1
|
Lin X, Ou J, Wang Y, Wu Y, Yang L, Zhang M, Zhou C. Coping target checklist for home-based older adults living with disabilities and their spousal caregivers. Public Health Nurs 2024; 41:383-391. [PMID: 38311855 DOI: 10.1111/phn.13282] [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] [Received: 07/27/2023] [Revised: 12/21/2023] [Accepted: 01/11/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND The substantial rise in the population of older adults living with disabilities is a prominent concern, presenting a profound challenge for healthcare and social welfare systems. Community-based home care is seen as an effective approach to meet the care needs of older adults living with disabilities. OBJECTIVE To construct a coping target checklist for home-based older adults living with disabilities and their spousal caregivers. METHODS The initial draft was developed based on a comprehensive literature review, followed by two rounds of Delphi correspondence final version. RESULTS A comprehensive literature review resulted in the development of 7 modules, 20 topics. After round 1, 3 items were removed, 3 sections, 1 topic and 1 objective were new additions, 16 items were modified, split or combined. Four sections, 3 sections (Individual coping target for spousal caregivers, Individual coping target for older adults living with disabilities, and Shared coping target), 7 modules, 18 topics and 49 objectives were finally identified in round 2. The content of the list tool is derived from three perspectives: self-management strategies for older adults living with disabilities, caregiving strategies for spousal caregivers, and combined. CONCLUSIONS The coping target checklist was intended to be evidence-based and reflective of a practical direction for home-based older adults living with disabilities and their spousal caregivers living at home.
Collapse
Affiliation(s)
- Xiaolu Lin
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Jiexia Ou
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Yanfang Wang
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Yanni Wu
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Lingli Yang
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Mi Zhang
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| | - Chunlan Zhou
- Nursing Department, Nanfang Hospital, Southern Medical University, Guangdong, China
| |
Collapse
|
2
|
Zhao X, Zhang Q, Xu H, Li X, Lou VWQ, Liu H. Unmet needs and depression among spousal caregivers: the mediating role of marital satisfaction. Aging Ment Health 2023; 27:2027-2033. [PMID: 36995262 DOI: 10.1080/13607863.2023.2194851] [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: 10/25/2022] [Accepted: 03/15/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVES Previous research has identified that unmet needs are associated with adverse mental health outcomes in older adults. However, the unmet needs of older adults' spousal caregivers are unknown. The present study examined the association between unmet needs and depression among spousal caregivers, and whether marital satisfaction mediated this association. METHODS We included 1,856 participants who provided care to their spouses with difficulties in activities of daily living (ADL) and instrumental activities of daily living (IADL) from the 2018 China Health and Retirement Longitudinal Survey. Unmet needs of spousal caregivers were assessed as the total number of ADL/IADL tasks with which respondents had unmet needs. Path models were conducted to evaluate the associations between unmet needs, marital satisfaction, and depression. Subgroup analyses by sex were conducted to examine the sex differences regarding the associations. RESULTS Spousal caregivers with more unmet ADL/IADL needs reported higher levels of depression (p < 0.001). Additionally, for wife caregivers, unmet ADL/IADL needs were associated with lower marital satisfaction, and lower marital satisfaction was associated with higher degrees of depression, indicating that marital satisfaction partially mediated the association between unmet needs and depression (p < 0.01). However, marital satisfaction did not mediate the association between unmet needs and depression among husband caregivers. CONCLUSIONS The mediating effect of marital satisfaction on the association between unmet needs and depression only existed in wife caregivers. Social services should be provided to meet the needs of caregivers with ADL/IADL difficulties, and interventions should be implemented to promote the marital satisfaction of wife caregivers.
