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1.
Am J Alzheimers Dis Other Demen ; 34(7-8): 523-529, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31266345

RESUMO

OBJECTIVES: This study examined the efficacy of the General Practitioner Assessment of Cognition-Chinese version (GPCOG-C) in screening dementia and mild cognitive impairment (MCI) among older Chinese. METHODS: Survey questionnaires were administered to 293 participants aged 80 or above from a university hospital in mainland China. Alzheimer disease and MCI were diagnosed in light of the National Institute on Aging and the Alzheimer's Association (NIA/AA) criteria. The sensitivity and specificity of GPCOG-C and Mini-Mental State Examination (MMSE) in screening dementia and MCI were compared to the NIA/AA criteria. RESULTS: The GPCOG-C had the sensitivity of 62.3% and specificity of 84.6% in screening MCI, which had comparable efficacy as the NIA/AA criteria. In screening dementia, GPCOG-C had a lower sensitivity (63.7%) than the MMSE and a higher specificity (82.6%) higher than the MMSE. CONCLUSIONS: The GPCOG-C is a useful and efficient tool to identify dementia and MCI in older Chinese in outpatient clinical settings.

2.
Aging Clin Exp Res ; 30(8): 993-998, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29188578

RESUMO

BACKGROUND: The Montreal cognitive assessment (MoCA) has become one of the most widely used cognitive screening instruments since its initial publication. To date, only a handful of studies have explored longitudinal characteristics of the MoCA. AIM: The aim of this study is to characterize the trajectory of MoCA performance across a broad age continuum of older adults. METHODS: Data from 467 cognitively normal participants were used in this analysis. The sample was grouped into four strata based on the participants' age at baseline (60-69, 70-79, 80-89, and 90-99). Mixed model repeated measures (MMRM) analysis and mixed-effects spline models were used to characterize the trajectory of MoCA scores in each age stratum and in the entire sample. Intrasubject standard deviation (ISD) was used to characterize the natural variability of individual MoCA performance over time. RESULTS: The ISD values for each of the age strata indicated that year-to-year individual variation on the MoCA ranged from zero to three points. MMRM analysis showed that the 60-69 stratum remained relatively stable over time while the 70-79 and 80-89 strata both showed notable decline relative to baseline performance. The mixed-effects spline model showed that MoCA performance declines linearly across the older adult age span. DISCUSSION: Among cognitively normal older adults MoCA performance remains relatively stable over time, however across the older adult age-span MoCA performance declines in a linear fashion. These results will help clinicians better understand the normal course of MoCA change in older adults while researchers may use these results to inform sample size estimates for intervention studies. CONCLUSION: This study provides an enhanced view of the MoCA's intraindividual trajectory in normal elderly aged 60 and older.


Assuntos
Cognição/fisiologia , Disfunção Cognitiva/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Testes de Estado Mental e Demência , Pessoa de Meia-Idade , Testes Neuropsicológicos
3.
J Transcult Nurs ; 28(4): 398-407, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-27389911

RESUMO

PURPOSE: Specific stressors associated with caregiving in Mexican American (MA) families are not well documented, yet caregiving issues are paramount because informal care for parents is central to their culture. Although MA families who band together to provide care for one member are not unique, the literature does not describe the phenomenon of collective caregiving, which may be widespread but unrecognized. This article describes these understudied families who are poorly served by contemporary health systems because their characteristics are unknown. DESIGN: Descriptive, multisite, longitudinal mixed-methods study of MA caregiving families. FINDINGS: We identified three types of collective caregivers: those providing care for multiple family members simultaneously, those providing care successively to several family members, and/or those needing care themselves during their caregiving of others. DISCUSSION AND CONCLUSIONS: Collective caregiving of MA elders warrants further investigation. IMPLICATIONS FOR PRACTICE: Exploration of collective caregiving may provide a foundation for tailored family interventions.


