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Stevens M, Brimblecombe N, Gowen S, Skyer R, Moriarty J. Young carers' experiences of services and support: What is helpful and how can support be improved? PLoS One 2024; 19:e0300551. [PMID: 38551988 PMCID: PMC10980198 DOI: 10.1371/journal.pone.0300551] [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: 10/18/2023] [Accepted: 02/28/2024] [Indexed: 04/01/2024] Open
Abstract
Globally, many children and young people provide support to family members who have poor physical or mental health, are disabled, or misuse drugs and alcohol. These young carers are at higher risk of poorer education, employment, health, and social participation outcomes compared to their peers without caring responsibilities. In the UK, awareness of the challenges faced by young carers, and a framework of their legal rights, are relatively well-developed. However, it is unclear how support can most effectively be provided. Taking a qualitative approach we explored experiences and views of young carers (aged 9-25), conducting focus groups or interviews with 133 young carers and 17 parent care recipients. We explored what aspects of services and support are seen as helpful, valued, and acceptable to young people, and what could be improved. A reflexive, thematic analysis was conducted. Valued support came from: young carers groups (including peer support), school-based and mental health support, and support for the care recipient. Helpful aspects of support included someone who listens and understands, and can be trusted not to break confidentiality; involving the young person in information, decision-making and planning (sometimes including regarding the care recipient); and finding and linking to other services. There was a difficult balance for practitioners between being perceived as proactive, persistent or intrusive when offering support to a young carer, but it was important to allow opportunities for young carers, and those they care for, to change their minds about when and whether to access support. Many interactions were perceived as unhelpful or threatening to the family, and there was often not enough of the type of support that was valued. Sharing of positive experiences can be beneficial for both people seeking support and those delivering it; key messages on what is helpful from the perspective of young carers can help support and shape practice approaches.
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Affiliation(s)
- Madeleine Stevens
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Nicola Brimblecombe
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Sara Gowen
- Sheffield Young Carers, Sheffield, South Yorkshire, United Kingdom
| | - Robin Skyer
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, United Kingdom
| | - Jo Moriarty
- NIHR Health & Social Care Workforce Research Unit, King’s College London, London, United Kingdom
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Allison KR, Patterson P, McDonald FE, Bibby K, Ciarrochi J, Tracey D, Hayes LL, Wright A, Konings S, Davis E, Hulbert-Williams NJ, Wakefield CE, White K. Truce: Feasibility and acceptability of an Acceptance and Commitment Therapy-based intervention for adolescents and young adults impacted by parental cancer. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023. [DOI: 10.1016/j.jcbs.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Dang S, Looijmans A, Ferraris G, Lamura G, Hagedoorn M. Exploring the Needs of Spousal, Adult Child, and Adult Sibling Informal Caregivers: A Mixed-Method Systematic Review. Front Psychol 2022; 13:832974. [PMID: 35401295 PMCID: PMC8992373 DOI: 10.3389/fpsyg.2022.832974] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Informal caregivers (ICGs) provide care to their family or friends in case of an illness, disability, or frailty. The caregiving situation of informal caregivers may vary based on the relationship they have with the care recipient (CR), e.g., being a spouse or being an adult child. It might be that these different ICGs also have different needs. This study aims to explore and compare the needs of different groups of ICGs based on the relationship they have with their CR. We conducted a systematic review, performing a search in the databases PubMed, CINAHL, and PsycINFO. We included studies with qualitative, quantitative, or mixed-method study designs. We analyzed the data using the thematic analysis method. We included 22 articles (18 qualitative; 4 quantitative). The included articles reported the needs of ICGs taking care of a spouse (spousal ICGs), parent (adult child ICG), or sibling aged 18 years or above (adult sibling ICGs). We did not include other relationships due to the limited number of articles on these relationships. The most prominent needs reported by the spousal, adult child, and adult sibling ICGs were the need for information and need for support. The three groups differed in their needs as well. Adult child and adult sibling ICGs indicated a need to be acknowledged by the people around them for their role of carer, while they also needed to be seen as an individual having their own personal needs. Moreover, spousal ICGs indicated a unique need of redefining their role and relationship with their CR. Overall, the findings indicate that along with experiencing common needs, the investigated groups have unique needs as well. Knowing the needs of different groups of ICGs can help develop tailored solutions to improve the quality of life of the ICGs and their CR. Systematic Review Registration: [www.crd.york.ac.uk/prospero/], identifier [CRD42020188560].
