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Yue X, Wang Y, Zheng R, Li L. The coping experiences in patients with hepatocellular carcinoma and their spouses following postoperative recurrence: A dyadic qualitative study. Asia Pac J Oncol Nurs 2025; 12:100665. [PMID: 40104041 PMCID: PMC11919323 DOI: 10.1016/j.apjon.2025.100665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 02/05/2025] [Indexed: 03/20/2025] Open
Abstract
Objective Dyadic coping practices can vary depending on cultural contexts, socioeconomic factors, and the stages of the cancer journey. This study aimed to explore the dyadic coping experiences of hepatocellular carcinoma (HCC) patients and their spouses following postoperative recurrence in the Chinese cultural context, where cancer recurrence is frequently seen as a death sentence, and family-centered care is prioritized. Methods A descriptive qualitative research design was used, involving face-to-face, in-depth semi-structured interviews with 13 pairs of hepatocellular carcinoma patients and their spouses at a tertiary cancer hospital from July to October 2023. The interview guide was designed based on the Actor-Partner Interdependence Model (APIM) framework. Data were analyzed using thematic analysis, and the study adhered to the COnsolidated criteria for REporting Qualitative research (COREQ) checklist. Results Three themes were identified: (1) active coping strategies, (2) negative coping tendencies, and (3) the need for systematic coping support. The majority of couples perceived hepatocellular carcinoma recurrence as a death sentence, which prompted them-especially the spouses-to adopt proactive strategies, such as striving to seek advanced treatments and concealing unfavorable information. In contrast, patients, particularly those with a hereditary hepatocellular carcinoma background, often exhibited passivity, withdrawal, and contemplation of treatment abandonment. Spouses frequently felt overwhelmed and unable to alleviate their partners' anxiety about recurrence and death, particularly in the absence of support from health care professionals. They expressed a strong need for professional guidance and targeted interventions to address end-of-life concerns, emphasizing the need for increased financial support, empowerment through knowledge, and access to peer support networks. Conclusions This research emphasizes the importance of recognizing the interdependent coping experiences of recurrent HCC patients and their spouses. Health care professionals are encouraged to implement culturally sensitive, dyadic interventions that foster collaborative coping, address death-related anxiety, and empower couples in managing recurrence together, thereby enhancing their coping strategies and confidence.
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Affiliation(s)
- Xian Yue
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Yanhui Wang
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Ruishuang Zheng
- Department of Hepatobiliary, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Laiyou Li
- Department of Nursing, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China
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Wang Y, Xu X, Lv Q, Zhang X, Yang W, Li Y, Zhao Y, Zang X. The Association Between Impaired Dyadic Coping and Frailty in Elderly Patients With Hypertension: A Latent Profile Analysis. J Cardiovasc Nurs 2025; 40:268-279. [PMID: 38456911 DOI: 10.1097/jcn.0000000000001081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
BACKGROUND Lifelong hypertension highlights the importance of dyadic engagement in coping with the disease. Although dyadic coping is heterogeneous in patients with other diseases, little is known about it in elderly patients with hypertension. In addition, whether impaired dyadic coping is associated with frailty has yet to be elucidated. OBJECTIVES The aim of this study was to investigate the latent profiles and characteristics of dyadic coping and the potential association between impaired dyadic coping and frailty in elderly patients with hypertension. METHODS We recruited a total of 741 elderly patients with hypertension. Latent profile analysis was then used to identify the best-fitting model. Then, we used regression analysis to determine profile predictors and identify the association between impaired dyadic coping and frailty. RESULTS The 5-profile model was considered to be the best-fitting model, as follows: profile 1, severely impaired dyadic coping; profile 2, mildly impaired dyadic coping; profile 3, normal dyadic coping; profile 4, better dyadic coping; and profile 5, the highest dyadic coping. In the fully adjusted model, the probability of frailty was 1.94-fold higher in the mildly impaired dyadic coping group (odds ratio, 1.94; 95% confidence interval, 1.09-3.47) and 2.66-fold higher in the severely impaired dyadic coping group (odds ratio, 2.66; 95% confidence interval, 1.11-6.39). CONCLUSIONS We identified heterogeneity in dyadic coping and demonstrated that impaired dyadic coping was associated with frailty. Those at risk of dyadic coping impairment need to be identified early, followed by dyadic coping-based interventions to prevent or delay frailty.
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Kwete X, Knaul FM, Essue BM, Touchton M, Arreola-Ornelas H, Langer A, Calderon-Anyosa R, Nargund RS. Caregiving for China's one-child generation: a simulation study of caregiving responsibility and impact on women's time use. BMJ Glob Health 2024; 9:e013400. [PMID: 38843897 PMCID: PMC11163626 DOI: 10.1136/bmjgh-2023-013400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 03/30/2024] [Indexed: 06/12/2024] Open
Abstract
INTRODUCTION The introduction, strict enforcement and recent exit of China's one-child policy (OCP) resulted in China's demographical changes, and, alongside its epidemiological transition, disproportionately impacted caregiving needs and demands on women. This study examines women's caregiving responsibilities in contemporary China and evaluates how the OCP affected them. METHODS We simulated the female population aged 25-54 years in 2020 in China and their caregiving responsibilities based on epidemiological and demographic data for women, their parents and parents-in-law, and children under 10. Three different health states were simulated for children and the senior generation: (1) healthy, (2) end of life-decedents and (3) non-decedents in need of palliative care. We combine the care responsibility for senior family members and for children using an aggregate indicator-the Care Responsibility Score (CRS) -to compare the impact of the OCP across different generations of women. RESULTS Approximately 60 million working-age women are living with medium to high levels of care responsibilities (a CRS over 0.8), which is equivalent to caring for a senior family member with palliative care needs without any assistance from siblings. This includes more than one-third of the 156 million women born after the OCP and only 5% of women born before the OCP. CONCLUSION For women born under the OCP, the additional responsibility generated by a lack of siblings outweighs the benefit of having four dedicated grandparents to support them in raising children.
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Affiliation(s)
- Xiaoxiao Kwete
- Yaozhi Global Health Research and Consulting, Yangzhou, China
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
| | - Felicia Marie Knaul
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Beverley M Essue
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Michael Touchton
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Department of Political Science, University of Miami College of Arts and Sciences, Coral Gables, Florida, USA
| | - Héctor Arreola-Ornelas
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- Intitute for Obesity Research, Tecnologico de Monterrey, Monterrey, Nuevo León, Mexico
- School of Government and Public Transformation, Tecnologico de Monterrey, Mexico City, Mexico City, Mexico
- Tómatelo a Pecho A.C, Mexico City, Mexico City, Mexico
- Fundación Mexicana para la Salud, A.C, Mexico City, Mexico City, Mexico
| | - Ana Langer
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Renzo Calderon-Anyosa
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
- McGill University, Montreal, Québec, Canada
| | - Renu Sara Nargund
- Institute for Advanced Study of the Americas, University of Miami, Coral Gables, Florida, USA
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Lee MMS, Yeoh EK, Wang K, Wong ELY. Caregiver Employees' Mental Well-Being in Hong Kong. Healthcare (Basel) 2024; 12:1013. [PMID: 38786422 PMCID: PMC11121220 DOI: 10.3390/healthcare12101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/01/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The rapidly aging global population has increased the demand for caregivers. Many caregivers simultaneously engage in paid employment, and the dual role makes the needs of caregiver employees conceivably more remarkable. However, there is a gap in the literature about the specific needs of caregiver employees. METHOD Caregiver employees (n = 1205) across Hong Kong caring for those ≥65 years were recruited for a cross-sectional face-to-face survey from December 2021 to January 2022, to evaluate mental well-being measured by the Short Warwick -Edinburgh Mental Well-being Scale. Univariate and multivariate analyses were conducted; significant variables (p < 0.05) were included in multiple linear regression, along with caregiver-friendly workplace policies' availability, to understand their association with their mental well-being. FINDINGS The mean score of the Short Warwick-Edinburgh Mental Well-being Scale among caregiver employees in this study was 24.9, with 7.2% indicative of probable clinical depression and 10.0% possible mild depression. In addition, the current study showed that 30.2% of the caregiver employees felt distressed about the caregiving role. Among external factors, family support (measured by the Lubben Social Network Scale) and workplace culture (measured by the Marshall Supervision Subscale) positively correlated with mental well-being with regression coefficients of 0.252 (p < 0.001) and 0.482 (p < 0.001), respectively. In the fully adjusted model, a negative regression coefficient was observed for overall spillover (-0.050, p < 0.001) and Short Warwick-Edinburgh Mental Well-being Scale scores, while positive regression coefficients were observed for overall self-rate (0.041, p < 0.001), Lubben (0.124, p < 0.001), and corporate culture (0.365, p < 0.001). Better Short Warwick-Edinburgh Mental Well-being Scale scores were observed when caregiver-friendly workplace policies were clearly stated than when they were made on a case-by-case discretionary basis. CONCLUSIONS Caregiver-friendly workplace policies may be critical to Hong Kong's sustainable future, both economically and socially, as they ensure a healthy and productive workforce to support an aging population.
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Affiliation(s)
| | | | | | - Eliza Lai-Yi Wong
- The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Central Avenue, Hong Kong, China; (M.M.-S.L.); (E.-K.Y.); (K.W.)
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Ng MSN, So WKW, Choi KC, Akingbade O, Chan WCH, Chan HYL, Chan CWH. Social capital for carers of patients with advanced organ failure: a qualitative exploration of stakeholders' perspectives. BMC Public Health 2024; 24:670. [PMID: 38429719 PMCID: PMC10908001 DOI: 10.1186/s12889-024-18213-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/26/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Carers of patients with advanced organ failure (AOF) experience a tremendous caregiving burden. Social capital utilizes the internal strength of a community to support its members and may provide carers with comprehensive support. This study aimed to identify the different sources of social capital that can support carers of patients with AOF from the perspectives of stakeholders. METHOD A descriptive qualitative study was conducted in community settings from April 2021 to May 2022. Stakeholders from medical social work departments, self-help groups, and non-governmental organizations were recruited, while some community members were invited through online media platforms. Individual semi-structured interviews were conducted using an interview guide. Interview transcripts were analyzed using a qualitative description approach. In total, 98 stakeholders, including 25 carers, 25 patients, 24 professionals, and 24 community members, were recruited using purposive and snowball sampling. RESULTS Six categories about social capital for carers emerged, namely, carer attributes, the community, social care services, healthcare services, information, and policies. While the attributes of carers and their relationships with care recipients had a significant influence on caregiving, support from different groups in the community, such as neighbors and employers, was valued. Good communication of information about caregiving and social services was emphasized as being helpful by carers and other stakeholders. While carers presented a need for various healthcare and social care services, several features of these services, including their person-centeredness and proactive reach, were deemed useful. At the societal level, policies and research on comprehensive supportive services are warranted. The different sources of social capital constitute a multi-layer support system in the community. CONCLUSION Carers can utilize personal attributes, interpersonal relationships, community resources, and societal contexts to enhance their caregiving. While this system can serve as a framework for building carer-friendly communities, interventions may be required to strengthen some aspects of social capital.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China.