Assuntos
Atitude , Cuidadores/psicologia , Cultura , Família/psicologia , Americanos Mexicanos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Cuidadores/normas , Família/etnologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Estados Unidos/etnologia
4.
J Fam Nurs ; 22(4): 606-630, 2016 11.
Artigo em Inglês | MEDLINE | ID: mdl-27903942

RESUMO

Palliative and end-of-life care (PEOLC) in Mexican American (MA) caregiving families remains unexplored. Its onset was uncovered in our mixed methods, multisite, interdisciplinary, qualitative descriptive study of 116 caregivers, most of whom had provided long-term informal home care for chronically ill, disabled older family members. This subanalysis used Life Course Perspective to examine the "point of reckoning" in these families, where an older person is taken in for care, or care escalates until one recognizes oneself as the primary caregiver. Ninety-three of 116 caregivers recognized and spontaneously reported a "reckoning point" that initiated the caregiving trajectory, while eight cited "gradual decline" into caregiving for elders in their homes. This "reckoning point," which marks the assumption of this role, may afford a fertile opportunity for referral to community resources or initiation of formal PEOLC, thereby improving the quality of life for these older individuals and their families.


Assuntos
Cuidadores/psicologia , Americanos Mexicanos , Qualidade de Vida , Assistência Terminal , Adulto , Idoso , Idoso de 80 Anos ou mais , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cuidados Paliativos
5.
Digit Health ; 22016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27928511

RESUMO

OBJECTIVE: To gain an understanding of Latino/Hispanic caregivers' dementia-related dressing issues, their impressions of using a "smart" context-aware dresser to coach dressing, and recommendations to improve its acceptability. METHOD: The same Latina moderator conducted all the caregiver focus groups. She followed a semi-structured interview guide that was previously used with White and African American family caregivers who experienced Alzheimer's disease related dressing challenges. From that study, the Preservation of Self model emerged. Using a deductive qualitative analytic approach, we applied the thematic domains from the Preservation of Self model to ascertain relevance to Latino/Hispanic caregivers. RESULTS: Twenty Latino/Hispanic experienced caregivers were recruited, enrolled, and participated in one of three focus groups. The majority were female (75%) and either the spouse (25%) or adult child (35%). Striking similarities occurred with the dressing challenges and alignment with the Preservation of Self model. Ethnic differences arose in concerns over assimilation weakening the Latino culture of family caregiving. Regional clothing preferences were noted. Technology improvement recommendations for our system, called DRESS, included developing bilingual prompting dialogs and video modules using the local vernacular to improve cultural sensitivity. Caregivers identified the potential for the technology to enable user privacy, empowerment, and exercise as well as offering respite time for themselves. CONCLUSION: Findings suggest dementia-related dressing issues were shared in common by different racial/ethnic groups but the response to them was influenced by cultural dynamics. For the first time Latino/Hispanic voices are heard to reflect their positive technology impressions, concerns, and recommendations in order to begin to address the cultural digital disparities divide.

6.
Aging Clin Exp Res ; 28(5): 863-9, 2016 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26572156

RESUMO

The purpose of this article is to describe the Longevity Study: Learning From Our Elders, a research program on healthy aging that began in 2007 at the Center for Healthy Aging at Banner Sun Health Research Institute. As of June 2015, 1139 participants (age range of 50-110 years) completed baseline assessments with the majority living in the Sun Cities retirement communities northwest of Phoenix, Arizona but expanding throughout the state. The registry includes over 830 currently active participants with 450 aged 80 years and older, 188 aged 90 and older, and 27 centenarians. Data from in-person interviews at the Center for Healthy Aging in Sun City or in the participants' residences which includes sociodemographic, medical, cognitive, physical and psychosocial variables have been collected since the study's inception. This paper outlines some of the key demographic and clinical characteristics of the Longevity Study, its progress, and future directions. It also reflects on how exceptional aging individuals function psychosocially, cognitively and physically, particularly among individuals aged 85 and older.


