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“We’ve All Lost So Much”: The Long-Term Care Home Experiences of Essential Family Caregivers During COVID-19. Can J Aging 2022; 42:284-296. [PMID: 36384854 DOI: 10.1017/s0714980822000496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Abstract
Background
During the coronavirus (COVID-19) pandemic, long-term care homes (LTCHs) imposed visitor restrictions that prevented essential family caregivers (EFCs) from entering the homes. Under these policies, EFCs had to engage in virtual, window, and outdoor visits, prior to the re-initiation of indoor visits.
Objective
To understand EFCs’ visitation experiences with LTCH residents during COVID-19.
Methods
Seven virtual focus groups with EFCs were conducted and analysed using a thematic approach.
Findings
Six themes were identified: (a) inconsistent and poor communication; (b) lack of staffing and resources; (c) increasing discord between EFCs and staff during COVID-19; (d) shock related to reunification; (e) lack of a person-centred or family-centred approach; and, (f) EFC and resident relationships as collateral damage.
Discussion
Our findings reflect how EFCs’ visitation experiences were affected by factors at the individual, LTCH, and health-system levels. Future sectoral responses and visitation guidelines should recognize EFCs as an integral part of the care team.
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Kenntemich L, von Hülsen L, Schäfer I, Böttche M, Lotzin A. Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis. Stress Health 2022; 39:460-473. [PMID: 36083785 PMCID: PMC9539043 DOI: 10.1002/smi.3196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/13/2022] [Accepted: 09/04/2022] [Indexed: 11/11/2022]
Abstract
During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ2 = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ2 = 82.21, p <0.001) or primarily dysfunctional (χ2 = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.
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Affiliation(s)
- Laura Kenntemich
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany,Department of PsychologyMSH Medical School HamburgHamburgGermany
| | - Leonie von Hülsen
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany
| | - Ingo Schäfer
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany
| | - Maria Böttche
- ForschungsabteilungZentrum ÜBERLEBENBerlinGermany,Division of Clinical Psychological InterventionFreie Universität BerlinBerlinGermany
| | - Annett Lotzin
- Department of Psychiatry and PsychotherapyUniversity Medical Center Hamburg EppendorfHamburgGermany,Department of PsychologyMSH Medical School HamburgHamburgGermany
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The Post-Traumatic Growth of Primary Caregivers of Patients after Liver Transplantation. Healthcare (Basel) 2022; 10:healthcare10091617. [PMID: 36141229 PMCID: PMC9498416 DOI: 10.3390/healthcare10091617] [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: 06/20/2022] [Revised: 08/23/2022] [Accepted: 08/24/2022] [Indexed: 11/29/2022] Open
Abstract
Liver transplantation is a very important surgery. In many cases, it involves two loved ones (receiver and donor in the same family) and causes stress and feelings of burden in family caregivers. The purpose of this study was to investigate post-traumatic growth in primary caregivers of liver transplant patients. A cross-sectional research design was adopted to recruit 84 participants. The Perceived Stress Scale, Short-Form Coping Strategies Scale, and Post-traumatic Growth Scale were used. The results revealed that the total score of perceived stress of the main caregivers of liver transplantation was 27.27 ± 6.63; problem-oriented coping and emotion-oriented coping were used as the main coping strategies, and the traumatic growth score was 42.01 ± 13.84. All three variables were significant predictors of post-traumatic growth (F = 13.71, p < 0.05), explaining 38% of the total variance. This study can help nurses understand the post-traumatic growth status and related factors of the main caregivers of liver transplant patients. It can also help caregivers understand their own perceived pressure and then take relevant care measures to reduce the degree of physical and mental load and achieve a balanced state.
