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.

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.

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.

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.

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.

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.

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.

Assessment of burden and coping strategies among caregivers of cancer patients in sub-Saharan Africa

BACKGROUND Cancer is a devastating and debilitating chronic disease that affects both patients and family members.Available evidence has confirmed that the care of chronically ill relatives by family members can be very challenging.This is because caregiving of cancer patients often presents a high level of burden on the caregivers.Consequently,this leads to a necessity to adopt coping mechanisms to cushion the effect of the burden experienced during caregiving.AIM To determine the burden experienced and coping strategies among caregivers of advanced cancer patients attending University of Calabar Teaching Hospital(UCTH),Cross River State,Nigeria.METHODS The study adopted a descriptive cross-sectional study design and the study population included informal family caregivers providing services to histologically diagnosed advanced cancer patients receiving treatment at the UCTH at the time of this survey.A researcher-developed structured questionnaire,a 22-item standardized validated Zarit Burden Interview(ZBI)and a modified 17-item Coping Orientation to Problems Experienced(COPE)Inventory were used to collect data from 250 eligible informal caregivers who were selected with regard to caregiver’s characteristics,caregivers’level of burden and caregiver’s coping strategies,respectively.Data gathered from the respondents were collated,coded and analyzed using Statistical Package for Social Sciences(SPSS version 24.0)software and Predictive Analytical Software(PAS version 19.0).Chi-square was used to test for association between categorical variables at the 0.05 level of significance.The results are presented in tables and charts.RESULTS The respondents consisted of more females 132(62.86%)than males 78(37.14%).The majority of respondents(46.2%)were aged between 31-50 years with a mean age of 35.9±18.1 years.The assessment of burden level revealed that 97 caregivers(46.19%)experienced severe burden,37(17.62%)experienced trivial or no burden,while 76(36.2%)perceived moderate burden.The coping strategies used by caregivers to ease the level of burden experienced during caregiving included;acceptance,reprioritization,appreciation,family,positive self-view and empathy.Also,it was documented that there was a strong association between caregivers’level of burden and coping strategies(P=0.030).Findings also showed that age(P=0.000),sex(P=0.000),educational status(P=0.000),functional ability(P=0.000),duration of care(P=0.000),desire to continue caregiving(P=0.000)and type of cancer(P=0.000)were statistically significantly associated with caregivers’coping strategies.CONCLUSION There is great recognition of the role of informal caregivers in improving the health of their relatives and family members who are chronically ill.It was recommended that support groups in collaboration with health care providers should organize a symposium for informal caregivers on the intricacies of caregiving in chronically ill patients.This would create a platform for experience sharing,information dissemination and health care professional-caregiver interaction to enhance positive caregiving outcomes.

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.

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.

The burden of depression,anxiety and schizophrenia among the older population in ageing and aged countries:an analysis of the Global Burden of Disease Study 2019

Background Depression,anxiety and schizophrenia among older persons have become global public health challenges.However,the burden of these disorders in ageing and aged countries has not been analysed.Aims To investigate the burden of depression,anxiety and schizophrenia among older adults in ageing and aged countries.Methods Using data from the Global Burden of Disease Study 2019,we calculated the estimated annual percentage change(EAPC)in the age-standardised incidence rates(ASiR)and age-standardised disability-adjusted life years(DALYs)rates(ASDR)for depression,anxiety and schizophrenia of older people in ageing countries(China,India,Indonesia)and aged countries(Japan,Italy,Portugal)between 1990 and 2019.Trends in incidence and DALYs were analysed by gender and age.Results In 2019,the highest incidence of depression,anxiety and schizophrenia in the older population in aged countries was in Japan(927271.3(752552.3-1125796.5),51498.2(37625.7-70487.3)and 126.0(61.0-223.2),respectively),while the highest incidence in ageing countries was in China(5797556.9(4599403.4-7133006.5),330256.1(246448.9-445987.4)and 1067.7(556.2-1775.9),respectively).DALYs for these disorders were similar,with the highest in Japan and China.From 1990 to 2019,the ASIR for depressive disorders decreased in aged countries but increased in ageing countries;the ASIR for anxiety disorders and schizophrenia declined in both ageing and aged countries.The ASDR for depressive disorders was consistent with the ASIR but not for anxiety disorders and schizophrenia.The ASIR for depressive disorders was higher in older women,while the opposite was observed in anxiety disorders and schizophrenia.Notably,the conditions of burden of depressive disorders,anxiety disorders and schizophrenia in the 65-70-year-old age group were the most burdensome.Conclusions The incidence and DALYs of these three mental disorders increased while exhibiting differences between ageing and aged countries.Raising awareness about formulating health policies for preventing and treating mental disorders in the older population is necessary to reduce the future burden posed by the ageing challenge.

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.

Impact of living with bipolar patients: Making sense of caregivers' burden

The aim of the present review was to examine objective and subjective burdens in primary caregivers(usually family members) of patients with bipolar disorder(BD) and to list which symptoms of the patients are considered more burdensome by the caregivers. In order to provide a critical review about caregiver's burden in patients with bipolar disorder, we performed a detailed Pub Med, Bio Med Central, ISI Web of Science, Psyc INFO, Elsevier Science Direct and Cochrane Library search to identify all papers and book chapters in English published during the period between 1963 and November 2011. The highest levels of distress were caused by the patient's behavior and the patient's role dysfunction(work, education and social relationships). Furthermore, the caregiving role compromises other social roles occupied by the caregiver, becoming part of the heavy social cost of bipolar affective disorder. There is a need to better understand caregivers' views and personal perceptions of the stresses and demands arising from caring for someone with BD in order to develop practical appropriate interventions and to improve the training of caregivers.

