International Journal of Environmental Research and Public Health

Research

13 pages, 844 KiB

Open AccessArticle

Caregiving + Migrant Background = Double Jeopardy? Associations between Caregiving and Physical and Psychological Health According to Migrant Backgrounds in Norway

by Kamila Hynek, Aslaug Gotehus, Fredrik Methi, Ragnhild Bang Nes, Vegard Skirbekk and Thomas Hansen

Int. J. Environ. Res. Public Health 2023, 20(10), 5800; https://doi.org/10.3390/ijerph20105800 - 12 May 2023

Viewed by 1838

Abstract

Informal caregiving can have detrimental consequences for physical and psychological health, but the impacts are highly heterogenous. A largely ignored question is whether these impacts differ with migrant backgrounds, and whether caregiving and a migrant background combine to create double jeopardy. We explored [...] Read more.

Informal caregiving can have detrimental consequences for physical and psychological health, but the impacts are highly heterogenous. A largely ignored question is whether these impacts differ with migrant backgrounds, and whether caregiving and a migrant background combine to create double jeopardy. We explored these questions using large-scale data that allows stratification by sex, regional background, and types (inside vs. outside of household) of caregivers. We used cross-sectional 2021 data collected from two Norwegian counties as part of the Norwegian Counties Public Health Survey (N = 133,705, RR = 43%, age 18+). The outcomes include subjective health, mental health, and subjective well-being. The findings show that both caregiving, especially in-household caregiving, and a migrant background relate to lower physical–psychological health. In bivariate analysis, non-Western caregivers, women particularly, reported poorer mental health and subjective well-being (but not physical health) than other caregiver groups. After controlling for background characteristics, however, no interaction exists between caregiver status and migrant background status. Although the evidence does not suggest double jeopardy for migrant caregivers, caution is warranted due to the likely underrepresentation of the most vulnerable caregivers of migrant backgrounds. Continued surveillance of caregiver burden and distress among people of migrant backgrounds is critical to develop successful preventive and supportive intervention strategies for this group, yet this aim hinges on a more inclusive representation of minorities in future surveys. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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16 pages, 742 KiB

Open AccessArticle

How do Informal Caregivers of Seniors’ Tasks Lead to Presenteeism and Absenteeism Behaviors? A Canadian Quantitative Study

by Marie-Ève Beauchamp Legault, Denis Chênevert, Francis Maisonneuve and Sari Mansour

Int. J. Environ. Res. Public Health 2023, 20(7), 5392; https://doi.org/10.3390/ijerph20075392 - 4 Apr 2023

Cited by 1 | Viewed by 2043

Abstract

This study extends our knowledge on the role of informal caregivers of seniors and the impact of this role on presenteeism and absenteeism at work. Based on the conservation of resources theory, this article seeks to gain insights into the mechanisms and antecedents [...] Read more.

This study extends our knowledge on the role of informal caregivers of seniors and the impact of this role on presenteeism and absenteeism at work. Based on the conservation of resources theory, this article seeks to gain insights into the mechanisms and antecedents of presenteeism and absenteeism among employees who are also informal caregivers of seniors. Specifically, this article argues that family–work conflict and emotional exhaustion mediate the relationship between the informal caregiver’s role, presenteeism, and absenteeism. Quantitative data (questionnaire) from this cross-sectional study were collected from 915 informal caregivers of seniors from 8 Canadian organizations. Structural equation modelling (SEM) was undertaken using IBM SPSS AMOS 28.0 to test all hypotheses. Informal caregivers of seniors who need to coordinate and organize healthcare are at a higher risk of experiencing family–work conflict. Family–work conflict experienced by informal caregivers subsequently leads to emotional exhaustion, presenteeism, and absenteeism. Because informal caregiving of seniors is likely to increase in coming years for many workers, organizations must be aware of the possible consequences of this role on work productivity. This study shows that not all tasks of informal caregivers of older adults lead to presenteeism and absenteeism through family–work conflict and emotional exhaustion. This study is innovative because, to our knowledge, no study of informal caregivers of older adults has examined the effect of different tasks in this role on presenteeism and absenteeism. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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17 pages, 371 KiB

Open AccessArticle

Barriers and Facilitators of Health and Well-Being in Informal Caregivers of Dementia Patients: A Qualitative Study

by Sally C. Duplantier and Francesca A. Williamson

Int. J. Environ. Res. Public Health 2023, 20(5), 4328; https://doi.org/10.3390/ijerph20054328 - 28 Feb 2023

Cited by 5 | Viewed by 2501

Abstract

Background: Given the dramatic projected increase in Alzheimer’s disease globally and the increased risk of morbidity and mortality for family caregivers of these patients, there is an urgent need to provide more targeted, timely resources to support the health and well-being of these [...] Read more.