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | | | - Wallace Chi Ho Chan
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK
| | - Helen Yue Lai Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
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Kustanti CY, Chu H, Kang XL, Pien LC, Chen R, Tsai HT, Chou KR. Anticipatory grief prevalence among caregivers of persons with a life-threatening illness: A meta-analysis. BMJ Support Palliat Care 2024; 13:e1074-e1083. [PMID: 35149523 DOI: 10.1136/bmjspcare-2021-003338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 01/24/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Caring for a family member with a life-threatening illness may lead to increased levels of psychological morbidity. Given the lack of recognition of caregivers' grief, this study aimed to determine the prevalence of anticipatory grief disorders in caregivers of persons with a life-threatening illness for better intervention and management. METHODS CINAHL, Cochrane, Embase, Medline, PubMed, Scopus, PsycINFO and Web of Science were searched up to 21 March 2021 without language and time restrictions. The quality of the included studies was assessed with Hoy's criteria. A random-effects model was applied to calculate pooled prevalence rates, and multi-regression was performed to examine heterogeneity among studies. RESULTS A total of 3278 citations were retrieved, and 18 studies met the eligibility criteria involving 5470 caregivers. The pooled prevalence of anticipatory grief was 24.78% (95% CI 19.04% to 30.99%). The prevalence rates were significantly higher in female caregivers (16.64%; 95% CI 12.24% to 21.53%) compared with male caregivers (6.11%; 95% CI 4.55% to 7.87%). The married group also had a higher risk (14.66%; 95% CI 10.66% to 19.16%) than single group (5.47%; 95% CI 4.31% to 6.76%). CONCLUSIONS The overall pooled prevalence is substantially higher compared with after-loss grief in the general population and supported the presumptions that preloss grief has a greater magnitude compared with after-loss grief. Bereavement support, educational programmes and relevant resources should be delivered even before the actual loss to address the burden of caregivers.
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Affiliation(s)
- Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Hsin Chu
- Institute of Aerospace and Undersea Medicine, School of Medicine, National Defense Medical Center, Taipei, Taiwan
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Xiao Linda Kang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- School of Nursing, University of Pennsylvania, PA, Pennsylvania, USA
| | - Li-Chung Pien
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
| | - Hsiu-Ting Tsai
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
- Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan
- Center for Nursing and Healthcare Research in Clinical Practice Application, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
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Luo Y, Yuan K, Li Y, Liu Y, Pan Y. The "spillover effect" of long-term care insurance in China on spouses' health and well-being. Soc Sci Med 2024; 340:116487. [PMID: 38096600 DOI: 10.1016/j.socscimed.2023.116487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/23/2024]
Abstract
This study examined the spillover effect of long-term care insurance (LTCI) on the health outcomes and well-being of spouses for Chinese middle and old-aged adults with expected LTC demand or actual care burdens. Using panel data from the China Health and Retirement Longitudinal Study between 2011 and 2018, we investigated the impact of the introduction of LTCI pilots across several cities on old individuals by using the difference-in-differences (DID) approach. We found a spillover effect of LTCI on the health and well-being outcomes of spouses of middle and old-aged individuals with functional limitations. It might due to the fact that LTCI could relieve economic burden by reducing out-of-pocket medical expenditures, which further affects health and well-being of spouses. The spillover effect on health and well-being was found to be stronger for male spouses and low-educated spouses. Spouses of the individuals aged below 80 years old and those live without adult children were more likely to benefit from the introduction of LTCI. Moreover, providing combination benefits seems to make spouses better off than offering direct services. Therefore, the results implied that the expansion of LTCI not only helped the care recipients themselves but could also improve the health and well-being of the spouses of functionally impaired older adults.
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Affiliation(s)
- Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China; Institute for Global Health and Development, Peking University, Beijing, China
| | - Kexin Yuan
- School of Software and Microelectronics, Peking University, Beijing, China
| | - Yuxiao Li
- School of Applied Economics, Renmin University of China, Beijing, China
| | - Yating Liu
- School of Nursing, Peking University, China
| | - Yao Pan
- School of Economics, Zhongnan University of Economics and Law, Wuhan, China.
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Chu L, Gong X, Lay JC, Zhang F, Fung HH, Kwok T. The perks of doing housework: Longitudinal associations with survival and underlying mechanisms. BMC Geriatr 2023; 23:355. [PMID: 37280557 PMCID: PMC10242587 DOI: 10.1186/s12877-023-04039-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Accepted: 05/14/2023] [Indexed: 06/08/2023] Open
Abstract
BACKGROUND Although the majority of existing literature has suggested positive effects of housework on older adults' health and survival rate, the underlying mechanisms of such effects remain unclear. To address potential mechanisms, the present study examined the association between older adults' housework engagement and days of survival across 14 years and tested three potential mediation pathways in this association. METHODS Four thousand Hong Kong older adults (50% female; aged between 65 and 98 years) participated in a longitudinal study in which they reported initial housework engagement and health status across three domains (cognitive functioning, physical health, and mental health) at the baseline, and the numbers of days they survived over the subsequent 14-year period were recorded. Linear regression, Cox proportional hazard, and parallel mediation analyses were performed to examine the relationship between housework engagement and days survived, and the mediating effects of these three health factors. RESULTS The results showed a positive association between housework engagement and days survived after controlling for demographic variables (age, sex, education, marital status, subjective social status, and living alone). Physical health and mental health, but not cognitive functioning, partially mediated the relationship between housework engagement and days survived. The findings suggest that doing housework may contribute to longer survival by improving older adults' physical and mental health. CONCLUSION The current study confirms positive relations of housework with health and mortality among Hong Kong older adults. As the first study examining the relationships and mediation pathways between doing housework and survival in later life, the findings advance our understanding of the mechanisms underlying the positive association between housework and mortality and provide insights for future daily-life health-promotion interventions for older adults.
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Affiliation(s)
- Li Chu
- Department of Psychology, Stanford University, Stanford, USA
| | - Xianmin Gong
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
- Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jennifer C Lay
- Department of Psychology, University of Exeter, Exeter, England
| | - Fan Zhang
- Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China.
| | - Helene H Fung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Timothy Kwok
- Department of Medicine and Therapeutic, The Chinese University of Hong Kong, Hong Kong SAR, China
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Kuramoto Y, Nabeshima H, Khan MSR, Kadoya Y. The Association of Caregivers' Socio-Economic Conditions with Family Caregiving Norms: Evidence from China. Behav Sci (Basel) 2023; 13:bs13050362. [PMID: 37232599 DOI: 10.3390/bs13050362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 04/22/2023] [Accepted: 04/24/2023] [Indexed: 05/27/2023] Open
Abstract
Similar to her neighboring country, Japan, China faces significant difficulties in providing long-term care to the elderly. Female household members who traditionally provided necessary caregiving are no longer available as much as in the past due to the demographic and socioeconomic changes over the past few decades. Against this backdrop, we investigated how socioeconomic factors affect the perception of family caregiving norms in China, using an international comparative household dataset that allowed us to compare China with Japan, the latter being extensively investigated. We used ordered probit regression to estimate the model equation. Our results show that rural residency, household assets, and government dependency are positively associated with the perception of care. A notable difference from the Japanese results is that rural residents have a rather positive perception of family caregiving norms. Furthermore, urban-rural subsample analyses revealed that women in rural areas perceive caregiving negatively.
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Affiliation(s)
- Yu Kuramoto
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima 7398525, Japan
| | - Honoka Nabeshima
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima 7398525, Japan
| | | | - Yoshihiko Kadoya
- School of Economics, Hiroshima University, 1-2-1 Kagamiyama, Higashihiroshima 7398525, Japan
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Chow EOW, Fung SF, Singh H. Actor-partner effects of wellbeing, hope and self-esteem on depression in stroke survivor-caregiver dyads: A randomized controlled trial. Clin Rehabil 2023; 37:394-406. [PMID: 36453001 PMCID: PMC9912309 DOI: 10.1177/02692155221128758] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
BACKGROUND Stroke is a disabling, long-term condition that challenges the mental and physical health of stroke-survivors concurrently with their primary family-caregivers (dyad). However, there has been a lack of emphasis on this dyadic need. Thus, this study aims to investigate the impacts of two interventions on hope, self-esteem and hedonic wellbeing on depression among the stroke-survivor-caregiver dyad. METHODS This randomized-controlled-trial applied the actor-partner interdependence model to 100 randomly-selected dyads (N = 200) of stroke-survivors, mean (SD) age was 73.63(7.22) and family-caregivers, mean (SD) age was 62.49(14.44) years, recruited from Hong Kong hospitals and rehabilitation centres. The intervention was eight-weekly two-hour narrative therapy group sessions (n = 54 dyads), compared with the current model of psychoeducational group to each dyad as needed. Outcomes were collected via questionnaires and interviews, at four time-points: baseline (T1), during-intervention (T2) (1-month), immediately post-intervention (T3) (2-months) and follow-up (T4) (6-months). RESULTS The results demonstrated that there are actor effects on stroke-survivors (β = -0.353, p < 0.05) and caregivers (β = -0.383, p < 0.05), where higher levels of hedonic wellbeing were associated with fewer depressive symptoms. Partner effects were observed as caregivers' depressive symptoms were possessing a significant negative relationship with stroke survivors' wellbeing (β = -0.387, p < 0.05). Those stroke survivors in the intervention group had a significantly higher level of self-esteem associated with lower levels of depression (β = -0.314, p < 0.05). CONCLUSIONS Improving hope, self-esteem and wellbeing through narrative therapy significantly mediates depressive symptoms, strengthening the dyadic support of stroke survivors and family caregivers.
