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1.
Nihon Ronen Igakkai Zasshi ; 61(2): 145-154, 2024.
Artigo em Japonês | MEDLINE | ID: mdl-38839313

RESUMO

OBJECTIVE: To examine the relationship between difficulties experienced by family in supporting elderly patients with diabetes and these patients' higher-level functions. METHODS: The subjects were outpatients with diabetes ≥65 years old at Ise Red Cross Hospital and their family members. The Tokyo Metropolitan Institute of Gerontology Index of Competence (TMIG-IC) was used to assess patients' higher-level functions. The Japanese version of the Diabetes Caregiver Activity and Support Scale (D-CASS-J) was used to measure difficulties experienced by family in supporting elderly patients with diabetes. Using a multiple regression analysis with TMIG-IC scores (instrumental ADL, intellectual activity, and social participation) as the dependent variable and D-CASS-J scores (based on the highest scoring Q1 group among the three quartiles of D-CASS-J scores) as the explanatory variables, standardized regression coefficients (ß) for higher-level functions on the family's perceived support difficulties were calculated. RESULTS: In total, 429 patients (254 male patients and 175 female patients) were included in the analysis. For male patients, the adjusted beta values for TMIG-IC scores in Q2 and Q3 were -0.039 (P=0.649) and -0.352 (P<0.001), respectively, and the adjusted beta values for the instrumental ADL scores were -0.064 (P=0.455), -0.192 (P=0.047), -0.090 (P=0.375), and -0.360 (P=0.002) for the Intellectually Active scores, respectively, and the adjusted beta for social role scores were 0.054 (P=0.581) and -0.261 (P=0.019), respectively. However, there was no association between the patients' higher-level functions and family support difficulties among female patients. CONCLUSIONS: Difficulty experienced by the family in supporting elderly male patients with diabetes is associated with reduced higher-level functioning.


Assuntos
Diabetes Mellitus , Humanos , Masculino , Feminino , Idoso , Diabetes Mellitus/psicologia , Família/psicologia , Atividades Cotidianas , Idoso de 80 Anos ou mais , Cuidadores/psicologia , Apoio Social
2.
Clin J Oncol Nurs ; 28(3): 241-246, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38830256

RESUMO

Moving Beyond Cancer to Wellness is a patient- and caregiver-focused educational outreach event with an inspirational message and lectures that address common concerns among cancer survivors. This event is open to the communi.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Sobreviventes de Câncer/psicologia , Neoplasias/enfermagem , Feminino , Masculino , Necessidades e Demandas de Serviços de Saúde , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Cuidadores/psicologia , Cuidadores/educação
3.
J Midwifery Womens Health ; 69(3): 383-393, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38831486

RESUMO

INTRODUCTION: Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs). METHODS: Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members. RESULTS: Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05). DISCUSSION: As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.


Assuntos
Nativos do Alasca , Cuidadores , Diabetes Gestacional , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Feminino , Diabetes Gestacional/psicologia , Gravidez , Estudos Transversais , Adolescente , Adulto Jovem , Adulto , Nativos do Alasca/psicologia , Cuidadores/psicologia , Mães/psicologia , Indígenas Norte-Americanos/psicologia , Criança , Fatores de Risco , Modelo de Crenças de Saúde
4.
BMC Palliat Care ; 23(1): 138, 2024 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-38824599

RESUMO

BACKGROUND: The role of family caregivers in the management of cerebrovascular accident survivors is invaluable. So far, there is a strong evidence affirming the effectiveness of family support for cerebrovascular accident survivors. Meanwhile, caring for cerebrovascular survivors can be labour and time intensive and pretty stressful for caregivers. The purpose of the study was to examine the lived experiences of family caregivers of cerebrovascular accident survivors in the Ho Municipality in the Volta Region of Ghana. This aims are to establish their caregivers' knowledge, preparedness, and impact of caregiving on the caregiver, and coping strategies caregivers adopted. METHODS: Using a four-item (with 14 prompts) interview guide and descriptive phenomenological approach, we gathered and analysed data from 37 family caregivers in the Ho Municipality of Ghana. RESULTS: We found that caregivers had limited knowledge about cerebrovascular disease-risk factors and were ill-prepared for their caregiving roles. Additionally, we found limited knowledge about coping strategies among the caregivers. We further report that some caregivers lost close relationships, and their jobs because of the caregiving, they also used fasting and prayer as coping strategies. CONCLUSIONS: Caregivers suffered broken relationship, loss their jobs and incomes due to their caregiving roles. Moreover, some engaged in fasting and prayers, and alcohol use to cope with the stress associated with caring for the cerebrovascular accident survivors. We discussed the potential implications of our findings on the realisation of the Sustainable Development Goal 3.4. The aim of this goal is to reduce by 75% premature deaths due to cerebrovascular and other non-communicable diseases by 2030.


