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Agyemang-Duah W, Rosenberg MW. Geographical location as a determinant of caregiver burden: a rural-urban analysis of the informal caregiving, health, and healthcare survey in Ghana. BMC PRIMARY CARE 2024; 25:317. [PMID: 39198724 PMCID: PMC11351011 DOI: 10.1186/s12875-024-02562-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 08/05/2024] [Indexed: 09/01/2024]
Abstract
BACKGROUND The caregiving scholarship widely acknowledges informal caregivers' contributions to maintaining older adults' health and well-being. However, informal caregivers encounter economic, physical, social, financial and psychological challenges when caring for older adults. The caregiving literature has shown variations in caregiving intensity and motivation between rural and urban informal caregivers of older adults. This situation is likely to result in rural-urban disparities in caregiver burden. However, the literature on predictors of caregiver burden is more focused on demographic, socio-economic, caregiving and health-related factors with very little attention to geographical dynamics. For this reason, the effects of demographic, socio-economic, caregiving, and health-related factors on the variations in caregiver burden between rural and urban informal caregivers of older adults are yet to be known in the sub-Saharan African context, including Ghana. Notably, the impact of geographical location on caregiver burden is mainly missing in the informal caregiving literature in Ghana. Situated within the stress process model, we determine the association between geographical location and caregiver burden among informal caregivers of older adults in Ghana. METHODS This study employed data from a large cross-sectional survey on informal caregiving, health, and healthcare among caregivers of older adults aged 50 years or above (N = 1,853) in Ghana. We selected the World Health Organization Impact of Caregiving Scale to measure caregiver burden. Generalized multivariable linear regression models were employed to determine the association between geographical location and caregiver burden among informal caregivers of older adults. We reported beta values and standard errors with significance levels of 0.05 or less. RESULTS The results showed that rural informal caregivers of older adults significantly have a decreased caregiver burden compared to urban informal caregivers (β = -1.64; SE = 0.41). Also, participants across all the self-rated health categories (poor/very poor: β = 12.63; SE = 1.65; fair: β = 9.56; SE = 1.07; good: β = 11.00; SE = 0.61, very good: β = 7.03; SE = 0.49) have a significantly increased caregiver burden for the full sample and for both rural (poor/very poor: β = 13.88; SE = 2.4; fair: β = 6.11; SE = 1.62; good: β = 9.97; SE = 0.96, very good: β = 6.06; SE = 0.71) and urban (poor/very poor: β = 11.86; SE = 2.25; fair: β = 12.33; SE = 1.42; good: β = 11.80; SE = 0.79, very good: β = 7.90; SE = 0.67) participants. This study further revealed that participants with no financial support needs reported a decreased caregiver burden compared to those with financial support needs for the full sample (β = -2.92, p-value < 0.01) and for both rural (β = -3.20; p-value < 0.01) and urban (β =-2.70; p-value < 0.01) participants. CONCLUSION The findings from this study underscore geographical location differences in caregiver burden among informal caregivers of older adults in Ghana. Given these findings, the need to consider geographical location variations in providing welfare and health support programs to lessen caregiver burden among informal caregivers of older adults is welcomed. In line with the stress process model, such welfare and health programs should consider background, context, and stressor factors that contribute to variations in caregiver burden between rural and urban informal caregivers of older adults in Ghana and other sub-Saharan African countries.
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Affiliation(s)
- Williams Agyemang-Duah
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada.
