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Soluk Özdemir Y, Paker N, Şişmanoğlu Ataç N, Buğdaycı D, Öneş K. COVID-19-related anxiety and obsession levels in stroke patients and family caregivers and their effects on caregiver burden. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT OSTERREICHISCHER NERVENARZTE UND PSYCHIATER 2024; 38:24-31. [PMID: 38315321 DOI: 10.1007/s40211-024-00490-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024]
Abstract
PURPOSE The aim of this study is to describe coronavirus disease 2019 (COVID-19)-related dysfunctional anxiety and thinking in patients with stroke and caregivers who are family members and their effects on caregiver burden. METHODS This cross-sectional study included 79 stroke patients and their primary caregivers who were hospitalised in a tertiary rehabilitation hospital. Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) were used to assess the levels of COVID-19-related dysfunctional anxiety and obsession of the patients and their caregivers. Caregiver burden was assessed via the Zarit Burden Interview (ZBI). RESULTS In the patients with stroke, COVID-19-related anxiety and COVID-19-related obsession rates were 13.9% (n = 11) and 7.6% (n = 6), respectively, while 17.7% (n = 14) of caregiver family members had COVID-19-related anxiety and 11.4% (n = 9) had COVID-19-related obsession. The CAS score of caregivers showed a significant positive correlation with the CAS and OCS scores of patients (p = 0.000, r = 0.423; p = 0.007, r = 0.300, respectively). The OCS score of caregivers showed a significant positive correlation with the OCS scores of the patients (p = 0.000, r = 0.476). The mean ZBI score of caregiver family members was 31.9 ± 13.5. A significant positive correlation was observed between the caregiver's OCS and CAS scores and ZBI scores (p = 0.002, r = -0.349; p = 0.004, r = 0.323, respectively). CONCLUSION In this study, a significant relationship between caregiver burden and COVID-19-related anxiety and obsession in the caregivers of stroke patients was identified. Therefore, caregivers of stroke patients should not be forgotten during pandemics and should receive physical and psychological support.
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Affiliation(s)
- Yelda Soluk Özdemir
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey.
| | - Nurdan Paker
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Nazlı Şişmanoğlu Ataç
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Derya Buğdaycı
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
| | - Kadriye Öneş
- Istanbul Physical Medicine and Rehabilitation Training and Research Hospital, Istanbul, Turkey
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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.
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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
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Brickell TA, Wright MM, Sullivan JK, Varbedian NV, Tippett CE, Byrd AM, French LM, Lange RT. Health outcomes before and during the COVID-19 pandemic in caregivers of service members and veterans with traumatic brain injury. Qual Life Res 2023; 32:3463-3474. [PMID: 37572244 DOI: 10.1007/s11136-023-03491-1] [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] [Accepted: 07/14/2023] [Indexed: 08/14/2023]
Abstract
PURPOSE To examine change in health-related quality of life (HRQOL) during the COVID-19 pandemic in caregivers of service members/veterans (SMVs) with traumatic brain injury (TBI), by comparing HRQOL during the first year of the pandemic to HRQOL 12 months pre-pandemic. METHODS Caregivers (N = 246) were classified into three COVID-19 Pandemic Impact groups based on impact ratings of the pandemic on HRQOL: No Impact (n = 50), Mild Impact (n = 117), and Moderate-Severe Impact (n = 79). Caregivers completed 19 measures across physical, social, caregiving, and economic HRQOL domains, and a measure of SMV Adjustment. T-scores were used to determine individual symptom trajectories for each measure as follows: Asymptomatic (pre + during < 60 T); Developed (pre < 60 + during ≥ 60 T); Improved (pre ≥ 60 T + during < 60 T); and Persistent (pre + during ≥ 60 T). RESULTS Using ANOVA, during the pandemic, the Moderate-Severe Impact group reported worse scores on 19 measures (d = 0.41-0.89) compared to the No Impact group and 18 measures (d = 0.31-0.62) compared to the Mild Impact group (d = 0.31-0.38). The Mild Impact group reported worse scores on two measures compared to the No Impact group (d = 0.42-0.43). Using the entire sample, the majority of HRQOL measures were classified as Asymptomatic (47.2-94.7%), followed by Persistent (2.4-27.2%). Few were classified as Developed (0.4-12.6%) or Improved (2.4-13.8%). Using repeated measures ANOVA, no meaningful effects sizes were found for mean scores on all measures completed pre-pandemic compared to during the pandemic (d ≤ 0.17). CONCLUSION The vast majority of caregivers reported stability in HRQOL pre-pandemic compared to during the pandemic. The COVID-19 pandemic was not associated with a high prevalence of decline in caregiver HRQOL.
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Affiliation(s)
- Tracey A Brickell
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA.
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
- General Dynamics Information Technology, Silver Spring, MD, USA.
| | - Megan M Wright
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Ciconix, Annapolis, MD, USA
| | - Jamie K Sullivan
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- General Dynamics Information Technology, Silver Spring, MD, USA
| | - Nicole V Varbedian
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Ciconix, Annapolis, MD, USA
| | - Corie E Tippett
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Ciconix, Annapolis, MD, USA
| | - Anice M Byrd
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Ciconix, Annapolis, MD, USA
- Traumatic Brain Injury Center of Excellence, Naval Medical Center San Diego, San Diego, CA, USA
| | - Louis M French
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Rael T Lange
- Traumatic Brain Injury Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- National Intrepid Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD, USA
- General Dynamics Information Technology, Silver Spring, MD, USA
- University of British Columbia, Vancouver, BC, Canada
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Linton KF, Aharon-Ezer J, Ramirez M, Hodge M, Hernandez R, Supple K, Rumbo B, Kao R. Family Caregiver Support Interventions' Effectiveness Before and During the COVID-19 Pandemic. SOCIAL WORK IN PUBLIC HEALTH 2023; 38:359-372. [PMID: 37740894 DOI: 10.1080/19371918.2023.2259896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/25/2023]
Abstract
The authors aimed to assess the impact of a family caregiver support intervention on caregiver burden and hospital readmission before and during the COVID-19 pandemic. By adopting a quasi-experimental design with no randomization, caregivers (n = 65) received a 90-day home visitation caregiver support intervention before the COVID-19 pandemic and caregivers (n = 41) received a 90-day phone-only visitation caregiver support intervention during the COVID-19 pandemic. Caregiver burden was collected in a survey, and hospital readmission of the care recipient was collected by hospital data. The results of a repeated-measures ANOVA demonstrated that participants of a family caregiver support intervention during the COVID-19 pandemic improved their caregiver burden statistically significantly more than those who received the intervention before the pandemic. There were no significant differences in hospital readmissions before or during the COVID-19 pandemic. The study demonstrates the efficacy of family caregiver support interventions over the phone during a pandemic.
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Affiliation(s)
- Kristen Faye Linton
- Ambulatory Medicine, Community Memorial Health System, Ventura, CA, USA
- Health Science Program, California State University Channel Islands, Camarillo, CA, USA
| | | | - Mayra Ramirez
- Social Work, St. John's Medical Center, Oxnard and Camarillo, CA, USA
| | - Maureen Hodge
- Ambulatory Medicine, Community Memorial Health System, Ventura, CA, USA
| | - Rosie Hernandez
- Social Work, St. John's Medical Center, Oxnard and Camarillo, CA, USA
| | - Kristine Supple
- Ambulatory Medicine, Community Memorial Health System, Ventura, CA, USA
| | - Benito Rumbo
- Health Science Program, California State University Channel Islands, Camarillo, CA, USA
| | - Rasmey Kao
- Health Science Program, California State University Channel Islands, Camarillo, CA, USA
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Turner RL, Reese-Melancon C, Harrington EE, Andreo M. Caregiving During the COVID-19 Pandemic: Factors Associated With Feelings of Caregiver Preparedness. J Appl Gerontol 2023; 42:2089-2099. [PMID: 37395127 PMCID: PMC10333559 DOI: 10.1177/07334648231182242] [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: 07/04/2023] Open
Abstract
Examination of caregiver preparedness for the COVID-19 pandemic can inform efforts to support caregivers in future times of global crisis. Informal caregivers of adults with dementia or severe disabilities (n = 72, Mage = 62.82 years, 90.28% female) were recruited through Adult Day Centers across the United States. Caregivers responding to an online survey regarding their experiences and preparedness reported an increase in burden, stress, and time spent caregiving since the onset of the pandemic. Caregivers reported feeling prepared for typical caregiving responsibilities but felt less prepared for someone else to assume the role of primary caregiver. Multiple regression modeling indicated that resilience accounted for significant variance in primary caregiver preparedness, over and above burden, but only caregiver age accounted for significant variability in a component representing feeling prepared to delegate caregiving to another person. These findings have implications for research and applied efforts to promote caregiver well-being and preparedness.
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Affiliation(s)
- Rachael L. Turner
- Department of Psychology, Oklahoma State University, Stillwater, OK, USA
| | | | - Erin E. Harrington
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA
| | - Micaela Andreo
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
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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.
