Quality of informal care is multidimensional.

PURPOSE: To demonstrate that assessing quality of informal care involves more than merely determining whether care recipient needs for assistance with activities of daily living (ADLs) are routinely satisfied. We investigated the extent to which potentially harmful behavior (PHB), adequate care, and exemplary care (EC) are empirically distinct dimensions of quality of care. DESIGN: 237 care recipients completed the quality of care measures, and their caregivers completed psychosocial measures of their own depression, life events, cognitive status, and perceptions of pre-illness relationship quality. RESULTS: Although PHB was moderately related to EC, adequate care was not associated with PHB and was only slightly related to EC. Psychosocial variables were not related to adequate care but were differentially associated with PHB and EC, providing additional evidence for the distinction between these measures of quality of care. CONCLUSIONS: ADL assistance can be adequate in the presence of PHB and/or the absence of EC. Declines in EC may signal increases in PHB, independent of adequacy of care. These findings produce a brief, portable, and more comprehensive instrument for assessing quality of informal care.

Emerging adult versus adult status among college students: examination of explanatory variables.

The first purpose of this study was to report how many college students, 18 to 25 years of age, are classified as "emerging adults," "undecideds" or "adults." The second purpose was to determine the relationships between emerging adults versus adults and (a) background characteristics, (b) risk-taking behaviors; (c) sensation-seeking scores, and (d) income. A survey was administered to a total of 450 students enrolled in psychology classes in a southern state. Based on responses to four questions, 186 (41%) were emerging adults, 148 (33%) undecided, and 116 (26%) adults. Adult status was not significantly associated with gender or parenthood. Adults were more likely to be African-American and low income and were less likely to consume alcohol, binge drink, smoke cigarettes, and gamble. In addition, adults had significantly lower disinhibition scores than emerging adults.

Patient characteristics and availability of onsite non-rapid and rapid HIV testing in US substance use disorder treatment programs.

Racial and ethnic minorities and injection drug users (IDUs) are at increased risk of HIV infection. However, the associations between these caseload characteristics and the availability of onsite HIV testing in substance use disorder treatment programs are unknown. This study uses data collected in 2008-2009 from 198 program administrators of treatment programs participating in the National Institute on Drug Abuse's Clinical Trials Network to address this gap in the literature. Results show positive associations between the percentages of African American, Hispanic, and IDU patients and the odds of offering non-rapid onsite HIV testing versus no onsite testing. The associations between racial/ethnic composition and the availability of rapid HIV testing were more complicated. These findings suggest that many programs are responding to the needs of at-risk populations. However, programs and their patients may benefit from greater adoption of rapid testing which is less costly and better ensures that patients receive their results.

Depression and quality of informal care: a longitudinal investigation of caregiving stressors.

This research examined longitudinal associations between caregiving stressors, caregiver depression, and quality of care. Informal caregivers of elderly care recipients were interviewed at baseline (N = 310) and again one year later (N = 213). Hierarchical regression analyses indicated that increases in caregiving stressors (i.e., caregiver physical health symptoms, caregiver activity restriction, and care recipient controlling and manipulative behavior) were related to increased caregiver depression. In turn, increased caregiver depression and decreased caregiver respectful behavior predicted increases in potentially harmful behavior. These results extend previous cross-sectional findings and indicate that changes in caregiving stressors, caregiver depression, and caregiver respect over time may signal that intervention is warranted in order to forestall or prevent poor quality of care.