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Silaule O, Adams F, Nkosi NG. Health effects of caregiving and coping with severe mental disorders: A caregivers' experience. S Afr J Psychiatr 2024; 30:2144. [PMID: 38628903 PMCID: PMC11019034 DOI: 10.4102/sajpsychiatry.v30i0.2144] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 01/24/2024] [Indexed: 04/19/2024] Open
Abstract
Background Informal caregivers are an essential health resource in the care of persons with severe mental disorders, particularly in South Africa where access to mental healthcare services is limited. Aim The study aimed to explore and describe the coping strategies used by informal caregivers and the specific health impacts they face in the context of severe mental disorders in South Africa. Setting The study was conducted in Bushbuckridge municipality situated in the northeastern parts of Mpumalanga province, South Africa. Methods A descriptive qualitative methodology was used to conduct semi-structured interviews with 12 purposefully selected participants. Audio-recorded interviews were translated, transcribed and analysed inductively on NVivo12 using reflexive thematic analysis. Results The themes identified were caregivers' experience of consequences of caregiving and caregivers' experience of coping with their caregiving role. Participants experienced negative consequences on their emotional, mental and physical health. The participants use internal and external resources to cope with the challenges they face, and many highlighted using emotion-focused coping strategies. Conclusion The findings revealed an urgent need to develop support strategies to strengthen informal caregivers' coping and promote good health particularly in rural South Africa where informal caregivers play a crucial role in the management of severe mental disorders. Contribution The finding demands that policymakers and healthcare providers prioritise the health and well-being of the informal caregivers. There should be policies targeted specifically at developing and implementing caregiver-orientated healthcare services.
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Affiliation(s)
- Olindah Silaule
- Department of Occupational Therapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Fasloen Adams
- Division of Occupational Therapy, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Nokuthula G. Nkosi
- Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Roberto KA, McCann BR, Savla J, Blieszner R. Family Caregivers' Management of Behavioral Expressions of Dementia. Gerontologist 2024:gnae020. [PMID: 38408276 DOI: 10.1093/geront/gnae020] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Indexed: 02/28/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Behavioral expressions of dementia are often stressful for family caregivers to manage as they strive to ensure their relative's needs are met. Guided by Lazarus and Folkman's Transactional Model of Stress and Coping, we identified specific behaviors that disrupt daily routines and challenge the achievement of caregiving goals, and the approaches and strategies caregivers employ to address them. RESEARCH DESIGN AND METHODS We conducted semi-structured interviews with 30 family caregivers in rural Appalachia caring for a relative living with dementia. Analysis involved use of open and focused coding processes to identify the ways caregivers managed behaviors and bar graphs to examine management approaches relative to categories of behaviors and caregiver demographic and emotional well-being variables. RESULTS Analyses revealed 10 types of behavioral expressions of dementia associated with confusion, irritability, and resistance to engaging in necessary activities of daily living. Caregiver approaches to managing behaviors included gentle persuasion, being harsh by yelling or threatening, being persistent in expecting the person with dementia to complete the tasks at hand, disengaging by postponing the activity, and employing a combination of strategies. Approaches differed across types of behavior and caregiver demographics and had varying effects on caregiver well-being. DISCUSSION AND IMPLICATIONS Uncovering specific behaviors family caregivers of persons living with dementia found bothersome, caregivers' adaptive strategies for managing behaviors, and the impact of those approaches provides new information to inform training on effective dementia caregiving practices and development of targeted intervention programs for dementia care.