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Affiliation(s)
- Esther OW Chow
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China,Esther OW Chow, Department of Social and
Behavioural Sciences, City University of Hong Kong, Tat Chee Avenue, Kowloon,
Hong Kong.
| | - Sai-fu Fung
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China
| | - Hardev Singh
- Department of Social and Behavioural Sciences, City University of Hong
Kong, Hong Kong, China
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Liao Z, Wang C, Lan X, Wu J, Yuan X, Wu Y, Hu R. Never forsake-The positive experiences of dyadic coping among patients with acute leukemia and their spouses: A qualitative study. Eur J Oncol Nurs 2023; 62:102262. [PMID: 36603493 DOI: 10.1016/j.ejon.2022.102262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/26/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022]
Abstract
PURPOSE This study aimed to explore the positive experiences of dyadic coping between patients with acute leukemia and their spouses in China, and to highlight the target factors that could promote coping and adaptation. METHODS A qualitative descriptive study was employed. This study was conducted at a tertiary hospital in China from September 2021 to February 2022. A purposive sampling method was used to select participants, and 17 patients diagnosed with acute leukemia and their spouses were interviewed. Qualitative data were analyzed using the content analysis method. This study followed the COREQ checklist. RESULTS This study's data were categorized into five themes and twelve subthemes: (1) adapting to a new role-couples used role adjustments to adapt; (2) commitment to companionship-patients benefit from spousal commitment in word or in deed; (3) active communication-allows couples to get to know each other better; (4) white lies-shield partner from negative information; (5) seeking external support-outside of couple cohesion. In sum, positive dyadic coping experiences between couples follow the marital commitment of "never forsake." CONCLUSIONS This study contributes new knowledge to the understanding of the dyadic coping experiences of patients with acute leukemia and their spouses within the Chinese social-cultural context and contributes to cross-cultural comparisons. The results can be used to design and implement couple-based intervention programs to support couples by enhancing their mutual support to cope with and adjust to acute leukemia effectively.
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Affiliation(s)
- Zhenling Liao
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
| | - Chunfeng Wang
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
| | - Xiaoyan Lan
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
| | - Junjun Wu
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
| | - Xiaohuan Yuan
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
| | - Yong Wu
- Department of Hematology, Fujian Medical University Union Hospital, Fuzhou City, Fujian Province, China.
| | - Rong Hu
- The School of Nursing, Fujian Medical University, No.1 of Xueyuan Road, Shangjie Town, Minhou County, Fuzhou City, Fujian Province, China.
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12
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Guan Z, Wiley JA, Tang S, Sun M. Internalised stigma, social support, coping and care-giving burden among Chinese family caregivers of adults diagnosed with schizophrenia: A parallel mediation analysis. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:2300-2310. [PMID: 35355363 DOI: 10.1111/hsc.13780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Revised: 01/22/2022] [Accepted: 02/27/2022] [Indexed: 06/14/2023]
Abstract
Care-giving burden and internalised stigma are prevalent among family caregivers of people diagnosed with schizophrenia. Internalised stigma has been regarded as a source of care-giving burden. But it remains unclear if high levels of internalised stigma directly contribute to an increased risk of care-giving burden or if the effects could be buffered by psychological factors. This cross-sectional study was to investigate the relationship between internalised stigma and care-giving burden, and to determine the mediating effects of coping styles and social support. Data were collected from 344 Chinese family caregivers of adults diagnosed with schizophrenia in a psychiatric outpatient department of a tertiary hospital in Changsha, Hunan between April and August 2018. A self-reported questionnaire was used to collect data anonymously. Instruments included the Simplified Coping Style Questionnaire, the Multidimensional Scale of Perceived Social Support, the Internalized Stigma of Mental Illness Scale and the Caregiver Burden Inventory. Data analysis was conducted using descriptive statistics, the Spearman correlation and regression analysis to estimate direct and indirect effects using bootstrap analysis. Results showed that internalised stigma, social support and passive coping were significant correlates of care-giving burden; social support partially mediated the relationship between internalised stigma and care-giving burden; active coping did not show impacts on internalised stigma and care-giving burden. This study provided social workers and healthcare providers with a better understanding of the development of care-giving burden. Comprehensive interventions should be designed to provide supportive resources and reduce the possibilities of internalisation of stigma and passive coping, to alleviate care-giving burden.
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Affiliation(s)
- Ziyao Guan
- School of Social Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - James A Wiley
- Xiangya School of Nursing, Central South University, Changsha, China
- School of Medicine, Institute for Health Policy Studies, University of California San Francisco, San Francisco, California, USA
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Mei Sun
- Xiangya School of Nursing, Central South University, Changsha, China
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13
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Maximiano-Barreto MA, Alves LCDS, Monteiro DQ, Gratão ACM, Pavarini SCI, Luchesi BM, Chagas MHN. Cultural factors associated with burden in unpaid caregivers of older adults: A systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e3629-e3642. [PMID: 36069278 DOI: 10.1111/hsc.14003] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 07/21/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
The aim of the present systematic review was to investigate cultural factors associated with burden in unpaid caregivers of older adults. Searches were conducted in the Pubmed, Web of Science, PsycInfo, Scopus, Embase, LILACs and SciELO databases for relevant articles published in English, Portuguese and Spanish using the search terms 'Caregiver AND Culture AND (Burnout OR Caregiver Burden) AND Aged'. No restriction was imposed regarding year of publication. A total of 1234 articles were identified, 34 of which were selected for the present review. The following sociodemographic characteristics were associated with burden: being female, married, White caregivers, young and the spouse of the care recipient; having no siblings; having low schooling and low economic status. Cultural factors associated with burden were living with the care recipient, not professing a religion or having little spirituality, familism (i.e. less reciprocity) and an absence of social support. The present findings underscore the importance of developing intervention strategies that consider cultural factors to minimise the negative impacts of care on unpaid caregivers of older adults.
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Affiliation(s)
| | | | | | - Aline Cristina Martins Gratão
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Sofia Cristina Iost Pavarini
- Nursing Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Gerontology Department, Federal University of São Carlos, São Carlos, SP, Brazil
| | - Bruna Moretti Luchesi
- Três Lagoas Campus, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | - Marcos Hortes Nisihara Chagas
- Psychology Department, Federal University of São Carlos, São Carlos, SP, Brazil
- Bairral Institute of Psychiatry, Itapira, SP, Brazil
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14
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The Implementation of Palliative Home Care in Southeast Asian Countries: An Integrative Review. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2022. [DOI: 10.1177/10848223221113858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In Asia where family caregiving is part of the culture, palliative home care becomes the most suitable service to keep patients close to their family and to reduce costs. There is a wide variety of palliative home care services due to different cultures and levels of involvement of the family. This review aims to explore the implementation of palliative home care in East and Southeast Asian countries. The articles reviewed in this study were obtained from 3 electronic databases: EbscoHost, PubMed, and Scopus. Journal articles that discussed palliative home care for patients with cancer in East and Southeast Asia countries were included. Review papers were excluded. Seven studies were used in the current review. In general, there are 6 services provided for palliative home care in this region, which are daily activity living care, planning and preparation for palliative home care, education and counseling, patients’ follow-up, symptom management, and direct care for family. Most of the programs involve family caregivers during the treatment. The palliative home care team consists of at least a doctor and a nurse. Symptom management is the most common service and direct care for family is the least offered palliative home care service in this region. Alleviating symptoms is one of the targets in palliative care, therefore involving family in symptom management for palliative home care is fundamental. Although caregiving is part of the culture, family members need to be supported to maintain their quality of life.
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15
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Ho KHM, Cheung DSK, Lee PH, Lam SC, Kwan RYC. Co-living with migrant domestic workers is associated with a lower level of loneliness among community-dwelling older adults: A cross-sectional study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e1123-e1133. [PMID: 34288198 DOI: 10.1111/hsc.13520] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 06/02/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Loneliness (inclusive social loneliness and emotional loneliness) of older adults is a prominent public health issue internationally. Factors consistently associated with loneliness are age, gender, education, living arrangements, social network, and functional status. Intergenerational co-living with spouse and adult children is important for the exchange of social, emotional, practical, and financial support provided to older adults. Co-living with migrant domestic workers (MDWs) to care for older adults became an emergent phenomenon internationally, particularly in Asian countries. According to the convoy model of social relations, the effect of co-living with MDWs on older adults' loneliness is unknown. This study examined (1) the prevalence of loneliness among community-dwelling older adults; and (2) the association between co-living with MDWs and older adult loneliness. Using the Chinese version of the 6-item De Jong Gierveld Loneliness Scale on loneliness, 380 older adults were interviewed at busy points in Hong Kong, including subway stations. 35.3% of older adults experienced moderate-to-severe loneliness. Linear regression was performed to examine the association between co-living with MDWs and loneliness. The results showed that co-living with MDWs was significantly associated with lower levels of overall loneliness (β = -0.636; p = .022) and emotional loneliness (β = -0.298, p = .039), but not for social loneliness (β = -0.337, p = .084). While MDWs could be an attachment figure for older adults, they might not be effective in promoting the social integration of older adults. There is a need to investigate the barriers of social integration faced by older adults co-living with MDWs.
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Affiliation(s)
- Ken Hok Man Ho
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | | | - Paul Hong Lee
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Rick Yiu Cho Kwan
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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16
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Kamalzadeh L, Salehi M, Rashedi V, Ahmadzad Asl M, Malakouti SK, Seddigh R, Almasi-Doghaee M, Shariati B. Perceived burden of dementia care, clinical, psychological and demographic characteristics of patients and primary caregivers in Iran. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:627-638. [PMID: 32749153 DOI: 10.1080/23279095.2020.1798960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Caregiving for dependent older adults with dementia has become an important public health issue. However, not much is known about the caregiver experience for caregivers of patients with dementia in Iran. This study was designed to examine the relationship between variables pertaining to primary caregivers and patients and the level of perceived caregiver burden. The participants of this cross-sectional study were 60 caregiver and care-recipient pairs presented to Rasoul-e Akram hospital and Brain and Cognition Clinic, in Tehran, Iran. A sociodemographic questionnaire, the Zarit Caregiver Burden Interview (ZBI), the General health questionnaire-28 (GHQ-28), the NEO Five-Factor Inventory (NEO-FFI), the Spiritual Well-Being Scale (SWBS), the Neuropsychiatric Inventory (NPI), and the Mini-Mental State Examination (MMSE) were used. Descriptive statistics, correlation coefficients, T-test, and multiple linear regression analyses were used in this study. Years of caregiving, hours of caregiving/week, total and subscale GHQ-28 scores, existential well-being subscale score on SWBS, and total NPI score were found to be significantly associated with the level of caregiving burden (p < 0.05). In addition, among the caregivers' personality traits, neuroticism and agreeableness predicted caregiver burden. Other sociodemographic factors and MMSE scores were not found to be significantly related to caregiver burden. A better understanding of the indicators of caregiver burden can help physicians, policy makers, and mental health managers to tailor the most appropriate preventative and remedial interventions for family caregivers.
