Measuring the intangible resources caregivers need to provide nurturing care during the complementary feeding period: a scoping review in low- and lower-middle-income countries.

OBJECTIVE: Caregivers require tangible (e.g. food and financial) and intangible resources to provide care to ensure child health, nutrition and development. Intangible resources include beliefs and knowledge, education, self-efficacy, perceived physical health, mental health, healthy stress levels, social support, empowerment, equitable gender attitudes, safety and security and time sufficiency. These intangible caregiver resources are included as intermediate outcomes in nutrition conceptual frameworks yet are rarely measured as part of maternal and child nutrition research or evaluations. To facilitate their measurement, this scoping review focused on understudied caregiver resources that have been measured during the complementary feeding period in low- and lower-middle-income countries. DESIGN: We screened 9,232 abstracts, reviewed 277 full-text articles and included 163 articles that measured caregiver resources related to complementary feeding or the nutritional status of children 6 months to 2 years of age. RESULTS: We identified measures of each caregiver resource, though the number of measures and quality of descriptions varied widely. Most articles (77 %) measured only one caregiver resource, mental health (n 83) and social support (n 54) most frequently. Psychometric properties were often reported for mental health measures, but less commonly for other constructs. Few studies reported adapting measures for specific contexts. Existing measures for mental health, equitable gender attitudes, safety and security and time sufficiency were commonly used; other constructs lacked standardised measures. CONCLUSIONS: Measurement of caregiver resources during the complementary feeding period is limited. Measuring caregiver resources is essential for prioritising caregivers and understanding how resources influence child care, feeding and nutrition.

Examining cultural adaptations of the savvy caregiver program for Korean American caregivers using the framework for reporting adaptations and modifications-enhanced (FRAME).

BACKGROUND: The Framework for Reporting Adaptations and Modifications-Enhanced (FRAME) is a tool that systematically guides decision-making and reporting of adaptations made to evidence-based interventions. Using FRAME, we documented the process and outcomes of adapting the Savvy Caregiver Program (SCP) for Korean American dementia caregivers. METHODS: Sequential adaptation was initiated with linguistic attunement, followed by pilot implementation and full adaptation. Our data-driven adaptation with multiple data sources and a feedback loop among multiple stakeholders yielded a total of 32 modifications, and each was coded according to the eight domains of FRAME: (1) what was modified, (2) who participated in recommending and deciding the modification to be made, (3) when the modification occurred, (4) whether the modification was planned, (5) whether the modification was fidelity-consistent, (6) whether the modification was temporary, (7) at what level of delivery, the modification was made, and (8) why the modification was made. RESULTS: The areas of adaptation were evenly distributed across context (37.5%), content (31.2%), and training (31.2%). The primary reasons for modification were for engagement (62.5%), followed by fit with recipients (43.8%) and outcome improvement (31.1%). About 66% of the modifications were applied to the entire target group, and all modifications were fidelity-consistent. CONCLUSIONS: The FRAME categorization provided a detailed understanding of the process and nature of adapting the SCP and served as a foundation for further implementation and scale-up. FRAME not only serves as a guide for adapting evidence-based interventions but also promotes their replicability and scalability.

Attitude of Indian nurses towards importance of families in nursing care: A cross-sectional study.

