Anticipatory grief of spousal and adult children caregivers of people with dementia.

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.

Applications of Three-Dimensional Printing in Surgery.

Three-dimensional (3D) printing is a rapidly advancing technology in the field of surgery. This article reviews its contemporary applications in 3 aspects of surgery, namely, surgical planning, implants and prostheses, and education and training. Three-dimensional printing technology can contribute to surgical planning by depicting precise personalized anatomy and thus a potential improvement in surgical outcome. For implants and prosthesis, the technology might overcome the limitations of conventional methods such as visual discrepancy from the recipient's body and unmatching anatomy. In addition, 3D printing technology could be integrated into medical school curriculum, supplementing the conventional cadaver-based education and training in anatomy and surgery. Future potential applications of 3D printing in surgery, mainly in the areas of skin, nerve, and vascular graft preparation as well as ear reconstruction, are also discussed. Numerous trials and studies are still ongoing. However, scientists and clinicians are still encountering some limitations of the technology including high cost, long processing time, unsatisfactory mechanical properties, and suboptimal accuracy. These limitations might potentially hamper the applications of this technology in daily clinical practice.