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Affiliation(s)
- Leila Kamalzadeh
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mahdiyeh Salehi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Masoud Ahmadzad Asl
- Research Center of Addiction and Risky Behavior, Iran University of Medical Sciences, Tehran, Iran
| | | | - Ruohollah Seddigh
- Spiritual Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Almasi-Doghaee
- Department of Neurology, Firouzgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Behnam Shariati
- Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran
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17
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Ng MSN, So WKW, Choi KC, Chan WCH, Chan HYL, Chan CWH. Exploring social capital for family caregivers of patients with chronic organ failure: study protocol for a concept mapping study. BMJ Open 2022; 12:e063691. [PMID: 35715187 PMCID: PMC9207919 DOI: 10.1136/bmjopen-2022-063691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Many family caregivers experience significant burdens, especially those who take care of patients with chronic organ failure. Although the social welfare system offers some material assistance, a more sustainable approach to supporting caregivers is warranted. This study aims to explore the social capital (ie, the internal strengths of a community that facilitate different social roles) available for these family caregivers. METHODS AND ANALYSIS A participatory design based on Trochim's concept mapping framework will be used in this study. A total of 119 participants, including patients, family caregivers, professionals and other community members, will be recruited from the community. The study will be divided into three phases. In Phase I, qualitative methods will be used to prepare and generate statements. Participants will be asked to share their views on social capital for family caregivers through interviews. In Phase II, quantitative methods will be used to arrange these statements into a concept map, and participants will be asked to complete a questionnaire to prioritise the statements. Statistical methods will be used to create a map based on the responses. In Phase III, the concept map will be used to formulate action plans. The findings will be presented to the public to produce recommendations for social policy. ETHICS AND DISSEMINATION This study was approved by The Chinese University of Hong Kong Survey and Behavioural Research Ethics Committee (Reference No.: SBRE-20-714). Informed consent will be obtained from all participants. This study will reveal which forms of social capital can be mobilised to support family caregivers of patients with chronic organ failure. Recommendations on policies to improve the caregiving experience, strengthen social capital and enhance social care will be produced. Findings will be disseminated through academic conferences and journals, as well as local media to create a greater social impact. TRIAL REGISTRATION NUMBER ChiCTR2100044171.
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Affiliation(s)
- Marques Shek Nam Ng
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Winnie Kwok Wei So
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Kai Chow Choi
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Wallace Chi Ho Chan
- Department of Social Work, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Helen Yue Lai Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Carmen Wing Han Chan
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, Hong Kong
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18
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Chan SM, Lam LCW, Law WY, Hung SF, Chan WC, Chen EYH, Chung GKK, Chan YH, Chung RYN, Wong H, Yeoh EK, Woo J. Inequalities in Psychiatric Morbidity in Hong Kong and Strategies for Mitigation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:7095. [PMID: 35742339 PMCID: PMC9222799 DOI: 10.3390/ijerph19127095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 02/01/2023]
Abstract
This study explores the social gradient of psychiatric morbidity. The Hong Kong Mental Morbidity Survey (HKMMS), consisting of 5719 Chinese adults aged 16 to 75 years, was used. The Chinese version of the Revised Clinical Interview Schedule (CIS-R) was employed for psychiatric assessment of common mental disorders (CMD). People with a less advantaged socioeconomic position (lower education, lower household income, unemployment, small living area and public rental housing) had a higher prevalence of depression and anxiety disorder. People with lower incomes had worse physical health (OR 2.01, 95% CI 1.05-3.82) and greater odds of having CMD in the presence of a family history of psychiatric illnesses (OR 1.67, 95% CI 1.18-2.36). Unemployment also had a greater impact for those in lower-income groups (OR 2.67; 95% CI 1.85-3.85), whereas no significant association was observed in high-income groups (OR 0.56; 95% CI 0.14-2.17). Mitigating strategies in terms of services and social support should target socially disadvantaged groups with a high risk of psychiatric morbidity. Such strategies include collaboration among government, civil society and business sectors in harnessing community resources.
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Affiliation(s)
- Siu-Ming Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Linda Chiu-Wa Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China; (L.C.-W.L.); (W.-Y.L.); (S.-F.H.)
| | - Wing-Yan Law
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China; (L.C.-W.L.); (W.-Y.L.); (S.-F.H.)
| | - Se-Fong Hung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong SAR, China; (L.C.-W.L.); (W.-Y.L.); (S.-F.H.)
| | - Wai-Chi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China; (W.-C.C.); (E.Y.-H.C.)
| | - Eric Yu-Hai Chen
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China; (W.-C.C.); (E.Y.-H.C.)
| | - Gary Ka-Ki Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
| | - Yat-Hang Chan
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
| | - Roger Yat-Nork Chung
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Hung Wong
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
- Department of Social Work, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jean Woo
- CUHK Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong SAR, China; (S.-M.C.); (G.K.-K.C.); (Y.-H.C.); (R.Y.-N.C.); (H.W.); (E.-K.Y.)
- CUHK Institute of Ageing, The Chinese University of Hong Kong, Hong Kong SAR, China
- School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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19
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Chiu MYL, Leung CLK, Li BKK, Yeung D, Lo TW. Family caregiving during the COVID-19 pandemic: factors associated with anxiety and depression of carers for community-dwelling older adults in Hong Kong. BMC Geriatr 2022; 22:125. [PMID: 35164704 PMCID: PMC8845211 DOI: 10.1186/s12877-021-02741-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 12/14/2021] [Indexed: 11/23/2022] Open
Abstract
Background The COVID-19 pandemic disrupts the daily routine and increases the caregiving load of the family carers of older adults. This study examined how the pandemic may impact mental health and investigated the prevalence of anxiety and depressive symptoms in family carers of older people. Methods Two hundred and thirty-six family carers of older adults participated in this cross-sectional survey study. Outcome measures included their symptoms of anxiety and depression, pandemic-related psychosocial factors, external factors, and the practice of preventive behaviours. Results Caseness prevalence of anxiety and depression among family carers was 25 and 56% respectively. Working carers were more depressed than non-working, while younger carers reported more anxiety and depression symptoms than older. Hand hygiene and getting drugs from the hospital positively predicted depression while healthy lifestyle negatively predicted depression. These variables, together with perceived risk and severity and the worry of getting infected, predicted anxiety. Conclusions The prevalence of mental health symptoms was alarming. Telemedicine practice, including online pharmaceutical services and the Internet Hospital plus Drug Delivery platform, could be a solution in alleviating the burden and worry of infection of family carers. Tailored-made interventions by age and working status of the family carers are recommended.
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Affiliation(s)
- Marcus Y L Chiu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong. .,University of Bolton, England, UK.
| | - Cyrus L K Leung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong.,JC School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Ben K K Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - Dannii Yeung
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
| | - T W Lo
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong
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20
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Wong ELY, Lau JYC, Chau PYK, Chung RYN, Wong SYS, Woo J, Yeoh EK. Caregivers’ Experience of End-of-Life Stage Elderly Patients: Longitudinal Qualitative Interview. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042101. [PMID: 35206288 PMCID: PMC8871572 DOI: 10.3390/ijerph19042101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/11/2022] [Accepted: 02/12/2022] [Indexed: 02/01/2023]
Abstract
Objectives: This study seeks to provide an understanding of the changing experiences in caregivers of end-of-life patients in Hong Kong through exploring their caregiving journey. Methods: Using longitudinal individual qualitative interviews, a total of 14 caregivers of community-dwelling elderly patients receiving end-of-life care were recruited between 2015 and 2016. A series of in-depth interviews and observations were conducted in 14 cases during the end-of-life journey. Results: A thematic analysis revealed four sequential experiential stages, abbreviated as “CAPE” that caregivers confronted: Stage 1 Certainty, (1a) lack of certainty regarding the progression of decline at the end-stage of life (1b) feelings of despair as patients’ function decreased; Stage 2 Ambivalence, (2a) feelings of ambivalence after decisions were made regarding EOL care, (2b) struggle over care responsibility within families; Stage 3 Perturbed, (3a) varied in quality of EOL care, (3b) depressed mood arisen from frequent exposure to the suffering of elderly patients; and Stage 4 Expectation, (4a) losing the caregiving role as patients showing signs of imminent death. Conclusions: These findings increase our understanding of caregivers’ in-depth experience over time that arise within the structural context of end-of-life care. Our data highlights the need for end of life related knowledge and information, provision of a caring atmosphere and communication, and professional-led detachment in creating caregiving-friendly service in healthcare system, thus as to provide support and alleviate stress for caregivers with their critical responsibility and role during the course of end-of-life care.
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Affiliation(s)
- Eliza Lai-Yi Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
- Correspondence:
| | - Janice Ying-Chui Lau
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Patsy Yuen-Kwan Chau
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Roger Yat-Nork Chung
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Samuel Yeung-Shan Wong
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
| | - Jean Woo
- The Jockey Club Institute of Ageing, The Chinese University of Hong Kong, Hong Kong, China;
| | - Eng-Kiong Yeoh
- Centre for Health Systems and Policy Research, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (J.Y.-C.L.); (P.Y.-K.C.); (R.Y.-N.C.); (S.Y.-S.W.); (E.-K.Y.)
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21
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Liu X, Chen C, Wu Q, Ji Q, Zhu P. Dilemma: Disclosure Experience Among Young Female Breast Cancer Survivors in China. J Adolesc Young Adult Oncol 2021; 11:486-492. [PMID: 34962155 DOI: 10.1089/jayao.2021.0124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Culture influences whether cancer patients disclose their disease diagnosis to others. Understanding Chinese young female breast cancer survivors (BCSs)' experiences and perspectives on disclosure could play a vital role in clinical nursing. This study explores the experiences of Chinese young female BCSs with disease disclosure and describes the reasons for their choices. Methods: Using the tenets of phenomenological research and a purpose sampling method, semistructured interviews were conducted with 31 BCSs from February to April 2021. Colaizzi's analysis method was performed with NVivo software to develop common themes from the data. Results: From the analysis of the interviews of the 31 participants, three main themes were identified: (1) disclosure-to whom, including core family members, close friends, roommates, and employers; (2) disclosure to achieve positive outcomes, including: to gain social support, tell others to take precautions, obtain relevant information, and get permission to work flexibly, and (3) nondisclosure to avoid negative outcomes, including fear of discrimination and stigmatization, strengthen the role of the patient, bring excessive burden, and fear of excessive compassion. Conclusions: For young women diagnosed with breast cancer in China, it is a very complicated matter whether they choose to disclose their diagnosis to others. While disclosure can bring many benefits, it is important to look at the reasons why these women are concealing their diagnosis.