AIMS AND OBJECTIVE: To evaluate the attitudes of Indian nurses towards the importance of family involvement in nursing care and the association between nurse attitudes and sociodemographic characteristics. BACKGROUND: Involving the family in the care process is crucial for delivering family- and patient-centred care and ensuring the best possible patient outcomes. Nevertheless, published literature revealed that the nurses may lack clarity regarding the role of family members in the patient's care, which in turn hinders families' participation in care. DESIGN: Cross-sectional descriptive study. The STROBE checklist was used to report the present study. METHODS: A total of 203 Nurses participated in a prospective cross-sectional study between May 2022 and August 2022. They were recruited through convenience sampling from two tertiary care centres in India. A two-part questionnaire was used to gather the data; the first section contained questions for gathering sociodemographic information, and the second part contained the standardized FINC-NA scale. RESULTS: The mean age of the nurses was (28.08 ± 4.722) years, and their median professional experience was 2.5 (1-5.5) years. Nurses' attitude regarding family's importance in patient care was found to be significantly associated (p ≤ .05) with education level, marital status, religion and hometown region. CONCLUSION: In several items Indian nurses have positive attitudes towards family involvement in care but some of the lower scoring items can present opportunities for focused improvement. Continuing development programmes about family-centered care can constitute important strategies to improve the positive attitudes of nurses towards families in practice. PATIENT AND PUBLIC CONTRIBUTION: No patient or public contribution.

Healthcare Service Needs of Orphans and Vulnerable Children in Orphanages and Barriers Caregivers face in meeting their Healthcare Service Needs: A Mixed Method Research.

Poor health and well-being among orphans and vulnerable children (OVC) in orphanages has been documented in literature, and evidence has shown an association between access to healthcare and well-being among this population. This study assessed the healthcare service needs of OVC and explored the barriers their caregivers face in meeting their healthcare service needs using a mixed method research approach. The study utilized a multi-stage sampling technique in selecting 384 OVC and 14 caregivers that participated in the study. Data were collected using pre-tested questionnaire and interview guide. The quantitative data were analyzed using Statistical Product and Service Solutions (SPSS) version 23, while the qualitative data were analyzed using thematic and content analysis. The result of the study shows that regular health assessment while in the orphanage tops the list of health services needed by OVC; this was followed by health assessment before or during admission into orphanages and facility visits for management of common illness by health professionals while health education for the children and caregivers ranked third. Mental healthcare was the least need reported by the children. From the caregivers' perspectives, financial, structural and psychological barriers emerged as major themes for barriers faced in meeting the healthcare service needs of OVC. The study concluded that OVC are mainly in need of regular health assessment and treatment of common ailments during facility visits by health professionals. The study further shows that caregivers face significant barriers in meeting the healthcare service needs of OVC.

Caregivers' concerns through health professionals' eyes.

OBJECTIVES: Advancements in medicine and science have enabled more and more people to live longer with a chronic medical condition, namely cancer. Nevertheless, the palliative care (PC) approach continues to be introduced and incorporated later in the lives of patients and families dealing with such conditions. Thus, the need for individuals to care for this population in our society is increasing, giving rise to the so-called "informal caregivers." The present study intends to examine the main obstacles faced by informal caregivers taking care of a cancer patient receiving PC based on what health professionals working in these settings perceive and write down. To achieve this goal, the written files of 2 Portuguese palliative care institutions were analyzed. METHODS: An inductive thematic analysis was conducted, focusing on the contact between health professionals and family caregivers and based on the notes taken by health professionals. RESULTS: Three main overarching themes were identified: (1) burden, (2) intra-family impact of the illness, and (3) network vulnerabilities. Included in this are the emphasis on the role of the family and social support, the high levels of psychological morbidity and caregiver burden present over this period, and a great need for information about the illness. SIGNIFICANCE OF RESULTS: This study provided a broader awareness regarding the daily struggle experienced by family caregivers, particularly those who juggle between "roles." It is vital to understand the scope of the obstacles experienced by caregivers during the terminal phase of their loved one's illness, given how important it is to address the family's needs. Future studies and practitioners should consider these observations and topics when considering new approaches for this population, as they ought to be quite focused and short in time in order to meet people's needs.

Effectiveness of interventions by non-professional community-level workers or family caregivers to improve outcomes for physical impairments or disabilities in low resource settings: systematic review of task-sharing strategies.

