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.

Caregiving in Asia:Priority areas for research,policy,and practice to support family

Population aging presents a growing societal challenge and imposes a heavy burden on the healthcare system in many Asian countries.Given the limited availability of formal long-term care(LTC)facilities and personnel,family caregivers play a vital role in providing care for the increasing population of older adults.While awareness of the challenges faced by caregivers is rising,discussions often remain within academic circles,resulting in the lived experiences,well-being,and needs of family caregivers being frequently overlooked.In this review,we identify four key priority areas to advance research,practice,and policy related to family caregivers in Asia:(1)Emphasizing family caregivers as sociocultural navigators in the healthcare system;(2)addressing the mental and physical health needs of family caregivers;(3)recognizing the diverse caregiving experiences across different cultural backgrounds,socioeconomic status,and countries of residence;and(4)strengthening policy support for family caregivers.Our review also identifies deficiencies in institutional LTC and underscores the importance of providing training and empowerment to caregivers.Policymakers,practitioners,and researchers interested in supporting family caregivers should prioritize these key areas to tackle the challenge of population aging in Asian countries.Cross-country knowledge exchange and capacity development are crucial for better serving both the aging population and their caregivers.

Positive aspects of caregiving in schizophrenia: A review

Schizophrenia is a severe mental illness which is associated with significant consequences for both the patients and their relatives. Due to chronicity of the illness, the relatives of patients of schizophrenia have to bear the main brunt of the illness. Studies across the world have evaluated various aspects of caregiving and caregivers such as burden, coping, quality of life, social support, expressed emotions, and psychological morbidity. In general the research has looked at caregiving as a negative phenomenon, however, now it is increasingly recognised that caregiving is not only associated with negative consequences only, also experience subjective gains and satisfaction. This review focus on the conceptual issues, instruments available to assess the positive aspects of caregiving and the various correlates of positive aspects of caregiving reported in relation to schizophrenia. The positive aspect of caregiving has been variously measured as positive caregiving experience, caregiving satisfaction, caregiving gains and finding meaning through caregiving scale and positive aspects of caregiving experience. Studies suggests that caregivers of patients with schizophrenia and psychotic disorders experience caregiving gains(in the form of becoming more sensitive to persons with disabilities, clarity about their priorities in life and a greater sense of inner strength), experience good aspects of relationship with the patient, do have personal positive experiences. Some of the studies suggest that those who experience greater negative caregiving experience also do experience positive caregiving experience.

Distance caregiving a family member with cancer:A review of the literature on distance caregiving and recommendations for future research

Distance caregivers(DCGs) are a growing phenomenon in the United States Family members are struggling to provide care to loved ones with chronic illnesses such as cancer,from a distance.Unlike local caregiving research,distance caregiving research is limited and inconsistent definitions of distance make it difficult to compare studies.To date,DCGs have not been afforded the opportunities for educational and emotional support that local caregivers have received from the health care teams.Because they are not usually present at medical appointments,DCGs do not receive first-hand information from the health care team about the patient's condition,disease progression,and/or treatment options.These caregivers report feeling left out of important family discussions.They experience anxiety related to the uncertainty of the family members' well-being and guilt related to not being available to help local caregivers more.The challenges of distance caregiving are especially evident when the distance caregiver has a parent with advanced cancer.Family-centered care,attending to the needs of the whole family regardless of their geographic location is critical for quality cancer care.In this manuscript,the sparse literature on distance caregiving is reviewed.Recommendations for future research and for the development of creative technologically advanced interventions for this underserved caregiving population are suggested.

Caregiving in Alzheimer’s Disease: Research Designs &Considerations

Alzheimer’s disease and related dementias have made a considerable impact on society, and can take a significant toll on familial caregivers. Recent successful caregiving interventions suggest a promising future, though informed research design, a priori, is paramount in ensuring quality results that the Government and public may use to make informed policy and personal healthcare decisions. Research designs including basic science, randomized controlled trials (RCTs), qualitative, and quasi-experimental designs serve as the primary basis for discussion with literary examples and caveats.

