, ON K9L 0G2, Canada;
| | - Olive Wahoush
- School of Nursing, McMaster University, Hamilton, ON L8S 4L8, Canada;
| |
Collapse
|
35
|
Chu AMY, Lam BSY, Tsang JTY, Tiwari A, Yuk H, Chan JNL, So MKP. An automatic speech analytics program for digital assessment of stress burden and psychosocial health. NPJ MENTAL HEALTH RESEARCH 2023; 2:15. [PMID: 38609493 PMCID: PMC10955916 DOI: 10.1038/s44184-023-00036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 08/24/2023] [Indexed: 04/14/2024]
Abstract
The stress burden generated from family caregiving makes caregivers particularly prone to developing psychosocial health issues; however, with early diagnosis and intervention, disease progression and long-term disability can be prevented. We developed an automatic speech analytics program (ASAP) for the detection of psychosocial health issues based on clients' speech. One hundred Cantonese-speaking family caregivers were recruited with the results suggesting that the ASAP can identify family caregivers with low or high stress burden levels with an accuracy rate of 72%. The findings indicate that digital health technology can be used to assist in the psychosocial health assessment. While the conventional method requires rigorous assessments by specialists with multiple rounds of questioning, the ASAP can provide a cost-effective and immediate initial assessment to identify high levels of stress among family caregivers so they can be referred to social workers and healthcare professionals for further assessments and treatments.
Collapse
Affiliation(s)
- Amanda M Y Chu
- Department of Social Sciences and Policy Studies, The Education University of Hong Kong, Tai Po, Hong Kong, China
| | - Benson S Y Lam
- Department of Mathematics, Statistics and Insurance, The Hang Seng University of Hong Kong, Shatin, Hong Kong, China
| | - Jenny T Y Tsang
- School of Nursing, Tung Wah College, Ho Man Tin, Hong Kong, China
| | - Agnes Tiwari
- School of Nursing, The University of Hong Kong, Pokfulam, Hong Kong, China
- School of Nursing, Hong Kong Sanatorium & Hospital, Happy Valley, Hong Kong, China
| | - Helina Yuk
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Jacky N L Chan
- Department of Information Systems, Business Statistics and Operations Management, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
| | - Mike K P So
- Department of Information Systems, Business Statistics and Operations Management, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China.
| |
Collapse
|
36
|
Turabi N, Tomar SP, Anyagwa OE, Durganaudu H, Ishwarya V, Kivan H, Kras MM, Samouti P, Khaled E, Ramesh NN, Krishnegowda AS, Shabani MM, Palacios-Garay MA, Ambriz-Salas F, Aigbonoga DE, Bassiony M. Sleep Disturbances among Caregivers of Home-Isolated and Hospitalized COVID-19 Patients: A Multi-National Cross-Sectional Study. Indian J Community Med 2023; 48:676-683. [PMID: 37970177 PMCID: PMC10637614 DOI: 10.4103/ijcm.ijcm_690_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 07/20/2023] [Indexed: 11/17/2023] Open
Abstract
Background Since the coronavirus (COVID-19) pandemic began, several studies were published on the possible prevention and treatment of the disease caused by severe acute respiratory syndrome coronavirus (SARSCoV-2), and its complications. However, one aspect that was overlooked is the impact on the mental health of the caregivers of COVID-19 patients. The current study endeavors to investigate sleep quality disturbances in the caregivers of COVID-19 patients in different countries. Material and Methods This cross-sectional multi-center study was performed between August 1, 2021, and August 30, 2022, across 11 countries. A total of 2411 responses meeting the inclusion criteria (being a family member or caregiver involved in patient care) were collected. The sleep quality was assessed using the self-reported Pittsburgh Sleep Quality Index (PSQI) 12. Total scores ranged from 0 to 21. A ≥5 indicated poor sleep quality with 89.6% sensitivity and 86.5% specificity. Results A total of 2411 responses meeting the inclusion criteria showed that mean PSQI scores (P = 0.3604) were higher in caregivers of hospitalized patients than in patients isolated at home. Approximately 62.4% of caregivers reported sleep quality problems while caring for their patients. Conclusion The results showed that the majority of caregivers of patients with COVID-19 reported disturbances in sleep quality and impaired sleep was more common among caregivers of hospitalized patients, perhaps because hospitalization is associated with a more severe course of the disease. There is a pressing need to take measures to improve the mental health of these caregivers. There should be treatment programs set up to reverse sleep disturbances in this population sufficiently.