Assuntos
Envelhecimento , Avaliação Geriátrica , Longevidade , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Envelhecimento/psicologia , Arizona/epidemiologia , Cognição , Demografia , Feminino , Avaliação Geriátrica/métodos , Avaliação Geriátrica/estatística & dados numéricos , Geriatria/métodos , Nível de Saúde , Humanos , Estudos Longitudinais , Masculino , Psicologia , Fatores Socioeconômicos
7.
J Rehabil Res Dev ; 53(6): 945-958, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28475201

RESUMO

Some individuals with mild cognitive impairment (MCI) experience not only cognitive deficits but also a decline in motor function, including postural balance. This pilot study sought to estimate the feasibility, user experience, and effects of a novel sensor-based balance training program. Patients with amnestic MCI (mean age 78.2 yr) were randomized to an intervention group (IG, n = 12) or control group (CG, n = 10). The IG underwent balance training (4 wk, twice a week) that included weight shifting and virtual obstacle crossing. Real-time visual/audio lower-limb motion feedback was provided from wearable sensors. The CG received no training. User experience was measured by a questionnaire. Postintervention effects on balance (center of mass sway during standing with eyes open [EO] and eyes closed), gait (speed, variability), cognition, and fear of falling were measured. Eleven participants (92%) completed the training and expressed fun, safety, and helpfulness of sensor feedback. Sway (EO, p = 0.04) and fear of falling (p = 0.02) were reduced in the IG compared to the CG. Changes in other measures were nonsignificant. Results suggest that the sensor-based training paradigm is well accepted in the target population and beneficial for improving postural control. Future studies should evaluate the added value of the sensor-based training compared to traditional training.


Assuntos
Disfunção Cognitiva/fisiopatologia , Terapia por Exercício , Retroalimentação Fisiológica , Equilíbrio Postural , Acidentes por Quedas , Idoso , Idoso de 80 Anos ou mais , Feminino , Marcha , Humanos , Masculino , Projetos Piloto
8.
Artigo em Inglês | MEDLINE | ID: mdl-25942388

RESUMO

The original validation study for the Montreal Cognitive Assessment (MoCA) suggests a cutoff score of 26; however, this may be too stringent for older adults, particularly for those with less education. Given the rapidly increasing number of older adults and associated risk of dementia, this study aims to provide appropriate age- and education-adjusted norms for the MoCA. Data from 205 participants in an ongoing longevity study were used to derive normative data. Individuals were grouped based on age (70-79, 80-89, 90-99) and education level (≤12 Years, 13-15, ≥16 Years). There were significant differences between age and education groups with younger and more educated participants outperforming their counterparts. Forty-six percent of our sample scored below the suggested cutoff of 26. These normative data may provide a more accurate representation of MoCA performance in older adults for specific age and education stratifications.


Assuntos
Cognição , Testes Neuropsicológicos/normas , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Escolaridade , Feminino , Humanos , Masculino , Entrevista Psiquiátrica Padronizada
9.
J Gerontol B Psychol Sci Soc Sci ; 70(2): 247-57, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24077744

RESUMO

OBJECTIVES: Guided by a Sociocultural Health Belief Model (SHBM), this study examined the roles of cultural beliefs of Alzheimer's disease (AD) and scientific knowledge of AD in influencing the perceived threat of AD in a sample of Chinese American older adults. METHOD: With the input from focus groups of 17 older Chinese volunteers, survey questionnaires were refined and then delivered through face-to-face interviews to 385 participants aged 55-100 in the Phoenix metropolitan area. RESULTS: Hierarchical regression analyses found that those aged 55-64 were more worried about AD than those aged 85 or older. Both cultural beliefs of AD and AD factual knowledge contributed to higher levels of perceived threat of AD. Education tended to moderate the effect of cultural beliefs of AD and AD knowledge on perceived threat of AD. DISCUSSIONS: Findings support inclusion of key factors in the SHBM relevant to perceived threat of AD and help enrich the understanding of AD literacy from both scientific and cultural perspectives. AD education programs and interventions should help address crucial cultural beliefs related to AD and the emotional consequences (e.g., concerns or fear of AD) that might be due to the exposure to AD factual knowledge, particularly for those with limited education.


