The burden and psychosocial impact on immediate caregivers of patients with spinal cord injury in a tertiary health facility,Edo State,Nigeria

Objective:This study aimed to assess the burden and psychosocial impact of spinal cord injury on the immediate caregivers at a tertiary health facility in Benin City,Edo State.Materials and Methods:A descriptive cross-sectional survey design was adopted among 73 family caregivers in the neurological ward of a tertiary health facility using a structured questionnaire as instrument of data collection.Data collected were analyzed using descriptive statistics and multiple logistic regression.Results:Findings revealed that an overall mean of 2.73 indicates that the burden on the caregivers was moderate with a moderate psychological impact(m=2.88)and a high sociological impact(m=3.12).Factors affecting the caregiving provided by immediate caregivers include social and household responsibilities(94.5%),financial situation(89.0%),family support(83.6%),and health status of the caregiver(80.8%).Age(odds ratio[OR]=5.67,95%confidence interval[CI]:1.23-27.17,P=0.027),education(OR=3.75,95%CI:1.05-13.39,P=0.041),and“others”(spouses,siblings,friends,or extended family members)(OR=3.167,95%CI:1.583-6.337,P=0.001)were predictors for high psychological impact while education(OR=0.074;95%CI:0.015-0.370,P=0.001)and caregiving role(OR=3.167;95%CI:0.1.583-6.337,P=0.001)high sociological impact.Conclusion:Majority of the caregivers experience moderate burden,moderate psychological impact,and high sociological impact.Understanding these factors is essential for developing targeted interventions and support services to address the unique needs of caregivers and mitigate the burden of caregiving on their psychosocial health.

Community Caregivers’ Experiences and Programmatic Strategies to Improve Active Case Finding in Community Tuberculosis Care in Botswana 2016-2021

Background: The community tuberculosis care program was started to reduce the impact of TB and increase successful treatment outcomes, thus contributing to meeting WHO targets on TB. According to the Botswana Ministry of Health, community tuberculosis care was introduced with the main goal of reducing tuberculosis-related morbidity and mortality among communities through the expansion of direct observed therapy and community involvement to community settings. The community caregivers were to support tuberculosis patients throughout their treatment period until they were cured or had completed their treatment. Settings: Two major cities of Botswana, Francistown and Gaborone, with more than twenty-two health clinics offering tuberculosis care. Objective: To investigate community caregivers’ experiences and identify programmatic strategies to improve active TB case findings under the community TB care (CTBC) program in Botswana during 2016-2021. Methods: We adopted a descriptive qualitative research design, followed by convenience purposive sampling. We obtained consent and interviewed 40 participants who met the inclusion criteria, 16 out of 73 in Gaborone and 24 out of 38 from Francistown. Results: We interviewed 40 caregivers with a mean age of 43.4 years. Accepting the caregiving role was identified as the main experience by more than two thirds of the caregivers. While at least more than two-fifth felt obligated to care for the patient at home due to personal relations. More than half of the respondents found caregiving difficult or frustrating due to some challenges encountered during the caregiving role. Behavioral modifications were suggested under different subthemes as strategies to improve active case finding. [-rId13-]Conclusion: Acceptance was the major experience in CTBC. Intensification of known programmatic strategies was suggested by caregivers to improve tuberculosis active case finding in CTBC.

Hospital Discharge Plan in Family Caregivers of Children with Coronary Artery Aneurysm in Kawasaki Disease: A Review

Objective:The study reviews status,main time nodes and hospital discharge services for family caregivers of children with Kawasaki disease complicated by coronary artery aneurysm to provide references for the development of hospital discharge preparation services for medical personnel and patients.Background:CAL of Kawasaki disease is the main cause of acquired heart disease in children,but there is not enough research on the readiness for hospital discharge.Design:Systematic review of observational and interventional studies.

Progress in Investigating the Current Mental Health Status Among Caregivers for Surgical Oncology Patients

This article aims to discuss the current state and research progress concerning the mental health of caregivers for surgical oncology patients.The goal is to offer insights that can serve as a reference for further enhancements in caregivers’mental well-being.This article conducts a comprehensive review and analysis of recent studies on the mental health of caregivers for patients undergoing oncologic surgery.These studies reveal that caregivers commonly grapple with mental health issues,including anxiety,depression,and stress.These problems are closely linked to the stress of the patient’s condition and treatment,the caregiver’s own mental strain,and a lack of social support.In addition,the mental health status of caregivers significantly influences the patient’s treatment and recovery process.Implementing various interventions,such as mental health education,services,the establishment of mental health support teams,and engagement in mental health promotion activities,can contribute to the improvement of caregivers’mental well-being.This,in turn,has the potential to enhance treatment outcomes and the overall quality of life for patients.