Collapse
Affiliation(s)
- Nafisa Turabi
- Department of Medicine, Netaji Subhash Chandra Bose Medical College, Jabalpur, Madhya Pradesh, India
| | | | | | - Hanusha Durganaudu
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University, Malaysia
| | - V Ishwarya
- Department of Medicine, Chettinad Hospital and Research Institute, Chennai, Tamil Nadu, India
| | - Husam Kivan
- Faculty of Medicine, OnDokuz Mayıs University, Atakum, Samsun, Turkey
| | - Magdalena M. Kras
- Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland
| | - Paraskevi Samouti
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Eman Khaled
- School of Medicine, Ankara University, Ankara, Turkey
| | - N Nishitha Ramesh
- Department of Medicine, Father Muller Medical College, Mangalore, Karnataka, India
| | - Amruth S. Krishnegowda
- Department of Medicine, Employees State Insurance Corporation Medical College, Bengaluru, Karnataka, India
| | - Moshi Moshi Shabani
- Department of Orthopaedics and Traumatology, Mbeya Zonal Referral Hospital, Mbeya, Tanzania
| | | | - Fernanda Ambriz-Salas
- Department of Medicine, Faculty of Medicine, Universidad Justo Sierra, Escuela de Medicina, México
| | | | | |
Collapse
|
37
|
Morgan T, Gott M, Williams L, Naden J, Wang Y, Smith B, Fanueli E, Budi Setyawati M, Morgan K, Robinson J, Anderson N, Carey M, Moeke-Maxwell T. A bad time to die? Exploring bereaved families/wha-nau experiences of end-of-life care under COVID-19 restrictions: a qualitative interview study. Palliat Care Soc Pract 2023; 17:26323524231189525. [PMID: 37584059 PMCID: PMC10424543 DOI: 10.1177/26323524231189525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 07/05/2023] [Indexed: 08/17/2023] Open
Abstract
Background There have been international concerns raised that, during the COVID-19 pandemic, there was an absence of good palliative care resulting in poor end-of-life care experiences. To date, there have been few studies considering the pandemic's impact on people dying from non-COVID-19 causes and their families and friends. In particular, there has been very less empirical research in relation to end-of-life care for Indigenous, migrant and minoritised ethnic communities. Objectives To explore bereaved next-of-kin's views and experiences of end-of-life care under COVID-19 pandemic regulations. Design This qualitative study involved in-depth one-off interviews with 30 ethnically diverse next-of-kin who had a family member die in the first year of the pandemic in Aotearoa, New Zealand. Methods Interviews were conducted by ethnically matched interviewers/interviewees. A reflexive thematic analysis was used to explore and conceptualise their accounts. Results A key finding was that dying alone and contracting COVID-19 were seen as equally significant risks by bereaved families. Through this analysis, we identified five key themes: (1) compromised connection; (2) uncertain communication; (3) cultural safety; (4) supported grieving and (5) silver linings. Conclusion This article emphasises the importance of enabling safe and supported access for family/whanau to be with their family/wha-nau member at end-of-life. We identify a need for wider provision of bereavement support. We recommend that policy makers increase resourcing of palliative care services to ensure that patients and their families receive high-quality end-of-life care, both during and post this pandemic. Policy makers could also promote a culturally-diverse end-of-life care work force and the embedding of culturally-safety practices across a range of institutions where people die.