Assuntos
Doença de Alzheimer/etnologia , Americanos Asiáticos/etnologia , Conhecimentos, Atitudes e Prática em Saúde/etnologia , Idoso , Idoso de 80 Anos ou mais , Arizona/etnologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
10.
J Sex Med ; 11(9): 2308-17, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24888965

RESUMO

INTRODUCTION: Gay men with prostate cancer (GMPCa) may have differential health-related quality of life (HRQOL) and sexual health outcomes than heterosexual men with prostate cancer (PCa), but existing information is based on clinical experience and small studies. AIMS: Our goals were to: (i) describe HRQOL and examine changes in sexual functioning and bother; (ii) explore the psychosocial aspects of sexual health after PCa; and (iii) examine whether there were significant differences on HRQOL and sexual behavior between GMPCa and published norms. METHODS: A convenience sample of GMPCa completed validated disease-specific and general measures of HRQOL, ejaculatory function and bother, fear of cancer recurrence, and satisfaction with prostate cancer care. Measures of self-efficacy for PCa management, illness intrusiveness, and disclosure of sexual orientation were also completed. Where possible, scores were compared against published norms. MAIN OUTCOME MEASURES: Main outcome measures were self-reported sexual functioning and bother on the Expanded Prostate Cancer Index. RESULTS: Compared with norms, GMPCa reported significantly worse functioning and more severe bother scores on urinary, bowel, hormonal symptom scales (Ps < 0.015-0.0001), worse mental health functioning (P < 0.0001), greater fear of cancer recurrence (P < 0.0001), and were more dissatisfied with their PCa medical care. However, GMPCa reported better sexual functioning scores (P < 0.002) compared with norms. Many of the observed differences met criteria for clinical significance. Physical functioning HRQOL and sexual bother scores were similar to that of published samples. GMPCa tended to be more "out" about their sexual orientation than other samples of gay men. CONCLUSIONS: GMPCa reported substantial changes in sexual functioning after PCa treatment. They also reported significantly worse disease-specific and general HRQOL, fear of recurrence, and were less satisfied with their medical care than other published PCa samples. Sexual health providers must have an awareness of the unique functional and HRQOL differences between gay and heterosexual men with PCa.


Assuntos
Pessoal de Saúde , Homossexualidade Masculina , Neoplasias da Próstata/psicologia , Qualidade de Vida , Sexologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias da Próstata/fisiopatologia , Neoplasias da Próstata/terapia , Recursos Humanos
11.
Hisp J Behav Sci ; 36(3): 344-365, 2014 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27228120

RESUMO

This mixed methods, multi-site, National Institute of Nursing Research (NINR)-funded, interdisciplinary, descriptive study aimed to identify expressions of worry in qualitative data obtained from caregiving Mexican American (MA) families assisting older adults. The purpose of this portion of the inquiry was to determine how worry is expressed, what happens to caregivers when they worry, and what adaptive strategies they used. We examined semi-structured interviews completed during six in-home visits with 116 caregivers. We identified 366 worry quotations from 639 primary documents in ATLAS.ti, entered them into matrices, and organized findings under thematic statements. Caregivers expressed cultural and contextual worries, worried about transitions and turning points in care, and identified adaptive strategies. Despite these strategies, worry persisted. Constant worry may be an allied, important aspect of caregiver burden. We need additional longitudinal research to better understand the experience of MA caregivers for older adults and to provide empirically supported interventions, programs, and services that reduce worry.

12.
Rehabil Nurs ; 38(5): 221-30, 2013 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23703962

RESUMO

PURPOSE: The purpose of this article is to provide an overview of changing sleep patterns and common sleep disorders in older adults and to discuss treatment options of sleep disturbances within inpatient rehabilitation facilities (IRFs). METHODS: Through extensive review of the existing literature, common sleep disorders among older adults and several key factors that may impact sleep in older adults in inpatient rehabilitation facilities, such as behavioral and environmental factors, psychosocial and emotional factors, medical conditions, and medications were identified. FINDINGS: Current literature on the factors associated with sleep disturbance in older adults in IRFs is based on work with community-dwelling older adults and those in long-term care facilities. While interventions to address these disorders and research investigation key factors associated with sleep problems among older adults appear in the literature, there is very little work that applies these interventions within IRFs. CONCLUSIONS AND CLINICAL RELEVANCE: Research is needed to examine the impact of sleep problems on older adults in IRFs, including work that focuses on intervention trials to identify successful treatments for these problems and translate those approaches into practice.


