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What Do Rural Dementia Caregivers Find Stressful?  [PDF]
Kaye Ervin, Carol Reid, Sharon Moore
Open Journal of Nursing (OJN) , 2015, DOI: 10.4236/ojn.2015.54040
Abstract: This study aimed to determine what carers of people with dementia in rural Australia found stressful in their caring role. It was part of a broader mixed methods study exploring carer depression, anxiety and stress and utilisation of formal community support services. The findings suggest that carer stress varies among individuals, but that a predominant source of stress is the unremitting burden experienced when caring for someone with dementia. Improved utilisation of support services in rural areas and tailoring services to individual carers dependent on the source of stress is recommended.
Kingston Caregiver Stress Scale (KCSS) Greek Validation on Dementia Caregiver Sample  [PDF]
Artemis Pitsikali, Michael Galanakis, Liza Varvogli, Christina Darviri
Psychology (PSYCH) , 2015, DOI: 10.4236/psych.2015.69116
Abstract: In this study, we focus on the Greek validation of the Kingston Caregiver Stress Scale (KCSS) and its 3 categories: “Caregiving issues”, “Family issues” and “Financial issues”. Our sample consists of 100 caregivers (Ν = 100) who support a relative that suffers from a type of dementia. The participants are looking after the patients, systematically, for at least an hour per week. The questionnaires were distributed by day care centres for patients with dementia, which were located in Athens. Also, we correlated KCSS with the following questionnaires: Zarit Burden Interview (ZBI), Perceived Stress Scale (PSS), Older Americans Resources and Services (OARS), Multidimensional Functional Assessment Questionnaire (MFAQ)-Activities of Daily Living Section (ADL). The results for the reliability and the validity of the scale were satisfactory and the tool had high reliability a = 0.85. We also concluded that KCSS had criterion validity as it showed a positive correlation with both ZBI and PSS, while it had a negative correlation with OARS-MFAQ-ADL.
HIV clinic caregivers’ spiritual and religious attitudes and behaviors  [PDF]
Elizabeth A. Catlin, Jeanne H. Guillemin, Julie M. Freedman, Mary Martha Thiel
Health (Health) , 2010, DOI: 10.4236/health.2010.27120
Abstract: Based on prior research, we hypothesized that staff in an outpatient clinic caring for an HIV patient population might rely on religious and spiritual frameworks to cope with the strains of their work and that their responses to a spiritual and religious survey might reflect work-related spiritual distress. Surveys were completed by 78.7% of staff (n = 59). All respondents scored in the "moderate" range for religious and spiritual well-being as well as existential satisfaction with living. The large majority agreed that the religious and spiritual concerns of patients have a place in patient care. Nurses, (88.2% of nurse respondents) viewed assessing the spiritual needs of patients as their responsibility, (p = 0.03). While 82% of HIV clinic respondents privately prayed for patients always, often or sometimes, this did not include physicians. Physicians in this clinic setting appeared to be less spiritual and religious, based on their survey responses, than coworkers and than US physicians in general. The majority of clinic physicians (78%) believed that God does not suffer with the suffering patients, in contrast to the majority of support staff (69%) and nearly half of the nurses, who believed that God does suffer with them, (p = 0.018). Contrary to our expectation, respondents did not report work-related spiritual distress, which may be related to improved therapies that can prolong and improve patients’ lives. Survey data revealed, however, a surprising level of engagement in and reliance on spiritual and religious frameworks among nurses and support staff. Whether the absence of measured spiritual distress is linked, in a causal rather than random manner, to spiritual and religious reliance by certain of these health care providers, is unknown.
Gender differences in anxiety and depression among the caregivers of patients with dementia  [PDF]
Rohit Verma, Kuljeet Singh Anand
Advances in Alzheimer's Disease (AAD) , 2012, DOI: 10.4236/aad.2012.13003
Abstract: Background: Providing care to dementia patients itself poses risk of distress in bio-psychosocial paradigm. It is important to assess the mental health status and attend to the needs of caregivers. The present investigation focuses on gender differences related to anxiety and depression in caregivers of dementia patients. Methods: This cross-sectional study was carried out in an out-patient setting in the Dementia clinic of a tertiary care hospital. Sixty caregivers of consescutive dementia patients receiving outpatient care were assessed using the Hospital Anxiety and Depression Scale (HADS). Descriptive analysis was done to find in between group differences for the male and female caregivers and Pearson’s correlation coefficient was calculated to find the association between the number of family members with chronic illness and the scores on HADS. Results: Male and female care- givers differed significantly on the HADS—Total, Anxiety and Depression subscale scores with female care givers having significantly higher scores. There was a significant correlation between the number of family members with chronic illness and HADS-Anxiety subscale scores in female caregivers. Conclusion: It is crucial to screen caregivers, especially females, of patients with dementia for presence of anxiety and depression. This approach will help timely identification and proper management of these individuals. It is important to promote measures to soften the impact that the patient has on the caregiver, and that, at the same time, improves the quality of life of the patient.
