The effects of the COVID-19 pandemic on the activities of Initial-phase Intensive Support Team for Dementia in Kobe City.

BACKGROUND: This study aimed to review the activities of the Kobe City Initial-phase Intensive Support Team for Dementia pre- and during the coronavirus disease 2019 (COVID-19) pandemic, to compare the characteristics of the target population and the performance of the team's activities, and determine the impact of the pandemic on the team's project. METHODS: The summary data obtained at the time of consultation, team activities, and participants' characteristics were extracted from 662 participants who started to receive support between April 2018 and March 2022. Statistical analysis was performed by dividing the participants into the following two groups: pre- and during COVID-19 pandemic groups. RESULTS: There was no significant difference in the number of new cases or cases that led to a dementia diagnosis between the pre- and during COVID-19 pandemic groups. However, there were significant differences in the number of home visits and rate of introduction of medical care between the two groups. In our study population, the number of participants with financial management difficulties and delusions increased and the number of participants who refused visitations slightly decreased. CONCLUSION: The Kobe City Initial-phase Intensive Support Team was able to continue its activities during the pandemic partly because the team is an independent, dedicated team. During the pandemic, there was an increase in the number of participants who were isolated because they were deprived of opportunities to interact with others, and who developed delusions and other psychiatric symptoms. Despite this situation, the professional team responded quickly through individual assessment of the individual needs by continuous outreach, taking into account the infection situation, and thus this outreach team functioned well even under the COVID-19 pandemic.

Outcome of Camp Approach in Treatment of Alcohol Use Disorder: A Non-randomized Controlled Study.

Background: Studies examining the outcome of the camp approach in the treatment of alcohol dependence are limited in India. Aim: The aim of the study was to compare the outcomes of the community-based camp (CBC) approach and the hospital-based camp (HBC) approach in the treatment of persons with alcohol dependence. Methods: The study used a non-randomized controlled study design (quasi-experimental research design before and after with a control group). In total, 60 respondents were selected through the census method (30 in the study group and 30 in the control group). Thirty respondents from the CBC formed the experimental group, and another 30 from the HBC formed the control group. The CBC was held for 7 days, and the HBC was held for 10 days. The tools used are the Alcohol Use Disorders Identification Test and the World Health Organization quality of life (QoL)-BREF. Statistical Analysis: Independent t-test and effect size analysis were used. Kasturba Hospital Institute Ethics Committee, Manipal, had given the ethical clearance. Results: The majority (73%) of the respondents in the CBC and 57% of the HBC participants maintained complete abstinence during the post-test. The relapse rate was lower in the CBC (27%) than in the HBC (43%). CBC is effective at increasing the number of follow-ups and decreasing alcohol intake during relapse. The effect of the camp intervention on increasing the number of follow-ups was medium (d = 0.36). The CBC had a small effect on enhancing the QoL of treated individuals with alcohol dependence syndrome during the post-test (d = 0.27). Conclusion: The CBC approach is more effective than the hospital one at increasing follow-up and QoL and reducing the relapse rate.

Economic Evaluation of an Integrated Care Program Compared to Conventional Care for Patients With Chronic Kidney Disease in Rural Communities of Thailand.

Introduction: An integrated care program for chronic kidney disease (CKD) in Thailand has shown its effectiveness in delaying the decline in kidney function, as evidenced by the Effectiveness of Integrated Care on Delaying Progression of Stages 3 to 4 CKD in Rural Communities of Thailand (ESCORT-1) randomized control trial and the ESCORT-2 prospective cohort study. Designed for sustainability within the primary healthcare system, the program optimizes the use of the existing workforce by fostering collaboration among local multidisciplinary care teams (MDCTs) and community care networks (CCNs). Methods: A Markov model with a lifetime horizon was used to conduct a cost-utility analysis from a societal perspective. Individual participant level data from ESCORT studies, national registries, and relevant literature were used to estimate model parameters. A budget impact analysis from the payer's perspective was also assessed over a 5-year period. Results: The integrated care program yielded a dominant result with 1.84 quality-adjusted life years (QALYs) gained with "less" lifetime cost, resulting in a negative incremental cost-effectiveness ratio (ICER). Probabilistic analysis showed that the intervention being cost-effective almost 100% of the time at the local willingness-to-pay threshold. The intervention maximized cost-effectiveness when delivered as early as possible, both in terms of age and stage. The budget impact analysis estimated that the introduction of the intervention could save about 7% of the Thai government's total health expenditure or 205 billion Thai-Baht ($5.9 billion) over 5 years with cost savings beginning from the third year onwards. Conclusion: The integrated care program for CKD offers potential benefits and cost savings for patients, caregivers, and payers. Future efforts should focus on the screening and implementation processes across various regions and healthcare settings.

