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Wilson DM, Bykowski KA, Banamwana G, Bryenton FM, Dou Q, Errasti-Ibarrondo B. Intra-Family End-Of-Life Conflict: Findings of a Research Investigation to Identify Its Incidence, Cause, and Impact. Omega (Westport) 2022:302228221133504. [PMID: 36216497 DOI: 10.1177/00302228221133504] [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
With few investigations of intra-family end-of-life conflict, this study sought to identify its incidence, cause, and impacts. A questionnaire was completed by 102 hospice/palliative nurses, physicians, and other care providers in Alberta, a Canadian province. Participants reported on how often they had observed intra-family conflict when someone in the family was dying, and the impacts of that conflict. 12 survey participants were then interviewed about the intra-family conflict that they had encountered, with interviews focused on why conflict occurred and what the impacts (if any) were. Nearly 80% of families were thought to experience end-of-life conflict, periodically or continuously, among various family members. The interviews confirmed three reasons for intra-family end-of-life conflict and three conflict outcomes that were revealed in a recent literature review. The findings indicate routine assessments for intra-family end-of-life conflict are advisable. Attention should be paid to preventing or mitigating this conflict for the good of all.
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Affiliation(s)
- Donna M Wilson
- Faculty of Nursing, University of Alberta, Edmonton, AL, CA
| | | | | | | | - Qinqin Dou
- Faculty of Nursing, University of Alberta, Edmonton, AL, CA
| | - Begoña Errasti-Ibarrondo
- Faculty of Nursing, University of Navarra and IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
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Abstract
OBJECTIVES We examined associations among three measures of caregiver experiences (i.e., positive aspects of caring [PAC], caregiver burden, and mutuality) in 228 dyads involving persons with dementia (PWD) and their informal caregivers. The associations between predisposing, enabling, and need factors and each of these three measures of caregiver experiences were also examined. METHODS We used baseline data from a randomized controlled trial of a psychosocial intervention aimed at preventing aggression in PWD. Associations among PAC, caregiver burden, and mutuality were examined. The Behavioral Model of Health Services Utilization guided the selection of predisposing, enabling, and need components. RESULTS Enabling characteristics (e.g., race/ethnicity, caregiver education and employment and PWD education) and most predisposing characteristics (e.g., caregiver age, PWD age, relationship type) were not associated with any caregiving experience measures. Need characteristics (e.g., levels of memory and functional impairment, behavioral problems, depression, pleasant events) were associated with the caregiving experience. CONCLUSIONS Bivariate correlations between PAC, caregiver burden, and mutuality were between -0.20 and -0.58. Predisposing, enabling, and need factors were differentially associated with outcomes, with need characteristics being most frequently associated with various aspects of caregiving. CLINICAL IMPLICATIONS Assessment of both positive and negative aspects of caregiving is important. Particular attention to depression and interventions that improve depressive symptoms may increase PAC and mutuality and reduce caregiver burden.
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Affiliation(s)
- Srijana Shrestha
- Wheaton College, Norton, MA
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Sheila Richey
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
| | - Martha Lipovac-Dew
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - Mark E. Kunik
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
| | - Melinda A. Stanley
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX
| | - David Ramsey
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
| | - Amber B. Amspoker
- Department of Medicine, Baylor College of Medicine, Houston, TX; Michael E. DeBakey VA Medical Center
- Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX
- VA South Central Mental Illness Research, Education and Clinical Center (a virtual center)
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3
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Gérain P, Zech E. A Harmful Care: The Association of Informal Caregiver Burnout With Depression, Subjective Health, and Violence. J Interpers Violence 2022; 37:NP9738-NP9762. [PMID: 33399030 DOI: 10.1177/0886260520983259] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Providing informal care to a relative can lead to informal caregiver burnout, which is expected to lead to deleterious consequences. Among these consequences lie the risk of perpetrating violent behaviors against the care-recipient, the caregivers' risk of depression, and their low subjective health. To investigate these associations, a sample of 499 informal caregivers completed a questionnaire addressing informal caregiver burnout, depression, subjective health, and violence. Hierarchical regression models were used to investigate the potential association of burnout with these potential consequences, while controlling for sociodemographic variables and received violence. The results show that burnout, and especially emotional exhaustion, is significantly associated with depression, low subjective health, and perpetrated physical violence, but not with perpetrated psychological violence. For both psychological and physical violence, it appears that receiving violence is one of the best predictors of perpetrating violence. With these results, this cross-sectional study confirms the association of informal caregiver burnout with deleterious consequences-even if this observation must be pondered-and the central role of received violence in predicting perpetrated violence, suggesting the risk of violence escalation. The implications of these results suggest that the emotional state of informal caregivers is one of the indicators of potential deleterious consequences and should, as such, be considered as a warning signal by field workers.