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Affiliation(s)
- Karen A Roberto
- Center for Gerontology and Institute for Society, Culture and Environment, Virginia Tech, Blacksburg, VA, USA
| | | | - Jyoti Savla
- Center for Gerontology and Department of Human Development and Family Science, Virginia Tech, Blacksburg, VA, USA
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Schlebusch L, Chambers N, Rosenstein D, Erasmus P, de Vries PJ. Supporting caregivers of children with developmental disabilities: Findings from a brief caregiver well-being programme in South Africa. Autism 2024; 28:199-214. [PMID: 36352758 DOI: 10.1177/13623613221133182] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
LAY ABSTRACT Young children with developmental disabilities and delays who live in low- and middle-income countries are at significant risk of not reaching their full potential. We know that daily interactions with their caregivers (parents or other people taking care of them) play an important role in promoting their development. However, having a child with developmental disabilities can have a negative impact on carers' mental health and well-being, which in turn can influence their capacity to care for their children. To date, very little attention has been given to the caregivers' capacity to care. The World Health Organization developed a Caregiver Skills Training programme which includes a brief, three-session module that focuses on improving caregivers' well-being and mental health. This well-being programme is based on acceptance and commitment therapy. Acceptance and commitment therapy shows increasing evidence of helping people respond to their stressors, thoughts, feelings and experiences a little differently and commit to small changes that are in line with their personal values. Acceptance and commitment therapy has shown promise in improving feelings of well-being in caregivers of children with developmental disabilities. We adapted the World Health Organization Caregiver Skills Training Caregiver well-being module to suit the South African context. The resultant 'Well Beans for Caregivers' was then delivered to caregivers from a rural, low-resource setting in South Africa. We found the intervention easy to implement, highly acceptable to caregivers and showed promising impacts on caregivers' well-being and mental health. This intervention has the potential to be implemented widely and sustainably to build caregivers' capacity to care for their children.
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Mao W, Qi X, Chi I, Wichinsky L, Wu B. Technology-Based Interventions to Address Social Isolation and Loneliness Among Informal Dementia Caregivers: A Scoping Review. J Am Med Dir Assoc 2023; 24:1700-1707. [PMID: 37678415 DOI: 10.1016/j.jamda.2023.08.005] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 09/09/2023]
Abstract
OBJECTIVE Social isolation and loneliness are major public health concerns. Informal dementia caregivers are particularly vulnerable, as many are older adults themselves and at elevated risk of adverse mental and physical health outcomes. Technology-based interventions could offer accessible, affordable, and convenient solutions. A previous review included Internet-based supportive interventions for informal dementia caregivers published up to 2013; however, new publications, technological advances, and targeted outcomes justify conducting this scoping review. Here, we identified and synthesized recent technology-based interventions that addressed social isolation and loneliness among informal dementia caregivers. DESIGN Scoping review. SETTING AND PARTICIPANTS Informal dementia caregivers in the community. METHODS Following Arksey and O'Malley's scoping review framework, we conducted a systematic search of peer-reviewed studies across 6 databases within the last 11 years, including identifying research questions, selecting relevant studies, charting data, and summarizing results. RESULTS From the 2937 articles identified, 10 eligible studies were included in this review. The intervention type, format, and duration varied widely. Three categories of interventions to address social isolation and loneliness among informal dementia caregivers included technology-assisted peer support, newly developed Web-based multicomponent psychoeducational programs and platforms, and virtual adaptation and modification of existing programs. Predominantly qualitative evidence suggests that technology-based interventions have the potential to reduce feelings of loneliness and improve caregiver well-being. Quantitative evidence tends to be preliminary and inconclusive. CONCLUSIONS AND IMPLICATIONS The findings offer preliminary evidence for technology-based interventions to reduce or prevent social isolation and loneliness in informal dementia caregivers. Technology-based interventions addressing social isolation and loneliness in informal dementia caregivers have the potential to overcome barriers to low uptake of services and withdrawal from interventions and improve the sustainability of the interventions. In the long run, by reducing or preventing social isolation and loneliness in informal dementia caregivers, the transition from home care to facility-based care might be delayed.
