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Patel R, Evans I, Stoner CR, Spector A. Investigating the Feasibility, Acceptability, and Impact of a Brief Dementia Awareness for Caregivers (DAC) Course: A Mixed Methods Study. Clin Interv Aging 2023; 18:1923-1935. [PMID: 38020448 PMCID: PMC10676089 DOI: 10.2147/cia.s429556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 11/05/2023] [Indexed: 12/01/2023] Open
Abstract
Aim Informal caregivers are vital in assisting people with dementia. However, this role can significantly impact caregivers' lives and interventions to support them are crucial. This study aimed to develop a United Kingdom version of the Dementia Awareness for Caregivers (DAC) course and to investigate the feasibility, acceptability, and impact of delivering the course online to informal dementia caregivers. Methods This study comprised a mixed-methods pre-post intervention parallel group design. Fifty-one informal dementia caregivers were randomized into either an experimental (receiving the DAC course) or control group (treatment as usual). Outcomes relating to perceived burden, attitude, competence, relationship quality and positive caregiving aspects were measured at baseline and follow-up, alongside statistics relating to recruitment, retention, attendance, and adherence. Semi-structured interviews were conducted to explore qualitative acceptability and impact among caregivers who completed the DAC course. Results The study found high retention and attendance rates with low levels of unexplained attrition. Analysis indicated positive change for four of the outcome measures in favor of the DAC course, however this was not statistically significant. Qualitative analysis generated 11 subthemes organized into four overarching main themes; "acceptability of course", "impact of course on caregivers", "using skills from course" and "outcome measures". Conclusion Findings provide promising evidence for the feasibility, acceptability and impact of the Dementia Awareness for Caregivers course when delivered online to informal caregivers in the United Kingdom.
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Affiliation(s)
- Ria Patel
- Faculty of Brain Sciences, Division of Psychology and Language Sciences, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 6BT, UK
| | - Isabelle Evans
- Faculty of Brain Sciences, Division of Psychology and Language Sciences, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 6BT, UK
| | - Charlotte R Stoner
- Centre for Chronic Illness and Ageing, Institute of Life Course Development, School of Human Sciences, University of Greenwich, Old Royal Naval College, London, SE10 9LS, UK
| | - Aimee Spector
- Faculty of Brain Sciences, Division of Psychology and Language Sciences, Research Department of Clinical, Educational and Health Psychology, University College London, London, WC1E 6BT, UK
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Huang Y, Li X, Liu Z, Huo J, Guo J, Chen Y, Chen Y, Chen R. Projections of the economic burden of care for individuals with dementia in mainland China from 2010 to 2050. PLoS One 2022; 17:e0263077. [PMID: 35113895 PMCID: PMC8812891 DOI: 10.1371/journal.pone.0263077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 01/11/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND China has stepped into an era of aging society, where the impending considerable economic burden attributed to high prevalence of dementia in the elderly appears to be one of the most important health and social issues to deal with for the country. However, population-based quantification and projections for the economic burden of dementia in China are lacking for further health action and policy making. OBJECTIVE To estimate and predict the costs of managing dementia in the elderly population aged 60 and above from 2010 to 2050 in China. METHODS Data were collected from a six-province study (n = 7072) and other multiple sources for calculation of the economic burden of dementia. With the convincing data from published studies, we quantified and projected the costs attributed to dementia in China from 2010 to 2050. RESULTS The national cost of dementia in 2010 was estimated to be US$22.8 billion by the opportunity cost method and US$26.4 billion by the proxy method. In 2050, the costs would increase to US$372.3 billion by the opportunity cost method and US$430.6 billion by the proxy method, consuming 0.53% and 0.61% of China's total GDP, respectively. A series of sensitivity analyses showed that the changes in the proportions of informal caregiving led to the most robust changes in the total burden of care for dementia in China. CONCLUSION Dementia represents an enormous burden on China's population health and economy. Due to the changes in policies and population structure, policymakers should give priority to dementia care.