Assuntos
Adaptação Psicológica , Cuidadores , Acidente Vascular Cerebral , Sobreviventes , Humanos , Cuidadores/psicologia , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Gana , Acidente Vascular Cerebral/psicologia , Sobreviventes/psicologia , Idoso , Pesquisa Qualitativa , Estresse Psicológico/psicologia , Estresse Psicológico/etiologia
5.
PLoS One ; 19(6): e0300450, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38870142

RESUMO

BACKGROUND: Family caregivers often play a key role in medical decision-making for patients with cancer. Adult-children account for nearly half of caregivers, but often have less experience with serious illness care and decision-making and face unique relational challenges as the patient's child. Yet little research explores the potentially distinctive decision-making, involvement in decisions, and support needs of adult-child caregivers. METHODS: Analysis of survey data of U.S. cancer caregivers conducted by CancerCare® in 2021. Chi-square tests and multivariable regression models assessed whether adult-child and spousal caregivers differed on the type of medical decisions they participated in (e.g., treatment planning, medication management), who made the decision (e.g., caregiver or joint decision), and the resources that informed decisions (e.g., friends and family, education materials). RESULTS: Adult-children (N = 892) were less likely than spouses (N = 314) to participate in treatment planning (beta = -0.41; 95%CI = -0.81,-0.01), but more likely to be involved in decisions about whether to challenge medical authority (e.g., seeking alternative treatment, second opinion) (beta = 0.50; 95%CI = 0.22,0.78). Compared to spouses, adult-children made joint decisions with patients less often (-13.2-percentage points; 95%CI = -19.64,-6.67) and acted as primary decision-maker more frequently (5.60-percentage points; 95%CI = 0.01,10.43). More adult-children than spouses sought help and information regarding decisions from the oncology team (8.42-percentage points; 95%CI = 1.98,14.87) and friends and family (7.91-percentage points; 95%CI = 1.34,14.48). CONCLUSIONS: How cancer caregivers and patients are related to each other shapes caregivers' medical decision-making. Adult-children's and spouses' probabilities of participating in and influencing decisions differed for certain types of decisions while adult-children were more likely to seek information and social support regarding decisions. These findings highlight the importance of the patient's and caregiver's relationship type in medical decision-making, suggesting that decision support programs may be more effective if they tailor programs by relationship type.


Assuntos
Cuidadores , Neoplasias , Cônjuges , Humanos , Cuidadores/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Neoplasias/terapia , Neoplasias/psicologia , Adulto , Cônjuges/psicologia , Filhos Adultos/psicologia , Idoso , Tomada de Decisões , Inquéritos e Questionários
6.
Front Public Health ; 12: 1366143, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38873291

RESUMO

Background: Affiliate stigma experienced by family caregivers of individuals with dementia may seriously affect home care and prognosis of these patients. This study aimed to explore the levels of perceived affiliate stigma and its influencing factors among family caregivers of patients with dementia in mainland China, which remains a relatively unexplored topic. Methods: In this cross-sectional study, purposive sampling was used to recruit dementia family caregivers from an online communication group between April and May 2022. A total of 727 eligible caregivers were included and asked to complete the demographic questionnaire, the affiliate stigma scale, and the caregiver burden inventory. Descriptive statistics, independent sample t-test, one-way analysis of variance, Pearson correlation analysis, and multiple linear regression were used to explore the factors that influence perceived affiliate stigma among dementia family caregivers. Results: The mean score for affiliate stigma of dementia family caregivers was 48.09 ± 16.38 (range: 22-86). Whether there were regular breaks during patient care, time-dependent burden, developmental burden, physical burden, and social burden were significant factors influencing the affiliate stigma of dementia family caregivers. Conclusion: Dementia family caregivers showed a moderate to high level of affiliate stigma. Those who had regular breaks during patient care, higher time-dependent burden, developmental burden, and physical burden and lower social burden exhibited higher levels of affiliate stigma.


Assuntos
Cuidadores , Demência , Estigma Social , Humanos , Estudos Transversais , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Demência/enfermagem , Demência/psicologia , China , Masculino , Feminino , Pessoa de Meia-Idade , Inquéritos e Questionários , Idoso , Adulto , Idoso de 80 Anos ou mais
7.
BMC Public Health ; 24(1): 1566, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862957