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Affiliation(s)
- Srishti Dang
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Anne Looijmans
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Giulia Ferraris
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Giovanni Lamura
- Centre for Socio-Economic Research on Ageing, INRCA IRCCS, National Institute of Health and Science on Ageing, Ancona, Italy
| | - Mariët Hagedoorn
- Department of Health Psychology, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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A Qualitative Study Exploring the Lives and Caring Practices of Young Carers of Stroke Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073941. [PMID: 35409626 PMCID: PMC8997658 DOI: 10.3390/ijerph19073941] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/18/2022] [Accepted: 03/21/2022] [Indexed: 11/23/2022]
Abstract
This study investigated the life transformation of children when a parent returned home from hospital after a stroke. The study explored children’s experiences of taking on caring roles in partnership with their well parent and stroke survivors’ perceptions of the young carer roles. The study aimed to identify unmet support needs in order to inform future service provision. Semi-structured interviews were conducted separately with stroke survivors (n = 7) (age range 41–60 years, mean 50.6) and their young carers (n = 11) (age range 11–20 years, mean 16). Interviews were audio recorded, transcribed and analysed using reflexive thematic analysis. Three overarching themes were identified: the lives of young carers, impact of stroke, and insulating the family. All the children were providing some level of care. None were in receipt of any formal support. Children moved in and out of the caring role in the absence of an adult, to act as primary carer. Young carers valued the life skills they were gaining but reported gaps in their knowledge and understanding of stroke. The well parent and young carers worked together in a bi-directional partnership to ameliorate the impact of stroke on the family. The study concluded that age appropriate and stroke specific information for children of stroke survivors could enhance agency and optimise positive outcomes of caring.
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Mental health of young informal carers: a systematic review. Soc Psychiatry Psychiatr Epidemiol 2022; 57:2345-2358. [PMID: 35798995 PMCID: PMC9263065 DOI: 10.1007/s00127-022-02333-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 06/20/2022] [Indexed: 10/25/2022]
Abstract
PURPOSE This systematic review aims to assess and evaluate quantitative evidence on the association between informal caregiving and mental health in young people. METHODS This review was registered in PROSPERO (CRD42021251666). We conducted our search in the following four databases: Medline (PubMed and OVID), EMBASE, PsycInfo and Web of Science. The last search was performed on the 17th of March of 2021. Quantitative studies that focused on carers aged 25 years or less and compared the mental health status of carers and non-carers were eligible for inclusion. Two reviewers independently assessed articles for eligibility and performed the quality assessment using the Risk of Bias tool in Non-Randomised Studies of Exposures (ROBINS-E). RESULTS We identified a total of ten eligible articles. Mental health outcomes included depression, anxiety and other mental or emotional problems. Nine out of the ten studies showed that being a young carer was consistently associated with poor mental health. However, the overall quality of evidence was low, and longitudinal data were limited to three articles. The primary sources of bias were confounding and outcome measurement. CONCLUSION Young carers experience poorer mental health outcomes than their non-caring peers. However, we identified an overall lack of quantitative evidence of high methodological rigour. To establish if young caring leads to poor mental health, future research should focus on addressing the identified methodological limitations and understanding the mechanisms explaining these associations. Addressing these gaps can better inform the allocation of appropriate support and resources to optimise the mental health of young carers.