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Affiliation(s)
- Weiyu Mao
- School of Social Work, University of Nevada, Reno, Reno, NV, USA.
| | - Xiang Qi
- Rory Meyers College of Nursing, New York University, New York, NY, USA
| | - Iris Chi
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | | | - Bei Wu
- Rory Meyers College of Nursing, New York University, New York, NY, USA
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Sheikh S, Wimberly CE, Towry L, Walsh KM. Beyond Anxiety and Grief: Mapping the Emotional Landscape of Parents Facing a Childhood Cancer Diagnosis. medRxiv 2023:2023.05.24.23290421. [PMID: 37292771 PMCID: PMC10246129 DOI: 10.1101/2023.05.24.23290421] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Objective We sought to explore the variation in emotional responses and identify clusters of emotional patterns associated with sociodemographic, clinical, and familial factors. Methods A large-scale survey with questions on demographics, experiences, and emotions at the time of diagnosis was sent to childhood cancer caregivers and completed between August 2012 and April 2019. Dimensionality reduction and statistical tests for independence were used to investigate relationships between sociodemographic, clinical, and psychosocial factors and 32 representative emotions. Results Data from 3142 respondents were analyzed. Through principal components analysis and t-distributed stochastic neighbor embedding analysis, three clusters of emotional responses were identified, captured 44%, 20% and 36% of respondents, respectively. Hallmark emotions within each cluster were "anger and grief" (Cluster 1), "pessimism, relief, impatience, insecurity, discouragement, and calm" (Cluster 2), and "hope" (Cluster 3). Cluster membership was associated with differences in parental factors, such as educational attainment, family income, and biological parent status, as well as child-specific factors, including age at diagnosis and cancer type. Conclusions The study revealed substantial heterogeneity in emotional responses to a child's cancer diagnosis than previously recognized, with differences linked to both caregiver and child-related factors. These findings underscore the importance of developing responsive and effective programs to improve targeted support for caregivers from the time of diagnosis throughout a family's childhood cancer journey.
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Affiliation(s)
- Shanzeh Sheikh
- Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
| | - Courtney E. Wimberly
- Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
| | - Lisa Towry
- Alex’s Lemonade Stand Foundation, Bala Cynwyd, PA, USA
| | - Kyle M. Walsh
- Department of Neurosurgery and Preston Robert Tisch Brain Tumor Center, Duke University School of Medicine, Durham, NC, USA
- Duke Cancer Institute, Duke University School of Medicine, Durham, NC, USA
- Children’s Health and Discovery Institute, Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA
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Yu JA, Bayer ND, Beach SR, Kuo DZ, Houtrow AJ. A National Profile of Families and Caregivers of Children With Disabilities and/or Medical Complexity. Acad Pediatr 2022; 22:1489-1498. [PMID: 36002069 DOI: 10.1016/j.acap.2022.08.004] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/10/2022] [Accepted: 08/13/2022] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Provide an up-to-date description of the well-being of families and caregivers of children with disability and medical complexity at the national level. METHODS We performed a secondary analysis of the 2016-2019 National Survey of Children's Health and divided the sample based on a child's disability and medical complexity status: children with no special health care needs (non-CSHCN), children with special health care needs (CSHCN), CSHCN with significant disabilities (CSHCN-SD), and children with medical complexity (CMC). Outcomes included survey items assessing 1) caregiver emotional well-being, 2) family functioning, and 3) economic adversity. We conducted multivariable logistic regression analyses to examine associations between child disability and medical complexity status with study outcomes. RESULTS Among 131,774 survey responses, CSHCN-SD (weighted n = 4.2 million) and CMC (n =1.1 million) disproportionately reported adverse outcomes for every measure of well-being. Notably, caregivers of CSHCN-SD and CMC were more likely to report frequently feeling bothered (aOR 5.0 and 6.3, respectively) and angry (aOR 3.0 and 3.1) with their child than non-CSHCN caregivers. Families of CSHCN-SD and CMC had 40% lower odds of endorsing all aspects of family resilience and more likely to report three or more adverse childhood experiences (aOR 3.3 and 3.7) than non-CSHCN families. CSHCN-SD and CMC families were also more likely to experience difficulty covering basics (aOR, 2.6 and 3.3) and report caregivers changing jobs due to their child's care (aOR, 3.1 and 5.0). CONCLUSIONS Development and testing of interventions specifically targeting the well-being of CSHCN-SD and CMC families and caregivers is needed.