Complexities in supportive care for people with metastatic breast cancer: a qualitative study.

PURPOSE: The complexity of metastatic breast cancer, its rapidly evolving treatment, and the changing trajectory toward long-term survivorship create unique challenges for the provision of supportive care. The experiences of health professionals enacting supportive care in contexts of those living long-term with incurable cancer have received limited research attention. This qualitative study aimed to gain further insight into health professionals' experiences of supportive care in this context. METHOD: Semi-structured interviews were conducted via phone and online with 25 health and community-care professionals who support people living with metastatic breast cancer in Australia. A mix of sampling strategies was used. Thematic analysis was undertaken. Findings were interpreted through an ethics of care lens. RESULTS: Three key themes were identified. First, participants experienced supportive care as highly relational. Second, they encountered numerous moral and ethical dilemmas in enacting supportive care. Finally, enacting supportive care was complicated by fragmented and sporadic provision in a system in which supportive care is differentially valued across professions and settings. CONCLUSION: Findings draw attention to complexities in enacting supportive care in the context of metastatic breast cancer, with implications to patients and professionals. To improve the quality of care provided to patients and minimise the risk of professional burnout, greater attention is needed in supportive care guidelines to the ethical, moral, and emotional complexities experienced by professionals in this context. IMPLICATIONS FOR CANCER SURVIVORS: People living with metastatic breast cancer are a growing proportion of cancer survivors. The knowledge gained through this study may help professionals to better meet the supportive care needs of people living with metastatic breast cancer, a treatable but not curable condition.

Can you be a peer if you don't share the same health or social conditions? A qualitative study on peer integration in a primary care setting.

BACKGROUND: Peer support has been extensively studied in specific areas of community-based primary care such as mental health, substance use, HIV, homelessness, and Indigenous health. These programs are often built on the assumption that peers must share similar social identities or lived experiences of disease to be effective. However, it remains unclear how peers can be integrated in general primary care setting that serves people with a diversity of health conditions and social backgrounds. METHODS: A participatory qualitative study was conducted between 2020 and 2022 to explore the feasibility, acceptability, and perceived effects of the integration of a peer support worker in a primary care setting in Montreal, Canada. A thematic analysis was performed based on semi-structured interviews (n = 18) with patients, relatives, clinicians, and a peer support worker. FINDINGS: Findings show that peers connect with patients through sharing their own hardships and how they overcame them, rather than sharing similar health or social conditions. Peers provide social support and coaching beyond the care trajectory and link identified needs with available resources in the community, bridging the gap between health and social care. Primary care clinicians benefit from peer support work, as it helps overcome therapeutic impasses and facilitates communication of patient needs. However, integrating a peer into a primary care team can be challenging due to clinicians' understanding of the nature and limits of peer support work, financial compensation, and the absence of a formal status within healthcare system. CONCLUSION: Our results show that to establish a relationship of trust, a peer does not need to share similar health or social conditions. Instead, they leverage their experiential knowledge, strengths, and abilities to create meaningful relationships and reliable connections that bridge the gap between health and social care. This, in turn, instills patients with hope for a better life, empowers them to take an active role in their own care, and helps them achieve life goals beyond healthcare. Finally, integrating peers in primary care contributes in overcoming obstacles to prevention and care, reduce distrust of institutions, prioritize needs, and help patients navigate the complexities of healthcare services.

Trends in Bundled Outpatient Behavioral Health Services in VA-Direct Versus VA-Purchased Care.