Background: Given the dramatic projected increase in Alzheimer’s disease globally and the increased risk of morbidity and mortality for family caregivers of these patients, there is an urgent need to provide more targeted, timely resources to support the health and well-being of these informal caregivers. Few studies have investigated the barriers to health and well-being and potential strategies to facilitate better self-care from the unique perspective of the caregivers themselves. Purpose: This qualitative study aimed to identify barriers and facilitators to health and well-being for informal caregivers of family members with Alzheimer’s. Method: We conducted semi-structured interviews with eight informal caregivers, including daughters, wives, and one husband, ages 32 to 83. Using Reflexive Thematic Analysis, we identified three main themes and subthemes across caregivers’ experiences. Findings: We found that caregivers (1) prioritized mental and social well-being over physical health or health behaviors; (2) characterized the subjective burden of caregiving as a “mantle of responsibility” that could not easily be shed due to the complex subjective burden of loss, grief, guilt, resentment, isolation, loneliness, and lack of agency; (3) sought to be recognized as “additional patients”, instead of being viewed as invisible patients, with support services tailored to their life stage and challenges. Conclusions: The findings suggest that the subjective burden of strain experienced by family caregivers of Alzheimer’s patients has a profound impact on their health and well-being, even more so than the objective burden of strain that is the result of their day-to-day caregiving activities. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

14 pages, 1007 KiB

Open AccessArticle

The Longitudinal Association between Co-Residential Care Provision and Healthcare Use among the Portuguese Population Aged 50 and Over: A SHARE Study

by Fátima Barbosa, Sara Simões Dias, Gina Voss and Alice Delerue Matos

Int. J. Environ. Res. Public Health 2023, 20(5), 3975; https://doi.org/10.3390/ijerph20053975 - 23 Feb 2023

Viewed by 1621

Abstract

Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers’ healthcare use are lacking. This study aims [...] Read more.

Co-residential care is associated with poor caregiver health and a high burden. Although Portugal relies heavily on co-residential care by individuals aged 50 and over, studies on the impact of co-residential care provision on Portuguese caregivers’ healthcare use are lacking. This study aims to analyze the impact of co-residential care (spousal and non-spousal care) on healthcare use of the Portuguese population aged 50 plus. Data from waves 4 (n = 1697) and 6 (n = 1460) of the Survey of Health, Ageing and Retirement in Europe (SHARE) were used. Negative Binomial Generalized Linear Mixed Models with random (individual level) and fixed (covariates) effects were performed. The results show that the number of visits to the doctor decrease significantly over time for the co-residential spousal caregivers as compared to the non-co-residential caregivers. This result highlights the fact that the Portuguese co-residential spousal caregiver group is at a higher risk of not using healthcare, thus jeopardizing their own health and continuity of care. Promoting more accessible healthcare services and implementing public policies adjusted to the needs of informal caregivers are important to improve the health and healthcare use of Portuguese spousal co-residential caregivers. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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10 pages, 925 KiB

Open AccessArticle

Filial Maturity, Resolution of a Parent’s Disease, and Well-Being in Offspring of Parents Diagnosed with Alzheimer’s Disease

by Alon Goldberg

Int. J. Environ. Res. Public Health 2023, 20(1), 761; https://doi.org/10.3390/ijerph20010761 - 31 Dec 2022

Cited by 1 | Viewed by 1232

Abstract

Background: Alzheimer’s Disease (AD) is one of the most common forms of dementia. However, research dealing with the experience of adult children of a parent diagnosed with AD, regardless of whether the offspring is a caregiver, is not well developed. Objective: The current [...] Read more.

Background: Alzheimer’s Disease (AD) is one of the most common forms of dementia. However, research dealing with the experience of adult children of a parent diagnosed with AD, regardless of whether the offspring is a caregiver, is not well developed. Objective: The current research is a cross-sectional study that examines the associations between filial maturity, offspring’s coming to terms with their parent’s AD, and the well-being of the offspring. Method: one hundred and forty Israeli adult children of parents with AD participated in the study and completed self-report questionnaires assessing their filial maturity, resolution of their parent’s diagnosis with AD, the adult children’s well-being, and the severity of the parent’s AD according neurologist’s report.Results: Results showed that higher resolution of the parent’s disease was positively associated with well-being. In addition, filial maturity was negatively associated with resolution of the parent’s disease, and resolution of the parent’s disease mediated the association between filial maturity and well-being. Conclusion: Resolution of a parent’s AD is highly challenging for offspring with high filial maturity, and the lack of resolution affects their well-being. Offering prolonged emotional support for offspring of parents diagnosed with AD may improve their ability to integrate the new reality into their lives and foster their well-being. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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15 pages, 406 KiB

