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1.
J Prof Nurs ; 50: 35-42, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-38369369

RESUMEN

The intricacies of the unique educational and leadership development trajectories of Black PhD-prepared nurse scientists are largely invisible in nursing faculty development literature. A broadened understanding of nursing leadership development and science mentorship can facilitate support for the next generation of Black nurse scientists. Historically Black Colleges and Universities (HBCUs) can serve as formative launch pads for nurse scientist development. However, the role of HBCUs and strategies for supporting robust educational and mentor/training opportunities for Black PhD-prepared nurse scientists require thoughtful description and application. Incorporating an intrapersonal, interpersonal, and integrative leadership framework, we describe and synthesize four Black nurse scientists and HBCU graduates' experiences to highlight early science mentorship and leadership resilience through the excellent educational foundations provided at HBCUs.


Asunto(s)
Negro o Afroamericano , Docentes de Enfermería , Liderazgo , Universidades , Humanos , Mentores
2.
J Gerontol Nurs ; 48(6): 13-18, 2022 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-35648582

RESUMEN

The purpose of the current study was to identify stressors of Black family caregivers (FCGs) of persons with memory problems (PWMPs), services of interest, and barriers to use of these services. Black FCGs were recruited from the Alzheimer's family program at the University of Alabama at Birmingham and affiliated geriatric clinics, media sources, and word-of-mouth referrals. Of 38 Black FCGs interviewed, 26 (68%) were female, 18 (47%) were employed, and 21 (55%) were adult children. Average age of FCGs was 52.11 years. Mean scores for the AD8 Dementia Screening Scale (mean = 13.95, SD = 2.17) and Clinical Dementia Scale Sum of Boxes (mean = 7.29, SD = 0.87) were higher than clinical cutoffs. The most common stressors for Black FCGs were PWMPs' inability to remember who they were, managing care recipients' financial affairs, and managing PWMPs' comorbid conditions. FCGs were most interested in educational material regarding treatment and diagnosis (55.3%), caring for people with dementia (52.6%), understanding dementia (52.6%), and financial/legal services (52.6%). FCGs stated that transportation difficulties and the need for a relief person were barriers to use of services. Results suggest that Black FCGs may be more likely to participate in interventions that include virtual conferencing modalities. [Journal of Gerontological Nursing, 48(6), 13-18.].


Asunto(s)
Cuidadores , Demencia , Niños Adultos , Anciano , Demencia/terapia , Femenino , Humanos , Masculino
3.
Vaccine X ; 11: 100162, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35492506

RESUMEN

Despite a national vaccination effort prioritizing frontline healthcare workers, COVID-19 vaccination rates among nurses have been lower than necessary to protect workforce and patient health. Historically, nurses have been more vaccine hesitant than other healthcare workers. To assess the vaccine attitudes and COVID-19 vaccine intent of California's registered nurses, we conducted a statewide cross-sectional survey among 603 licensed RNs working in direct patient care. Of 167 respondents (27.7%), 111 met inclusion criteria. Their mean score of 3.01 on a 6-point rating scale on the Vaccine Attitudes Examination scale measuring general vaccine hesitancy was comparable to previous findings among U.S. West Coast adults. Greater vaccine hesitancy was significantly associated with lower COVID-19 vaccine intent, after controlling for relevant confounders. Since nurses make up the largest portion of the healthcare workforce, it is crucial to specifically address this group's vaccine hesitancy.

4.
Alzheimer Dis Assoc Disord ; 36(1): 92-95, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34966023

RESUMEN

Currently, over 16 million dementia caregivers in the US provide over 18 billion hours of care. As the number of persons living with dementia increases, so too will the number of family caregivers. Given the projected steady growth in caregivers and their health-related needs in caring for persons living with Alzheimer disease and related dementias, several initiatives are underway that focus on caregivers. One overlooked mechanism to meet caregiver needs is the National Institute on Aging's Alzheimer's Disease Research Centers (ADRCs). Through secondary analysis, we present a picture of dementia caregiving from the National Alzheimer's Coordinating Center's database and discuss a call to action for ADRCs to engage caregivers and further support the mission of the ADRC to advance the field of dementia research.