| | - Mark W Rosenberg
- Department of Geography and Planning, Queen's University, Kingston, ON, K7L 3N6, Canada
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Gao Y, Zhong F, Zhan X, Bao Y, Zhu X. Postoperative rehabilitation exercise experiences of geriatric patients with femoral neck fractures based on the perspective of medical staff: a qualitative study. BMC Geriatr 2024; 24:667. [PMID: 39117996 PMCID: PMC11308417 DOI: 10.1186/s12877-024-05266-w] [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: 03/12/2024] [Accepted: 07/31/2024] [Indexed: 08/10/2024] Open
Abstract
BACKGROUND The incidence of femoral neck fractures in older adults is increasing each year. Active and reasonable postoperative rehabilitation exercises can restore the activity of geriatric patients with femoral neck fractures to a great extent, while also avoiding bedridden complications and re-fractures. This study explores the perspectives, experiences, and recommendations of medical staff regarding the implementation status, existing problems, promoting factors, and hindering factors of post-surgical rehabilitation exercises for geriatric patients with femoral neck fractures. The ultimate goal is to further optimize rehabilitation exercise programs and to expedite this process for patients. METHODS A qualitative, descriptive phenomenological study was conducted. A total of 21 clinical medical staff were selected using the purposive sampling method for semi-structured interviews. A content analysis method was used to collate and analyze the collected interview data. RESULTS A total of 2 themes and 6 sub-themes were defined. The themes consisted of multiple obstacles occurring during the implementation of rehabilitation exercises and the scientific cognition of medical staff on these exercises. Respondents found that patient initiative during rehabilitation exercises was insufficient, that the comprehensiveness and continuity of exercises could not be guaranteed, and that unification between textbook theory and clinical practice was incomplete. Moreover, respondents believed that their professional quality should be excellent, but that staffing and organizational management required optimization, and that support was required for the implementation of rehabilitation exercises. CONCLUSION This study investigated the opinions and experiences of medical staff during postoperative rehabilitation exercises in geriatric patients with femoral neck fractures. Collaborative efforts should fully engage hospitals, communities, and families, enhance the alignment of health education with patient needs, advance the scientific development of an integrated medical model by refining the curriculum and teaching system, and significantly elevate the level of medical science and technology. This study will serve as a valuable reference for the establishment of future professional, and personalized rehabilitation programs tailored for geriatric patients with femoral neck fractures.
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Affiliation(s)
- Yazhuo Gao
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Fangfang Zhong
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China
| | - Xiaoyan Zhan
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, China
| | - Yunchun Bao
- The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Chinese Medicine), Hangzhou, 310006, China
| | - Xuehua Zhu
- School of Nursing, Zhejiang Chinese Medical University, Hangzhou, 310053, China.
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Mashhadi-Naser S, Sabet FP, Nasiri M, Vasli P. Benefits of a family-based care transition program for older adults after hip fracture surgery. Aging Clin Exp Res 2024; 36:142. [PMID: 39002096 PMCID: PMC11246294 DOI: 10.1007/s40520-024-02794-8] [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: 05/22/2024] [Accepted: 06/21/2024] [Indexed: 07/15/2024]
Abstract
BACKGROUND Hip fracture (HF) in older adults is strongly associated with a greater decline in their activities of daily living (ADLs) and health-related (HRQoL). The present study aimed to evaluate the effects of a family-based care transition program (FBCTP) on ADLs, HRQoL and social support in this age group after HF surgery. METHODS A quasi-experimental design was conducted on 100 older adults who had undergone HFS and were selected by convenience sampling and allocated to the IG (n = 50) and the CG (n = 50). Data were collected utilizing the Barthel Index, the 12-item Short Form Health Survey (SF-12), and the Multidimensional Scale of Perceived Social Support. The FBCTP was delivered in-hospital education sessions, home visit, and a follow-up and telephone counselling session. The data were collected at three stages, including the baseline, four weeks after discharge, and eight weeks later. The level of statistical significance was set at 0.05. RESULTS The results of the study indicated that the effects of time and group on the increase in ADLs were 15.2 and 36.69 (p < 0.000), respectively, following the completion of the FBCTP. Furthermore, time and group were found to have a positive effect on HRQoL, with an increase of 2.82 and 5.60 units, respectively (p < 0.000). In this context, time and group also interacted in the IG compared to the CG, with scores increasing by 1.86 units over time (p < 0.000). Although the study results indicated that social support improved by 1.98 units over time (p < 0.000), the effects of group alone and the time × group interaction were not statistically significant. This indicates that the program was not effective in accelerating social support. CONCLUSION Consequently, nurses, policymakers, and planners engaged in geriatric healthcare may utilize these results to enhance the health status of this age group following HFS.
