Science.gov

Sample records for residents family caregivers

  1. Mixed Methods Research of Adult Family Care Home Residents and Informal Caregivers

    ERIC Educational Resources Information Center

    Jeanty, Guy C.; Hibel, James

    2011-01-01

    This article describes a mixed methods approach used to explore the experiences of adult family care home (AFCH) residents and informal caregivers (IC). A rationale is presented for using a mixed methods approach employing the sequential exploratory design with this poorly researched population. The unique challenges attendant to the sampling…

  2. Family Caregiver Alliance

    MedlinePlus

    ... on your schedule. Look for our launch soon! FAMILY CARE NAVIGATOR ─ Click on Your State AL AK ... Group) Smart Patients Caregivers Community In partnership with Family Caregiver Alliance Learn more Caregiver Research Caregivers exhibit ...

  3. La CLAve to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

    PubMed Central

    López, Steven R.; Kopelowicz, Alex; Solano, Susana; del Carmen Lara, Ma.; Foncerrada, Hector; Aguilera, Adrian

    2014-01-01

    The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons’ literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device—La CLAve (The Clue)—to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can identify psychosis in others, (c) attributions to mental illness, and (d) professional help-seeking. Assessments were conducted before and after administering the program to both community residents (n = 57) and family caregivers of persons with schizophrenia (n = 38). For community residents, the authors observed increases across the 4 domains of symptom knowledge, efficacy beliefs, illness attributions, and recommended help-seeking. For caregivers, increases were observed in symptom knowledge and efficacy beliefs. La CLAve is a conceptually informed psychoeducational tool with a developing empirical base aimed at helping Spanish-speaking Latinos with serious mental illness obtain care in a timely manner. PMID:19634968

  4. [Small-scale, homelike care environments for people with dementia: effects on residents, family caregivers and nursing staff].

    PubMed

    Verbeek, H; Zwakhalen, S M G; van Rossum, E; Kempen, G I J M; Hamers, J P H

    2013-12-01

    Institutional dementia care is increasingly directed towards small-scale and homelike care environments, in The Netherlands as well as abroad. In these facilities, a small number of residents, usually six to eight, live together, and normal daily household activities and social participation are emphasized. In a quasi-experimental study, we studied the effects of small-scale, homelike care environments on residents (n = 259), family caregivers (n = 206) and nursing staff (n = 305). We compared two types of institutional nursing care during a 1 year period (baseline assessment and follow-up measurements at 6 and 12 months): (28) small-scale, homelike care environments and (21) psychogeriatric wards in traditional nursing homes. A matching procedure was applied to increase comparability of residents at baseline regarding functional status and cognition. This study was unable to demonstrate convincing overall effects of small-scale, homelike care facilities. On our primary outcome measures, such as quality of life and behaviour of residents and job satisfaction and motivation of nursing staff, no differences were found with traditional nursing homes. We conclude that small-scale, homelike care environments are not necessarily a better care environment than regular nursing homes and other types of living arrangements should be considered carefully. This provides opportunities for residents and their family caregivers to make a choice which care facility suits their wishes and beliefs best.

  5. The Stress Process of Family Caregiving in Institutional Settings.

    ERIC Educational Resources Information Center

    Whitlatch, Carol J.; Schur, Dorothy; Noelker, Linda S.; Ejaz, Farida K.; Looman, Wendy J.

    2001-01-01

    Adapts Stress Process Model (SPM) of family caregiving to examine predictors of depression in a sample of caregivers (N=133) with demented relatives residing in suburban skilled nursing facilities. Results suggest that caregiver depression is closely linked to how well resident and caregiver adjust to the nursing home environment. (BF)

  6. Collecting saliva and measuring salivary cortisol and alpha-amylase in frail community residing older adults via family caregivers.

    PubMed

    Hodgson, Nancy A; Granger, Douglas A

    2013-12-18

    Salivary measures have emerged in bio-behavioral research that are easy-to-collect, minimally invasive, and relatively inexpensive biologic markers of stress. This article we present the steps for collection and analysis of two salivary assays in research with frail, community residing older adults-salivary cortisol and salivary alpha amylase. The field of salivary bioscience is rapidly advancing and the purpose of this presentation is to provide an update on the developments for investigators interested in integrating these measures into research on aging. Strategies are presented for instructing family caregivers in collecting saliva in the home, and for conducting laboratory analyses of salivary analytes that have demonstrated feasibility, high compliance, and yield quality specimens. The protocol for sample collection includes: (1) consistent use of collection materials; (2) standardized methods that promote adherence and minimize subject burden; and (3) procedures for controlling certain confounding agents. We also provide strategies for laboratory analyses include: (1) saliva handling and processing; (2) salivary cortisol and salivary alpha amylase assay procedures; and (3) analytic considerations.

  7. Empowering Family Caregivers: The Powerful Tools for Caregiving Program

    ERIC Educational Resources Information Center

    Boise, Linda; Congleton, Leslie; Shannon, Kathy

    2005-01-01

    "Powerful Tools for Caregiving" is an education program for family caregivers of older adults. Based on a self-efficacy model, the program empowers family caregivers to reduce negative effects of caregiving and to practice self-care. Through a train-the-trainer approach, professional and community volunteers were trained as class leaders and…

  8. Moving beyond caregiver burden: identifying helpful interventions for family caregivers.

    PubMed

    Sorrell, Jeanne M

    2014-03-01

    Family members serving as informal caregivers for loved ones often experience physical, psychological, emotional, social, and financial consequences that can be conceptualized as caregiver burden. As the number of older adults in our society continues to increase, there will be even more demand for family caregivers. It is important to move beyond a focus on the statistics and characteristics of caregiver burden and identify helpful interventions to reduce this burden. Interventions that decrease caregiver burden can enable family caregivers to delay placement of the individual in an institutional setting and improve quality of life for both the caregiver and care recipient.

  9. Family Caregiving or Caregiving Alone: Who Helps the Helper?

    ERIC Educational Resources Information Center

    Sims-Gould, Joanie; Martin-Matthews, Anne

    2007-01-01

    This study advances the understanding of family caregiving by examining the relationship between adult children caregivers and their helpers. Specifically, it focuses on examining "who helps whom" and extends analyses beyond the dyadic focus of caregiving in later life. The focus on helping and caregiving addresses the variety of…

  10. R. I. Caregivers. Caring: A Training Program for Family Caregivers.

    ERIC Educational Resources Information Center

    Rhode Island State Dept. of Elderly Affairs, Providence.

    This document presents a training manual to help caregivers who provide care to older family members and friends at home. The program, which offers a practical approach to caregiving and a realistic view of the aging process, is intended to clarify the problems confronting caregivers of older people, serve as a basic source manual for training…

  11. Widening the Generational Circle: Family Caregivers.

    ERIC Educational Resources Information Center

    Smith, Bert Kruger

    This document addresses the dilemma faced by families with an aging or disabled member and the stress associated with the role of family caregiver. Emotions experienced by family caregivers, especially when the caregiver is an adult child caring for an elderly or frail parent, are discussed and feelings of desertion, dependence, and sibling…

  12. [Dependent seniors: families and caregivers].

    PubMed

    Karsch, Ursula M

    2003-01-01

    This article focuses on health care for dependent seniors in relation to chronic illnesses. Expectations about family support for the dependent elderly are related to the role of family caregivers, but care requires support from the public and private sectors. Governments throughout the developed countries are examining their role in the provision of social welfare programs, especially in the public health sector. To recommend home care and family assistance, the context of changing family structures, the type of care needed, and professional follow-up must be taken into account.

  13. How Do Family Caregivers of Older People Give Up Caregiving?

    PubMed Central

    Mortazavi, Hamed; Peyrovi, Hamid; Joolaee, Soodabeh

    2015-01-01

    Background Population aging has social, economic and political consequences. Most family caregivers prefer to care for their family member older person with chronic disease at home. Despite traditional culture within Iranian families, in some cases, hospitalization of the elderly in nursing home is inevitable, and this affects the old person and his/her family. The aim of this study was to explain how Iranian family cargivers give up caring their older person with chronic condition at home. Methods A grounded theory approach was used to conduct the study. The study setting included four nursing homes under the auspices of Iran Welfare Organization. Fourteen participants were recruited through purposive sampling. Data were collected from December 2010 to March 2011 by Semi-structured interviews lasting about 17 to 95 minutes (average 52 minutes). Constant comparative analysis was used to analyze the data. Results Three main categories appeared at the end of the analysis: “going out of the road of usual life”, “challenge of meeting older person, family and caregivers care needs”, and “the appearance of inconstancy in the family”. They explained exclusively how family caregivers of old people give up caregiving. Conclusion Health care providers are recommended to become familiar with challenges of family caregivers in taking care of older person with chronic disease at home, and then organize their supportive and consulting actions according to family situations in order to improve the life quality of older person and family caregivers. PMID:26171407