Assuntos
Envelhecimento , Centros de Reabilitação , Enfermagem em Reabilitação , Transtornos do Sono-Vigília/epidemiologia , Transtornos do Sono-Vigília/enfermagem , Idoso , Idoso de 80 Anos ou mais , Educação Continuada em Enfermagem , Humanos , Pacientes Internados , Fatores de Risco
13.
J Sex Med ; 9(12): 3189-97, 2012 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23035896

RESUMO

INTRODUCTION: A growing literature suggests relationships between erectile dysfunction medications (EDM) and riskier sexual behavior among men who have sex with men (MSM). Questions remain concerning EDM use and related HIV/sexually transmitted infections (STI) risk among older MSM, particularly those 40 years and over, for whom EDM may be medically warranted. AIM: This exploratory pilot study explores the relationship between EDM and risky sexual behavior in a convenience sample of MSM using EDM and attending historic sex-on-premises venues. METHODS: We examined anonymous surveys from 139 MSM. Bivariate relationships were examined. We then fit a multiple logistic regression model to determine predictors of engaging in unprotected anal intercourse (UAI) at last EDM, using variables identified as being significantly related to UAI in the bivariate analyses. Potential predictors entered the model in a stepwise fashion. MAIN OUTCOME MEASURES: The primary outcome measure was engaging in UAI at last EDM use. RESULTS: MSM participating in the study ranged from 27 to 77 years and averaged 52.0 years (standard deviation = 10.73 years). These participants were primarily older MSM; fewer were younger MSM (12.12%), under age 40. Participants reporting UAI at last EDM use (N = 41) were significantly younger (P < 0.01). Men visiting bars within the last 6 months reported less UAI (P < 0.01). Both variables were independent predictors of UAI in the logistic regression model (P < 0.01). CONCLUSIONS: Similar to reports from younger MSM, our findings suggest older MSM using EDM and reporting UAI are also recreational drug users. We include recommendations for urologists and other sexual medicine physicians treating MSM who may be at elevated risk for HIV/STI infection because of joint EDM and club drug use.


Assuntos
Homossexualidade Masculina , Inibidores da Fosfodiesterase 5/uso terapêutico , Assunção de Riscos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Sexo sem Proteção/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Infecções por HIV/transmissão , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Medição de Risco , Doenças Sexualmente Transmissíveis/transmissão , Inquéritos e Questionários
14.
J Fam Nurs ; 18(4): 439-66, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22740307

RESUMO

La familia drives elder care in Mexican-American (MA) families, but nursing home placement can result from day-to-day caregiving demands that increase caregiver difficulty with activities of daily living (ADLs). Using life course perspective, this article describes the initial data wave of 31 MA caregivers from a descriptive, longitudinal, mixed-methods study of 110 MA caregivers and care recipients over 15 months in their caregiving trajectories. Fifteen of 31 caregivers consistently indicated "no help needed" on the Katz ADL, whereas all but one reported "help needed" during semistructured interviews with cultural brokers. In addition to the discrepancy between results on the Katz ADL and interviews, findings include consideration of nursing home placement by moderately acculturated caregivers and minimization of their illnesses by caregivers. Additional methods of MA caregiver assessment may be needed due to the questionable accuracy of the Katz ADL; additional research should explore minimization and acculturation in MA caregivers.