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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
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Damian AC, Mihăilescu AI, Anghele C, Ciobanu CA, Petrescu C, Riga S, Dionisie V, Ciobanu AM. Quality of Life Predictors in a Group of Informal Caregivers during the COVID-19 Pandemic. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1486. [PMID: 37629776 PMCID: PMC10456842 DOI: 10.3390/medicina59081486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background and Objectives: The informal caregiver's contribution to the wellbeing of dementia patients is critical since these individuals become dependent on others for all daily activities. Our goal was to investigate the dynamics of anxiety, depression, burnout, sleep, and their influence on quality of life over a 6-month period in the context of pandemic distress in a sample of informal caregivers of Alzheimer's patients. Materials and Methods: For this prospective, longitudinal study, we conducted a 6-month telephonic survey between 2021 and 2022, administering a series of questionnaires at three timepoints (baseline, 3 months and 6 months) to a group of informal caregivers of patients suffering from dementia due to Alzheimer's disease. Results: A total of 110 caregivers were included at baseline, out of which 96 continued to the second stage and 78 followed through to the last stage. The majority of the participants were female (most likely the patients' daughters), around 55 years old, living in urban areas, married, with children, having a high school degree or a higher education degree, and working in jobs that required physical presence; in the best-case scenario, they were sharing their responsibilities with another two-three caregivers. More than half of the 110 participants (50.9%) reported mild to moderate anxiety at baseline, and 27.3% reported significant anxiety, with no changes between the three timepoints, F(2, 154) = 0.551, p = 0.57; 25% reported moderate-severe depression at the start, with no changes between the three timepoints, F(2, 154) = 2.738, p = 0.068; and many reported a decrease in quality of life, poor quality of sleep, and decreased fear of COVID infection. Cynicism, professional effectiveness, anxiety, depression, and sleep quality explained up to 87.8% of the variance in quality of life. Conclusions: Caregivers' decreased quality of life during the pandemic was explained by their levels of burnout, anxiety, and depression throughout the 6-month period.
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Affiliation(s)
- Ana Claudia Damian
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | - Alexandra Ioana Mihăilescu
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
- Department of Medical Psychology, Faculty of Medicine, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Cristina Anghele
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | | | - Cristian Petrescu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
| | - Sorin Riga
- Department of Stress Research and Prophylaxis, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania;
- Romanian Academy of Medical Sciences, 927180 Bucharest, Romania
| | - Vlad Dionisie
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
- Department of Psychiatry and Psychology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania
| | - Adela Magdalena Ciobanu
- Neuroscience Department, Discipline of Psychiatry, Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (A.C.D.); (C.P.); (A.M.C.)
- Department of Psychiatry, ‘Prof. Dr. Alexandru Obregia’ Clinical Hospital of Psychiatry, 041914 Bucharest, Romania; (A.I.M.); (V.D.)
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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.
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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
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Thrower C, Barrie C, Baxter S, Bloom M, Borja MC, Butters A, Dudgeon D, Haque A, Lee S, Mahmood I, Mirhosseini M, Mirza RM, Murzin K, Ankita A, Skantharajah N, Vadeboncoeur C, Wan A, Klinger CA. Interventions for Grieving and Bereaved Informal Caregivers: A Scoping Review of the Canadian Literature. J Palliat Care 2023; 38:215-224. [PMID: 35726197 PMCID: PMC10026166 DOI: 10.1177/08258597221101826] [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: 11/16/2022]
Abstract
Background: The palliative approach to care is playing a larger role in the healthcare of older adults in Canada. Within (hospice) palliative care, informal caregivers play a crucial role as part of the interdisciplinary care team. Ensuring high quality palliative care includes providing effective grief and bereavement supports for them. Objective: This study aimed to identify current interventions addressing the grief and bereavement experiences of informal caregivers of geriatric patients in the Canadian (hospice) palliative/end-of-life care realm. Methods: A scoping review was undertaken using Arksey and O'Malley's framework. Seven electronic health and social science databases were searched. In addition, several stakeholder organizations' websites were reviewed to identify grey literature sources. Interventions that took place in Canada, were in English, and explored grief and bereavement supports for informal caregivers in an adult/geriatric (hospice) palliative care setting were included. After full text review, data were extracted and charted. Major themes were established following thematic content analysis. Results: Within a total of 18 sources, three themes were identified: (1) Classification of intervention, (2) Format of intervention, and (3) Intervention target. Method of delivery and type of intervention for grief and bereavement supports were aligned with the international literature. There is a need for large-scale evaluations of interventions and informal caregivers should be engaged in this process. Practitioners should be encouraged to direct bereavement interventions toward grieving caregivers, and to collaborate with them to improve access to these interventions. Policy makers should provide additional funding for grief interventions for informal caregivers. Conclusions: It is important to better understand the needs of informal caregivers experiencing grief and bereavement. Interdisciplinary collaborations will be necessary to develop, evaluate, and scale future interventions.
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Affiliation(s)
- Carly Thrower
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Carol Barrie
- Canadian Frailty Network (CFN), Kingston, Ontario, Canada
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
| | - Sharon Baxter
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Hospice Palliative Care Association (CHPCA), Ottawa, Ontario, Canada
| | - Meryl Bloom
- Global Health Office, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Maria Carolina Borja
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Anica Butters
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Deborah Dudgeon
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Partnership Against Cancer (CPAC), Toronto, Ontario, Canada
- School of Medicine, Queen's University, Kingston, Ontario, Canada
| | - Ayeshah Haque
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Suzanna Lee
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Iqra Mahmood
- Health Studies Program, Faculty of Arts and Science, University of Toronto, Toronto, Ontario, Canada
| | - Mehrnoush Mirhosseini
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- College of Family Physicians of Canada (CFPC), Mississauga, Ontario, Canada
- Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Raza M Mirza
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada
| | - Kate Murzin
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Realize, Toronto, Ontario Canada
| | - Ankita Ankita
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Neerjah Skantharajah
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christina Vadeboncoeur
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Canadian Network of Palliative Care for Children (CNPCC), Ottawa, Ontario, Canada
- Department of Pediatrics, University of Ottawa, Ottawa, Ontario, Canada
| | - Andrew Wan
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Christopher A Klinger
- Translational Research Program, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Quality End-of-Life Care Coalition of Canada (QELCCC), Ottawa, Ontario, Canada
- Life Course and Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
- National Initiative for the Care of the Elderly (NICE), Toronto, Ontario, Canada
- Department of Family Medicine, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada
- Pallium Canada, Ottawa, Ontario, Canada
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10
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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.].
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11
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Donnellan WJ, Sepulveda Garcia L, Gibson SM, Butcher P, Lariviere MJ. What are the Challenges and Resilience Resources Identified by Informal Carers During the First UK COVID-19 Lockdown? A Longitudinal Qualitative Study Using Naturalistic Data. QUALITATIVE HEALTH RESEARCH 2023; 33:236-246. [PMID: 36702851 PMCID: PMC9892806 DOI: 10.1177/10497323221150131] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
COVID-19 has posed serious challenges for informal carers living in the UK. This article examines some of the specific challenges facing carers and the resources they used to manage them throughout the first UK lockdown. We used a framework approach to analyse naturalistic, longitudinal data from 30 carers taking part in 96 of Mobilise's daily Virtual Cuppas between March and July 2020. We found that lack of information and social restrictions cumulatively impacted carers' sense of certainty, control and motivation. This took an emotional toll on the carers, leading to exhaustion and burden. However, carers quickly established new routines and used humour and self-care to actively manage their wellbeing. Carers received support but also provided it to those in need, including fellow members of the caregiving community, supporting an ecological approach to carer resilience. Our findings may be used to anticipate challenges and promote protective resilience resources in future lockdowns.
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Affiliation(s)
| | | | | | - Paige Butcher
- Brain Injury Rehabilitation Trust,
Disabilities Trust, Liverpool,
UK
| | - Matthew J. Lariviere
- Centre for Research on Health and
Social Care, School for Policy Studies, University of
Bristol, Bristol, UK
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12
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Salud mental de cuidadores de niños con trastornos del neurodesarrollo durante la pandemia. NEUROLOGÍA ARGENTINA 2023. [PMCID: PMC9868982 DOI: 10.1016/j.neuarg.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Los cuidadores son especialmente propensos a verse más afectados psicológicamente durante las restricciones sociales y del sistema sanitario generadas por la pandemia por COVID-19. Los cuidadores de niños con trastornos del neurodesarrollo (es decir, autismo, discapacidad intelectual, déficit de atención, hiperactividad, discapacidad motora) tienen un papel más importante que los que acompañan niños sanos. Se diseñó un estudio cuantitativo transversal, utilizando técnicas estadísticas descriptivas, comparativas y correlacionales, para analizar la calidad de vida relacionada con la salud, el malestar emocional y la sobrecarga en cuatro subgrupos de cuidadores, clasificados según el diagnóstico del niño. Se incluyeron 132 cuidadores (86,4% mujeres). En el grupo 1 (discapacidad cognitiva) participaron 28 cuidadores; en el grupo 2 (TDAH) se incluyeron 51; en el grupo 3 (trastorno del espectro autista) participaron 33 cuidadores, y en el grupo 4 (discapacidad motora) se incluyeron 20. Los principales hallazgos de este estudio fueron: 1) alteraciones en el rol físico, el dolor corporal, la salud general y la vitalidad; 2) porcentajes muy bajos de sintomatología de depresión, ansiedad, estrés y sobrecarga; 3) diferencias en el funcionamiento social entre los grupos de discapacidad motora y TDAH, y en el estrés y la sobrecarga entre los grupos de autismo y discapacidad motora, y 4) correlaciones moderadas entre las dimensiones de dolor corporal y rol emocional y la depresión, la ansiedad, el estrés y la sobrecarga. Se concluyó que hay más afectación en variables asociadas con la salud física que con las de la salud mental.