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Affiliation(s)
- Xinyi Liu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Chen Chen
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Qiwei Wu
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Qiaoying Ji
- School of Nursing, Yangzhou University, Yangzhou, China
| | - Pingting Zhu
- School of Nursing, Yangzhou University, Yangzhou, China.,Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, China
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22
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Chow EOW, Wong YY, Fok DYH, Liao X, Li C. Positive life stories of Stroke-Survivor's spousal caregiving in Hong Kong: Lessons for policy and practice. Soc Sci Med 2021; 291:114476. [PMID: 34700116 DOI: 10.1016/j.socscimed.2021.114476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Advances in medical-care for immediately post-stroke mean that many stroke-survivors now live a normal lifespan, although they may suffer residual disability. They are often cared for at home by their spouse, who may be ill-prepared for this task, and may also have health concerns. As demands on formal services increase with population aging in Hong Kong, equipping spousal-caregivers with positive effective caring strategies is increasingly important. OBJECTIVE To understand what constitutes positive spousal-caregiving for stroke-survivors in Hong Kong within the cultural lens of 'Zhong (Loyalty)' METHOD: Naturalistic qualitative research was employed to hear stories about positive caregiving from Hong Kong couples living with stroke sequelae. Three in-depth face-to-face semi-structured interviews were undertaken with eleven dyads (stroke-survivor alone, spousal-caregiver alone, then the couple together). Data validation was by member-checking, further questions, and feedback at a second interview, and corroboration by field-notes. FINDINGS A strength-based interactive model of positive spousal-caregiving was described, whose core tenet was Zhong (Loyalty). This fostered, and in turn was nurtured by, three paired key behaviours (1. Learning new skills linked with satisfaction when efforts paid off; 2. Utilizing formal and informal resources linked with supporting others; 3. Cherishing and bringing out the best linked with managing life- and self-care). Couples' capacity to develop these behaviours reflected their inner strengths. CONCLUSIONS Couples who practiced positive caring and were resilient in the face of adversity were likely to optimise dyadic health and deal constructively with unexpected challenges. To address a looming shortfall between client need, and formal health and social services in Hong Kong, evidence-based policies are required to support effective, positive community-based spousal-caregiving.
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Affiliation(s)
- Esther O W Chow
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong.
| | - Yuk Yi Wong
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Doris Y H Fok
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Xu Liao
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
| | - Chaoyu Li
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong
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23
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Lun MWA, Gorton ME. Multiple Social Roles and Role Transference: Lessons Learned from a Chinese American Family Caregiver. HEALTH & SOCIAL WORK 2021; 46:227-230. [PMID: 34313762 DOI: 10.1093/hsw/hlab014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 03/03/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Man Wai Alice Lun
- associate professor, Borough of Manhattan Community College, City University of New York, 199 Chambers Street, New York, NY 10007
| | - Melissa E Gorton
- clinical therapist, Ascension Providence DePaul Center, Waco, TX
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24
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Lee Y, Song Y. Coping as a Mediator of the Relationship between Stress and Anxiety in Caregivers of Patients with Acute Stroke. Clin Nurs Res 2021; 31:136-143. [PMID: 34105381 DOI: 10.1177/10547738211021223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
According to Lazarus and Folkman's theory, stress and coping affect an individual's anxiety, which is an adaptive outcome. This study examined the mediation effects of stress-coping strategies on the relationship between stress and anxiety in caregivers of patients with acute stroke. A cross-sectional descriptive design was used to analyze a total of 131 caregivers caring for patients with acute stroke at a university hospital. The Caregivers Stress Scale, Ways of Coping Questionnaire, and Korean Beck Anxiety Inventory were used to quantify the participants' responses. Our results revealed that emotion-focused coping (β = .56, p < .001) partially mediated the relationship between stress and anxiety (Z = 3.30, p < .001), suggesting its ability to exacerbate anxiety in the short term by acting as a mediator between stress and anxiety. Developing appropriate coping strategies for caregivers of patients with acute stroke is therefore critical for reducing their anxiety.
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Affiliation(s)
- Yoonmi Lee
- Kyungpook National University, Daegu, South Korea
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25
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Association between primary caregiver type and mortality among Chinese older adults with disability: a prospective cohort study. BMC Geriatr 2021; 21:268. [PMID: 33882871 PMCID: PMC8061058 DOI: 10.1186/s12877-021-02219-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 04/15/2021] [Indexed: 11/30/2022] Open
Abstract
Background Socio-demographic transitions have dramatically changed the traditional family care settings in China, caused unmet care needs among older adults. However, whether different primary caregiver types have different influences on disabled older adults’ health outcomes remain poorly understood. We aimed to examine the association between the type of primary caregiver (e.g., spouse and children) and death among community-dwelling Chinese older adults disabled in activities of daily living. Methods We used data from Chinese Longitudinal Healthy Longevity Survey. The analytic sample comprised 4278 eligible adults aged ≥ 80 years. We classified primary caregiver type into five categories: spouse, son/daughter-in-law, daughter/son-in-law, grandchildren, and domestic helper. We used Cox regression model to examine the association between primary caregiver type and all-cause mortality. Covariates included age, sex, residence, years of education, co-residence status, financial independence, whether living with children, number of ADL disability, number of chronic conditions, and self-reported health, cognitive impairment, and caregiving quality. Results Married older adults whose primary caregivers were son/daughter-in-law had a 38% higher hazard of death than those who had spouse as the primary caregiver. Married men who received care primarily from son/daughter-in-law or daughter/son-in-law had a 64 and 68% higher hazard of death, respectively, than those whose primary caregiver was spouse. The association between primary caregiver type and mortality among widowed older adults differed between urban and rural areas. Urban residents who had domestic helpers as the primary caregiver had an 16% lower hazard of death, while those living in rural areas had a 50% higher hazard of death, than those having son/daughter-in-law as the primary caregiver. Conclusions The quality of care of the primary caregiver may be a risk factor for mortality of disabled older adults in China. Interventions are necessary for reducing unmet needs and managing care burden.
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26
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Lee JJ, Tsang WN, Yang SC, Kwok JYY, Lou VWQ, Lau KK. Qualitative Study of Chinese Stroke Caregivers' Caregiving Experience During the COVID-19 Pandemic. Stroke 2021; 52:1407-1414. [PMID: 33588588 DOI: 10.1161/strokeaha.120.032250] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE The coronavirus disease 2019 (COVID-19) outbreak has led to disruptions in health care service delivery worldwide, inevitably affecting stroke survivors requiring ongoing rehabilitation and chronic illness management. To date, no published research has been found on stroke caregiving during the COVID-19 pandemic. This study aimed to explore Hong Kong stroke caregivers' caregiving experiences in the midst of this difficult time. METHODS Individual semistructured interviews were conducted with 25 Chinese adult primary stroke caregivers from May to June 2020 via telephone. Interviews were transcribed verbatim and analyzed using an interpretive description approach and constant comparison strategy. RESULTS Five themes of the stroke caregiving experience during the COVID-19 pandemic emerged: care service adversities, additional caregiving workload and strain, threatened relationship between caregiver and stroke survivors, threats to caregivers' physical and psychological well-being, and needs for continuing caregiving roles. Our findings suggested that caregivers have worsened physical and psychological well-being because of increases in care burden with simultaneously reduced formal and informal support. The relationship between caregiver and stroke survivor was subsequently affected, placing some survivors at heightened risk of abuse. CONCLUSIONS Our study provides valuable findings about stroke caregiving experiences and needs during the pandemic. Delivery of psychological support, telemedicine, and household hygiene resources would be useful to mitigate caregivers' psychological distress during the COVID-19 pandemic.
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Affiliation(s)
- Jung Jae Lee
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Wing Nga Tsang
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Sook Ching Yang
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, United Kingdom (S.C.Y.).,Now with Central Coast Local Health District, New South Wales Health, Australia (S.C.Y)
| | - Jojo Yan Yan Kwok
- School of Nursing (J.J.L., W.N.T., J.Y.Y.K.), The University of Hong Kong, Hong Kong SAR
| | - Vivian W Q Lou
- Sau Po Centre on Ageing, Department of Social Work and Social Administration (V.W.Q.L.), The University of Hong Kong, Hong Kong SAR
| | - Kui Kai Lau
- Division of Neurology, Department of Medicine, Queen Mary Hospital, LKS Faculty of Medicine (K.K.L.), The University of Hong Kong, Hong Kong SAR
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27
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Liu J. Spouse and Adult-Child Dementia Caregivers in Chinese American Families: Who Are More Stressed Out? J Am Med Dir Assoc 2021; 22:1512-1517. [PMID: 33453175 DOI: 10.1016/j.jamda.2020.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 10/21/2020] [Accepted: 12/07/2020] [Indexed: 01/12/2023]
Abstract
OBJECTIVES Though many studies have explored differences between spouses and adult children in dementia care, empirical evidence is lacking on racial- and ethnic-minority populations. To fill this research gap, this study examined care tasks, caregiver burden, and depressive symptoms of Chinese spouse and adult-child caregivers in dementia care. Guided by the stress process model, this study asked 3 questions: Do spouse and adult-child caregivers take up different care tasks and experience different levels of caregiver burden and depressive symptoms? Does gender moderate the differences between spouse and adult-child caregivers? Whether care tasks and burden mediate the association between being a spouse/adult-child caregiver and depressive symptoms? SETTING AND PARTICIPANTS Data were collected from a questionnaire-based survey of Chinese Americans who provided care for their family members with dementia in New York City. The analytical sample included 126 Chinese spouse or adult-child caregivers. METHODS Care tasks was indicated by intensity of 8 types of care tasks. Caregiver burden and depressive symptoms were measured by Zarit's Burden Interview and the 10-item Center for Epidemiologic Studies Depression Scale. Linear regression, interaction term (spouse/adult-child caregiver by gender), and path analysis were conducted to address the 3 questions. RESULTS The results of linear regression show no significant difference in care tasks between the 2 groups, but spouse caregivers had significantly higher levels of caregiver burden and depressive symptoms than adult children. Wives had higher levels of caregiver burden and depressive symptoms than husbands, daughters, and sons. Caregiver burden mediated the association between being a spouse caregiver and higher depressive symptoms, whereas care tasks did not shape such association. CONCLUSIONS AND IMPLICATIONS This study highlighted the emotional stress of Chinese American older adults in providing care for their spouses. The findings indicate the necessity of developing culturally meaningful activities to support Chinese American spouse caregivers.
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Affiliation(s)
- Jinyu Liu
- School of Social Work, Columbia University, New York, NY, USA.
