Effectiveness of Internet-Based or Mobile App Interventions for Family Caregivers of Older Adults with Dementia: A Systematic Review.

INTRODUCTION: Global aging presents socioeconomic and health challenges. Dementia, a growing concern, affects millions of older adults, intensifying the burden on family caregivers. E-health interventions offer hope through technological solutions, although current research is limited. This study evaluated the effectiveness of internet-based or mobile app interventions for family caregivers of older adults with dementia. METHODOLOGY: A systematic review with a narrative synthesis was conducted using databases (PubMed, CINAHL, Scopus, LILACS, and PsycInfo) and the bibliographies of retrieved articles, with no restrictions on time or language. RESULTS: The search yielded 2092 results, of which 22 studies met the inclusion criteria, encompassing a total of 2761 family caregivers. Twenty-one different outcomes were evaluated and classified into three main types of interventions: psychoeducational, psychotherapeutic, and multicomponent. CONCLUSIONS: The study highlights the importance of internet-based and mobile app interventions in supporting family caregivers of older adults with dementia. These interventions positively affect many aspects of caregiver well-being, suggesting their utility in addressing this group's emotional, social, and self-care needs.

Factors Influencing Nutritional Status in Hospitalized Individuals Aged 70 and Above.

BACKGROUND: Older adults are vulnerable to malnutrition due to physical, psychological, and social factors. Malnutrition, a prevalent and modifiable issue in this population, is associated with an elevated risk of adverse clinical outcomes. The purpose of the study is to assess the nutritional status of older adult individuals admitted to a general hospital and examine its correlation with socio-health and demographic variables. METHODS: The study included 239 individuals aged 70 and above, employing a cross-sectional descriptive observational approach with a convenience sampling method. Sociodemographic information was gathered, and variables such as cognitive impairment, functional capacity, comorbidities, medication consumption, and nutritional status were evaluated. Statistical analysis involved descriptive calculations, bivariate analysis, and multivariate analysis, utilizing binary logistic regression. RESULTS: Approximately half of the sample were at risk of malnutrition, with a more notable prevalence among women. Factors such as age (OR = 1.04), cognitive impairment (OR = 1.06), functional dependence (OR = 0.96), and comorbidities (OR = 1.08) were linked to an elevated risk of malnutrition. In our regression model, age, cognitive impairment, and drug consumption emerged as significant predictors of malnutrition risk. CONCLUSIONS: Individuals aged 70 and above have a notably high prevalence of malnutrition risk, particularly among those experiencing functional dependence and cognitive impairment. In our sample, cognitive impairment in older adults, coupled with above-median drug consumption, emerges as the primary predictor for malnutrition risk.

Relationship between sense of coherence and health-related behaviours in adolescents and young adults: a systematic review.

BACKGROUND: The sense of coherence is developed through the learning process and contributes to the positioning of individuals in the health-disease continuum, facilitating successful and adaptive personal outcomes. Health-related behaviours represent a health determinant of utmost importance for public health and the development of adolescent and youth health promotion policies, as they are related to the main risk factors and problems of morbidity and mortality in our society. Previous studies have analysed the relationship between sense of coherence and only some individual health outcomes such as oral health, the relationship of sense of coherence with smoking and alcohol consumption, concluding that salutogenic factors are related to quality of life and preventive behaviours. The aim of this systematic review was to describe the relationship of sense of coherence with different health-related behaviours investigated so far in the adolescent and youth population. METHODS: A systematic review was carried out in databases (PubMed, CINAHL, Scopus and PsycInfo) and in the bibliographies of the retrieved articles, without limitation of time or language. Associations between sense of coherence and health-related behaviours have been assessed. RESULTS: A total of 1214 investigations were reviewed and 21 of them were included in this systematic review. The relationship between sense of coherence and eight health-related behaviours were identified (alcohol use, physical activity, tobacco use, eating habits, rest periods, use of illegal substances, behaviours related to oral health and time spent in games on the computer). CONCLUSIONS: Our results increase the available evidence and support the solid relationship of the sense of coherence with health behaviours both as a protective factor against risk behaviours and for its positive association with preventive and health promoting behaviours of adolescents, young adults and university students.