The Veterans Health Administration (VA) increasingly purchases community-based care (CC) to improve healthcare access, including behavioral health. In 2018, VA introduced standardized episodes of care (SEOCs) to guide authorization and purchase of CC services for specific indications in a defined timeframe without bundling payment. In this retrospective cross-sectional study, we describe trends in VA and CC behavioral healthcare utilization using the VA Outpatient Psychiatry SEOC definition. Counts of Outpatient Psychiatry SEOC-allowable service and procedure codes during fiscal years 2016-2019 were organized according to four SEOC-defined service types (evaluation and management, laboratory services, psychiatry services, transitional care) and measured as percentages of all included codes. Trends comparing behavioral healthcare utilization between Veterans using any CC versus VA only were analyzed using a linear mixed effects model. We identified nearly 3 million Veterans who registered 60 million qualifying service and procedure codes, with overall utilization increasing 77.8% in CC versus 5.2% in VA. Veterans receiving any CC comprised 3.9% of the cohort and 4.7% of all utilization. When examining service type as a percent of all Outpatient Psychiatry SEOC-allowable care among Veterans using CC, psychiatry services increased 12.2%, while transitional care decreased 8.8%. In regression analysis, shifts in service type utilization reflected descriptive results but with attenuated effect sizes. In sum, Outpatient Psychiatry SEOC-allowable service utilization grew, and service type composition changed, significantly more in CC than in VA. The role of SEOCs and their incentives may be important when evaluating future behavioral healthcare quality and value in bundled services.

Patients with venous leg ulcers can be managed safely in the community ----results of an observational comparison study in Singapore.

AIM: To examine the healing outcomes of patients with venous leg ulcers requiring compression bandaging in community care versus tertiary care. METHOD: This was an analytical observational cohort study. Venous leg ulcer (VLU) patients who required compression bandaging were recruited from an outpatient vascular clinic between May 2021 and August 2022. Eligible patients received two-or four-layer compression bandaging and followed up with the community care or tertiary care centre nurses. The primary outcome was the difference in the total surface area of the VLU after 12 weeks, and the secondary outcome was the patient's quality of life, as measured by the Cardiff Wound Impact Schedule (CWIS). RESULTS: Forty-seven VLU patients were recruited; 27 received compression bandaging in the community care and 20 by the tertiary care centre. Mean age 70 years old (SD 11.04). The two most prevalent comorbidities were hypertension (51.06 %) and diabetes mellitus (38.29 %). Among those who completed follow-up (12 weeks), the median difference of the total surface area of the VLU between community-based care (p = 0.02) versus tertiary-based care (0.003) was significant. However, there was no difference in the healing status between community and tertiary-based care (p = 0.68). There was no difference in the quality of life of patients between groups. CONCLUSION: This first tropical study comparing VLU healing outcomes between community and tertiary care found no significant difference in healing with compression bandaging by nurses in either setting. However, the small sample size and high dropout rate limit the generalizability of the findings, necessitating a larger-scale study with longer follow-up. Despite these limitations, the study is a crucial step toward improving wound care services in Singapore, and highlights the need for further research to guide future community wound care implementation.

People with dementia and family carers are welcoming of a model of dementia palliative care, but sceptical of its implementation.

INTRODUCTION: A palliative care approach can improve quality-of-life for people with dementia. It is the preference of many people with dementia to remain living at home until death, with the appropriate care. To develop a successful model for dementia palliative care in the community, it is essential to assimilate the perspectives and experiences of those affected. The guiding research question for this study was: What are people with dementia and family carers' views on a model for dementia palliative care?. METHODS: Focus groups (n = 3) were conducted with bereaved or current family carers (n = 11), and people with dementia (n = 2). Discussions centred around a proposed model of dementia palliative care. These were transcribed and analysed using thematic analysis. RESULTS: Three main themes were identified: living and dying well with dementia; reducing carer burden to fulfil the wish for home care; and lack of faith in the healthcare system. One statement which summarised the analysis was: "Dementia palliative care is a dream, but not a reality." This reflected participants' repeated "wish" for this "ideal" model of care, but simultaneous scepticism regarding its implementation, based on their prior experiences of healthcare services. CONCLUSION: All participants were welcoming of the proposed model for dementia palliative care and were generally positive about palliative care as a concept relating to dementia. There was consensus that the model would allow people to live and die well with dementia, and reducing the carer burden would fulfil the wish to remain at home. However systemic changes in the healthcare system will be needed to facilitate a truly person-centred, holistic, individualised and flexible model of care.

Unmet community care needs among older adults in China: an observational study on influencing factors.