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Affiliation(s)
- Pierre Gérain
- Fonds National pour la Recherche Scientifique, Brussels, Belgium
- UCLouvain, Louvain-la-Neuve, Belgium
| | - Emmanuelle Zech
- Fonds National pour la Recherche Scientifique, Brussels, Belgium
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4
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Barrios CL, Gornall V, Bustos-López C, Cirac R, Calvo P. Creation and Validation of a Tool for Evaluating Caregiver Burnout Syndrome in Owners of Dogs ( Canis lupus familiaris) Diagnosed with Behavior Disorders. Animals (Basel) 2022; 12:1185. [PMID: 35565611 PMCID: PMC9103032 DOI: 10.3390/ani12091185] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/26/2022] [Accepted: 04/27/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, domestic dogs (Canis lupus familiaris) are the most common species among companion animals. The close bond that can grow between owners and their dogs could be worn out and finally broken due to various causes. One main cause is canine behavioral problems, leading to dogs being abandoned or euthanized due to the costs faced by the owner when caring for the animal. Tools have been developed to evaluate the mental and emotional cost of caring for humans, but there is currently no validated tool for evaluating this particular problem. The objective of this study was to develop a questionnaire to evaluate caregiver burnout syndrome for owners of dogs with behavioral disorders. The methodology used consisted of drafting the tool, peer validation using the Delphi methodology and internal validation via Cronbach's alpha. Non-linear snowball sampling was used (n = 156 participants). A questionnaire with 35 questions was obtained which referred to various aspects of caregivers' lives. Regarding the description of the sample used, 50% had Low Burnout, 41% had Medium-Low Burnout and 9% had Medium-High Burnout. Furthermore, regarding the internal validation of the questionnaire, the general Cronbach's alpha coefficient was α = 0.9468. We can thus conclude that the questionnaire is valid for measuring caregiver burnout syndrome in owners of dogs with behavioral disorders.
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Affiliation(s)
- Carmen Luz Barrios
- Escuela de Medicina Veterinaria, Facultad de Ciencias, Ingeniería y Tecnología, Universidad Mayor, Camino La Pirámide 5750, Huechuraba 8580745, Región Metropolitana, Chile;
| | - Vanessa Gornall
- Escuela de Medicina Veterinaria, Facultad de Ciencias, Ingeniería y Tecnología, Universidad Mayor, Camino La Pirámide 5750, Huechuraba 8580745, Región Metropolitana, Chile;
| | - Carlos Bustos-López
- Departamento de Ciencias Básicas, Facultad de Ciencias, Universidad Santo Tomás, Av. Ejército Libertador 146, Santiago 8320000, Región Metropolitana, Chile;
| | - Rosa Cirac
- Investigador Independiente, Sant Andreu del Palomar, 08030 Barcelona, Spain;
| | - Paula Calvo
- Cátedra Animales y Sociedad, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, 28933 Madrid, Spain;
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O'Connor C, Dhonncha EN, Murphy M. "His first word was 'cream'." The burden of treatment in pediatric atopic dermatitis-A mixed methods study. Dermatol Ther 2021; 35:e15273. [PMID: 34914164 DOI: 10.1111/dth.15273] [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: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 11/30/2022]
Abstract
The burden of treatment (BOT) is the workload of health care experienced by patients with chronic conditions and consequences on well-being. This study aimed to assess the BOT of atopic dermatitis (AD) on children and caregivers using mixed methods. The quantitative component of this mixed methods study involved the Treatment Burden Questionnaire. The qualitative component involved interviews with parents of children with moderate-severe AD. The questionnaire was completed by 168 parents; 32.1% had mild AD, 39.9% had moderate AD, and 28% had severe AD. The average burden score was 3.5 (out of 10). Average burden scores were low in mild AD (1.0 out of 10) and were proportionally higher in moderate (3.9 out of 10) and severe (5.8 out of 10) AD (p < 0.001). Increased frequency of therapy had increased perceived burden. In moderate-severe AD, oral therapy was rated as less burdensome than topical therapies. Semi-structured interviews were conducted with 15 parents of children with moderate-severe AD. Thematic analysis grouped experiences into health care burden, treatment burden, and financial burden. Insights from health care burden analysis included "mixed messages," "treatment futility," and "expectant resolution." Insights from treatment burden included treatment routine, schooling impact, and "topical-sparing" with systemic treatment. Factors of financial burden included topical treatments, clothing, and health care visits. Moderate-severe AD is associated with high BOT, particularly related to topical therapies, which may be reduced by systemic treatment. All physicians treating children with AD should avoid potentially damaging communication regarding mixed messages, treatment futility, and expectant resolution.
