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Shi Y, Dong S, Liang Z, Xie M, Zhang H, Li S, Li J. Affiliate Stigma among family caregivers of individuals with dementia in China: a cross-sectional study. Front Public Health 2024; 12:1366143. [PMID: 38873291 PMCID: PMC11169882 DOI: 10.3389/fpubh.2024.1366143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 05/13/2024] [Indexed: 06/15/2024] Open
Abstract
Background Affiliate stigma experienced by family caregivers of individuals with dementia may seriously affect home care and prognosis of these patients. This study aimed to explore the levels of perceived affiliate stigma and its influencing factors among family caregivers of patients with dementia in mainland China, which remains a relatively unexplored topic. Methods In this cross-sectional study, purposive sampling was used to recruit dementia family caregivers from an online communication group between April and May 2022. A total of 727 eligible caregivers were included and asked to complete the demographic questionnaire, the affiliate stigma scale, and the caregiver burden inventory. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson correlation analysis, and multiple linear regression were used to explore the factors that influence perceived affiliate stigma among dementia family caregivers. Results The mean score for affiliate stigma of dementia family caregivers was 48.09 ± 16.38 (range: 22-86). Whether there were regular breaks during patient care, time-dependent burden, developmental burden, physical burden, and social burden were significant factors influencing the affiliate stigma of dementia family caregivers. Conclusion Dementia family caregivers showed a moderate to high level of affiliate stigma. Those who had regular breaks during patient care, higher time-dependent burden, developmental burden, and physical burden and lower social burden exhibited higher levels of affiliate stigma.
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Affiliation(s)
- Yingying Shi
- School of Nursing, Wenzhou Medical University, Zhejiang, China
| | - Shishi Dong
- School of Nursing, Wenzhou Medical University, Zhejiang, China
| | - Zhiqi Liang
- School of Nursing, Wenzhou Medical University, Zhejiang, China
| | - Mengting Xie
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Zhejiang, China
| | - Hanyi Zhang
- School of Nursing, Wenzhou Medical University, Zhejiang, China
| | - Sixie Li
- School of Nursing, Wenzhou Medical University, Zhejiang, China
| | - Jufang Li
- School of Nursing, Wenzhou Medical University, Zhejiang, China
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Nwakasi C, Esiaka D, Staab T, Philip AA, Nweke C. HIV knowledge and information access among women cancer survivors in Nigeria. J Cancer Policy 2024; 39:100456. [PMID: 37989454 DOI: 10.1016/j.jcpo.2023.100456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 10/09/2023] [Accepted: 11/15/2023] [Indexed: 11/23/2023]
Abstract
Women in Nigeria have a high burden of diseases, such as cancer and HIV. Nigerian women also have inadequate access to health information, especially for disease prevention and health promotion. Researchers have indicated that living with HIV can be particularly harmful to the health and survival of cancer survivors. However, there is a dearth of research on Nigerian women cancer survivors' knowledge of cancer and HIV linkage and their access to HIV health information. This knowledge gap may have negative health consequences. Therefore, there is a need to ensure HIV prevention among Nigerian women cancer survivors by improving access to health information. This study used a qualitative descriptive method to examine HIV knowledge and access to health information among women cancer survivors in Nigeria. Semi-structured interviews were conducted with a purposive sample of 30 women cancer survivors from Abuja, Nigeria. We identified three themes from the data, illuminating women's knowledge of the connection between HIV and cancer. The themes include: (a) perception of HIV versus cancer which described views of HIV and cancer as distinct health conditions, (b) perceived effect of HIV on cancer given that HIV can worsen cancer outcomes, and (c) sourcing for HIV health information which highlighted issues of inadequate or inaccessible HIV-cancer information. Our findings showed that targeted health education interventions are required to address the lack of HIV information among cancer survivors.
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Affiliation(s)
- Candidus Nwakasi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA.
| | - Darlingtina Esiaka
- Department of Behavioral Science, Center for Health Equity Transformation (CHET), The University of Kentucky College of Medicine, Lexington, KY, USA
| | - Theresa Staab
- Department of Health Sciences, Providence College, Providence, RI, USA
| | - Aaron Akpu Philip
- Faculty of Health, School of Public Health, and Social Work, Queensland University of Technology (QUT) Brisbane, Australia
| | - Chizobam Nweke
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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Nwakasi C, Esiaka D, Chinelo N, Ahmed S. How will I live this life that I'm trying to save? Being a female breast cancer survivor in Nigeria. ETHNICITY & HEALTH 2024; 29:147-163. [PMID: 37936496 DOI: 10.1080/13557858.2023.2279478] [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: 07/20/2023] [Accepted: 10/31/2023] [Indexed: 11/09/2023]
Abstract
OBJECTIVES Nigeria is experiencing an increasing rate of new cancer cases while marred by a weak health system. As cancer prevalence increases in Nigeria, especially among women, it is crucial to understand the experiences of female cancer survivors, given that their quality of life may be influenced by perceptions of cancer and what it means to be a cancer survivor. DESIGN This study employed a qualitative descriptive method. Semi-structured interviews were conducted with a purposive sample of 30 female breast cancer survivors in Abuja, Nigeria. RESULTS The three major themes were views about being a cancer survivor, cancer can be stigmatizing, and life after cancer diagnosis and therapy. CONCLUSION We argue that cancer-related identity and cancer-related stigma are key factors with help-seeking and quality-of-life implications. Tailored interventions such as cancer health education and social support for cancer survivors may help reduce the burden of cancer in Nigeria.