Motivos y percepciones del cuidado familiar de mayores dependientes / Motives and perceptions of family care for dependent elderly

Objetivo: Identificar y analizar los motivos que llevan a las personas a asumir el cuidado de un familiar mayor dependiente y sus percepciones de la situación de cuidado. Diseño: Estudio cualitativo fenomenológico. Emplazamiento: El estudio se ha realizado en el Distrito Sanitario Jaén-Norte, durante 2013 y 2014. Participantes: Participaron un total de 13 personas cuidadoras principales de familiares mayores dependientes con una experiencia mínima de un año en el cuidado, seleccionadas por muestreo intencional. Método: Análisis del discurso de entrevistas en profundidad considerando el contenido semántico y pragmático y las notas de campo. Se realizó triangulación en el análisis para favorecer la credibilidad del estudio. Resultados: Los motivos para cuidar a un familiar mayor dependiente son: el «familismo», las «ganancias materiales» y la «presión social». A su vez, el «familismo» aglutina 7 dimensiones/motivos: «obligación familiar», «afecto a la persona cuidada», «devolver lo recibido», «bienestar de la persona cuidada», «respeto a la decisión de la persona cuidada», «compromiso», «costumbre». Cuando el motivo principal para cuidar es la «obligación familiar», las «ganancias materiales» o la «presión social» las personas cuidadoras no manifiestan percepciones positivas por cuidar, y viceversa. Conclusión: Este estudio ha identificado que el «familismo», las «ganancias materiales» y la «presión social» son motivos por los que las personas cuidan a un familiar mayor dependiente en nuestro entorno sociocultural, así como su relación con la percepción de la situación de cuidado. Esto facilitará la identificación de las personas cuidadoras con mayor predisposición a padecer consecuencias negativas por cuidar y el desarrollo de intervenciones dirigidas a la prevención de dichas consecuencias

Objective: To identify and analyze the motives that lead people to take care of a dependent relative and their perceptions of the care situation. Design: Phenomenological qualitative study. Location: The study was conducted in the Jaén-Norte Sanitary District, during 2013 and 2014. Participants: A total of 13 primary caregivers of dependent elderly relatives with a minimum experience of one year in care participated, selected by intentional sampling. Method: Discourse analysis of 13 in-depth interviews considering the semantic and pragmatic content and field notes. Triangulation was performed in the analysis to favor the credibility of the study. Results: The motives for caring for a dependent relative are: 'Familism', 'Material gains' and 'Social pressure'. In turn, the 'Familism' include 7 dimensions/motives: 'Family obligation', 'Affection to the person taken care of', 'Return the received', 'Well-being of the person taken care of’ ,'Respect to the decision of the person taken care of', 'Agreement', 'Habit'. When the main motive to take care of is the 'Family obligation', the 'Material gains' or the 'Social pressure' caregivers do not manifest positive perceptions for caring, and vice versa. Conclusion: This study has identified that 'Familism', 'Material gains' and 'Social pressure' are reasons why people care for a dependent relative in our sociocultural environment, as well as the relationship with the perception of the care situation. This will facilitate the identification of caregivers with greater predisposition to suffer negative consequences for caring and the development of interventions aimed at the prevention of such consequences

Perceived Needs of The Family Caregivers of People with Dementia in a Mediterranean Setting: A Qualitative Study.

The purpose of this study was to identify, classify and analyze the perceived needs of caregivers of elderly people with dementia during the care process. A descriptive phenomenological qualitative study using seven focus groups was conducted in different primary health care centers in the province of Jaén (Spain) between July 2012 and February 2013. Eighty-two family caregivers who were caring for people with dementia in different stages of the disease were selected by purposeful maximum variation sampling. Data were analyzed and organized thematically, considering the semantic and pragmatic content and field notes. Two main categories of the perceived needs of caregivers were identified. The first was related to the management of caring for a relative with dementia, and the second was related to the management of the caregivers' own care. Our findings support the provision of comprehensive interventions for the improvement of caregivers' emotional health that encompass more than one care need. This is where psycho-educational interventions aimed at managing the various aspects of dementia and self-care in caregivers can be accommodated. In addition, proactive interventions to develop important skills to care for a relative with dementia, which are not perceived as needs by the caregivers, are needed. These include skills in family negotiation, planning and searching for resources outside the family.

[Motives and perceptions of family care for dependent elderly]. / Motivos y percepciones del cuidado familiar de mayores dependientes.

OBJECTIVE: To identify and analyze the motives that lead people to take care of a dependent relative and their perceptions of the care situation. DESIGN: Phenomenological qualitative study. LOCATION: The study was conducted in the Jaén-Norte Sanitary District, during 2013 and 2014. PARTICIPANTS: A total of 13 primary caregivers of dependent elderly relatives with a minimum experience of one year in care participated, selected by intentional sampling. METHOD: Discourse analysis of 13 in-depth interviews considering the semantic and pragmatic content and field notes. Triangulation was performed in the analysis to favor the credibility of the study. RESULTS: The motives for caring for a dependent relative are:'Familism','Material gains' and'Social pressure'. In turn, the'Familism' include 7 dimensions/motives:'Family obligation','Affection to the person taken care of','Return the received','Well-being of the person taken care of','Respect to the decision of the person taken care of','Agreement','Habit'. When the main motive to take care of is the'Family obligation', the'Material gains' or the'Social pressure' caregivers do not manifest positive perceptions for caring, and vice versa. CONCLUSION: This study has identified that'Familism','Material gains' and'Social pressure' are reasons why people care for a dependent relative in our sociocultural environment, as well as the relationship with the perception of the care situation. This will facilitate the identification of caregivers with greater predisposition to suffer negative consequences for caring and the development of interventions aimed at the prevention of such consequences.