BACKGROUND: With the rapidly aging population in China, there is an urgent need to understand and address the community care needs of older adults. This study sought to examine these unmet community care needs of older adults in China and the factors influencing them, with the goal of providing essential groundwork for the development of community care health policies. METHODS: This study used data from the 2018 China Longitudinal Healthy Longevity Survey of 8,870 adults aged 65 years and older. Logistic regression analysis was performed to identify factors related to unmet community care needs. RESULTS: The results showed that lower number of children, increased years of schooling, poorer self-perceived economic and health status, residing in an institution rather than living with household members, not having public old-age pensions, and not having activity due to daily living impairments were associated with a higher likelihood of unmet community care needs among older adults. CONCLUSIONS: These findings indicate the necessity for crafting policies that consider the factors affecting unmet community care needs of older adults, including their health vulnerabilities and individual needs. Implementing national initiatives aimed at enhancing the quality of services delivered to older adults is crucial, along with establishing programmes to proactively address their vulnerabilities and individual needs. This study can contribute to the formulation of policy measures aimed at enhancing community care services of older adults in China.

Should We Defund the National Health Service?

Despite record investment in Scotland's National Health Service, ever-increasing numbers of people remain in hospital despite being clinically fit for discharge. This paper curiously explores two of the whole-system problems ensuring discharges are delayed and argues that greater investment in, and contractual changes to, social care commissioning is required to support more people to live their best lives in their own homes. A more creative perspective is required to ensure better outcomes for the population.

Predicting a Risk of Transition to a Higher Level of Care for Home Support Service Recipients.

This longitudinal, non-randomized, retrospective study uses the Kaplan-Meier estimates method and the Cox Proportional Hazard model to assess the risk of home support recipients' transitioning to a higher level of care after being hospitalized. The Kaplan-Meier survival analysis revealed that 50% of home support recipients were expected to move on to a higher level of care by day 1,374. The Cox Proportional Hazard model indicated that the risk of transitioning to a higher level of care increases by about 2% as a client ages by one year, and by about 10% if there were no emergency room visits in the last 12 months. Also, the risk will decrease by about 13% if an individual is getting more than one hour of home support service per visit on average, compared to those who are receiving less than one hour of home support services per visit. These results will help project long term home support demand and resource planning for home support and the health care system.

Online collaborative research on seasonal work. Collective capabilities to resist on precarious work and living conditions.

BACKGROUND: The number of seasonal workers in the agricultural sector in France is increasing and their working conditions are difficult and disgraceful. While they have been shown in various studies to be subject to processes that result in them being unable to act on occupational health, some of them, mobilized online, have formed a collective whose is permitted them to develop collective actions. OBJECTIVES: Our article aims to describe this online collective and how the power to act emerged from the discussions. The purpose it's also to determine how the functioning of these groups fosters the expression of a collective point of view and the achievement of goals that is not attained elsewhere. METHODS: We carried out a collaborative research online with a collective of seasonal workers, which consisted in following and taking part in discussions about conditions at work and outside of work, using an instant messaging tool. The results of this collaborative research, included testimonies registration and co-produced with seasonal workers, has been analyzed mobilizing A. Sen's capabilities approach. RESULTS: During their online discussions, the seasonal workers allow themselves to share the situations of injustice they are subject to with the other members. Here, we present their output and collective actions which were made possible by the mobilization of the resources of some of their members or by collaborating with other actors. CONCLUSIONS: In spite of the remarkable conversion factors made available through this collective action online, certain "failures" show that in order for these workers to have better access to their rights, effective support by public policy is indispensable.

Community health services in European literature: A systematic review of their features, outcomes, and nursing contribution to care.

BACKGROUND: To meet the population's needs, community care should be customized and continuous, adequately equipped, and monitored. INTRODUCTION: Considering their fragmented and heterogeneous nature, a summary of community healthcare services described in European literature is needed. The aim of this study was to summarize their organizational models, outcomes, nursing contribution to care, and nursing-related determinants of outcomes. METHODS: A systematic review was performed by searching PubMed, CINAHL, Scopus, and Embase in October 2022 and October 2023 (for updated results). Quantitative studies investigating the effects of community care, including nursing contribution, on patient outcomes were included and summarized. Reporting followed the PRISMA checklist. The review protocol was registered on PROSPERO (CRD42022383856). RESULTS: Twenty-three studies describing six types of community care services were included, which are heterogeneous in terms of target population, country, interventions, organizational characteristics, and investigated outcomes. Heterogeneous services' effects were observed for access to emergency services, satisfaction, and compliance with treatment. Services revealed a potential to reduce rehospitalizations of people with long-term conditions, frail or older persons, children, and heart failure patients. Models are mainly multidisciplinary and, although staffing and workload may also have an impact on provided care, this was not enough investigated. DISCUSSION: Community health services described in European literature in the last decade are in line with population needs and suggest different suitable models and settings according to different care needs. Community care should be strengthened in health systems, although the influence of staffing, workload, and work environment on nursing care should be investigated by developing new management models. CONCLUSIONS AND IMPLICATIONS FOR HEALTH POLICY: Community care models are heterogeneous across Europe, and the optimum organizational structure is not clear yet. Future policies should consider the impact of community care on both health and economic outcomes and enhance nursing contributions to care.