Burden among caregivers for children with asthma:A mixed-method study in Guangzhou,China

Objective:Research suggests that caregivers of children with asthma experience a substantial amount of stress,though no comprehensive study examines this problem.Here we both quantitatively and qualitatively examined the burden on caregivers of children with asthma.Methods:Surveys were administered to 138 caregivers of asthmatic children by convenience sampling.The Zarit Caregiver Burden Interview(ZBI)was used to assess the degree of caregiver burden.In addition,13 qualitative semi-structured interviews were carried out via purposive sampling and were used to explore the perception of caregivers.SPSS and content analysis were used to analyze quantitative and qualitative data,respectively.Results:We found that caregiver burden(mean=31.56±14.19)ranged from 24%with no or mild burden,52%with mild to moderate burden,22%with moderate to severe burden and 2%with very severe burden.Caregiver burden was also assessed as 5 different dimensions.Selfcriticism ranked most burdensome(2.09±1.05),followed by sacrifice(1.57±0.94),embarrassment/anger(1.30±0.80),dependency(1.21±0.77),and lastly,loss of control(1.20±0.84).The highest individually scored item on the ZBI was“fear of the future of the relative”(mean=3.04).Interviews of caregiver burden were summarized into three main themes,namely:1)life is too chaotic;2)negative emotions;and 3)gaps in themedical support system.Conclusions:These findings expand our understanding about the burden caregivers of children with asthma face,and may help to propose targeted strategies to help caregivers adapt to their roles,and maintain and promote the health of themselves and their families.

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.

Burden of gallstone disease in the United States population:Prepandemic rates and trends

BACKGROUND Gallstone disease is one of the most common digestive disorders in the United States and leads to significant morbidity,mortality,and health care utilization.AIM To expand on earlier findings and investigate prepandemic rates and trends in the gallstone disease burden in the United States using national survey and claims databases.METHODS The National Ambulatory Medical Care Survey,National Inpatient Sample,Nationwide Emergency Department Sample,Nationwide Ambulatory Surgery Sample,Vital Statistics of the United States,Optum Clinformatics®Data Mart,and Centers for Medicare and Medicaid Services Medicare 5%Sample and Medicaid files were used to estimate claims-based prevalence,medical care including cholecystectomy,and mortality with a primary or other gallstone diagnosis.Rates were age-adjusted(for national databases)and shown per 100000 population.RESULTS Gallstone disease prevalence(claims-based,2019)was 0.70%among commercial insurance enrollees,1.03%among Medicaid beneficiaries,and 2.09%among Medicare beneficiaries and rose over the previous decade.Recently,in the United States population,gallstone disease contributed to approximately 2.2 million ambulatory care visits,1.2 million emergency department visits,625000 hospital discharges,and 2000 deaths annually.Women had higher medical care rates with a gallstone disease diagnosis,but mortality rates were higher among men.Hispanics had higher ambulatory care visit and hospital discharge rates compared with Whites,but not mortality rates.Blacks had lower ambulatory care visit and mortality rates,but similar hospital discharge rates compared with whites.During the study period,ambulatory care and emergency department visit rates with a gallstone disease diagnosis rose,while hospital discharge and mortality rates declined.Among commercial insurance enrollees,rates were higher compared with national data for ambulatory care visits and hospitalizations,but lower for emergency department visits.Cholecystectomies performed in the United States included 605000 ambulatory laparoscopic,280000 inpatient laparoscopic,and 49000 inpatient open procedures annually.Among commercial insurance enrollees,rates were higher compared with national data for laparoscopic procedures.CONCLUSION The gallstone disease burden in the United States is substantial and increasing,particularly among women,Hispanics,and older adults with laparoscopic cholecystectomy as the mainstay treatment.Current practice patterns should be monitored for better health care access.

High-chromium vanadium-titanium magnetite all-pellet integrated burden optimization and softening-melting behavior based on flux pellets

High-chromium vanadium-titanium magnetite(HVTM)is a crucial polymetallic-associated resource to be developed.The allpellet operation is a blast furnace trend that aims to reduce carbon dioxide emissions in the future.By referencing the production data of vanadium-titanium magnetite blast furnaces,this study explored the softening-melting behavior of high-chromium vanadium-titanium magnetite and obtained the optimal integrated burden based on flux pellets.The results show that the burden with a composition of 70wt%flux pellets and 30wt%acid pellets exhibits the best softening-melting properties.In comparison to that of the single burden,the softening-melting characteristic temperature of this burden composition was higher.The melting interval first increased from 307 to 362℃and then decreased to 282℃.The maximum pressure drop(ΔPmax)decreased from 26.76 to 19.01 kPa.The permeability index(S)dropped from 4643.5 to 2446.8 kPa·℃.The softening-melting properties of the integrated burden were apparently improved.The acid pellets played a role in withstanding load during the softening process.The flux pellets in the integrated burden exhibited a higher slag melting point,which increased the melting temperature during the melting process.The slag homogeneity and the TiC produced by over-reduction led to the gas permeability deterioration of the single burden.The segregation of the flux and acid pellets in the HVTM proportion and basicity mainly led to the better softening-melting properties of the integrated burden.

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.

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.