Caregiving, Family Burden and Medication Adherence

Caregivers are an essential component of any community. Advances in medicalcare have brought about an increasing population which is reliant on care, and communities deal with most of the burdens and practicalities of public health issues. In order to provide efficient support services, we need to know the challenges of caregivers so that we can address what types of support they require. The current study examines whether those who have a mental health difficulty and are either engaged in caregiving duties or perceive family burden may be less adherent to their medications in comparison with those who also have a mental health difficulty but do not perceive family burden or perform caregiving. Data used was from the National Comorbidity Study Replication (NCS-R), which examines the mental health profile of the American population. The group examined were those who received the family burden interview, and indicated that they were taking a prescription medication for a mental health difficulty under the supervision of a health professional (N = 489). Zero inflated Poisson regression showed that caregiving/family burden was unrelated to adherence to supervised prescription medicines for mental health difficulties, regardless of the kinship of who was ill, or the nature of their illness (physical versus mental). Adherence to prescription medications for mental health difficulties does not appear to be one of the challenges faced by this group. Findings are discussed in terms of the economic and moral importance of health professionals identifying and understanding the challenges experienced by caregivers/those reporting family burden. This is necessary so that appropriate interventions and support services can be targeted, and further research plays an important role in achieving this objective.

Long-Term Impact of Caregiving and Metabolic Syndrome with Perceived Decline in Cognitive Function 8 Years Later: A Pilot Study Suggesting Important Avenues for Future Research

The chronic stress of caregiving has been associated with increased risk for cognitive decline and dementia. One theoretical model suggests that a group of risk factors known as the metabolic syndrome MET_SYN (e.g., hypertension, poor glucose regulation, central obesity, and high triglyceride levels) that have demonstrated associations with both stress and cognitive decline, may mediate the association between caregiver stress and cognitive decline. It is also possible that caregiving may moderate the association between MET_SYN and cognitive decline. The present study examined these two potential models. The study sample consisted of 53 caregivers for a relative with dementia and 24 participants who did not have caregiving responsibilities at baseline. We examined associations among caregiving history (yes/no), self-reported decline in cognitive function (the AD8) at follow-up, and a MET_SYN factor comprised of increased systolic blood pressure (SBP), glycosylated hemoglobin concentration (HbA1c), waist circumference, and triglyceride levels at baseline when caregiving was assessed. MET_SYN was associated with AD8 (p = 0.010). Caregiving history was not directly associated with AD8 ratings, however, caregiving did moderate the association between MET_SYN and AD8 (p = 0.043) assessed 8 years later. In caregivers MET_SYN scores reflecting higher risk were associated with scores on the AD8 indicting decline, whereas, in controls MET_SYN was unrelated to AD8 assessment. Thus, it can be concluded that caregiver stress may increase the association between metabolic risk factors and decline in cognitive functioning up to 8 years later.

Interaction between Caregiving Ability and Home Discharge Using Severity Classification upon Discharge

Background: The interaction between self-care and caregiving ability in home discharged stroke patients is unclear. Purpose: This study investigates the interaction between caregiving ability and individual self-care activities for post-stroke patients upon home discharge based on their motor-Functional Independence Measure (m-FIM) score. Methods: A total of 2626 stroke patients registered in the Japanese Rehabilitation Database were retrospectively analyzed. Extracted data were divided into three groups based on the m-FIM score at discharge and classified into two groups based on their discharge destination (home discharge, non-home discharge). After the data were modified as mean-centered values, a hierarchical multiple regression analysis evaluated the change in variance amount (ΔR2) using discharge destination as the dependent variable. Model 1 used two independent variables (Rankin Scale and cognitive FIM score), model 2 used two independent variables (caregiving ability and individual self-care), which were added to model 1, and model 3 used an interaction term value, which was added to model 2. Furthermore, a simple slope analysis was performed for these interaction effects. Results: The ΔR2 exhibited six and five self-care items in the moderate and mild groups, respectively. The interaction was significant on simple slope analysis in the moderate group for six self-care items (except dressing upper body, toileting, and bowel management) and in the mild group for three self-care items, including dressing upper body, bladder management, and climbing stairs). Conclusion: This study suggests the need for intervention, especially bladder management and single-foot standing ability during step climbing, in stroke patients discharged to home. In addition, caregiving ability is one of the factors that should be considered in mild group.