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Affiliation(s)
- Cathal O'Connor
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland.,INFANT Research Centre, University College Cork, Cork, Ireland
| | - Eilis Nic Dhonncha
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland
| | - Michelle Murphy
- Department of Dermatology, South Infirmary Victoria University Hospital, Cork, Ireland.,Department of Medicine, University College Cork, Cork, Ireland
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Tam MT, Dosso JA, Robillard JM. The Impact of a Global Pandemic on People Living with Dementia and Their Care Partners: Analysis of 417 Lived Experience Reports. J Alzheimers Dis 2021; 80:865-875. [PMID: 33554905 PMCID: PMC8075406 DOI: 10.3233/jad-201114] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [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] [Indexed: 12/19/2022]
Abstract
Background: The COVID-19 pandemic is impacting the physical and emotional health of older adults living with dementia and their care partners. Objective: Using a patient-centered approach, we explored the experiences and needs of people living with dementia and their care partners during the COVID-19 pandemic as part of an ongoing evaluation of dementia support services in British Columbia, Canada. Methods: A survey instrument was developed around the priorities identified in the context of the COVID-19 and Dementia Task Force convened by the Alzheimer Society of Canada. Results: A total of 417 surveys were analyzed. Overall, respondents were able to access information that was helpful for maintaining their own health and managing a period of social distancing. Care partners reported a number of serious concerns, including the inability to visit the person that they care for in long-term or palliative care. Participants also reported that the pandemic increased their levels of stress overall and that they felt lonelier and more isolated than they did before the pandemic. The use of technology was reported as a way to connect socially with their loved ones, with the majority of participants connecting with others at least twice per week. Conclusion: Looking at the complex effects of a global pandemic through the experiences of people living with dementia and their care partners is vital to inform healthcare priorities to restore their quality of life and health and better prepare for the future.
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Affiliation(s)
- Mallorie T Tam
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's & Women's Hospital, Vancouver, BC, Canada
| | - Jill A Dosso
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's & Women's Hospital, Vancouver, BC, Canada
| | - Julie M Robillard
- Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's & Women's Hospital, Vancouver, BC, Canada
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7
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Newkirk LA, Dao VL, Jordan JT, Alving LI, Davies HD, Hewett L, Beaudreau SA, Schneider LD, Gould CE, Chick CF, Hirst RB, Rose SMSF, Anker LA, Tinklenberg JR, O'Hara R. Factors Associated with Supportive Care Service Use Among California Alzheimer's Disease Patients and Their Caregivers. J Alzheimers Dis 2021; 73:77-86. [PMID: 31743997 DOI: 10.3233/jad-190438] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 01/07/2023]
Abstract
BACKGROUND Existing literature on factors associated with supportive care service (SCS) use is limited. A better understanding of these factors could help tailor SCS to the needs of frequent users, as well as facilitate targeted outreach to populations that underutilize available services. OBJECTIVE To investigate the prevalence of SCS use and to identify factors associated with, and barriers to, service use. METHODS California Alzheimer's Disease Center patients with AD (n = 220) participated in the study from 2006-2009. Patients and their caregivers completed assessments to determine SCS use. Cognitive, functional, and behavioral status of the patients were also assessed. A two-part hurdle analysis identified 1) factors associated with any service use and 2) service use frequency among users. RESULTS Forty percent of participants reported using at least one SCS. Patients with more impaired cognition and activities of daily living and more of the following: total number of medications, comorbid medical conditions, and years of education were more likely to use any SCS (p < 0.05). Factors associated with more frequent SCS use included younger age, more years of education, older age of AD onset, female gender, and having a spouse or relative for a caregiver (p < 0.05). Caregivers frequently indicated insufficient time as a reason for not receiving enough services. CONCLUSION Factors associated with any SCS use mostly differed from those associated with SCS frequency, suggesting different characteristics between those who initiate versus those who continue SCS use. Our findings highlight the importance of targeted education on services and identifying barriers to long-term SCS use.