BACKGROUND: In low-resource settings, access to basic rehabilitation could be supplemented by community-level interventions provided by community health workers, health volunteers, or family caregivers. Yet, it is unclear whether basic physical rehabilitation interventions delivered to adults by non-professional alternative resources in the community, under task-shifting or task-sharing approaches, are effective as those delivered by skilled rehabilitation professionals. We aim to synthesize evidence on the effectiveness of community-level rehabilitation interventions delivered by non-professional community-level workers or informal caregivers to improve health outcomes for persons with physical impairments or disabilities. METHODS: We performed a systematic review with a PROSPERO registration. Eight databases were searched for (PubMed, CINAHL, Global Health, PDQ Evidence, Scopus, ProQuest, CENTRAL, and Web of Science), supplemented by snowballing and key-informant recommendations, with no time restrictions, applied. Controlled and non-controlled experiments were included if reporting the effects of interventions on mobility, activities of daily living (ADLs), quality of life, or social participation outcomes. Two independent investigators performed the eligibility decisions, data extraction, risk of bias, and assessed the quality of the evidence using the GRADE approach. RESULTS: Ten studies (five randomized controlled trials [RCTs]) involving 2149 participants were included. Most common targeted stroke survivors (n = 8); family caregivers were most frequently used to deliver the intervention (n = 4); and the intervention was usually provided in homes (n = 7), with training initiated in the hospital (n = 4). Of the four RCTs delivered by family caregivers, one demonstrated a statistically significant improvement in mobility (effect size: 0.3; confidence interval [CI] 121.81-122.19; [p = 0.04]) and another one in ADLs (effect size: 0.4; CI 25.92-35.08; [p = 0.03]). Of the five non-RCT studies by community health workers or volunteers, one demonstrated a statistically significant improvement in mobility (effect size: 0.3; CI 10.143-16.857; [p < 0.05]), while two demonstrated improved statistically significant improvement in ADLs (effect size: 0.2; CI 180.202-184.789 [p = 0.001]; 0.4; CI - 7.643-18.643; [p = 0.026]). However, the quality of evidence, based on GRADE criteria, was rated as low to very low. CONCLUSIONS: While task-sharing is a possible strategy to meet basic rehabilitation needs in low-resource settings, the current evidence on the effectiveness of delivering rehabilitation interventions by non-professional community-level workers and informal caregivers is inconclusive. We can use the data and experiences from existing studies to better design studies and improve the implementation of interventions. Trial registration PROSPERO registration number: CRD42022319130.

Co-created Technological Solutions for Caregivers in Health Care: Systematic Review.

BACKGROUND: Support interventions for caregivers can reduce their stress, possibly improving the quality of patients' care while reducing care costs. Technological solutions have been designed to cover their needs, but there are some challenges in making them truly functional for end users. Co-design approaches present important opportunities for engaging diverse populations to help ensure that technological solutions are inclusive and accessible. OBJECTIVE: This study aimed to identify co-created technological solutions, as well as the process followed for their co-creation, in the field of health for caregivers. METHODS: The literature review was conducted in the Medline, Web of Science, Scopus, Science Direct, Scielo, and IEEE Xplore databases. The inclusion criteria were studies written in English or Spanish and with a publication date until May 2021. The content had to specify that the caregivers actively participated in the co-creation process, which covered until the development phase of the technological solution (prototype). The level of evidence and the methodological quality were analyzed when possible, using the Scottish Intercollegiate Guidelines Network criteria and the Mixed Methods Appraisal Tool, version 2018, respectively. RESULTS: In total, 410 papers were identified, and 11 met the eligibility criteria. The most predominant articles were mixed methods studies and qualitative studies. The technology used in the analyzed articles were mobile or web applications (9 studies) and specific devices such as sensors, cameras, or alarm systems (2 studies) to support the health and social aspects of caregivers and improve their education in care. The most common patient profile was older people (7 studies); 6 studies used co-creation in the requirements phase, 6 studies detailed the design phase. In 9 studies, the prototype was iteratively refined in the development phase, and the validation phase was performed in 5 of the reviewed studies. CONCLUSIONS: This systematic review suggests that existing co-created technological solutions in the field of health for caregivers are mostly mobile or web applications to support caregivers' social health and well-being and improve their health knowledge when delivering care to patients, especially older people. As for the co-creation process, caregivers are particularly involved during development and in the design. The scarce literature found indicates that further research with higher methodological quality is needed.