Assuntos
Atividades Cotidianas , Cuidadores , Família , Americanos Mexicanos , Aculturação , Adulto , Idoso , Enfermagem Familiar , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
15.
J Mix Methods Res ; 5(4): 276-292, 2011 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-22368533

RESUMO

There is a growing acceptance of the utility of mixed methods in health sciences but there is no widely accepted set of ideas in regard to use of a conceptual or theoretical framework to guide inquiry. Few mixed methods health science articles report the use of such a framework. Lack of available conceptual maps provided by theoretical frameworks, necessary intricacy of design, and the qualitative "black box" tradition all contribute to a dearth of methodological guidance in such studies. This article uses a funded National Institutes of Health study as an example to explain the utility of a theoretical framework in conceptualizing a study, making design decisions such as sampling and recruitment, collecting and analyzing data, and data interpretation.

16.
Geriatr Nurs ; 30(6): 426-36, 2009 Nov-Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19998566

RESUMO

Family caregivers of older adults with significant cognitive and/or physical impairment are at increased risk for both psychiatric and physical morbidity. This article examines the research literature dedicated to the development of effective interventions to reduce distress and enhance well-being for these caregivers. Using a recent empirically based treatment (EBT) review of the literature as a backdrop, 3 overarching types of interventions were described as effective: psychoeducational skill building, psychotherapy (cognitive-behavioral in focus), and multicomponent (using a combination of at least 2 approaches such as education, family meetings, and skill building). Suggestions are made to facilitate future caregiver intervention research and translation of EBTs into the community including the need to expand rigorous research with caregivers of older adults facing problems other than dementia, including older patients with psychiatric problems; develop and test interventions designed for transitions into and out of the caregiving roles, as well as interventions designed to improve physical health outcomes and promote health behaviors; create linkages between interventions at multiple levels of delivery; extend caregiver intervention work with underrepresented ethnic and racial populations; and investigate the cost-effectiveness of caregiver interventions.


Assuntos
Cuidadores/psicologia , Família/psicologia , Estresse Psicológico/terapia , Humanos , Autoeficácia
17.
Cancer J ; 15(1): 34-40, 2009 Jan-Feb.
Artigo em Inglês | MEDLINE | ID: mdl-19197171

RESUMO

Many published articles have documented the impact of prostate-cancer treatment on sexual functioning in men treated for localized disease. Surprisingly, the literature on interventions to rehabilitate men's sexual functioning is much more limited. In this article, we review the sexual-rehabilitation interventions for prostate-cancer patients and identify a number of common themes across interventions. We also identify areas where further research is needed and propose a conceptual model based on psychologic and nursing theories and informed by the published research.


Assuntos
Neoplasias da Próstata/complicações , Disfunções Sexuais Fisiológicas/reabilitação , Disfunções Sexuais Psicogênicas/reabilitação , Adaptação Psicológica , Administração de Caso , Aconselhamento , Metas , Processos Grupais , Humanos , Masculino , Modelos Psicológicos , Neoplasias da Próstata/terapia , Grupos de Autoajuda , Disfunções Sexuais Fisiológicas/etiologia , Disfunções Sexuais Psicogênicas/etiologia , Parceiros Sexuais
18.
Behav Ther ; 39(4): 366-74, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19027433

RESUMO

The primary purpose of this study was to examine the synchronous and temporal relations between engagement in activities and the two primary dimensions of affect--namely, positive and negative affect--using an intensive time-series design called concomitant time series analysis (CTSA). Twenty-four dementia caregivers completed 56 diary measures (4 times per day for 2 weeks) assessing their experience of positive and negative affect as well as engagement in a variety of activities. Total number of activities was significantly correlated with positive affect (r=.40), but not negative affect (r=-.12). Obtained pleasure from activities was significantly correlated with both positive (r=.42) and negative affect (r=-.17). These results may help further develop behavioral models of depression by suggesting that behavioral or self-reinforcing activities are associated primarily (or more saliently) with one's experience of positive affect. Future research examining the effect of behavioral interventions on both positive and negative affect is suggested, as is the examination of factors that may be more strongly associated with negative affect.