Collapse
Affiliation(s)
- Xinyi Zhao
- School of Health Humanities, Peking University, Beijing, China
| | - Quan Zhang
- National School of Development, Peking University, Beijing, China
| | - Honghong Xu
- School of Health Humanities, Peking University, Beijing, China
| | - Xinxuan Li
- School of Health Humanities, Peking University, Beijing, China
| | - Vivian W Q Lou
- Department of Social Work and Social Administration, Sau Po Centre on Ageing, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Huiying Liu
- Department of Sociology, Central South University, Changsha, China
| |
Collapse
|
3
|
Zhou J, Chen X, Wang Z, Li Q. Couple-Based Communication Interventions for Cancer Patient- Spousal Caregiver Dyads' Psychosocial Adaptation to Cancer: A Systematic Review. Healthcare (Basel) 2023; 11:healthcare11020236. [PMID: 36673604 PMCID: PMC9858755 DOI: 10.3390/healthcare11020236] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [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: 11/15/2022] [Revised: 01/07/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
(1) Background: Effective communication among couples in which one has been diagnosed with cancer is critical to improve their psychosocial adaptation to cancer. The objective of this review was to explore the characteristics and measurement outcomes of existing couple-based communication interventions in the cancer context. (2) Methods: Eight electronic databases were searched from database initiation to August 2022 to identify eligible articles. Hand searching was also performed on the included articles' reference lists and authors. (3) Results: A total of 14 intervention studies were eligible to be included in this review. Cancer couples with distress or communication problems before intervention were more likely to benefit from the couple-based communication interventions. Positive outcomes were reported, including an improvement in relationship functioning (including mutual communication, intimacy, and relationship satisfaction) and individual functioning (including a decline of anxiety, depression and cancer-related concerns, and an increase in psychological adjustment and quality of life). (4) Conclusions: These findings supported the importance of improving mutual communication behaviors to promote cancer patient-spousal caregiver dyads' psychosocial adaptation to cancer. While most included studies were conducted in western countries and the sample size was relatively small, more research is warranted to develop more efficacious couple-based communication interventions.
Collapse
|
4
|
Jeon SY, Kim JL. Caregiving for a Spouse with Cognitive Impairment: Effects on Nutrition and Other Lifestyle Factors. J Alzheimers Dis 2021; 84:995-1003. [PMID: 34602480 DOI: 10.3233/jad-210694] [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: 11/15/2022]
Abstract
BACKGROUND Being a spousal caregiver (SCG) for a patient with cognitive impairment is well known to be associated with increased risk for dementia and cognitive decline. OBJECTIVE This study examined the impact of the care recipient's cognitive status on lifestyle factors influencing cognitive decline in SCGs, focusing on nutritional status and blood biomarkers. METHODS Fifty-one SCGs participated (mean age 73.5±7.0 years) in this study. All participants underwent clinical assessment including the Mini Nutritional Assessment (MNA), Geriatric Depression Scale, Pittsburgh Sleep Quality Index, and International Physical Activity Questionnaire to evaluate lifestyle factors, and the Mini-Mental State Examination to assess global cognition. Also, nutritional blood biomarkers were measured. RESULTS SCGs caring for a demented spouse showed significantly higher depression scores (t = -3.608, p = 0.001) and malnutrition risk (t = 2.894, p = 0.006). Decreased care recipients' cognition was significantly correlated with higher GDS (β= -0.593, t = -4.471, p < 0.001) and higher MNA scores (β= 0.315, t = 2.225, p = 0.031) and lower level of high-density lipoprotein (HDL) cholesterol (β= 0.383, t = 2.613, p = 0.012) in their SCGs. Gender had moderating effects on association of care recipients' cognition with sleep quality (B[SE] = 0.400[0.189], p = 0.041) and HDL cholesterol (B[SE] = -1.137[0.500], p = 0.028) among SCGs. Poorer care-recipient cognition was associated with worse sleep quality and low HDL cholesterol among wives but not husband caregivers. CONCLUSION This study provides substantial evidence that SCGs are at risk for depression and malnutrition, which can further affect cognitive decline. As such, these factors should be well assessed and monitored among SCGs for patient with cognitive impairment.