Medication management strategies by family caregivers of children with special healthcare needs.

BACKGROUND: Little is known about the strategies utilized by family caregivers managing medications for their children with special healthcare needs (CSHCN), those who require higher than normal care due to their multifaceted healthcare needs. Medication management strategies are a set of methods or techniques developed or adapted by caregivers to overcome medication-related barriers and ensure successful therapeutic outcomes. An in-depth understanding of such strategies is a requisite first step toward developing interventions that support caregiver-mediated medication management. METHODS: We conducted semi-structured qualitative interviews with 20 family caregivers of CSHCN who were recruited as part of a community engaged research between Purdue University College of Pharmacy and Indiana Family to Family. Interviews were conducted through zoom and audio recorded. Each participant was provided with a $50 honorarium. Interviews were professionally transcribed and content analyzed to generate categories of medication management strategies. RESULTS: Five overarching categories of medication management strategies were identified. These included (1) medications, supplies and equipment inventory management; (2) organizing and tracking medications, supplies and equipment; (3) medication-related communication, coordination and engagement; (4) medication administration and (5) researching and learning about medications. Within each category, caregivers developed or adapted specific strategies to overcome barriers in diverse care contexts (e.g., when interacting with healthcare systems, school staff or other members of their household). CONCLUSION: These findings can inform current clinical practice through improved awareness of different strategies employed by caregivers and lay a foundation to develop interventions designed to support caregiver mediated medication management.

Perspectives of patients, families and nurses on pain after cardiac surgery: A qualitative study.

BACKGROUND: Post-cardiac surgery pain affects patients, family caregivers and nurses. The pain experiences of patients, caregivers and nurses remain largely unknown. Therefore, it is important to examine the experiences of patients, caregivers and nurses in depth to ensure effective pain management. AIM: The aim of this study is to examine post-cardiac surgery pain from the perspectives of patients, caregivers and nurses. STUDY DESIGN: A descriptive qualitative research design was used. The study was carried out in the cardiovascular surgery ward of a tertiary hospital in Türkiye between June and December 2022. The data-driven triangulation method was used in the research. The study sample consisted of eight patients who had undergone cardiac surgery in the tertiary hospital, eight family caregivers and nine nurses who provided care for these individuals. A 'semi-structured interview form' was used to collect data through face-to-face and in-depth interviews. The data were analysed using the thematic analysis method. The COREQ checklist was used for reporting the study. RESULTS: As a result of the interviews, six themes were elicited from the data. These themes were 'explaining pain', 'assessment of pain', 'responses to pain', 'effect of pain on activities of daily living', 'expectations in painful situations' and 'pain management'. CONCLUSIONS: This study revealed the differences between pain perceptions and coping processes of patients who experienced pain after cardiac surgery, their caregivers and nurses. RELEVANCE TO CLINICAL PRACTICE: Considering the experiences of patients, caregivers and nurses in pain management after cardiac surgery, applications that will ensure joint participation in care practices should be planned.

Understanding Occupations of Terminally Ill Chinese Adults and Their Caregivers: A Scoping Review.

This scoping review explored the occupations of terminally ill Chinese adults and their caregivers. Seven databases were searched for peer-reviewed journal articles published in English or Chinese before June 2020. Of the 16 studies that met the selection criteria, only one directly used the term "occupations" while the other 15 studies contained descriptions of occupations. Eight themes were extracted and compared with existing literature. The top two reported themes were occupations surrounding life roles and tasks and those surrounding food and eating. More study is required about the occupational engagement of this client group.