Open AccessArticle

Musculoskeletal Pain in Family Caregivers: Does a Therapeutic Physical Program in Primary Care Work? A Randomized Controlled Trial

by Federico Montero-Cuadrado, Laura Barrero-Santiago, Rocío Llamas-Ramos and Inés Llamas-Ramos

Int. J. Environ. Res. Public Health 2023, 20(1), 185; https://doi.org/10.3390/ijerph20010185 - 23 Dec 2022

Cited by 1 | Viewed by 1916

Abstract

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed [...] Read more.

Background: Family caregivers play a crucial role in the overall healthcare system and in our society. The elderly population is significantly increasing, which creates a high demand for family caregivers. Few studies have investigated the impact of caregiving on musculoskeletal pain or proposed an active approach for dealing with it. Objectives: To determine and characterize musculoskeletal pain in female family caregivers (FFCs) and assess the effects of adding a therapeutic exercise program to a family caregiver care program (FCCP) on the quality of life, physical conditions, and psychological well-being of FFCs. Methods: A multicenter randomized controlled clinical trial was conducted with 68 FFCs recruited in two public healthcare areas. The intervention and control groups received the same conventional FCCP for 6 h across 4 sessions. The intervention group received an additional 36 sessions of physical therapeutic exercise (PTE) program over 12 weeks. Results: All caregivers reported having pain in particular locations. Lower back pain and neck pain were the locations most frequently cited, with a prevalence of 69.4% and 56.7%, respectively. In total, 80% of participants presented moderate pain intensity. The intervention group showed a significant decrease in the intensity of the pain (p < 0.001), as well as in anxiety, depression, subjective burden perception (p < 0.01), and quality-of-life variables, including MCS (mental component summary) (p < 0.05) and PCS (physical component summary) (p < 0.001). Conclusions: A PTE program improved the musculoskeletal pain of FFCs in a clinically relevant way. The caregivers who improved the most were those who initially presented the most intense pain, had the greatest levels of disability, and had the lowest quality of life. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

12 pages, 898 KiB

Open AccessArticle

Accelerometer-Measured Physical Activity, Inactivity, and Related Factors in Family Caregivers of Patients with Terminal Cancer

by Inmaculada Valero-Cantero, Cristina Casals, Juan Corral-Pérez, Francisco Javier Barón-López, Julia Wärnberg and María Ángeles Vázquez-Sánchez

Int. J. Environ. Res. Public Health 2023, 20(1), 179; https://doi.org/10.3390/ijerph20010179 - 22 Dec 2022

Cited by 1 | Viewed by 1609

Abstract

The physical activity (PA) and inactivity of family caregivers of cancer patients were investigated and related to burden and quality of life through a cross-sectional multicentre study. A total of 75 caregivers were recruited from June 2020 to March 2021. The levels of [...] Read more.

The physical activity (PA) and inactivity of family caregivers of cancer patients were investigated and related to burden and quality of life through a cross-sectional multicentre study. A total of 75 caregivers were recruited from June 2020 to March 2021. The levels of PA and inactivity were estimated with a wrist accelerometer, 24 h a day, for 7 consecutive days. The Quality of Life Family Version, the Caregiver Strain Index, the total duration of care, the average number of hours spent in care, and the assistance received were registered. Our results showed that moderate-to-vigorous PA was 96.40 ± 46.93 min/day, with 90.7% of participants performing more than 150 min/week of physical activity, and this was significantly associated with age (r = −0.237). Daily inactivity was 665.78 ± 94.92 min, and inactivity for 20–30 min was significantly associated with caregiver burden (r = 0.232) and quality of life (r = −0.322). Compliance with the World Health Organization recommendations was significantly associated with a lower quality of life (r = −0.269). The strength of these associations was limited (r ~0.2). In conclusion, the PA performed by most caregivers met the established recommendations, although older caregivers (>65 years old) performed lower moderate-to-vigorous PA than younger ones. In addition, the mean inactive time was high (11 h/day), showing slight relationships with the burden and quality of life of caregivers. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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12 pages, 357 KiB