Assuntos
Afeto/fisiologia , Doença de Alzheimer/enfermagem , Cuidadores/psicologia , Assistência Domiciliar/psicologia , Modelos Psicológicos , Atividades Cotidianas , Idoso , Nível de Alerta/fisiologia , Demência/enfermagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Autoimagem , Inquéritos e Questionários
19.
J Am Geriatr Soc ; 56(3): 413-20, 2008 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-18179480

RESUMO

OBJECTIVES: To examine the cost-effectiveness of a randomized, clinical trial of a home-based intervention for caregivers of people with dementia. DESIGN: This cost-effectiveness analysis examined Resources for Enhancing Alzheimer's Caregivers Health (REACH II), a multisite, randomized, clinical trial, from June 2002 through December 2004, funded by the National Institute on Aging and the National Institute of Nursing Research, of a behavioral intervention to decrease caregivers' stress and improve management of care recipient behavioral problems. SETTING: Community-dwelling dementia caregiving dyads from the Memphis REACH II site. PARTICIPANTS: Of Memphis' random sample of 55 intervention and 57 control black and white dyads, 46 in each arm completed without death or discontinuation. Family caregivers were aged 21 and older, lived with the care recipient, and had provided 4 or more hours of care per day for 6 months or longer. Care recipients were cognitively and functionally impaired. INTERVENTION(S): Twelve individual sessions (9 home sessions and 3 telephone sessions) supplemented by five telephone support-group sessions. Control caregivers received two "check in" phone calls. MEASUREMENTS: Incremental cost-effectiveness ratio (ICER), the additional cost to bring about one additional unit of benefit (hours per day of providing care). RESULTS: At 6 months, there was a significant difference between intervention caregivers and control caregivers in hours providing care (P=.01). The ICER showed that intervention caregivers had 1 extra hour per day not spent in caregiving, at a cost of $5 per day. CONCLUSION: The intervention provided that most scarce of caregiver commodities--time. The emotional and physical costs of dementia caregiving are enormous, and this intervention was able to alleviate some of that cost.


Assuntos
Doença de Alzheimer/terapia , Cuidadores/psicologia , Custos de Cuidados de Saúde , Serviços de Assistência Domiciliar/economia , Estresse Psicológico/prevenção & controle , Idoso , Doença de Alzheimer/psicologia , Análise Custo-Benefício , Feminino , Comportamentos Relacionados com a Saúde , Educação em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Estresse Psicológico/etiologia , Resultado do Tratamento
20.
Geriatr Nurs ; 28(5): 289-96, 2007 Sep-Oct.
Artigo em Inglês | MEDLINE | ID: mdl-17982809

RESUMO

Thirteen percent of Hispanic households provide care to an adult aged 50 or older, but given their dramatic population growth, an increasingly large number of families will soon be placed in a caregiving role. The purpose of this study was to determine whether Hispanic caregivers could be accessed through local provider groups, with the goal of generating interventions to decrease caregiver burden. Study findings raise Anglo nurses' awareness of the need for staff who share the values and language of diverse subgroups. Second, they confirm the presence of male caregivers, sons who alone provide personal care to a parent. Lastly, the effect of empathetic, informal interactions and personal stories in communication with Hispanics cannot be overstated. We believe that our findings are of interest to clinicians who help Hispanic families access community care agencies and, conversely, will help community agencies identify families who need assistance and clinical researchers who are seeking study participants.


Assuntos
Atitude do Pessoal de Saúde/etnologia , Cuidadores , Demência , Acesso aos Serviços de Saúde/organização & administração , Hispano-Americanos , Adulto , Idoso , Arizona , Atitude Frente a Saúde/etnologia , Cuidadores/educação , Cuidadores/psicologia , Comunicação , Efeitos Psicossociais da Doença , Diversidade Cultural , Demência/etnologia , Demência/enfermagem , Empatia , Família/etnologia , Feminino , Grupos Focais , Necessidades e Demandas de Serviços de Saúde , Hispano-Americanos/educação , Hispano-Americanos/etnologia , Assistência Domiciliar/educação , Assistência Domiciliar/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Papel do Profissional de Enfermagem/psicologia , Pesquisa Metodológica em Enfermagem , Relações Profissional-Família , Pesquisa Qualitativa
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