The Reliability and Validity Study of Turkish Version of the Death Depression Scale-Revised Among Nurses.

The study aimed to establish the reliability and validity of the Turkish version of the Death Depression Scale-Revised (DDS-R) with a sample of 284 nurses. Cronbach's coefficient for the whole scale was .909 and the sub-dimension values were calculated as .934, .798, .715, and .537. The test-retest reliability coefficient was found to be .880. The content validity index (CVI) of the scale was calculated as .86. The results of the exploratory factor analysis showed that 62.254% variance was explained in 4 sub-dimensions of the scale (existential vacuum, death emptiness, other death, death sadness). Confirmatory factor analysis revealed that a four-dimensional structure yielded a good fit (X2/df = 3.124, RMSEA = .087). TDDS-R was found to be a valid and reliable measurement tool in determining the death depression levels of nurses.

The impact of assistive devices on community-dwelling older adults and their informal caregivers: a systematic review.

OBJECTIVE: The purpose of this systematic review is to assess the impact of assistive devices on the life satisfaction of (Research Question 1), and informal caregiving hours received by (Research Question 2), community-dwelling older adults (≥ 65 years). METHODS: We searched CINAHL, MEDLINE, and Scopus from database inception to March 2022. For each question, two reviewers independently screened citations, extracted and narratively synthesized the data, and assessed article quality and strength of evidence. RESULTS: Of the 1391 citations screened, we found two articles pertaining to each question, for a total of four articles. In general, assistive device use was not associated with life satisfaction, while it was positively associated with informal caregiving hours. However, the risk of bias was serious across the two studies for Research Question 1, and the overall quality of evidence was "very low". The risk of bias was not serious across the two studies included in Research Question 2 and the overall quality of evidence was "low". CONCLUSION: Due to the scarcity of studies, the limitations of existing studies (i.e., risk of bias), and the evidence being low or very low quality, we could not draw firm conclusions about the associations of interest. Additional research will produce a better understanding of the two relationships and provide further evidence to inform policy decisions regarding the provision and funding of assistive devices for community-dwelling older adults. TRIAL REGISTRATION: This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) database of systematic reviews (identification number: CRD42021248929 ).

Optimizing the integration of family caregivers in the delivery of person-centered care: evaluation of an educational program for the healthcare workforce.

BACKGROUND: While family caregivers provide 70-90% of care for people living in the community and assist with 10-30% of the care in congregate living, most healthcare providers do not meaningfully involve family caregivers as partners in care. Recent research recommends that the healthcare workforce receive competency-based education to identify, assess, support, and partner with family caregivers across the care trajectory. OBJECTIVE: This paper reports a mixed-methods evaluation of a person-centered competency-based education program on Caregiver-Centered Care for the healthcare workforce. METHODS: This foundational education was designed for all healthcare providers and trainees who work with family caregivers and is offered free online (caregivercare.ca). Healthcare providers from five healthcare settings (primary, acute, home, supportive living, long-term care) and trainees in medicine, nursing, and allied health were recruited via email and social media. We used the Kirkpatrick-Barr health workforce training evaluation framework to evaluate the education program, measuring various healthcare providers' learner satisfaction with the content (Level 1), pre-post changes in knowledge and confidence when working with family caregivers (Level 2), and changes in behaviors in practice (Level 3). RESULTS: Participants were primarily healthcare employees (68.9%) and trainees (21.7%) and represented 5 healthcare settings. Evaluation of the first 161 learners completing the program indicated that on a 5-point Likert scale, the majority were satisfied with the overall quality of the education (Mean(M) = 4.69; SD = .60). Paired T-tests indicated that out of a score of 50, post-education changes in knowledge and confidence to work with family caregivers was significantly higher than pre-education scores (pre M = 38.90, SD = 6.90; post M = 46.60, SD = 4.10; t(150) = - 16.75, p < .0001). Qualitative results derived from open responses echoed the quantitative findings in satisfaction with the education delivery as well as improvements in learners' knowledge and confidence. CONCLUSION: Health workforce education to provide person-centered care to all family caregivers is an innovative approach to addressing the current inconsistent system of supports for family caregivers. The education program evaluated here was effective at increasing self-reported knowledge and confidence to work with family caregivers.

