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.

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.

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.

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.

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.

Assessing Barriers to Mental Healthcare Interventions for Deaf People in Ghana

While mental health issues are increasingly gaining attention in Ghana, little is known about the situation among deaf people. This study assessed the mental health care needs of deaf people in Ghana. A descriptive design, consisting of interviews and focus group discussions, was used to collect data from 97 participants. Findings indicated that participants had limited knowledge on mental health issues. Mental health stigma, inaccessible mental health information and exclusion from mental health programmes were the major barriers hindering access to mental health care services. This study bridges the knowledge gap and provides evidence for the implementation of deaf-friendly services.

Perception and Management of Hemorroid Disease at the CSREF of the Commune Bamako Mali

This work was a prospective transversal study over 6 (six) months from May 2 to December 31, 2017 at the Reference Health Center of Commune I and the Chérif la Confessional Health Center in Bamako. The aim was to study the knowledge, attitudes and behavioral practices linked to hemorrhoids in Commune I of the Bamako district, to evaluate the frequency of hemorrhoidal disease, to determine the knowledge, attitudes and behavioral practices linked to hemorrhoids among patients, their companions and traditional therapists in Commune I of the district of Bamako and the factors which influence the motivations and decisions to resort to medical-surgical care and traditional medicine in patients suffering from hemorrhoids in order to analyze the results of the management of hemorrhoidal disease at Cs Ref CI. We collected 36 patients with hemorrhoidal disease, 25 caregivers and 15 traditional hemorrhoidal disease therapists. The sex ratio was 1.25 for patients;6.5 for traditional therapists and 1.5 for accompanying people. The average age of the patients was 32.75 years;49 years for traditional therapists and 28.76 years for those accompanying them. 55.6% of patients claim to know about hemorrhoidal disease;100% of traditional therapists and 80% of accompanying people. The dietary factor of hemorrhoidal disease was mentioned by 90% of patients;66.7% of traditional therapists and 100% of caregivers. Most patients initially resorted to traditional treatment out of fear of surgery and its after-effects. The patients were treated medically and surgically.

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.

How Music Intervention Lowered Participants’ Morning Cortisol—Qualitative Case Stories

Non-pharmacological interventions for improved home care of persons with dementia and their family caregiver are and will be increasingly important for society. A music intervention study was performed on persons with persons with dementia and family caregiver. The persons with dementia and family caregiver were instructed to choose a daily routine for joint listening to recorded music. They selected the music they were interested in from a menu. The intervention period lasted for two months. Both persons with dementia and family caregiver provided daily saliva samples for the assessment of stress-related steroid hormones. In previous reports we have reported that the morning cortisol levels decreased significantly among the family caregiver when the intervention group was compared to a control group. In the present study we report narratives from four dyads, two of whom with beneficial effects of the music intervention, one dyad with no clear beneficial effects and one dyad with mixed results. The narratives illustrate the strong cohesive effect that the joint music listening could have, leading to improved social functioning paralleled by decreased morning cortisol levels particularly in the family caregiver. The narratives also illustrate reasons for failed effects.

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.

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.

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.