Coping and Caregiving-Satisfaction among Caregivers of Patients with Cancer at the Uganda Cancer Institute and Mbarara Regional Referral Hospital in Uganda

This study aimed at investigating the relationship between coping and caregiving satisfaction among informal cancer caregivers in Ugandan referral hospitals. A convenient sample of 436 consenting informal care givers aged 18 years and above were interviewed;a cross-sectional design was used. Because of the difficulty in defining a fixed population for this category of care givers, whoever was found at the bed side meeting the inclusion and exclusion criteria were recruited into the study. A tri-dimensional coping scale (namely;problem solving, denial and venting) was used to measure coping. After controlling for all the relevant covariates (Patient’s age, sex of care giver, education of caregiver, respondent’s age, respondent’s education level, respondent’s education, respondent’s country of origin, respondent’s religion, stage of cancer, score on burnout scale), the venting aspect of coping had a significant effect on caregiving satisfaction (F = 1.83, P-value = 0.03). The above covariates accounted for 41.3% of the variability in care giving satisfaction scores (R2 = 0.413). Venting as a coping mechanism had a significant effect on caregiving satisfaction. There is need to pay attention to the coping strategies of informal cancer caregivers to enhance their care giving experience. There is need to help caregivers develop healthy coping methods as they participate in cancer care.

Reliability and validation of the Positive Aspects of Caregiving scale among Japanese caregivers of people with dementia

Objectives:This study aimed to validate the Positive Aspects of Caregiving(PAC)scale's psychometric properties among Japanese informal caregivers of people with dementia.Methods:A cross-sectional research design was used.Data were collected from the Kinki region of Japan during January 2019 and July 2019.Translation and back-translation were performed to acquire the optimal translation of the PAC scale.In total,194 participants responded to questionnaires that included the Japanese version of the PAC scale and the Geriatric Depression Scale(GDS).Reliability was evaluated by examining the internal consistency and test-retest reliability.Exploratory factor analysis with maximum likelihood estimation and oblique rotation was performed to assess the PAC scale structure.Concurrent validity was determined using Pearson's correlation coefficient.Results:The final version of the Japanese version of the PAC scale contained nine items.Exploratory factor analysis revealed two factors(Living an enriched life and Self-usefulness).The Cronbach's α coefficient of the total scale was 0.895,the subscales Cronbach's α coefficient were 0.896 and 0.823.The intraclass correlation coefficient for test-retest reliability was 0.721,indicating acceptable reliability.PAC was significantly correlated to GDS(r=—0.54&P<0.01).Conclusions:This study found that the Japanese version of the PAC scale was a suitable scale to measure PAC among Japanese caregivers of people with dementia.However,the construct differed from the original model.This scale could help health-care professionals understand the degree of caregivers'recognition about dementia care and support those with a low degree of positive aspects of caregiving.

Informal caregivers'quality of life and management strategies following the transformation of their cancer caregiving role:A qualitative systematic review

Objectives:Globally,informal caregivers caring for cancer patients meet challenges within their caregiving role,which significantly influence their quality of life.This qualitative systematic review aimed to analyze how cancer caregiving influence the quality of life of informal caregivers and the management strategies of informal caregivers for their role as cancer caregivers.Methods:Following the enhancing transparency in reporting the synthesis of qualitative research(ENTREQ)statement,Wanfang database,the China National Knowledge Infrastructure(CNKI),CINAHL,MEDLINE,PubMed,Cochrane Library,PsycARTICLES and PsycINFO,and grey literature in English and Chinese from 1 May 2009 to 31 December 2019 were searched.Quality of included studies was assessed by the Critical Appraisal Skills Programme(2018)Qualitative Checklist and thematic synthesis was conducted.Results:Of the 8,945 studies identified,6 studies met the inclusion criteria.One analytical theme relating to the QoL of informal caregivers following cancer caregiving was identified:"challenges of caregiving".In terms of the management strategies to the role of cancer caregivers,two analytical themes were identified:"self-adjustment"and"seeking for formal and informal support".Conclusions:Cancer caregiving influences informal caregivers'QoL significantly and informal caregivers develop diverse coping strategies to deal with the difficulties occurred while balancing the relationship between their own lives and caregiving.However,professional and policy support remain inadequate for informal caregivers that require the need for improvement in terms of health care professionals and policymakers.