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Affiliation(s)
- Candidus Nwakasi
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Darlingtina Esiaka
- Department of Behavioral Science, Center for Health Equity Transformation, University of Kentucky, Lexington, KY, USA
| | - Nduka Chinelo
- Department of Community Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Sarah Ahmed
- Department of Health Sciences, Providence College, Providence, RI, USA
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Oyinlola O, Mahmoud K, Adeoti AB, Abiodun AA. COVID-19: Experiences of Social Workers Supporting Older Adults With Dementia in Nigeria. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241239844. [PMID: 38500245 PMCID: PMC10949545 DOI: 10.1177/00469580241239844] [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: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/28/2024] [Indexed: 03/20/2024]
Abstract
Amidst the COVID-19 pandemic, numerous public health protocols were instituted by government agencies to safeguard individuals with dementia, their family caregivers, and formal care providers. While these preventive measures were implemented with good intentions, they inadvertently imposed significant challenges on medical social workers in Nigeria. This paper explored the experiences of medical social workers caring for people with dementia during the COVID-19 pandemic in Nigeria. Twenty-six medical social workers from 6 government hospitals in Southwestern Nigeria participated in an in-depth interview. The research reveals 3 pivotal aspects: Firstly, the escalating demands within the work environment, where medical social workers grapple with the intricate task of conveying sensitive information about dementia diagnosis and COVID-19 prevention protocol, managing expectations regarding dementia diagnoses, and navigating resource constraints for individuals with dementia during the pandemic. Secondly, discernible impacts on the work climate and interprofessional relationships shed light on the challenges these professionals face in collaborating with other healthcare providers. Lastly, the reverberations on social workers' personal lives underscore the pandemic's toll on their well-being. Thus, the findings underscore the need for proactive measures to equip medical social workers to face the distinctive challenges in dementia care during future pandemics. Recognizing the potential resurgence of global health crises, the research highlights the need for strategic preparedness to mitigate the impact of future pandemics on the well-being of individuals with dementia and the professionals dedicated to their care.
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Affiliation(s)
- Oluwagbemiga Oyinlola
- School of Social Work, McGill University, Montreal, QC, Canada
- Medical Social Services Department, University College Hospital, Ibadan, Oyo, Nigeria
| | - Kafayat Mahmoud
- Center for Innovation in Social Science, Boston University, Boston, MA, USA
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Gerwing J, White AEC, Henry SG. Communicative Practices Clinicians Use to Correct Patient Misconceptions in Primary Care Visits. HEALTH COMMUNICATION 2023:1-16. [PMID: 38111218 DOI: 10.1080/10410236.2023.2283658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2023]
Abstract
To investigate how clinicians correct patient misconceptions, we analyzed 23 video recordings of primary care visits. Analysis focused on operationalizing, identifying, and characterizing clinician corrections, integrating two inductive approaches: microanalysis of clinical interaction and conversation analysis. According to our definition, patient misconception-clinician correction episodes met three essential criteria: (1) the clinician refuted something the patient had said, (2) which the patient had presented without uncertainty, and (3) which contained a proposition that was factually incorrect. We identified 59 such episodes; the patient misconceptions most commonly related to medication issues; fewer than half had foreseeable implications for patients' future actions. We identified seven clinician correction practices: Three direct practices (displaying surprise, marking disagreement, contradicting the patient) and four indirect practices (presenting the correct proposition, providing explanations, invoking an outside authority, demonstrating with evidence). We found an almost equal distribution of these direct and indirect practices.