RESUMO

BACKGROUND: Female informal caregivers of older adults experience a higher burden of physical and mental health problems compared to their male counterparts due to the greater intensity of care they provide. This is likely to result in an imbalance in health needs, including health insurance enrollment, between male and female informal caregivers of older adults. However, to date, no study is available on the role of gender in health insurance enrollment among informal caregivers of older adults in Ghana. This study examines the association between gender and health insurance enrollment among informal caregivers of older adults in Ghana. METHODS: Cross-sectional data from the Informal Caregiving, Health, and Healthcare Survey among caregivers of older adults aged 50 years or above (N = 1,853 and mean ages = 39.15 years and 75.08 years of informal caregivers and their care recipients, respectively) in Ghana were analyzed. A binary logit regression model was used to estimate the association between gender and health insurance enrollment. All statistical inferences were made at the 5% significance level. RESULTS: The final Model (3) showed that female informal caregivers were 2.70 times significantly more likely to enrol in a health insurance scheme than their male counterparts (AOR: 2.70, 95% CI: 2.09-3.48, p-value = 0.001). Apart from gender, the results revealed that participants aged 55-64 years (AOR = 2.38, 95%CI: 1.29-4.41, p-value = 0.006), with tertiary education (AOR: 3.62, 95% CI: 2.32-5.66, p-value = 0.001) and living with the care recipients (AOR: 1.50, 95% CI: 1.14-1.98, p-value = 0.003) were significantly more likely to enrol in a health insurance scheme than their counterparts. The findings further showed that those who earned between GH¢1000 and 1999 (US$99.50-198.50) monthly (AOR: 0.70, 95% CI: 0.52-0.95, p-value = 0.022) and were affiliated with African traditional religion (AOR: 0.30, 95%CI: 0.09-0.99, p-value = 0.048) were significantly less likely to enrol in a health insurance scheme than their counterparts. CONCLUSION: Gender was a significant predictor of health insurance enrollment among informal caregivers of older adults. This finding contributes to the empirical debates on the role of gender in health insurance enrollment among informal caregivers of older adults. Policymakers need to develop gender-specific measures to address gender gaps in health insurance enrollment among informal caregivers of older adults in Ghana. Such health policies and programs should consider other significant demographic and socioeconomic factors associated with health insurance enrolment among informal caregivers of older adults in Ghana.


Assuntos
Cuidadores , Seguro Saúde , Humanos , Gana , Feminino , Masculino , Cuidadores/estatística & dados numéricos , Cuidadores/psicologia , Pessoa de Meia-Idade , Idoso , Estudos Transversais , Seguro Saúde/estatística & dados numéricos , Adulto , Fatores Sexuais , Pesquisas sobre Atenção à Saúde , Idoso de 80 Anos ou mais
8.
BMC Public Health ; 24(1): 1571, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38862974

RESUMO

BACKGROUND: Rates of self-harm and suicide are rising for young people globally and many implicate social media in this problem. To address this concern and to increase the confidence of adults to communicate safely about suicide and social media with young people, the #chatsafe Guide for Parents and Carers was developed in Australia. With significant uptake of the resource among Australian adults, the aim of the current study was to update and contextualise the #chatsafe Guide for Parents and Carers for audiences in 15 countries globally. To improve the relevance of this resource for parents and carers in these countries, the present study sought to understand the concerns held by parents, carers and suicide prevention professionals around the world about these topics and to explore the extent to which a resource such as #chatsafe would be helpful within their communities. METHODS: Seven focus groups were conducted via Zoom with parents, carers and suicide prevention professionals (n = 40) from 15 countries. Transcribed data were coded and thematically analysed using both inductive and deductive processes. RESULTS: Six themes are reported: (1) Two scary 'S' words; (2) Country and culture impact who talks (or is silent) about self-harm and suicide; (3) The need for a protective social ecosystem; (4) #chatsafe is a tool that can help parents, carers and young people worldwide; (5) #chatsafe should consider local context and end users to improve its relevance for parents and carers worldwide; and (6) A range of marketing and dissemination strategies are needed to reach adults with #chatsafe information. Findings of this study informed the update and contextualisation of the #chatsafe Guide for Parents and Carers for adult audiences in 15 countries. CONCLUSIONS: The findings from this study underscore a universal need for psychoeducation initiatives that provide adults with the skills and knowledge to support the mental health of young people, both online and offline, and that resources like #chastafe can play an important role in providing reliable information about these topics to adults across a range of cultures and contexts.


Assuntos
Cuidadores , Grupos Focais , Pais , Pesquisa Qualitativa , Mídias Sociais , Humanos , Pais/psicologia , Cuidadores/psicologia , Cuidadores/estatística & dados numéricos , Adulto , Masculino , Feminino , Austrália , Mídias Sociais/estatística & dados numéricos , Comportamento Autodestrutivo/prevenção & controle , Prevenção do Suicídio , Pessoa de Meia-Idade , Adolescente , Adulto Jovem , Apoio Social , Suicídio/psicologia , Suicídio/estatística & dados numéricos
9.
PLoS One ; 19(6): e0305432, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38865337