Collapse
Affiliation(s)
- Tessa Morgan
- Applied Social Science Group, Department of Public Health and Primary Care, The University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK
| | - Merryn Gott
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Lisa Williams
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Joe Naden
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Yingmin Wang
- School of Foreign Studies and School of International Culture, South China Normal University, Guangzhou, China
| | - Brianna Smith
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Elizabeth Fanueli
- School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Martyarini Budi Setyawati
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Kathryn Morgan
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Jackie Robinson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Natalie Anderson
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Melissa Carey
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Tess Moeke-Maxwell
- School of Nursing, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| |
Collapse
|
38
|
Hensel DJ, Mark KP, Abdelhamed A, Burns S, Esho T, Hendriks J, Jobim Fischer V, Ivanova O, Marks M, Michelsen K, Nimby F, Strizzi J, Tucker J, Uhlich M, Erausquin JT. Changes in Solo and Partnered Sexual Behaviors following the First COVID-19 Wave: Data from an International Study of 26 Countries. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:459-480. [PMID: 38601728 PMCID: PMC10903556 DOI: 10.1080/19317611.2023.2224777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 04/21/2023] [Accepted: 05/28/2023] [Indexed: 04/12/2024]
Abstract
Objective To determine individual- and country-level factors associated with self-reported changes in solo and partnered sexual behaviors in an international sample of adults during COVID-19. Methods Data were from the International Sexual Health And REproductive Health during COVID-19 study (I-SHARE)-a cross-sectional, multi-country study (N = 26 countries) assessing adult (N = 19,654) sexual/reproductive health before and during the first wave of COVID-19. We examined self-reported changes (three-point scale: decreased, no change, increased) in solo masturbation, hugging/holding hands/cuddling with a partner, sex with a primary partner, sex with a casual partner, sexting with a partner, viewing sexually explicit media and partnered cybersex. Ordinal regression assessed the impact of individual (age, gender- and sexual-identity, romantic partnership status, employment and income stability, household change and content, mental well-being, changes in alcohol use, and changes in marijuana use) and country-level (e.g., Oxford Stringency Index, Human Development Index, and the Palma Ratio) factors on behavior change. Results The most common behavior to increase was hugging, kissing, or cuddling with a partner (21.5%), and the most common behavior to decrease was sex with a main partner (36.7%). Household factors like job/income instability and having children over the age of 12 years were significantly associated with decreased affectionate and sexual partnered sexual behaviors; more frequent substance use was linked to significantly increased solo, partnered, and virtual sexual behaviors. Conclusions Understanding changes in sexual behaviors-as well as the factors that make changes more or less likely among adults around the world-are important to ensure adequate sexual health support development for future public health emergencies.
Collapse
Affiliation(s)
- Devon J. Hensel
- Division of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Sociology, Indiana University Purdue University-Indianapolis, Indianapolis, IN, USA
| | - Kristen P. Mark
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Amr Abdelhamed
- Department of Dermatology, Venereology & Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Sharyn Burns
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | | | - Jacqueline Hendriks
- Discipline of Health Promotion & Sexology, Curtin School of Population Health, Curtin University, Perth, Australia
| | - Vinicius Jobim Fischer
- Department of Behavioural and Cognitive Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Olena Ivanova
- Department of Infectious Diseases, University Hospital LMU Munich, Munich, Germany
| | - Michael Marks
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Kristien Michelsen
- Department of Public Health and Primary Care, University of Ghent, Ghent, Belgium
| | - Fillipo Nimby
- Foundation for Professional Development, Rome, Italy
| | - Jenna Strizzi
- Centre for Medical Science and Technology Studies, University of Copenhagen, Copenhagen, Denmark
| | - Joe Tucker
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | |
Collapse
|
39
|
Romero DE, Maia L, Muzy J, Andrade N, Souza Junior PRBD. Factors associated with worsening in the self-rated health status of Brazilian women who lived with dependent elderly people during the first wave of COVID-19. CIENCIA & SAUDE COLETIVA 2023; 28:2051-2064. [PMID: 37436318 DOI: 10.1590/1413-81232023287.13702022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/25/2022] [Indexed: 07/13/2023] Open
Abstract
The objective is to analyze the factors associated with the worsening of the self-rated health (SRH) of Brazilian women who live with elderly people with functional dependence (EFD) during the first wave of COVID-19. ConVid - Behavior Research was used as a data source. For the analysis, the group of women who lived with EFD was compared with those who lived with the elderly without any dependence. Hierarchical prevalence ratio (PR) models were estimated to test the associations between sociodemographic characteristics, changes in income, routine activities and health in the pandemic, with the outcome of worsening SRH. This worsening was more frequent in the group of women living with EFD. After adjusting for hierarchical factors, being black (PR=0.76; 95%CI 0.60-0.96) and having a per capita income lower than minimum wage (PR=0.78; 95%CI 0.64- 0.96) were shown to be protective factors for SRH worsening among EFD co-residents. Indisposition, emergence/worsening of back problems, affected sleep, poor SRH, feeling loneliness and difficulty in carrying out routine activities during the pandemic were positively associated factors. The study demonstrates that living with EFD was associated with a worsening in the health status of Brazilian women during the pandemic, especially among those of higher social status.