Asunto(s)
Enfermedad de Alzheimer , Cuidadores , Enfermedad de Alzheimer/terapia , Humanos
5.
West J Nurs Res ; 44(3): 239-249, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34865588

RESUMEN

Stress is a significant part of daily life, and systemic social inequities, such as racism and discrimination, are well-established contributors of chronic stress for African Americans. Added exposure to the stress of caregiving may exacerbate adverse health outcomes. This secondary analysis describes subjective and objective stress in African American family caregivers, and relationships of subjective and objective stress to health outcomes. Baseline data from 142 African American dementia family caregivers from the "Great Village" study were described using means and frequencies; regression models and Pearson's correlation were used to examine associations between demographics, social determinants of health, and health outcomes. Mixed models were used to examine change and change variation in cortisol. Most caregivers had moderate degrees of stress. Stress was associated with sleep disruption and depressive symptoms, and discrimination appeared to be an independent contributor to depressive symptoms. This work provides a foundation for interpreting subjective and objective indicators of stress to tailor existing multicomponent interventions.


Asunto(s)
Negro o Afroamericano , Demencia , Cuidadores , Humanos , Hidrocortisona , Estrés Psicológico
6.
Ethn Health ; 27(2): 435-452, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-32116006

RESUMEN

African American Alzheimer's disease and related dementia (ADRD) family caregivers are understudied in intervention research with discrepant evidence existing on their mental and physical health outcomes. The stress toll of ADRD caregiving, coupled with the well-documented health disparities for African Americans, place these caregivers at higher risk for morbidity and mortality.Objectives: The purpose of this study was to explore African American ADRD family caregivers' perceptions of caregiving and self-care.Design: Qualitative descriptive study based on individual, one-time, semi-structured interviews from a purposeful sample of current/former African American ADRD community-dwelling family caregivers. Participants agreed to either face-to-face or telephonic interviews between 60 and 90 minutes in length.Results: Twenty-one caregiver interviews were conducted with primarily adult children (mean age = 62.61 (SD = 12.88); 81% completed college; 57% women). Content analysis yielded three major themes: Stressors, Resources, and Coping. The results demonstrate a complex interaction of sociocultural and environmental stressors and perceptions of resources that influence the coping strategies adopted by caregivers to navigate their caregiving experience.Conclusions: These findings suggest a broadened perspective to further inform the development and testing of interventions to address the health outcomes and caregiving needs of African American ADRD caregivers.


Asunto(s)
Enfermedad de Alzheimer , Cuidadores , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Negro o Afroamericano , Investigación Cualitativa , Autocuidado , Niños Adultos
7.
Nurs Outlook ; 70(1): 119-126, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-34627614

RESUMEN

The pandemics of COVID-19 and systemic racism highlighted health inequities that have existed for decades among Black communities. Nurses are positioned to address these health inequities through innovative ideas and research. More specifically, Black nurses, because of their shared lived experience, understand sociostructural factors underpinning health inequities and how to best engage with Black communities. However, only 8% of Black nurses make up the overall nursing workforce and far fewer are nurse scientists. Historically Black Colleges and Universities (HBCUs) can offer critically important options for success in addressing the dearth of Black nurse scientists working across sectors and contributing to rich academic milieu, informing innovative national policy, and creating impactful practice. We discuss challenges and strategies to promoting research careers at HBCUs to attract Black nurse scientists as the next leaders in health inequities research.


Asunto(s)
Negro o Afroamericano , Educación en Enfermería , Personal de Laboratorio/provisión & distribución , Liderazgo , Enfermeras y Enfermeros/provisión & distribución , Universidades , Investigación Biomédica , COVID-19 , Humanos , Racismo
9.
Psychoneuroendocrinology ; 133: 105399, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34482256