RESUMO

INTRODUCTION: Involving parents of children with cerebral palsy (C-CP) in home exercise programmes (HEP) is globally practiced strategy closely linked to improved physical performance and functional outcomes for the child. Nevertheless, non-adherence to HEP is increasing at an alarming rate, and little is known about the factors influencing adherence to HEP (AHEP) especially in parents of C-CP. This systematic review aimed to identify the factors enhancing AHEP among parents of C-CP to reinforce the efficacy of rehabilitation practices proposed by health professionals, researchers, and educators. MATERIALS AND METHODS: We conducted searches in PubMed, Scopus, CINHAL, PsycINFO, and Embase for articles published up to March 2023, that investigated the factors influencing AHEP among parents of C-CP. A narrative synthesis was conducted using the search results and pertinent material from other sources. RESULTS: Overall, non-adherence rates to HEP were moderate to high, ranging from 34% to 79.2%. Strong evidence suggests that factors enhancing AHEP fall into three categories: child-related (such as younger age and better gross motor function [GMF]), the caregiver-related (including high self-efficacy and knowledge, strong social support, low levels of depression, anxiety and stress symptoms, and a low perception of barriers), and the physiotherapist-related. For the latter category, the parent's perception of a supportive and collaborative relationship with the therapist is one of the conditions most favourably influences AHEP. CONCLUSION: Our findings highlight that factors influencing AHEP are multifactorial. Some, such as GMF or the economic and social conditions of the family, are challenging to change. However, the relationship between therapist and parent is an aspect that can be strengthened. These results underscore the importance of substantial training and psychosocial support for therapists to enhance their awareness and competence in building supportive relationship with parents.


Assuntos
Paralisia Cerebral , Pais , Humanos , Paralisia Cerebral/reabilitação , Paralisia Cerebral/psicologia , Pais/psicologia , Criança , Terapia por Exercício/métodos , Apoio Social , Cuidadores/psicologia , Serviços de Assistência Domiciliar , Cooperação do Paciente/psicologia
10.
JMIR Res Protoc ; 13: e55216, 2024 Jun 13.
Artigo em Inglês | MEDLINE | ID: mdl-38869929

RESUMO

BACKGROUND: The Hispanic and Latinx community is disproportionately affected by Alzheimer disease and related dementias (ADRDs). In the United States, approximately 8.5 million caregivers of individuals with ADRDs identify as Hispanic and Latinx people, and caregiving-related stress and burden place caregivers at elevated risk for poor mental health outcomes, as well as loneliness and social isolation. To date, there is limited knowledge about the daily stress experiences of Hispanic and Latinx caregivers. Given this knowledge gap, it is critical to examine how personal, cultural, and contextual factors influence daily stress, mental health, and resilience over time among Hispanic and Latinx ADRD caregivers. OBJECTIVE: The goal of this protocol report is to present the rationale, methodology, planned analytical strategy, progress completed to date, and implications of future findings for "Nuestros Días" (Spanish for "our days"), a fully remote daily diary (DD), observational cohort study examining the day-to-day experiences of Hispanic and Latinx ADRD caregivers. METHODS: The study will recruit a cohort of up to 500 Hispanic and Latinx caregivers of individuals living with ADRD. Participants will complete measures assessing contextual, individual-level, and cultural factors at 3 intervals (enrollment, 6 months, and 12 months). Each of the timepoints will be followed by 21 days of DD surveys to report on daily stress, stress moderators, and mental health variables. RESULTS: Data collection began in March 2023 and is projected to end in December 2026. As of March 2024, we have enrolled 60 caregivers in the Nuestros Días study, 78.9% (n=15) of whom are Spanish speakers. The current completion rate for DD surveys is 79.4%, averaging approximately 18 surveys out of 21 completed. We expect to enroll 10 to 15 participants per month moving forward to achieve our enrollment goal. CONCLUSIONS: Results from this study will identify which Hispanic and Latinx ADRD caregivers, and under what circumstances, appear to be at the greatest risk of experiencing poor mental health outcomes over time. This study represents a critical step forward in providing key guidance to develop effective, culturally sensitive interventions to support the health and well-being of Hispanic and Latinx ADRD caregivers, a historically underrepresented and underserved population in aging and caregiving research. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/55216.


Assuntos
Cuidadores , Demência , Hispânico ou Latino , Humanos , Hispânico ou Latino/psicologia , Cuidadores/psicologia , Estudos de Coortes , Demência/psicologia , Demência/etnologia , Feminino , Masculino , Estresse Psicológico/psicologia , Pessoa de Meia-Idade , Idoso , Estados Unidos/epidemiologia , Adulto , Diários como Assunto
11.
Rev Lat Am Enfermagem ; 32: e4140, 2024.
Artigo em Inglês, Espanhol, Português | MEDLINE | ID: mdl-38865553