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Gehr TJ, Freiberger E, Sieber CC, Engel SA. A typology of caregiving spouses of geriatric patients without dementia: caring, worried, desperate. BMC Geriatr 2021; 21:483. [PMID: 34488636 PMCID: PMC8419985 DOI: 10.1186/s12877-021-02425-1] [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: 02/17/2021] [Accepted: 08/09/2021] [Indexed: 11/22/2022] Open
Abstract
Background An increasing number of older people in Germany receive care at home from family members, particularly from spouses. Family care has been associated not only with subjective burden but also with negative effects on caregivers’ health. A heterogeneous group, caregivers are confronted with individual situational demands and use different available coping strategies. To date, little is known about the relationship between burden and coping by spousal caregivers, particularly in the context of geriatric patients without dementia. Objectives The aim of this study is to explore the burden and coping strategies of caregiving spouses of geriatric patients without dementia and with a hospitalization within the last year. To help explore this population, a typology is presented that has been based on reported perceptions of home care burden and individual coping strategies. Furthermore, a case study is presented for each type of spousal caregiver. Methods The study used a concurrent mixed method design with a sample of nine spousal caregivers (mean age: 78.9 years). Four women and five men were recruited in an acute hospital setting during the TIGER study. Quantitative data were collected using a self-questionnaire and qualitative data were gathered through nine problem-centered interviews with spousal caregivers. The latter were subsequently analyzed utilizing the structured content analysis method. The data were then summarized to nine individual cases. Finally, the results were clustered using the empirically grounded construction of types and typologies. Each type of spousal caregiver is presented by a case study. Results Three types of caregiving spouses were identified: “The Caring Partner”, “The Worried Manager” and “The Desperate Overburdened”. These types differ primarily in the level of subjective burden and caregiving stress, the coping strategies, the motivation for caregiving, and expressed emotions. Conclusions The development of this new typology of caregiving spouses could help health care professionals better understand caregiving arrangements and thus provide more targeted advice. Trial registration The TIGER study was registered with clinicaltrials.gov: NCT03513159. Registered on April 17, 2018. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02425-1.
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Affiliation(s)
- Thomas Johann Gehr
- Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nürnberg, Kobergerstraße 60, 90408, Nürnberg, Germany. .,Hospital of the Order of St. John of God Regensburg, Regensburg, Germany.
| | - Ellen Freiberger
- Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nürnberg, Kobergerstraße 60, 90408, Nürnberg, Germany
| | - Cornel Christian Sieber
- Institute for Biomedicine of Aging, Friedrich-Alexander-University Erlangen-Nürnberg, Kobergerstraße 60, 90408, Nürnberg, Germany.,Department of Internal Medicine, Kantonsspital Winterthur, Winterthur, Switzerland
| | - Sabine Alexandra Engel
- Department of Social Services, Catholic University of Applied Sciences of North Rhine-Westphalia, Campus Paderborn, Paderborn, Germany.,Private Institute for Gerontological Intervention and EduKation at Dementia GmbH, Buckenhof, Germany
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Yuan Q, Wang P, Tan TH, Devi F, Poremski D, Magadi H, Goveas R, Ng LL, Chong SA, Subramaniam M. Coping Patterns Among Primary Informal Dementia Caregivers in Singapore and Its Impact on Caregivers-Implications of a Latent Class Analysis. THE GERONTOLOGIST 2021; 61:680-692. [PMID: 32592582 PMCID: PMC8276612 DOI: 10.1093/geront/gnaa080] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Existing studies typically explore the factor structure of coping strategies among dementia caregivers. However, this approach overlooks the fact that caregivers often use different coping strategies simultaneously. This study aims to explore the coping patterns of primary informal dementia caregivers in Singapore, examine their significant correlates, and investigate whether different patterns would affect the depressive symptoms of caregivers. RESEARCH DESIGN AND METHODS Two hundred eighty-one primary informal caregivers of persons with dementia (PWD) were assessed. Coping strategies were measured by the Brief Coping Orientation to Problem Experienced inventory. A latent class analysis was performed to explore caregivers' coping patterns, followed by logistic regressions to identify the significant correlates and the relationships between coping patterns and caregiver depression. RESULTS The latent class analysis suggested a three-class solution that was featured by the frequency and variety of coping strategies used by caregivers-high coping (36.3%), medium coping (37.7%), and low coping (26.0%). Factors influencing the coping patterns of our sample were mainly related to caregivers' individual resources such as personal characteristics and caregiving stressors like PWD's problematic behaviors and caregiving burden. Compared to caregivers in the low coping group, those in the medium coping group had significantly higher risks of potential depression. DISCUSSION AND IMPLICATIONS The current study confirmed that there are distinct coping patterns among primary informal dementia caregivers, and caregivers with the low coping pattern had fewer depressive symptoms. Future research is needed to explore if coping patterns from our sample are generalizable to dementia caregivers elsewhere.