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Development and Initial Psychometric Validation of the COVID-19 Pandemic Burden Index for Healthcare Workers. J Gen Intern Med 2023; 38:1239-1247. [PMID: 36652099 PMCID: PMC9847449 DOI: 10.1007/s11606-023-08028-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 12/30/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND The burden of COVID-19 on healthcare workers (HCWs) is reported to be increasing, yet the psychometric scales now in use evaluate only single aspects; few measure the pandemic-specific burden on HCWs comprehensively. OBJECTIVE To develop a scale to quantify the physical, mental, and socioeconomic burden of the COVID-19 pandemic on HCWs. DESIGN Scale development and cross-sectional survey. PARTICIPANTS Consenting HCWs aged ≥20. MAIN MEASURES Development of an item-list based on literature reviews and HCW panel input, evaluation of content validity and item selection using the Delphi method, psychometric testing conducted on HCWs, validity assessment by factor analyses and hypothesis verification, internal consistency evaluation by Cronbach's alpha, test-retest analysis, and interpretability assessment. KEY RESULTS Through the Delphi process, a 29-item pilot scale was generated. In psychometric testing, data from 863 HCWs contributed to the development of the final version of this scale, called Pandemic Burden Index twenty for HCWs (PBI-20), a 20-item scale to measure six domains: fatigue, fear of infection, inadequacy as a medical professional, mental health concerns, prejudice or discrimination, and anxiety about one's livelihood and daily life. Factor analysis showed each factor corresponded to the six domains of this scale. Hypothesis verification showed the PBI-20 total score to be moderately to highly correlated with the Short Form 36 vitality score and mental health score and with intention of turnover. The PBI-20 had good internal consistency (Cronbach's alpha 0.92). Test-retest analysis showed the intraclass correlation coefficient to be 0.70 and the minimal important change to be -7.0. CONCLUSIONS The psychometrically sound questionnaire we developed to measure pandemic-specific burdens for HCWs provides an understanding of comprehensive burdens on HCWs and may serve to evaluate interventions to reduce the burdens.
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Wiegelmann H, Hess M, Domhoff D, Heinze F, Schmidt A, Seibert K, Stolle C, Preuß B, Rothgang H, Wolf-Ostermann K. [The situation of informal caregivers of working age in the COVID-19 pandemic-results of an online survey in Germany]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2023; 66:265-274. [PMID: 36749365 PMCID: PMC9903257 DOI: 10.1007/s00103-023-03659-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/12/2023] [Indexed: 02/08/2023]
Abstract
BACKGROUND The consequences of the COVID-19 pandemic have posed major challenges to different groups. One of these are informal caregivers. This study investigates the changes the pandemic has caused for informal caregivers and the extent to which quality of life and burden of care have changed for specific subgroups. METHODS Data for this cross-sectional study was gathered in the summer of 2020 in a convenient sample of informal caregivers (< 67 years of age, N = 1143). In addition to sociodemographic data, information on the care situation, compatibility of care and work, as well as stress and quality of life was collected in an online survey. The analysis of care situations and compatibility of care and work is done descriptively. Logistic regression models are used for a subgroup analysis of quality of life and care burden. RESULTS The care situation has changed for 54.7% of participants and has become more time consuming. For 70.8% of respondents, the COVID-19 pandemic has made it even more difficult to balance care-giving and work. However, most respondents were satisfied with their employers' pandemic management (65.9%). A sharp decline in the quality of life and an increase in the burden of care for informal caregivers was ascertained. Both developments are stronger for young and female caregivers and for those caring for people with a greater need of support. DISCUSSION The results indicate that living situations worsened for a substantial proportion of informal caregivers during the COVID-19 pandemic. Policymakers should recognize additional challenges that informal caregivers have faced since the outbreak of the COVID-19 pandemic and how they vary by subgroups. It is important to include home-based informal care as well as other care settings in future pandemic concepts.
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Affiliation(s)
- Henrik Wiegelmann
- Institut für Public Health und Pflegeforschung, Abteilung Pflegewissenschaftliche Versorgungsforschung, Universität Bremen, Grazer Straße 4, 28359, Bremen, Deutschland.
| | - Moritz Hess
- Hochschule Niederrhein, Niederrhein, Deutschland
| | - Dominik Domhoff
- Institut für Public Health und Pflegeforschung, Abteilung Pflegewissenschaftliche Versorgungsforschung, Universität Bremen, Grazer Straße 4, 28359 Bremen, Deutschland
| | - Franziska Heinze
- SOCIUM Forschungszentrum Ungleichheit und Sozialpolitik, Universität Bremen, Bremen, Deutschland
| | - Annika Schmidt
- Institut für Public Health und Pflegeforschung, Abteilung Pflegewissenschaftliche Versorgungsforschung, Universität Bremen, Grazer Straße 4, 28359 Bremen, Deutschland ,Zentrum für Pflegeforschung und Beratung, Hochschule Bremen, Bremen, Deutschland
| | - Kathrin Seibert
- Institut für Public Health und Pflegeforschung, Abteilung Pflegewissenschaftliche Versorgungsforschung, Universität Bremen, Grazer Straße 4, 28359 Bremen, Deutschland
| | - Claudia Stolle
- Zentrum für Pflegeforschung und Beratung, Hochschule Bremen, Bremen, Deutschland
| | - Benedikt Preuß
- SOCIUM Forschungszentrum Ungleichheit und Sozialpolitik, Universität Bremen, Bremen, Deutschland
| | - Heinz Rothgang
- SOCIUM Forschungszentrum Ungleichheit und Sozialpolitik, Universität Bremen, Bremen, Deutschland
| | - Karin Wolf-Ostermann
- Institut für Public Health und Pflegeforschung, Abteilung Pflegewissenschaftliche Versorgungsforschung, Universität Bremen, Grazer Straße 4, 28359 Bremen, Deutschland
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15
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Chyu J, Cantu P, Mehta N, Markides K. Caregiving for People With Dementia or Cognitive Impairment During the COVID-19 Pandemic: A Review. Gerontol Geriatr Med 2022; 8:23337214221132369. [PMID: 36299916 PMCID: PMC9585366 DOI: 10.1177/23337214221132369] [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: 05/30/2022] [Revised: 08/23/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022] Open
Abstract
The COVID-19 pandemic has been a major source of stress for informal caregivers
for people with dementia. Studies show the unique challenges caregivers face,
such as social isolation, extended work hours, and adherence to public health
guidelines. We conducted a narrative review of factors impacting well-being of
informal caregivers of older adults with dementia during the COVID-19 pandemic.
Sixty-four papers were identified as published between June 2020 and December
2021. All studies were conducted in the U.S. or other Western countries and were
cross-sectional and conducted prior to COVID-19 vaccines. Articles highlighted
increasing burdens such as financial and physical stress, as well as worsened
psychological well-being from anxiety and depression. Protective factors such as
social support and telehealth interventions also emerged. Limitations include
lack of longitudinal information to identify broader themes on caregiving during
the pandemic. Studies not only identified new, pandemic-related risk factors,
but also a heightened effect of pre-existing risk factors (e.g., income, living
situation) on caregiver burden.
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Affiliation(s)
- Joanna Chyu
- University of Texas Medical Branch,
Galveston, USA
| | - Philip Cantu
- University of Texas Medical Branch,
Galveston, USA
| | - Neil Mehta
- University of Texas Medical Branch,
Galveston, USA
| | - Kyriakos Markides
- University of Texas Medical Branch,
Galveston, USA,Kyriakos Markides, School for Public and
Population Health, University of Texas Medical Branch, Galveston, TX 77551, USA.
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16
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Sadarangani TR, Gaugler JE, Dabelko-Schoeny H, Marx KA. Adult Day Services, Health Equity for Older Adults With Complex Needs, and the COVID-19 Pandemic. Am J Public Health 2022; 112:1421-1428. [PMID: 36103694 PMCID: PMC9480461 DOI: 10.2105/ajph.2022.306968] [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] [Accepted: 05/31/2022] [Indexed: 11/04/2022]
Abstract
Morbidity and mortality from COVID-19 have unduly affected older adults from racial and ethnic minority groups. In this article, we highlight the experiences and vulnerabilities of diverse older adults with complex health and social needs when their access to vital, but overlooked, community-based adult day service centers (ADSCs) was abruptly cut off during a pandemic. Pandemic-related ADSC closures left vulnerable older adults and their care partners without essential daily support and services, such as health monitoring and socialization. However, the magnitude of the impact of ADSC closures on well-being, particularly among members of racial/ethnic minority groups, has yet to be measured with any form of "big data" because large-scale, nationally representative data sets consisting of participant-level information and outcomes associated with ADSC participation do not yet exist. Unmet needs of older adults resulting from pandemic-related ADSC closures are underrecognized because of a lack of systematic data collection, undermining efforts to achieve health equity. We call on ADSCs to link rigorous collection of racial and ethnic data to quality measures of access to equitable "age-friendly" care as a means of better supporting diverse community-dwelling older adults beyond the COVID-19 pandemic. (Am J Public Health. 2022;112(10):1421-1428. https://doi.org/10.2105/AJPH.2022.306968).
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Affiliation(s)
- Tina R Sadarangani
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Joseph E Gaugler
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Holly Dabelko-Schoeny
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
| | - Katherine A Marx
- Tina R. Sadarangani is with the Rory Meyers College of Nursing, New York University, New York. Joseph E. Gaugler is with the School of Public Health, Division of Health Policy and Management, University of Minnesota, Minneapolis. Holly Dabelko-Schoeny is with the College of Social Work, Age-Friendly Innovation Center, Ohio State University, Columbus. Katherine A. Marx is with the School of Nursing, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD
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17
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Santoyo-Olsson J, Lorig K, Romo EM, Luzanilla M, Ramirez GA, Cheng J, Chesla C, Covinsky KE, Karliner L, Thompson DG, Fahrenwald N, Yank V. Study protocol for a hybrid effectiveness-implementation trial of the Building Better Caregivers online workshop for rural family/friend caregivers of people living with dementia. Contemp Clin Trials 2022; 121:106903. [PMID: 36057375 DOI: 10.1016/j.cct.2022.106903] [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: 06/21/2022] [Revised: 08/26/2022] [Accepted: 08/26/2022] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Dementia caregiving is complex and disproportionally burdens caregivers living in rural areas due to fewer resources and formal support systems. There is an immediate need to identify effective, scalable, and accessible online programs to support rural caregivers' well-being. Building Better Caregivers (BBC), a possible solution, is an asynchronous online 6-week, interactive, and skills-building workshop developed for caregivers of persons with dementia. This research aims to assess the effectiveness and implementation of the BBC workshop when delivered among rural dementia caregivers in the United States. METHODS A hybrid effectiveness and implementation trial applying mixed methods will be conducted in collaboration with local, state, and national partnering organizations. Eligible participants live in a rural area of the United States, give care at least 10 h a week for a family member or friend with dementia, and have internet access. Evaluation is based on the RE-AIM framework. Effectiveness outcomes are assessed using a randomized control trial. Caregivers are randomly assigned to the BBC workshop (intervention) or attention control group. Implementation outcomes are assessed using surveys and debriefing interviews from partnering organizations and participants. The study protocol including the study design, methods of recruitment and assessment, and outcomes are described. CONCLUSION This is the first known study to evaluate both the effectiveness and implementation of a caregiver support intervention under real-world conditions in rural areas. If successful, this online workshop will be a practical and acceptable approach for promoting the health and well-being of geographically isolated rural dementia caregivers.