Optimism,Social Support,and Caregiving Burden among the Long-Term Caregivers:The Mediating Effect of Psychological Resilience

Background:As the elderly population grows,the demand for long-term care services is increasing.Despite significant investments in care quality and workforce training,long-term care workers often face challenges such as work fatigue,heavy workloads,and inadequate support.These issues can impact job satisfaction,mental health,and care quality,leading to staff turnover.This study examines how optimism,social support,and psychological resilience relate to caregiving burden,aiming to understand their effects on caregivers’well-being and performance to enhance the quality of long-term care services.Methods:The participants were 542 long-term care workers.Descriptive statistics,t-tests,one-way ANOVA,and hierarchical regression were used for data analysis.Results:(1)Optimism and social support were significantly and positively correlated with psychological resilience and significantly and negatively associated with caregiving burden.(2)Regarding differences in optimism,social support,psychological resilience,and caregiving burden among long-term care workers,females scored significantly higher than males in“social support;”married workers scored significantly higher than unmarried workers in“optimism,”“social support,”and“psychological resilience”;workers aged 45–65 scored significantly higher than those aged 25–45 in“optimism”;workers aged 25–45 scored significantly higher than those aged 45–65 in“caregiving burden”;social workers scored significantly higher than nursing staff in“optimism.”(3)Psychological resilience partially mediated the relationship between social support and caregiving burden concerning explanatory and predictive power.Conclusions:These findings suggest that optimism,social support,and psychological resilience are essential factors in reducing the caregiving burden among long-term care workers.The study highlights the importance of promoting psychological resilience and providing social support to alleviate the burden of caregiving.

Research Progress on the Mental Toughness of Family Caregivers of Children with Malignant Solid Tumors

The physical,emotional,and caregiving quality of caregivers for children with malignant solid tumors is significantly influenced by mental toughness.The definition of mental toughness,study methods,primary influencing factors,and intervention strategies for the mental toughness of caregivers of children with malignant solid tumors will be examined in this paper.To improve the mental toughness of caregivers of children with malignant solid tumors,it is recommended that future studies enhance the number of intervention research methods and establish particular evaluation tools.

Insomnia Burden among Informal Caregivers of Hospitalized Lung Cancer Patients and Its Influencing Factors

Objective This study aimed to reveal the insomnia burden and relevant influencing factors among informal caregivers(ICs)of hospitalized patients with lung cancer.Methods A cross-sectional study on ICs of hospitalized patients with lung cancer was conducted from December 31,2020 to December 31,2021.ICs’burden was assessed using the Caregiver Reaction Assessment(CRA),Hospital Anxiety and Depression Scale(HADS),and Insomnia Severity Index(ISI).Linear and logistic regression models were used to identify the influencing factors.Results Among 289 ICs of hospitalized patients with lung cancer,83(28.72%),53(18.34%),and 14(4.84%)ICs experienced mild,moderate,and severe insomnia,respectively.The scores concerning self-esteem,lack of family support,financial problems,disturbed schedule,and health problems were 4.32±0.53,2.24±0.79,2.84±1.14,3.63±0.77,and 2.44±0.95,respectively.ICs with higher Activities of Daily Living Scale(ADLS)scores were associated with a lower risk of insomnia,with an odd ratio(OR)and 95%confidence interval(CI)of 0.940(0.898–0.983).Among the ICs,female gender(OR=2.597),alcohol consumption(OR=3.745),underlying medical conditions(OR=11.765),long-term caregiving experience(OR=37.037),and higher monthly expenses(OR=5.714)were associated with a high risk of insomnia.Conclusion Of the hospitalized patients with lung cancer,51.9%experienced insomnia.Patients’ADL,ICs gender,alcohol consumption,underlying medical conditions,caregiving duration,and monthly expenses were influencing factors.Therefore,prompt screening and early intervention for ICs of patients with lung cancer is necessary.