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Affiliation(s)
- Yixiang Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Guangdong Health Economics Association, Guangzhou, China
| | - Xiande Li
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zifeng Liu
- Department of Clinical Data Center, The 3 Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jinhai Huo
- Department of Health Services Research, Management and Policy, The University of Florida, Gainesville, Florida, United States of America
| | - Jianwei Guo
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Yingying Chen
- Guangdong Hospital of Traditional Chinese Medicine, Guangzhou, China
| | - Yanmei Chen
- The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ruoling Chen
- Centre for Health and Social Care Improvement (CHSCI), Faculty of Education, Health and Wellbeing (FEHW), University of Wolverhampton Millennium City Building, Wolverhampton, United Kingdom
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Gao W, Zhang T, Wang H, Wang S, Liu Y, Pang X. Supporting caregivers of people with dementia: A systematic review of guidelines. Health Soc Care Community 2022; 30:e305-e324. [PMID: 34750910 DOI: 10.1111/hsc.13513] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 06/21/2021] [Accepted: 06/25/2021] [Indexed: 06/13/2023]
Abstract
Caregivers of people with dementia (PwD) frequently experience poor physical, mental and social health. Over the past decade, several guidelines have offered recommendations on supporting caregivers to improve their health outcomes. This systematic review aimed to assess the quality and evidence base of guidelines on supporting caregivers of PwD and review the content of their recommendations on caregiver support to facilitate the adoption and implementation of a specific guideline among policymakers and practitioners. A systematic search for guidelines on supporting caregivers of PwD was performed using journal databases, websites of guideline development organisations and professional dementia-related societies from inception to 30 June 2020. Four independent reviewers performed the quality assessment of the included guidelines using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. A thematic synthesis was used to analyse the content of recommendations on caregiver support extracted from the included guidelines by two independent reviewers. The strength of recommendations and level of evidence were reclassified and analysed. Literature searches identified nine guidelines. Their quality was variable. The applicability domain on AGREE II yielded the lowest median score (62.2%; range: 18.6%-86.6%), suggesting that some guidelines lacked applicability in certain fields, leaving them open to interpretation. Most evidence underlying the extracted recommendations was rated as Levels 3 (51.3%) and 4 (31.1%). High-quality evidence is required to fortify these recommendations. The nine guidelines covered six themes-assessment, education, skill training, information provision, psychosocial support and general support policies-which can guide future policies and interventions of caregiver support. The recommendations extracted were consistent across guidelines, but each guideline failed to cover all six themes. Thus, more applicable and comprehensive guidelines that fully address all themes of support for caregivers of PwD are needed.
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Affiliation(s)
- Weijie Gao
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Tieling Zhang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongyun Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shanshan Wang
- School of Nursing, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yuling Liu
- Community Health Service Centers of Jieyuan Dao, Tianjin, China
| | - Xiaoli Pang
- Office of Academic Studies, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Bassola B, Cilluffo S, Lusignani M. Going inside the relationship between caregiver and care-receiver with Amyotrophic Lateral Sclerosis in Italy, a Grounded Theory study. Health Soc Care Community 2021; 29:1083-1090. [PMID: 32876339 DOI: 10.1111/hsc.13142] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 06/24/2020] [Accepted: 07/27/2020] [Indexed: 06/11/2023]
Abstract
People with amyotrophic lateral sclerosis become dependent on caregivers for daily activities and to perform self-care activities at home. The family caregiver has an important role in the care. The patient decides and controls care but depends on the caregiver to implement self-care behaviours. The quality of caregiver-patient relationships could influence clinical outcomes, as it occurs in other illnesses, so the aim of this study was to investigate the relationship between the Amyotrophic Lateral Sclerosis patients and their family caregiver and how it impacts care, and patient and caregiver outcomes. We interviewed 22 patients/caregivers in a Neuromuscular Clinical Center in the South of Europe, between July and October 2018. A Grounded Theory approach was used, comprising line by line 'initial coding', memos writing, 'focused coding', advanced memos and categories definition. From the interviews three main categories emerged: 'reciprocity', 'loving to care' and 'changing to care' and four secondary categories: 'having support', 'sharing suffering', 'protecting each other' and 'thinking positive'. A stable and calm relationship between patient and caregiver, characterised by reciprocity, mutual help and affection affected patient self-care provided at home and the caregiver burden. The concept of mutuality seems to describe this relationship, despite the patient's dependence on the caregiver. The relationship with health professionals and educational interventions could influence the quality of the relationship. Further studies are needed to describe the quality of the relationship in this dyad, to investigate the presence of mutuality and how it affects patient and caregiver outcomes.