A social network analysis to explore collaborative practice in home care: research protocol.

BACKGROUND: The conceptualization of the home as a care environment and maintaining a high standard of care requires different professionals to collaborate. This study will explore collaborative practice in home care, needs and expectations of the stakeholders involved, and identify their roles and tasks. Secondly, it will investigate possible strategies to improve home care management and, more particularly, optimize collaborative practice in home care. METHODS: The study will be conducted during three distinct consecutive phases, within a multiphase mixed-methods design. Phase 1 will use a quantitative approach in which a social network analysis will be conducted to have an overview of collaborative practice in home care in French-speaking Switzerland. Phases 2 and 3 will be qualitative and focus on three different situations involving different locations (rural and urban) and different home care functioning (home care provided by agencies and home care providing by independent caregivers). In each situation, semi-structured interviews will be conducted with home care recipients and their home caregivers. In phase 2, results of phase 1's network analysis will be discussed, such as roles, needs, and expectations of all stakeholders involved in home care. In phase 3, phase 2's findings will be discussed and strategies to improve home care and to optimize collaborative practice will be explored. DISCUSSION: Over the past years, home care has grown considerably. Therefore, more and more different caregivers are involved in the recipients' homes. Since optimal coordination between these different caregivers is a prerequisite for quality and safe care, it is essential to investigate the existing collaborative practice and how it is functioning. This study will provide knowledge on roles, needs and expectations of different caregivers involved in home care. It will also allow for strategies to optimize collaborative practice and thus ensure comprehensive care for recipients. Finally, it will serve as a basis for future studies that can be conducted to address identified needs.

A comparative analysis of the work environments for registered nurses, nurse aides, and caregivers using the 5th Korean Working Conditions Survey.

BACKGROUND: Since the quality of work life of healthcare workers is affected by various factors, an improvement in their work environment can reduce the burden on them, increasing their performance. This study aimed to identify the current problems in working environments for registered nurses (RNs), nurse aides (NAs), and caregivers using the 5th Korean Working Conditions Survey (KWCS), presenting measures to improve working conditions by analyzing their predictors: 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working patterns, 3) work-family balance, 4) work situations, and 5) self-rated health. METHODS: The sampling frame was a list of apartment and general survey zones, excluding islands, dormitories, special social facilities, tourist hotels, and foreigner zones, among the total survey zones of the 2010 Population and Housing Census. The KWCS was given to 50,205 participants of various occupations, and responses from 494 RNs, 201 NAs, and 505 caregivers were extracted to compare their 1) degree of exposure to work-related risk factors (musculoskeletal and mental), 2) working pattern, 3) work-family balance, 4) work situations, and 5) self-rated health. RESULTS: The response rate was 0.449. There were significant differences in all the variables (exposure to musculoskeletal and mental work-related risk factors, working pattern, work-family balance, work situations, self-rated health, and satisfaction with working conditions) among RNs, NAs, and caregivers (p < 0.001). The degree of work-related musculoskeletal and mental risk exposure was higher among caregivers and RNs than among NAs; irregular working patterns, challenges with work-family balance, and work environment satisfaction were higher among caregivers than among NAs. In addition, work situations were poorer among caregivers and NAs than among RNs. Self-rated health was the highest among caregivers, followed by RNs and NAs. The most potent predictor of self-rated health was occupation, followed by work environment satisfaction and work-family balance; the most potent predictor of work environment satisfaction was self-rated health, followed by degree of exposure to work-related musculoskeletal and mental risk factors, occupation, work-family balance, work situation, and working patterns. CONCLUSION: This study confirmed that a variety of factors influence work environment satisfaction. Thus, practical and realistic measures to improve work environments tailored to each healthcare occupation should be developed at the national and community levels. Further qualitative studies are needed to analyze the work environments of nurses and other care workers in depth.