Relationship between primary caregivers’social support function,anxiety,and depression after interventional therapy for acute myocardial infarction patients

BACKGROUND An acute myocardial infarction(AMI)is often treated with direct coronary intervention and requires home-based rehabilitation.Caregivers of patients with AMI need adequate social support to maintain high-quality care;however,their social support function is low,and relevant indicators for intervention must be identified.AIM To analyze the correlation between social support for primary caregivers,their anxiety,and depression,when caring for patients with AMI after interventional therapy.METHODS Using convenience sampling,we selected 300 primary caregivers of patients with AMI who had undergone interventional therapy.The Social Support Rating Scale(SSRS),Self-Rating Anxiety Scale(SAS),and Self-Rating Depression Scale(SDS)were used to assess the primary caregivers.A Pearson’s correlation analysis was used to analyze the correlations between the SSRS,SAS,and SDS,and a multiple logistic regression analysis was used to analyze the factors influencing the low social support function of primary caregivers.The receiver operating characteristic curve and area under the curve(AUC)were used to evaluate the predictive ability of the SAS and SDS for low social support function in primary caregivers.RESULTS Considering the norm among Chinese people,AMI caregivers’objective support,subjective support,support utilization,and SSRS scores were lower,while their SAS and SDS scores were higher.The SSRS scores of female caregivers were higher than those of the male caregivers(t=2.123,P=0.035).The Pearson correlation analysis showed that objective support,subjective support,support utilization,and SSRS total scores were significantly correlated with both SAS(r=-0.414,-0.460,-0.416,-0.535)and SDS scores(r=-0.463,-0.379,-0.349,-0.472).Among the 300 AMI caregivers,56 cases(18.67%)had a low level of support function(SSRS≤22 points).Logistic regression model analysis showed that SAS and SDS were independent risk factors for low social support function of AMI caregivers,regardless of adjustment for other variables(P<0.05).SAS and SDS predicted that the AUC of AMI caregivers with low support function was 0.84,sensitivity was 67.9 and 71.4,and specificity was 84.0 and 70.9,respectively.CONCLUSION The social support function of the primary caregiver of patients with AMI after interventional therapy was lower and negatively correlated with anxiety and depression in the primary caregiver.

Determinants of State of Mental Health among Caregivers of Children with Disabilities

This study aimed to determine the association and predictive capacities of job satisfaction,workplace stress,work motivation,and self-esteem on state of mental health of caregivers of children with disabilities in South-West Nigeria.The self-determination theory provided a theoretical framework for the study.A closed-ended paper-pencil questionnaire tagged‘Mental Healthiness Scale for Caregivers’was used for data collection from 241 care-givers of children with disabilities.Data collected was analyzed using descriptive of frequency count,simple per-centage and mean as well as inferential statistics involving Pearson product moment correlation and Binary Logistic Regression at 95%confidence interval.Findings revealed a significant but inverse association between self-esteem,workplace stress and mental health.Work motivation had a direct association with mental health while job satisfaction had no significant association with mental health of caregivers of children with disabilities.Caregivers(18–40 years)had the highest odds for mental health concerns.Lowered self-esteem and workplace stress increased mental health concerns while job satisfaction significantly predicted a higher likelihood for posi-tive state of mental health among caregivers of children with disabilities.

Analysis of load status and management strategies of main caregivers of patients with malignant tumors of digestive tract

Caregiver load refers to the subjective and objective negative impact of caregivers in the care of patients,and excessive load will have a serious impact on patients and caregivers themselves and can reduce their quality of life.For the main caregivers,it not only needs to care for the patients in life and daily life,but also needs to pay the cost of treatment for the patients,coupled with the need to carry out their own original work,life,etc.excessive life pressure,economic pressure,work pressure,emotional pressure,etc.lead to heavy load of the main caregivers,which can easily cause caregivers to have different degrees of psychological problems,which will cause serious adverse effects on the caregivers themselves and cancer patients,not conducive to the construction of a harmonious family and society.This article analyzes the current situation of primary caregiver burden in patients with gastrointestinal malignant tumors,analyzes its influencing factors,and specifies specific treatment strategies.It is hoped to provide scientific guidance for later related research and application.