Collapse
Affiliation(s)
- Dalia Elena Romero
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Leo Maia
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Jessica Muzy
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Nathália Andrade
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| | - Paulo Roberto Borges de Souza Junior
- Laboratório de Informação em Saúde, Instituto de Comunicação e Informação Científica e Tecnológica em Saúde, Fundação Oswaldo Cruz (Fiocruz). Av. Brasil 4.365, Pavilhão Haity Moussatché, Manguinhos. Rio de Janeiro RJ Brasil.
| |
Collapse
|
40
|
Guedes DA, Gomes NP, Carvalho AADS. Subjective well-being in informal caregivers during the COVID-19 pandemic. Open Med (Wars) 2023; 18:20230739. [PMID: 37333446 PMCID: PMC10276610 DOI: 10.1515/med-2023-0739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/28/2023] [Accepted: 05/29/2023] [Indexed: 06/20/2023] Open
Abstract
The study of subjective well-being (SWB) is important as it is related to the reduction of morbidity and mortality, with the maintenance of functionality and autonomy in the elderly population. The impact of the formative intervention on the SWB of informal caregivers (ICGs) during the pandemic crisis of COVID-19 was analyzed. This study is a quasi-experimental single-group, longitudinal study with a sample of 31 ICGs and their dependents. A form was used for data collection, and data processing was performed using IBM SPSS (Statistical Package for the Social Sciences), using descriptive statistics and inferential statistics. Of the total sample, the majority were female (90.3%). The difference between the mean of positive affection and negative affection at Moment 1 (M1) was -0.0581 ± 0.71590 and 0.04645 ± 0.53326 at Moment 2 (M2). The mean rank ordering of the difference between the two types of affection differed significantly between M2 and M1 (Wilcoxon: p < 0.000), with that of M2 being higher than M1 (16.93 > 2.50). The formative intervention, within the scope of community nursing, had a significant impact on increasing the SWB of the ICG in this sample. This study may contribute to improving the SWB of ICG and their dependents.
Collapse
Affiliation(s)
- Daniela Alves Guedes
- Grouping of Health Centres Tâmega I, Baixo Tâmega, Marão Várzea Personalised Health Care Unit, Amarante, Portugal
| | | | - Amâncio António de Sousa Carvalho
- Department of Health School, University of Trás-os-Montes e Alto Douro/Nursing School, Vila Real, Portugal
- CIEC – Research Centre on Child Studies, University of Minho, Braga, Portugal
| |
Collapse
|
41
|
Ward A, Buffalo L, McDonald C, L'Heureux T, Charles L, Pollard C, Tian PG, Anderson S, Parmar J. Supporting First Nations Family Caregivers and Providers: Family Caregivers', Health and Community Providers', and Leaders' Recommendations. Diseases 2023; 11:diseases11020065. [PMID: 37218878 DOI: 10.3390/diseases11020065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/23/2023] [Indexed: 05/24/2023] Open
Abstract
Family caregivers and care providers are increasingly becoming more distressed and reaching a breaking point within current systems of care. First Nations family caregivers and the health and community providers employed in First Nations communities have to cope with colonial, discriminatory practices that have caused intergenerational trauma and a myriad of siloed, disconnected, and difficult-to-navigate federal-, provincial/territorial-, and community-level policies and programs. Indigenous participants in Alberta's Health Advisory Councils described Indigenous family caregivers as having more difficulty accessing support than other Alberta caregivers. In this article, we report on family caregivers', providers', and leaders' recommendations to support First Nations family caregivers and the health and community providers employed in First Nations. We used participatory action research methods in which we drew on Etuaptmumk (the understanding that being in the world is the gift of multiple perspectives) and that Indigenous and non-Indigenous views are complementary. Participants were from two First Nation communities in Alberta and included family caregivers (n = 6), health and community providers (n = 14), and healthcare and community leaders (n = 6). Participants advised that family caregivers needed four types of support: (1) recognize the family caregivers' role and work; (2) enhance navigation and timely access to services, (3) improve home care support and respite, and (4) provide culturally safe care. Participants had four recommendations to support providers: (1) support community providers' health and wellbeing; (2) recruit and retain health and community providers; (3) improve orientation for new providers; and (4) offer providers a comprehensive grounding in cultural awareness. While creating a program or department for family caregivers may be tempting to address caregivers' immediate needs, improving the health of First Nations family caregivers requires a population-based public health approach that focuses on meaningful holistic system change to support family caregivers.