Problemas en el proceso de adaptación a los cambios en personas cuidadoras familiares de mayores con demencia / Problems in the process of adapting to change among the family caregivers of elderly people with dementia

Objetivo: Identificar y analizar los problemas que surgen en el proceso de adaptación de la persona cuidadora a los cambios durante el cuidado familiar a una persona afectada por demencia. Método: Estudio cualitativo basado en la metodología de la teoría fundamentada constructivista de Charmaz. Se realizaron siete grupos focales en diferentes centros de atención primaria de salud en la provincia de Jaén (España). Participaron 82 personas cuidadoras principales familiares de mayores con demencia, seleccionadas por muestreo propositivo de máxima variación y teórico. Se llevó a cabo una triangulación del análisis para favorecer la validez interna del estudio. Resultados: Se obtuvieron tres categorías centrales, que fueron «Cuidados cambiantes», «Problemas en el proceso de adaptación a los cambios» y «Factores facilitadores del proceso de adaptación a los cambios». La persona cuidadora desempeña su rol en una realidad caracterizada por el cambio, tanto personal como de la persona a la que cuida y su contexto social y cultural. El reto adaptativo está en el balance entre los problemas que dificultan la adaptación a los cambios de la persona cuidadora a las nuevas situaciones de cuidado y los factores que facilitan su labor cuidadora. Conclusiones: La escasez de apoyo formal y el infradiagnóstico de la demencia dificultan la adaptación de la persona cuidadora al cuidado de una persona afectada por demencia. El proceso de adaptación podría mejorar reforzando el apoyo formal en las primeras fases del cuidado para reducir el estrés del proceso de aprendizaje autodidacta de las familias cuidadoras, así como adaptando las intervenciones a cada fase de la evolución del rol cuidador (AU)

Objective: To identify and analyse problems in adapting to change among the family caregivers of relatives with dementia. Method: Qualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity. Results: We obtained three main categories: ‘Changing Care’, ‘Problems in the process of adapting to change’ and ‘Facilitators of the process of adapting to change’. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role. Conclusions: The adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role (AU)

[Problems in the process of adapting to change among the family caregivers of elderly people with dementia]. / Problemas en el proceso de adaptación a los cambios en personas cuidadoras familiares de mayores con demencia.

OBJECTIVE: To identify and analyse problems in adapting to change among the family caregivers of relatives with dementia. METHOD: Qualitative study based on the methodology of Charmaz's Constructivist Grounded Theory. Seven focus groups were conducted in different primary health care centres in the province of Jaen (Spain). Eighty-two primary family caregivers of relatives with dementia participated by purposeful maximum variation sampling and theoretical sampling. Triangulation analysis was carried out to increase internal validity. RESULTS: We obtained three main categories: 'Changing Care', 'Problems in the process of adapting to change' and 'Facilitators of the process of adapting to change'. Family caregivers perform their role in a context characterized by personal change, both in the person receiving the care and in the social and cultural context. The challenge of adaptation lies in the balance between the problems that hamper adaptation of the caregiver to new situations of care and the factors that facilitate the caregiver role. CONCLUSIONS: The adaptation of family caregivers to caring for a person with dementia is hindered by the lack of formal support and under-diagnosis of dementia. The adaptation process could be improved by strengthening formal support in the early stages of care to reduce the stress of family caregivers who must teach themselves about their task and by interventions adapted to each phase in the development of the caregiver role.

En torno al concepto de necesidad / About need concept

El concepto de necesidad es muy utilizado en las políticas sociales que, a pesar de su aparente simplicidad, ha tenido un desarrollo conceptual notable, por lo que precisa acotación terminológica y precisión en su uso. En este artículo se revisa el concepto según diferentes áreas de conocimiento, la taxonomía creada en torno al concepto y se describen los principales enfoques en su utilización dentro de la política sanitaria: enfoque humanista versus enfoque racionalista. Finalmente se analizan algunos elementos del debate entre necesidad y demanda en los servicios públicos de atención a la salud y de servicios sociales y se proponen recomendaciones para el empleo adecuado del concepto

The concept of need is commonly used in social policy, despite its apparent simplicity, it has developed very much and precise dimensioning remarkable conceptual and terminological precision in use. This article reviews the concept and describes the main approaches in use within health policy: rationalist approach versus humanistic approach. Finally we analyze some elements of the debate between need and demand for public services to health care and social services and proposes recommendations for the appropriate use of the concept