Effectiveness of family psychosocial intervention on mental health and family function of caregivers of children with cancer:a meta-analysis

Objective:To evaluate the effect of family psychosocial intervention on the mental health and family function of caregivers of children with cancer.Methods:A comprehensive literature search of CNKI,Wanfang,VIP,CMB,PubMed,Web of Science,MEDLINE,Embase,Cochrane Library,and PsycARTICLES was conducted to retrieve randomized controlled trials of family psychosocial intervention from database inception until 19 September 2021.RevMan(version 5.4.1)was used to analyze the data.Results:A total of 894 caregivers participated in 11 studies.The analysis showed that anxiety(standardized mean difference[SMD]=−0.22,95%confidence interval[CI]=−0.37 to−0.07,P=0.004)and depression(SMD=−0.33,95%CI=−0.57 to−0.08,P=0.01)were significantly reduced,while family function(SMD=−0.86,95%CI=−1.28 to−0.45,P<0.001)was significantly improved by the family psychosocial intervention compared with the controls.According to subgroup analysis,family psychosocial interventions were found to reduce posttraumatic stress disorder(PTSD)symptoms when the follow-up time was>1 month(SMD=−0.48,95%CI=0.68 to−0.27,P<0.00001).Conclusions:Current evidence supports the use of family psychological intervention to reduce depression and anxiety and improve family function.However,its effect on PTSD symptoms requires further study.Future studies should further identify the role of specific family psychosocial interventions on families and caregivers of children with cancer.

Psychiatric disorders and caregiver burden in children with transfusion dependentβ-thalassaemia and their caregivers

BACKGROUND Children with thalassemia need care from the first years of life owing to the physical and psychological effects of their disorder.Thalassemia is a concern not only for the children’s physical health but also the mental health of themselves and their caregivers.AIM To screen the psychosocial problems and assessment of psychiatric morbidities among thalassaemic children and their caretakers,along with an assessment of caregiver burden in them.METHODS In this observational cross-sectional study,children with transfusion-dependent thalassemia,were included and were assessed for psychiatric morbidity and global functioning.Their parents were assessed for psychiatric morbidity and the caregiver burden they faced.All the parents completed two different questionnaires to assess their knowledge about the psycho-social functioning[using Pediatric Symptom Checklist-35(PSC-35)]of their children and the level of the burden faced by them by Caregiver Burden Scale(CBS).RESULTS A total of 46 children(28 boys and 18 girls)with transfusion-dependent thalassemia with a mean age of 8.83±2.70 years and 46 parents(12 fathers and 34 mothers)were included in this study.More than 32 children had some psychosocial problems on screening by PSC-35.On assessment by CBS moderate caregiver burden was perceived in domains of general strain,isolation,disappointment,emotional involvement,and environment.A total of 65.3%of children and 62.7%of parents were diagnosed with psychiatric problems.CONCLUSION Thalassemia affects not only the persons with the disorder but also their caregivers in several aspects,including their psychosocial well-being.This study emphasizes the role of a supportive group in the psychological well-being of caregivers,which could be used to prevent the pathological effects of caregiver burden and enhance their psychological well-being through counselling.

Exploring the Experiences of Personal Recovery among Mental Health Consumers and Their Caregivers Receiving Strength- Based Family Interventions

Background:This study explored the personal recovery of consumers and their caregivers receiving the strength-based family intervention.Method:A three-year project was implemented with 43 dyads from 5 community psychiatric rehabilitation agencies in northern,central,and Southern Taiwan.This paper presents qualitative analysis with a focus on describing the experiences of personal recovery.To gain a deeper understanding of the participants’personal experiences and perspectives,semi-structured in-depth interviews were conducted on three occasions(six months after the inception of the experiment,18 months after,and when the participants left the services of this study).Over the three occasions,a total of 27 consumers and 28 caregivers were interviewed.Data analysis was conducted based on grounded theory.Results:Consumers expressed positive experiences in the domain of the recovery process(positive sense of self,taking responsibility,and better coping)and on the objective indicators of recovery(functioning,interpersonal interaction,and family relationship).Caregivers experienced lessened psychological burdens.They also revealed improvements to their sense of self(recovery process)and subjective indicators of recovery outcomes,including feeling empowered and having a better quality of life.Moreover,they had better interaction with consumers(objective domain of recovery).Conclusion:These findings suggest that the strength-based perspective is an acceptable,culturally-compatible approach among Chinese mental health consumers and their caregivers.The investigators suggest that additional resources would be necessary to support a change in the service system in Taiwan so that family-based services can be provided to promote the recovery of mental health consumers and their family caregivers.