RESUMEN

Greater family caregiver exposure to uncontrolled patient symptoms is predictive of greater caregiver psychological and physiological stress in dementia and other chronic illnesses, but these phenomena have not been well-studied in heart failure (HF) - a disease with high symptom burden. The purpose of this study was to test the hypothesis that worse patient functional status (as reflected by increasing HF symptoms) would be associated with elevated psychological and physiological stress for the caregiver. This was a secondary analysis of data from 125 HF caregivers in the Caregiver Opportunities for Optimizing Lifestyle (COOL) study. Psychological stress was measured on four dimensions: care-related strain/burden (Oberst Caregiving Burden Scale), depression (Center for Epidemiological Studies Depression Scale), anxiety (State-Trait Anxiety Index), and general stress (Perceived Stress Scale). Physiological stress was measured by markers of HPA axis function (elevated cortisol awakening response [CAR]), endothelial dysfunction (increased PAI-1), and inflammation (increased IL-6, hsCRP). HF patient functional status was quantified by caregiver assessment of New York Heart Association (NYHA) Class. Generalized linear models were used to test associations between patient NYHA Class and stress (one model per indicator). NYHA Class (ordinal) was backwards difference coded in each model to examine caregiver stress in relation to increasing levels of HF severity. Caregivers were mostly female and in their mid-fifties, with a slight majority of the sample being African American and the patient's spouse. Overall, patient functional status was associated with greater caregiver psychological and physiological stress. In terms of psychological stress, higher NYHA Class was significantly associated with greater caregiver anxiety and general stress, but not with caregiver burden or depression. In terms of physiological stress, higher NYHA Class was associated with elevated markers in all models (elevated CAR and higher IL-6, hsCRP, and PAI-1). Across models, most associations between NYHA Class and stress were present at relatively early stages of functional limitation (i.e. Class II), while others emerged when functional limitations became more severe. To inform timing and mechanisms for much-needed caregiver interventions, research is needed to determine which aspects of HF symptomatology are most stressful for caregivers across the HF trajectory.


Asunto(s)
Cuidadores , Salud de la Familia , Insuficiencia Cardíaca , Sistema Hipotálamo-Hipofisario , Sistema Hipófiso-Suprarrenal , Proteína C-Reactiva , Cuidadores/psicología , Femenino , Humanos , Interleucina-6 , Masculino , Persona de Mediana Edad , Inhibidor 1 de Activador Plasminogénico
10.
Am J Nurs ; 120(4): 34-42, 2020 04.
Artículo en Inglés | MEDLINE | ID: mdl-32218045

RESUMEN

Among adults ages 65 and older, dementia doubles the risk of hospitalization. Roughly one in four hospitalized patients has dementia, and the prevalence of dementia in the United States is rising rapidly. Patients with dementia have significantly higher rates of hospital-acquired complications, including urinary tract infections, pressure injuries, pneumonia, and delirium, which when unrecognized and untreated can accelerate physical and cognitive decline, precipitating nursing home placement and death. The authors discuss the unique needs of patients with dementia who require acute care, highlighting evidence-based strategies for nurses to incorporate into practice.


Asunto(s)
Demencia/enfermería , Atención Dirigida al Paciente , Guías de Práctica Clínica como Asunto , Anciano , Comunicación , Delirio/diagnóstico , Delirio/tratamiento farmacológico , Femenino , Hospitalización , Humanos , Casas de Salud , Neumonía/diagnóstico , Infecciones Urinarias/complicaciones
11.
Gerontologist ; 60(Suppl 1): S29-S40, 2020 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-32057080

RESUMEN

This article presents a comprehensive conceptual framework designed to foster research in the changing needs of caregivers and persons with dementia as they move through their illness trajectory. It builds on prior theoretical models and intervention literature in the field, while at the same time addressing notable gaps including inadequate attention to cultural issues; lack of longitudinal research; focus on primary caregivers, almost to the exclusion of the person with dementia and other family members; limited outcome measures; and lack of attention to how the culture of health care systems affects caregivers' quality of life. The framework emphasizes the intersectionality of caregiving, sociocultural factors, health care systems' factors, and dementia care needs as they change across time. It provides a template to encourage longitudinal research on reciprocal relationships between caregiver and care recipient because significant changes in the physical and/or mental health status of one member of the dyad will probably affect the physical and/or mental health of the partner. This article offers illustrative research projects employing this framework and concludes with a call to action and invitation to researchers to test components, share feedback, and participate in continued refinement to more quickly advance evidence-based knowledge and practice in the trajectory of dementia caregiving.


Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Proyectos de Investigación , Humanos , Calidad de Vida
12.
Gerontologist ; 60(Suppl 1): S5-S13, 2020 02 14.
Artículo en Inglés | MEDLINE | ID: mdl-32057081

RESUMEN

The number of older adults living with functional decline and serious illness is growing exponentially at a time when availability of both family and professional caregivers is strained. Achieving optimal outcomes for this vulnerable population involves advancing the knowledge needed to improve the quality of care delivered by families, health professionals, and community programs. Recent reports from National Institute of Health and the National Academy of Science, Engineering and Medicine have called for the identification of gaps in key areas of family caregiving intervention research. In March 2018, the Family Caregiving Institute at UC Davis convened an invitational meeting of over 50 thought leaders in family caregiving-representing service agencies, funding organizations, and academia-to participate in the Research Priorities in Caregiving Summit: Advancing Family-Centered Care across the Trajectory of Serious Illness. Using an iterative process, attendees identified the top 10 research priorities and created research priority statements that incorporated a definition of the priority topic, rationale for the priority; problem(s) to address; priority population(s); and example research topics. The research priority statements serve as a roadmap for research development that will address the most significant gaps in the caregiving field.


Asunto(s)
Cuidadores , Enfermedad Crónica/enfermería , Anciano , Familia , Humanos , Atención Dirigida al Paciente , Investigación
14.
Nurs Outlook ; 67(5): 586-595, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31030904

RESUMEN

BACKGROUND: The nursing profession will need one million more nurses by 2024, yet nursing schools are turning away applicants due to insufficient numbers of nursing faculty. Likewise, minority nursing faculty are needed in order to attract diverse nursing students who can then address health care disparities. PURPOSE: The purpose of this paper is to describe the use of a group think tank (GTT) as a mentoring strategy for supporting the recruitment and retention of minority nursing faculty. METHOD: Guided by Kotter's theory of change, this paper describes the application of the GTT approach with 5 African American (AA) faculty, one AA doctoral student and a cross-cultural mentor. FINDINGS: Results are presented based upon the metrics typically used to support career advancement, promotion and/or tenure. DISCUSSION: The GTT is a promising mentoring model that can be used to integrate cross-cultural and peer mentoring into academic communities to support diversity in academia.


Asunto(s)
Negro o Afroamericano/estadística & datos numéricos , Diversidad Cultural , Docentes de Enfermería/normas , Guías como Asunto , Grupos Minoritarios/estadística & datos numéricos , Selección de Personal/normas , Facultades de Enfermería/normas , Adulto , Docentes de Enfermería/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Grupo Paritario , Selección de Personal/estadística & datos numéricos , Facultades de Enfermería/estadística & datos numéricos
15.
J Psychosoc Nurs Ment Health Serv ; 57(1): 17-24, 2019 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-29916525

RESUMEN

Family caregivers of individuals with Alzheimer's disease and related dementias (ADRD) experience long-term mental health effects. Although caregivers who place relatives in long-term care (LTC) experience increased depression, anxiety, and chronic grief post-placement, interventions to improve caregivers' mental health have focused mainly on in-home care. Current researchers previously tested a group-based Chronic Grief Management Intervention (CGMI) with ADRD caregivers of individuals in LTC, with significant effects on caregiver mental health outcomes. In the current study, researchers adapted the CGMI for synchronous online video using Adobe® ConnectTM and iPads® (Chronic Grief Management-A Live-Streaming, Online Intervention [CGMI-V]). Specific aims were to test feasibility of digital delivery of the CGMI-V and explore caregivers' online group experience. Researchers assessed participants at baseline for sociodemographic information and at the end of the program with a four-item satisfaction survey and focus group. Digital delivery of the CGMI-V was feasible and caregiver satisfaction was high. [Journal of Psychosocial Nursing and Mental Health Services, 57(1), 17-24.].