RESUMO

OBJECTIVE: to describe and explore the relationship of loneliness, anxiety and depression with adoption of the caregiver role among individuals caring for people with chronic diseases in Colombia. METHODS: this was an exploratory and cross-sectional study involving 960 primary caregivers of individuals with chronic diseases. We applied the Caregiver Role Adoption Scale, the University of California at Los Angeles Loneliness Scale, and the Anxiety and Depression Scale. Principal component and multiple correspondence analyses were performed for clustering. RESULTS: among the participating caregivers, 40.8% reported experiencing depression, 59% reported anxiety, 54.6% reported moderate to severe loneliness, and 88.6% reported satisfactory adoption of the caregiver role. Caregivers who presented basic or insufficient role adoption levels tended to have higher scores for anxiety, depression and loneliness. CONCLUSION: adoption of the caregiver role is a mediator in the anxiety, depression and loneliness levels among caregivers. Strategies aimed at supporting caregivers should include training for the caregiver role to mitigate the negative impacts of anxiety, depression and loneliness. (1) More than half of the caregivers reported moderate or severe anxiety and loneliness. (2) Caregivers with low role adoption levels presented more anxiety, depression and loneliness. (3) Satisfactory adoption of the caregiver role reduces anxiety, depression and loneliness. (4) Role adoption should be intervened to reduce the impact on caregivers' mental health.


Assuntos
Ansiedade , Cuidadores , Depressão , Solidão , Humanos , Cuidadores/psicologia , Estudos Transversais , Masculino , Solidão/psicologia , Feminino , Depressão/epidemiologia , Depressão/psicologia , Pessoa de Meia-Idade , Doença Crônica/psicologia , Ansiedade/epidemiologia , Adulto , Idoso , Papel (figurativo) , Adulto Jovem
13.
Front Public Health ; 12: 1352815, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38859900

RESUMO

Background: Firearm-related suicide is the second leading cause of pediatric firearm death. Lethal means counseling (LMC) can improve firearm safe-storage practices for families with youth at risk of suicide. Objectives: This study aims to evaluate the feasibility of pediatric emergency department (ED) behavioral mental health (BMH) specialists providing LMC to caregivers of youth presenting with BMH complaints and to test for changes in firearm safety practices, pre-post ED LMC intervention, as measures of preliminary efficacy. Methods: Prospective pilot feasibility study of caregivers of youth presenting to a pediatric ED with BMH complaints. Caregivers completed an electronic survey regarding demographics and firearm safe-storage knowledge/practices followed by BMH specialist LMC. Firearm owners were offered a free lockbox and/or trigger lock. One-week follow-up surveys gathered self-reported data on firearm safety practices and intervention acceptability. One-month interviews with randomly sampled firearm owners collected additional firearm safety data. Primary outcomes were feasibility measures, including participant accrual/attrition and LMC intervention acceptability. Secondary outcomes included self-reported firearm safety practice changes. Feasibility benchmarks were manually tabulated, and Likert-scale acceptability responses were dichotomized to strongly agree/agree vs. neutral/disagree/strongly disagree. Descriptive statistics were used for univariate and paired data responses. Results: In total, 81 caregivers were approached; of which, 50 (81%) caregivers enrolled. A total of 44% reported having a firearm at home, 80% completed follow-up at one week. More than 80% affirmed that ED firearm safety education was useful and that the ED is an appropriate place for firearm safety discussions. In total, 58% of participants reported not having prior firearm safety education/counseling. Among firearm owners (n = 22), 18% reported rarely/never previously using a safe-storage device, and 59% of firearm owners requested safe storage devices.At 1-week follow-up (n = 40), a greater proportion of caregivers self-reported asking about firearms before their child visited other homes (+28%). Among firearm owners that completed follow-up (n = 19), 100% reported storing all firearms locked at one week (+23% post-intervention). In total, 10 caregivers reported temporarily/permanently removing firearms from the home. Conclusion: It is feasible to provide LMC in the pediatric ED via BMH specialists to families of high-risk youth. Caregivers were receptive to LMC and reported finding this intervention useful, acceptable, and appropriate. Additionally, LMC and device distribution led to reported changes in safe storage practices.


Assuntos
Serviço Hospitalar de Emergência , Estudos de Viabilidade , Armas de Fogo , Prevenção do Suicídio , Humanos , Armas de Fogo/estatística & dados numéricos , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Masculino , Estudos Prospectivos , Adolescente , Projetos Piloto , Criança , Cuidadores/estatística & dados numéricos , Cuidadores/psicologia , Adulto , Inquéritos e Questionários , Aconselhamento
14.
JMIR Aging ; 7: e55557, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38861708