Open AccessArticle

In Caring for Older People in Low- and Middle-Income Countries, Do Older Caregivers Have a High Level of Care Burden and Psychological Morbidity Compared to Younger Caregivers?

by Ruttana Phetsitong, Patama Vapattanawong, Rosie Mayston, Martin Prince and Kia-Chong Chua

Int. J. Environ. Res. Public Health 2022, 19(24), 16405; https://doi.org/10.3390/ijerph192416405 - 7 Dec 2022

Cited by 3 | Viewed by 1894

Abstract

Caregivers have become older as longevity increases. Caregiving for older people can cause burdens and psychological morbidity, which are the chronic stresses perceived by informal caregivers. This study aimed to compare the levels of care burden and psychological morbidity between older and younger [...] Read more.

Caregivers have become older as longevity increases. Caregiving for older people can cause burdens and psychological morbidity, which are the chronic stresses perceived by informal caregivers. This study aimed to compare the levels of care burden and psychological morbidity between older and younger caregivers in low- and middle-income countries. A cross-sectional survey was conducted in Cuba, the Dominican Republic, Peru, Venezuela, Mexico, Puerto Rico, and China. Data were collected by the 10/66 Dementia Research Group. The Zarit Burden Inventory was used to measure the levels of burden on caregivers. Psychological morbidity was assessed through the Self-Reporting Questionnaire. Data from 1348 households in which informal caregivers provided home care for one older person were included in the analysis. Multivariable logistic regression was used to investigate the effects of caregiver age upon care burden and psychological morbidity. A fixed-effect meta-analysis model was used to obtain a pooled estimate of the overall odds ratios of each country. The unadjusted and the adjusted model for potential covariates revealed no significant difference in care burden and psychological morbidity between older caregivers and younger caregivers. The adjusted pooled estimates, however, indicated a lower psychological morbidity among older caregivers (OR = 0.61, 95% CI: 0.41–0.93, I² = 0.0%). The demographic implications of caregiver age may suggest different policy responses across low- and middle-income countries. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

15 pages, 1276 KiB

Open AccessArticle

Caregiver Burden, Psychological Distress and Quality of Life among Informal Caregivers of Patients with Head and Neck Cancer: A Longitudinal Study

by Kira S. Van Hof, Arta Hoesseini, Maarten C. Dorr, Irma M. Verdonck-de Leeuw, Femke Jansen, C. René Leemans, Robert P. Takes, Chris H. J. Terhaard, Robert Jan Baatenburg de Jong, Aniel Sewnaik and Marinella P. J. Offerman

Int. J. Environ. Res. Public Health 2022, 19(23), 16304; https://doi.org/10.3390/ijerph192316304 - 5 Dec 2022

Cited by 8 | Viewed by 2332

Abstract

(1) Background: The aim of this study was to investigate caregiver burden among informal caregivers of head and neck cancer patients, in relation to distress and quality of life (QoL), and the relationship between informal caregivers and patients. (2) Methods: Data of 234 [...] Read more.

(1) Background: The aim of this study was to investigate caregiver burden among informal caregivers of head and neck cancer patients, in relation to distress and quality of life (QoL), and the relationship between informal caregivers and patients. (2) Methods: Data of 234 dyads from the multicenter prospective cohort study Netherlands Quality of life and Biomedical Cohort studies in cancer was used. Caregiver burden, psychological distress, global QoL, physical and social functioning were measured from baseline until 24 months after treatment. (4) Conclusions: This prospective cohort study shows the high burden of caring for HNC patients, the impact of this burden and the interaction between caregiver and patient. We suggest that healthcare professionals include caregivers in counseling and support. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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21 pages, 462 KiB

Open AccessArticle

Caregiving Situation as a Predictor of Subjective Caregiver Burden: Informal Caregivers of Older Adults during the COVID-19 Pandemic

by Simona Hvalič-Touzery, Marina Trkman and Vesna Dolničar

Int. J. Environ. Res. Public Health 2022, 19(21), 14496; https://doi.org/10.3390/ijerph192114496 - 4 Nov 2022

Cited by 2 | Viewed by 2383

Abstract

The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to [...] Read more.