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Affiliation(s)
- Justin A Yu
- Department of Pediatrics, Divisions of Palliative Care and Pediatric Hospital Medicine (JA Yu), University of Pittsburgh School of Medicine and UPMC Children's Hospital, Pittsburgh, Pa.
| | - Nathaniel D Bayer
- Department of Pediatrics, Division of Pediatric Hospital Medicine (ND Bayer), University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY
| | - Scott R Beach
- University Center for Social and Urban Research (SR Beach), University of Pittsburgh, Pittsburgh, Pa
| | - Dennis Z Kuo
- Department of Pediatrics, Division of Developmental and Behavioral Pediatrics (DZ Kuo), University of Rochester Medical Center and Golisano Children's Hospital, Rochester, NY
| | - Amy J Houtrow
- Division of Pediatric Rehabilitation Medicine, Department of Physical Medicine & Rehabilitation (AJ Houtrow), University of Pittsburgh School of Medicine, Pittsburgh, Pa
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Koumoutzis A, Mehri N. The Impact of Caregiving Intensity and Religiosity on Spousal Caregivers' Health and Mortality in the US (2004-2014). J Aging Health 2022; 34:640-652. [PMID: 35112885 DOI: 10.1177/08982643211052725] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Despite adverse physical and mental health outcomes related to caregiving, family caregivers also experience lower mortality rates compared to noncaregivers. However, research has not yet examined the role of caregiving intensity and religiosity with health and mortality among spousal caregivers. METHODS Data include spousal caregivers (n=5,214 person-wave observations) and noncaregivers (n=50,311 person-wave observations) from the Health and Retirement Study (2004-2014 waves). Multinomial logistic regression was used to explore how caregiving intensity and religiosity were associated with health and mortality among spousal caregivers, compared health and mortality between caregivers and noncaregiving peers, and examined gender differences in these mechanisms. RESULTS Greater religious salience and attending religious services, although dependent on gender and caregiving intensity, are protective for caregivers' health and mortality. DISCUSSION Religiosity may buffer adverse effects of caregiving on health and mortality for spousal caregivers. Continuation of prior religiosity may enhance positive aspects of caregiving and decrease caregiver burden.
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Broome B, Madisetti M, Prentice M, Williams KW, Kelechi T. Food Allergy Symptom Self-Management With Technology (FASST) mHealth Intervention to Address Psychosocial Outcomes in Caregivers of Children With Newly Diagnosed Food Allergy: Protocol for a Pilot Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e25805. [PMID: 33656448 PMCID: PMC7970224 DOI: 10.2196/25805] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 01/05/2021] [Accepted: 01/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background Approximately 2.4 million children in the United States suffer from food-induced anaphylaxis, a condition that is annually responsible for over 200 deaths and 200,000 emergency room visits. As a result, caregivers of children newly diagnosed with severe and life-threatening food allergic reactions experience clinically significant symptoms of psychological distress, including fatigue, anxiety, depressed mood, social isolation, and substantially reduced quality of life. Despite this recognition, there is a lack of caregiver-centered self-management interventions to address these concerns. Objective In this protocol, we propose to develop and conduct feasibility testing of a technology-enhanced, self-management, mobile health, smartphone app intervention called Food Allergy Symptom Self-Management with Technology for Caregivers (FASST) designed to meet the psychosocial health needs of caregivers of children with a new diagnosis of food allergy. Methods This pilot study uses qualitative work (Phase I) to inform a 4-week longitudinal randomized controlled trial (Phase II). In Phase I, 10 caregivers of children (≤18 years old) with established food allergy (≥1 year from diagnosis) will participate in semistructured interviews to inform the development of the FASST app. In Phase II, 30 caregivers of children (≤18 years old) with a newly diagnosed food allergy (≤90 days from diagnosis) will be randomized 2:1 to receive the FASST intervention (n=20) or control condition (basic app with educational resources; n=10). Process measures include feasibility, caregiver acceptability, adherence, and satisfaction. Outcome measures include caregiver fatigue, anxiety, depression, sleep, self-efficacy, and quality of life measured at baseline, week 4, and 3 months post study completion. Results Phase I study activities have been completed, and Phase II participant enrollment into the randomized controlled trial is expected to commence in 2021. Conclusions With limited readily available resources at their disposal, the results from this study have the potential to provide caregivers of children with a newly diagnosed food allergy a tool to help them self-manage and mitigate negative psychosocial factors during a critical time period in the caregiving/condition trajectory. Trial Registration ClinicalTrials.gov Identifier NCT04512924: https://clinicaltrials.gov/ct2/show/NCT04512924 International Registered Report Identifier (IRRID) DERR1-10.2196/25805