Subjective Burden on Family Carers of Hemodialysis Patients  [PDF]
Magda M. Bayoumi
Open Journal of Nephrology (OJNeph) , 2014, DOI: 10.4236/ojneph.2014.42011

Background: Hemodialysis (HD) is an important objective burden (task) on patient with end stage renal disease (ESRD) and the caregiver has a subjective burden which contributes to lifestyle changes, which result in depression, anxiety declining physical health, social isolation and financial strain. Aim: To evaluate the subjective burden on family caregiver who cares patient on maintenance hemodialysis therapy. Methods: Fifty main family caregivers for each patient on HD and the instrument were used by Caregiver Burden Interview (CBI) completed by caregiver as a major of subjective response to care giving. Results: The present study findings demonstrated that main age of caregiver was 40 (11.0) years, two thirds of females, and they were mostly married (78.0%) with children. The total family caregiver burden reported was 43.3 (21.7), role strain 50.0 (25.4) and the personal strain 39.5 (19.7). The total caregivers’ burden significantly positively correlated with the patients’ age (r = 0.461) and negatively correlated with patients’ level of education (r = ?0.290). Moreover the role strain, personal strain and total caregiver burden scores were statistically and significantly negatively correlated with their age (r = ?0.444) and level of education (r = ?0.416) and the total burden scores were ranked as moderately to severely burdened all family caregivers. Conclusion: Caregivers’ appraisal, coping strategies, interpersonal relationship issues, and social support would need to be considered for caregivers of patients maintained on HD.

Evaluation of Anxiety and Depression in Caregivers of Patients Affected by Alzheimer’s Disease  [PDF]
Anna Vespa, Maria Velia Giulietti, Marica Ottaviani, R. Spatuzzi, F. Merico, Guido Gori, Olimpia Claudia Rossi, L. Paciaroni, Giuseppe Pelliccioni, Pietro Scendoni, Cristina Meloni
Advances in Alzheimer's Disease (AAD) , 2015, DOI: 10.4236/aad.2015.42003
Abstract: Background: Many studies have been underlined as care giving for people with Alzheimer’s disease (AD) is highly stressful and has significant negative consequences, such as anxiety and depression. Objective: The specific aim of our study is to establish whether a difference exists in the prevalence of depression of family caregivers of Alzheimer’s disease patients and healthy subjects not caregiver. Methods: Study group (n = 60) consists of caregivers of patients affected by Alzheimer’s disease, whereas control group (n = 120) consists of healthy individuals who are not care giving (from at least 5 years). All the subjects were subdivided on the basis of the following independent variables: sex, age, marital status and educational level. The subjects of study and control groups studied have filled in the following tests: IPAT CDQ e IPAT ASQ Tests by Cattell which describe depression and anxiety. Such tests have been validated on the adult and elderly Italian population. Statistical analysis: Student t test has been applied for the comparison between experimental and control groups. Results: The caregivers show higher levels of anxiety (medium to high, P < 0.001) and depression in comparison to the group of control (medium to high, P < 0.001). This result indicates the caregiver shows serious depression. Conclusions: The high levels of depression and anxiety suggest the following considerations: interventions of social and psychological support are fundamental not only to maintain the patient in the family nucleus but also to maintain the caregiver’s psychological health.
Family Home Caregivers for Old Persons in the Arab Region: Perceived Challenges and Policy Implications  [PDF]
Azza O. Abdelmoneium, Sanaa T. Alharahsheh
Open Journal of Social Sciences (JSS) , 2016, DOI: 10.4236/jss.2016.41019
Abstract: The profound demographic changes that the Arab region has experienced during the past few decades have led to slow, albeit noteworthy increase in the proportion of older people, which will inevitably place heavy burdens on families who are assumed the responsibility in providing care for its older members. Although there has been much research about elderly caregiving issues in other regions around the world, less is known about aging family member caregiving, the challenges that family member caregivers face in the Arab region, and the facilities provided for family support to the elderly and to the caregivers themselves. Thus, the purposes of this study are to gain an overview of the current situation of ageing and elderly family member caregiving in the Arab region; to address the challenges family caregivers face, such as necessary skills and know- ledge, communication, cultural issues, health, financial burdens and enhancement of quality of life in association with their care-giving role. These challenges can negatively impact the quality of life for the caregiver and the care receiver. The importance of implementing research and policy intervention to meet these challenges for all concerned will be discussed.