Asunto(s)
Cuidadores/psicología , Demencia/enfermería , Pesar , Procesos de Grupo , Cuidados a Largo Plazo , Grabación de Cinta de Video/métodos , Adulto , Grupos Focales , Humanos , Persona de Mediana Edad , Encuestas y Cuestionarios
16.
J Hosp Palliat Nurs ; 20(6): 548-553, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30379799

RESUMEN

The aim of this study was to develop and trial a screening tool to increase palliative care referrals for hospitalized patients with chronic obstructive pulmonary disease (COPD) at a community hospital. Baseline data were collected retrospectively to determine the palliative care referral rate of patients with COPD at a high risk for readmission using the LACE index. A palliative care referral tool was developed to screen the patients who were at a high risk for readmission for palliative care referral. A 3-month pilot project prospectively evaluated the palliative care referral rate after educating staff on the use of the screening tool and implementing its use. During the baseline study, 2 palliative care referrals were placed out of 19 patients who were deemed appropriate by the screening tool (10.5%). During the pilot project, 16 palliative care referrals were placed out of 45 patients who were deemed appropriate by the screening tool (35.6%). Emergency room visits and readmissions were not significantly different between those with palliative referrals and those without. Barriers to palliative care referral were explored. The improvement in palliative care referrals, which occurred after the introduction of the consensus-driven screening process for patients with COPD, suggests the possibility of improved patient care using this model.


Asunto(s)
Accesibilidad a los Servicios de Salud/normas , Tamizaje Masivo/normas , Cuidados Paliativos/normas , Enfermedad Pulmonar Obstructiva Crónica/terapia , Derivación y Consulta/normas , Anciano , Femenino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Tamizaje Masivo/métodos , Tamizaje Masivo/estadística & datos numéricos , Persona de Mediana Edad , Cuidados Paliativos/métodos , Cuidados Paliativos/estadística & datos numéricos , Proyectos Piloto , Enfermedad Pulmonar Obstructiva Crónica/psicología , Derivación y Consulta/estadística & datos numéricos , Estudios Retrospectivos
17.
J Psychosoc Nurs Ment Health Serv ; 56(11): 18-26, 2018 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-29741750

RESUMEN

A secondary data analysis of 25,560 minutes of structured clinical observations from a longitudinal study examined the impact of time-varying background factors, social environment, and psychotropic medication use on behavioral symptoms of nursing home residents with Alzheimer's disease (AD). Data were collected at baseline (N = 177), 12 months (N = 138), and 24 months (N = 111). Mixed-effects regression modeling showed that at 24 months: (a) higher cognitive and physical function and having a private bedroom/bathroom had the most positive influence on resident positive behaviors; (b) use of antipsychotic medications and solitary activities had the most negative influence on resident positive behaviors; (c) higher cognitive function significantly decreased negative behaviors; and (d) care-related activities and total number of psychotropic medications significantly increased negative behaviors. The current study describes risk factors for behavioral disturbances and the impact of activities, social environment, and psychotropic medications on behavioral outcomes in nursing home residents with AD. [Journal of Psychosocial Nursing and Mental Health Services, 56(11), 18-26.].


Asunto(s)
Enfermedad de Alzheimer/tratamiento farmacológico , Síntomas Conductuales/psicología , Casas de Salud , Psicotrópicos/uso terapéutico , Medio Social , Actividades Cotidianas , Anciano de 80 o más Años , Cognición/fisiología , Femenino , Humanos , Estudios Longitudinales , Masculino , Factores de Riesgo
18.
Issues Ment Health Nurs ; 38(12): 996-1004, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28956706