The impact of an educational intervention in caregiving outcomes in Jordanian caregivers of patients receiving hemodialysis: A single group pre-and-post test

Objectives:Chronic renal failure affects the physiological,psychological,functional ability,and independent status of the patient,which might result in a burden to the family members caring for them.The objective of the study was to identify caregivers'level of burden and establish the impact of educational intervention programs on caregiving outcomes.Methods:This was a one-group pre-test post-test study conducted between April and August 2017 on family caregivers of hemodialysis patients.A convenient sample of 169 caregivers was used.A sociodemographic questionnaire,the OBCS,and BCOS were utilized for data collection,which occurred at baseline and two weeks post-intervention.The collected data were analyzed using SPSS where t-test determined the impact of the intervention.Results:Caregivers were found to be moderately burdened(M=2.73,SD=0.23)and their lives had changed for the worst as a result of caregiving(M=3.17,SD=5.89).There were significant differences in caregiving outcome scores before and after the intervention(P<0.05).Conclusion:Caring for patients receiving hemodialysis adds extra responsibilities to the caregivers'schedule thus leaving them substantially burdened.Educating caregivers on the required care eased their burden and improved caregiving outcomes.Recommendations are made that healthcare professionals should assess caregiver burden,and address their physical and mental health needs.Caregivers should also be regularly educated on the regular caregiving tasks to ease their burden.

Informal Caregiving for Persons with Chronic Conditions: Trends and Considerations

Aging adults with chronic conditions rely heavily on an informal network of caregivers to remain within their communities of choice. This reliance can take a significant toll on caregivers through the lens of physical and psychological problems, financial issues, and social isolation. These variables may then lead to less desirable outcomes for care recipients. This review highlights existing support services in their many forms, including: psychosocial interventions, environmental interventions, respite care, and health information technology as a method of delivery. Given the current trend with informal caregivers assuming increased responsibility in healthcare, programs and services supporting these caregivers must be understood and trialed to ensure that their needs are not overlooked.

Surgery and Caregiving: Loneliness of the Patients and Those Who Care for Them

This research, conducted on patients and caregivers, examined the qualitative aspects of their loneliness. Patients were divided into those who were approached before they had surgery, and those post operatively. We collected information about their tumors, which were either benign or malignant. The patients’ loneliness was compared to their caregivers who were either intimate partners or “others”, i.e. family members and friends. The loneliness questionnaire, has already been extensively utilized in previous studies, and was used to explore the various aspects of loneliness of those groups. Significant differences in subscale scores were found in patients pre and post surgery, with those who have already had surgery scoring higher. Additionally, those who were cared for by a partner scored lower on the loneliness subscales than those attended to by “other”. Interestingly, the only significant difference in the caregiver group was between men and women, in line with the socialization process of the genders, which makes women more open and vocal about their feelings and needs.

Informal Caregiving and Disaster Risk Reduction:A Scoping Review

Informal caregivers are a population currently in the shadows of disaster risk reduction(DRR),and yet essential to the provision of healthcare services.This scoping review explored the literature to understand issues related to informal caregiving and promising practices to support resilience for disasters.Following guidelines for scoping review as outlined by Tricco et al.(2016),relevant publications were identified from five major databases—Medline,Embase,PubMed,Web of Science,and Scopus.Relevant studies referenced informal caregiving and disasters for a variety of population groups including children,people with disabilities or chronic illnesses,and older adults.Studies were excluded if they discussed formal caregiving services(for example,nursing),lacked relevance to disasters,or had insufficient discussion of informal caregiving.Overall,21 articles met the inclusion criteria and were fully analyzed.Five themes were identified:(1)the need for education and training in DRR;(2)stressors around medication and supply issues;(3)factors affecting the decision-making process in a disaster;(4)barriers leading to disaster-related problems;and(5)factors promoting resilience.Recommended areas of strategic action and knowledge gaps are discussed.Many informal caregivers do not feel adequately prepared for disasters.Given the important role of informal caregivers in healthcare provision,preparedness strategies are essential to support community resilience for those requiring personal care support.By understanding and mobilizing assets to support the resilience of informal caregivers,we also support the resilience of the greater healthcare system and the community,in disaster contexts.