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Affiliation(s)
| | - Anne E C White
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego
| | - Stephen G Henry
- Department of Internal Medicine, University of California Davis
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Wang S, Shan Q, Cheung DSK, Xu X, Leung ISH, Leung AYM. Influence of dementia literacy and caregiving appraisal on the psychological wellbeing of informal caregivers of people with dementia: A cross-sectional study. Front Med (Lausanne) 2022; 9:971481. [PMID: 36186770 PMCID: PMC9515462 DOI: 10.3389/fmed.2022.971481] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundDementia informal caregiving is a global phenomenon. It is well documented that caregivers' psychological health is often affected by busy caregiving schedules. Lawton's two-factor model indicates that caregivers' psychological wellbeing is influenced by caregiving appraisal and other caregiver factors. Our review also identified the significance of dementia literacy, which was an essential caregiver factor. However, it is imperative for a clear understanding of the mechanism of how psychological wellbeing is influenced by them.ObjectivesTo explore the association among dementia literacy, caregiving appraisal, and psychological wellbeing and the influencing mechanisms between them.MethodsTwo hundred and twenty-three informal caregivers of people with dementia were involved in this cross-sectional study. Dementia literacy was measured by the Alzheimer's Disease Knowledge Scale and Dementia Attitude Scale. Caregiving appraisal and psychological wellbeing were measured with the Caregiving Appraisal Scale and Ryff's Psychological wellbeing Scale, respectively. Descriptive statistics were used to describe the characteristics of participants and key outcome variables. Pearson's correlation analysis was used to analyze the correlation among the variables. Structural equation modeling was used to examine the hypothetical mediating role of caregiving appraisal in the relationship between dementia literacy (i.e., knowledge of dementia and attitude toward dementia) and caregivers' psychological wellbeing.ResultsThe hypotheses were partially confirmed. Attitude toward dementia was significantly associated with caregiving appraisal (r = 0.312, p < 0.01) and psychological wellbeing (r = 0.311, p < 0.01). However, knowledge of dementia was only significantly associated with psychological wellbeing (r = 0.136, p < 0.05). The structural equation modeling fitted well (p = 0.078, CFI = 0.987, RMSEA = 0.038). In the fitted model, caregiving appraisal partially mediated the association between attitude toward dementia and psychological wellbeing. In contrast, attitude toward dementia and caregiving appraisal fully mediated the association between knowledge of dementia and psychological wellbeing.ConclusionEfforts can be exerted to improve dementia caregivers' caregiving appraisal and attitude toward dementia to improve their psychological wellbeing.
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Affiliation(s)
- Shanshan Wang
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- School of Nursing and Health, Zhengzhou University, Henan, China
- WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
- *Correspondence: Shanshan Wang
| | - Qiuju Shan
- The Second Affiliated Hospital of Zhengzhou University, Henan, China
| | - Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
| | - Xinyi Xu
- School of Nursing, Hebei Medical University, Hebei, China
- Postdoctoral Research Station in Basic Medicine, Hebei Medical University, Hebei, China
| | - Isaac Sze Him Leung
- Department of Statistics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Angela Yee Man Leung
- School of Nursing, The Hong Kong Polytechnic University, Kowloon, Hong Kong SAR, China
- WHO Collaborating Center for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, Hong Kong SAR, China
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Manderson L, Brear M, Rusere F, Farrell M, Gómez-Olivé FX, Berkman L, Kahn K, Harling G. Protocol: the complexity of informal caregiving for Alzheimer's disease and related dementias in rural South Africa. Wellcome Open Res 2022; 7:220. [PMID: 37538406 PMCID: PMC10394391 DOI: 10.12688/wellcomeopenres.18078.1] [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] [Accepted: 08/17/2022] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND With aging, many people develop Alzheimer's disease or related dementias (ADRD) as well as chronic physical health problems. The consequent care needs can be complicated, with heavy demands on families, households and communities, especially in resource-constrained settings with limited formal care services. However, research on ADRD caregiving is largely limited to primary caregivers and high-income countries. Our objectives are to analyse in a rural setting in South Africa: (1) how extended households provide care to people with ADRD; and (2) how the health and wellbeing of all caregivers are affected by care roles. METHODS The study will take place at the Agincourt health and socio-demographic surveillance system site of the MRC/Wits Rural Public Health and Health Transitions Research Unit in Mpumalanga Province, northeast South Africa. We will recruit 100 index individuals predicted to currently have ADRD or cognitive impairment using data from a recent dementia survey. Quantitative surveys will be conducted with each index person's nominated primary caregiver, all other household members aged over 12, and caregiving non-resident kin and non-kin to determine how care and health are patterned across household networks. Qualitative data will be generated through participant observation and in-depth interviews with caregivers, select community health workers and key informants. Combining epidemiological, demographic and anthropological methods, we will build a rich picture of households of people with ADRD, focused on caregiving demands and capacity, and of caregiving's effects on health. DISCUSSION Our goal is to identify ways to mitigate the negative impacts of long-term informal caregiving for ADRD when formal supports are largely absent. We expect our findings to inform the development of locally relevant and community-oriented interventions to improve the health of caregivers and recipients, with implications for other resource-constrained settings in both higher- and lower-income countries.
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Affiliation(s)
- Lenore Manderson
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Social Sciences, Monash University, Clayton, Australia
| | - Michelle Brear
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- School of Social Sciences, Monash University, Clayton, Australia
- School of Public Health and Preventive Medicine, Monash University, Clayton, Australia
| | - Farirai Rusere
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Meagan Farrell
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francesc Xavier Gómez-Olivé
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
| | - Lisa Berkman
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kathleen Kahn
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
| | - Guy Harling
- MRC/Wits Rural Public Health & Health Transitions Research Unit (Agincourt), University of the Witwatersrand, Johannesburg, South Africa
- Harvard Center for Population and Development Studies, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Institute for Global Health, University College London, London, UK
- Africa Health Research Institute, KwaZulu-Natal, South Africa
- School of Nursing & Public Health, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
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