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Affiliation(s)
| | | | | | | | | | - Jing Cheng
- University of California San Francisco, San Francisco, CA, USA
| | | | - Kenneth E Covinsky
- University of California San Francisco, San Francisco, CA, USA; San Francisco VA Healthcare System, San Francisco, CA, USA
| | - Leah Karliner
- University of California San Francisco, San Francisco, CA, USA
| | | | | | - Veronica Yank
- University of California San Francisco, San Francisco, CA, USA
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18
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Berg JA, Woods NF, Shaver J, Kostas-Polston EA. COVID-19 effects on women's home and work life, family violence and mental health from the Women's Health Expert Panel of the American Academy of Nursing. Nurs Outlook 2022; 70:570-579. [PMID: 35843755 PMCID: PMC9259042 DOI: 10.1016/j.outlook.2022.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 04/21/2022] [Accepted: 05/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The COVID-19 pandemic exaggerated women's roles in families as primary caretakers and overseers of family health. This is compounded by possible loss of work and resultant loss of health insurance. PURPOSE We examine how pandemic-related factors have altered women's roles and created stressors challenging stress adaptation and typical coping strategies, including how registered nurses have faced unique challenges. FAMILY VIOLENCE AND PANDEMIC-RELATED MENTAL HEALTH CHALLENGES Enforced stay-athome orders exaggerated by work-from-home has amplified family violence worldwide. Besides COVID-19 protective measures increasing greater contact with abusers, they limited women's access to help or support. Pandemic-related issues increased anxiety, anger, stress, agitation and withdrawal for women, children, and registered nurses. DISCUSSION More evidence about pandemic-related impacts on women's home and work lives, especially the scope of stressors and emotional/mental health manifestations is urgently needed. Policies to support interventions to improve mental health resilience are paramount.
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Affiliation(s)
- Judith A Berg
- University of Arizona College of Nursing, Tucson, AZ.
| | | | - Joan Shaver
- University of Arizona College of Nursing, Tucson, AZ
| | - Elizabeth A Kostas-Polston
- Daniel K. Inouye Graduate School of Nursing, Uniformed Services University of the Health Sciences, Bethesda, MD
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19
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Chávez Sosa JV, Mego Gonzales FM, Aliaga Ramirez ZE, Cajachagua Castro M, Huancahuire-Vega S. Depression Associated with Caregiver Quality of Life in Post-COVID-19 Patients in Two Regions of Peru. Healthcare (Basel) 2022; 10:1219. [PMID: 35885746 PMCID: PMC9323236 DOI: 10.3390/healthcare10071219] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 12/19/2022] Open
Abstract
Due to COVID-19, the workload experienced by caregivers has increased markedly which has led them to experience fatigue, anxiety and depression. This study aims to determine the relationship between quality of life and depression in caregivers of post-COVID-19 patients in two regions of Peru. In a cross-sectional analytical study, the sample was non-probabilistic and by snowball, and consisted of 730 caregivers, to whom the questionnaires "Modified Betty Ferell Quality of Life" and the "Beck Depression Inventory" were applied. It was determined that being a male caregiver (OR: 2.119; 95% CI: 1.332-3.369) was associated with a good quality of life. On the other hand, caregivers who had children (OR: 0.391; 95% CI: 0.227-0.675), were vaccinated against COVID-19 (OR: 0.432; 95% CI: 0.250-0.744), were immediate family members (OR: 0.298; 95% CI: 0.117-0.761) and had high depression (OR: 0.189; 95% CI: 0.073-0.490) were associated with poor quality of life. The results of this study allow us to conclude the association between depression and poor quality of life in caregivers of these patients so it is necessary to monitor the mental health of caregivers, and to develop adaptation strategies to pandemic conditions.
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Affiliation(s)
- Janett V. Chávez Sosa
- Escuela Profesional de Enfermería, Universidad Peruana Unión (UPeU), Lima 15464, Peru; (J.V.C.S.); (F.M.M.G.); (Z.E.A.R.); (M.C.C.)
| | - Flor M. Mego Gonzales
- Escuela Profesional de Enfermería, Universidad Peruana Unión (UPeU), Lima 15464, Peru; (J.V.C.S.); (F.M.M.G.); (Z.E.A.R.); (M.C.C.)
| | - Zoila E. Aliaga Ramirez
- Escuela Profesional de Enfermería, Universidad Peruana Unión (UPeU), Lima 15464, Peru; (J.V.C.S.); (F.M.M.G.); (Z.E.A.R.); (M.C.C.)
| | - Mayela Cajachagua Castro
- Escuela Profesional de Enfermería, Universidad Peruana Unión (UPeU), Lima 15464, Peru; (J.V.C.S.); (F.M.M.G.); (Z.E.A.R.); (M.C.C.)
| | - Salomón Huancahuire-Vega
- Escuela Profesional de Medicina, Universidad Peruana Unión (UPeU), Lima 15464, Peru
- Dirección General de Investigación, Universidad Peruana Unión (UPeU), Lima 15464, Peru
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20
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Zuo Y, Luo BR, Wang LN, Cheng BC, Hu XL. Exploring lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the COVID-19 lockdown in China: A phenomenological study. Midwifery 2022; 109:103316. [PMID: 35364369 PMCID: PMC8933869 DOI: 10.1016/j.midw.2022.103316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/20/2022] [Accepted: 03/18/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVE We aimed to explore the lived experiences of informal caregivers for pregnant women seeking scheduled antenatal care during the early stage of China's COVID-19 lockdown and potential measures to address the challenges. DESIGN This is a phenomenological qualitative study. SETTING The study was carried out in a leading teaching hospital in Southwest China. PARTICIPANTS We recruited 15 informal caregivers for healthy pregnant women on routine antenatal visits about six months after China launched the city-wide lockdown and other control measures for COVID-19, including 10 males and 5 females with diverse demographic backgrounds. MEASURES AND FINDINGS The research team developed a demographic form and an interview outline with key questions, conducted semi-structured interviews with the informal caregivers, and analyzed the data using the Colazzie's method. Five themes of lived experiences were revealed, i.e., increased caregiving burdens, disruption of routines in family life, lack of accurate information and knowledge, active role adjustment, and positive attitudes and coping in a difficult time. Some caregivers reacted positively to the lockdown experience and saw it as an opportunity to rethink their lives and improve family relations. KEY CONCLUSIONS The informal caregivers experienced increased physical and psychological burdens. Strategies such as adoption of a less frequent prenatal visit schedule, use of tele-medicine technologies, and provision of accurate information and knowledge may help to ease the increased informal caregiving burdens. Psychological counseling, community services and disaster response policies specially targeting pregnant women and their informal caregivers may also be valuable resources. IMPLICATIONS FOR PRACTICE Attention should be drawn to the group of informal caregivers for pregnant women during a COVID-19 lockdown, including professional assistance delivered by nursing and other related professionals. Measures are called for to minimize exposure opportunities such as adoption of a new prenatal care schedule and tele-medicine technologies. Patient education with reliable information should be provided, preferably by nursing staff and physicians. Social support efforts including professional mental counseling may added and work with other resources such as community services and policy makers.
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Affiliation(s)
- Yan Zuo
- West China School of Nursing, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education. #20 3rd Section, Renmin Nan Road, Chengdu 610041 Sichuan Province, China
| | - Bi-ru Luo
- West China School of Nursing, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education. #20 3rd Section, Renmin Nan Road, Chengdu 610041 Sichuan Province, China
| | - Ling-ning Wang
- West China School of Nursing, Sichuan University / Department of Nursing, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education. #20 3rd Section, Renmin Nan Road, Chengdu 610041 Sichuan Province, China
| | - Bo-chao Cheng
- Radiology Department, West China Second University Hospital, Sichuan University / Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education. #20 3rd Section, Renmin Nan Road, Chengdu 610041 Sichuan Province, China
| | - Xiao-lin Hu
- West China School of Nursing, Sichuan University / Department of Nursing, West China Hospital, Sichuan University. #37 Guoxue Alley, Wuhou District, Chengdu 610041, Sichuan Province, China,Corresponding author
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21
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Savela RM, Välimäki T, Nykänen I, Koponen S, Suominen AL, Schwab U. Addressing the Experiences of Family Caregivers of Older Adults During the COVID-19 Pandemic in Finland. J Appl Gerontol 2022; 41:1812-1820. [PMID: 35543183 PMCID: PMC9096174 DOI: 10.1177/07334648221095510] [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] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
This cross-sectional study assessed the experiences of family caregivers of older adults during the COVID-19 pandemic. Participants were recruited (n = 101) between April and December 2019. We applied a mixed-method approach. Quantitative data were analyzed using an independent samples t-test and logistic regression analysis, and qualitative experiences with modified thematic content analysis. The mean age of the family caregivers was 76 years (SD = 7), and 72% were females. Experiences of loneliness and worry during the pandemic were evaluated by self-assessment. Approximately one-third of the participants reported loneliness and worry. These experiences were further associated with female sex, increased psychological distress and depressive symptoms, and decreased physical condition and social relationships. Family caregivers were also worried about the pandemic's impact on health and well-being. Thus, the COVID-19 pandemic has added an extra psychosocial load to family caregivers. The post-pandemic era requires increased attention to re-evaluating policies and services.