The COVID-19 pandemic has created and exacerbated emotional, financial, and technical challenges for informal caregivers of older people. The aim of this study was to explore the caregiving situation and subjective burden of informal caregivers of older family members during COVID-19, and to investigate how a caregiving situation’s characteristics predict the subjective burden of care in times of COVID-19. The study was conducted in April and May 2021 via an online access panel. The sample (n = 612) was determined using a screening test that enabled us to focus on a Slovenian population of informal caregivers aged 40+ caring for a person aged 65+ for at least four hours/week on average. Our findings reveal that the subjective burden of care was high among informal caregivers during COVID-19. Multiple regression analysis showed that the provision of activities of daily living, care duration, average hours of care per week, formal care status, and recipients’ health problems related to dementia or other memory problems significantly predicted the subjective burden of caregivers. These findings call for better recognition of the role of informal caregivers. The time and effort devoted to informal care should be supported by legislation and social security. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

16 pages, 728 KiB

Open AccessArticle

Extremely Distant and Incredibly Close: Physical Proximity, Emotional Attachment and Caregiver Burden

by Eva Bei, Karin Mashevich, Orit Rotem-Mindali, Shira Galin-Soibelman, Ofra Kalter-Leibovici, Tami Schifter and Noa Vilchinsky

Int. J. Environ. Res. Public Health 2022, 19(14), 8722; https://doi.org/10.3390/ijerph19148722 - 18 Jul 2022

Cited by 4 | Viewed by 2406

Abstract

Informal caregivers are at risk of caregiver burden, and physical proximity to the care recipient may add to this negative outcome. Yet, individual differences in emotional proximity to the care recipient such as attachment orientations may contribute to caregivers’ comfort towards different degrees [...] Read more.

Informal caregivers are at risk of caregiver burden, and physical proximity to the care recipient may add to this negative outcome. Yet, individual differences in emotional proximity to the care recipient such as attachment orientations may contribute to caregivers’ comfort towards different degrees of physical proximity, leading to varying levels of burden. The current study is the first to explore the role of physical proximity on caregiver burden as moderated by attachment orientations. A sample of 162 Israeli caregivers who are active users of the Camoni website completed our online survey. Sociodemographic characteristics, including a self-reported questionnaire on the physical proximity to the care recipient, were collected. Caregivers’ attachment orientations were assessed with the Experiences in Close Relationships–Relationship Structures questionnaire. Caregiver burden was assessed using the Caregiver Burden Inventory. Multiple regression and simple slope analyses were conducted. Attachment anxiety and avoidance were positively associated with burden, whereas physical proximity was not. Attachment avoidance, but not attachment anxiety, moderated the association between physical proximity and caregiver burden, with caregivers who live closer to their care recipient experiencing greater burden when high levels of avoidance were present. Our findings reveal the complex dynamics between attachment orientations and physical proximity in the context of informal care, highlighting the need for better integration of these two interlinked constructs in both care research and practice. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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10 pages, 898 KiB

Open AccessArticle

The Role of Contact Care by Adult Children in Relieving Depression in Older Adult Individuals

by Seo-Youn Hong and Jae-Hyun Kim

Int. J. Environ. Res. Public Health 2022, 19(13), 7981; https://doi.org/10.3390/ijerph19137981 - 29 Jun 2022

Viewed by 1463

Abstract

The purpose of this study is to investigate how contact care by adult children influences the effect of caring for grandchildren on depression in older adult individuals. Studies have shown that caring for grandchildren either increases or decreases the symptoms of depression in [...] Read more.

The purpose of this study is to investigate how contact care by adult children influences the effect of caring for grandchildren on depression in older adult individuals. Studies have shown that caring for grandchildren either increases or decreases the symptoms of depression in older adult individuals, while other studies have shown no effect. The reason for these inconsistent results is that the key control variable, contact care by adult children, has been omitted from these previous studies. An analysis of panel data consisting of observations from 162 older adult respondents in the Korean Longitudinal Study of Aging over the 2008–2016 period confirms that the positive effect of caring for grandchildren on depression in older adults increased as the number of adult children who visited their older adult parents after entrusting their children to them increased. As more of their adult children visited the older adult individuals, the latter were more likely to feel that caring for their grandchildren was healing rather than stressful. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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18 pages, 816 KiB

Open AccessArticle

Help-Seeking in Informal Family Caregivers of People with Dementia: A Qualitative Study with iSupport as a Case in Point

by Anna Messina, Rebecca Amati, Emiliano Albanese and Maddalena Fiordelli

Int. J. Environ. Res. Public Health 2022, 19(12), 7504; https://doi.org/10.3390/ijerph19127504 - 19 Jun 2022

Cited by 6 | Viewed by 2493

Abstract

Supportive measures and training interventions can improve the care of people with dementia and reduce the burden on informal caregivers, whose needs remain largely unmet. iSupport is an evidence-based online intervention developed by the World Health Organization to provide support and self-guided education [...] Read more.