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Affiliation(s)
- Sahar Mashhadi-Naser
- Student Research Committee, Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pashaei Sabet
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parvaneh Vasli
- Department of Community Health Nursing, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Zhang Y, Liu S, Miao Q, Zhang X, Wei H, Feng S, Li X. The Heterogeneity of Symptom Burden and Fear of Progression Among Kidney Transplant Recipients: A Latent Class Analysis. Psychol Res Behav Manag 2024; 17:1205-1219. [PMID: 38524288 PMCID: PMC10959014 DOI: 10.2147/prbm.s454787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 03/26/2024] Open
Abstract
Purpose Kidney transplant recipients (KTRs) may experience symptoms that increase their fear of progression (FoP), but a dearth of research examines the issue from a patient-centered perspective. Our study aimed to first determine the category of symptom burden, then to explore the differences in characteristics of patients in different subgroups, and finally to analyze the impact of symptom subgroup on FoP. Patients and Methods Sociodemographic and Clinical Characteristics, Symptom Experience Scale, and Fear of Progression Questionnaire-Short Form were used. Latent class analysis was used to group KTRs according to the occurrence of symptoms. We used multivariate logistic regression to analyze the predictors of different subgroups. The differences in FoP among symptom burden subgroups were analyzed by hierarchical multiple regression. Results Three subgroups were identified, designated all-high (20.5%), moderate (39.9%), and all-low (39.6%) according to their symptom occurrence. Multivariate logistic regression showed that gender, post-transplant time, per capita monthly income, and hyperuricemia were the factors that distinguished and predicted the all-high subgroup (P < 0.05). Hierarchical multiple regression showed that symptom burden had a significant effect on FoP (class1 vs class3: β = 0.327, P < 0.001; class2 vs class3: β = 0.104, P = 0.046), explaining the 8.0% variance of FoP (ΔR2 = 0.080). Conclusion KTRs generally experience moderate or low symptom burden, and symptom burden is an influencing factor in FoP. Identifying the traits of KTRs with high symptom burden can help clinicians develop targeted management strategies and ease FoP of KTRs.
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Affiliation(s)
- Ying Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Sainan Liu
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Qi Miao
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xu Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - He Wei
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Shuang Feng
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
| | - Xiaofei Li
- The First Affiliated Hospital of China Medical University, Shenyang, 110001, People’s Republic of China
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Smith TO, Langford S, Ward K, Gray R. Unpaid caregiving for people following hip fracture: longitudinal analysis from the English Longitudinal Study of Ageing. Eur Geriatr Med 2023; 14:1249-1260. [PMID: 37537519 PMCID: PMC10754765 DOI: 10.1007/s41999-023-00843-5] [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: 04/16/2023] [Accepted: 07/19/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE To determine the provision and its change over time in unpaid care for people following hip fracture. METHODS Data were sought from the English Longitudinal Study of Ageing (ELSA) cohort. We identified participants who self-reported experiencing a hip fracture, who had clinical and caregiving data in the previous and subsequent two data collection waves. Demographic and clinical data were collected in addition to data on provision of unpaid care, who provided care and the frequency of needs being met. RESULTS The analysed cohort consisted of 246 participants [150 females (61%), mean age 78.9 years (standard deviation: 8.6)]. There was an increase in the number of participants requiring unpaid care between the Pre-Fracture and Fracture Wave (29% vs. 59%), which plateaued in the subsequent two waves (56%; 51%). Although both spouse and daughters provided the most unpaid care to participants over this study period, there was an increase in support provided during the Fracture Wave by both sons and daughters. This increased support offered by spouses continued until Post-Fracture Wave 2 when this plateaued. Support provided by friends increased from 3 to 8% and brothers and sisters increased from 0 and 1% Pre-Fracture to 8% by Post-Fracture Wave 2. CONCLUSION These findings provide insights into who, what and how unpaid carers support people following hip fracture over time. Given the level of support unpaid carers offer, and previously reported carer stress and burden, undertaking clinical trials to assess the effectiveness of carer-patient support interventions would be valuable.