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Affiliation(s)
- Barbara Bassola
- School of Nursing, University of Milan, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Silvia Cilluffo
- Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Maura Lusignani
- School of Nursing, University of Milan, Azienda Socio Sanitaria Territoriale Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Biomedical Science for Health Department, University of Milan, Milan, Italy
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Liao X, Huang Y, Zhang Z, Zhong S, Xie G, Wang L, Xiao H. Factors associated with health-related quality of life among family caregivers of people with Alzheimer's disease. Psychogeriatrics 2020; 20:398-405. [PMID: 32027776 DOI: 10.1111/psyg.12528] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 01/20/2020] [Accepted: 01/21/2020] [Indexed: 11/29/2022]
Abstract
AIM Based on the ageing population and the inadequate healthcare system in China, the majority of care for patients with Alzheimer's disease (AD) is provided by family caregivers. Caregivers suffer a long-term heavy care burden and pressure, which affects their physical and mental health. The present study aims at investigating health-related quality of life (HRQOL) among family caregivers of AD patients and exploring its influencing factors. METHODS This study included 206 family caregivers (76 male, 130 female) of AD patients recruited from one Tier 3 hospital, one psychiatric hospital, two gerocomiums and three communities in Ganzhou city, Jiangxi Province, China. Measures included the World Health Organization (WHO) Quality of Life (WHO/ QOL-BREF) questionnaire, Zarit burden of care scale (ZBI), and social support rating scale (SSRS).We performed face-to-face or telephone interviews with patients and caregivers. The association between possible factors and changes in HRQOL was examined through stepwise multiple regression analysis. RESULTS The majority of family caregivers felt moderate to severe level of burden. The average HRQOL score was 54.24 ± 10.36. The mean SSRS score was 30.4 ± 10.9. The average ZBI score was 41.2 ± 12.8. The HRQOL of family caregivers of AD patients was negatively correlated with the neuropsychiatric questionnaire score, ZBI score, and chronic diseases of caregivers (P < 0.05), and positively correlated with the SSRS score (P < 0.05). CONCLUSION Reduced QOL was highly prevalent among AD patient family caregivers, and the level of burden, neuropsychiatric symptoms of patients, social support, and chronic diseases of caregivers were factors associated with HRQOL, and the effect of care burden is greatest. Interventions aimed at reducing the level of burden should focus not only on the patient but also on the caregiver.
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Affiliation(s)
- Xiangping Liao
- Gannan Medical University, Ganzhou, Jiangxi, China.,Department of Psychology, The Third People's Hospital of Ganzhou, China
| | - Ying Huang
- Department of Neurology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | | | - Shanquan Zhong
- Department of Neurology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
| | - Gaosheng Xie
- Department of Neurology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Linghong Wang
- Department of Neurology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China
| | - Hai Xiao
- Department of Neurology, the First Affiliated Hospital of Gannan Medical University, Ganzhou, Jiangxi, China.,Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases, Ministry of Education, Gannan Medical University, Ganzhou, China
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Abstract
Objectives: Some spouses providing care for a partner with dementia experience continuity in the relationship: Despite the changes that have occurred, the person with dementia and the relationship are felt to be essentially the same as they were before the dementia. Others experience discontinuity: The person and the relationship feel very different. Previous qualitative research has suggested that continuity may be linked with the delivery of more person-centred care. Using a mixed-methods approach, the present study aimed to provide a more robust test of this claim.Method: Twenty-six spousal carers completed the Birmingham Relationship Continuity Measure and the Caregiver Hassles Scale, and took part in an interview about their response to challenging care needs. Attributions about the causes of those needs were extracted from the interviews and coded. Codes referred either to dementia as a cause, or to a range of other causes that reflected a more person-centred focus. A measure of person-centred care was obtained by calculating the percentage of the total number of attributions that fell into these more person-centred categories.Results: Consistent with the hypothesis that continuity and person-centred care are linked, those who reported greater continuity reported a significantly higher percentage of person-centred attributions.Conclusions: Person-centred care is important for the well-being of those giving and those receiving the care. Little is currently known about how to support families to be more person-centred. The possibility of supporting person-centred care through enhancing the experience of continuity merits investigation.