RESUMO

BACKGROUND: Cognitive stimulation therapy (CST) is an evidence-based, group psychosocial intervention for people with dementia, and it has a positive impact on cognition and quality of life. CST has been culturally adapted for use globally. It was developed as a face-to-face intervention but has recently been adapted for online delivery. OBJECTIVE: In this study, we aimed to explore the feasibility and acceptability of online or virtual CST (vCST) delivery in India and Brazil, emphasizing barriers and facilitators to implementation. METHODS: A single-group, multisite, mixed methods, feasibility study was conducted, with nested qualitative interviews. Primary feasibility outcomes were recruitment rate, attendance, attrition, acceptability, and outcome measure completion. Exploratory pre- and postintervention measures, including cognition and quality of life, were assessed. Qualitative interviews were conducted with people with dementia, family caregivers, and group and organizational leaders following intervention delivery, and the data were analyzed using the Consolidated Framework for Implementation Research. RESULTS: A total of 17 vCST group sessions with 59 participants were conducted for 7 weeks, with 53% (31/59) of participants attending all 14 sessions. Attrition rate was 7% (4/59), and outcome measure completion rate at follow-up was 68% (40/59). Interviews took place with 36 stakeholders. vCST was acceptable to participants and group leaders and enabled vital access to services during pandemic restrictions. While online services broadened geographic access, challenges emerged concerning inadequate computer literacy, poor technology access, and establishing interpersonal connections online. Exploratory, uncontrolled analyses indicated positive trends in quality of life but negative trends in cognition and activities of daily living, but these results were not statistically significant. CONCLUSIONS: vCST demonstrated feasibility and acceptability, serving as a crucial resource during the pandemic but raised challenges related to technology access, computer literacy, and long-term implementation. The study highlights the potential of vCST while emphasizing ongoing development and solutions to address implementation challenges.


Assuntos
Terapia Cognitivo-Comportamental , Demência , Estudos de Viabilidade , Qualidade de Vida , Humanos , Demência/terapia , Índia/epidemiologia , Brasil/epidemiologia , Feminino , Masculino , Idoso , Terapia Cognitivo-Comportamental/métodos , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Idoso de 80 Anos ou mais , Cuidadores/psicologia
15.
BMC Geriatr ; 24(1): 511, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867158

RESUMO

OBJECTIVE: The primary objective of this research was to use qualitative methods to assess the knowledge, attitudes, and confidence of caregivers in their ability to provide oral hygiene assistance to residents. The secondary objective was to assess the knowledge and attitude of administrators on the provision of oral hygiene assistance for residents, and their confidence in caregivers' ability to provide oral hygiene assistance to nursing home residents in San Antonio, Texas. METHODS: A semi-structured interview guide was used to conduct face-to-face interviews with seven caregivers and twelve administrative staff from ten nursing homes in San Antonio, Texas. Employees in nursing homes who are caring for residents are referred to as caregivers and those whom they care for are referred to as nursing home residents. One survey instrument was developed for the caregiver's knowledge, attitude, and confidence toward providing oral health care, and another to assess the administrator's knowledge, attitude, and confidence in caregivers providing oral care for nursing home residents. The interviews were recorded, transcribed, and coded for thematic content. RESULTS: The findings revealed that caregivers and administrators had adequate knowledge of the connection between oral and systemic health. The administrators were confident that caregivers were adequately trained to provide oral hygiene care for residents. Caregivers had a positive attitude toward the importance of good oral health. They regularly assessed the residents' oral health, but due to time constraints, staffing shortages, and other competing tasks providing oral health care to the residents was challenging. Most caregivers were confident in their skills in providing oral care for the residents since 85.6% agreed. On the contrary, almost half of the administrators were confident that caregivers have the necessary skills to provide oral care for residents, while 41.7% were unsure. CONCLUSIONS: The study gave a broader insight into the provision of oral care in nursing home residents from the perspectives of caregivers and administrative staff. Administrators must provide caregivers with adequate training and time so they can provide adequate oral health care for the residents.


Assuntos
Cuidadores , Conhecimentos, Atitudes e Prática em Saúde , Casas de Saúde , Saúde Bucal , Higiene Bucal , Humanos , Cuidadores/psicologia , Texas , Masculino , Feminino , Pessoa de Meia-Idade , Adulto , Idoso , Atitude do Pessoal de Saúde
16.
BMC Geriatr ; 24(1): 512, 2024 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-38867155