Analysis of the Status and Factors Influencing Anxiety and Depression in Patients with Chronic Heart Failure and Their Primary Caregivers: Empirical Quantitative Research

Objective: This study examined the associations between anxiety, depression, and quality of life among hospitalized patients with chronic heart failure and their primary caregivers. Patients and Methods: Between May and September 2018, the data were collected from 61 patients and their caregivers. Demographic information of CHF patients was collected by questionnaires; the Hospital Anxiety and Depression Scale (HADS) and the Minnesota Living with Heart Failure Questionnaire (MLHFQ) were used to assess CHF patient’s anxiety, depression and quality of life (QOL); the HADS, the Family Caregiver Quality of Life (FAMQOL) were used to assess primary caregivers’ anxiety, depression and QOL. Descriptive statistics, correlation analysis, independent-sample t-test, one-way analysis of variance and multiple stepwise regression were used in the statistical analysis. SPSS 17.0 was used to manage and perform statistical analyses. Results: Quality of life, anxiety, and depression of the patients and caregivers had significant positive correlations. Gender, quality of life, number of hospitalizations, duration of patients’ heart failure, and the quality of life of caregivers influenced patients’ anxiety. Gender, quality of life, relationship with the patient, and depression of caregivers influenced their anxiety. The quality of life and anxiety of patients influenced their depression. Daily caregiving time, anxiety, relationship with patients, and the patients’ heart function influenced caregivers’ depression. Conclusion: The patients and caregivers experienced anxiety and depression, which interacts and decreases their quality of life. It is important to regularly assess anxiety, depression, and quality of life in patients with chronic heart failure and their primary caregivers.

Assessing the Relationship between Caregivers Burden and Availability of Support for Family Caregivers’ of HIV/AIDS Patients in Calabar, South East Nigeria

Purpose: This study examined the level of burden and the extent of support on family caregivers of people living with AIDS (PLWHA) in Calabar, South East Nigeria. Methods: A mixed method with cross sectional approach was used. Purposive sampling technique guided the recruitment process and data collection methods included, semi-structured questionnaires and focusing group discussion. 260 respondents participated in the study. The quantitative data were mined with the aid of SPSS and the qualitative data were analysed with the aid of NVivo8 using thematic analysis. Results: Results indicated high level of burden with limited support to caregivers. A Chi-square value of 25.1 was obtained at P < 0.05, suggesting a significant relationship between availability of support and caregivers burden. This relationship was supported by the themes of physical, social, emotional and financial burden for the caregivers. Similarly, information on coping skills, emotional support, financial assistance and help with caregiving themes emerged for social support. Conclusion: In Nigeria, the burden of caring for HIV/AIDS patients has a remarkable impact on family caregivers. This calls for the development of policies that can systematically address the needs of family caregivers in order to ameliorate the negative consequences of caregiving for PLWHA.

Analysis on nursing competence and training needs of dementia caregivers in long-term care institutions

Objective:It is aimed to investigate the nursing competence and corresponding influence factors of dementia caregivers in long-term care institutions of Tianjin and identify the training needs of caregivers.Methods:In the cross-section survey of this study,246 dementia caregivers were selected from 6 long-term care institutions in Tianjin as objects of study through convenient sampling.Results:The scores for nursing competence of dementia caregivers were 140.28±7.73,at a moderate level.Study findings that nursing competence of dementia caregivers were positively associated with the work experience(β=0.115,P=0.005),educational level(β=0.333,P<0.01),pervdceived health status(β=0.108,P=0.003)and training times within 1 year(β=0.371,P<0.01).Through the analysis,it is found that the training needs of dementia caregivers are inconsistent with the current situation in terms of content,methods and teachers.There are some problems in the training,such as unreasonable time,single mode and not deepening the understanding of the elderly with dementia.Conclusion:Long term care institutions shall arrange training no less than 12 times a year and evaluate training needs regularly to improve training effect.Providing online and offline training and adding more specialized contents like case analysis,employing experts in the field of dementia to teach courses.

