Psychosocial Adjustment to Illness Scale in family caregivers of patients with Parkinson's Disease: Spanish validation study

Living with long-term conditions: validation of a new instrument for family caregivers in a Spanish-speaking population

INTRODUCTION

Optimising the management of chronicity has been a global challenge for decades. Individuals with long-term conditions (LTCs) and their families live with them for years. Thus, it is necessary to include both of their perspectives in the management and adaptation of the interventions proposed. The psychometric properties of the living with LTCs scale from the perspective of the family caregiver are unknown. The objective of the present study is to describe the psychometric properties of the EC-PC-Fam in a Spanish-speaking population.

METHODS

An observational, cross-sectional study was performed with a retest of part of the sample. The fit of the model was optimised with a factorial analysis, and the psychometric properties were verified.

RESULTS

A sample of 311 caregivers was recruited. Most of them were women (68.2%) and had a mean age of 58.29±9.91 years (range: 32-84 years). The initial version did not obtain acceptable fit scores. To improve the fit, different versions were tested, refining the distribution of the items until optimisation was reached in V.10 (19 items). Cronbach's alpha was 0.81 for the scale as a whole. The intraclass correlation coefficient was 0.77. The EC-PC-Fam scale is strongly and inversely correlated with a scale that measures the burden of the caregiver (rs=-0.46), and moderately related to the health-related quality of life (rs=0.373) and social support (rs=0.38).

CONCLUSIONS

The EC-PC-Fam scale from a family perspective is defined as a promising tool for promoting personalised care and for optimising the management of LTCs, and a new approach that includes family caregivers is proposed for clinical practice. The scale is an instrument with a moderate fit and optimum psychometric properties to measure living with LTCs from the perspective of a family caregiver. New validation studies are recommended to verify the fit of the proposed factorial solution.

Family members' experiences of everyday caregiving for a family member living with Parkinson's disease: a qualitative thematic analysis study

BACKGROUND

In the daily life of individuals living with Parkinson's disease, their loved ones are crucial. Adapting family members to the patient's condition, support in providing care, and psychosocial adaptations is essential.

AIM

To explore family members' perception of everyday caregiving for a family member living with Parkinson's disease and to describe their role in the care and everyday life.

METHODS

In a descriptive, qualitative thematic analysis study, semi-structured interviews were conducted with ten people between the ages of 20 and 70, the closest family members of people living with Parkinson's disease. The analysis of the collected data was carried out using thematic analysis.

RESULTS

We generated the main theme: "Living with a family member with Parkinson's disease", with associated secondary-level sub-themes: "Response", "Change", "Care", and "Support". Family members of individuals living with Parkinson's disease frequently encounter similar life situations. The most notable transformation in their daily lives primarily revolves around adapting to various activities.

CONCLUSIONS

Family members are the ones who most often take on the role of caregiver and provide help to their loved ones. Many of them accept the disease as a part of everyday life and learn to live with it. It is of fundamental importance that we offer family members the necessary support, knowledge, and involvement in holistic treatment and care.

Understanding support systems for Parkinson's disease management in community settings: A cross-national qualitative study

BACKGROUND

Health and social care systems face difficulties in managing multimorbidity, disease burden and complex needs in long-term conditions such as Parkinson's disease.

OBJECTIVE

This study aimed to develop a European understanding of how health and social care professionals can collaborate with stakeholders from different organizations and sectors to enhance the management of Parkinson's disease in a community setting by identifying the existing gaps in this process and how people with Parkinson's disease and their family carers could benefit from these partnerships.

METHODS

A mixed-methods sequential study was conducted in Denmark, Norway, Spain and the United Kingdom. The findings from the qualitative phase are presented. Individual semistructured interviews were analysed using Braun's and Clarke's thematic analysis. A meta-ethnography approach was used to analyse and synthesize cross-national findings.

RESULTS

A total of 41 healthcare professionals and 39 stakeholders from different disciplines and sectors were interviewed in the four countries. The participants acknowledged a lack of awareness of available resources and poor communication between the different support systems in the management of Parkinson's disease. To promote multiagency collaborations, the participants highlighted the need to organize services along the Parkinson's disease journey, patient involvement and strategic involvement of carers in organizing resources and Parkinson's disease care pathways. According to the participants, the benefits from multiagency partnerships could lead to an enhanced continuity of care and specialized knowledge, mobilization of resources in the community, personalized support and improved access to services.

CONCLUSIONS

Policymakers are called upon to create formal structures that facilitate multisectoral collaborations to promote an integrated system of care for the management of Parkinson's disease in the community. To address this challenge, we propose five strategies showing how organizations can work together to optimize the use of resources and enhance the management of Parkinson's disease throughout the illness trajectory.

PATIENT OR PUBLIC CONTRIBUTION

Patient and Public Involvement groups made up of stakeholders, healthcare professionals, patients with Parkinson's disease and family carers participated in the design of the study, the development of the interview guides and the validation of the findings.

Living with Long Term Conditions from the Perspective of Family Caregivers. A Scoping Review and Narrative Synthesis

(1) Background: When living with one or more long term conditions (LTCs), both the patient and the family experience the impact of the condition at different levels. The family's needs and perceptions should be considered in the process of caring for people with LTCs. The aim of this review is to understand "the process of living with LTCs" from a family perspective. (2) Methods: A scoping review and narrative synthesis were conducted using a systematic methodology in MEDLINE, CINAHL, Web of Science and PsycINFO, in English and Spanish, including evidence from 2018. (3) Results: A total of 28 articles were included in the review. Acceptance, coping, self-management, integration, and adjustment were key attributes in the process of living with LTCs from the perspective of family caregivers that interrelated in a dynamic way through different mechanisms: being aware of the changing situation, personal networks, information and education, personal conditions, attitude to life and communication. (4) Conclusions: The five attributes that comprise living with LTCs from the perspective of the family caregiver are closely connected of to those of patients living with LTCs; however, self-management and integration have a different meaning and application.