  14. Caregiving Styles: A Cognitive and Behavioral Typology Associated With Dementia Family Caregiving

    PubMed Central

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer’s disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a “cultural activity,” and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted. Understanding this thinking–action process has important implications for future research and service. Reasoned action theory provides empirical evidence that attitudes and beliefs, as they are influenced by the social environment, predict intentions to act. In turn, behavioral intentions can reliably predict behaviors. This grounded theory study describes a typology of caregiving styles relevant to family members of an individual with ADRD, where caregiving style is defined as a culturally based pattern in thinking and action. The goal of this study was to characterize the relationship between caregiver intentions and care strategies. Methods: Study participants included 97 individuals residing in the Washington, DC, area, who provide daily care for a family member with ADRD. Narrative data were collected from each caregiver during three 1-hr interview sessions. A subset of 30 caregiver–care recipient (CR) dyads was videotaped during typical interactions. Results: Four caregiving styles were identified (facilitating, balancing, advocating, and directing), which differ primarily in the intended focus of care and preferred interactions with the CR. Implications: The results provide a foundation for future studies of the relationships between sociocultural context, caregiving styles and strategies, and ensuing outcomes for caregiver–CR dyads. PMID:21335422

  15. Family Caregiver Identity: A Literature Review

    ERIC Educational Resources Information Center

    Eifert, Elise K.; Adams, Rebecca; Dudley, William; Perko, Michael

    2015-01-01

    Background: Despite the multitude of available resources, family caregivers of those with chronic disease continually underutilize support services to cope with the demands of caregiving. Several studies have linked self-identification as a caregiver to the increased likelihood of support service use. Purpose: The present study reviewed the…

  16. Family Caregivers of Women with Physical Disabilities

    PubMed Central

    Elliott, Timothy R.; Berry, Jack W.; Shewchuk, Richard M.; Oswald, Kimberly D.; Grant, Joan

    2008-01-01

    Cross-sectional, correlational analyses of data from two separate studies were conducted to examine the correlates of adjustment among family caregivers of women with disabilities. Participants included 40 caregivers of women with spinal cord injuries in the first study and 53 caregivers of women with cerebral palsy, traumatic brain injury, and other neuromuscular disabilities in the second study. It was hypothesized that a negative problem-solving style would be associated with greater caregiver distress in both studies, and that caregiver adjustment would be associated with care recipient depression in the second study. As expected, results indicated that a higher negative orientation toward solving problems was associated with caregiver depression and lower well-being. However, in the second study, caregiver characteristics were not associated with care recipient depression. These data indicate that considerable variability exists in caregiver adjustment. Methodological limitations and the implications for research, service, and policy formation are! discussed. PMID:18716670

  17. Caregiver Burden in Fragile X Families

    PubMed Central

    Iosif, Ana-Maria; Sciolla, Andres F.; Brahmbhatt, Khyati; Seritan, Andreea L.

    2013-01-01

    Complex caregiving issues occur in multigenerational families carrying the fragile X mutation and premutation. The same family members may care for children or siblings with fragile X syndrome (FXS) and for elderly parents with fragile X-associated tremor/ataxia syndrome (FXTAS). Family caregivers experience anxiety, depression, neglect of personal health care needs, employment difficulties, and loss of social support, leading to isolation and further psychiatric consequences. There is growing awareness of caregiver burden with regard to parents of children with FXS, but much less is known about the needs of informal caregivers of patients with FXTAS. In this paper, we review the available literature to date and provide suggestions for further exploration of caregivers' needs. Evidence-based strategies to address these needs are included. Many more research studies exploring caregiver burden in multigenerational fragile X families are needed, as well as studies aimed at investigating interventions and their impact on reduction. PMID:24348279

  18. Family caregivers of people with dementia

    PubMed Central

    Brodaty, Henry; Donkin, Marika

    2009-01-01

    Family caregivers of people with dementia, often called the invisible second patients, are critical to the quality of life of the care recipients. The effects of being a family caregiver, though sometimes positive, are generally negative, with high rates of burden and psychological morbidity as well as social isolation, physical ill-health, and financial hardship. Caregivers vulnerable to adverse effects can be identified, as can factors which ameliorate or exacerbate burden and strain. Psychosocial interventions have been demonstrated to reduce caregiver burden and depression and delay nursing home admission. Comprehensive management of the patient with dementia includes building a partnership between health professionals and family caregivers, referral to Alzheimer's Associations, and psychosocial interventions where indicated. PMID:19585957

  19. Narratives of family caregiving: four story types.

    PubMed

    Ayres, L

    2000-10-01

    Researchers across disciplines have recognized considerable individual variation among caregivers in their response to the experiences of caregiving. One explanation for individual variation is that caregivers make different meanings from caregiving even under externally similar circumstances. This paper describes findings from a study that combined two qualitative strategies, across-case, thematic analysis and within-case, narrative analysis, to investigate meaning in accounts of family caregiving. Themes identified in the across-case analysis were interpreted in the context of patterns identified in the narrative analysis, as well as in the overall framework of caregivers' process of making meaning. Caregivers in this study told four types of stories: stories of ideal lives, stories of ordinary lives, stories of compromised lives, and ambiguous stories. Characteristics of each story type are described, and an example of an ambiguous story is also included as an illustration of the method. Findings suggest a new approach to understanding family caregiving that incorporates the diverse meanings caregivers make of their often similar experiences.

  20. Family Caregivers and Consumer Health Information Technology.

    PubMed

    Wolff, Jennifer L; Darer, Jonathan D; Larsen, Kevin L

    2016-01-01

    Health information technology has been embraced as a strategy to facilitate patients' access to their health information and engagement in care. However, not all patients are able to access, or are capable of using, a computer or mobile device. Although family caregivers assist individuals with some of the most challenging and costly health needs, their role in health information technology is largely undefined and poorly understood. This perspective discusses challenges and opportunities of engaging family caregivers through the use of consumer-oriented health information technology. We compile existing evidence to make the case that involving family caregivers in health information technology as desired by patients is technically feasible and consistent with the principles of patient-centered and family-centered care. We discuss how more explicit and purposeful engagement of family caregivers in health information technology could advance clinical quality and patient safety by increasing the transparency, accuracy, and comprehensiveness of patient health information across settings of care. Finally, we describe how clarifying and executing patients' desires to involve family members or friends through health information technology would provide family caregivers greater legitimacy, convenience, and timeliness in health system interactions, and facilitate stronger partnerships between patients, family caregivers, and health care professionals.

  1. Family Caregivers in Cancer (PDQ®)—Patient Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  2. Conflict, Emotion, and Personal Strain among Family Caregivers.

    ERIC Educational Resources Information Center

    Sheehan, Nancy W.; Nuttall, Paul

    1988-01-01

    Examined influence of interpersonal conflict, affection, and distress concerning dependency and caregiving satisfactions in predicting caregiver strain and negative emotion in 98 family caregivers. Found that interpersonal conflict between elderly carereceiver and caregiver predicted greatest amount of variance in both caregiver strain and…

  3. Family Caregivers' Perspectives on Institutionalization Decisions.

    ERIC Educational Resources Information Center

    Townsend, Aloen L.

    Family caregivers may face ethical dilemmas when deciding whether a parent or spouse should enter a nursing home. There is considerable evidence that decisions about institutionalization are usually stressful and difficult for family members. This study obtained qualitative and quantitative data from two studies conducted at the Margaret Blenkner…

  4. A Model of Health for Family Caregivers of Elders

    PubMed Central

    Weierbach, Florence M.; Cao, Yan

    2016-01-01

    Family members who provide care to their loved ones experience changes in their own health. The caregiver health model (CGHM) is a new model that identifies health holistically and identifies four determinant(s) that contribute to the health status of the family caregiver. The purpose is to introduce the CGHM: Hypothesis 1: the determinants of health in the CGHM contribute to the health of the Caregiver, Hypothesis 2: the determinants of health contribute to changes in the caregivers’ health at 8 and 16 weeks, and Hypothesis 3: a change in health occurs from baseline to 8 and 16 weeks. Methods: A descriptive, longitudinal design used three data collection points and five survey instruments. Community recruitment (N = 90) occurred through word of mouth and newspapers. Inclusion criteria consisted of being a family caregiver, living in a rural residence, and providing care to elders with necessary activities of daily living (ADLs) and/or instrumental ADLs (IADLs). Following a participant generated phone call to provide consent, caregivers received an initial study packet, additional packets were sent upon return of the previous packet. Analysis for the three hypotheses included multiple backwards stepwise linear regression, generalized estimating equations (GEE), and analysis of variance (ANOVA) α = 0.05. Results: A significant decrease in mental (p < 0.01) but not physical health at 8 weeks (p = 0.38) and 16 weeks (p = 0.29) occurred over time. Two determinants displayed significant (p < 0.05 or less) changes in mental and/or physical health at one or more time points. Study limitations include caregiver entry at varying times and self-report of elder nursing needs and medical conditions. Conclusions: Findings support two of the four determinants contributing to caregiver health. PMID:28025490

  5. Identifying Changeable Barriers to Family Involvement in the Nursing Home for Cognitively Impaired Residents

    ERIC Educational Resources Information Center

    Port, Cynthia Lindman

    2004-01-01

    Purpose: Barriers to family involvement in the nursing home with the potential for change through intervention are examined, including transportation, caregiver health, relationships with staff, and resident characteristics. Design and Methods: Data were collected for 93 family caregiver-resident pairs by means of telephone interviews and chart…

  6. Dementia: The Experience of Family Caregivers.

    ERIC Educational Resources Information Center

    Chenoweth, Barbara; Spencer, Beth

    1986-01-01

    Caregivers of family members with dementia of the Alzheimer's type were surveyed for their experiences with early symptoms, obtaining a diagnosis, home care, and institutionalization. At each stage in the process of providing care there are new and different stresses that can be ameliorated by appropriate professional assistance. (Author)

  7. Family Caregiver Research and the HIPAA Factor

    ERIC Educational Resources Information Center

    Albert, Steven M.; Levine, Carol

    2005-01-01

    Research in family caregiving recently has become more challenging because of the strict protection of privacy mandated in the Health Insurance Portability and Accountability Act (HIPAA) of 1996. We ask when should Institutional Review Boards (IRBs) follow HIPAA rules to the letter and when might they use the waiver option? What is the appropriate…

  8. Teaching University Students Family Caregiving Online

    ERIC Educational Resources Information Center

    Taylor, James

    2004-01-01

    This article describes an online course developed and currently offered at Middle Tennessee State University. Considering the statistics of family caregivers, their needs, and students and human service professionals education, the author demonstrates the necessity of such courses and their benefits. The author also considers the standards for…

  9. Teaching University Students Family Caregiving Online

    ERIC Educational Resources Information Center

    Taylor, James E.