RESUMO

BACKGROUND: Enhancing preparedness of family caregivers and support for caregiving is essential for the mutual benefit of both caregivers and the well-being of those under their care. This study aimed to translate and evaluate psychometric properties of the Caregiver Preparedness Scale among family caregivers of older adults undergoing hemodialysis. METHODS: In this methodological study, 400 family caregivers of older adult patients undergoing hemodialysis enrolled to the study via convenience sampling method. The study was conducted in two stages: translation and psychometric evaluation. At first, the translation of the scale was done using Beaton et al. method. In the psychometric evaluation stage, quantitative face validity, content validity, item analysis and construct validity of the scale were evaluated. The internal consistency of the scale was assessed through the calculation of Cronbach's alpha, McDonald's omega, and average inter-item correlation coefficients. RESULTS: All items had an impact score greater than 1.5. The content validity ratio and the kappa coefficient for all items were above 0.75. In the item analysis, item 2, which had a correlation with the total score of less than 0.3, was removed. Following exploratory factor analysis, only one factor composed of all items (7 items) was extracted, explaining 75.7% of the total variance. This model had acceptable fit indices in confirmatory factor analysis. Cronbach's alpha and omega of 0.95 and an average inter-item correlation of 0.75 were obtained. CONCLUSIONS: The study results demonstrated that the Caregiver Preparedness Scale exhibits appropriate psychometric properties. Geriatric nurses can utilize this Scale for assessment of caregivers. This assessment can aid in decision-making regarding educational programs aimed at enhancing family caregiver preparedness.


Assuntos
Cuidadores , Psicometria , Diálise Renal , Humanos , Cuidadores/psicologia , Psicometria/métodos , Masculino , Feminino , Diálise Renal/psicologia , Idoso , Pessoa de Meia-Idade , Irã (Geográfico) , Adulto , Inquéritos e Questionários , Reprodutibilidade dos Testes , Idoso de 80 Anos ou mais
17.
BMJ Open ; 14(6): e077637, 2024 Jun 08.
Artigo em Inglês | MEDLINE | ID: mdl-38851226

RESUMO

OBJECTIVES: We sought to understand the influence of recurrent assessments on the behaviour of children and caregivers in a 2-year study of an agricultural livelihood intervention. DESIGN: This study used qualitative exit interviews from caregivers in the control arm of a large, cluster-randomised control trial, Shamba Maisha. SETTING: The study was conducted in Western Kenya and involved 12 health facilities between 2016 and 2019. PARTICIPANTS: Participants were 99 caregivers in the control arm who had a child that was 6-36 months in age at the start of the study. INTERVENTIONS: Intervention participants within Shamba Maisha received an irrigation pump, farming lessons and a microloan. Control participants received no intervention but were offered the intervention after completing the 2-year study. RESULTS: Despite receiving no formal benefits, control caregivers reported improved mental health and enhanced knowledge of their child's health compared with the beginning of the study and reported changes in the child's play and diet that they attributed to participation in study assessments. Caregivers in the control arm attributed their changed behaviour to recurrent questioning, instrumental support, interactions with study staff and increased health knowledge. CONCLUSIONS: Recurrent assessments altered participant behaviour, which may have made inference of the intervention's impact more difficult. In designing future, such studies with intervention and control arms, a trade-off between the gains in statistical power provided by recurrent visits and the avoidance of alterations in participants' behaviour that could affect responses to assessments must be considered when deciding on the number of visits for assessment. TRIAL REGISTRATION NUMBERS: NCT03170986; NCT02815579.


Assuntos
Agricultura , Cuidadores , Pesquisa Qualitativa , Humanos , Quênia , Cuidadores/psicologia , Feminino , Masculino , Pré-Escolar , Lactente , Adulto , Conhecimentos, Atitudes e Prática em Saúde , Saúde Mental
18.
Support Care Cancer ; 32(7): 422, 2024 Jun 11.
Artigo em Inglês | MEDLINE | ID: mdl-38858225

RESUMO

OBJECTIVE: Caregivers support individuals undergoing cancer treatment by assisting with activities, managing care, navigating healthcare systems, and communicating with care teams. We explored the quality and quantity of caregiver participation during recorded decision-making clinical appointments in women with metastatic breast cancer. METHODS: This was a convergent parallel mixed methods study that utilized qualitative and quantitative data collection and analysis. Caregiver participation quality was operationalized using a summative thematic content analysis to identify and sum caregiver actions performed during appointments. Performance of a greater number of actions was considered greater quality of participation. Caregiver participation quantity was measured by calculating the proportion of speaking time. Participation quality and quantity were compared to patient activation, assessed using the Patient Activation Measure 1-month post decision-making appointment. RESULTS: Fifty-three clinical encounters between patients with MBC, their caregivers, and oncologists were recorded. Identified caregiver actions included: General Support; Management of Treatment or Medication; Treatment History; Decision-Making; Insurance or Money; Pharmacy; Scheduling; Travel Concerns; General Cancer Understanding; Patient Specific Cancer Understanding; Caregiver-Initiated or Emphasis on Symptom Severity; and Caregiver Back-Up of Patient Symptom Description. Caregivers averaged 5 actions (SD 3): 48% of patient's caregivers had low quality (< 5 actions) and 52% had high quality (> 6 actions) participation. Regarding quantity, caregivers spoke on average for 4% of the encounter, with 60% of caregivers speaking less than 4% of the encounter (low quantity) and 40% of caregivers speaking more than 4% (high quantity). Greater quality and quantity of caregiver participation was associated with greater patient activation. CONCLUSIONS: Caregivers perform a variety of actions during oncological decision-making visits aiding both patient and provider. Greater participation in terms of quantity and quality by the caregiver was associated with greater patient activism, indicating a need for better integration of the caregiver in clinical decision-making environments.