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Affiliation(s)
- Toby O Smith
- Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
- Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK.
| | - S Langford
- Department of Trauma and Orthopaedics, Northumbria Healthcare NHS Foundation Trust, Newcastle upon Tyne, UK
| | - K Ward
- Scottish Hip Fracture Audit, Public Health Scotland, Edinburgh, UK
| | - R Gray
- James Paget Hospital, Gorleston, Norfolk, UK
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Wang Z, Wang G, Jing B, Feng S, Zhang S, Wu D, Song Z, Niu L, Qi B. Does the timing of surgery affect outcomes in young and middle-aged patients undergoing surgical stabilization of rib fractures? Feedback was based on real data from physicians, patients, and family caregivers. Eur J Trauma Emerg Surg 2023; 49:2467-2477. [PMID: 37436467 DOI: 10.1007/s00068-023-02321-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 06/26/2023] [Indexed: 07/13/2023]
Abstract
BACKGROUND There is a general clinical consensus that early surgical stabilization of rib fractures (SSRF, ≤ 48-72 h after admission) can benefit patients, and this is only regarding the surgeon's opinions. This study assessed the true outcomes of young and middle-aged patients at different surgical timings. METHODS This retrospective cohort study was conducted among patients aged 30-55 years who were hospitalized with a diagnosis of isolated rib fractures and underwent SSRF between July 2017 and September 2021. The patients were divided into early (≤ 3 days), mid- (4-7 days) and late (8-14 days) groups, according to the interval (days) between surgery and injury date. The impact of different surgical timings on clinical outcomes, patients, and families was assessed by comparing SSRF-related data during hospitalization and follow-up studies of clinicians, patients themselves, and family caregivers 1-2 months after surgery. RESULTS In this study, 155 complete patient data were finally included, including 52, 64, and 39 patients in the early, mid, and late groups, respectively. Length of operation, preoperative closed chest drainage rate, length of hospital stay, intensive care unit length of stay, duration of invasive mechanical ventilation in the early group were lower than those in the intermediate and late groups. Additionally, hemothorax and excess pleural fluid incidence after SSRF was lower in the early group than in the intermediate and late groups. Postoperative follow-up results showed that patients in the early group had higher SF-12 physical component summary scores and shorter duration of absence from work. Family caregivers had lower Zarit Burden Interview scores than those in the mid- and late groups. CONCLUSION From the experience of our institution's SSRF, early surgery is safe and offers additional potential benefits for young and middle-aged patients and families with isolated rib fractures.
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Affiliation(s)
- Zhimeng Wang
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Gang Wang
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Baoli Jing
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Shanghua Feng
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Shaobo Zhang
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Dinghua Wu
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Zhe Song
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Lin Niu
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Bin Qi
- Department of Thoracic Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China.
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Bao J, Wang XY, Chen CH, Zou LT. Relationship between primary caregivers’ social support function, anxiety, and depression after interventional therapy for acute myocardial infarction patients. World J Psychiatry 2023; 13:919-928. [DOI: 10.5498/wjp.v13.i11.919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/20/2023] [Accepted: 10/11/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND An acute myocardial infarction (AMI) is often treated with direct coronary intervention and requires home-based rehabilitation. Caregivers of patients with AMI need adequate social support to maintain high-quality care; however, their social support function is low, and relevant indicators for intervention must be identified.
AIM To analyze the correlation between social support for primary caregivers, their anxiety, and depression, when caring for patients with AMI after interventional therapy.
METHODS Using convenience sampling, we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy. The Social Support Rating Scale (SSRS), Self-Rating Anxiety Scale (SAS), and Self-Rating Depression Scale (SDS) were used to assess the primary caregivers. A Pearson’s correlation analysis was used to analyze the correlations between the SSRS, SAS, and SDS, and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers. The receiver operating characteristic curve and area under the curve (AUC) were used to evaluate the pre-dictive ability of the SAS and SDS for low social support function in primary caregivers.