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Affiliation(s)
- Lori A Newkirk
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Virginia L Dao
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA
| | - Joshua T Jordan
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Loren I Alving
- California Alzheimer's Disease Center, University of California San Francisco at Fresno, Fresno, CA, USA
| | - Helen D Davies
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Linda Hewett
- California Alzheimer's Disease Center, University of California San Francisco at Fresno, Fresno, CA, USA
| | - Sherry A Beaudreau
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,School of Psychology, University of Queensland, Brisbane, Australia
| | - Logan D Schneider
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Christine E Gould
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Geriatric Research Education and Clinical Center, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Christina F Chick
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA
| | - Rayna B Hirst
- Pacific Graduate School of Psychology, Palo Alto University, Palo Alto, CA, USA
| | | | - Lauren A Anker
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jared R Tinklenberg
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Ruth O'Hara
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.,Sierra Pacific Mental Illness Research Education and Clinical Centers, Palo Alto, CA, USA.,Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
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8
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Ko Y, Park S. Life after hospital discharge for people with long-term mental disorders in South Korea: Focusing on the "revolving door phenomenon". Perspect Psychiatr Care 2021; 57:531-538. [PMID: 32643195 DOI: 10.1111/ppc.12575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 03/02/2020] [Revised: 06/24/2020] [Accepted: 06/28/2020] [Indexed: 11/29/2022] Open
Abstract
PURPOSE The purpose of this study was to explore the lives of Koreans with long-term mental disorders who had experienced multiple readmissions after hospital discharges. METHODS In-depth interviews were conducted with 11 participants and thematic analysis was used to examine their data. FINDINGS Four themes emerged from the data, describing their lives: they suffered in the aspects of social maladjustment, loneliness, causing shame to their families, and managing mental illnesses. PRACTICAL IMPLICATIONS After patients with mental disorders are discharged from the hospital, they need transitional care before systematic community-based care to enhance their autonomy and reduce the burden on their families.
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Affiliation(s)
- Yejung Ko
- Department of Nursing, Gwangju University, Gwangju, South Korea
| | - Sihyun Park
- Department of Nursing, Chung-Ang University, Seoul, South Korea
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9
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Levenberg K, George DR, Lokon E. Opening Minds through Art: A preliminary study evaluating the effects of a creative-expression program on persons living with dementia and their primary care partners. Dementia (London) 2021; 20:2412-2423. [PMID: 33635115 DOI: 10.1177/1471301221997290] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
For people living with dementia and their care partners, a decline in the ability to effectively communicate can cause significant distress. However, in recent decades, the arts have emerged as an effective care modality in fostering communication and expression for those with declining verbal skills and memory loss. Opening Minds through Art (OMA) is a national initiative that empowers people living with dementia by facilitating creative expression and social engagement through art-making in partnership with trained college student volunteers. Research has demonstrated that participation in the program benefits quality of life for those living with dementia and also improves student attitudes toward dementia. To date, however, no research has involved primary care partners. We implemented an OMA program at three residential care homes in State College, Pennsylvania, with residents cocreating artwork alongside primary care partners (i.e., a family member or primary medical personnel) over the course of four art-making sessions. We evaluated the effects of participation on quality of life and care partner burnout through pre-post use of "emotional thermometers" (measuring levels of distress, anxiety, depression, anger, and perceived quality of life), the National Institute of Health NIH emotional support scale, and the NIH caregiver assessment (care partner burnout). For people living with dementia, participation significantly increased perceived quality of life while decreasing distress, anxiety, depression, and anger (p < .01; n = 12) after each class; however, the intervention did not significantly impact perceived emotional support. For care partners, participation significantly lowered post-intervention measures of burnout and self-rated stress (p < .01; n = 9). This preliminary study suggests that a structured art-based activity appears to positively impact acute mood for patients and, importantly, decrease care partner burnout. Future research can bring more robust methods to bear in determining how to use OMA and other arts interventions to optimize social support for people living with dementia and their care partners.