    2004-01-01

    This article describes an online course developed and currently offered at Middle Tennessee State University. Considering the statistics of family caregivers, their needs, and students' and human service professionals' education, the author demonstrates the necessity of such courses and their benefits. The author also considers the standards for…

  10. 76 FR 68621 - National Family Caregivers Month, 2011

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-04

    ... Documents#0;#0; ] Proclamation 8748 of November 1, 2011 National Family Caregivers Month, 2011 By the... National Family Caregivers Month, we pay tribute to the individuals throughout America who ensure the... observe National Family Caregivers Month, we honor the tireless compassion of Americans who heal,...

  11. A Pilot Evaluation of the Family Caregiver Support Program

    ERIC Educational Resources Information Center

    Chen, Ya-Mei; Hedrick, Susan C.; Young, Heather M.

    2010-01-01

    The purposes of this study were to evaluate a federal and state-funded Family Caregiver Support Program (FCSP) and explore what types of caregiver support service are associated with what caregiver outcomes. Information was obtained on a sample of 164 caregivers' use of eleven different types of support service. Descriptive and comparative…

  12. Typical and Atypical Dementia Family Caregivers: Systematic and Objective Comparisons

    ERIC Educational Resources Information Center

    Nichols, Linda O.; Martindale-Adams, Jennifer; Burns, Robert; Graney, Marshall J.; Zuber, Jeffrey

    2011-01-01

    This systematic, objective comparison of typical (spouse, children) and atypical (in-law, sibling, nephew/niece, grandchild) dementia family caregivers examined demographic, caregiving and clinical variables. Analysis was of 1,476 caregivers, of whom 125 were atypical, from the Resources for Enhancing Alzheimer's Caregivers Health (REACH I and II)…

  13. Understanding social support burden among family caregivers.

    PubMed

    Wittenberg-Lyles, Elaine; Washington, Karla; Demiris, George; Oliver, Debra Parker; Shaunfield, Sara

    2014-01-01

    Despite the abundance of research on social support, both as a variable in larger studies and as a central focus of examination, there is little consensus about the relationship between social support and health outcomes. Current social support measures typically account only for frequency and size of network, and a paucity of research exists that has explained social support burden, defined as the burden associated with accessing and receiving support from others. We analyzed audio-recorded discussions by hospice family caregivers about their caregiving problems and potential solutions to examine social relationships within networks and identify the processes that influence social support seeking and receiving. Using qualitative thematic analysis, we found that caregivers providing hospice care experience social support burden resulting from perceived relational barriers between friends and family, the inclination to remain in control, recognition of the loss of the patient as a source of social support and guidance in decision making, family dynamics, and decreased availability of emotional support. Social support researchers should consider how the quality of communication and relationships within social networks impacts the provision and subsequent outcomes of social support in varying contexts. Findings from this study suggest that hospice social support resources should be tailored to the caregiver's support needs and include assessment on the type of support to be offered.

  14. Zoning, accessory dwelling units, and family caregiving: issues, trends, and recommendations.

    PubMed

    Liebig, Phoebe S; Koenig, Teresa; Pynoos, Jon

    2006-01-01

    This article explores the relationship between zoning regulations and co-residential family caregiving in the United States. It first provides an overview of U.S. housing policies, especially zoning. We then describe major changes in family structure and composition in the United States with their implications for caregiving and discuss how multigenerational housing options, particularly accessory dwelling units (ADUs) in single-family homes, can help support family caregiving. After an overview of zoning policies and actions that inhibit ADU production, we document current trends, incorporating information from a small non-random study of ADU activity we conducted in 2004. Finally, we present recommendations for promoting more multigenerational housing as a supplement to other family support programs (e.g., dependent care assistance, family caregiver payments) and as a source of affordable, supportive housing for those families choosing co-residence as their eldercare solution.

  15. Family Caregiving. A Manual for Caregivers of Older Adults.

    ERIC Educational Resources Information Center

    Mehrotra, Chandra, Ed.; And Others

    This manual provides caregivers with practical knowledge and suggestions that could be of help to them in this important role. Chapter 1 gives an overview of the volume and tells how to use it. Chapter 2 identifies who caregivers are, what they do, and what changes have taken place in their lives since they became caregivers. Chapter 3 begins with…

  16. Classification of caregiving families according to the Family Caregivers' Appraisal Checklist.

    PubMed

    Horiguchi, Kazuko; Iwata, Noboru; Matsuda, Nobuko

    2013-04-05

    This study aimed to classify caregiving families according to the Family Caregivers' Appraisal Checklist (FACL; Horiguchi et al., 2012), which was originally developed to evaluate the probability of continuing caregiving. After nationwide targeting in Japan, the selected survey candidates included 1279 families utilizing domiciliary nursing services chosen by stratified two-stage sampling, and available data were obtained from 945 out of 1020 returned responses (return ratio: 79.8%). Scores for the seven components of FACL were cluster analyzed, and the following six clusters were extracted: Cluster A (12.8%) yielded high scores for all components; Cluster B (34.0%) yielded average scores; Cluster C (20.7%) scored mostly average but low for "quality of care service"; Cluster D (15.8%) showed relatively low scores for all components; Cluster E (11.4%) yielded low scores for all components except for "quality of care service" and "preparedness for emergencies"; and Cluster F (5.3%) scored significantly poorly for all components except for "preparedness for emergencies". Significant intercluster differences were observed for care recipient's age, the number of medical care, employment status, principal caregiver's subjective health, and the advice from family and friends. Caregiving duration was significantly associated with "positive appraisal of family caregiving", the number of medical care and the number of care types, and marginally with the level of care stipulated by the public long-term care insurance program (p < 0.07). Implications of classification of family type according to the FACL and the importance of positive appraisal of caregiving are discussed along with the future direction of use of the FACL.

  17. 77 FR 66525 - National Family Caregivers Month, 2012

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-06

    ... and partners become caregivers to the ones they love even as they navigate their own health challenges..., social engagement, and stability to those they love. Family caregivers have an immeasurable impact on...

  18. [Terminal patient home care: the family caregivers perspective].

    PubMed

    Oliveira, Stefanie Griebeler; Quintana, Alberto Manuel; Denardin-Budó, Maria de Lourdes; de Moraes, Natália de Andrade; Lüdtke, Manoela Fonseca; Cassel, Paula Argemi

    2012-09-01

    This study was aimed at getting to know the relationships built among patients, family caregivers and the health care team, during home care,from the perspective of the family caregiver It is a qualitative study with 11 family caregivers of terminal patients, registered on a home care service of a university hospital in the South of Brazil. Data collection was carried out through narrative interviews that were recorded transcribed and analyzed through content analysis. Three categories were built from data analysis: relationships among the family caregiver, the patient and the health care team; awareness of the patient's terminal condition. the caregiver's perspective; and situation in which patients are unaware of their terminal condition. They approach how the home care relationships are established among the caregivers, such as health care professionals and family caregivers, and the people who are taken care of such as the patients, highlighting the importance of communication in such care related context.

  19. The Impact of Family Functioning on Caregiver Burden among Caregivers of Veterans with Congestive Heart Failure

    ERIC Educational Resources Information Center

    Moore, Crystal Dea

    2010-01-01

    A cross-sectional study of 76 family caregivers of older veterans with congestive heart failure utilized the McMaster model of family functioning to examine the impact of family functioning variables (problem solving, communication, roles, affective responsiveness, and affective involvement) on caregiver burden dimensions (relationship burden,…

  20. Cancer Communication and Family Caregiver Quality of Life

    PubMed Central

    Wittenberg, Elaine; Borneman, Tami; Koczywas, Marianna; Del Ferraro, Catherine; Ferrell, Betty

    2017-01-01

    Family caregivers have enormous communication responsibilities tied to caregiving, such as sharing the patient’s medical history with providers, relaying diagnosis and prognosis to other family members, and making decisions about care with the patient. While caregiver stress and burden has been widely documented in the caregiving literature, little is known about how communication burden, real or perceived communication challenges, impacts caregiver quality of life. In family caregiving, the City of Hope (COH) Quality of Life model proposes that the caregiving experience is reciprocal to the patient experience, impacting physical, social, psychological, and spiritual quality of life. We used data from a pilot study testing a communication coaching call intervention with family caregivers of lung cancer patients to analyze caregiver reported communication burden and quality of life. We found variances in each quality of life domain, suggesting that caregiver interventions should range from self-care skill building for physical care to psycho-educational interventions that support caregiver coping and communication skill building. These findings demonstrate the importance of caregiver assessment and attention to communication burden in quality cancer care. PMID:28257110

  1. Assessing family caregiver skill in managing behavioral symptoms of Alzheimer’s disease

    PubMed Central

    Farran, Carol J.; Fogg, Louis G.; McCann, Judith J.; Etkin, Caryn; Dong, Xinqi; Barnes, Lisa L.