The role of the ICU liaison nurse services on anxiety in family caregivers of patients after ICU discharge during COVID-19 pandemic: a randomized controlled trial.

BACKGROUND: With the onset of the COVID-19 pandemic and the need to maintain social distancing and changes in wards' structure, families no longer access the routine support they received during the hospitalization of their patients in the ICU. This study aimed to determine the effects of ICU liaison nurse services on the anxiety in patients' family caregivers after ICU discharge during the COVID-19 pandemic. METHODS: This randomized controlled trial was performed in western Iran from February 2020, to March 2021. Sixty subjects were selected from the family caregivers of the patients transferred from the ICU and were randomly assigned to the control (n = 30) and the intervention groups (n = 30). The control group received routine transfer care. In the intervention group, liaison nurse services were offered in 4 dimensions: patient support, family support, training, support of the ward's staff, and the evaluation of the destination ward. The participants' anxiety was measured using the Spielberger State Anxiety Inventory immediately after the patient transfer and 6 h after admission to the general ward. Data analyzed with SPSS V16, descriptive and inferential statistics, including Chi-square test, Mann-Whitney test, Wilcoxon test, and Generalized Linear Model with cumulative logit link function. Results were reported at a 0.05 significance level. RESULTS: A statistically significant difference was observed in baseline anxiety levels (P = 0.035) and age group (P < 0.001) between the intervention and control groups. After moderating baseline anxiety levels, the age group, and marital status, the impact of the intervention was significant (X2 = 10.273, df = 1, P < 0.001), meaning that the intervention could reduce the relative chances of developing higher levels of anxiety by 92.1% (OR: 0.08, 95%CI: 0.017-0.373, P < 0.001). CONCLUSIONS: This study confirmed the positive impact of nursing services on reducing anxiety in family caregivers during the COVID-19 pandemic. It is recommended to use these services, especially during the COVID-19 condition, to facilitate the patient transfer, support the patient's family, and reduce the health care gap between the ICU and the ward.

Sociodemographic, Health, and Caregiving Patterns of Aging Caregivers in Oregon: Gender Comparisons and the Role of Leisure Activities.

Recent studies have projected an increase in aging informal caregivers who are often dealing with their frailty. However, little is known about their health, caregiving factors, or coping resources that promote health. Informed by lifespan perspective and health behavior models, this study examined the gender differences in health and caregiving profiles of aging informal caregivers and investigated the association between leisure activity and unhealthy days. A sample of 565 informal caregivers (>50 years) was drawn from the Oregon version of the 2017 Behavioral Risk Factor Surveillance System. Descriptive analyses revealed that the caregivers were mainly women between 60 and 69, White non-Hispanic, married, college graduates, retired and healthinsured. Negative binomial regression showed that leisure activities were related to fewer odds of reporting unhealthy days for most comparison scenarios. Findings emphasize the importance of accounting for group differences and similarities in understanding health and caregiving factors among informal caregivers.

Caregiving stress among family caregivers of older adults living with disabilities in China.

OBJECTIVES: This study aimed to describe caregiving stress among family caregivers of Chinese older adults living with disabilities, and explore how care intensity, financial expenses, and care difficulties are associated with caregiving stress. METHODS: Data of 220 older adult-caregiver dyads were collected from 6 urban districts and 6 rural counties from Shandong province, China. Descriptive analyses and multivariate ordinal logistic regression analyses were performed. RESULTS: Family caregivers providing nine or more hours of care per day reported higher caregiving stress than those who provided fewer than nine hours. Caregivers who experienced insufficient care abilities, economic hardships, or time conflicts were more likely to report caregiving stress. Financial support provided to older adults was not associated with caregiving stress. CONCLUSIONS: Family caregivers of Chinese older adults with disabilities are experiencing excessive caregiving stress. Social support groups and China's long-term care insurance system should be promoted to better assist family caregivers.