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Affiliation(s)
- Qi Yuan
- Research Division, Institute of Mental Health, Singapore
| | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore
| | - Tee Hng Tan
- Research Division, Institute of Mental Health, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore
| | - Daniel Poremski
- Department of Clinical Governance and Quality, Institute of Mental Health, Singapore
| | - Harish Magadi
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore
| | - Richard Goveas
- Department of Geriatric Psychiatry, Institute of Mental Health, Singapore
| | - Li Ling Ng
- Department of Psychological Medicine, Changi General Hospital, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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Shigeto A, Laxman DJ, Landy JF, Scheier LM. Typologies of coping in young adults in the context of the COVID-19 pandemic. THE JOURNAL OF GENERAL PSYCHOLOGY 2021; 148:272-304. [PMID: 33475048 DOI: 10.1080/00221309.2021.1874864] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The COVID-19 pandemic has created major upheavals in the lives of people worldwide. The virus has mostly affected elderly populations, but there may be corollary effects on young adults' psychosocial adjustment due to educational, economic, and occupational disruptions. Using latent class analysis, we examined unique typologies of coping in response to the pandemic among young adults. We used an expanded set of indicators including traditional measures of problem- and emotion-focused coping as well as measures of resilience and coping flexibility. We also examined whether class membership could be predicted by demographics, stress appraisal, and psychosocial characteristics including catastrophic thinking and impulsivity. The sample of 1,391 young adults (ages 18-35) was recruited via Amazon's Mechanical Turk (MTurk) and snowball methods from late-April to early-May 2020. Six classes were identified: (1) Resilient Flexible Problem-Focused Copers, (2) Resilient Inflexible Problem-Focused Copers, (3) Non-Resilient Flexible Problem-Focused Venters, (4) Non-Resilient Flexible Problem-Focused Copers, (5) Non-Resilient Flexible Non-Copers, and (6) Non-Resilient Inflexible Non-Copers. Using Class 1 as the reference class, we found perceived centrality and uncontrollability of the pandemic as well as catastrophic thinking and impulsivity were significant predictors of class membership. The mean levels of stress appraisal and psychosocial characteristics varied significantly between the classes, reinforcing the structural validity of these classes. The findings suggest the importance of training young adults to develop resilience and flexibility as well as specific coping skills that can help offset the psychological effects of dramatic lifestyle changes that may result from pandemics or other health crises in the future.
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Bianchi M, Flesch LD, Alves EVDC, Batistoni SST, Neri AL. Zarit Burden Interview Psychometric Indicators Applied in Older People Caregivers of Other Elderly. Rev Lat Am Enfermagem 2016; 24:e2835. [PMID: 27901220 PMCID: PMC5172616 DOI: 10.1590/1518-8345.1379.2835] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 09/15/2016] [Indexed: 11/29/2022] Open
Abstract
Objective: to derive psychometric indicators of construct validity and internal consistence
of the Zarit Burden Interview scale for caregivers, describing associations of the
scale with metrics related to care demands, coping strategies and depression in
aged caregivers. Method: crosscutting descriptive and correlational study. The convenience sample was
composed by a hundred and twenty one senior caregivers (Avg=70.5 ± 7.2 years, 73%
women). They answered a questionnaire to check the physical and cognitive demands
of care, the Zarit Burden Interview (ZBI), the California Inventory of Coping
Strategies and the Geriatric Depression Scale (GDS-15). Results: ZBI showed good internal consistency and also for the three factors emerging from
factor analysis, explaining 44% of variability. ZBI is positively related with
objective care demands (p < 0.001), depression (p = 0.006) and use of
dysfunctional coping strategies (p = 0.0007). Conclusion: ZBI is of interest to be applied to aged caregivers and the association of higher
degrees of burden, dysfunctional coping and depression show a vulnerability
scenario that may affect to older people taking care of other elderly.