    2011-01-01

    Objectives This measurement study operationalized family caregiver skill in managing behavioral symptoms associated with Alzheimer’s disease (AD) by testing a Caregiver Assessment of Behavioral Skill-Self Report measure (CAB-SR). Method A cross-sectional design was used. Caregivers had a family member with possible/probable AD, resided at home with the care recipient and provided the majority of care (N=82). The mail-administered assessment included the CAB-SR and other care recipient and caregiver measures. Results Preliminary CAB-SR reliability and validity were determined, using reliability, factor analytic and correlational procedures. Conclusion This measure provides a preliminary assessment of caregiver skill in managing behavioral symptoms of AD and shows promise for use in research and clinical intervention settings. PMID:21500018

  2. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2011-07-01 2011-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided...

  3. Development of the Family Caregiver Medication Administration Hassles Scale

    ERIC Educational Resources Information Center

    Travis, Shirley S.; Bernard, Marie A.; McAuley, William J.; Thornton, Megan; Kole, Tristen

    2003-01-01

    Purpose: "Medication administration hassles" are the minor daily irritants that family caregivers experience when they assist a dependent family member with medication regimens. This study was designed to develop and test a multidimensional measure of the hassles in family caregiver medication administration. Design and Method: The authors…

  4. 38 CFR 52.71 - Participant and family caregiver responsibilities.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Participant and family....71 Participant and family caregiver responsibilities. The program management has a written statement of participant and family caregiver responsibilities that are posted in the facility and provided...

  5. Family-based therapy for dementia caregivers: clinical observations

    PubMed Central

    MITRANI, V. B.; CZAJA, S. J.

    2008-01-01

    Family caregiving for dementia patients is a major social and clinical problem. Family caregivers face major stressful emotional, social and economic burdens, and the negative consequences associated with caregiving are well documented. Given the projected increase in the number of people with dementia, there is a need to identify approaches that will help families manage the challenges of caregiving. Social support from friends and family members has consistently been found to mediate caregiver outcomes, yet many caregivers face problems with isolation and estrangement from family members. In this regard, family-based therapy is a promising intervention for increasing social support for caregivers, and enhancing their quality of life and ability to provide care.This paper will discuss how family-based therapy can be applied as an intervention for family caregivers of dementia patients.The clinical implications of specific interactional patterns will be presented via case examples from an ongoing clinical trial with white American and Cuban American caregivers of dementia patients.The intent is to demonstrate how identification of interactional patterns is a valuable tool for implementing family-based interventions. PMID:18548132

  6. Caregiver burden among Iranian heart failure family caregivers: A descriptive, exploratory, qualitative study

    PubMed Central

    Bahrami, Masoud; Etemadifar, Shahram; Shahriari, Mohsen; Farsani, Alireza Khosravi

    2014-01-01

    Background: Living with patients of chronic diseases such as heart failure (HF) is a difficult situation for the caregivers. This study explored the Iranian family caregivers’ burden of caregiving for patients with HF. Materials and Methods: Eighteen family caregivers of the HF patients from two governmental medical training centers in Isfahan, Iran were recruited using purposive sampling. Data were collected through face-to-face semi-structured interviews. Each interview was transcribed verbatim and was thematically analyzed concurrently. Results: Four major themes emerged from the analysis of the transcripts: Lack of care-related knowledge, physical exhaustion, psychosocial exhaustion, and lack of support. Family caregivers believed that they have little knowledge about the patients’ disease, drugs, and how to perform caregiving roles. They experienced negative physical and psychosocial consequences of full-time and highly extended caregiving roles, such as musculoskeletal disorder, fatigue, and sleep disturbance, and a high level of anxiety, stress, and social isolation. Caregivers believed that they receive little familial and organizational support on the emotional and financial dimensions of caregiving. Conclusions: The findings of this study can be used by healthcare providers, especially nurses, to provide more effective social, informational, and professional support for family caregivers. PMID:24554961

  7. The Caregiving Experience in a Racially Diverse Sample of Cancer Family Caregivers

    PubMed Central

    Siefert, Mary Lou; Williams, Anna-leila; Dowd, Michael F.; Chappel-Aiken, Lolita; McCorkle, Ruth

    2009-01-01

    The literature supports a variety of predictor variables to account for the psychological and stress burden experienced by cancer family caregivers. Missing among the predictor variables are the differences by or influence of race/ethnicity. The purpose of this study was to describe the sample, explore differences in outcomes by patient and family caregiver characteristics, and determine if any of the patient and family characteristics, including race/ethnicity, predicted outcomes. Cross-sectional surveys were used to determine sociodemographics, psychological and physical health, and burdens of caregiving among 54 caregivers. The analysis consisted of descriptive methods, including frequencies and t tests, and regression modeling. The sample was 35% African American or Hispanic. African American and Hispanic caregivers were younger than white caregivers and more often women, were rarely the spouse of the patient, and frequently had other dependents, including children and older parents. African American and Hispanic caregivers reported lower incomes and more burden related to finances and employment than did white caregivers. When controlling for sociodemographic factors, there was no difference by race/ethnicity on the outcome measures. The experience of caregiving may supersede race/ethnicity and may be its own cultural entity. Areas of concern include the interrelationship between socioeconomic status and race/ethnicity, the absence of cultural frameworks to direct caregiver research, and the question of cultural relevance of measurement tools. PMID:18772665

  8. Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina.

    PubMed

    Elnasseh, Aaliah G; Trujillo, Michael A; Peralta, Silvina Victoria; Stolfi, Miriam E; Morelli, Eliana; Perrin, Paul B; Arango-Lasprilla, Juan Carlos

    2016-01-01

    This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries.

  9. Family Dynamics and Personal Strengths among Dementia Caregivers in Argentina

    PubMed Central

    Elnasseh, Aaliah G.; Trujillo, Michael A.; Peralta, Silvina Victoria; Stolfi, Miriam E.; Morelli, Eliana; Perrin, Paul B.

    2016-01-01

    This study examined whether healthier family dynamics were associated with higher personal strengths of resilience, sense of coherence, and optimism among dementia caregivers in Argentina. Caregivers are usually required to assist individuals with dementia, and family members have typically fulfilled that role. Personal strengths such as resilience, sense of coherence, and optimism have been shown to protect caregivers from some of the negative experiences of providing care, though the family-related variables associated with these personal strengths are largely unknown. Hierarchical multiple regressions investigated the extent to which family dynamics variables are associated with each of the caregiver personal strengths after controlling for demographic and caregiver characteristics. A sample of 105 caregivers from Argentina completed a set of questionnaires during a neurologist visit. Family dynamics explained 32% of the variance in resilience and 39% of the variance in sense of coherence. Greater family empathy and decreased family problems were uniquely associated with higher resilience. Greater communication and decreased family problems were uniquely associated with higher sense of coherence. Optimism was not found to be significantly associated with family dynamics. These results suggest that caregiver intervention research focused on the family may help improve caregiver personal strengths in Argentina and other Latin American countries. PMID:27413574

  10. 78 FR 66617 - National Family Caregivers Month, 2013

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-05

    ... Documents#0;#0; ] Proclamation 9053 of October 31, 2013 National Family Caregivers Month, 2013 By the... Family Caregivers Month, we thank these tireless heroes for the long, challenging work they perform... system, our workplaces, and our communities. This month, as we reflect on the generosity, grace,...

  11. Trends Impacting Public Policy Support for Caregiving Families

    ERIC Educational Resources Information Center

    Singer, George H. S.; Biegel, David E.; Ethridge, Brandy L.

    2010-01-01

    Public policy aimed at supporting the caregiving capacity of families has risen to prominence on the public agenda in the United States. Initiatives at the state and federal levels have created some initial services. Three trends that are pushing the issue of family caregiving to the surface are discussed, including large-scale social,…

  12. Relationships Between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health Among Homeless Families

    PubMed Central

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and trauma exposure among homeless families, in order to better serve the needs of this vulnerable population. The objective of this study is to explore the relationships between caregiver exposure to violence, caregiver depression, and youth depression and behavioral problems among homeless families. Preliminary findings indicate that among this sample of homeless families, caregiver violence exposure has statistically significant relationships with both youth behavioral problems and youth depression symptoms, as mediated by caregiver depression. These findings indicate that youth behavioral health is associated with caregiver mental health, which, in turn, is associated with caregiver trauma exposure. This highlights the importance of taking into account adult mental health while treating youth externalizing and internalizing behaviors and ensuring that caregivers, too, have access to adequate treatment and supports. Furthermore, this treatment should be trauma informed, given the link between trauma and mental health. PMID:26420978

  13. The Effects of Caregiving on the Family.

    ERIC Educational Resources Information Center

    Bailey, Eric J.; Young, Rosalie F.