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Affiliation(s)
- Gerard A Riley
- Centre for Applied Psychology, University of Birmingham, Birmingham, UK
| | - Julie Achiampong
- Centre for Applied Psychology, University of Birmingham, Birmingham, UK
| | | | - Jan R Oyebode
- Bradford Dementia Group, Faculty of Health Studies, University of Bradford, Bradford, UK
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Chan EY, Lim ZX, Ding YY, Chan YH, Lim WS. Development of a Brief Caregiver-centric Screening Tool to Identify Risk of Depression among Caregivers of Hospitalized Older Adults. J Nutr Health Aging 2019; 23:578-585. [PMID: 31233081 PMCID: PMC6586909 DOI: 10.1007/s12603-019-1197-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 03/14/2019] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Caregivers of hospitalized older adults experience elevated levels of stress and are at risk of poor health outcomes. There is a lack of screening tools based on self-reported caregiver variables incorporating both protective and risk factors, for early identification of at-risk caregivers. This study reports the development of a caregiver-centric screening tool to identify risk of depression at admission and predicts 3-month risk of depression and quality of life amongst caregivers of older adults with an unplanned admission. DESIGN, SETTING AND PARTICIPANTS This prospective cohort study was conducted in the medical wards of a tertiary-care hospital from July 2015 to May 2017. We recruited family caregivers of patients aged 65 years and above who fulfilled the following criteria: a) unplanned admission, b) not residing in nursing homes; and c) requiring assistance in activities of daily living. MEASUREMENTS We examined 11 candidate caregiver variables (mastery, burden and nine demographic variables). Risk of depression (score ≥8 on Hospital Anxiety and Depression Scale (HADS-D) depression subscale) was the primary outcome, and was assessed during the index admission. Logistic regression models were used to identify risk factors and risk scores (weights). The total risk scores were then stratified into three risk levels. Predictive validity of the screening tool was assessed using 3-months post-discharge risk of depression and health-related quality of life (HRQoL). RESULTS The study included 274 caregiver-patient dyads. The mean (SD) age of the caregivers was 59 (10) years with 33.6% caregivers screening positive for risk of depression. The final model comprised three caregiver variables: mastery, burden and education. The total risk scores ranged from 0 to 6 and showed good discrimination (AUC:0.82, 95% CI: 0.77 to 0.87). Caregivers were classified into low-risk (0-1 points), intermediate-risk (2-4 points), and high-risk (5-6 points) groups, with corresponding rates of risk of depression (HADS-D≥8) of 10.7%, 44.6% and 73.3%, during admission. Relative risk rates of the intermediate- and high- risk group using the low-risk group as reference were 4.16 and 6.84 respectively. At 3-months post-discharge, the rates of caregivers at risk of depression or having poor HRQoL also increased corresponding to the three risk levels as per baseline, supporting the predictive validity of the tool. CONCLUSIONS/IMPLICATIONS The caregiver-centric tool is a novel, practical, self-administered, relatively brief caregiver-centric instrument that can be used for rapid screening and stratification of caregivers at risk of depression. Uniquely, the tool comprised of assessment of protective factor (mastery) in addition to risk factors to provide a holistic assessment of the caregiver. It can be incorporated as part of older adults' admission evaluation so that prompt intervention can be rendered to their at-risk caregivers.