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Affiliation(s)
- Mariana Bianchi
- Doctoral student, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | - Leticia Decimo Flesch
- Doctoral student, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil. Assistant Professor, Faculdade Metropolitana da Grande Fortaleza, Ceará, Brazil
| | - Erika Valeska da Costa Alves
- Doctoral student, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil. Scholarship holder at Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brazil
| | | | - Anita Liberalesso Neri
- PhD, Full Professor, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil
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Lu N, Liu J, Wang F, Lou VWQ. Caring for disabled older adults with musculoskeletal conditions: A transactional model of caregiver burden, coping strategies, and depressive symptoms. Arch Gerontol Geriatr 2016; 69:1-7. [PMID: 27855319 DOI: 10.1016/j.archger.2016.11.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 10/30/2016] [Accepted: 11/03/2016] [Indexed: 01/18/2023]
Abstract
OBJECTIVES This study investigated the mediating role of coping strategies in the relationship between caregiver burden and depressive symptoms among family caregivers caring for disabled older adults with musculoskeletal (MSK) conditions. METHODS The cross-sectional data were from a quota sampling of 494 pairs of disabled older adults and their primary family caregivers in Shanghai, China. The disabled older adults had MSK conditions and limitations in activities of daily living. The mean ages of the older adults and their caregivers were 83.9 and 62.6 years. Path analysis was conducted to test the proposed hypotheses. RESULTS Caregivers of adults with MSK conditions were more likely to use active coping to handle time dependence (β [SD]=0.182 [0.055]) and physical burden (β [SD]=0.226 [0.071]) and to use avoidant coping to handle developmental burden (β [SD]=0.414 [0.061]). Both coping strategies were used to handle social burden(active: β [SD]=0.179 [0.078]; avoidant: β [SD]=0.241 [0.073]). Experiencing emotional burden reduced the likelihood of using both coping strategies (active: β [SD]=-0.266 [0.066]; avoidant: β [SD]=-0.373 [0.062]). Active coping had a protective impact on depressive symptoms (β [SD]=-0.228 [0.050]), whereas avoidant coping had an adverse impact on depressive symptoms (β [SD]=0.232 [0.053]). CONCLUSIONS The findings confirm the mediating effects of coping strategies in the relationship between caregiver burden and depressive symptoms.
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Affiliation(s)
- Nan Lu
- Department of Social Work, School of Sociology and Population Studies, Renmin University of China, No. 59 Zhongguancun St., Haidian District, Beijing, China
| | - Jinyu Liu
- School of Social Work, Columbia University, 1255 Amsterdam Avenue, New York, NY 10027, USA
| | - Fei Wang
- Medical Social Services, Changi General Hospital, 2 Simei Street 3, Singapore
| | - Vivian W Q Lou
- Department of Social Work & Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Pokfulam Road, Hong Kong.
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Steinberg JR, Tschann JM, Furgerson D, Harper CC. Psychosocial factors and pre-abortion psychological health: The significance of stigma. Soc Sci Med 2016; 150:67-75. [PMID: 26735332 PMCID: PMC4737478 DOI: 10.1016/j.socscimed.2015.12.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 09/09/2015] [Accepted: 12/04/2015] [Indexed: 01/21/2023]
Abstract
RATIONALE Most research in mental health and abortion has examined factors associated with post-abortion psychological health. However, research that follows women from before to after their abortion consistently finds that depressive, anxiety, and stress symptoms are highest just before an abortion compared to any time afterwards. OBJECTIVE This finding suggests that studies investigating psychosocial factors related to pre-abortion mental health are warranted. METHODS The current study uses data from 353 women seeking abortions at three community reproductive health clinics to examine predictors of pre-abortion psychological health. Drawing from three perspectives in the abortion and mental health literature, common risks, stress and coping, and sociocultural context, we conducted multivariable analyses to examine the contribution of important factors on depressive, anxiety, and stress symptoms just before an abortion, including sociodemographics, abortion characteristics, childhood adversities, recent adversities with an intimate partner, relationship context, future pregnancy desires, and perceived abortion stigma. RESULTS Childhood and partner adversities, including reproductive coercion, were associated with negative mental health symptoms, as was perceived abortion stigma. Before perceived abortion stigma was entered into the model, 18.6%, 20.7%, and 16.8% of the variance in depressive, anxiety, and stress symptoms respectively, was explained. Perceived abortion stigma explained an additional 13.2%, 9.7%, and 10.7% of the variance in depressive, anxiety, and stress symptoms pre-abortion. CONCLUSION This study, one of the first to focus on pre-abortion mental health as an outcome, suggests that addressing stigma among women seeking abortions may significantly lower their psychological distress.
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Affiliation(s)
- Julia R Steinberg
- Department of Family Science, University of Maryland College Park, USA.
| | - Jeanne M Tschann
- Department of Psychiatry, University of California, San Francisco, USA
| | | | - Cynthia C Harper
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA
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