    The topic of caregiving was investigated with respect to the burden experienced by primary caregivers of older persons who had recently suffered a myocardial infarction. Structured interviews were completed with 104 primary care providers who were part of a larger National Institute on Aging funded survey. The caregivers were of both sexes and…

  14. The role of family caregivers in HIV medication adherence.

    PubMed

    Beals, K P; Wight, R G; Aneshensel, C S; Murphy, D A; Miller-Martinez, D

    2006-08-01

    This study examines the role that mid-life and older wives and mothers play in promoting medication adherence among their HIV-infected husbands or adult sons who require daily living assistance. Interviews were conducted with 112 caregiving dyads, with caregivers reporting on their own behaviours and attitudes towards medications, and care-recipients (persons living with HIV [PLH]) providing information about their own adherence practices. By examining how caregiver characteristics, behaviours, and attitudes may influence PLH adherence it is explicitly recognized that caregivers and PLH are linked within a caregiving dyad. Findings indicate that caregivers often remind PLH to take medications, but these reminders are not significantly associated with adherence. Caregivers also report strong attitudes about medication hassles, concerns over treatment failure and general concerns about adherence. Controlling for background characteristics, high perceived adherence hassles on the part of the caregiver were associated with low PLH adherence, providing evidence of shared influence within the caregiving dyad. Adherence interventions may maximize their effectiveness if they consider the role of the family caregiver because these data suggest that caregiver attitudes are linked with PLH adherence behaviours.

  15. Caregiving Practice Patterns of Asian, Hispanic, and Non-Hispanic White American Family Caregivers of Older Adults Across Generations.

    PubMed

    Miyawaki, Christina E

    2016-03-01

    This study is a cross-sectional investigation of caregiving practice patterns among Asian, Hispanic and non-Hispanic White American family caregivers of older adults across three immigrant generations. The 2009 California Health Interview Survey (CHIS) dataset was used, and 591 Asian, 989 Hispanic and 6537 non-Hispanic White American caregivers of older adults were selected. First, descriptive analyses of caregivers' characteristics, caregiving situations and practice patterns were examined by racial/ethnic groups and immigrant generations. Practice patterns measured were respite care use, hours and length of caregiving. Three hypotheses on caregiving patterns based on assimilation theory were tested and analyzed using logistic regression and generalized linear models by racial/ethnic groups and generations. Caregiving patterns of non-Hispanic White caregivers supported all three hypotheses regarding respite care use, caregiving hours and caregiving duration, showing less caregiving involvement in later generations. However, Asian and Hispanic counterparts showed mixed results. Third generation Asian and Hispanic caregivers used respite care the least and spent the most caregiving hours per week and had the longest caregiving duration compared to earlier generations. These caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color. Findings suggest the importance of considering the cultural values of each racial/ethnic group regardless of generation when working with racially and ethnically diverse populations of family caregivers of older adults.

  16. Family Stigma and Caregiver Burden in Alzheimer's Disease

    ERIC Educational Resources Information Center

    Werner, Perla; Mittelman, Mary S.; Goldstein, Dovrat; Heinik, Jeremia

    2012-01-01

    Purpose: The stigma experienced by the family members of an individual with a stigmatized illness is defined by 3 dimensions: caregiver stigma, lay public stigma, and structural stigma. Research in the area of mental illness suggests that caregivers' perception of stigma is associated with increased burden. However, the effect of stigma on…

  17. Clinical Efficacy of Psychoeducational Interventions with Family Caregivers

    ERIC Educational Resources Information Center

    Limiñana-Gras, Rosa M.; Colodro-Conde, Lucía; Cuéllar-Flores, Isabel; Sánchez-López, M. Pilar

    2016-01-01

    The goal of this study is to investigate the efficacy of psychoeducational interventions geared to reducing psychological distress for caregivers in a sample of 90 family caregivers of elderly dependent (78 women and 12 men). We conducted an analysis of the statistical and clinical significance of the changes observed in psychological health…

  18. Equity Matters: Doing Fairness in the Context of Family Caregiving

    ERIC Educational Resources Information Center

    Lashewicz, Bonnie; Manning, Gerald; Hall, Margaret; Keating, Norah

    2007-01-01

    Although family scholars conceptualize caregiving in terms of networks of carers, little attention has been given to equity within these groups. Siblings comprise a prevalent caregiving network of members who feel responsible for parent care, expect to share these responsibilities with each other, and look to each other to evaluate the fairness of…

  19. Young Caregivers: Effect of Family Health Situations on School Performance

    ERIC Educational Resources Information Center

    Siskowski, Connie

    2006-01-01

    Recognition, assessment, education, support, and research of young caregivers is yet to be well established throughout the United States. Studies show that as a result of family caregiving, employees miss work, arrive late, have telephone interruptions, and pass up promotions. Education is essentially the work-life of a student. Research among…

  20. Caring for the Family Caregiver: Lessons Learned in Child Health.

    PubMed

    Keilty, Krista; Cohen, Eyal

    2015-01-01

    Policy to support informal caregivers is a critical health policy issue in Canada. Lessons may be learned from the perspectives and experience in the child health field with applicability for all cared-for persons and their informal caregivers. Familycentred care addresses the centrality of the family caregiver in the design and delivery of health services. A life course approach focuses on key periods of transition and downstream effects facing caregivers over their lifetime. The medical home model where care delivery is more coordinated offers potential direct cost savings for both family caregivers and the healthcare system. Models of pediatric home care that focus on promoting caregiver capacity and integration of unregulated providers show the promise of being acceptable and sustainable solutions to increasing demands for caregiver respite. Finally, a number of assumptions that are somewhat unique to the pediatric caregiver experience are explored and/or challenged. These lessons and assumptions may provide insight for policymakers in the development of systems and supports for all cared-for persons and their caregivers in Canada.

  1. Behavioral and Psychosocial Interventions for Family Caregivers

    ERIC Educational Resources Information Center

    Zarit, Steven; Femia, Elia

    2008-01-01

    Gerontologic research in the past 40 years has shown that caring for an older, disabled person affects the health and well-being of the caregiver. This important contribution led to a wide range of programs and services designed to buffer caregivers from the effects of stressors. Many of these programs have been quite innovative. Although…

  2. Gender differences in caregiving among family - caregivers of people with mental illnesses

    PubMed Central

    Sharma, Nidhi; Chakrabarti, Subho; Grover, Sandeep

    2016-01-01

    All over the world women are the predominant providers of informal care for family members with chronic medical conditions or disabilities, including the elderly and adults with mental illnesses. It has been suggested that there are several societal and cultural demands on women to adopt the role of a family-caregiver. Stress-coping theories propose that women are more likely to be exposed to caregiving stressors, and are likely to perceive, report and cope with these stressors differently from men. Many studies, which have examined gender differences among family-caregivers of people with mental illnesses, have concluded that women spend more time in providing care and carry out personal-care tasks more often than men. These studies have also found that women experience greater mental and physical strain, greater caregiver-burden, and higher levels of psychological distress while providing care. However, almost an equal number of studies have not found any differences between men and women on these aspects. This has led to the view that though there may be certain differences between male and female caregivers, most of these are small in magnitude and of doubtful clinical significance. Accordingly, caregiver-gender is thought to explain only a minor proportion of the variance in negative caregiving outcomes. A similar inconsistency characterizes the explanations provided for gender differences in caregiving such as role expectations, differences in stress, coping and social support, and response biases in reporting distress. Apart from the equivocal and inconsistent evidence, there are other problems in the literature on gender differences in caregiving. Most of the evidence has been derived from studies on caregivers of elderly people who either suffer from dementia or other physical conditions. Similar research on other mental illnesses such as schizophrenia or mood disorders is relatively scarce. With changing demographics and social norms men are increasingly

  3. Relationships between quality of life and family function in caregiver

    PubMed Central

    2011-01-01

    Background There are caregivers who see their quality of life (QoL) impaired due to the demands of their caregiving tasks, while others manage to adapt and overcome the crises successfully. The influence of the family function in the main caregiver's situation has not been the subject of much evaluation. The aim of this study is to analyse the relationship between the functionality of the family and the QoL of caregivers of dependent relatives. Methods We conducted a cross-sectional study including 153 caregivers. Setting: Two health centers in the city of Salamanca(Spain). Caregiver variables analysed: demographic characteristics, care recipient features; family functionality (Family APGAR-Q) and QoL (Ruiz-Baca-Q) perceived by the caregiver. Five multiple regressions are performed considering global QoL and each of the four QoL dimensions as dependent variables. The Canonical Correspondence Analysis (CCA) was used to study the influence of the family function questionnaire on QoL. Results Family function is the only one of the variables evaluated that presented an association both with global QoL and with each of the four individual dimensions (p < 0.05). Using the CCA, we found that the physical and mental well-being dimensions are the ones which present a closer relationship with family functionality, while social support is the quality dimension that is least influenced by the Family APGAR-Q. Conclusion We find an association between family functionality and the caregiver's QoL. This relation holds for both the global measure of QoL and each of its four individual dimensions. PMID:21496270

  4. Innovative Program Aims to Improve Support for Cancer Family Caregivers

    Cancer.gov

    An article about an educational program at the City of Hope Cancer Center intended to provide health professionals with the tools and information needed to help family caregivers care for themselves and their loved ones with cancer.

  5. Family caregivers' support needs after brain injury: a synthesis of perspectives from caregivers, programs, and researchers.