RESULTS Considering the norm among Chinese people, AMI caregivers’ objective support, subjective support, support utilization, and SSRS scores were lower, while their SAS and SDS scores were higher. The SSRS scores of female caregivers were higher than those of the male caregivers (t = 2.123, P = 0.035). The Pearson correlation analysis showed that objective support, subjective support, support utilization, and SSRS total scores were significantly correlated with both SAS (r = -0.414, -0.460, -0.416, -0.535) and SDS scores (r = -0.463, -0.379, -0.349, -0.472). Among the 300 AMI caregivers, 56 cases (18.67%) had a low level of support function (SSRS ≤ 22 points). Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers, regardless of adjustment for other variables (P < 0.05). SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84, sensitivity was 67.9 and 71.4, and specificity was 84.0 and 70.9, respectively.
CONCLUSION The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.
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Affiliation(s)
- Jun Bao
- Department of Cardiovascular Medicine, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Xiao-Yan Wang
- Department of Cardiovascular Medicine, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Chong-Hao Chen
- Department of Cardiovascular Medicine, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
| | - Li-Ting Zou
- Department of Emergency, Affiliated Hospital of Jiangnan University, Wuxi 214000, Jiangsu Province, China
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Fernández-González M, Lozano-Lozano M, Martín-Martín L, Ortiz-Piña M, Martín-Matillas M, Ariza-Vega P. Is a telerehabilitation programme for older adults with hip fracture associated with burden of family caregivers who provide support? Digit Health 2023; 9:20552076231213574. [PMID: 38025098 PMCID: PMC10656811 DOI: 10.1177/20552076231213574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Objective @ctivehip is a home-based multidisciplinary telerehabilitation programme for older adults with hip fracture, conducted with the assistance of their family caregivers. This programme was useful in improving their functional recovery. Nevertheless, we were concerned about how the programme might have affected caregivers, whose assistance was essential for supporting older adults in using new technologies and ensuring their safety during the exercises and activities at home. The aim of the present study was to compare the burden, psychological factors and physical fitness of the family caregivers of older adults who opted the @ctivehip telerehabilitation programme versus those family caregivers of older adults who received the face-to-face rehabilitation provided by the Andalusian Public Healthcare System (in Spain). Methods In this single-blinded, non-randomized clinical trial, participants were older adults with hip fracture and their family caregivers. The telerehabilitation group (n = 30) underwent a 12-week multidisciplinary telerehabilitation programme, and the comparative group (n = 32) received face-to-face rehabilitation. Caregivers outcomes measured were (i) the burden using the Zarit Burden Interview, (ii) the anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), and (iii) the Physical Fitness with the International Fitness Scale (IFIS). Results There were not statistically significant differences on caregiver burden between family caregivers in the @ctivehip and the comparative group, although there was a trend towards lower values [[Mean (95%CI); 14.73 (9.09 to 20.37) vs 16.03 (10.63 to 21.43); p = 0.771] as well as for anxiety and depression [5.66 (3.21 to 8.78) vs 11.19 (8.52 to 13.86); p = 0.022]. Likewise achieved better, though not statistically significant, scores in physical fitness [19.37 (17.94 to 20.81) vs 17.15 (15.77 to 18.53); p = 0.055]. Conclusion Caregiver burden is not associated with telerehabilitation. In addition, telerehabilitation is associated with lower anxiety and depression levels among family caregivers who opt for this programme. Physical fitness is not related with telerehabilitation.