Collapse
Affiliation(s)
- Amber Ward
- Faculty of Medicine, University of Victoria, Victoria, BC V6T 1Z3, Canada
| | | | | | - Tanya L'Heureux
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Lesley Charles
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Cheryl Pollard
- Faculty of Nursing, University of Regina, Regina, SK S4S 0A2, Canada
| | - Peter G Tian
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Sharon Anderson
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| | - Jasneet Parmar
- Division of Care of the Elderly, Department of Family Medicine, University of Alberta, Edmonton, AB T6G 2T4, Canada
| |
Collapse
|
42
|
Mitchell LL, Horn B, Stabler H, Birkeland RW, Peterson CM, Albers EA, Gaugler JE. Caring for a Relative With Dementia in Long-Term Care During the COVID-19 Pandemic: A Prospective Longitudinal Study. Innov Aging 2023; 7:igad034. [PMID: 37213326 PMCID: PMC10195573 DOI: 10.1093/geroni/igad034] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Indexed: 05/23/2023] Open
Abstract
Background and Objectives The coronavirus disease 2019 (COVID-19) pandemic introduced unprecedented threats and disruptions for caregivers of people with dementia living in residential long-term care (LTC) facilities. Qualitative and cross-sectional studies have reported substantial negative effects of the pandemic on dementia caregivers' well-being, but little to no prospective research has examined the impact of COVID-19 on caregiver well-being using pre-pandemic assessments. The present study used longitudinal data from an ongoing randomized controlled trial of a psychosocial intervention to support family caregivers whose relatives had entered LTC. Research Design and Methods Data collection began in 2016 and continued through 2021. Caregivers (N = 132) completed up to 7 assessments measuring their depressive symptoms, self-efficacy, and burden. Results Latent growth curve models testing preregistered hypotheses revealed no significant effects of the pandemic on caregiver outcomes on average, though caregivers varied in terms of individual intercepts and slopes. Furthermore, factors such as caregiver-care recipient relationship closeness, care recipient's COVID-19 infection status, and caregivers' ratings of LTC facilities' COVID-19 policies did not significantly moderate trajectories of well-being. Discussion and Implications Findings highlight the heterogeneity of caregivers' experiences during the pandemic, and suggest caution when interpreting cross-sectional findings on the impacts of the COVID-19 pandemic on caregiver well-being and distress.
Collapse
Affiliation(s)
- Lauren L Mitchell
- Department of Psychology & Neuroscience, Emmanuel College, Boston, Massachusetts, USA
| | - Brenna Horn
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Henry Stabler
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Robyn W Birkeland
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Colleen M Peterson
- Transportation Research Institute, University of Michigan, Ann Arbor, Michigan, USA
| | - Elle A Albers
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Joseph E Gaugler
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
43
|
Xu EL, Kim PS, Yee C, Zhang M, Reckrey JM, Lubetsky S, Zhao D, Ornstein KA, Franzosa E. "I Depend on Her for Everything": A Retrospective Chart Review of Home Care Worker Service Disruptions for Homebound Older Adults During the COVID-19 Pandemic. J Appl Gerontol 2023; 42:561-570. [PMID: 36283965 PMCID: PMC9597284 DOI: 10.1177/07334648221135584] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/15/2022] Open
Abstract
Home care workers played critical roles in meeting the complex medical and social needs of homebound adults during COVID-19, yet their contributions remain underappreciated. This study characterizes home care workers' roles during COVID-19 and examines how home care disruptions impacted homebound individuals and caregivers. Using a qualitative analysis of electronic medical records among a randomly sampled subset of homebound patients in a home-based primary care practice, we found that home care workers were essential in meeting existing and new needs of homebound individuals. Insufficient home care worker services, including unstable schedules and inadequate hours of paid care, became particularly disruptive, leading to risks for patients and their caregivers. Given their integral role on care teams, home care workers must be a policy focus to prepare for emergent situations and ensure that homebound individuals have access to high quality, stable home care.