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Affiliation(s)
- Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Sohvi Koponen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, Kuopio, Finland
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22
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Semonella M, Andersson G, Dekel R, Pietrabissa G, Vilchinsky N. Making a Virtue Out of Necessity: COVID-19 as a Catalyst for Applying Internet-Based Psychological Interventions for Informal Caregivers. Front Psychol 2022; 13:856016. [PMID: 35465576 PMCID: PMC9022647 DOI: 10.3389/fpsyg.2022.856016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 02/22/2022] [Indexed: 12/17/2022] Open
Affiliation(s)
| | - Gerhard Andersson
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Division of Psychiatry, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Rachel Dekel
- School of Social Work, Bar-Ilan University, Ramat Gan, Israel
| | - Giada Pietrabissa
- Department of Psychology, Catholic University of Milan, Milan, Italy.,Psychology Research Laboratory, Istituto Auxologico Italiano - Istituto di Ricovero e Cura a Carattere Scientifico, Milan, Italy
| | - Noa Vilchinsky
- Department of Psychology, Bar-Ilan University, Ramat Gan, Israel
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23
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Allen J, Uekusa S, Alpass FM. Longitudinal Cohort Study of Depression and Anxiety Among Older Informal Caregivers Following the Initial COVID-19 Pandemic Response in Aotearoa New Zealand. J Aging Health 2022; 34:653-665. [PMID: 35412393 PMCID: PMC9008474 DOI: 10.1177/08982643211052713] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Abstract
Objectives To assess the impact of providing care and conditions of care on psychological wellbeing among older informal caregivers following the initial period of COVID-19 pandemic restrictions in Aotearoa New Zealand. Methods Data were from population-based cohorts of older adults participating in the 2020 Health, Work and Retirement longitudinal survey (n = 3839, 17.4% informal caregivers). Changes in symptoms of depression and anxiety over 2018–2020 surveys associated with sociodemographic factors, caregiving, cohabitation with the care recipient, assistance provided with activities of daily living, support in providing care, and opportunity cost of care were assessed. Results Increased depression, but not anxiety, was associated with providing informal care. Among caregivers, lower living standards and cohabitation were associated with increased depression. Lower living standards, unemployment, and lower help from friend/family networks were associated with increased anxiety. Discussion Economic hardship and social capital provide targets for supporting psychological wellbeing of older caregivers during periods of pandemic restrictions.
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Affiliation(s)
- Joanne Allen
- 6420Massey University, Palmerston North, New Zealand
| | - Shinya Uekusa
- 6420Massey University, Palmerston North, New Zealand
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24
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Brown N, Cedar T, Tziraki C. Psychodrama with persons with dementia on zoom: Proof of concept. DEMENTIA 2022; 21:1289-1303. [PMID: 35236150 PMCID: PMC9189438 DOI: 10.1177/14713012221074484] [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] [Indexed: 01/10/2023]
Abstract
COVID-19 pandemic and subsequent lockdowns created a global public health crisis generating mental health problems including social isolation, stress, and anxiety especially for persons with dementia and their carers. This article reports on the use of digital technology to maintain social connectivity via a virtual group session that focused on the topic of "what is home." Participants in this session included 16 day-care center clients representing an immigrant community identified with mild to moderate cognitive impairment. A trained psychodrama therapist conducted the virtual group meeting based on five key techniques: spectrogram, role reversal, doubling, mirroring, and soliloquy. The NVivo software was used for the qualitative analysis of the transcribed video recording to identify key themes based on grounded theory methodology. Zooming from home, clients engaged in significant social interaction. Findings of the NVivo analysis identified the following themes of "what is home": Emotions and home, Home is family, Home is community, and Reminiscence (with objects and traditions). Findings suggest that digital interactive technologies, like Zoom, enhance social connectivity thus mitigating the negative impact of social isolation for persons with dementia especially during pandemic lockdowns. Our pilot findings based on virtual group meetings from home demonstrate that participants can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. While larger studies are needed to confirm these findings, we suggest that this methodology may be used to support persons with dementia not only in times of pandemics but also as an addition to other community and home care services. Changes in reimbursement policies to include these innovative home services may be helpful in building more resilient communities for the more highly vulnerable populations.
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Affiliation(s)
- Nancy Brown
- Talpiot English-speaking Center, 151027MELABEV-Community Clubs for Eldercare, Jerusalem, Israel.,PhD Candidate, University of Edinburgh, Edinburgh, Scotland, UK
| | - Tzippi Cedar
- Talpiot English-speaking Center, MELABEV-Community Clubs for Eldercare, Jerusalem, Israel
| | - Chariklia Tziraki
- Talpiot English-speaking Center, MELABEV-Community Clubs for Eldercare, Jerusalem, Israel.,Hebrew University, Jerusalem, Israel
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25
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Huang YH, Nagao CA, Santos KMB, Werchowsky MI. Impact of Culture, Spirituality, and Mental Health Attitudes on Intergenerational Asian-American Caregivers: A Pilot Study. Am J Occup Ther 2022; 76:23198. [PMID: 35143608 DOI: 10.5014/ajot.2022.046912] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Asian-Americans are more likely than other ethnic groups to care for older family members and less likely to seek mental health services. The research on caregiver burden among Asian-American intergenerational caregivers is limited. OBJECTIVE To investigate how spirituality and mental health help-seeking attitudes correlate with and predict perceived feelings of caregiver burden among Asian-American caregivers. Favorable mental health help-seeking attitudes were predicted to negatively correlate with caregiver burden, and spirituality was predicted to negatively correlate with and negatively predict caregiver burden. DESIGN Quantitative survey research. SETTING Community mental health. PARTICIPANTS One hundred one participants were recruited using the following inclusion criteria: Asian-Americans who currently or previously provided care to an Asian family member at least one generation older than the caregiver for at least 1 mo and in the past 3 yr. Outcomes and Measures: Items from the Burden Scale for Family Caregivers, Spirituality Scale, Expressions of Spirituality Inventory-Revised, Mental Help Seeking Attitudes Scale, and Self-Stigma of Seeking Psychological Help measured caregiver burden, spirituality, and mental health help-seeking attitudes. RESULTS A statistically significant negative correlation was found between caregiver burden and spirituality and between caregiver burden and mental health help-seeking attitudes. Spirituality and number of domains of care were statistically significant predictors of caregiver burden. CONCLUSIONS AND RELEVANCE Spirituality was found to negatively predict caregiver burden among Asian-American intergenerational caregivers. Mental health help-seeking attitudes were negatively correlated with caregiver burden. Occupational therapy practitioners have the opportunity to integrate spirituality and culturally sensitive mental health promotion into their services to Asian-Americans. What This Article Adds: Evidence that spirituality is a negative predictor of caregiver burden for Asian-American intergenerational caregivers offers a unique opportunity for occupational therapy practitioners to offer alternative methods of mental health promotion with this population. Understanding that spirituality and mental health help-seeking attitudes are culturally mediated allows practitioners to be informed about a dynamic in Asian-American culture.
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Affiliation(s)
- Yan-Hua Huang
- Yan-hua Huang, PhD, OTR/L, is Professor, Department of Occupational Therapy, College of Health, Human Services and Nursing, California State University Dominguez Hills, Carson;
| | - Ciara A Nagao
- Ciara A. Nagao, MS, OTR/L, is Occupational Therapist, Orange, CA. At the time of the study, Nagao was Master's Student, California State University Dominguez Hills, Carson
| | - Kelsey Michelle B Santos
- Kelsey Michelle B. Santos, MS, OTR/L, is Occupational Therapist, Orange County, CA. At the time of the study, Santos was Master's Student, California State University Dominguez Hills, Carson
| | - Madison I Werchowsky
- Madison I. Werchowsky MS, OTR/L, is Occupational Therapist, Los Angeles, CA. At the time of the study, Werchowsky was Master's Student, California State University Dominguez Hills, Carson
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26
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Bining M, Wasserman S, Brahim LO, Belzile E, Magalhaes M, Lambert SD. An Evaluation of Publicly Available Smartphone Apps to Support Unpaid Cancer Caregivers. J Pain Symptom Manage 2022; 63:430-439. [PMID: 34606930 DOI: 10.1016/j.jpainsymman.2021.09.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/23/2021] [Accepted: 09/24/2021] [Indexed: 11/18/2022]
Abstract
CONTEXT With advancements in mobile technology and increased access to smartphones, the use of Mobile Health applications (apps) has surged. These apps provide an innovative avenue for supporting cancer caregivers who face increasing burden and lack formal support; however, the quality of these apps has not been formally evaluated. OBJECTIVES Evaluate the quality, usefulness, therapeutic potential, and security of publicly available apps to support unpaid cancer caregivers in managing their roles and responsibilities. METHODS Cancer caregiving apps were identified through a search of the Apple and Google Play stores in October 2020. Two authors evaluated the apps using 1) the Mobile App Rating Scale (MARS) tool for quality, 2) complementary sections of Enlight for therapeutic persuasiveness and alliance, security and privacy, and 3) an unmet needs checklist to assess usefulness. Analyses were undertaken to identify high-scoring apps. RESULTS Overall, 24 apps were evaluated by two authors (MB, SW). Across the sample, the mean quality score (MARS) was adequate at 65.7% (3.3/5.0, SD = .5, range: 2.3-4.2). The combined score for therapeutic persuasiveness and alliance (Enlight) was fair at 60.7% (3.0/5.0, SD = .8, range: 1.1-4.5), and the privacy and security checklists yielded means of 79.3% (6.3/8.0, SD = 1.4, range: 50.0%-100.0%) and 41.3% (1.7/4.0, SD = 1.4, range: 0.0-100.0%), respectively. The unmet needs checklist was 43.2% (SD = 5.3, range: 9.4%-69.7%). A hierarchical cluster analysis identified 12 high scoring apps. CONCLUSION Superior cluster apps scored acceptably for quality and privacy and low for security and usefulness. Findings will assist clinicians, caregivers, and families identify apps to support cancer caregivers.
