A Clinical Bridge between Family Caregivers and Older Adults: The Contribution of Patients' Frailty and Optimism on Caregiver Burden.
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ABSTRACT:
SUBMITTER: Sardella A
PROVIDER: S-EPMC8037634 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundMany older adults receive help from both family caregivers and home care workers. We aimed to understand family caregivers' perspectives on home care workers.MethodsThis qualitative study took place at an academic medical center in New York, N.Y. We interviewed family caregivers of community-dwelling older adults about their experiences with home care workers. We analyzed transcripts thematically.ResultsWe interviewed 17 family caregivers and identified four major themes: (a) home care workers provide functional and emotional support; (b) home care is logistically challenging; (c) finding the right fit between home care workers, older adults, and families is essential; and (d) home care workers and family caregivers coordinate care well beyond the initiation of home care.ConclusionDespite its logistical challenges, home care benefits patients and family caregivers. Given the growing prevalence of caregiving, clinicians and family caregivers might benefit from training and support about working with home care workers.
| S-EPMC7990746 | biostudies-literature
Project description:BackgroundCoping strategies play a key role in modulating the physical and psychological burden on caregivers of stroke patients. The present study aimed to determine the relationship between the severity of burden of care and coping strategies amongst a sample of Iranian caregivers of older stroke patients. It also aimed to examine the differences of coping strategies used by male and female caregivers.MethodsA total of 110 caregivers of older patients who previously had a stroke participated in this descriptive and cross-sectional study. The Zarit Burden Interview and Lazarus coping strategies questionnaires were used for data collection. Questionnaires were completed by the caregivers, who were selected using convenience sampling. The collected data were analyzed using Pearson's correlations and independent t-tests.ResultsThe mean age of participants was 32.09 ± 8.70 years. The majority of the caregivers sampled reported mild to moderate (n = 74, 67.3%) burden. The most commonly used coping strategies reported were positive reappraisal and seeking social support. Results of the independent t-test showed that male caregivers used the positive reappraisal strategy (t(110) = 2.76; p = 0.007) and accepting responsibility (t(110) = 2.26; p = 0.026) significantly more than female caregivers. Pearson's correlations showed a significant positive correlation between caregiver burden and emotional-focused strategies, including escaping (r = 0.245, p = 0.010) and distancing (r = 0.204, p = 0.032).ConclusionsCaregivers with higher burden of care used more negative coping strategies, such as escape-avoidance and distancing. In order to encourage caregivers to utilize effective coping skills, appropriate programs should be designed and implemented to support caregivers. Use of effective coping skills to reduce the level of personal burden can improve caregiver physical health and psychological well-being.
| S-EPMC8017750 | biostudies-literature
Project description:BackgroundIn this paper, we analyse the economic burden of elder care in the Czech Republic by assessing how family members of senior citizens engage in caregiving. To do this, we examined the time and cost associated with caregiving as a function of age, gender, and income of the caregiver.MethodsA questionnaire comprising 17 items was used to gather data from 155 informal caregivers whose seniors are affiliated with 200 registered home care agencies. Spearman rank correlation was adopted to analyse how caregivers' income, age and gender influences the costs accrued and time spent in caring for elders. The expenses are divided into direct and indirect. Publicly available sources are used to establish expenses on treatment and medication, which cannot be determined by the questionnaire survey.ResultsResults show that around-the-clock care is the most common. Spouses of care recipients make up the highest number of caregivers, and women represent the largest portion of this group. Additionally, the more the time spent caring for an elder, the higher the cost associated with such care. The total annual burden of informal caregivers is determined by the sum of annual average indirect costs, amounting to € 36,888, and annual direct costs, amounting to € 2775, resulting in a total of € 39,663 per year.ConclusionCzech social policymakers should begin to consider better packages for caregivers in the form of incentives and other monetary benefits to improve living standards and care for ageing seniors.