Enhancing service provision for looked after children and young people in Doncaster.

The 0-19 looked after children (LAC) team in Doncaster, England, is a well-established service that has developed over time to identify and address the health needs of looked after children and young people and care leavers. Its aims are to improve outcomes for these children and young people by offering a holistic approach to assessing their health and well-being. The principle of having a dedicated nurse specialist for LAC following each child or young person throughout their care journey enables a trusting relationship to be established and the voice of the child or young person to be heard. This article reports on several developments in the Doncaster LAC team, including a local pilot of joint nurse and GP initial health assessments and participation in a national pilot of mental health assessments.

Academic Medical Centers and Federally Qualified Health Centers: Collaboration for the Care of Underserved Communities.

Academic Medical Centers (AMCs) and Federally Qualified Health Centers (FQHCs) are similarly tasked with managing the health of their local community, yet they each face unique challenges in their ability to do so. Integrating AMCs and FQHCs into novel care delivery models can leverage both organizations strengths, providing care in a comprehensive and sustainable fashion. Johns Hopkins Medicine (JHM) implemented this model with a large East Baltimore medical center, creating an AMC-FQHC collaboration focused on providing care to the East Baltimore patient population. This system provided various improvements in care delivery, including increased staffing, new wraparound services, improved access to funding dollars, and decreased out of pocket costs for patients qualifying for financial assistance. The academic missions of research and training were preserved, serving as the primary continuity clinic for several residency programs and as a community site for research. These changes resulted in more robust care for patients while improving the financial standing of the clinic. Through AMC and FQHC partnership, progress can be made toward providing holistic and financially sustainable primary care services in underserved areas while preserving the tripartite mission of academic medicine, with significant pedagogical and research opportunities.

Mapping Quality Indicators to Assess Older Adult Health and Care in Community-, Continuing-, and Acute-Care Settings: A Systematic Review of Reviews and Guidelines.

Quality indicators (QIs) play a vital role in enhancing the care of older adults. This study aimed to identify existing QIs relevant to the health and care of older adults in community-care, continuing-care, and acute-care settings, along with available information such as definitions and calculation methods. A systematic review of published review studies, grey literature, and guidelines was undertaken, utilizing six electronic databases searched for materials dated from 2010 to 2 June 2023. To be included in this study, the literature had to provide data on QIs in a setting involving older adults. This study included 27 reviews and 44 grey literature sources, identifying a total of 6391 QIs. The highest number of indicators (37%) were relevant to continuing care; 32% and 28% were pertinent to community- and acute-care settings, respectively. The process domain had the highest number of QIs (3932), while the structure domain had the fewest indicators (521). A total of 39 focus areas were identified, with the five most common areas being, in descending order, orthopedics/hip fractures, end-of-life/palliative care, appropriate prescribing, neurocognitive conditions, and cardiovascular conditions; these areas ranged between 10% and 6%. When mapped against the Quadruple Aim framework, most QIs (85%) were linked to improving health outcomes. This inclusive compilation of QIs serves as a resource for addressing various focus areas pertinent to the Quadruple Aims. However, few quality indicators have been designed to provide a comprehensive and thorough evaluation of a specific aspect, taking into account all three key domains: structure, process, and outcomes. Addressing the description and psychometric properties of QIs is foundational for ensuring their trustworthiness and effective application.

Exploring the 'citizen organization': an evaluation of a regional Australian community-based palliative care service model.