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Affiliation(s)
- Mira Bining
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada.
| | - Sydney Wasserman
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada
| | - Lydia Ould Brahim
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada
| | - Eric Belzile
- St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
| | - Mona Magalhaes
- St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
| | - Sylvie D Lambert
- Ingram School of Nursing (M.B., S.W., L.O.B., S.D.L.), McGill University, Montreal, Canada; St. Mary's Research Centre (E.B., M.M., S.D.L.), Montreal, Canada
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27
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Ventura-León J, Caycho-Rodríguez T, Talledo-Sánchez K, Casiano-Valdivieso K. Depression, COVID-19 Anxiety, Subjective Well-being, and Academic Performance in University Students With COVID-19-Infected Relatives: A Network Analysis. Front Psychol 2022; 13:837606. [PMID: 35222215 PMCID: PMC8867004 DOI: 10.3389/fpsyg.2022.837606] [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] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
This study aimed to examine the relationship between anxiety, depression, subjective well-being, and academic performance in Peruvian university health science students with COVID-19-infected relatives. Eight hundred two university students aged 17-54 years (Mean 21.83; SD = 5.31); 658 females (82%) and 144 males (18%); who completed the Patient Health Questionnaire-2, Coronavirus Anxiety Scale, Subjective Well-being Scale (SWB), and Self-reporting of Academic Performance participated. A partial unregularized network was estimated using the ggmModSelect function. Expected influence (EI) values were calculated to identify the central nodes and a two-tailed permutation test for the difference between the two groups (COVID-19 infected and uninfected). The results reveal that a depression and well-being node (PHQ1-SWB3) presents the highest relationship. The most central nodes belonged to COVID-19 anxiety, and there are no global differences between the comparison networks; but at the local level, there are connections in the network of COVID-19-infected students that are not in the group that did not present this diagnosis. It is concluded that anxious-depressive symptomatology and its relationship with well-being and evaluation of academic performance should be considered in order to understand the impact that COVID-19 had on health sciences students.
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Affiliation(s)
- José Ventura-León
- Department of Health Sciences, Universidad Privada del Norte (UPN), Lima, Peru
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28
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Deskins BP, Letvak S, Kennedy-Malone L, Rowsey PJ, Bedini L, Rhew D. The Experiences of African American Male Caregivers. Healthcare (Basel) 2022; 10:healthcare10020252. [PMID: 35206867 PMCID: PMC8871800 DOI: 10.3390/healthcare10020252] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023] Open
Abstract
Aging of the population has led to an increasing number of caregivers. While research has been conducted on caregiver experiences, less is known about the experiences of African American males in the U.S. This qualitative descriptive study describes the experiences of 13 African American men who acted as caregivers to adult chronically ill or debilitated loved ones, the majority of whom provided care during the COVID-19 pandemic. The revised Sociocultural Stress and Coping Model (R-SSCM) guided this study. Individual interviews were conducted via the Zoom application. Content analysis revealed four themes: (1) “My time to take the reins”, (2) “It’s a male thang”, (3) “Caring amid a pandemic”, and (4) “Effects of the caregiver’s journey”. This study’s findings in relation to the literature provide overdue attention to the African American male caregiving experience, especially in relation to the COVID-19 pandemic. The implications of our findings include the need for more culturally congruent support services for African American male caregivers, as well as increased efforts to encourage trust in the healthcare system—especially in relation to vaccination for the SARS-CoV-2 virus.
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Affiliation(s)
| | - Susan Letvak
- School of Nursing, UNC Greensboro, Greensboro, NC 27402, USA; (L.K.-M.); (P.J.R.)
- Correspondence: ; Tel.: +1-336-256-1024
| | | | | | - Leandra Bedini
- School of Health and Human Sciences, UNC Greensboro, Greensboro, NC 27402, USA;
| | - Denise Rhew
- Cone Health, Greensboro, NC 27401, USA; (B.P.D.); (D.R.)
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29
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Brault A, Vaillancourt G. Group Telehealth Music Therapy With Caregivers: A Qualitative Inquiry. J Patient Exp 2022; 9:23743735221107241. [PMID: 35734471 PMCID: PMC9208043 DOI: 10.1177/23743735221107241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Informal caregivers of older adults are faced with increased responsibilities as health and social systems fail to respond to the rising demands associated with the aging populations. For many caregivers, the COVID-19 pandemic has severely impacted their access to already sparse supportive resources, highlighting the importance of varying service delivery methods to meet caregivers’ needs. This qualitative study explored the experiences of informal caregivers of older adults who took part in group telehealth music therapy. Semi-structured interviews with 5 women caregivers were conducted. Through a thematic analysis process, the following themes were identified: (a) affordances of group telehealth music therapy, (b) challenges of group telehealth music therapy, and (c) music as a health resource. Telehealth considerations, clinical implications, as well as ways to support caregiver agency are discussed.
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Affiliation(s)
- Annabelle Brault
- Department of Creative Arts Therapies, Concordia University, Montréal, QC, Canada
- Annabelle Brault, Department of Creative Arts Therapies, Concordia University, 1455 Boulevard de Maisonneuve W, Montréal, QC, H3G 1M8, Canada.
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30
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Garcia‐Rudolph A, Sauri J, Garcia‐Molina A, Cegarra B, Opisso E, Tormos JM, Frey D, Madai VI, Bernabeu M. The impact of coronavirus disease 2019 on emotional and behavioral stress of informal family caregivers of individuals with stroke or traumatic brain injury at chronic phase living in a Mediterranean setting. Brain Behav 2022; 12:e2440. [PMID: 34910375 PMCID: PMC8785633 DOI: 10.1002/brb3.2440] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 10/30/2021] [Accepted: 11/03/2021] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Even in nonpandemic times, persons with disabilities experience emotional and behavioral disturbances which are distressing for them and for their close persons. We aimed at comparing the levels of stress in emotional and behavioral aspects, before and during coronavirus disease 2019 (COVID-19), as reported by informal family caregivers of individuals with chronic traumatic brain injury (TBI) or stroke living in the community, considering two different stratifications of the recipients of care (cause and injury severity). METHODS We conducted a STROBE-compliant prospective observational study analyzing informal caregivers of individuals with stroke (IC-STROKE) or traumatic brain injury (IC-TBI). IC-STROKE and IC-TBI were assessed in-person before and during COVID-19 online, using the Head Injury Behavior Scale (HIBS). The HIBS comprises behavioral and emotional subtotals (10 items each) and a total-HIBS. Comparisons were performed using the McNemar's test, Wilcoxon signed-rank test or t-test. Recipients of care were stratified according to their injury severity using the National Institutes of Health Stroke Scale (NIHSS) and the Glasgow Coma Scale (GCS). RESULTS One hundred twenty-two informal caregivers (62.3% IC-STROKE and 37.7% IC-TBI) were assessed online between June 2020 and April 2021 and compared to their own assessments performed in-person 1.74 ± 0.88 years before the COVID-19 lockdown. IC-STROKE significantly increased their level of stress during COVID-19 in five emotional items (impatience, frequent complaining, often disputes topics, mood change and overly sensitive) and in one behavioral item (overly dependent). IC-TBI stress level only increased in one behavioral item (impulsivity). By injury severity, (i) mild (14.7%) showed no significant differences in emotional and behavioral either total-HIBS (ii) moderate (28.7%) showed significant emotional differences in two items (frequent complaining and mood change) and (iii) severe (56.6%) showed significant differences in emotional (often disputes topics) and behavioral (impulsivity) items. CONCLUSIONS Our results suggest specific items in which informal caregivers could be supported considering cause or severity of the recipients of care.
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Affiliation(s)
- Alejandro Garcia‐Rudolph
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Joan Sauri
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Alberto Garcia‐Molina
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Blanca Cegarra
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Eloy Opisso
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Josep Maria Tormos
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
| | - Dietmar Frey
- CLAIM Charité Lab for AI in MedicineCharité Universitätsmedizin BerlinBerlinGermany
| | - Vince Istvan Madai
- CLAIM Charité Lab for AI in MedicineCharité Universitätsmedizin BerlinBerlinGermany
- QUEST Center for Transforming Biomedical ResearchBerlin Institute of Health (BIH), Berlin, Germany, Charité – Universitätsmedizin BerlinBerlinGermany
- School of Computing and Digital TechnologyFaculty of Computing, Engineering and the Built Environment, Birmingham City UniversityUnited Kingdom
| | - Montserrat Bernabeu
- Universitat Autònoma de BarcelonaBellaterraCerdanyola del VallèsSpain
- Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i PujolBadalonaSpain
- Institut Guttmann Hospital de NeurorehabilitacioBadalonaSpain
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31
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Sheth K, Ritter PL, Lorig K, Steinman L, FallCreek S. Remote Delivery of the Chronic Pain Self-management Program Using Self-directed Materials and Small-group Telephone Support: A Pilot Study. J Appl Gerontol 2021; 41:1329-1335. [PMID: 34965766 DOI: 10.1177/07334648211062805] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
A remote (telephone and tool kit) chronic pain program was studied using the RE-AIM (reach, effectiveness, adoption, implementation, and maintenance) framework. This 6-week pilot took place in underserved communities in Cleveland, Ohio. We determined reach by the diversity of the population, nearly 50% Black and mostly low income. Effectiveness over 7 weeks was shown with validated instruments (depression, pain, sleep, quality of life, self-rated health, and self-efficacy). Changes in pain, depression, and self-efficacy were significant. (p < .01). Remote implementation was accomplished by sending participants a box of materials (book, exercise and relaxation CDs, a self-test, and tip sheets). Participants also participated in peer-facilitated, weekly, scripted telephone calls. Maintenance was demonstrated as the study site has offered nine additional programs with more plan. In addition, 60 additional organizations are now offering the program. This proof-of-concept study offers an alternate to in-person chronic pain self-management program delivery.