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Affiliation(s)
- María Fernández-González
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Mario Lozano-Lozano
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Lydia Martín-Martín
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- “Cuídate” Support Unit for Oncology Patients, Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Mariana Ortiz-Piña
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Miguel Martín-Matillas
- PROFITH (PROmoting FITness and Health through physical activity) Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Patrocinio Ariza-Vega
- Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de Investigación Biosanitaria ibs.Granada, Granada, Spain
- PA-HELP “Physical Activity for HEaLth Promotion” Research Group, Department of Physical Education and Sports, Faculty of Sport Science, University of Granada, Granada, Spain
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Li B, Guo Y, Deng Y, Zhao S, Li C, Yang J, Li Q, Yan Y, Li F, Li X, Rong S. Association of social support with cognition among older adults in China: A cross-sectional study. Front Public Health 2022; 10:947225. [PMID: 36225770 PMCID: PMC9548585 DOI: 10.3389/fpubh.2022.947225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/29/2022] [Indexed: 01/21/2023] Open
Abstract
Objective This study aimed to examine the relationship between social support and its sub-domains and cognitive performance, and the association with cognitive impairment among older adults in China. Design A cross-sectional study. Setting and participants We included 865 community-based individuals aged 65 and above from Hubei province, China. Methods The level of social support was evaluated using the social support rating scale (SSRC). The Mini-Mental State Examination was adopted to assess cognitive function, and its cut-offs were used to determine cognitive impairment among the participants. Multiple linear regression models and logistic regression models were used to estimate the β and odds ratios (ORs) and their 95% CIs, respectively. Results The participants were divided into quartiles 1-4 (Q1-Q4), according to the total scores of SSRC. After adjusting for sociodemographic characteristics, lifestyle factors, and history of diseases, for MMSE scores, compared to these in Q1, the β of Q2-Q4 were -0.22 (-0.88, 0.43), 0.29 (-0.35, 0.94), and 0.86 (0.19, 1.53), respectively; For cognitive impairment, the ORs of Q2-Q4 were 1.21 (0.80, 1.82), 0.62 (0.40, 0.94), and 0.50 (0.32, 0.80), respectively. Considering SSRC scores as the continuous variable, per 1-unit increase, the β was 0.05 (0.02, 0.09) for the cognitive score, and the OR was 0.95 (0.92, 0.98) for cognitive impairment. In addition, higher levels of both subjective support and support utilization were related to better MMSE performance and lower risks of cognitive impairment. Conclusion and implications Among the older adults in China, as expected, there is a positive relationship between social support and cognitive performance, and high levels of social support, particularly in support utilization, were related to low risks of cognitive impairment. More social support should be provided in this population to improve cognitive function and reduce the risks of cognitive impairment.
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Affiliation(s)
- Benchao Li
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Guo
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Yan Deng
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Siqi Zhao
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Changfeng Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Jiajia Yang
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiuying Li
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yaqiong Yan
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Fang Li
- Wuhan Centers for Disease Prevention and Control, Wuhan, China
| | - Xiaonuan Li
- Wuhan Municipal Health Commission, Wuhan, China
| | - Shuang Rong
- Department of Nutrition Hygiene and Toxicology, School of Public Health, Medical College, Academy of Nutrition and Health, Wuhan University of Science and Technology, Wuhan, China
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Keihanian F, Kouchakinejad-Eramsadati L, Yousefzadeh-Chabok S, Homaie Rad E. Burden in caregivers of spinal cord injury patients: a systematic review and meta-analysis. Acta Neurol Belg 2022; 122:587-596. [PMID: 35157242 DOI: 10.1007/s13760-022-01888-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/31/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Caregivers of individuals with spinal cord injury encounter high levels of physical, psychosocial, and financial burden by providing lifelong assistance. In the present study, we aimed to assess the overall burden score of caregivers in spinal cord injury by pooling different standard scores together as a review. METHOD Search on databases of PubMed/Medline, Web of Science and Scopus was conducted using PRISMA guidelines. Studies that assessed the burden of care using the caregiver burden inventories of CBI (caregiver burden inventory), CBS (caregiver burden scale), CG (caregiver), CSI (Caregiver Strain Index), and short- and long-form Zarit questionnaires were included in our study. The results were analyzed using the meta-analysis method and a random effect pooled estimator. All analyses were performed using STATA SE software version 14. RESULT A total of 23 articles out of 399 retrieved studies were added to this review study. The overall score of caregiver burden in individuals with SCI was calculated 48.68 (95% CI 42.574-54.788). The I2 heterogeneity was 11.7%, suggesting a low level of heterogeneity among the included studies. There was no systematic difference between various questionnaires added to meta-analysis (P = 0.526). In addition, the caregiver burden did not differ in less and highly developed countries (P = 0.405). CONCLUSION Since SCI places a considerable burden on caregivers, scoring the burden of care can help policymakers plan for essential interventions and allocate more facilities for these patients and their caregivers.