    PubMed

    Gan, Caron; Gargaro, Judith; Brandys, Clare; Gerber, Gary; Boschen, Kathryn

    2010-01-01

    There is a dearth of support for family members who assume caregiving responsibilities following acquired brain injury (ABI). This qualitative study broadens the understanding of ABI caregiver support needs through data triangulation from multiple interview sources across different settings. Thirty-nine caregivers across urban and rural settings in Ontario participated in focus groups. Interviews focused on ABI support services received, their utility, access barriers, needed supports, and suggestions for service delivery. Key informant interviews were also held with four US researchers funded through the TBI Model Systems, one Canadian provincial government health official, and representatives from 11 Ontario ABI programs including two brain injury associations. Interviews focused on existing or proposed caregiver programs and gaps in services. A coding framework was developed through content analysis, centring on five themes: coping, supports that worked, supports needed, barriers, and ideal world recommendations. Perspectives from those involved in receiving, providing and researching caregiver interventions following ABI were synthesized to provide a thorough, detailed depiction of the ongoing support needs of caregivers. This convergence of evidence underscores that caregiver support needs transcend geographical boundaries and must be comprehensive, accessible, long-term, and encompass education, emotional, and instrumental support. Recommendations for ABI caregiver support services are offered.

  6. Family, religion, and depressive symptoms in caregivers of disabled elderly

    PubMed Central

    Zunzunegui, M. V.; Beland, F.; Llacer, A.; Keller, I.

    1999-01-01

    STUDY OBJECTIVE: To explain the variations in depressive symptomatology among primary caregivers of community dwelling activities of daily living disabled elderly and to evaluate the role of family and religiosity on the mental health consequences of caregiving in Spain. DESIGN: Cross sectional study. SETTING: City of Leganes in the metropolitan area of Madrid, Spain. PARTICIPANTS: All caregivers of a representative sample of community dwelling activities of daily living disabled persons, aged 65 and over were approached. The response rate was 85% (n = 194). Depression was assessed by the Center for Epidemiologic Studies Depression (CES-D) Scale. MAIN RESULTS: Controlling for caregivers' income, education, health status, and caregiving stress, religiosity was associated with more depressive symptoms among children caregivers while for spouses the association was negative. Emotional support was negatively associated with depression, but instrumental support was not significant. CONCLUSIONS: Depressive symptomatology is frequent among Spanish caregivers of disabled elderly. This study concludes that religiosity and family emotional support play an important part in the mental health of Spanish caregivers. The role of religiosity may be different according to kinship tie and needs further investigation.   PMID:10396484

  7. Interactive use of genograms and ecomaps in family caregiving research.

    PubMed

    Rempel, Gwen R; Neufeld, Anne; Kushner, Kaysi Eastlick

    2007-11-01

    This article argues for the concurrent and comparative use of genograms and ecomaps in family caregiving research. A genogram is a graphic portrayal of the composition and structure of one's family and an ecomap is a graphic portrayal of personal and family social relationships. Although development and utilization of genograms and ecomaps is rooted in clinical practice with families, as research tools they provide data that can enhance the researcher's understanding of family member experiences. In qualitative research of the supportive and nonsupportive interactions experienced by male family caregivers, the interactive use of genograms and ecomaps (a) facilitated increased understanding of social networks as a context for caregiving, (b) promoted a relational process between researcher and participant, and (c) uncovered findings such as unrealized potential in the participant's social network that may not be revealed with the use of the genogram or ecomap alone, or the noncomparative use of both.

  8. American Indian Family Caregivers' Experiences with Helping Elders

    PubMed Central

    Jervis, Lori L.; Boland, Mathew E.; Fickenscher, Alexandra

    2011-01-01

    Abstract In recent years, a vast literature has accumulated on the negative effects on family caregivers of providing care to elders, while relatively little research has explored caregiving as a positive experience. Only a handful of studies have examined any aspect of informal caregiving among American Indians. This mixed methods study explores the negative and positive aspects of providing elder care among 19 northern plains American Indian family members. These caregivers described low levels of burden and high levels of reward, attributable to cultural attitudes toward elders and caregiving, collective care provision, strong reciprocal relationships with elders, enjoyment of elders, and relatively low levels of care provision. Caregiving manifested as part of a complex exchange of assistance rather than a unidirectional provision of assistance from the family member to the elder. That caregiving emerged as such an overwhelmingly positive experience in a community faced with poverty, alcohol disorders, trauma, and cultural traumatization is testimony to the important roles that elders often continue to play in these communities. PMID:21063902

  9. Relationships between Caregiver Violence Exposure, Caregiver Depression, and Youth Behavioral Health among Homeless Families

    ERIC Educational Resources Information Center

    McGuire-Schwartz, Mandy; Small, Latoya A.; Parker, Gary; Kim, Patricia; McKay, Mary

    2015-01-01

    Homelessness affects a large and increasing number of families in the United States, and exposure to violence and other potentially traumatic events is common among homeless families. It is important to understand more about this population and, more specifically, about the relationship between youth mental health and caregiver mental health and…

  10. The Sociocultural Context of Caregiving Experiences for Vietnamese Dementia Family Caregivers

    PubMed Central

    Nguyen, Kim Hanh; Dao, To Nhu; Vu, Phuoc; Arean, Patricia; Hinton, Ladson

    2015-01-01

    The goal of this qualitative study was to describe the beliefs and experiences of Vietnamese caregivers caring for a family member with dementia and to elicit their ideas about promising interventions. We recruited 10 caregivers from support groups, the Alzheimer’s Association, and local community-based organizations in Northern California. We conducted semi-structured in-depth interviews with all caregivers, as well as a focus group to obtain ideas about supportive strategies. Several themes emerged from the data: (1) Filial piety was influential in caregiving; (2) A sense of loss/grief or trauma was pervasive; and (3) Caregivers had clear sources of stress and sources of support. An overarching theme underlying these three topics was that cultural beliefs, values, and expectations impacted the caregiving experience. Suggestions for promising interventions included education, language-congruent and/or telephone support groups, case management, inclusion of the care recipient in the intervention, and importance of credibility of the intervention. It also may be valuable to include an understanding of cultural values and promotion of spirituality and religion as key components. Findings highlight targets for dementia caregiver interventions to reduce burden and distress in an understudied population. PMID:26617956

  11. Partners in Caregiving in a Special Care Environment: Cooperative Communication between Staff and Families on Dementia Units

    ERIC Educational Resources Information Center

    Robison, Julie; Curry, Leslie; Gruman, Cynthia; Porter, Martha; Henderson, Charles R., Jr.; Pillemer, Karl

    2007-01-01

    Purpose: This article reports the results of a randomized, controlled evaluation of Partners in Caregiving in a Special Care Environment, an intervention designed to improve communication and cooperation between staff and families of residents in nursing home dementia programs. Design and Methods: Participants included 388 family members and 384…

  12. Ranked motives of long-term care providing family caregivers.

    PubMed

    Beneken Genaamd Kolmer, Deirdre; Tellings, Agnes; Gelissen, John; Garretsen, Henk; Bongers, Inge

    2008-03-01

    Family caregivers provide long-term care to their chronically ill loved ones and as a consequence they experience physical, relational and financial problems. This study investigates how long-term family caregivers rank 12 motives for caregiving. Motives are derived from the views of four philosophical anthropologists and are related to self-reported stress and joy and to several different background characteristics of respondents. Motives that focus on feelings concerning the relationship between caregiver and care recipient are more popular as a first choice than motives stemming from feelings of obligation or a general feeling of happiness and are also more popular than more self-directed motives. An analysis of full ranking data shows that two groups can be distinguished, one group of family caregivers with mixed motives and one group of family caregivers with motives that focus on reciprocal mutually equal relationships. The latter are mainly women taking care for a partner or a child, the former report high levels of stress. Implications for intervention programmes and health policy are being discussed.

  13. Family Caregivers in Cancer: Roles and Challenges (PDQ®)—Health Professional Version

    Cancer.gov

    Expert-reviewed information summary about the challenges faced by family caregivers of cancer patients. This summary focuses on typical caregiver roles and concerns, and helpful interventions for caregivers.

  14. Caring for bereaved family caregivers: analyzing the context of care.

    PubMed

    Holtslander, Lorraine F

    2008-06-01

    Deaths from cancer will continue to rise with an increasing and aging population. Family caregivers of patients with cancer will face loss, grief, and bereavement as a result. As mandated by cancer and palliative care clinical practice guidelines, support for family caregivers continues through the processes of grief and bereavement to facilitate a positive transition through loss. To provide evidence-based nursing with this population, an analysis of their context of care was undertaken. Key health policies, characteristics of the healthcare delivery system, and the results of research with bereaved palliative caregivers are described. A model of effectiveness, efficiency, and equity is used to examine the situation of bereaved caregivers and to suggest research questions to fill the gaps in what is known about their needs and experience. Bereaved caregivers are at high risk for many distressing symptoms, including depression and sleeplessness, related to a range of complex variables, such as age, gender, social support, resources, and their experiences during caregiving. Current systems of support have not been adequate to meet the needs of this population and very little is known about the caregivers' quality of life, well-being, and health outcomes or how best to provide compassionate and effective nursing care.

  15. Assisting Cognitively Impaired Nursing Home Residents with Bathing: Effects of Two Bathing Interventions on Caregiving

    ERIC Educational Resources Information Center

    Hoeffer, Beverly; Talerico, Karen Amann; Rasin, Joyce; Mitchell, C. Madeline; Stewart, Babara J.; McKenzie, Darlene; Barrick, Ann Louise; Rader, Joanne; Sloane, Philip D.