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Affiliation(s)
- Kate Levenberg
- College of Medicine, 12310Penn State University College of Medicine, State College, Hershey, PA, USA
| | - Daniel R George
- Department of Humanities, 12310Penn State University College of Medicine, Hershey, PA, USA
| | - Elizabeth Lokon
- Scripps Gerontology Center, Miami University, Oxford, OH, USA
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10
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Peterson CM, Mikal JP, McCarron HR, Finlay JM, Mitchell LL, Gaugler JE. The Feasibility and Utility of a Personal Health Record for Persons With Dementia and Their Family Caregivers for Web-Based Care Coordination: Mixed Methods Study. JMIR Aging 2020; 3:e17769. [PMID: 32589158 PMCID: PMC7381256 DOI: 10.2196/17769] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 01/10/2020] [Revised: 03/05/2020] [Accepted: 05/01/2020] [Indexed: 01/18/2023] Open
Abstract
Background Managing the complex and long-term care needs of persons living with Alzheimer disease and related dementias (ADRD) can adversely impact the health of informal caregivers and their care recipients. Web-based personal health records (PHRs) are one way to potentially alleviate a caregiver’s burden by simplifying ADRD health care management Objective This study aimed to evaluate Personal Health Record for Persons with Dementia and Their Family Caregivers (PHR-ADRD), a free web-based information exchange tool, using a multiphase mixed methods approach. Methods Dementia caregivers (N=34) were surveyed for their well-being and perceptions of PHR-ADRD feasibility and utility at 6 and 12 months using close- and open-ended questions as well as a semistructured interview (n=8). Exploratory analyses compared participants’ characteristics as well as PHR-ADRD use and experiences based on overall favorability status. Results Feasibility and utility scores decreased over time, but a subset of participants indicated that the system was helpful. Quantitative comparisons could not explain why some participants indicated favorable, neutral, or unfavorable views of the system overall or had not engaged with PHR-ADRD. Qualitative findings suggested that technology literacy and primary care provider buy-in were barriers. Both qualitative and qualitative findings indicated that time constraints to learn and use the system affected most participants. Conclusions Development and dissemination of PHRs for family caregivers of persons with ADRD should aim to make systems user-friendly for persons with limited time and technological literacy. Establishing health care provider buy-in may be essential to the future success of any PHR system.
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Affiliation(s)
- Colleen M Peterson
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jude P Mikal
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Hayley R McCarron
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Jessica M Finlay
- Institute for Social Research, University of Michigan, Ann Arbor, MI, United States
| | - Lauren L Mitchell
- Center for Care Delivery & Outcomes Research, Minneapolis VA Health Care System & University of Minnesota, Minneapolis, MN, United States
| | - Joseph E Gaugler
- Division of Health Policy & Management, School of Public Health, University of Minnesota, Minneapolis, MN, United States
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11
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Staloff J, Diop M, Matuk R, Riese A, White J. Caring for Caregivers: Burnout and Resources for Caregivers in Rhode Island. R I Med J (2013) 2018; 101:10-11. [PMID: 30384512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Jonathan Staloff
- Population Medicine Candidate, Warren Alpert Medical School of Brown University
| | - Michelle Diop
- Population Medicine Candidate, Warren Alpert Medical School of Brown University
| | - Rani Matuk
- Population Medicine Candidate, Warren Alpert Medical School of Brown University
| | - Alison Riese
- Assistant Professor of Pediatrics at The Warren Alpert Medical School of Brown University
| | - Jordan White
- Assistant Dean for Student Affairs and Assistant Professor of Family Medicine at The Warren Alpert Medical School of Brown University
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Abstract
OBJECTIVES Agitation in nursing home residents with dementia leads to increase in psychotropic medication, decrease in quality of life, and to patient distress and caregiver burden. Music therapy has previously been found effective in treatment of agitation in dementia care but studies have been methodologically insufficient. The aim of this study was to examine the effect of individual music therapy on agitation in persons with moderate/severe dementia living in nursing homes, and to explore its effect on psychotropic medication and quality of life. METHOD In a crossover trial, 42 participants with dementia were randomized to a sequence of six weeks of individual music therapy and six weeks of standard care. Outcome measures included agitation, quality of life and medication. RESULTS Agitation disruptiveness increased during standard care and decreased during music therapy. The difference at -6.77 (95% CI (confidence interval): -12.71, -0.83) was significant (p = 0.027), with a medium effect size (0.50). The prescription of psychotropic medication increased significantly more often during standard care than during music therapy (p = 0.02). CONCLUSION This study shows that six weeks of music therapy reduces agitation disruptiveness and prevents medication increases in people with dementia. The positive trends in relation to agitation frequency and quality of life call for further research with a larger sample.
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Affiliation(s)
- Hanne Mette O Ridder
- Doctoral Programme in Music Therapy, Department of Communication & Psychology, Aalborg University, Aalborg Øst, Denmark.
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