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Affiliation(s)
- Brantlee Broome
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Mohan Madisetti
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Margaret Prentice
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Kelli Wong Williams
- College of Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Teresa Kelechi
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
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Abstract
OBJECTIVES Compare care demands, strain, and health across 912 primary and secondary caregivers of parents, other family, and friends aged 50 and older. METHODS Data came from the nationally representative Caregiving in the U.S. 2015 data set. Two by three factorial ANOVAs and binary logistic regression examined the effects of primary caregiver status and relationship type on care demands and well-being. RESULTS Primary caregivers provided more hours of care for a longer duration and were more likely to report financial stress, and that caregiving made their health worse. Primary caregivers did not differ from secondary caregivers in emotional stress, and physical strain was comparable in primary and secondary caregivers of parents and other family. Caregivers of parents generally reported the highest levels of demands and stress/strain. Controlling for amount of care provided attenuated some of these differences. CONCLUSIONS Secondary caregivers provide less care but report emotional stress comparable to primary caregivers. Primary caregivers of friends provide high levels of assistance that may increase their physical strain. CLINICAL IMPLICATIONS Caregiver research and intervention should include greater attention to needs of secondary caregivers, and caregivers of friends, and ways to strengthen their potentially critical roles.
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Affiliation(s)
- Victoria R Marino
- School of Aging Studies, University of South Florida , Tampa, Florida, USA
| | - Adrian N S Badana
- Graduate Medical Education, Wellstar Atlanta Medical Center , Atlanta, Georgia, USA
| | - Wiliam E Haley
- School of Aging Studies, University of South Florida , Tampa, Florida, USA
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Smith VA, Lindquist J, Miller KEM, Shepherd-Banigan M, Olsen M, Campbell-Kotler M, Henius J, Kabat M, Van Houtven CH. Comprehensive Family Caregiver Support and Caregiver Well-Being: Preliminary Evidence From a Pre-post-survey Study With a Non-equivalent Control Group. Front Public Health 2019; 7:122. [PMID: 31179259 PMCID: PMC6538764 DOI: 10.3389/fpubh.2019.00122] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 04/30/2019] [Indexed: 11/13/2022] Open
Abstract
Introduction: In May 2010, the Caregivers and Veterans Omnibus Health Services Act of 2010, was signed into law in the United States, establishing the Program of Comprehensive Assistance for Family Caregivers (PCAFC) provided through the VA Caregiver Support Program (CSP). Prior to this program, over half of family caregivers reported being untrained for the tasks they needed to provide. The training through PCAFC represents the largest effort to train family caregivers in the U.S., and the features of the program, specifically a monthly stipend to caregivers and access to a Caregiver Support Coordinator at each VA medical center nationally, make it the most comprehensive caregiver support program ever enacted in the U.S. Methods: The purpose of this study is to examine the association between PCAFC participation and caregiver well-being following enrollment, comparing participating PCAFC caregivers to caregivers who applied to but were not approved for PCAFC participation (non-participants). Well-being is defined using three diverse but related outcomes: depressive symptoms, perceived financial strain, and perceived quality of the Veteran's health care. Additional well-being measures also examined include the Zarit Burden Inventory and positive aspects of caregiving. Results: The survey sample comprised of 92 caregivers approved for PCAFC and 66 caregivers not approved. The mean age of responding caregivers was 45; over 90% of caregivers were female; and over 80% of caregivers were married in both groups. We find promising trends in well-being associated with PCAFC participation. First, the perception of financial strain declined among participants compared to non-participants. Second, while depressive symptoms did not improve for the PCAFC caregivers, depressive symptoms increased among non-participants. Third, perceived quality of the Veteran's VA healthcare was no different between participants and non-participants. However, the 158 returned surveys reflect only a 5% response rate; hence this evidence is preliminary. Conclusion: Despite cautioning that results be interpreted as preliminary, this study provides unique descriptive information about young caregivers of U.S. post-9/11 Veterans, and offers a first step in filling the evidence gap about how comprehensive caregiver support in the U.S. may affect caregiver well-being. These preliminary findings should be explored and validated in a larger sample.