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28
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Zhou DHR, Hung SL, Lo TLT. Can We Hit Two Birds with One Stone: An Effectiveness Study of Peer-support Groups for Low-income Spousal and Adult Children Caregivers of Hong Kong Older Adults. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2020; 63:227-249. [PMID: 32264770 DOI: 10.1080/01634372.2020.1746722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/18/2020] [Accepted: 03/20/2020] [Indexed: 06/11/2023]
Abstract
This study aims to assess the effectiveness of peer support groups for low-income older adults' caregivers in the Hong Kong community. It compares the effectiveness of peer support groups on spouse and adult children caregivers. The peer support program was structured into three stages, including six training sessions for peer specialists, eight caregiver support group sessions, and non-structured informal contact. The study adopted a quasi-experiment design supplemented with qualitative data collected from focused group interviews. It involved a user group of 58 participants and a control group of 42 participants. Both quantitative and qualitative data were collected before, after the peer support groups, and at a three-month follow-up. The quantitative results showed that the peer support program was more effective in promoting social support for adult children caregivers but not for spousal caregivers. Three focus group interviews suggested that the community-based peer-support group could be helpful to improve stress management, emotional regulation skills, and social networks of the caregivers. Based on the research findings, we discuss the various needs of spousal and adult children caregivers, provide recommendations for service providers and practitioners to consider homogenous group services to address the diverse needs of spousal and adult children caregivers.
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Affiliation(s)
- De-Hui Ruth Zhou
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, China
| | - Suet-Lin Hung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, China
| | - Temmy Lee Ting Lo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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29
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30
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Wong DFK, Ng TK, Zhuang XY. Caregiving burden and psychological distress in Chinese spousal caregivers: gender difference in the moderating role of positive aspects of caregiving. Aging Ment Health 2019; 23:976-983. [PMID: 29781713 DOI: 10.1080/13607863.2018.1474447] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Objectives: This study endeavors to advance the current literature by examining the gender differences in the caregiving experiences and the stress-buffering role of positive aspects of caregiving (PAC) among Chinese spousal caregivers of frail elders in Hong Kong. Method: Forty-nine husband caregivers and 121 wife caregivers of frail elders in Hong Kong (N = 170) responded to the Positive Aspects of Caregiving (PAC) scale, the Zarit Burden Interview (ZBI), the 21-item Depression, Anxiety, and Stress Scales (DASS-21), and demographic questions. These spousal caregivers were diverse in age, and their care receivers were diverse in terms of age and health condition. Results: As predicted, there were significant gender differences in the moderating effects of PAC on the relationships of caregiving burden to depression, anxiety, and overall psychological distress. While PAC significantly buffered the effects of caregiving burden on depression, anxiety, and overall psychological distress for wife caregivers, the moderating effects of PAC were not significant for husband caregivers. Unexpectedly, wife caregivers reported lower PAC, higher caregiving burden, and higher psychological distress. Conclusion: As these findings suggest that PAC is lower but more beneficial for Chinese wife caregivers than Chinese husband caregivers, helping professionals are recommended to use strengths-based interventions that target PAC when working with Chinese wife caregivers.
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Affiliation(s)
- Daniel Fu Keung Wong
- a Department of Social Work and Social Administration , The University of Hong Kong , Pokfulam , Hong Kong
| | - Ting Kin Ng
- a Department of Social Work and Social Administration , The University of Hong Kong , Pokfulam , Hong Kong
| | - Xiao Yu Zhuang
- a Department of Social Work and Social Administration , The University of Hong Kong , Pokfulam , Hong Kong
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31
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Huang J, Lin D, Yu NX. Variations in Dyadic Adjustment Among Heterosexual HIV-Discordant Couples in Rural China: A Latent Profile Analysis. AIDS Patient Care STDS 2019; 33:323-335. [PMID: 31194573 DOI: 10.1089/apc.2019.0026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The systemic framework of resilience and dyadic perspective of couple coping suggests that HIV-discordant couples may show heterogeneous profiles of dyadic adjustment, shaped by contextual risks and resources. This study aimed to identify heterogeneous profiles of dyadic adjustment and thus investigate the expression of resilience among 159 heterosexual HIV-discordant couples in rural China. We hypothesized that the couples could be grouped into distinct profiles: both members showing poor well-being, both members showing good well-being, and discrepant well-being across the two members. A latent profile analysis classified the couples into three subgroups based on well-being, which was measured using the World Health Organization Well-Being Index. As expected, one subgroup, labeled Maladapted Couples (n = 58, 36.5%), reported poor well-being in both people living with HIV/AIDS (PLWHA) and the seronegative spouse. The second subgroup, labeled Resilient Couples (n = 50, 31.4%), was characterized by relatively good well-being in both partners. In the third subgroup, labeled Maladapted PLWHA and Resilient Spouses (n = 51, 32.1%), the PLWHA showed poor well-being, while the seronegative spouses demonstrated good well-being. The identified subgroups were validated against external well-being measures, including depression and self-rated health measures. Exploratory analyses identified distinct patterns of contextual risks (including HIV stigma and financial difficulties) and resource factors (including individual resources and relational resources) across the subgroups. These findings underscore the heterogeneity of adjustment among heterosexual HIV-discordant couples in rural China and suggest the potential usefulness of services tailored to specific subgroups.
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Affiliation(s)
- Jiasheng Huang
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
| | - Danhua Lin
- Institute of Developmental Psychology, Beijing Normal University, Beijing, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, China
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32
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Pan Y, Chen R, Yang D. The Role of Mutuality and Coping in a Nurse-Led Cognitive Behavioral Intervention on Depressive Symptoms Among Dementia Caregivers. Res Gerontol Nurs 2019; 12:44-55. [PMID: 30653651 DOI: 10.3928/19404921-20181212-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/09/2018] [Indexed: 11/20/2022]
Abstract
The current study explored whether mutuality and coping predicted and/or mediated the effect of a nurse-led cognitive behavioral intervention (NLCBI) on depressive symptoms of caregivers of persons with dementia. The intervention group (n = 56) received five monthly in-home nurse-led cognitive behavioral sessions and consultation calls after each session. The control group (n = 56) received five monthly short general conversations with the nurse interventionist. Questionnaires on study variables and demographics were collected at baseline, end of intervention, and 2-month follow up. Improved mutuality (β = -0.75, p = 0.049) and active coping (β = -2.06, p = 0.0001) and decreased passive coping (β = 1.43, p = 0.001) were found to predict the reduction of depressive symptoms among caregivers in the NLCBI. However, none of these variables mediated the interventional effect. Regular mental health nursing interventions are suggested to focus on enhancing mutuality and active coping and decreasing passive coping to maintain caregivers' mental health. TARGETS Caregivers of persons with dementia. INTERVENTION DESCRIPTION Nurse-led cognitive behavioral sessions and subsequent consultation calls. MECHANISMS OF ACTION Impacted caregivers' reappraisals, thus improving their active coping skills and mutuality and decreasing their passive coping, which directly reduced their depressive symptoms. OUTCOMES Mutuality, active coping, and passive coping played a predicting, but not mediating, role in the effect of the NLCBI. [Res Gerontol Nurs. 2019; 12(1):44-55.].
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33
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Nakajima Y, Schmidt SM, Malmgren Fänge A, Ono M, Ikaga T. Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16040613. [PMID: 30791516 PMCID: PMC6406492 DOI: 10.3390/ijerph16040613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 12/12/2022]
Abstract
This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.
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Affiliation(s)
- Yukie Nakajima
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
- Japan Society for the Promotion of Science, Koujimachi 5 3 1, Chiyoda, Tokyo 1020083, Japan.
| | - Steven M Schmidt
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
| | - Mari Ono
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
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34
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Goodyear RT. Preparing Interprofessionals as Teachers of Caregivers of Aged in Taiwan. J Nurse Pract 2019. [DOI: 10.1016/j.nurpra.2018.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Zhang F, Fung H, Kwok T. Spouse's subjective social status predicts older adults' prospective cognitive functioning. Aging Ment Health 2019; 23:277-285. [PMID: 29210597 DOI: 10.1080/13607863.2017.1406449] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES The current study aims to investigate the association between subjective social status (SSS) and prospective cognitive functioning of older adults and their spouses, and to explore the potential mediating roles of health habits and physical activities in this association. METHOD Using the longitudinal data of 512 pairs of community-dwelling older couples aged 65-91 years (M = 72.2 ± 4.6), we tested the effects of SSS in cognitive functioning using an Actor-Partner Interdependence Model. SSS was measured by a self-anchoring social ladder, and cognitive functioning was measured by the Mini-Mental State Examination at baseline and 4-year follow-up. Socioeconomic status (i.e. education) was tested as a moderator, and physical activity (measured by the Physical Activity Scale for the Elderly) as well as health habits (i.e. tobacco and alcohol consumption) were included as potential mediators. RESULTS A partner effect of SSS was found only in the low-education group, in which the wife's higher level of SSS in the community was associated with the husband's better cognitive functioning in the follow-up. A small proportion of this effect was found to be partially mediated by participation in housework, such that the wife's higher SSS was associated with the husband's increased housework activity, which was related to higher prospective cognitive functioning. CONCLUSION By examining the dyadic effects of SSS with a longitudinal design, our findings extended the understanding on how subjective social status influenced older couples' cognitive health, and provided evidence-based insights for future studies on cognitive health in later life.
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Affiliation(s)
- Fan Zhang
- a The Nethersole School of Nursing , The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Helene Fung
- b Department of Psychology , The Chinese University of Hong Kong , Shatin , Hong Kong
| | - Timothy Kwok
- c Department of Medicine & Therapeutics , The Chinese University of Hong Kong , Shatin , Hong Kong
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36
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Heyzer L, Ali NB, Chew AP, Chan M, Lim WS. Worry about Performance: Unravelling the Relationship between 'Doing More' and 'Doing Better'. J Nutr Health Aging 2019; 23:843-848. [PMID: 31641734 DOI: 10.1007/s12603-019-1225-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Recent studies have described worry about caregiver performance (WaP) as a distinct dimension of caregiver burden. We aimed to explore care recipient and caregiver characteristics between the concordant and discordant WaP groups in a population of caregivers of older adults with cognitive impairment. The secondary objective is to explore if there are differences between high and low WaP subsets in the 'doing more' and 'doing better' groups. DESIGN, SETTING AND PARTICIPANTS This is a retrospective study of 936 dyads of community-dwelling older adults with cognitive complaints and their primary family caregiver from a hospital in Singapore. MEASUREMENTS We performed descriptive and inferential statistics of the characteristics of caregivers and patients. We categorized caregiver-patient dyads into four groups, namely concordant (high vs low WaP) and discordant ('doing more' vs 'doing better') groups. For both concordant and discordant groups, we further defined low and high WaP subgroups using tertile cutoffs. RESULTS The concordant low WaP group is predicted by the spousal relationship (p<.001) and care recipients with fewer neuropsychiatric symptoms (p<.001). There is no significant difference between the discordant groups, which were predominantly the adult children. Further analysis of subgroups found that in the 'doing better' group, there were more spouses in the high as compared to low WaP subgroups, with the reverse true in the 'doing more' group. In the 'doing more' group, caregivers with high WaP also had higher total ZBI (p<0.05) with higher factors (F1, F2 and F3) scores (p<0.05). They also endorsed higher NPI-Q scores (p=0.045) particularly in the domain of depression / dysphoria (p=0.034). These differences are not seen in the 'doing better' group. CONCLUSION Our study suggests an association with caregiver characteristics (adult child) and disruptive behavior in the 'do more' high WaP discordant group. Delineating into the high and low WaP subgroups can help us identify the 'do more' high WaP subgroup that merits further attention and early intervention.