| S-EPMC7216393 | biostudies-literature
Project description:BackgroundDespite constipation being a common clinical condition in older adults, the clinical relevance of constipation related to frailty is less studied. Hence, we aimed to investigate the association between chronic constipation (CC) and frailty in older adults.MethodsThis is a cross-sectional analysis of a population-based, prospective cohort study of 1278 community-dwelling older adults in South Korea. We used the Rome criteria to identify patients with irritable bowel syndrome with predominant constipation (IBS-C) and functional constipation (FC). We investigated whether participants consistent with the criteria for IBS-C and FC had CC. Frailty was assessed using the Cardiovascular Health Study (CHS) frailty phenotype.ResultsIn the study population with a mean age of 75.3 ± 6.3 years, 136 (10.7%) had CC. The participants with CC were older, had higher medication burdens, and had worse physical performances compared to those without CC (All P < .05). By association analysis, the prevalence of CC was associated with frailty by the CHS criteria (P < .001). The CHS frailty score was associated with the presence of CC by the univariate logistic regression analysis and the multivariate analysis adjusted for age, sex, and multimorbidity.ConclusionsFrailty was associated with CC in community-dwelling older people, suggesting that constipation should be considered as an important geriatric syndrome in clinical practice concerning frail older adults.
| S-EPMC7995705 | biostudies-literature
Project description:Essential tremor (ET) is a progressive neurological disease associated with functional disability, diminished quality of life and, in some individuals, poorer balance, cognitive impairment, depression and sleep dysregulation. Individuals with ET may rely on family members and friends to act as informal caregivers to assist with daily activities and provide emotional support. There is a high prevalence of embarrassment among individuals with ET, which may be a result of the outwardly visible nature of tremor. Studies in populations with outwardly visible disability have shown that perception by caregivers of a care-recipient's social distress can contribute to caregiver burden. We hypothesize that in ET, perception by caregivers of ET participant embarrassment is a predictor for caregiver burden. Data were collected from 57 ET participants and their caregivers. We measured ET participant embarrassment using the Essential Tremor Embarrassment Assessment (ETEA), and measured perception by caregivers of ET participant embarrassment using a modified version of the ETEA. The Zarit Burden Interview was used to measure caregiver burden. Perceived embarrassment was associated with ET participant embarrassment. In linear regression models, perceived embarrassment was a stronger predictor for caregiver burden than measures of ET participant cognitive and physical impairment. The results indicate that perception of ET participant embarrassment can be burdensome for caregivers. Clinicians may wish to address patient embarrassment and perceived embarrassment to better support caregivers and ET patients.
| S-EPMC5739080 | biostudies-other
Project description:To determine whether caregiver burdens are associated with lifestyle behaviors 1 year following the hospitalization of a family member with cardiovascular disease (CVD).Prospective follow-up study of National Heart Lung and Blood Institute sponsored Family Intervention Trial for Heart Health participants.Hospital-based recruitment/baseline visit with 1-year follow-up.Family members of hospitalized CVD patients (N ?=? 423; 67% female; 36% racial/ethnic minority; mean age 49 years).Systematic evaluation at 1 year to determine heart-healthy diet (defined as <10% kcal from saturated fat; Block 98 Food Frequency Questionnaire) and physical activity (defined as ?4 d/wk; Behavioral Risk Factor Surveillance System Survey) behaviors and caregiver burdens (five domains: employment, financial, physical, social, and time; Caregiver Strain Questionnaire).Logistic regression adjusted for covariates.Heart-healthy diet was less frequent among caregivers citing feeling overwhelmed (odds ratio [OR] ?=? .50; 95% confidence interval [CI] ?=? .26-.97), sleep disturbance (OR ?=? .51; 95% CI ?=? .27-.96), financial strain (OR ?=? .41; 95% CI ?=? .20-.86), upsetting behavior (OR ?=? .48; 95% CI ?=? .25-.92), and/or time demands (OR ?=? .47; 95% CI ?=? .26-.85) as burdens. Physical activity was less frequent among caregivers reporting financial strain (OR ?=? .32; 95% CI ?=? .13-.81) or upsetting patient behavior (OR ?=? .33; 95% CI ?=? .15-.76) as burdens. The most commonly cited caregiver burdens included changes in personal plans (39%), time demands (38%), and sleep disturbance (30%).Caregiver burdens were associated with nonachievement of heart-healthy diet and physical activity behaviors among family caregivers 1 year after patient discharge. When developing heart-health promotion interventions, caregiver burden should be considered as a possible barrier to prevention among family members of CVD patients.