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Affiliation(s)
- Valerie A Smith
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States.,Division of General Internal Medicine, Department of Medicine, Duke University, Durham, NC, United States
| | - Jennifer Lindquist
- Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States
| | - Katherine E M Miller
- Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States.,Health Policy and Management, University of North Carolina, Chapel Hill, NC, United States
| | - Megan Shepherd-Banigan
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States
| | - Maren Olsen
- Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States.,Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States
| | - Margaret Campbell-Kotler
- Caregiver Support Program, United States Department of Veterans Affairs, Seattle, WA, United States
| | - Jennifer Henius
- Caregiver Support Program, United States Department of Veterans Affairs, Seattle, WA, United States
| | - Margaret Kabat
- Caregiver Support Program, United States Department of Veterans Affairs, Seattle, WA, United States
| | - Courtney Harold Van Houtven
- Department of Population Health Sciences, Duke University, Durham, NC, United States.,Health Services Research and Development, Durham VA Health Care System, Durham, NC, United States
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Augustinavicius JL, Familiar-Lopez I, Winch PJ, Murray SM, Ojuka C, Boivin MJ, Bass JK. Parenting self-efficacy in the context of poverty and HIV in Eastern Uganda: A qualitative study. Infant Ment Health J 2019; 40:422-438. [PMID: 30919471 PMCID: PMC9827514 DOI: 10.1002/imhj.21774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
We sought to understand social representations of effective parenting and parenting self-efficacy among female HIV-affected caregivers in rural Eastern Uganda. We conducted in-depth interviews (n = 21) to describe parenting experiences and caregivers' perceptions of their own parenting abilities and to create vignettes for use in directed focus groups. We carried out open focus groups (n = 2) to gain social perspectives on parenting, and directed focus groups (n = 2) concentrated on parenting self-efficacy. Analysis involved memoing and inductive and deductive coding of transcripts. Caregivers' perceptions of their own parenting were grounded in parenting values such as providing children with basic needs, having well-behaved children, and having good relationships with children. Caregivers' perceptions were influenced by challenges, including single parenthood, living with HIV, limited family resources, and mental health problems. When facing challenges, caregivers relied on social support and faith as well as their own parenting confidence. Caregivers' perceptions of their parenting abilities were influenced by how they felt others perceived them, their satisfaction in the parenting role, their perseverance despite challenges, and the extent to which they had a vision for their family. Our findings contextualize parenting self-efficacy within parenting values, challenges, and social perceptions among HIV-affected caregivers in rural Uganda.