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Affiliation(s)
- L Heyzer
- Louise Heyzer, Department of Geriatric Medicine, Tan Tock Seng Hospital, Annex 2 , Level 3, 11 Jalan Tan Tock Seng, Novena, Singapore 308433,
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Janardhana N. Understanding the wounded soul of an invisible workforce: Needs and issues of family carers. ARCHIVES OF MENTAL HEALTH 2019. [DOI: 10.4103/amh.amh_15_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Cheung DSK, Ho KHM, Cheung TF, Lam SC, Tse MMY. Anticipatory grief of spousal and adult children caregivers of people with dementia. BMC Palliat Care 2018; 17:124. [PMID: 30458746 PMCID: PMC6247750 DOI: 10.1186/s12904-018-0376-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/01/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Anticipatory grief (AG) among caregivers of people with dementia is common and has been found to be related to negative health outcomes. Previous studies showed different patterns of AG between spousal and adult children caregivers of people with dementia (PWD) at different stages; however, the levels of such grief are not yet compared. The findings in Western studies are very limited, and inconsistencies have also been found in Asian studies. METHODS One hundred and eight primary caregivers (54 spousal and 54 adult children) of community-dwelling PWD were recruited from elderly community services sectors in Hong Kong, China through quota sampling. The demographics, AG (measured by the Marwit-Meuser Caregiver Grief Inventory-short form), subjective caregiver burden, and well-being of the participants were assessed. A Functional Assessment Staging Test was used to grade the stages of dementia of the PWD. In this study, those in stages 4 and 5 were regarded as being at an earlier stage, and those in stages 6 and 7 at a later stage of dementia. The Mann-Whitney U-test and the Chi-square test were used to compare the variables between spousal and adult children caregivers, and the Kruskal-Wallis test was used to compare the outcomes among the sub-groups (spousal caregivers caring for relatives with earlier/later stage dementia; and adult children caregivers caring for relatives with earlier/later stage dementia). A post-hoc analysis was also conducted to identify differences between the sub-groups. Pearson's correlation was performed to investigate the bivariate relationships among AG, subjective caregiver burden, and well-being. RESULTS The results showed that spousal caregivers caring for relatives in a later stage of dementia experienced the highest level of AG and subjective caregiving burden, as compared with spousal caregivers caring for relatives in an earlier stage of dementia and adult children caregivers. Well-being was significantly negatively correlated with AG and subjective caregiver burden, while AG was also significantly correlated with subjective caregiver burden. CONCLUSION This study found that spousal caregivers of relatives in a later stage of dementia have significantly higher levels of AG, warranting special attention and extra support from palliative professionals.
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Affiliation(s)
- Daphne Sze Ki Cheung
- School of Nursing, The Hong Kong Polytechnic University, Room GH526, Hung Hom, Kowloon, Hong Kong.
| | - Ken Hok Man Ho
- School of Nursing, Tung Wah College, Room KPC 16/F, 31 Wylie Road, Homantin, Kowloon, Hong Kong
| | - Tsz Fung Cheung
- School of Nursing, The Hong Kong Polytechnic University, Room A133, Hung Hom, Kowloon, Hong Kong
| | - Simon Ching Lam
- School of Nursing, The Hong Kong Polytechnic University, Room GH523, Hung Hom, Kowloon, Hong Kong
| | - Mimi Mun Yee Tse
- School of Nursing, The Hong Kong Polytechnic University, Room FG425, Hung Hom, Kowloon, Hong Kong
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Bai X, Liu C, Baladon L, Rubio-Valera M. Multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Aging Ment Health 2018; 22:980-989. [PMID: 28541777 DOI: 10.1080/13607863.2017.1330872] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES The objective of this study was to examine multidimensional determinants of the caregiving burden among Chinese male caregivers of older family members in Hong Kong. Based on a modified stress process model, this study explored how background and contextual factors (demographic characteristics and mental health status of caregivers, caregiving-related factors, and support and services), primary stressors (degree of care dependency and special care needs), and secondary stressors (self-efficacy and gender role conflict) might affect the caregiving burden among male caregivers. METHOD A questionnaire survey was completed by 204 male caregivers who considered themselves as primary caregivers for older family members with care needs aged 60 and over. Descriptive, bivariate, and multivariate analyses were conducted. RESULTS Being the son of the care receiver, the presence of depressive symptoms, a higher degree of gender role conflict, a lower degree of caregiving self-efficacy, and the use of support and services all predicted greater caregiving burden among male caregivers. CONCLUSION This study established a modified stress process model specifically for male caregivers. Gender role conflict and caregiving self-efficacy were introduced into the model as secondary stressors and found to be significantly associated with the degree of caregiving burden. The findings of this study could inform the development of services and interventions to reduce the caregiving burden among male caregivers.
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Affiliation(s)
- Xue Bai
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong.,b Personal Social Services Research Unit , London School of Economics and Political Science , UK
| | - Chang Liu
- a Department of Applied Social Sciences , The Hong Kong Polytechnic University , Hong Kong
| | - Luisa Baladon
- c Adults Mental Health Centre of Garraf , Parc Sanitari Sant Joan De Déu , Barcelona , Spain
| | - Maria Rubio-Valera
- d Research and Teaching Unit , Fundació Sant Joan de Déu , Spain.,e Centre For Biomedical Research in Epidemiology and Public Health, CIBERESP , Madrid , Spain.,f School of Pharmacy , Universitat de Barcelona , Barcelona , Spain
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Juntunen K, Salminen AL, Törmäkangas T, Tillman P, Leinonen K, Nikander R. Perceived burden among spouse, adult child, and parent caregivers. J Adv Nurs 2018; 74:2340-2350. [PMID: 29869807 DOI: 10.1111/jan.13733] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 03/22/2018] [Accepted: 03/26/2018] [Indexed: 01/14/2023]
Abstract
AIMS To identify what factors are associated with the caregiver burden of spouse caregivers, adult child caregivers, and parent caregivers. BACKGROUND Caregivers often feel stressed and perceive caregiving as a burden. The caregiver burden has been little studied from the perspective of the personal relationship between caregiver and care recipient. DESIGN Cross-sectional study. METHODS A random sample of 4,000 caregivers in Finland was drawn in 2014 and those who remained either spouse, adult child, or parent caregivers at data collection were included in the analysis (N = 1,062). Data collection included recipients' characteristics. Caregivers' perceived burden was measured using the Caregivers of Older People in Europe index. General linear models were used to explain perceived caregiver burden. RESULTS Care recipients' low level of cognitive function was associated with greater perceived burden. Higher quality of support was associated with lower perceived burden among female and male spouse caregivers, daughter caregivers, and mother caregivers. Low cognitive function explained 3-6% and high quality of support 2-5% of the total variation in the burden explained by the models, which ranged between 45-55%. CONCLUSION Because cognitive challenges of care recipient are associated with greater perceived burden and high quality of support with lower burden among most of the caregiver groups, high-quality tailored nursing interventions will be needed especially for the caregivers of the most frail care recipients.
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Affiliation(s)
- Kristiina Juntunen
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,Field of Social Services and Health Care, JAMK University of Applied Sciences, Jyväskylä, Finland
| | | | - Timo Törmäkangas
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Päivi Tillman
- Social Insurance Institution of Finland, Helsinki, Finland
| | | | - Riku Nikander
- Unit of Health Sciences, Faculty of Sports and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.,GeroCenter Foundation for Aging Research and Development, Jyväskylä, Finland.,Department of Physical Medicine and Rehabilitation, Central Hospital of Central Finland, Jyväskylä, Finland
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Oliveira DC, Vass C, Aubeeluck A. The development and validation of the Dementia Quality of Life Scale for Older Family Carers (DQoL-OC). Aging Ment Health 2018; 22:709-716. [PMID: 28282723 DOI: 10.1080/13607863.2017.1293004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE Little is known about how caregiving affects the quality of life (QoL) of older family carers and no dementia and age-specific QoL scale is available for use with this population. This study aimed to develop and validate a unique dementia caregiving- and age-specific tool - the 'Dementia Quality of Life Scale for Older Family Carers' (DQoL-OC). METHODS The scale items were identified in focus groups with older family carers in the UK. Content and face validity were evaluated by a panel of six experts. A set of 100 items assessed on a 5-point Likert scale was tested with 182 older family carers. Test-re-test reliability was conducted with 18 individuals. Exploratory factor analysis was used to identify the QoL model and reduce the number of scale items. Convergent construct validity and internal consistency were also established. RESULTS A one-factor solution containing 22 items was obtained. Test-re-test reliability (lower bound r = 0.835; p < 0.001), internal consistency (Cronbach's α = 0.936), and convergent construct validity were established. Significantly lower levels of QoL were found in female older carers; those who perceived their relatives with dementia as being at the earlier stages of the disease and with unstable dementia symptoms; those providing care more hours per day and more days per week; and those in younger-old age. CONCLUSIONS The DQoL-OC is a valid and reliable scale that will be useful for research and in clinical practice with older family carers of people with dementia. These study results will inform future health and social care aiming to improve life quality for this overlooked population of carers.