Collapse
Affiliation(s)
- Emily L Xu
- Department of Medical Education, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Patricia S Kim
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| | - Cynthia Yee
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| | - Meng Zhang
- Department of Internal Medicine, 5925Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jennifer M Reckrey
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| | - Sara Lubetsky
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| | - Duzhi Zhao
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| | | | - Emily Franzosa
- Brookdale Geriatric Research, Education and Clinical Center, New York, NY, USA
| |
Collapse
|
44
|
Russell D, Burgdorf JG, Washington KT, Schmitz J, Bowles KH. "Second set of eyes:" Family caregivers and post-acute home health care during the COVID-19 pandemic. PATIENT EDUCATION AND COUNSELING 2023; 109:107627. [PMID: 36638714 PMCID: PMC9830895 DOI: 10.1016/j.pec.2023.107627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 06/17/2023]
Abstract
OBJECTIVES This study aimed to explore how the COVID-19 pandemic shaped the experiences of family caregivers of older adults who were hospitalized with COVID-19 and discharged to post-acute, skilled home health care (HHC) services. METHODS Thirty semi-structured interviews with family caregivers of older adults who received services from a large, not-for-profit HHC agency following hospitalization with COVID-19 infection were conducted between March-July 2021 and analyzed using thematic analysis. RESULTS During the pandemic, family caregivers encountered societal and institutional barriers to assisting older adults across post-acute care transitions. These barriers included hospital visitation restrictions as well as difficulties accessing community-based resources and medical equipment. Despite limitations and delays in HHC services, many family caregivers identified post-acute HHC, delivered in-person or via telehealth, as important to addressing care gaps for older adults, as well as their own needs for training and support during the pandemic. CONCLUSIONS Policies intended to reduce the spread of COVID-19 introduced new challenges for caregivers during HHC. However, HHC agencies and their staff adapted within this context to provide a needed bridge of support.
Collapse
Affiliation(s)
- David Russell
- Appalachian State University Department of Sociology, Boone, NC, USA; Center for Home Care Policy & Research at VNS Health, New York, NY, USA.
| | - Julia G Burgdorf
- Center for Home Care Policy & Research at VNS Health, New York, NY, USA
| | - Karla T Washington
- Division of Palliative Medicine at Washington University in St. Louis, St. Louis, MO, USA
| | - Jennifer Schmitz
- Southern Illinois University Edwardsville, Edwardsville, IL, USA
| | - Kathryn H Bowles
- Center for Home Care Policy & Research at VNS Health, New York, NY, USA; University of Pennsylvania School of Nursing, Philadelphia, PA, USA
| |
Collapse
|
45
|
Correia H, Martin-Lynch P, Finlayson M, Learmonth YC. Exploring COVID-19 experiences for persons with multiple sclerosis and carers: An Australian qualitative study. Health Expect 2023; 26:785-794. [PMID: 36639883 PMCID: PMC10010087 DOI: 10.1111/hex.13704] [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: 07/16/2022] [Revised: 11/29/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE The COVID-19 pandemic continues to impact communities around the world. In this study, we explored the COVID-19 experiences of persons with multiple sclerosis (MS) and carers. METHODS Using a qualitative approach, interviews were undertaken with 27 participants residing in Australia (10 persons with MS, 10 carers and 7 MS service providers). Demographic and background data were also collected. Interviews were analysed using an inductive iterative thematic analysis. RESULTS Across all groups, participants consistently recognized pandemic challenges and impacts for persons with MS and carers, especially due to disruption to routines and services. Emotional and mental health impacts were also highlighted, as anxiety, fear of contracting COVID-19 and stress, including relationship stress between persons with MS and carers and family members. Some persons with MS also mentioned physical health impacts, while for carers, the challenge of disruptions included increased demands and reduced resources. In addition to acknowledging challenges, persons with MS and carers also gave examples of resilience. This included coping and adapting by finding new routines and creating space through rest and breaks and through appreciating positives including the benefits of access to telehealth. CONCLUSION Additional support is required for persons with MS and carers in navigating the impacts of COVID-19 as the pandemic progresses. In addition to addressing challenges and disruptions, such support should also acknowledge and support the resilience of people with MS and carers and enhance resilience through supporting strategies for coping and adaptation. PATIENT AND PUBLIC CONTRIBUTION Service user stakeholders were consulted at the beginning and end of the study. They provided feedback on interview questions and participant engagement, as well as service user perspectives on the themes identified in the current study. Participants were provided with summaries of key themes identified and invited to provide comments.