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Affiliation(s)
- Jura L. Augustinavicius
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Peter J. Winch
- Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Sarah M. Murray
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Michael J. Boivin
- Departments of Psychiatry and Neurology and Ophthalmology, Michigan State University, East Lansing, Michigan
| | - Judith K. Bass
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
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12
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Eom K, Penkunas MJ, Chan AWM. Effect of caregiving relationship and formal long-term care service use on caregiver well-being. Geriatr Gerontol Int 2017; 17:1714-1721. [PMID: 28276179 DOI: 10.1111/ggi.12958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2016] [Revised: 07/13/2016] [Accepted: 09/20/2016] [Indexed: 11/29/2022]
Abstract
AIM Despite efforts to revise the traditional long-term care (LTC) model, informal caregivers continue to provide a substantial amount of support to older adults as front-line care providers. The present study aimed to understand the effect of informal caregiving on caregivers' well-being in Singapore with respect to different types of patient-caregiver relationships. Second, this study examined the association between formal LTC service use and caregivers' well-being. METHODS Two waves of data for 781 dyads of patients with LTC needs and their caregivers from a longitudinal study were analyzed. Multilevel regression models were used to examine the association between caregivers' well-being (self-rated general health, stress level and quality of life) and LTC service use among different patient-caregiver relationships. RESULTS Spousal caregivers reported significantly lower quality of life compared with adult children caregivers. Non-immediate family caregivers showed better overall well-being compared with spouse and adult children caregivers. Caregivers of patients referred to nursing homes reported higher levels of stress and poorer self-rated general health compared with caregivers of patients referred to community-based services. Spouse and non-immediate family caregivers of patients who utilized nursing home or home-based services presented poorer self-rated general health than caregivers of the patients who did not use any formal services. CONCLUSIONS Developing a better understanding of the associations between well-being and formal LTC service use for different types of patient-caregiver relationships is critical for policy makers and healthcare providers who aim to create holistic systems of care. Geriatr Gerontol Int 2017; 17: 1714-1721.
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Affiliation(s)
- Kirsten Eom
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore
| | - Michael J Penkunas
- Center for Aging Research and Education, Duke-NUS Medical School, Singapore
| | - Angelique W M Chan
- Program in Health Services and Systems Research, Duke-NUS Medical School, Singapore.,Center for Aging Research and Education, Duke-NUS Medical School, Singapore.,Department of Sociology, National University of Singapore, Singapore
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Grant JS, Clay OJ, Keltner NL, Haley WE, Wadley VG, Perkins MM, Roth DL. Does caregiver well-being predict stroke survivor depressive symptoms? A mediation analysis. Top Stroke Rehabil 2013; 20:44-51. [PMID: 23340070 PMCID: PMC3824614 DOI: 10.1310/tsr2001-44] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND AND PURPOSE Studies suggest that family caregiver well-being (ie, depressive symptoms and life satisfaction) may affect stroke survivor depressive symptoms. We used mediation analysis to assess whether caregiver well-being might be a factor explaining stroke survivor depressive symptoms, after controlling for demographic factors and stroke survivor impairments and problems. METHODS Caregiver/stroke participant dyads (N = 146) completed measures of stroke survivor impairments and problems and depressive symptoms and caregiver depressive symptoms and life satisfaction. Mediation analysis was used to examine whether caregiver well-being mediated the relationship between stroke survivor impairments and problems and stroke survivor depressive symptoms. RESULTS As expected, more stroke survivor problems and impairments were associated with higher levels of stroke survivor depressive symptoms (P < .0001). After controlling for demographic factors, we found that this relationship was partially mediated by caregiver life satisfaction (29.29%) and caregiver depressive symptoms (32.95%). Although these measures combined to account for 40.50% of the relationship between survivor problems and impairments and depressive symptoms, the direct effect remained significant. CONCLUSIONS Findings indicate that stroke survivor impairments and problems may affect family caregivers and stroke survivors and a high level of caregiver distress may result in poorer outcomes for stroke survivors. Results highlight the likely importance of intervening with both stroke survivors and family caregivers to optimize recovery after stroke.
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Abstract
This study examines the degree to which caregiver social connectedness influences the effects of strain associated with caring for a child with severe emotional disturbance (SED) on caregiver well-being. We propose a model describing the relationships among the variables of interest and investigate elements of this model. Caregiver strain and social connections were significantly associated with caregiver well-being. Although, no significant interaction effects of caregiver strain and social connections were detected, study findings suggest that caregiver well-being can affect child progress and adjustment. Implications for child- and family-serving systems are considered.
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Affiliation(s)
- Eylin Palamaro Munsell
- University of North Carolina at Charlotte, 9201 University City Blvd., Charlotte, NC 28205, USA.
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