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Affiliation(s)
- Deborah C Oliveira
- a Institute of Mental Health, Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham , Nottingham NG7 2TU , United Kingdom
| | - Catherine Vass
- b Division of Nursing, School of Health Sciences , University of Nottingham , United Kingdom
| | - Aimee Aubeeluck
- b Division of Nursing, School of Health Sciences , University of Nottingham , United Kingdom
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Tseng FM, Petrie D, Leon-Gonzalez R. The impact of spousal bereavement on subjective wellbeing: Evidence from the Taiwanese elderly population. ECONOMICS AND HUMAN BIOLOGY 2017; 26:1-12. [PMID: 28142088 DOI: 10.1016/j.ehb.2017.01.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Revised: 01/12/2017] [Accepted: 01/13/2017] [Indexed: 06/06/2023]
Abstract
Bereavement is an inevitable event in our life. This paper employs the Taiwanese panel Survey of Health and Living Status of the Elderly (SHLSE) to evaluate the impact of losing a spouse on self-assessed health and subjective well-being measured by depression and life satisfaction. Propensity score matching methods are used to generate a hypothetical bereavement date and a weight for the non-bereaved to create a comparable non-bereaved cohort and a difference-in-differences (DiD) approach is used to estimate the impact of spousal bereavement. The results show that spousal bereavement increases depression scale by 1.81 points but this increment decreases by 0.43 points every year after bereavement. It takes approximate 4 years to restore to the level prior to bereavement. We also examine the demographic and socioeconomic differences in the spousal bereavement impact and find that the spousal bereavement impact is greater on the bereaved in the higher income group in terms of self-assessed health and depression. Our results only represent a lower boundary of the possible impact of spousal bereavement on self-assessed health and subjective wellbeing due to data restrictions.
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Affiliation(s)
- Fu-Min Tseng
- Department of Economics, National Chung Cheng University, Taiwan.
| | - Dennis Petrie
- Centre for Health Economics, Monash University, Australia
| | - Roberto Leon-Gonzalez
- National Graduate Institute for Policy Studies, Tokyo, Japan; Rimini Centre for Economic Analysis, Italy
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Lu N, Liu J, Lou VW. Exploring the reciprocal relationship between caregiver burden and the functional health of frail older adults in China: A cross-lag analysis. Geriatr Nurs 2016; 37:19-24. [DOI: 10.1016/j.gerinurse.2015.08.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 08/25/2015] [Accepted: 08/31/2015] [Indexed: 10/23/2022]
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Lu N, Liu J, Lou VW. Caring for frail elders with musculoskeletal conditions and family caregivers’ subjective well-being: The role of multidimensional caregiver burden. Arch Gerontol Geriatr 2015. [DOI: 10.1016/j.archger.2015.07.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Honda A, Abe Y, Date Y, Honda S. The Impact of Multiple Roles on Psychological Distress among Japanese Workers. Saf Health Work 2015; 6:114-9. [PMID: 26106510 PMCID: PMC4476194 DOI: 10.1016/j.shaw.2014.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2014] [Revised: 12/02/2014] [Accepted: 12/30/2014] [Indexed: 01/08/2023] Open
Abstract
Background There has been considerable interest in Japanese society in the problem of work-related stress leading to depressive symptoms, and an increasing number of primary houseworkers maintain paid employment. The purpose of this study was to examine the differential impact of multiple roles associated with psychological distress among Japanese workers. Methods We studied 722 men and women aged 18–83 years in a cross-sectional study. The K10 questionnaire was used to examine psychological distress. Results The proportion of participants with psychological distress was higher in women (17.8%) compared with men (11.5%). Having three roles significantly decreased the risk of psychological distress [women: odds ratio (OR), 0.37-fold; men: OR, 0.41] compared with only one role. In working married women, there was significantly less psychological distress (OR, 0.27), and those with childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.38) than those with only an employment role. Similarly, working married men who had childrearing or caregiving responsibilities for elderly parents had significantly less psychological distress (OR, 0.41) than those who had only an employment role. Conclusion The present study demonstrated that participants who had only an employment role had an increased risk of psychological distress. The degree of psychological distress was not determined solely by the number of roles. It is important to have balance between work and family life to reduce role conflict and/or role submersion, which in turn may reduce the risk of psychological distress.
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Affiliation(s)
- Ayumi Honda
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Yutaka Date
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
| | - Sumihisa Honda
- Department of Nursing, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Nagasaki, Japan
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Chan WCH. Factor structure of the Chinese version of the Meaning in Life Questionnaire among Hong Kong Chinese caregivers. HEALTH & SOCIAL WORK 2014; 39:135-143. [PMID: 25095626 DOI: 10.1093/hsw/hlu025] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study examines the factor structure of the Chinese version of the Meaning in Life Questionnaire (C-MLQ) in a sample of Hong Kong Chinese caregivers of patients with chronic illness (N = 223). Confirmatory factor analysis was performed to examine the factor structure. Findings confirm that, identical to the original version, C-MLQ showed the same two-factor structure: Presence and Search. Correlation between Presence and Search was found to be positive and moderate (r = .47). This study establishes empirically the same factor structure as the original version of MLQ among caregivers in Hong Kong. The relationship between Presence and Meaning is discussed in the contexts of Chinese culture and caregiving. Results suggest caregivers' continuing need for meaning in life. Medical social workers may help caregivers to integrate their caregiving experience with their sense of meaning in life and search for meaning in life to sustain their caregiving role.
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Parveen S, Morrison V, Robinson CA. Does coping mediate the relationship between familism and caregiver outcomes? Aging Ment Health 2014; 18:255-9. [PMID: 23962313 DOI: 10.1080/13607863.2013.827626] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The sociocultural model of stress and coping, which despite receiving support from several studies conducted with diverse ethnic groups, has yet to be tested longitudinally or used within the context of positive caregiver outcomes. The aim of the current study was to test a specific component of the model, which posits that caregiver coping will be influenced by the cultural value of familism (feelings of solidarity and loyalty among family members), which will in turn affect caregiver outcomes. METHOD A questionnaire was completed by 123 family caregivers in the UK assessing familism, use of coping strategies, caregiver gains, anxiety and depression at three time points over nine months. RESULTS Mediation analysis followed guidelines proposed by Baron and Kenny. Religious coping and positive reframing at time 2 (T2) were found to significantly mediate between familism values at time 1 (T1) and caregiver gains at time 3 (T3). Behavioural disengagement at T2 was found to mediate between familism at T1 and caregiver depression at T3. Additionally familism was found to be positively associated with both negative and positive aspects of caregiving. CONCLUSION Our longitudinal findings suggest that interventions and services acknowledging caregiver values and the associated coping responses may prove beneficial.
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Affiliation(s)
- Sahdia Parveen
- a School of Psychology , Bangor University , Bangor , UK
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Honda A, Abe Y, Aoyagi K, Honda S. Caregiver burden mediates between caregiver's mental health condition and elder's behavioral problems among Japanese family caregivers. Aging Ment Health 2014; 18:248-54. [PMID: 23980935 DOI: 10.1080/13607863.2013.827625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES In Japan, the prevalence of depression has been reported to occur among 1 in 4 family caregivers. The purpose of this study was to investigate the self-rated burden associated with mental health conditions among caregivers. METHODS We studied 95 caregivers aged 38-87 years in a cross-sectional study. The General Health Questionnaire (GHQ-12) score of 4 or more was defined as poor mental health. RESULTS The proportion of caregivers with poor mental health was 24%. Caregivers with a high GHQ-12 score had the number of caregiver burdens increased by 2.5-fold compared to those with a low GHQ-12 score (p = 0.001). The proportion of caregivers with a high GHQ-12 score was significantly higher with an increasing number of behavioral problems among care recipients (p = 0.003). A mediational model was used to identify the underlying mechanism of the relationship between the number of behavioral problems and poor mental health in caregivers. Consequently, we found that mental health conditions in caregivers were associated with both the number of caregiver burdens and behavioral problems among care recipients. CONCLUSIONS It is vital to provide support not only to the caregivers but also to their elderly relatives, paying particular attention to early identification of poor mental health in caregivers so as to administer effective interventions, and to offer useful advice concerning how to deal with behavioral problems.
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Affiliation(s)
- Ayumi Honda
- a Department of Public Health , Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
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Chakrabarti S. Cultural aspects of caregiver burden in psychiatric disorders. World J Psychiatry 2013; 3:85-92. [DOI: 10.5498/wjp.v3.i4.85] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 10/21/2013] [Accepted: 11/16/2013] [Indexed: 02/05/2023] Open
Abstract
Caring for a mentally ill family member is well known to be mostly a stressful, distressing and burdensome experience. The dominant model for examining the process of caregiving has been the stress-appraisal-coping paradigm, in which interactions between stressors, appraisals, coping, and various mediators produce the eventual outcomes in terms of distress or well-being among caregivers. Ethnic and cultural factors have traditionally received the least research attention as mediators of the caregiving process. However, a large body of accumulated research evidence has clearly demonstrated that culturally-defined values, norms, and roles are among the major determinants of the caregiving experience. This research is based mainly on cross-cultural comparisons between caregivers of minority ethnic groups residing in the West and the native Caucasian population. It has been supplemented, to a limited extent, by research carried out among caregivers belonging to different cultures and residing in their countries of origin. Most of this research has been carried out among caregivers of elderly people with dementia; other psychiatric disorders such as schizophrenia have received much less attention. Results of this research have documented important differences in caregiving experiences and outcomes across cultural and ethnic groups. Cultural factors which could mediate these differences have been identified, and theories, which could provide a coherent framework to understand these differences, proposed. Though limited by methodological difficulties, this research has provided important insights into the impact of cultural and ethnic factors on the whole spectrum of the caregiving experiences. An improved understanding of the area is, nevertheless, required because it will eventually help in devising appropriate ways to reduce burden and distress among caregivers from diverse ethnic and cultural groups.
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Chan WCH, Chan CLF, Suen M. Validation of the Chinese version of the Modified Caregivers Strain Index among Hong Kong caregivers: an initiative of medical social workers. HEALTH & SOCIAL WORK 2013; 38:214-221. [PMID: 24432488 DOI: 10.1093/hsw/hlt021] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Family caregivers may often experience caregiving stress and burden. To systematically assess this issue, medical social workers may need to use a brief and valid measurement in their practice. In the Hong Kong Chinese context, one additional challenge is to examine whether a measurement developed in the West is valid for Hong Kong Chinese caregivers. Thus, medical social workers in Hong Kong initiated this research study to validate the Chinese version of the Modified Caregiver Strain Index (C-M-CSI). A total of 223 Chinese caregivers of patients with various chronic illnesses were recruited for this validation study. C-M-CSI demonstrated good reliability (Cronbach's alpha coefficient = .91), concurrent validity with the Chinese version of the Caregiver Burden Inventory, and discriminant validity with the Chinese version of the Meaning in Life Questionnaire. Factor analysis yielded a single factor as the original M-CSI, which explained 49 percent of variance. Construct validity was shown by differentiating spousal and nonspousal caregivers, as well as caregivers of patients with and without behavioral problems. C-M-CSI is recommended as a brief and valid measurement that can be used by medical social workers in assessing the caregiving strain of Chinese caregivers of patients in Hong Kong.
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Affiliation(s)
| | | | - Margaret Suen
- Department of Medical Social Work, Caritas Medical Centre, Hospital Authority, Shamshuipo, Kowloon
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