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Liu J, Gong T, Xu X, Fox KM, Oates M, Gandra SR. Heavy clinical and economic burden of osteoporotic fracture among elderly female Medicare beneficiaries. Osteoporos Int 2022; 33:413-423. [PMID: 34505178 DOI: 10.1007/s00198-021-06084-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED We comprehensively described elderly Medicare women with an outpatient visit in 2011 and fracture within 2 years before. These women were at very high risk for subsequent fracture and high healthcare utilization and cost, especially those with vertebral or multiple fractures. However, rates of fracture prevention treatments were low. INTRODUCTION Postmenopausal women with osteoporosis are stratified to high and very-high fracture risk categories, and this categorization drives algorithms for osteoporosis management in osteoporosis treatment guidelines. This study comprehensively describes a very-high-risk cohort. METHODS This retrospective cohort study used the Medicare 20% database; elderly women with an outpatient visit in 2011 and fracture within 2 years before the visit were included. Outcomes included fracture risk, all-cause and fracture-related healthcare resource utilization and cost, and osteoporosis medication use in the 5 years after the visit. RESULTS Overall, 43,193 patients were included. The 5-year probability was 0.36 for major fracture and 0.11 and 0.17 for hip fracture and vertebral fracture, respectively, much higher than the guidelines' 10-year probability thresholds for very-high-risk (0.3 for major fracture, 0.045 for hip fracture). Rates of hospitalizations, emergency department visits or observation stays, and skilled nursing facility stays in year 1 were 53.7, 57.0, and 18.8 per 100 patient-years, respectively, decreasing slightly in subsequent years. Mean healthcare cost was $23,700 in year 1, decreasing to $18,500 in year 5. About 29.1% of patients received osteoporosis medications in year 1, decreasing to 16.9% by year 5. Rates for all outcomes, especially fractures, were much higher among vertebral and multiple fracture cohorts. CONCLUSION Elderly women with a fracture within last 2 years were at very-high-risk for subsequent fracture and high healthcare utilization and cost, especially those with vertebral or multiple fractures. However, rates of fracture prevention treatments were low. More effort is needed to identify and treat patients at very-high-risk for fracture.
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Affiliation(s)
- J Liu
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, 701 Park Avenue, Suite S2.100, Minneapolis, MN, 55415, USA.
| | - T Gong
- Chronic Disease Research Group, Hennepin Healthcare Research Institute, 701 Park Avenue, Suite S2.100, Minneapolis, MN, 55415, USA
| | - X Xu
- Amgen Inc., Thousand Oaks, CA, USA
| | - K M Fox
- Strategic Healthcare Solutions, LLC., Aiken, SC, USA
| | - M Oates
- Amgen Inc., Thousand Oaks, CA, USA
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Xu L, Jan S, Chen M, Si L. Sociodemographic and health system factors associated with variations in hospitalization costs for fractures in adults aged 45 years and over: a cross-sectional study of provincial health accounts in Jiangsu Province, China. Arch Osteoporos 2021; 16:147. [PMID: 34606013 DOI: 10.1007/s11657-021-01009-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 09/22/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study reports hospitalization costs of fracture in Chinese patients aged over 45 years and evaluates their related factors in different fracture groups. PURPOSE To report hospitalization costs of treating fractures in Chinese patients aged over 45 years and to investigate the sociodemographic and health system factors related to variation in the costs. METHODS Study participants were selected from the 2016 Health Accounts Database in Jiangsu in which patients' hospitalization costs were kept at various levels in hospitals. A multi-stage stratified sampling method was used to select study participants. Electronic medical records of patients aged 45 years and over with fractures were included. The International Classification of Diseases, Tenth Revision (ICD-10) was used to identify patients who were hospitalized due to fractures. A generalized linear model was used to estimate the extent to which a range of health system and sociodemographic factors were associated with the variation on hospitalization costs. Costs data were presented and analyzed using 2016 U.S. dollars. RESULTS A total of 39,300 patients were included in the study. Vertebra, tibia/fibula, and hip were the most frequent fracture sites. The mean (median) of hospitalization cost of included fractures ranged from USD 3142 (USD 2420) for hand and wrist fractures to USD 10,355 (USD 9673) for hip fractures. Longer length of hospital stay, higher hospital level, and being covered by a health insurance were associated with higher hospitalization costs for all fracture types. CONCLUSION Our study reports hospital costs of the fracture using a large health accounts database in China and investigates the associated factors of hospital costs. Our results may inform cost-of-illness studies and economic evaluations of fracture preventions.