Collapse
Affiliation(s)
- So Yeon Jeon
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jeong Lan Kim
- >Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea.,Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, Republic of Korea
| |
Collapse
|
5
|
Luo X, Li J, Cao Q, Sun L, Chen Y, Zhao J, Li Q. A feasibility study of an integrated couples-based supportive programme for Chinese couples living with colorectal cancer. Nurs Open 2021; 8:920-926. [PMID: 33570269 PMCID: PMC7877155 DOI: 10.1002/nop2.700] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/04/2020] [Indexed: 02/06/2023] Open
Abstract
AIM To test the feasibility, acceptability and preliminary efficacy of using an integrated approach combined online and in-person delivery to support colorectal cancer (CRC) patients and their spousal caregivers coping positively with cancer together. DESIGN A single-arm pre-post-feasibility design was used. METHODS Chinese CRC patient-partner dyads (N = 24) accessed the blended intervention combined online platform and face-to-face sessions for six weeks between October 2019 to January 2020. Feasibility was measured through recruitment and retention and acceptability was examined by intervention engagement and post-treatment programme evaluation. Effect sizes were calculated using the complete data (N = 20 couple dyads) to evaluate preliminary treatment effect. RESULTS Recruitment (70.6%) and retention rates (83.3%) supported programme feasibility. Participants' positive intervention engagements and evaluations indicated acceptability. The overall small-to-medium improvements in most outcome measures verified preliminary efficacy of the integrated couples-based supportive programme. The findings support its feasible and acceptable for couples coping with CRC and show potential efficacy.
Collapse
Affiliation(s)
| | - Jieyu Li
- Wuxi Medical SchoolJiangnan UniversityWuxiChina
| | - Qian Cao
- Wuxi Medical SchoolJiangnan UniversityWuxiChina
| | - Liya Sun
- Affiliated HospitalJiangnan UniversityWuxiChina
| | - Ying Chen
- Affiliated HospitalJiangnan UniversityWuxiChina
| | - Jie Zhao
- Affiliated HospitalJiangnan UniversityWuxiChina
| | - Qiuping Li
- Wuxi Medical SchoolJiangnan UniversityWuxiChina
| |
Collapse
|
6
|
Abstract
Objective: Spousal caregiving is increasingly common, and it is a role that can alter the nature of marriage in later life. Some may find spousal caregiving to be distressing, while others may have more positive experiences. Spousal caregiving, in particular, may be difficult due to caregiver burden as well as a loss of couplehood within the relationship. The current study used grounded theory methods to better understand the experience of and changes in couplehood among spousal caregivers.Method: Thirteen spousal caregivers completed semi-structured interviews. Spousal caregivers ranged in age from 53 to 85 (mean age = 66.00, SD = 9.04).Results: Qualitative analysis revealed four major themes upon evaluation of the interviews (couplehood, positive mindset, later life roles and transitions, and looking towards the future).Conclusion: These themes exemplified the complex interplay of couplehood and caregiving as well as the range of perceptions of couplehood. Results showed that while some caregivers struggle to find meaning and happiness within their caregiver role, and others said the illness/impairment bonded them together. Caregivers who reported a low sense couplehood discussed feeling trapped in their relationship, sad, and isolated. For some caregivers, a strong sense of couplehood may have helped them reframe the experience as an opportunity to be a role model for others and a reminder that their situation could be worse. Future research should focus on pre-illness couplehood and whether the nature of the impairment (e.g., cognitive, physical) is related to caregiver's couplehood.