Place4Carers: a multi-method participatory study to co-design, piloting, and transferring a novel psycho-social service for engaging family caregivers in remote rural settings.

BACKGROUND: Family caregivers are key actors in the ageing society. They are mediators between practitioners and patients and usually provide also essential daily services for the elders. However, till now, few services have been deployed to help caregivers in their care tasks as in improving their mental health which can experience sever burden due to caregiving duties. The purpose of the study is to implement a community-based participatory research project to co-design an innovative organizational model of social services for family caregivers of elderly health consumers living in remote rural areas in Italy. METHODS: This is a community-based participatory research project in the remote area of Vallecamonica involving four main phases. These included a quantitative analysis of caregiver needs, a scoping review on existing services for caregivers, co-design workshops with local stakeholders and caregivers to create a novel service the piloting and a first implementation of the service and the assessment of project transferability to other contexts. RESULTS: As the hours dedicated to elder care increases, both objective and developmental caregiver's burden significantly increases. Conversely, higher levels of engagement were associated with lower physical and emotional burden, and caregiver engagement was positively correlated with their perceived self-efficacy in managing disruptive patient behaviours. Based on these preliminary results, four co-design workshops with caregivers were conducted and led to the definition of the SOS caregivers service, built on four pillars structured upon the previous need analysis: a citizens' management board, training courses, peer-to-peer meetings, and project and service information. We found that co-design is an effective means of creating new services for family caregivers, whose experiential knowledge proved to be a key resource for the project team in delivering and managing services. Less positively, the transferability analysis indicated that local municipalities remain reluctant to acknowledge caregivers' pivotal role. CONCLUSIONS: A dedicated support service for caregivers can ameliorate caregiving conditions and engagement levels. The service has resulted a successful co-productive initiative for a psycho-social intervention for family caregivers. For the future, we suggest that family caregiver should be considered an active partner in the process of designing novel psycho-social services and not just as recipients to enhance a better aging-in-place process.

Prerequisites for providing effective support to family caregivers within the primary care setting - results of a study series in Germany.

BACKGROUND: General Practitioners are considered to be well placed to monitor home-care settings and to respond specifically to family caregivers. To do this, they must be sensitive to the needs and expectations of caregivers. In order to determine the current status of GP care in terms of the support given to family caregivers, a series of studies were conducted to gather the perspectives of both caregivers and GPs. The results are used to derive starting points as to which measures would be sensible and useful to strengthen support offered to family caregivers in the primary care setting. METHODS: Between 2020 and 2021, three sub-studies were conducted: a) an online survey of 612 family caregivers; b) qualitative interviews with 37 family caregivers; c) an online survey of 3556 GPs. RESULTS: Family caregivers see GPs as a highly skilled and trustworthy central point of contact; there are many different reasons for consulting them on the subject of care. In the perception of caregivers, particular weaknesses in GP support are the absence of signposting to advisory and assistance services and, in many cases, the failure to involve family caregivers in good time. At the same time, GPs do not always have sufficient attention to the physical and psychological needs of family caregivers. The doctors interviewed consider the GP practice to be well suited to being a primary point of contact for caregivers, but recognise that various challenges exist. These relate, among other things, to the timely organisation of appropriate respite services, targeted referral to support services or the early identification of informal caregivers. CONCLUSIONS: GP practices can play a central role in supporting family caregivers. Caregivers should be approached by the practice team at an early stage and consistently signposted to help and support services. In order to support care settings successfully, it is important to consider the triadic constellation of needs, wishes and stresses of both the caregiver and the care recipient. More training and greater involvement of practice staff in the support and identification of caregivers seems advisable.