Optimizing dialysis modalities for diabetic end-stage kidney disease: A focus on personalized care and resource-limited settings

Diabetes is the leading cause of chronic kidney disease(CKD)and end-stage kidney disease(ESKD)worldwide.While both haemodialysis(HD)and peritoneal dialysis(PD)are commonly used treatment options for ESKD,the choice of dialysis modality in diabetic ESKD patients remains a critical decision influenced by various patient-related,healthcare system,and socio-economic factors.This article examines the factors influencing the selection of dialysis modalities for diabetic patients,with a focus on the challenges and opportunities in low-resource settings.Key considerations include the impact of comorbidities such as peripheral arterial disease and CKD-related mineral bone disorder(MBD),as well as patient preferences,caregiver burden,and the availability of healthcare infrastructure.The article highlights the need for personalized approaches to dialysis selection,considering both clinical outcomes and quality of life.It also emphasizes the potential benefits of home dialysis,including home HD and PD,in improving patient autonomy and long-term survival.The article advocates for better government policies,increased awareness,and improved support systems to enhance the accessibility and efficacy of dialysis treatments,particularly in underserved populations.Further research comparing the outcomes of different dialysis modalities across diverse settings is essential to guide global treatment strategies for diabetic ESKD patients.

Perspectives and Challenges of Family Members in Providing Mental Support to Cancer Patients:A Qualitative Study in Beijing,China

This study explores the perspectives and challenges faced by family members providing mental support to cancer patients in Beijing,China.The primary objective is to understand the emotional and practical roles family members undertake and the difficulties they encounter.Utilizing a qualitative research design,data were collected through semi-structured interviews with family caregivers of cancer patients.Thematic analysis revealed several key themes:the dual burden of emotional support and caregiving responsibilities,the impact on daily life and personal well-being,the role and effectiveness of external support systems,perceptions of medical staff support,and the common challenges and conflicts faced in caregiving.The findings highlight the critical need for comprehensive support systems that address both the emotional and practical needs of family caregivers.Recommendations for enhancing family-centered support programs in oncology settings are discussed.

Modern Ideas of Caring in Nursing Practices

For effective nursing practice,it is essential to have a strong foundation in ethical principles and a shared understanding of nursing and caring concepts.Emphasizing compassion in nursing is crucial.This study aimed to elucidate the core ideals of compassion,ethics,and care in nursing practice.Nurses can foster a deeper sense of personal significance in their caregiving relationships by demonstrating attentiveness,openness,and respect and treating each patient as an individual.Through self-reflection,nurses can develop a greater understanding of nursing,compassion,and ethical principles within the caregiving context.This reflective practice enables nurses to connect more profoundly with their patients,enhancing the quality of care.By integrating these core ideals into their practice,nurses not only improve patient outcomes but also find greater personal fulfilment in their professional roles.Thus,cultivating compassion and ethical awareness is fundamental to the holistic and effective practice of nursing.

Factors influencing the employed caregiver burden for patients with dementia residing in nursing homes:A cross-sectional study from China

Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,this study aimed to examine the relationship between basic attributes,caring ability,and caregiver burden in employed caregivers practicing in nursing homes.Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022.Caregiver burden was assessed using the Zarit Burden Interview(ZBI).Demographic characteristics of participants,characteristics of the older patients with dementia,caring characteristics,training in dementia care,and caring abilities were collected for analysis of influencing factors.A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes.Results:The ZBI score of employed caregivers in nursing homes was 40.42±10.18,representing a moderate caregiver burden.Factors such as age(U=27.82,P<0.001),residence(U=7.89,P<0.001),educational level(H=55.81,P<0.001),self-care of older patients with dementia(H=85.21,P<0.001),daily care hours(H=73.25,P<0.001),number of older people with dementia cared for(H=14.56,P<0.012)and training in dementia care(U=-9.43,P<0.001)were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden(r=-0.22,P<0.01).Furthermore,after controlling for demographic characteristics,the characteristics of older people with dementia,caring characteristics,training in dementia care,and caring ability explained 8.5%,5.8%,and 4.8%of the caregiver burden,respectively.Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors.We recommend tailored interventions,such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers.

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.