Collapse
Affiliation(s)
- Helen Correia
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia.,Psychological Sciences, Australian College of Applied Professions, Perth, Western Australia, Australia
| | - Pamela Martin-Lynch
- College of Science, Health, Engineering and Education, Murdoch University, Murdoch, Western Australia, Australia
| | - Marcia Finlayson
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Yvonne C Learmonth
- Centre for Molecular Medicine and Innovative Therapeutics, and Centre for Healthy Aging, Health Futures Institute, Murdoch University, Murdoch, Western Australia, Australia.,Discipline of Exercise Science, Murdoch University, Murdoch, Western Australia, Australia.,Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| |
Collapse
|
46
|
Faghani S, Ahmadi F, Mohammadi E. Caregiver, secondary victim: outcome of caring for patients with COVID -19: a qualitative content analysis study. BMC Health Serv Res 2023; 23:308. [PMID: 36997933 PMCID: PMC10062248 DOI: 10.1186/s12913-023-09319-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Considering the importance of caring for patients with COVID -19 at home and the majority of care being the responsibility of family caregivers, it is necessary to identify and assess the problems during the implementation of patient care in family caregivers. Therefore, the present study was conducted to discover the different consequences of caring for patients with COVID-19 in family caregivers. METHOD Using Purposive sampling, 15 female family caregivers were included in the study. This study was conducted between 2021 and 2022 in Iran. Unstructured face-to-face and virtual interviews were used to collect data until data saturation was reached. Data were analyzed through Granheim and Lundman conventional content analysis approach. RESULTS The analysis of data related to the outcome of caring for patients with COVID -19 in family caregivers, led to the extraction of six subcategories: " caregivers experiencing physical symptoms ", "perception of extra pressure and psychological symptoms in the caregiver", "disruption in marital relations", "feeling of homelessness and rejection" and " role pressure due to lack of family support". The subcategories led to the development of the main category "caregiver, the secondary victim", which is experienced by family caregivers during the provision of care for patients with COVID -19. CONCLUSION Family caregivers experience high levels of negative consequences from providing care to patients with COVID-19. Therefore, more attention should be paid to all dimensions of caregiver health such as physical, mental, and marital to provide quality care to patients finally.
Collapse
Affiliation(s)
- Safieh Faghani
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Fazlollah Ahmadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran.
| | - Eesa Mohammadi
- Nursing Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| |
Collapse
|
47
|
Humber MB, Yefimova M, Lessios AS, Trivedi RB, Sheffrin M, Martin M. "It Isn't the Same": Experiences of Informal Caregivers of Older Adults Enrolled in a Home-Based Senior Care Program During COVID-19. J Gerontol Nurs 2023; 49:19-26. [PMID: 36852991 DOI: 10.3928/00989134-20230209-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic placed new strains on informal caregivers, who are already vulnerable to negative psychosocial effects due to demands of the caregiving role. The current study aimed to explore the early impact of COVID-19 on caregivers living with and apart from care recipients. Semi-structured qualitative interviews with seven cohabitating and 10 distanced caregivers of patients in a home-based primary care program were conducted from April to November 2020. A framework matrix was used to identify patterns in caregiver experiences. Cohabitating and distanced caregivers reported shared concerns about COVID-19 and unique concerns dependent on cohabitation status. Cohabitating caregivers reported financial worries, care recipients with dementia being unable to understand restrictions, and concerns about community business changes. Distanced caregivers reported communication challenges with cognitively impaired care recipients and challenges with visitation policies. During pandemics, caregivers' clinical and policy support needs may differ depending on their place of residence relative to care recipients. [Journal of Gerontological Nursing, 49(3), 19-26.].
Collapse
|
48
|
Costi C, Hollingsworth B, O'Sullivan V, Zucchelli E. Does caring for others affect our mental health? Evidence from the COVID-19 pandemic. Soc Sci Med 2023; 321:115721. [PMID: 36827903 PMCID: PMC9872568 DOI: 10.1016/j.socscimed.2023.115721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 12/14/2022] [Accepted: 01/23/2023] [Indexed: 01/26/2023]
Abstract
Despite a growing literature about the mental health effects of COVID-19, less is known about the psychological costs of providing informal care during the pandemic. We examined longitudinal data from the UK's Understanding Society Survey, including eight COVID surveys, to estimate fixed effects difference-in-differences models combined with matching, to explore the causal effects of COVID-19 among informal carers. While matching accounts for selection on observables into caregiving, multiple period difference-in-differences specifications allow investigation of heterogeneous mental health effects of COVID-19 by timing and duration of informal care. The estimates suggest that while mental health fluctuated following the imposition of social restrictions, informal carers who started caregiving during the pandemic show the largest mental health deterioration, especially during lockdowns. Policies to mitigate the psychological burden of caregiving might be more effective if targeted at those starting to provide care for the first time.