    2006-01-01

    Purpose: When cognitively impaired nursing home residents exhibit agitated and aggressive behaviors during bathing, nursing home caregivers are in a unique position to improve residents' experience. This report addresses whether certified nursing assistants (CNAs) who received training in a person-centered approach with showering and with the…

  16. Relationships between nurses and family caregivers: partners in care?

    PubMed

    Ward-Griffin, C; McKeever, P

    2000-03-01

    Increasing reliance on family care of elderly people at home calls for a critical analysis of the relationship between formal and informal caregivers. Although much has been written about how health professionals and family caregivers should relate to one another, we know very little about the relationships that develop between them. Using data from a qualitative study, this article illustrates that relationships between community nurses and family members caring for frail elders are complex, dynamic, and multifaceted. Shifting boundaries in caring work leads to changes in nurse-family caregiver relationships, which can be categorized as four distinct, yet interconnected, types: (1) nurse-helper, (2) worker-worker, (3) manager-worker, and (4) nurse-patient. Each type is described, and implications for nursing practice and research are discussed.

  17. Information needs of family caregivers regarding liver transplant candidates.

    PubMed

    Sá, Amanda Silva; Ziviani, Luciana Costa; Castro-E-Silva, Orlando; Galvão, Cristina Maria; Mendes, Karina Dal Sasso

    2016-03-01

    Objective To assess the information needs of family caregivers of candidates on the waiting list for a liver transplant. Methods It is a cross-sectional study conducted in a transplant center in São Paulo State in the period between April and October of 2012. For the assessment of information needed, an instrument submitted to face and content value was used. The caregivers put 10 subjects in order according to their importance and the amount of interest they had in learning about each, prior to the transplant their family member would be subjected to. Sociodemographic characteristics were also recorded. For data analysis, descriptive statistics were used. Results 42 families participated in the study. The information need about liver disease complications, complications after transplantation and care needed after surgery had higher averages. Conclusions Knowing the information needs of caregivers is important to plan teaching-learning strategies aimed at improving assistance to patients and families in transplant programs.

  18. Health of Elderly Mexican American Adults and Family Caregiver Distress

    PubMed Central

    Rote, Sunshine; Angel, Jacqueline L.; Markides, Kyriakos

    2016-01-01

    Using newly available data on family caregivers from a large epidemiological study of elderly Mexican-origin adults (Hispanic Established Population for the Epidemiologic Study of the Elderly [HEPESE], 2010/2011), we identify which types of impairment (functional, psychological, and cognitive) in the elderly individual are associated with family caregiver depressive symptoms. Results from ordinary least squares regressions using 626 caregiver–care recipient dyads demonstrate that more severe mobility limitations (Performance-Oriented Mobility Assessment), social disability (instrumental activities of daily living), neuropsychiatric disturbances related to cognitive decline (Neuropsychiatric Inventory), and depressive symptoms in the elderly subject are positively associated with caregiver psychological distress. Perceived social stress partially accounts for these associations. We also identify certain segments of this caregiver population that are especially vulnerable to burden when caring for a family member with high levels of impairment, namely female and low-income caregivers. These vulnerabilities should be the focus of intervention efforts to reduce stress and improve the emotional and psychological well-being of Mexican-origin caregivers. PMID:25651573

  19. Effects of Guided Care on Family Caregivers

    ERIC Educational Resources Information Center

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients' primary care physician (PCP). The purpose of this study was to determine whether GC improves patients' primary caregivers' depressive symptoms, strain, productivity, and perceptions of the quality of…

  20. Effects of Guided Care on Family Caregivers

    PubMed Central

    Wolff, Jennifer L.; Giovannetti, Erin R.; Boyd, Cynthia M.; Reider, Lisa; Palmer, Sara; Scharfstein, Daniel; Marsteller, Jill; Wegener, Stephen T.; Frey, Katherine; Leff, Bruce; Frick, Kevin D.; Boult, Chad

    2010-01-01

    Purpose: Guided Care (GC) is a model of health care for multimorbid older adults that is provided by a registered nurse who works with the patients’ primary care physician (PCP). The purpose of this study was to determine whether GC improves patients’ primary caregivers’ depressive symptoms, strain, productivity, and perceptions of the quality of care recipients’ chronic illness care. Design and Methods: A cluster-randomized controlled trial of GC was conducted within 14 PCP teams. The study sample included 196 primary caregivers who completed baseline and 18-month surveys and whose care recipients remained alive and enrolled in the GC study for 18 months. Caregiver outcomes included the following: depressive symptoms (Center for Epidemiological Studies-Depression scale), strain (Modified Caregiver Strain Index), the quality of care recipients’ chronic illness care [Patient Assessment of Chronic Illness Care (PACIC)], and personal productivity (Work Productivity and Activity Impairment questionnaire, adapted for caregiving). Results: In multivariate regression models, between-group differences in depression, strain, work productivity, and regular activity productivity were not statistically significant after 18 months, but GC caregivers reported the overall quality of their recipients’ chronic illness care to be significantly higher (adjusted beta = 0.40, 95% confidence interval : 0.14–0.67). Quality was significantly higher in 4 of 5 PACIC subscales, reflecting the dimensions of goal setting, coordination of care, decision support, and patient activation. Implications: GC improved the quality of chronic illness care received by multimorbid care recipients but did not improve caregivers’ depressive symptoms, affect, or productivity. PMID:19710354

  1. [Family caregiver issues: gender, privacy, and public policy perspectives].

    PubMed

    Lee, I; Chou, Fan-Hao; Chen, Chung-Hey

    2011-04-01

    Due to the phenomenon of Taiwan'saging population has made, long-term care has become an issue of increasingly emphasized importance. According to the statistics, the family takes responsibility for most long-term care duties and more than 70% of primary family caregivers are female. In the past, because of gender-based divisions of labor and gender role expectations made, it was taken for granted that females would be the socially preferred family caregivers. Those men who devoting in themselves to such work were regarded as a rare precious. As such, family care signified entailed different life experiences for males and females. Over the years, amendments to the civil code have recognized family care contributions, and the allowance for caregivers underlines that care responsibilities have shifted away from the family to society. Traditional gender divisions of labor today are significantly more blurred; family structures have become smaller in size; female labor in the workplace has increased; and ten-year long-term care plans and long-term care insurance have been successively implemented. These transformations will make labor outsourcing more and more popular and transform family care from a private problem to a pubic policy issue. In the future, family caregivers require consideration and support on a sustained basis. It is also important to improve and monitor the quality of care services. Nurses, the major professional members of long-term care teams, should be concerned over the issue of family care while providing nursing care. They should include family caregivers in the care plan so that they can make sure that patients receive comprehensive and constant care in order to enhance the overall quality of nursing care.

  2. Wearable Technology to Garner the Perspective of Dementia Family Caregivers.

    PubMed

    Matthews, Judith T; Campbell, Grace B; Hunsaker, Amanda E; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H

    2016-04-01

    Family caregivers of individuals with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. The current article describes a prototype wearable camera system used to gather image and voice data from the caregiver's perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that include salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by the research team during screening) captured in the resulting video. The current authors anticipate future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses.

  3. Family practice clinics. Survey of family practice residents' attitudes.

    PubMed Central

    Rubenstein, H.; Levitt, C.

    1993-01-01

    All residents of McGill University's Department of Family Medicine were surveyed by mail about their family practice clinic experience. Residents were generally satisfied with their training site and their supervision, but noted problems with volume and diversity of patients, learning certain procedures, and knowledge of community resources. They did not want more family medicine clinic time. PMID:8219838

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

    PubMed Central

    Douglas, Sara L; Mazanec, Polly; Lipson, Amy; Leuchtag, Mary

    2016-01-01

    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. PMID:27081643

  5. The role of attitudes and culture in family caregiving for older adults.

    PubMed

    Anngela-Cole, Linda; Hilton, Jeanne M

    2009-01-01

    This study evaluated cultural differences in attitudes toward caregiving and the stress levels of family caregivers. Participants included 98 Japanese American and 86 Caucasian American family caregivers caring for frail elders. Analyses using MANOVA and multiple regression analyses revealed that the Caucasian caregivers had more positive attitudes and provided more hours of care than the Japanese caregivers but that both groups had elevated levels of caregiver stress. The stress that family caregivers currently experience could lead to a future generation of care recipients who enter old age in worse condition than their predecessors. Professionals need to work together to develop culturally appropriate, evidence-based interventions to address this issue.

  6. Caregiver, child, family, and service system contributors to caregiver strain in two child mental health service systems.

    PubMed

    Brannan, Ana María; Heflinger, Craig Anne

    2006-10-01

    Children's mental health researchers are increasingly recognizing the importance of caregiver strain (i.e., the impact on families of caring for children with emotional and behavioral disorders). This study examined the caregiver, child, family, and service variables associated with caregiver strain with special attention to the role of barriers to care. These relationships were compared across enrollees in a managed care Medicaid and a traditional fee-for-service system. Findings indicated that severity of child problems was the most consistent predictor of caregiver strain. Although there was considerable similarity in the variables associated with caregiver strain across the two systems, important differences were also evident. Caregivers in the managed care setting were significantly more likely to report provider/payer-related barriers to care. Provider/payer barriers predicted strain in the managed care sample. In the fee-for-service system, barriers related to family perceptions and inconvenient location and appointment times were significant predictors.

