Development of a caregiver empowerment model to promote positive outcomes.

Family members caring for aging parents experience both negative and positive outcomes from providing care. Theoretical explanations for negative outcomes have been developed. There is need for models that explain and predict positive outcomes. This article describes the evolution of the Caregiver Empowerment Model (CEM) to explain and predict positive outcomes of family caregiving. Although empirical findings support positive outcomes of family caregiving, less attention has been given to theoretical rationale for positive effects. The CEM predicts that, in the presence of filial values and certain background variables, caregiving demands are appraised as challenges instead of stressors. Appraising caregiving demands as a challenge, finding meaning, and using certain types of coping strategies are posited to be associated with growth and well-being. The CEM extends our understanding of the complexity of the caregiving experience, and can serve as a framework to guide in developing and testing theory-based interventions to promote positive outcomes.

Interprofessional Perspectives on Providing Spiritual Care for Patients With Lung Cancer in Outpatient Settings.

PURPOSE: To explore palliative care and oncology clinicians' perspectives on current challenges and facilitating factors in meeting the spiritual needs of patients with lung cancer and family caregivers. This study was conducted in preparation for a community-based lung cancer palliative care intervention. PARTICIPANTS & SETTING: 19 oncology and palliative care clinicians in three outpatient Kaiser Permanente sites in southern California. METHODOLOGIC APPROACH: This multisite qualitative study used focus group and key informant interviews. Data were analyzed using content analysis methodology, and a team approach was used to validate findings. FINDINGS: Clinicians described facilitating factors (interprofessional team support, assessment of spiritual needs, clinician-provided spiritual support, and provision of culturally respectful spiritual care) and challenges (related to providing culturally respectful spiritual care by respecting the patients' spiritual and cultural beliefs in an open way and in advocating for the patients' wishes) they encountered when addressing patient and caregiver spiritual needs. IMPLICATIONS FOR NURSING: This study demonstrated the need to provide nurses with practical tools, education, and a supportive environment to address patients' and family caregivers' spiritual concerns.

The Relationship Between Mutuality, Filial Piety, and Depression in Family Caregivers in China.

PURPOSE: Caregiving to parent stroke survivors in China is increasing and adult child-parent relationships are being challenged. The purpose of this study was to explore whether mutuality and filial piety have a protective role against caregiver depression. DESIGN: A cross-sectional correlational study was conducted with a nonproportional quota sample of 126 caregivers. Surveys were conducted at hospitals or in homes using structured questionnaires: the 15-item Mutuality Scale, the 4-item Filial Attitude Scale, the 9-item Filial Behavior Scale, and the 10-item Center for Epidemiological Studies Depression Scale. RESULTS: Higher mutuality and stronger filial attitudes were significantly associated with less caregiver depression after the covariates were controlled. Mutuality explained 5.5% ( p < .01) and filial attitude explained 4.6% ( p < .01) of the variance in caregiver depression. CONCLUSION: Mutuality and filial attitude may be protective factors against caregiver depression. IMPLICATIONS FOR PRACTICE: Supportive strategies can be implemented to enhance mutuality and filial attitude.