Collapse
Affiliation(s)
- Chiara Costi
- Department of Economics, Lancaster University Management School (LUMS), Lancaster University, UK.
| | | | | | - Eugenio Zucchelli
- Madrid Institute for Advanced Study (MIAS) and Department of Economic Analysis, Universidad Autónoma de Madrid (UAM), Spain; IZA, Germany; Lancaster University, UK
| |
Collapse
|
49
|
Guest JF, Fuller GW. Cohort study assessing the impact of COVID-19 on venous leg ulcer management and associated clinical outcomes in clinical practice in the UK. BMJ Open 2023; 13:e068845. [PMID: 36806131 PMCID: PMC9944296 DOI: 10.1136/bmjopen-2022-068845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023] Open
Abstract
OBJECTIVE To assess the impact of the COVID-19 pandemic on venous leg ulcer (VLU) management by the UK's health services and associated outcomes. DESIGN Retrospective cohort analysis of the electronic records of patients from The Health Improvement Network database. SETTING Clinical practice in primary and secondary care. PARTICIPANTS A cohort of 1946 patients of whom 1263, 1153 and 733 had a VLU in 2019, 2020 and 2021, respectively. PRIMARY AND SECONDARY OUTCOME MEASURES Clinical outcomes and wound-related healthcare resource use. RESULTS VLU healing rate in 2020 and 2021 decreased by 16% and 42%, respectively, compared with 2019 and time to heal increased by >85%. An estimated 3% of patients in 2020 and 2021 had a COVID-19 infection. Also, 1% of patients in both years had VLU-related sepsis, 0.1%-0.2% developed gangrene and 0.3% and 0.6% underwent an amputation on part of the foot or lower limb in 2020 and 2021 (of whom 57% had diabetes), respectively. The number of community-based face-to-face clinician visits decreased by >50% in both years and >35% fewer patients were referred to a hospital specialist. In 2020 and 2021, up to 20% of patients were prescribed dressings without compression compared with 5% in 2019. The total number of wound care products prescribed in 2020 and 2021 was >50% less than that prescribed in 2019, possibly due to the decreased frequency of dressing change from a mean of once every 11 days in 2019 to once every 21 days in 2020 and 2021. CONCLUSIONS There was a significant trend towards decreasing care during 2020 and 2021, which was outside the boundaries considered to be good care. This led to poorer outcomes including lower VLU healing rates and increased risk of amputation. Hence, the COVID-19 pandemic appears to have had a deleterious impact on the health of patients with a VLU.
Collapse
|
50
|
Kling SMR, Garvert DW, Lessios AS, Yefimova M, Martin M, Sheffrin M, Winget M. Home-Based Primary Care for Older Adults: Matched Case-Control Evaluation of Program’s Impact on Healthcare Utilization. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2023. [DOI: 10.1177/10848223231151975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Home-based Primary Care (HBPC) is an alternative model for homebound older adults. Healthcare utilization in HBPC was evaluated with a matched case-control design. Medical providers and social workers provided in-home visits. Enrolled patients were matched to controls on age, prior hospitalizations, and frailty risk. Difference-in-differences in utilization of primary care, specialty, and hospital services between 1-year pre- and 1-year post-enrollment were evaluated with hierarchical linear models. Analyses included 117 HBPC cases and 328 controls. HBPC cases had a significant increase in primary care visits compared to controls (7.8 ± 0.6; p < .0001) but significantly decreased utilization of in-clinic primary care visits (−3.2 ± 0.6; p < .0001). In-clinic specialty visits and hospital services did not differ between cases and controls (all p’s ≥ .75). Homebound patients accessed high-touch primary and social care, which is typically unachievable in clinic settings; however, additional work is needed to optimize services and target in-home care to impact healthcare utilization.
Collapse
Affiliation(s)
| | | | | | - Maria Yefimova
- Stanford University School of Medicine, Stanford, CA, USA
- Stanford Health Care, Stanford, CA, USA
| | - Marina Martin
- Stanford University School of Medicine, Stanford, CA, USA
| | - Meera Sheffrin
- Stanford University School of Medicine, Stanford, CA, USA
| | - Marcy Winget
- Stanford University School of Medicine, Stanford, CA, USA
| |
Collapse
|