RESUMEN

Increased attention to the effects of the stressful demands of caregiving on the mental health of dementia caregivers has resulted in the development of numerous interventions. The current study is a secondary analysis of a randomized controlled trial that tested a 12-month moderate physical activity intervention with dementia caregivers. Our secondary data analysis examined racial differences in caregiver mental health outcomes including subjective burden, depressive symptoms, and positive affect, as well as differences in physical activity. A total of 211 community-dwelling dementia family caregivers were randomly assigned to a 12-month Enhanced Physical Activity (treatment) Intervention (EPAI) or a Caregiver Skill Building (control) Intervention (CSBI). Of these, 34 African American and 80 Caucasian caregivers completed the study. At baseline, race was associated with subjective burden and positive affect, but not with depressive symptoms. Post intervention (12 months), there were no racial differences in subjective burden or depressive symptoms. However, race was significantly associated with decreased positive affect (p = 0.003) and decreased total minutes of physical activity (p = 0.012). Findings suggest that the mental health needs of African American caregivers warrant additional exploration, where physical activity may be of benefit. These findings provide a cultural perspective to consider during intervention development for future nurse-driven research.


Asunto(s)
Negro o Afroamericano/psicología , Cuidadores/psicología , Demencia/terapia , Depresión/epidemiología , Ejercicio Físico , Población Blanca/psicología , Anciano , Demencia/psicología , Depresión/prevención & control , Femenino , Humanos , Masculino , Persona de Mediana Edad , Calidad de Vida , Factores Socioeconómicos
19.
West J Nurs Res ; 38(10): 1264-81, 2016 10.
Artículo en Inglés | MEDLINE | ID: mdl-27106880

RESUMEN

The purpose of this study was to compare program evaluation responses between African American and Caucasian caregivers of persons with Alzheimer's disease and related dementias who completed a lifestyle physical activity randomized controlled trial. The aim was to determine if African Americans evaluated the study differently than Caucasians. Family caregivers (N = 211) were randomly assigned to a 12-month physical activity intervention or a control condition. Upon intervention completion (n = 114), caregivers responded to an 11-item questionnaire using Likert-type scale responses and three open-ended questions about the overall intervention quality. Findings indicated that African American caregivers evaluated both conditions more favorably than Caucasian caregivers (p = .02). Content analysis of the narrative responses revealed five major qualitative themes: support, resources, responsibility, adjusting, and time These findings suggest the value of both access to resources, and support for African American caregivers who participate in intervention research.


Asunto(s)
Cuidadores/psicología , Ejercicio Físico , Estilo de Vida , Evaluación de Programas y Proyectos de Salud , Grupos Raciales , Negro o Afroamericano/psicología , Demencia/enfermería , Femenino , Humanos , Estilo de Vida/etnología , Masculino , Persona de Mediana Edad , Calidad de Vida , Apoyo Social , Encuestas y Cuestionarios , Población Blanca/psicología
20.
AIMS Med Sci ; 3(1): 15-31, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-29147683

RESUMEN

PURPOSE: This study examined secondary benefits of an individualized physical activity intervention on improving dementia family caregivers' subjective burden, depressive symptoms and positive affect. DESIGN AND METHODS: A community-based randomized controlled trial (RCT) was implemented with family caregivers of persons with dementia (N = 211) who received the Enhanced Physical Activity Intervention (EPAI: treatment intervention, n = 106) or the Caregiver Skill Building Intervention (CSBI: control intervention, n = 105). Interventions were delivered over 12 months, including a baseline home visit and regularly spaced telephone calls. Data were collected in person at baseline, 6 and 12-months; and telephonically at 3 and 9-months. The EPAI integrated physical activity and caregiving content while the CSBI focused only on caregiving content. Descriptive, bivariate and intention-to-treat analyses using generalized estimating equations (GEE) were performed to examine secondary benefits of the EPAI on family caregiver burden, depressive symptoms and positive affect. RESULTS: Compared to caregivers in the CSBI group, caregivers in the EPAI significantly increased their overall and total moderate physical activity and showed a positive interaction between the intervention and time for positive affect at both six (p = 0.01) and 12-months (p = 0.03). The EPAI was significantly associated with improving burden at 3 months (p = 0.03) but had no significant effect on depressive symptoms. IMPLICATIONS: Caregiver involvement in an individualized physical activity intervention was associated with increased overall and total moderate physical activity and improved positive affect from baseline to 12 months. Improved positive affect may help caregivers to feel better about themselves and their situation, and better enable them to continue providing care for their family member for a longer time at lower risk to their own mental health.

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