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Affiliation(s)
- E-Y Chan
- Ee-Yuee Chan, 11 Jalan Tan Tock Seng, Nursing Service, Annex 1, Tan Tock Seng Hospital, Singapore 308433, Email address: , Telephone number: (65)63573185, Fax number: (65)63578515
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Carlozzi NE, Sherman CW, Angers K, Belanger MP, Austin AM, Ryan KA. Caring for an individual with mild cognitive impairment: a qualitative perspective of health-related quality of life from caregivers. Aging Ment Health 2018; 22:1190-1198. [PMID: 28699777 PMCID: PMC6141353 DOI: 10.1080/13607863.2017.1341468] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES Little is known regarding the effect that caring for an individual with Mild Cognitive Impairment (MCI) has on health-related quality of life (HRQOL). We sought to identify the most important aspects of HRQOL related to caring for an individual with MCI. METHODS Six focus groups were conducted with caregivers of individuals with MCI (n = 32). Qualitative frequency analysis was used to analyze the data. RESULTS Findings indicated that caregivers most frequently discussed social health, including changes in social roles and an increased need for social support (51.2% of the total discussion). This was followed by mental health concerns (37.9%) centering on anger/frustration, and a need for patience in the caregiving role, as well as caregiver-specific anxiety. Other topics included physical health (10.0%; including the impact that stress and burden have on medical heath), and caregivers' cognitive health (0.9%; including memory problems in relation to caregiver strain, sleep disruption, and cognitive fatigue). CONCLUSIONS Findings illustrate the multiple domains of HRQOL that are affected in individuals providing care for someone with MCI. Moreover, the findings highlight the need for extending support services to MCI caregivers, a group that is typically not offered support services due to the 'less severe' nature of an MCI diagnosis.
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Affiliation(s)
- Noelle E. Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA, 2800 Plymouth Road, Ann Arbor, MI 48109, 734-763-8917,
| | - Carey W. Sherman
- Institute for Social Research, University of Michigan, Ann Arbor, MI, USA, 5067 ISR, Ann Arbor, MI 48109, 734-764-2561,
| | - Kaley Angers
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, 1 Ohio University, Porter Hall 200, Athens, OH 45701,
| | - Mitchell P. Belanger
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA, 1415 Washington Heights, Ann Arbor, MI 48109,
| | - Amy M. Austin
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA, 2800 Plymouth Road, Ann Arbor, MI 48109, 734-764-0644,
| | - Kelly A. Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA, Plymouth Park Office Center, 2101 Commonwealth Blvd Ste C, Ann Arbor, MI 48105, 800-525-5188,
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Kuo LM, Huang HL, Liang J, Kwok YT, Hsu WC, Liu CY, Shyu YIL. Trajectories of health-related quality of life among family caregivers of individuals with dementia: A home-based caregiver-training program matters. Geriatr Nurs 2017; 38:124-132. [DOI: 10.1016/j.gerinurse.2016.08.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 08/21/2016] [Accepted: 08/29/2016] [Indexed: 01/07/2023]
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Kuo LM, Huang HL, Hsu WC, Wang YT, Shyu YIL. Home-based caregiver training: Benefits differ by care receivers' dementia diagnosis. Geriatr Nurs 2016; 37:376-384. [DOI: 10.1016/j.gerinurse.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 11/28/2022]
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Abstract
PURPOSE OF REVIEW Carers of people with dementia are at increased risk of experiencing psychological distress. This article reviews recent findings on the role of personality traits for psychological outcomes for carers of people with dementia. RECENT FINDINGS Several studies have now established that personality influences the caregiving experience, carer well-being and outcomes such as coping ability, burden and caregiving style. Several moderators of these associations have also been identified such as the effect of kinship and type of dementia. There is consistent evidence that carer personality characteristics influence the progression of the disease such as cognitive decline and severity. Most of the recent studies identified in this review are cross-sectional. SUMMARY Taken together, these results indicate that personality is an important psychological resource for carers. Recent findings indicate that personality traits are associated with and influence both carer and patient outcomes. Future research is necessary to guide interventions and to expand further on our understanding of how personality factors shape adjustment to the caregiving role and how these impact on the progression of the disease.
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Tzeng NS, Chang CW, Hsu JY, Chou YC, Chang HA, Kao YC. Caregiver Burden for Patients with Dementia with or Without Hiring Foreign Health Aides: A Cross-Sectional Study in a Northern Taiwan Memory Clinic. J Med Sci 2015. [DOI: 10.4103/1011-4564.172999] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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