Supportive measures and training interventions can improve the care of people with dementia and reduce the burden on informal caregivers, whose needs remain largely unmet. iSupport is an evidence-based online intervention developed by the World Health Organization to provide support and self-guided education to informal family caregivers of people with dementia. This qualitative study explored barriers and facilitators in the access and use of supportive measures for family caregivers of people with dementia living in Southern Switzerland (Ticino). We conducted five focus groups and explored experiences, beliefs, and attitudes toward seeking help (SH), and used thematic analysis to identify key themes. Participants (N = 13) reported a general reluctance to SH. We identified four main barriers to SH: high level of burden; sense of duty; fear of being misunderstood by others; and difficulty in reaching information. We also identified facilitators of help seeking behaviors and unveiled the need of caregivers to be assisted by a dementia case manager to facilitate access to support resources. Local services and interventions should be adapted to caregivers’ needs and expectations, with the aim of facilitating the acceptance of, access to, and service integration of existing and future support measures, including iSupport. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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11 pages, 344 KiB

Open AccessArticle

Caregiver Characteristics of Adults with Acute Traumatic Brain Injury in the United States and Latin America

by Shannon B. Juengst, Paul B. Perrin, Daniel W. Klyce, Therese M. O’Neil-Pirozzi, Susan Herrera, Brittany Wright, Jean Lengenfelder, Kirk Lercher, Librada Callender and Juan Carlos Arango-Lasprilla

Int. J. Environ. Res. Public Health 2022, 19(9), 5717; https://doi.org/10.3390/ijerph19095717 - 7 May 2022

Cited by 6 | Viewed by 2407

Abstract

Objectives: To compare characteristics of caregivers of adults with acute traumatic brain injury (TBI) in the U.S. and Latin America (Mexico and Colombia). Design: Secondary data analysis of two cohorts. Cohort 1: English-speaking caregivers of adults with TBI in the U.S. [...] Read more.

Objectives: To compare characteristics of caregivers of adults with acute traumatic brain injury (TBI) in the U.S. and Latin America (Mexico and Colombia). Design: Secondary data analysis of two cohorts. Cohort 1: English-speaking caregivers of adults with TBI in the U.S. (n = 80). Cohort 2: Spanish-speaking caregivers of adults with TBI in Mexico or Colombia (n = 109). Results: Similarities between the U.S. and Latin American caregiver groups, respectively, were: predominantly women (81.3%, 81.7%, respectively); spouses/domestic partners (45%, 31.2%); and motor vehicle accident (41.5%, 48.6%) followed by fall etiologies (40%, 21.1%). Differences between U.S. and Latin American caregivers were: age (49.5 years, 41.5 years, p < 0.001); employment status ((Χ₅² = 59.63, p < 0.001), full-time employment (63.7%, 25.7%), homemaker (2.5%, 31.2%), and retired (17.5%, 1.8%)); violence-related etiology (2.5%, 15.6%); and severity of depressive symptoms (M = 7.9, SD = 5.8; M = 5.8, SD = 5.7; p = 0.014). Conclusions: TBI caregivers in the U.S. were older and employed full-time or retired more often than those in Latin America. Violence-related etiology was nearly five times more common in Latin America, raising concerns for potential implications of post-traumatic stress and family adjustment after injury. Although both groups likely could use mental health support, this was particularly true of the U.S. cohort, maybe due to differential demographics, mechanisms of injury, or family and community support. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

14 pages, 713 KiB

Open AccessArticle

A Cross-Sectional Study about the Associations between Physical Activity Level, Self-Perceived Health Perception and Mental Health in Informal Caregivers of Elderly or People with Chronic Conditions in Spain

by Ángel Denche-Zamorano, Laura Muñoz-Bermejo, Jorge Carlos-Vivas, María Mendoza-Muñoz, Juan Manuel Franco-García, Jorge Rojo-Ramos, Alejandro Vega-Muñoz, Nicolás Contreras-Barraza and Sabina Barrios-Fernandez

Int. J. Environ. Res. Public Health 2022, 19(9), 5320; https://doi.org/10.3390/ijerph19095320 - 27 Apr 2022

Cited by 6 | Viewed by 2533

Abstract

Providing informal care for older people, or people with chronic conditions, is associated with poorer physical and mental health and reduced quality of life. This task, in many cases, often relies on the women in the immediate family. Physical activity (PA) is a [...] Read more.