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Affiliation(s)
- Khushboo Sheth
- Division of Immunology and Rheumatology, Department of Medicine, 6429Stanford University, Stanford, CA, USA.,19977VA Palo Alto Health Care System, Palo Alto, CA, USA.,Chinook Therapeutics, Seattle, WA, USA
| | - Philip L Ritter
- Division of Immunology and Rheumatology, Department of Medicine, 6429Stanford University, Stanford, CA, USA
| | - Kate Lorig
- Division of Immunology and Rheumatology, Department of Medicine, 6429Stanford University, Stanford, CA, USA
| | - Lesley Steinman
- Health Promotion Research Center, Department of Health Services, 7284University of Washington, Seattle, WA, USA
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Irani E, Niyomyart A, Zauszniewski JA. Caregiving Stress and Self-Rated Health during the COVID-19 Pandemic: The Mediating Role of Resourcefulness. Issues Ment Health Nurs 2021; 42:982-988. [PMID: 34080954 PMCID: PMC8714403 DOI: 10.1080/01612840.2021.1924324] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Family caregivers faced unprecedented circumstances and experienced increased levels of stress during the COVID-19 pandemic. Resourcefulness can minimize the effect of stress on health outcomes. The purpose of this study was to examine the associations between caregiving stress during the pandemic, resourcefulness, and self-rated health and assess the mediating effect of resourcefulness. A convenience sample of 70 family caregivers of adults with chronic and/or disabling conditions was recruited using social media groups and professional networking platforms. Data were collected using an online survey and analyzed using linear regression. Mediation analysis was conducted using the PROCESS macro. Higher levels of caregiving stress during the pandemic and lower levels of resourcefulness were associated with worse self-rated health, while controlling for age, employment status, and weekly caregiving hours. Resourcefulness mediated the relationship between caregiving stress and self-rated health. Our findings highlight the importance of assessing the psychological impact of the pandemic on family caregivers' outcomes. Resourcefulness skills can be targeted to improve the health and well-being of family caregivers during and beyond the pandemic.
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Affiliation(s)
- Elliane Irani
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Atsadaporn Niyomyart
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
| | - Jaclene A Zauszniewski
- Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio, USA
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Leggett AN, Carmichael A, Leonard N, Jackson J, Kirch M, Solway E, Kullgren JT, Singer D, Malani PN, Gonzalez R. Care Challenges Due to COVID-19 and Mental Health Among Caregivers of U.S. Adults With a Chronic or Disabling Condition. Innov Aging 2021; 5:igab031. [PMID: 34632106 PMCID: PMC8493889 DOI: 10.1093/geroni/igab031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Indexed: 01/21/2023] Open
Abstract
Background and Objectives The coronavirus disease 2019 (COVID-19) pandemic poses new challenges for caregivers of adults with chronic or disabling conditions. This study uses nationally representative data to examine the prevalence of pandemic care challenges and supports and their associations with caregiver mental health and interpersonal well-being. Research Design and Methods Participants include 311 caregivers aged 50–80 in the United States who were providing care for an adult with a chronic or disabling condition from the June 2020 National Poll on Healthy Aging. Five care challenges (e.g., confusion on public health guidelines) and 2 supports (e.g., physician offered information on care during COVID-19) are treated as predictors of caregiver mental health (care-related stress, self-reported mental health, and depressive symptoms) and interpersonal well-being (interpersonal conflicts, lack of companionship, and isolation). Results Each care challenge/support was endorsed by 13%–23% of caregivers. In adjusted models, difficulty getting needed medical care was associated with greater caregiver stress, depressive symptoms, and lower interpersonal well-being. All care challenges universally predicted greater caregiver stress. Caregiving supports were not independently associated with caregiver’ mental health and interpersonal well-being. Discussion and Implications Care challenges were associated with caregivers’ mental health and interpersonal well-being during the early months of the pandemic. Some of these challenges may be attributed to changing public health guidelines and practices as the pandemic unfolded, whereas others are relevant to all care contexts (e.g., less support from family). Tools and supports for caregivers must consider both changing policies and care needs.
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Affiliation(s)
- Amanda N Leggett
- Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, Michigan, USA.,Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Alicia Carmichael
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Natalie Leonard
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeannette Jackson
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Matthias Kirch
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Erica Solway
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Jeffrey T Kullgren
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Dianne Singer
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Preeti N Malani
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Richard Gonzalez
- Institute for Social Research, University of Michigan, Ann Arbor, Michigan, USA
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Bastoni S, Wrede C, da Silva MC, Sanderman R, Gaggioli A, Braakman-Jansen A, van Gemert-Pijnen L. Factors Influencing Implementation of eHealth Technologies to Support Informal Dementia Care: Umbrella Review. JMIR Aging 2021; 4:e30841. [PMID: 34623314 PMCID: PMC8538023 DOI: 10.2196/30841] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 01/26/2023] Open
Abstract
Background The worldwide increase in community-dwelling people with dementia underscores the need for innovative eHealth technologies that aim to provide support to both patients and their informal caregivers in the home setting. However, sustainable implementation of eHealth technologies within this target group can be difficult. Objective The goal of this study was to gain a thorough understanding of why it is often difficult to implement eHealth technologies in practice, even though numerous technologies are designed to support people with dementia and their informal caregivers at home. In particular, our study aimed to (1) provide an overview of technologies that have been used and studied in the context of informal dementia care and (2) explore factors influencing the implementation of these technologies. Methods Following an umbrella review design, five different databases were searched (PubMed, PsycINFO, Medline, Scopus, and Cochrane) for (systematic) reviews. Among 2205 reviews retrieved, 21 were included in our analysis based on our screening and selection procedure. A combination of deductive and inductive thematic analyses was performed, using the Nonadoption, Abandonment, Scale-Up, Spread, and Sustainability (NASSS) framework for organizing the findings. Results We identified technologies designed to be used “by informal caregivers,” “by people with dementia,” and “with people with dementia.” Within those groups, most of the represented technologies included, respectively: (i) devices for in-home monitoring of lifestyle, health, and safety; (ii) technologies for supporting memory, orientation, and day structure; and (iii) technologies to facilitate communication between the informal caregiver and person with dementia. Most of the identified factors influencing implementation related to the condition of dementia, characteristics of the technology, expected/perceived value of users, and characteristics of the informal caregiver. Considerably less information has been reported on factors related to the implementing organization and technology supplier, wider institutional and sociocultural context of policy and regulations, and continued adaptation of technology over time. Conclusions Our study offers a comprehensive overview of eHealth technologies in the context of informal dementia care and contributes to gaining a better understanding of a broad range of factors influencing their implementation. Our results uncovered a knowledge gap regarding success factors for implementation related to the organizational and broader context and continuous adaptation over the long term. Although future research is needed, the current findings can help researchers and stakeholders in improving the development and implementation of eHealth technologies to support informal dementia care.
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Affiliation(s)
- Sofia Bastoni
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Christian Wrede
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Marcia Cristina da Silva
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Robbert Sanderman
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands.,Department of Health Psychology, University Medical Center Groningen, Groningen, Netherlands
| | - Andrea Gaggioli
- Department of Psychology, Universitá Cattolica del Sacro Cuore, Milan, Italy.,Applied Technology for Neuro-Psychology Lab, Istituto Auxologico Italiano, Milan, Italy
| | - Annemarie Braakman-Jansen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - Lisette van Gemert-Pijnen
- Department of Psychology, Health & Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
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Family caregiving and changes in mental health status in Japan during the COVID-19 pandemic. Arch Gerontol Geriatr 2021; 98:104531. [PMID: 34563936 PMCID: PMC8497176 DOI: 10.1016/j.archger.2021.104531] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 09/10/2021] [Accepted: 09/15/2021] [Indexed: 11/24/2022]
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic has had a widespread significant impact on mental health. However, the effect of providing care to family members (informal caregiving) on changes in mental health status during the pandemic remains unclear. Methods Using cross-sectional data from a large internet survey conducted between August and September 2020, we investigated the association of informal caregiving status with the incidence of mental health deterioration (increased loneliness, self-reported deterioration in mental health, and new suicidal ideation) in Japan during the COVID-19 pandemic. Results Among 25,482 participants (mean age 48.8 [standard deviation 17.3]; 50.3% women), 2,500 (9.8%) were providing informal care during the pandemic. After adjusting for potential confounders, informal caregivers were more likely than non-caregivers to experience increased loneliness (adjusted odds ratio [aOR] 2.16; 95% confidence interval [CI] 1.70–2.76), self-reported deterioration in mental health (aOR 1.54; 95% CI 1.14–2.08), and new incidence of suicidal ideation (aOR 3.65; 95% CI 1.92–6.92). The degree of mental health deterioration depended on the intensity of care. For example, the incidence rates of new suicidal ideation were 15.0%, 5.2%, and 3.6% for individuals who provided high-intensity caregiving, those who provided low-intensity caregiving, and non-caregivers, respectively (p-for-trend<0.001). The stratified analysis by gender showed that informal caregiving was associated with self-reported deterioration in mental health status among women (aOR 2.19; 95% CI 1.49–3.21) but not men (aOR 1.08; 95% CI 0.75–1.56). Conclusion Informal caregivers were more likely to experience mental health deterioration than non-caregivers during the COVID-19 pandemic.