Collapse
Affiliation(s)
- Elizabeth Gallagher
- Department of Gerontology, University of Massachusetts Boston, Boston, MA, USA
| | | |
Collapse
|
7
|
Miyawaki CE, Chen NW, Meyer OL, Tran MT, Markides KS. Vietnamese Adult-Child and Spousal Caregivers of Older Adults in Houston, Texas: Results from the Vietnamese Aging and Care Survey (VACS). J Gerontol Soc Work 2020; 63:5-18. [PMID: 31900089 PMCID: PMC9564481 DOI: 10.1080/01634372.2019.1707735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2019] [Revised: 12/17/2019] [Accepted: 12/18/2019] [Indexed: 06/01/2023]
Abstract
Vietnamese are the largest Asian ethnic group in Houston, Texas; however, research on this population is scarce. To address this dearth of knowledge, we developed the Vietnamese Aging and Care Survey. The objective of the study was to explore the sociodemographic and health characteristics of Vietnamese adults aged 65 years and older (n = 132) and their family caregivers (n = 64). Adult-child caregivers (n = 41) were aged between 21 and 65 years old. The majority were married, working, female, and in good to excellent health. Spousal caregivers (n = 23) were between 57 and 82 years old, retired, female, and in fair to good health. Adult children received more caregiving-related help from others compared to spousal caregivers; however, they felt more caregiver burden, had more perceived stress, and were in challenging relationships with care recipients. Differences in life stages of adult-child versus spousal caregivers may contribute to these results. Implications are discussed.
Collapse
Affiliation(s)
| | - Nai-Wei Chen
- Beaumont Health, Beaumont Research Institute, Royal Oak, Michigan, USA
| | - Oanh L. Meyer
- University of California, Davis, Sacramento, California, USA
| | - Mindy Thy Tran
- College of Natural Sciences and Mathematics, University of Houston, Houston, Texas, USA
| | | |
Collapse
|
8
|
Rahmani F, Ebrahimi H, Seyedfatemi N, Namdar Areshtanab H, Ranjbar F, Whitehead B. Trapped like a butterfly in a spider's web: Experiences of female spousal caregivers in the care of husbands with severe mental illness. J Clin Nurs 2018; 27:1507-1518. [PMID: 29396860 DOI: 10.1111/jocn.14286] [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] [Subscribe] [Scholar Register] [Accepted: 01/21/2018] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To explore the experiences of female spousal caregivers in the care of husbands with severe mental illness. BACKGROUND Family involvement in the care of patients with chronic illness is essential to provide a backbone of support for them. However, little is known about how female spousal caregivers are confronted with challenges while taking care of their husbands with severe mental illness. DESIGN An exploratory qualitative study. METHODS Fourteen female spousal caregivers of people with severe mental illness (defined here as schizophrenia, schizoaffective disorders and bipolar affective disorders) were recruited using purposive sampling and were interviewed using a semistructured in-depth interview method. Data were analysed by conventional content analysis until data saturation was achieved. RESULTS Care of a husband with severe mental illness had a disruptive influence on the emotional relationships of the family and resulted in emotional detachment over time. Despite the caregivers' struggle to protect their families, the lack of supportive resources caused emotional exhaustion. Caregiving tasks interfering with their many other responsibilities, along with being a reference for family matters, led to loss of self. Consequently, they experienced psychological distress because of the transition to a caregiver role without any supportive resources. CONCLUSION Constant caring, without supportive resources, forced them to do various roles and manage other issues within the family. Being unprepared for a caregiving role led to the psychological distress of female spousal caregivers. Therefore, adequate information, education and supportive resources must be provided for spouses to facilitate their transition to caregiving roles. RELEVANCE TO CLINICAL PRACTICE It is necessary to pay close attention to the spousal caregivers' own mental health problems while they care for their mentally ill husbands. Mental health professionals should adopt a new approach to the prioritisation and planning of policies that support both family caregivers and patients.
Collapse
Affiliation(s)
- Farnaz Rahmani
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Ebrahimi
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Naeimeh Seyedfatemi
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Namdar Areshtanab
- Department of Psychiatric Nursing, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Fatemeh Ranjbar
- Research Center of Psychiatry and Behavioral Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | | |
Collapse
|