Assuntos
Neoplasias da Mama , Cuidadores , Tomada de Decisões , Participação do Paciente , Humanos , Feminino , Cuidadores/psicologia , Neoplasias da Mama/terapia , Pessoa de Meia-Idade , Participação do Paciente/estatística & dados numéricos , Idoso , Adulto , Metástase Neoplásica , Pesquisa Qualitativa
19.
BMC Health Serv Res ; 24(1): 713, 2024 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-38858686

RESUMO

BACKGROUND: A significant proportion of patients and informal caregivers favor an active role in decisions concerning their health. Simultaneously, governments aim to shift treatment from a professional care setting to a community setting, in light of an ageing population, a decreasing number of health workers and allocation of scarce resources. This transition of care solicits patients' and informal caregivers' ability to self-manage. Therefore, the Maastricht University Medical Centre + has established the Academy for Patients and Informal caregivers. The aim is to proactively and professionally support patients and their informal caregivers to enhance their self-management. For that, the Academy offers activities in three categories: (1) instruction of nursing techniques, (2) training of e-health competencies and (3) the provision of self-management programs. Both patients with an episodic care need, as well as patients and informal caregivers with chronic illness, are eligible to participate in the Academy's activities. However, little is known about the experience of these interventions from the perspective of patients, informal caregivers and healthcare professionals. METHODS: We conducted semi-structured interviews with 15 patients, 8 informal caregivers and 19 health care professionals who either participated in, referred to or received patients from the Academy. Topics revolved around self-management and the Quadruple aim, covering topics such as patient experiences, healthcare costs, health and well-being of the population and improving work life for health professionals. Data were analyzed using thematic analysis. RESULTS: Patients and caregivers experienced an increase in the ability to manage health needs independently, leading to increased mental well-being and self-efficacy. They felt recognized as partners in care, although managing illness needs came with its own burdens. Health care professionals indicated that they felt assured of the quality, uniformity and availability of activities due to its central organization, with instruction nurses finding greater meaning in their work. On the level of health care systems, participants in this study mentioned a decrease in use of formal healthcare, whilst enabling a more equitable division of care. CONCLUSION: Stakeholders' experiences with the Academy for Patients and Informal caregivers indicate that participation contributes to development of self-management, whilst also improving working conditions, reducing the appeal to formal care and advancing equity in healthcare. The burden for patients and informal caregivers is to be considered in future developments.


Assuntos
Cuidadores , Pessoal de Saúde , Pesquisa Qualitativa , Autogestão , Humanos , Cuidadores/psicologia , Feminino , Masculino , Pessoa de Meia-Idade , Idoso , Pessoal de Saúde/psicologia , Adulto , Entrevistas como Assunto , Doença Crônica/terapia , Telemedicina , Países Baixos , Participação do Paciente
20.
Support Care Cancer ; 32(7): 404, 2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38833189

RESUMO

PURPOSE: Family caregivers of patients with cancer often experience both loneliness and symptoms of psychological distress, such as anxiety and depression. The purpose of this study was to evaluate the associations between loneliness and anxiety and loneliness and depression among family caregivers of patients with cancer and to investigate whether positive aspects of caregiving can have a moderating effect on these relationships. METHODS: We conducted a cross-sectional exploratory study using baseline data from an ongoing multisite clinical trial. Multiple linear regression models were used to analyze the relationships between loneliness and psychological distress symptoms and the moderating effect of positive aspects of caregiving. Psychological distress outcomes were measured using PROMIS Short Forms (8a) for Anxiety and Depression. RESULTS: We identified a significant association between loneliness and symptoms of both anxiety and depression. Positive aspects of caregiving did not significantly moderate the relationship between loneliness and depression or loneliness and anxiety. CONCLUSION: The results of this study shed new light on the relationship between loneliness and symptoms of psychological distress experienced by family caregivers of cancer patients, providing a better understanding of the impact that recognition of positive aspects of caregiving has on the association between loneliness and psychological distress symptoms. Our findings emphasize the importance of targeting family caregiver loneliness in order to reduce psychological distress among family caregivers of cancer patients.


Assuntos
Ansiedade , Cuidadores , Depressão , Solidão , Neoplasias , Angústia Psicológica , Humanos , Solidão/psicologia , Cuidadores/psicologia , Masculino , Feminino , Neoplasias/psicologia , Estudos Transversais , Pessoa de Meia-Idade , Depressão/etiologia , Ansiedade/etiologia , Idoso , Adulto , Estresse Psicológico/etiologia , Modelos Lineares
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