Providing informal care for older people, or people with chronic conditions, is associated with poorer physical and mental health and reduced quality of life. This task, in many cases, often relies on the women in the immediate family. Physical activity (PA) is a tool to enhance caregivers’ physical and mental health and their quality of life. Thus, this study aimed to analyse the associations between the physical activity level (PAL), self-perceived health (SPH) and mental health (SM) and its factors (positive coping, self-esteem, and stress) by conducting a cross-sectional study by using data from in the National Health Survey 2017 (ENSE 2017), the last one before the COVID-19 pandemic. The sample included 2225 caregivers (866 men and 1361 women). Descriptive analysis and non-parametric statistical tests, including chi-square, the Kruskal–Wallis test, the Mann–Whitney U test, and the Spearman’s rho correlation coefficient, were used. Dependence relationships were found between PAL and SPH and MH and their factors. The population groups that performed moderate or vigorous PA showed better results in both SPH and MH. Women scored worse than men in all the variables analysed. Hence, intense, or moderate PA practice may improve SPH and MH in Spanish informal caregivers, requiring the implementation of policies and programs considering the differences found between men and women in PAL, SPH, and MH. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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11 pages, 1435 KiB

Open AccessArticle

Psychometrics of the Pearlin Mastery Scale among Family Caregivers of Older Adults Who Require Assistance in Activities of Daily Living

by Zhi Xiang Lim, Wei Ling Chua, Wee Shiong Lim, An Qi Lim, Kia Chong Chua and Ee-Yuee Chan

Int. J. Environ. Res. Public Health 2022, 19(8), 4639; https://doi.org/10.3390/ijerph19084639 - 12 Apr 2022

Cited by 9 | Viewed by 2700

Abstract

This study examined the psychometric properties of the seven-item mastery scale among 392 family caregivers of care dependent older adults in a tertiary hospital in Singapore. Item response theory (IRT) analysis and confirmatory factor analysis (CFA) were used to assess the scale’s psychometric [...] Read more.

This study examined the psychometric properties of the seven-item mastery scale among 392 family caregivers of care dependent older adults in a tertiary hospital in Singapore. Item response theory (IRT) analysis and confirmatory factor analysis (CFA) were used to assess the scale’s psychometric properties. Construct validity was assessed based on correlations between mastery and caregiver burden, depression, and quality of life. Data from the seven-item mastery scale showed acceptable reliability and model fit while IRT analysis showed that response categories were ordered but reflected poor fit for the two positively worded items. Without these two items, responses on the five-item version showed acceptable model fit and had acceptable reliability and high correlation with those on the seven-item version. Item responses on both the seven- and five-item versions show logical correlations with carer self-report on burden, depression, and quality of life. Further psychometric studies of the seven-item mastery scale are warranted. For practical applications such as caregiver screening during hospital admissions, the five-item mastery scale is fit for purpose. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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15 pages, 1858 KiB

Open AccessArticle

Listening to Caregivers’ Voices: The Informal Family Caregiver Burden of Caring for Chronically Ill Bedridden Elderly Patients

by Jinpitcha Mamom and Hanvedes Daovisan

Int. J. Environ. Res. Public Health 2022, 19(1), 567; https://doi.org/10.3390/ijerph19010567 - 5 Jan 2022

Cited by 10 | Viewed by 4440

Abstract

The informal family caregiver burden (IFCB) for chronically ill bedridden elderly patients (CIBEPs) is a major issue worldwide. It is a significant challenge due to the ongoing increased palliative care in the family setting; therefore, we explored the IFCB of caring for CIBEPs [...] Read more.

The informal family caregiver burden (IFCB) for chronically ill bedridden elderly patients (CIBEPs) is a major issue worldwide. It is a significant challenge due to the ongoing increased palliative care in the family setting; therefore, we explored the IFCB of caring for CIBEPs in Thailand. This article utilized a qualitative method, the total interpretive structural modeling (TISM) approach, with purposive sampling of thirty respondents between September and December 2020. The data were analyzed using cross-impact matrix multiplication applied to classification (MICMAC) to determine the relationship between the driving and dependence power of the enabling factors. The IFCB of the palliative care of CIBEPs was associated with primary care, nursing, extrinsic monitoring and complication prevention. The results showed that the IFCB involves taking responsibility, daily workload, follow-up caring, caring tasks, caregiving strain, financial distress, patient support, external support and caregiving strategy; thus, assistance with taking responsibility, extrinsic monitoring and follow-up care daily tasks may reduce the caregiver burden. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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Review

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14 pages, 626 KiB

Open AccessReview

Addressing Uncertainty in Informal Familial Caregivers of Stroke Survivors: A Systematic Meta-Ethnography

by Gabriella T. Ponzini, Brenna Kirk, Sarah E. Segear, Elizabeth A. Claydon, Elizabeth B. Engler-Chiurazzi and Shari A. Steinman

Int. J. Environ. Res. Public Health 2022, 19(17), 11116; https://doi.org/10.3390/ijerph191711116 - 5 Sep 2022

Cited by 3 | Viewed by 1962

Abstract

Background: Informal familial caregivers of stroke survivors experience uncertainty that begins at the time of the stroke event and continues into home-based care. The uncertainty faced by caregivers contributes to poor mental and physical health outcomes. Objective: This review details the factors associated [...] Read more.