Background: Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. Its goals are to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services and is grounded in equal partnerships between civic life, community members, patients and carers, and service providers. This takes many forms, including what we have termed the 'citizen organization'. Objectives: This paper reports on an evaluation of Little Haven's model of care and explores the organization's place as a 'citizen' of the community it services. Design: A co-designed evaluation approach utilizing mixed-method design is used. Methods: Multiple data sources obtained a broad perspective of the model of care including primary qualitative data from current patients, current carers, staff, volunteers and organizational stakeholders (interviews and focus groups); and secondary quantitative survey data from bereaved carers. Thematic analysis and descriptive statistics were generated. Results: This model of care demonstrates common service elements including early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users, with strong community engagement. These elements enable high-quality care for patients and carers who describe the support as 'over and above', enabling good quality of life and care at home. Staff and volunteers perceive the built-in flexibility of the model as critical to its outcomes; the interface between the service and the community is similarly stressed as a key service element. Organizational stakeholders observed the model as a product of local activism and accountability to the community. Conclusion: All participant groups agree the service model enables the delivery of excellent care. The construction of a community palliative care service as a citizen organization emerged as a new concept.

'Citizen organization': an Australian community-based palliative care service model Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. It aims to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services in equal partnerships between civic organizations, community members, patients and carers, and service providers. We undertook an evaluation of Little Haven's model of care by speaking with current patients, current and past carers, staff, volunteers and stakeholders about their experiences of Little Haven. We found that Little Haven's model contains the essential elements of a palliative care service and provides early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users. They have strong community engagement with a strong background in community activism. We identified that Little Haven's 'being in the community' goes beyond service provision or even sentiment. We observed a symbiotic relationship between the organization and the community it supports in what we have termed the 'citizen organization'. The distinctive characteristic of the citizen organization is its inseparability from the community in which it dwells.

An innovative model of delivering cancer care in the community: the experience of a tertiary cancer centre in Singapore.

BACKGROUND: Cancer care has evolved rapidly, increasing the demand on healthcare resources. While many non-oral cancer treatments are administered in the hospital, not all necessitate complex medical care. Treatments that can be administered subcutaneously, intramuscularly, or as short intravenous infusions with a low risk of extravasation can be safely administered in the community. PATIENTS AND METHODS: Since 2017, the National University Cancer Institute, Singapore (NCIS) has operated a program called NCIS on-the-go (NOTG) comprising a network of community cancer treatment clinics located within 20 km of the hospital. NOTG provides 17 low-risk treatments and nursing services run by oncology-trained nurses without on-site physicians. Patients who receive their first dose of cancer treatment uneventfully in the cancer centre can opt-in to receive subsequent doses at any NOTG clinic. RESULTS: Treatment at NOTG has become more mainstream over the years, with its workload increasing by over sevenfold since 2017, and is now responsible for ∼10% of the total main cancer centre workload. The program is sustainable and financially viable to operate. A survey of 155 patients revealed a 96.8% user satisfaction rate, with the majority reporting tangible savings in travelling time, waiting time, and travelling costs. The diversion of low-risk treatments to NOTG has indirectly increased capacity and reduced waiting times at the main cancer centre for patients requiring complex cancer treatments, resulting in a win-win situation. CONCLUSIONS: NOTG represents an innovative model of care to deliver low-risk cancer treatments safely in the community and can be easily replicated in other countries.

The Effects of Neuropsychiatric Symptom Clusters in People with Dementia on Family Caregiver Burden.

Background: Neuropsychiatric symptoms are a robust risk factor for caregiver burden in family dementia caregivers. By grouping these symptoms, clinical interpretations regarding neuropsychiatric symptoms may facilitated because different groups of symptoms may require a different approach for intervention, thereby reducing caregiver burden. Objective: As clustering of neuropsychiatric symptoms could be clinically relevant, we aimed to explore the effects of these clusters on burden in family dementia caregivers. Methods: 152 family dementia caregivers were included. Caregiver burden was measured using the Ervaren Druk door Informele Zorg (EDIZ)/Self-Perceived Pressure from Informal Care, a Dutch questionnaire. Caregivers also reported the neuropsychiatric symptoms and functional impairments in daily activities of the people with dementia they cared for. Multiple regression analyses were used in this cross-sectional study. Results: Adjusted for functional impairments and sociodemographic variables, neuropsychiatric symptoms were associated with more caregiver burden (p < 0.001). However, this association did not differ between the three neuropsychiatric symptom clusters (p = 0.745). Conclusions: Neuropsychiatric symptoms were associated with more family caregiver burden, but no conclusive evidence was found that this association differed for the three clusters. Clustering of neuropsychiatric symptoms is, however, worth exploring further in future studies with more participants. If specific links are found, these could be targeted in clinical practice in order to prevent, reduce and/or postpone caregiver burden.