The Implications of the Timing of Diagnosis of Dementia on the Dementia Caregiver  [PDF]
Kenneth K. W. Ng, Melinda Martin-Khan, Maree Farrow, Elizabeth Beattie, Nancy A. Pachana
Advances in Alzheimer's Disease (AAD) , 2016, DOI: 10.4236/aad.2016.54010
Abstract: This is a consumer-reference feedback and feasibility testing of a protocol to obtain qualitative responses of co-residing caregivers to questions regarding the timing of dementia diagnosis and their experience of the disclosure of a diagnosis of dementia. Data collection involved focus group discussions and individual phone interviews of a convenience sample (N = 5) of an Alzheimer’s Australia state based Consumer Advisory Committee. Thematic analysis utilised the Leximancer software. Consumer feedback suggested a reordering of the interview questions and reversing the data collection sequence to reduce the emotional impact on participants. Suggestions were offered to limit the number of participants in the focus group to shorten the duration of the focus group session to prevent fatigue and to provide a support person to improve participant focus group comfort. Responses to the interview questions indicated caregivers retrospectively considered a timely diagnosis would have provided useful dementia-focused planning, reduced the difficulties of living with uncertainty and would have provided more time to obtain information and support. There were strong expectations for medical practitioners to be sensitive to the possibility of dementia and to be cognisant of the diagnostic concerns of caregivers. The diagnosis of dementia and its timing is important to the dementia caregiver in providing an explanation of the problems experienced and allowing earlier organisation of care, future planning and caregiver education to reduce the difficulties of living with undiagnosed and unrecognised dementia.
Life Balance of Mothers of Children with Cerebral Palsy  [PDF]
Sepideh Nazi, Narges Shafaroodi, Laleh Lajevardi, Afsoon Hassani Mehraban, Farzaneh Yazdani, Samaneh Hosseinzadeh
International Journal of Clinical Medicine (IJCM) , 2017, DOI: 10.4236/ijcm.2017.811055
Abstract: Purpose: Having the child with Cerebral palsy is a very stressful experience for the family that could affect daily patterns and routines, habits, needs and occupational performances of all family members specially mothers. This study aimed to investigate life balance of mothers of children with Cerebral palsy (MCCPs) based on the Life Balance Model. Method: Fifty MCCPs aged 3 to 9 years with sample convenient method participated in this descriptive and cross-sectional study. The Severity of cerebral palsy was determined by Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS) and the life balance of mothers was evaluated by Persian version of the LBI (P_LBI). The collected data were evaluated and analyzed using SPSS software. Results: The total mean score of LBI and its subscales showed that there is no balanced or very balanced life in mothers and they could be categorized to unbalanced (n = 21) and very unbalanced (n = 29). The total mean score of LBI was 1.46. χ2 test revealed statistically significant difference between two categories (unbalanced and very unbalanced) of mothers regarding GMFCS level (p = 0.009). Also, the total mean score of LBI and its subscales showed no significant difference between two categories (unbalanced and very unbalanced) regarding mother job and age and child age (p > 0.05) but it has significant difference regarding mother education (p = 0.009). Evaluation of the results of LBI and its different subscales indicated that the life balance at balanced or very balanced levels was not observed in any of the studied mothers, and they could be categorized in 2 groups of unbalanced (21 mothers ) and very unbalanced (29 mothers) (Table 2). Discussion: Based on the result of this study, mothers of Cerebral Palsy do not experience balanced life and this feeling of unbalance is related to the level of their child’s disability. Thus, it is necessary to consider this fact in family-centered evaluations and Occupational therapy interventions.
Caregiver Burden in the Management of Frail Elderly Patients with Diabetes in Internal Medicine  [PDF]
José Miguel Seguí Ripoll, Vicente Jesús Seguí Llinares, Miguel J. Reig Pérez, Carles García Cervera, Juan Manuel Nú?ez Cruz, Pedro Esteve Atiénzar, Sara Ba?ón Escandell, Alberto López Serrano, María Dolores Jover Ríos, Juan Méndez Mora, Carmen Seguí Pérez, María Josefa Navarro Navarro, Pablo Roig Rico
Health (Health) , 2018, DOI: 10.4236/health.2018.1010107
Abstract: Aim: Advanced age and fragility often lead to dependence, making caregiver assistance necessary for performing the activities of daily living. Patients with diabetes are characterized by an elevated presence of comorbidities and subsequent frailty—a relevant consideration when making decisions regarding treatment goals. Health professionals may overlook the caregiver experience when assessing the circumstances surrounding frail elderly patients with diabetes, but this factor can have a large impact on relevant caregiver and patient outcomes. Methods: An observational, retrospective study was carried out to assess the impact of improved management in diabetes on caregiver burden. We assessed patients’ performance of activities of daily living using the Barthel scale. Our primary outcome was caregiver burden, as assessed using the Zarit scale. Results: At baseline, 81.4% of the caregivers reported severe overburden (>55 points on the Zarit scale). At three months, the proportion of caregivers reporting this level of burden had dropped to 76.7% and remained stable at six months (77.1%). In contrast, 8.5% of the caregivers reported moderate overburden (47 to 55 points) at baseline, compared to 13.3% at three months and 12.5% at six. The proportion of caregivers reporting no overburden (<47 points) was similar at all time points (10.2%, 10.0% and 10.4% at baseline, three months and six months, respectively). Conclusions: Caregiver burden remained persistently high, decreasing only slightly after six months.
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