Background: Informal familial caregivers of stroke survivors experience uncertainty that begins at the time of the stroke event and continues into home-based care. The uncertainty faced by caregivers contributes to poor mental and physical health outcomes. Objective: This review details the factors associated with, impacts of, and coping skills used to manage uncertainty across the caregiving trajectory. By defining uncertainty reduction and tolerance recommendations, this review also builds upon the Stroke Caregiver Readiness Model to improve preparedness following the stroke event. Methods: A meta-ethnographic review was systematically conducted on thirteen qualitative studies with 218 participants from four countries. The Critical Appraisal Skills Programme (CASP) was used to assess study quality. Results: Following the stroke event, caregivers reported a lack of knowing (e.g., about the cause of the stroke event and survivor prognoses) as contributing to post-stroke uncertainty. As a result of this uncertainty, caregivers expressed concerns about their abilities to navigate caregiving responsibilities and how to plan for the future. Longer-term concerns (e.g., managing finances) and feelings of hopelessness occurred after discharge. Still, caregivers identified strategies to manage uncertainty. Caregiver coping skills included present-focused thinking, gratitude, faith, humor, and social support. Conclusions: The uncertainty faced by informal familial caregivers of stroke survivors is pervasive and changes across time. Uncertainty reduction and tolerance interventions can be used to build upon caregiver strengths and promote preparedness across the caregiving trajectory. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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Other

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25 pages, 5228 KiB

Open AccessSystematic Review

Mortality, Morbidity and Health-Related Outcomes in Informal Caregivers Compared to Non-Caregivers: A Systematic Review

by Patrick Janson, Kristina Willeke, Lisa Zaibert, Andrea Budnick, Anne Berghöfer, Sarah Kittel-Schneider, Peter U. Heuschmann, Andreas Zapf, Manfred Wildner, Carolin Stupp and Thomas Keil

Int. J. Environ. Res. Public Health 2022, 19(10), 5864; https://doi.org/10.3390/ijerph19105864 - 11 May 2022

Cited by 14 | Viewed by 3580

Abstract

A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following [...] Read more.

A systematic overview of mental and physical disorders of informal caregivers based on population-based studies with good methodological quality is lacking. Therefore, our aim was to systematically summarize mortality, incidence, and prevalence estimates of chronic diseases in informal caregivers compared to non-caregivers. Following PRISMA recommendations, we searched major healthcare databases (CINAHL, MEDLINE and Web of Science) systematically for relevant studies published in the last 10 years (without language restrictions) (PROSPERO registration number: CRD42020200314). We included only observational cross-sectional and cohort studies with low risk of bias (risk scores 0–2 out of max 8) that reported the prevalence, incidence, odds ratio (OR), hazard ratio (HR), mean- or sum-scores for health-related outcomes in informal caregivers and non-caregivers. For a thorough methodological quality assessment, we used a validated checklist. The synthesis of the results was conducted by grouping outcomes. We included 22 studies, which came predominately from the USA and Europe. Informal caregivers had a significantly lower mortality than non-caregivers. Regarding chronic morbidity outcomes, the results from a large longitudinal German health-insurance evaluation showed increased and statistically significant incidences of severe stress, adjustment disorders, depression, diseases of the spine and pain conditions among informal caregivers compared to non-caregivers. In cross-sectional evaluations, informal caregiving seemed to be associated with a higher occurrence of depression and of anxiety (ranging from 4 to 51% and 2 to 38%, respectively), pain, hypertension, diabetes and reduced quality of life. Results from our systematic review suggest that informal caregiving may be associated with several mental and physical disorders. However, these results need to be interpreted with caution, as the cross-sectional studies cannot determine temporal relationships. The lower mortality rates compared to non-caregivers may be due to a healthy-carer bias in longitudinal observational studies; however, these and other potential benefits of informal caregiving deserve further attention by researchers. Full article

(This article belongs to the Special Issue Research on Informal Caregivers)

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