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36
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Sánchez-Teruel D, Robles-Bello MA, Sarhani-Robles M, Sarhani-Robles A. Exploring resilience and well-being of family caregivers of people with dementia exposed to mandatory social isolation by COVID-19. DEMENTIA 2021; 21:410-425. [PMID: 34517732 PMCID: PMC8818476 DOI: 10.1177/14713012211042187] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Background The COVID-19 pandemic has raised questions about the resilience of health
care systems worldwide. In this regard, one group of people whose physical
and mental health has been affected has been family caregivers of people
with dementia. Objective This study aims to identify the variables that predict a high degree of
well-being in family caregivers of people with dementia during this period
of mandatory lockdown. Methods A total of 310 respondents participated in an online survey (266 women and 44
men) from various regions in Spain, aged between 20 and 73 years old (M =
46.45; SD = 15.97), and all were family members. Results The results showed that there were notable differences in all the protective
variables, together with a significant strong positive relationship between
well-being and resilience (r = 0.92; p
< 0.01) and with coping strategies (r = 0.85;
p < 0.01), and there were also some significant
negative relationships between well-being and difficulties in emotional
regulation (ρ = −.78; p < 0.01). The most predictive
variables of a higher level of well-being included the type of dementia (β =
1.19; CI (95%) = 1.01-1.29; p< 0.01), living in a large
house (β = 0.97; CI (95%) =. 23-0.98; p < 0.01), social
support as a coping strategy (β = 1.27; CI (95%) = 1.21-1.29;
p < 0.01) and mainly resilience (β = 1.34; CI (95%)
= 1.30-1.37; p < 0.01). Discussion We discuss the importance of promoting higher levels of resilience through
the development of protective psychosocial variables in caregivers of people
with dementia exposed to situations of mandatory social isolation as a
modulator of the psychosocial well-being of these family caregivers.
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Affiliation(s)
| | | | - Mariam Sarhani-Robles
- 16741Faculty of Medicine of the Autonomous University of Barcelona, Barcelona, Spain
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Johnson SS, Sowa M, McCann R, Cohen SA, Nash CC, Greaney ML, Alexander RA, Kasten J, Martin MP, McEntee ML, Suri Y, Roman C, Bane S, Opthof E. Knowing Well, Being Well: well-being born of understanding: The Science of Teamwork. Am J Health Promot 2021; 35:1028-1047. [PMID: 34351249 DOI: 10.1177/08901171211030142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Cohen SA, Nash CC, Greaney ML. Informal Caregiving During the COVID-19 Pandemic in the US: Background, Challenges, and Opportunities. Am J Health Promot 2021; 35:1032-1036. [PMID: 34351245 DOI: 10.1177/08901171211030142c] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Avidor S, Ayalon L. "I Didn't Meet My Mother; I Saw My Mother": The Challenges Facing Long-Term Care Residents and Their Families in the Age of COVID-19. J Appl Gerontol 2021; 41:22-29. [PMID: 34365855 DOI: 10.1177/07334648211037099] [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: 11/16/2022] Open
Abstract
The present research examines the effects of protective measures due to the coronavirus disease 2019 (COVID-19) pandemic within long-term care (LTC) settings on residents and their family members. Open-ended qualitative interviews were conducted with 14 family members of older adults who resided in LTC settings during the first wave of the pandemic in Israel. The first theme identified is Rupture, including the physical disconnect; the disruption in routine treatment to residents; and decline in the satisfaction with the setting. The second theme is Response, including sharing viewpoints and involvement in decision-making, as well as an intense ambivalence shared by family members. Our findings highlight the distress caused to residents and family members by the isolation and restrictions in LTC settings during the pandemic and underscore values and priorities that are central to them and their family members, including maintaining continuity, transparency, and working in unison with their families, staff, and management.
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Cohen SA, Kunicki ZJ, Nash CC, Drohan MM, Greaney ML. Rural-Urban Differences in Caregiver Burden Due to the COVID-19 Pandemic among a National Sample of Informal Caregivers. Gerontol Geriatr Med 2021; 7:23337214211025124. [PMID: 34212069 PMCID: PMC8216387 DOI: 10.1177/23337214211025124] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 05/15/2021] [Accepted: 05/26/2021] [Indexed: 12/23/2022] Open
Abstract
The objective of this exploratory study was to explore potential associations between changes to caregiver burden (CB) due to the COVID-19 pandemic and rural-urban status using a nationally representative sample of 761 informal caregivers. Tertiles of two measures of rural-urban status were used: Rural-Urban Commuting Areas (RUCAs) and population density. Bivariate and multivariable binary and ordinal logistic regression were used to asses study objectives. Using RUCAs, rural informal caregivers were more than twice as likely as urban informal caregivers to report a substantial increase in CB due to COVID-19 (OR 2.27, 95% CI [1.28-4.02]). Similar results were observed for population density tertiles (OR 2.20, 95% CI [1.22-3.96]). Having a COVID-19 diagnosis was also significantly associated with increased CB. Understanding and addressing the root causes of rural-urban disparities in CB among informal caregivers is critical to improving caregiver health and maintaining this critical component of the healthcare system.
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Abdeta T, Desalegn D. Common Mental Disorders Among Informal Primary Caregivers of Adults With Mental Illness During the Coronavirus Disease 2019 Epidemic in Eastern Ethiopia: A Cross-Sectional Study. Front Psychiatry 2021; 12:676379. [PMID: 34497543 PMCID: PMC8419243 DOI: 10.3389/fpsyt.2021.676379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 07/21/2021] [Indexed: 01/16/2023] Open
Abstract
Background: Coronaviruses (CoVs) are emerging respiratory viruses and cause illnesses ranging from the common cold to severe acute respiratory syndrome (SARS). Informal primary caregivers of individuals with mental illness were special populations suffering from both the burden of caring for mentally ill individuals and the danger of the Coronavirus disease 2019 (Covid-19) epidemic. Objective: The objective of the study was to assess the prevalence and associated factors of common mental disorders (CMDs) among the informal primary caregivers of adults with mental illness during the Covid-19 epidemic. Methods: A hospital-based cross-sectional study design was conducted from July 1 to 30, 2020. A systematic random sampling technique was used to get samples of informal primary caregivers. Data were analyzed by bivariable and multivariable logistic regression analysis. In the final model, variables having a p-value < 0.05 were declared as associated with CMDs. Result: Out of a total of 218 informal primary caregivers, 215 responded to this study. The prevalence of CMDs was 40.5% [95% confidence interval (CI) = 36.66, 44.3%] among informal primary caregivers. Being female informal primary caregivers [adjusted odds ratios (AOR) 1.98, 95% CI = 1.05, 3.76], being student informal primary caregivers (AOR 5.8, 95% CI: 1.2, 28.4), caring patients with psychosis (AOR 3.33, 95% CI: 1.12, 9.92) and caring patients with bipolar disorder (AOR 3.12, 95% CI: 1.35, 7.23) were significantly associated with CMDs. Conclusion: Our study cannot show the causal relationship due to its cross-sectional study design nature. However, this study showed relatively higher prevalence of CMDs among informal primary caregivers of adults with any mental illness during the Covid-19 epidemics relative to pre-Covid-19 times. Being a female caregiver, being a student caregiver, and caring for adults with psychosis and bipolar disorder were factors associated with CMDs. Attention should be given, and essential psychosocial care should be provided, to maintain the mental health of informal primary caregivers of individuals with mental illness especially during the Covid-19 pandemic.
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Affiliation(s)
- Tilahun Abdeta
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Defaru Desalegn
- Department of Psychiatry, Faculty of Public and Medical Science, Mettu University, Mettu, Ethiopia
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Todorovic N, Vracevic M, Rajovic N, Pavlovic V, Madzarevic P, Cumic J, Mostic T, Milic N, Rajovic T, Sapic R, Milcanovic P, Velickovic I, Culafic S, Stanisavljevic D, Milic N. Quality of Life of Informal Caregivers behind the Scene of the COVID-19 Epidemic in Serbia. ACTA ACUST UNITED AC 2020; 56:medicina56120647. [PMID: 33255886 PMCID: PMC7761277 DOI: 10.3390/medicina56120647] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/18/2020] [Accepted: 11/19/2020] [Indexed: 12/17/2022]
Abstract
Background and objectives: The COVID-19 pandemic has had an unprecedented reliance on informal caregivers as one of the pillars of healthcare systems. The aim of this study was to assess the quality of life of informal caregivers during the COVID-19 epidemic in Serbia. Materials and Methods: A cross-sectional study was conducted among informal caregivers during the COVID-19 epidemic in Serbia. Physical and mental quality of life was measured by the 36-Item Short-Form Health Survey. Additional data included sociodemographic characteristics, caregiver and care recipient characteristics, and COVID-19 related concerns. The qualitative component was performed using focus groups and individual in-depth interviews. Results: Out of 112 informal caregivers enrolled, most were female (80%), and the average age was 51.1 ± 12.3 years. The majority was delivering care to one person, who was a family member, on a daily basis (86.4%, 92%, and 91.1%, respectively). In multiple regression models, significant predictors of caregivers’ physical health were delivering care to a family member and a higher level of care complexity, while significant predictors of caregivers’ mental health were a higher level of care complexity and increased concerns about self-health and the health of the person being cared for due to the COVID-19 epidemic. Conclusions: Informal caregivers are experiencing negative physical and mental health outcomes during the COVID-19 epidemic in Serbia.
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Affiliation(s)
| | | | - Nina Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Vedrana Pavlovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Petar Madzarevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Jelena Cumic
- Department of Anesthesiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (J.C.); (T.M.)
| | - Tanja Mostic
- Department of Anesthesiology, Clinical Center of Serbia, 11000 Belgrade, Serbia; (J.C.); (T.M.)
| | - Nikola Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Tatjana Rajovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Rosa Sapic
- Department of Occupational Therapy, College for Social Work, 11000 Belgrade, Serbia;
| | - Petar Milcanovic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Igor Velickovic
- Medical School, Academy of Vocational Studies Belgrade, 11000 Belgrade, Serbia;
| | - Slobodan Culafic
- Department of Interventional Neuroradiology, Special Hospital for Cerebrovascular Diseases “Saint Sava”, 11000 Belgrade, Serbia;
| | - Dejana Stanisavljevic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
| | - Natasa Milic
- Institute for Medical Statistics and Informatics, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia; (N.R.); (V.P.); (P.M.); (N.M.); (T.R.); (P.M.); (D.S.)
- Department of Internal Medicine, Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 11000, USA
- Correspondence:
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