Need-based intervention delivery for family caregivers of older adults with dementia.

Research on family caregivers of persons with dementia abounds with studies of psychoeducational and cognitive-behavioral interventions to reduce stress and promote mental health. Yet, the caregiver's needs for such interventions are rarely documented. This study of 87 dementia caregivers examined their needs for dementia education and Resourcefulness Training© using baseline cut scores on validated measures of dementia knowledge and resourcefulness skills. While 66 % showed high need for dementia education, 61 % showed moderate to high need for Resourcefulness Training© and 55 % showed moderate to high need for both, prompting future research to explore advantages of delivering both interventions to dementia caregivers.

Association between post-stroke depression and functional outcomes: A systematic review.

BACKGROUND: Post-stroke depression (PSD) is a frequent problem in stroke patients, affecting their rehabilitation process and functional outcomes. Several studies have investigated the relationship between PSD and functional outcomes, but the results have been inconsistent. OBJECTIVE: This systematic review of non-experimental studies aims to investigate the prevalence of post-stroke depression and the association between post-stroke depression and functional outcomes. METHOD: A search of PubMed, MEDLINE, Web of Science, and CINAHL Plus with Full Text was carried out from inception until January 2024. The literature was screened using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with relevant papers included. We extracted data from non-experimental studies that examined associations between PSD and functional outcomes. The Joanna Briggs Institute for systematic reviews was used for critical appraisal. RESULTS: Twenty-one studies met the study criteria, including sixteen cohort studies, four cross-sectional studies, and one case-control study. PSD prevalences ranged from 12.2% to 32.2% in the first two weeks, 17.9 to 35.5% in the first month, and 10.4% to 32.0% in the third month following a stroke. Functional outcomes were evaluated in four domains: degree of dependence, basic activity of daily living, instrumental activity of daily living, and physical and cognitive function. Significant associations between PSD and functional outcomes were identified after controlling potential factors such as age, comorbidities, and stroke severity. PSD had negative associations with functional outcomes in all four measure domains from one month to five years after a stroke. Depression treatment showed positive results on functional outcomes in stroke patients. CONCLUSION: PSD prevalence was high in the first three months after stroke. PSD is significantly associated with poor functional outcomes. PSD assessment and management should be performed on a frequent basis in the early stages of stroke to achieve the best possible functional recovery.

Resourcefulness Among Initial Ischemic Stroke Patients: A Longitudinal Study of 12 Months.

Objective: To explore distinct longitudinal trajectories of resourcefulness among initial ischemic stroke patients from diagnosis to 12 months, and to identify whether sociodemographic factors, disease-related factors, self-efficacy, family function, and social support can predict patterns in the trajectories of resourcefulness. Methods: A prospective longitudinal study was conducted. Initial ischemic stroke patients who met inclusion and exclusion criteria were followed up when still in hospital (Preparing for discharge, Baseline, T1), at 1 month (T2), at 3 months (T3), at 6 months (T4), at 9 months (T5) and 12 months (T6) (±1 week) after discharge. General information, National Institute of Health Stroke Scale (NIHSS), Modified Rankin Scale (mRS), General Self-Efficacy Scale (GSES), General Family Functioning Subscale (FAD-GF), and Social Support Rate Scale (SSRS) were used in T1. The Resourcefulness Scale© was evaluated at 6 time points. Growth mixture modeling was used to identify trajectory patterns of resourcefulness. Logistic regression was used to identify predictors of resourcefulness trajectories. Results: Three longitudinal trajectories of resourcefulness were identified and named as the high-stable class (38.9%, n=71), fluctuation class (41.2%, n=75), and low-stable class (19.9%, n=36), respectively. Dwelling areas (x2=6.805, P=0.009), education (x2=44.865, P=0.000), monthly income (x2=13.063, P=0.001), NIHSS scores (x2=44.730, P=0.000), mRS scores (x2=51.788, P=0.000), Hcy (x2=9.345, P=0.002), GSES (x2=56.933, P=0.000), FAD-GF (x2=41.305, P=0.000) and SSRS (x2=52.373, P=0.000) were found to be statistically significant for distinguishing between different resourcefulness trajectory patterns. Lower education (OR=0.404), higher NIHSS(OR=6.672) scores, and higher mRS(OR=21.418) scores were found to be risk factors for lower resourcefulness, whereas higher education(OR=0.404), GSES(OR=0.276), FAD-GF(OR=0.344), and SSRS(OR=0.358) scores were identified as protective factors enhancing resourcefulness. Conclusion: This study obtained three patterns of trajectories and identified their predictive factors in initial ischemic stroke. The findings will assist health care professionals in identifying subgroups of patients and when they may be at risk of low resourcefulness and provide timely targeted intervention to promote resourcefulness.

Demographic differences of adults with Diabetes Mellitus: a cross-sectional study

The purpose of this study was to examine differences in scores on diabetes knowledge, social support, self-efficacy, self-care agency, self-care management, and glycemic control of individuals who were males or females, younger or older, with less or more education, with type 1 or type 2 diabetes, and with a shorter or longer duration of diabetes. A descriptive, comparative, cross-sectional design was used in the study, which was a secondary analysis of data from a larger study. The sample for this analysis included 141 adults attending an outpatient diabetes care center in the Southern United States. The instruments consisted of a demographic questionnaire and standard tools with established psychometric properties. Data analysis consisted of t-tests. The results show that there were significant mean differences between individuals who (a) were younger and older in regard to diabetes knowledge, self-care agency, and diabetes self-care management, (b) had less or more than a high school education in regard to diabetes knowledge, and (c) had type 1 or type 2 diabetes in regard to diabetes knowledge, self-care agency, and diabetes self-care management. In conclusion, specific demographics variables differ in scores on diabetes knowledge, self-care agency, and self-care activities, which are some of the fundamental factors to achieve glycemic control and prevent disease-related complications. These variables should be considered when designing and implementing a diabetes educational program.