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Affiliation(s)
- Lizheng Xu
- The George Institute for Global Health, Sydney, NSW, Australia.,UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia
| | - Stephen Jan
- The George Institute for Global Health, Sydney, NSW, Australia
| | - Mingsheng Chen
- School of Health Policy and Management, Nanjing Medical University, No. 101, Longmian Avenue, Nanjing, 211166, China. .,Creative Health Policy Research Group, Nanjing Medical University, Nanjing, China. .,Center for Global Health, Nanjing Medical University, Nanjing, China.
| | - Lei Si
- The George Institute for Global Health, Sydney, NSW, Australia.,UNSW Medicine, UNSW Sydney, Sydney, NSW, Australia.,School of Health Policy and Management, Nanjing Medical University, No. 101, Longmian Avenue, Nanjing, 211166, China
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Wu Y, Liu Y, Cao X, Ying Z, Park J, Feng Q, Umeda M, Liu Z, Liao J. Burden of caregivers who care for oldest-old parents with disability: A cross-sectional study. Geriatr Nurs 2021; 42:792-798. [PMID: 34090222 DOI: 10.1016/j.gerinurse.2021.04.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/12/2021] [Accepted: 04/14/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To describe the characteristics of oldest-old Chinese with disability and their adult-child caregivers, and the extent to which these characteristics were associated with caregiver burden. METHODS The study was based on 168 pairs of disabled oldest-old adults and their adult-child caregivers, derived from the Chinese Longitudinal Healthy Longevity Survey. Descriptive analyses of care recipients' and caregivers' characteristics were conducted respectively, in reference to caregiver burden. Statistically significant characteristics identified in these bivariate analyses were then jointly evaluated in multiple linear regression models with caregiver burden as the outcome. RESULTS Care recipients positive emotion status [(β = -0.227 (-0.412, -0.042)], multiple chronic disease [(β = 0.513 (0.081, 0.945)], and caregivers spent more caregiving time [(β = 0.225 (0.061, 0.389)] were main factors associated with caregiver burden. CONCLUSION Adult-children caregivers perceived heavier burden if care recipients had low positive emotions, had multiple chronic diseases, and caregivers spent more time caregiving.
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Affiliation(s)
- Yanjuan Wu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Yuyang Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China
| | - Xingqi Cao
- Department of Big Data in Health Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Zhimin Ying
- Department of Orthopaedic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - JuYoung Park
- Florida Atlantic University, Phyllis and Harvey Sandler School of Social Work, Boca Raton, FL, USA
| | - Qiushi Feng
- Department of Sociology and Centre for Family and Population Research, National University of Singapore, Singapore
| | - Maki Umeda
- Research Institute of Nursing Care for People and Community, University of Hyogo, Japan
| | - Zuyun Liu
- Department of Big Data in Health Science, School of Public Health and the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, China; Sun Yat-sen Global Health Institute, School of Public Health and Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
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