Rational-emotive behavioral intervention helped patients with cancer and their caregivers to manage psychological distress and anxiety symptoms

There is a dearth of evidence-based data on how psychological distress and death anxiety symptoms experienced by cancer patients and caregivers are treated in developing regions. This article sheds light on the report of the findings from a 2016 study that revealed a rational-emotive behavioral intervention helped a select group of cancer patients and their family caregivers to manage problematic assumptions, psychological distress, and death anxiety symptoms in Nigeria.Based on my experience as a co-investigator and corresponding author of this previous study, I addressed the challenges of conducting such a study and the implications for future research in this article. This article encourages future researchers to replicate the study and endeavor to overcome the limitations of the previous study. Funders were also encouraged to ensure increased access to funds for conducting similar studies with cancer patients and their family caregivers in developing countries and other parts of the world.

Coping strategies of family caregivers of patients with schizophrenia in Iran: A cross-sectional survey

Objectives: This study aimed to identify coping strategies used by family caregivers of patients with schizophrenia and their determinants.Methods: This was a descriptive correlational study.Participants were 225 family caregivers of patients with schizophrenia who were referred to the psychiatric clinic at one large teaching referral hospital in Iran.They were selected through purposive sampling method.Data collection tools were demographic and clinical data form,the Zarit Burden Interview (ZBI) and the Family Coping Questionnaire (FCQ).Results: The score of caregiver burden was 65.14 ± 9.17.Of 225 family caregivers,23.11% used an avoiding coping strategy.There was a significant relationship between caregiver burden and coping strategies (P < 0.001).The regression model showed that adaptive coping strategies were significantly associated with some demographic characteristics including age,education level,gender,employment status,losing the job because of caregiving responsibilities,perceived income adequacy,duration of illness,duration of caregiving and caregiver burden (P < 0.05).Conclusion: Family caregivers of patients with schizophrenia experience a high level of burden,which can put them at risk of using maladaptive coping strategies.Mental health professionals should plan programs that support both family caregivers and patients in clinical and community settings.

The investigation of care burden and coping style in caregivers of spinal cord injury patients

Purpose:The level of care burden experienced by caregivers of patients with spinal cord injury and their coping style were evaluated in order to identify ways to improve their capacity to respond and reduce the care burden.Methods:A convenience sampling method was used to select 150 spinal cord injury patients who were discharged from the Second and the Third Affiliated Hospital of Nanchang University and their primary caregivers.The Chinese version of the Zarit Caregiver Burden Interview and the Simplified Coping Style Questionnaire were distributed to assess caregiver burden and coping strategies.Results:The care burden score of the caregivers of patients with spinal cord injury was 52.91
11.56 points.Eighty-eight percent of caregivers reported moderate or severe care burden levels.The largest proportion of caregivers were female spouses,who were less likely to use an active coping strategy.A negative coping strategy was more frequently used by caregivers compared to healthy adults,and was positively correlated with burden of care.In contrast,a negative correlation was found between the care burden and an active coping style.Conclusion:Primary caregivers of spinal cord injury patients report a heavy burden of care.As active coping strategies are more beneficial,medical care providers should encourage caregivers to make more use of these coping styles to promote physical and mental health for themselves,their patients and their family,as well as to improve the quality of care provided.

Training program for caregivers to prevent pressure ulcers among elderly residents at geriatric homes

Objectives:Pressure ulcer(PU)is one of the most common problem among the bedridden elderly and has significantly more burden on elderly and caregivers.This study is aimed to evaluate the effects of the training program for caregivers to prevent PUs among elderly residents at geriatric homes.Methods:A quasi-experimental design was used to carry out the current study.A purposive sample comprised of all formal(39 nurses)or informal caregivers(39)and all immobilized elderly residents(35)who are found in all geriatric centers in Helwan district.A structured questionnaire was used to assess caregivers’socio-demographic characteristics,knowledge,attitude,and observational checklists for their practice for prevention of PU at pre-and posttest and during follow-up.Results:After the training program,there were improvements in the level of knowledge,practice,and positive attitude of caregivers about PU prevention with a statistically significant difference between pre-,post-,and follow-up training programs(P<0.001).Conclusions:The study revealed that the training program seemed to change the knowledge,practice,and attitude of the subjects to PU prevention.This,in turn,implies that adequate knowledge affects directly the elderly caregivers’attitudes as well as practice for prevention could be important in reducing the burden of PU among the elderly.Thus,conducting a training program for caregivers at different geriatric homes about caring skills for elders can prevent PU,and using spontaneous reposition is very effective to prevent PUs.