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Ghofrani M, Nikfarid L, Nourian M, Nasiri M, Saiadynia M. Levels of unmet needs among adolescents and young adults (AYAs) impacted by parental cancer. Support Care Cancer 2018; 27:175-182. [PMID: 29922938 DOI: 10.1007/s00520-018-4310-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Accepted: 06/06/2018] [Indexed: 11/30/2022]
Abstract
PURPOSE In this study, we aim to assess types and levels of psychosocial needs in adolescents and young adults (AYAs) who have a parent with cancer. And define and describe the variables analyzing the demographic characteristics. METHODS This descriptive study with cross-sectional design was conducted on 217 participants from five hospitals in Tehran. By use of the "Offspring Cancer Needs Instrument," in adolescents and young adults who had the inclusion criteria, information about the psychosocial needs were collected. Also, a demographic questionnaire was completed by the participants. Mean and standard deviation calculated for each domain and overall scores. Independent t test and one-way ANOVA was used for the comparison of needs' mean and demographic variables. RESULTS Total scores' mean was 126 and among domains, the "information" got the highest and the "support from friends" the lowest mean. Among demographic variables, we found a relationship between parent education (p value = 0.007), treatment statue (p value = 0.015), parent gender (p value = 0.018), and parent-child relationship (p value = 0.027) with the level of psychosocial needs. CONCLUSIONS In this target group of adolescents and young adults, the need for "information" is the strongest domain of psychosocial need during parent cancer trajectory.
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Affiliation(s)
- Marjan Ghofrani
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Lida Nikfarid
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Manijheh Nourian
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maliheh Nasiri
- School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahindokhat Saiadynia
- Ayatollah Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Kallander EK, Weimand BM, Becker S, Van Roy B, Hanssen-Bauer K, Stavnes K, Faugli A, Kufås E, Ruud T. Children with ill parents: extent and nature of caring activities. Scand J Caring Sci 2017; 32:793-804. [PMID: 28869667 DOI: 10.1111/scs.12510] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 06/28/2017] [Indexed: 11/28/2022]
Abstract
RATIONALE Previous studies have shown that children may take on higher extents of caring activities if their parents are affected by severe illness or disability, especially when their parents lack access to formal and informal care. AIMS AND OBJECTIVES This study examined the extent and nature of caring activities done by patients' children; differences in caring activities between different types of parental illness; factors associated with caring activities. DESIGN An explorative cross-sectional multicentre study. METHODS Parents as patients in specialised healthcare services, and their children, were recruited from five health trusts in Norway. The sample included 246 children aged 8-17 years and their 238 parents with severe physical illness (neurological disease or cancer) (n = 135), mental illness (n = 75) or substance abuse (n = 28). MAIN OUTCOME MEASURE Multidimensional Assessment of Caring Activities (MACA-YC18). RESULTS A large number of children with ill parents are performing various caring activities. Increased caring activities among children due to their parent's illness were confirmed by their parents, especially with regard to personal care. We found no significant differences in the extent of caring activities between illness types, but there were some differences in the nature of these activities. Factors significantly associated with the extent and nature of caring activities were as follows: better social skills and higher external locus of control among the children; and poorer physical parental health. Parent's access to home-based services was limited. STUDY LIMITATIONS In recruitment of participants for the study, a sampling bias may have occurred. CONCLUSION To promote coping and to prevent inappropriate or extensive caring activities among children with ill parents, there is a need for increased access to flexible home-based services adapted to the type of parental illness.
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Affiliation(s)
- Ellen Katrine Kallander
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente M Weimand
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Saul Becker
- College of Social Sciences, University of Birmingham, Birmingham, UK
| | - Betty Van Roy
- Department of CAMHS, Clinic of Children and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Hanssen-Bauer
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Stavnes
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,The Research Department, Nordland Hospital Trust, Bodø, Norway
| | - Anne Faugli
- Vestre Viken Hospital Trust, Drammen, Norway
| | - Elin Kufås
- Vestre Viken Hospital Trust, Drammen, Norway
| | - Torleif Ruud
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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