| S-EPMC4041363 | biostudies-literature
Project description:BackgorundThis study aimed to design and psychometrically evaluate the caregiver burden questionnaire for family caregivers of hemodialysis patients.MethodsThis study was conducted using an exploratory sequential mixed method on family caregivers of hemodialysis patients in Iran. In the first phase, the generation of the items was done based on results of directed qualitative content analysis according to the Structural model of the caregiver burden and review of the literature. After developing the item pool, face and content validity, item analysis, structural, convergent and discriminant validity, internal consistency, reliability, interpretability, and feasibility were evaluated.ResultsThe primary tool entered the psychometric evaluation phase with 64 items. After performing face and content validity and item analysis, the number of items was reduced to 28. Exploratory factor analysis was performed with 28 items and 300 caregivers, and finally, four subscales with 21 items were developed. The results of confirmatory factor analysis indicated a good fit of the model. Cronbach's alpha and the Intraclass Correlation Coefficient of all subscales were higher than 0.7 and 0.9, respectively. The standard error of measurement was 1.39. All subscales had acceptable values in convergent validity criteria and the HTMT index less than the threshold value. The total score of the questionnaire had no ceiling and floor effect; the percentage of unanswered items was within the acceptable range.ConclusionThe results show that the caregiver burden questionnaire for caregivers of patients undergoing hemodialysis has good psychometric properties and can measure the caregiver burden in these caregivers.
| S-EPMC9446771 | biostudies-literature
Project description:IntroductionHealth care organizations are increasingly recognizing the need to integrate the health care system to better care for older adults. We partnered with a local health centre to inform the development of a Regional Frail Senior Strategy for Southwestern Ontario, Canada.MethodologyInterviews were conducted with 12 older adults (65+, with chronic conditions) and family caregivers. 44 interviews were also completed with health care providers from across the region. To engage with a range of stakeholders on the strategy, four feedback fairs were hosted. Interviewees emphasized the importance of person and family-centred care, integration of health care services, issues of access, and further training and education for health care professionals. Findings and stakeholder feedback were synthesized into 14 recommendations.DiscussionThe data and recommendations outlined in this paper informed the development of the frailty strategy for a region in Ontario. Participatory methods and stakeholder engagement identified pertinent themes related to enhancing care for older adults with frailty.ConclusionThe creation of a frailty strategy is imperative in recognizing and responding to the needs of older adults with complex conditions. Our approach may be relevant to other organizations and health systems interested in developing their own regional frailty strategies.
| S-EPMC9438459 | biostudies-literature
Project description:ObjectivesTo identify caregiver and children factors associated with caregiver burden on primary caregivers of children with cerebral palsy (CP).DesignSystematic review DATA SOURCES: Seven electronic databases, including PubMed, Cochrane Library, Scopus, PsycINFO, Web of Science, CINAHL and Embase, were systematically searched up to 1 February 2023.Eligibility criteriaOriginal observational studies reporting caregiver burden and related factors among caregivers of children with CP.Data abstraction and synthesisTwo reviewers independently screened results and assessed the quality of studies. Title, abstract, full-text screening and data abstraction were done independently by two reviewers. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies. The quality of evidence for factors was rated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach.Results16 articles were included in the review. All studies were cross-sectional and examined caregiver-reported burden measures. The Zarit Burden Interview was the most commonly used questionnaire. Depression of caregiver and severity of illness in children with CP were moderate quality of evidence for factors contributing to caregiver burden.ConclusionsHigher caregiver burden is associated with more depressive feelings and worse life quality of the caregiver, and with more severe physical disability of the children. Future studies should focus on high-quality longitudinal research and appropriate assistance to reduce caregiver burden and improve the quality of caregiving for children with CP.Prospero registration numberCRD42021268284.
| S-EPMC10083783 | biostudies-literature
Project description:Distance caregivers (DCGs), those who live more than an hour away from the care recipient, often play a significant role in patients' care. While much is known about the experience and outcomes of local family caregivers of cancer patients, little is known about the experience and outcomes of distance caregiving upon DCGs. The purpose of this study was to identify the relationships among stressors (patient cancer stage, anxiety, and depression), mediators (DCG emotional support and self-efficacy), and burden in DCGs' of patients with cancer. This study was a descriptive cross-sectional study and involved a secondary data analysis from a randomized clinical trial. The study sample consisted of 314 cancer patient-DCG dyads. The results of this study were: (1) 26.1% of DCGs reported elevated levels of burden; (2) significant negative relationships were found between mediators (DCG emotional support and self-efficacy) and DCG burden; and (3) significant positive relationships were found between patient anxiety, depression, and DCG burden. The prevalence of burden in DCGs, and its related factors, were similar to those of local caregivers of cancer patients, which suggests that interventions to reduce burden in local caregivers could be effective for DCGs as well.
| S-EPMC9689057 | biostudies-literature