  7. Group Intervention for Dementia Family Caregivers: A Longitudinal Perspective.

    ERIC Educational Resources Information Center

    Haley, William E.

    1989-01-01

    Conducted longitudinal follow-up to previously published experimental study of effectiveness of group intervention for dementia family caregivers. Found methodological and clinical issues relevant to future studies included issues of differential attrition from treatment, selection of participants,and need for measures appropriate to long-term…

  8. Accessible Support for Family Caregivers of Seniors with Chronic Conditions: From Isolation to Inclusion

    ERIC Educational Resources Information Center

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family…

  9. Wearable Technology to Garner the Perspective of Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Campbell, Grace B.; Hunsaker, Amanda E.; Klinger, Julie; Mecca, Laurel Person; Hu, Lu; Hostein, Sally; Lingler, Jennifer H.

    2015-01-01

    Family caregivers of persons with dementia typically have limited opportunity during brief clinical encounters to describe the dementia-related behaviors and interactions that they find difficult to handle. Lack of objective data depicting the nature, intensity, and impact of these manifestations of the underlying disease further constrains the extent to which strategies recommended by nurses or other health care providers can be tailored to the situation. We describe a prototype wearable camera system used to gather image and voice data from the caregiver’s perspective in a pilot feasibility intervention study conducted with 18 caregiving dyads. Several scenarios are presented that incorporate salient events (i.e., behaviors or interactions deemed difficult by the caregiver or identified as concerning by our team during screening) identified in the resulting video. We anticipate that future wearable camera systems and software will automate screening for salient events, providing new tools for assessment and intervention by nurses. PMID:26468655

  10. Differences in COPD Patient Care by Primary Family Caregivers: An Age-Based Study

    PubMed Central

    Hsiao, Peng-Ching; Chu, Chi-Ming; Sung, Pei-Yi; Perng, Wann-Cherng; Wang, Kwua-Yun

    2014-01-01

    Background Because Taiwan has the fastest aging rate among developed countries, care for the elderly is becoming more prominent in the country. Primary family caregivers play an important role in patient health and health promotion behavior. Chronic obstructive pulmonary disease (COPD), an age-related disease, is a major public health problem with high morbidity and mortality and can be a long-term burden for family members; however, little attention has been given to the differences in COPD care between elder caregivers and other caregivers. This study aimed to investigate the differences between elder family caregivers and non-elder family caregivers caring for COPD patients in Taiwan, including caring behavior, caregiver response, and caring knowledge. Methods This cross-sectional study was conducted between March 2007 and January 2008; 406 primary family caregivers of COPD patients from the thoracic outpatient departments of 6 hospitals in north-central Taiwan were recruited to answer questionnaires measuring COPD characteristics, care behavior, caregiver response, and COPD knowledge. All questionnaires, which addressed caregiver knowledge, care behaviors, and care reactions, were shown to have acceptable validity and reliability, and the data were analyzed using univariate and generalized linear model techniques. Results The elder caregivers group had 79 participants, and the non-elder caregivers comprised 327 participants. The COPD-related knowledge scale results were positively correlated with the family caregiver caring behavior scale, suggesting that better COPD-related knowledge among family caregivers may result in improved caring behavior. After adjusting for all possible confounding factors, the elder caregivers had significantly lower COPD-related knowledge than the non-elder caregivers (P<0.001). However, there were no significant differences in the family caregiver caring behavior scale or the caregiver reaction assessment scale between the two

  11. Spirituality and psychological well-being: testing a theory of family interdependence among family caregivers and their elders.

    PubMed

    Kim, Suk-Sun; Reed, Pamela G; Hayward, R David; Kang, Youngmi; Koenig, Harold G

    2011-04-01

    The family spirituality-psychological well-being model was developed and tested to explore how spirituality influences psychological well-being among elders and caregivers in the context of Korean family caregiving. The sample consisted of 157 Korean elder-family caregiver dyads in Seoul, Korea. The intraclass correlation coefficient and the actor-partner interdependence statistical model were used to analyze the data. There were significant correlations between elders' and caregivers' spirituality and between elders' and caregivers' psychological well-being. Elders' and caregivers' spirituality significantly influenced their own psychological well-being. The caregiver's spirituality significantly influenced the elder's psychological well-being, but the elder's spirituality did not significantly influence the caregiver's psychological well-being. Findings suggest that elders' and caregivers' spirituality should be assessed within the family to provide holistic nursing interventions.

  12. (Handicapped) caregiver: the social representations of family members about the caregiving process.

    PubMed

    de Azevedo, Gisele Regina; Santos, Vera Lúcia Conceição de Gouveia

    2006-01-01

    This study aimed to analyze what looking after physically disabled persons with spinal cord injury by trauma means to their caregivers and family members. The analysis of the testimony of eight caregivers, obtained in open interviews, which was methodologically based on the Social Representations Theory (SR), pointed out two main routes: coping with the suffering process in care practice and the troubled waters that permeate this suffering process. These two routes, characterized as SR Central Core and Peripheral System, respectively, consisted of themes like the way of looking at impairment, affectivity, religiosity, social-economical changes and (lack of) technical and institutional support. The results show a handicapped caregiver dedicated to look after someone who is physically disabled, considered incapacitated, and who leads his or her chores with distress and privations, based on guilt and religiosity, supported by ambiguous affection and affected by deteriorating social-economical changes and (lack of) technical and institutional support to practice an activity that implies so many peculiarities. The transformation alternatives of these caregivers' daily life principally lead to a symbiosis of disability with the patient - to live for the physically disabled - or yet, for a few, a sketch to restart personal life projects - to live with the physically disabled.

  13. Influence of family dynamics on burden among family caregivers in aging Japan

    PubMed Central

    Kusaba, Tesshu; Sato, Kotaro; Fukuma, Shingo; Yamada, Yukari; Matsui, Yoshinori; Matsuda, Satoshi; Ando, Takashi; Sakushima, Ken; Fukuhara, Shunichi

    2016-01-01

    Background. Long-term care for the elderly is largely shouldered by their family, representing a serious burden in a hyper-aging society. However, although family dynamics are known to play an important role in such care, the influence of caring for the elderly on burden among caregiving family members is poorly understood. Objective. To examine the influence of family dynamics on burden experienced by family caregivers. Methods. We conducted a cross-sectional study at six primary care clinics, involving 199 caregivers of adult care receivers who need long-term care. Participants were divided into three groups based on tertile of Index of Family Dynamics for Long-term Care (IF-Long score), where higher scores imply poorer relationships between care receivers and caregiving family: best, <2; intermediate, 2 to <5; worst, ≥5. The mean differences in burden index of caregivers (BIC-11) between the three groups were estimated by linear regression model with adjustment for care receiver’s activity of daily living and cognitive function. Results. Mean age of caregivers was 63.2 years (with 40.7% aged ≥ 65 years). BIC-11 scores were higher in the worst IF-Long group (adjusted mean difference: 4.4, 95% confidence interval: 1.2 to 7.5) than in the best IF-Long group. We also detected a positive trend between IF-Long score and BIC-11 score (P-value for trend <0.01). Conclusion. Our findings indicate that family dynamics strongly influences burden experienced by caregiving family members, regardless of the care receiver’s degree of cognitive impairment. These results underscore the importance of evaluating relationships between care receivers and their caregivers when discussing a care regimen for care receivers. PMID:27450988

  14. Family Caregiver Uplift and Burden: Associations with Aggressive Behavior in Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Unwin, Gemma; Deb, Shoumitro

    2011-01-01

    The purpose of this study was to investigate the experience of family caregivers caring for adults with intellectual disabilities (ID) who display aggressive behavior in terms of associations with caregiver burden and uplift. The family caregivers of 44 people with ID and aggressive behavior were interviewed using a suite of questionnaires and…

  15. Health-Related Quality of Life in the Family Caregivers of Stroke Survivors

    ERIC Educational Resources Information Center

    Chen, Yangkun

    2010-01-01

    The objective of this cross-sectional study was to identify the factors associated with health-related quality of life (HRQOL) of family caregivers of Chinese stroke patients. One hundred and twenty-three stroke patients consecutively admitted to a stroke clinic and their 123 family caregivers were recruited. The caregivers' HRQOLs were assessed…

  16. Executive Summary: Professional Partners Supporting Family Caregivers

    ERIC Educational Resources Information Center

    Kelly, Kathleen; Reinhard, Susan C.; Brooks-Danso, Ashley

    2008-01-01

    Today, more than three-quarters of adults who live in the community and need long-term care depend on family and friends as their only source of assistance with activities of daily living (such as bathing, dressing, and eating) or instrumental activities of daily living (such as transportation and managing finances). Research suggests that the…

  17. Experiences of caregiving, satisfaction of life, and social repercussions among family caregivers, two years post-stroke.

    PubMed

    Lurbe-Puerto, Kàtia; Leandro, Maria-Engracia; Baumann, Michèle

    2012-01-01

    Cerebrovascular diseases are a public health and social policy priority in Europe due to their high prevalence and the long-term disability they may result in (as the principal cause of handicap). Increasingly, family caregivers take over the care at home of these patients. Two years post-stroke, our study analyzed the feelings of family caregivers from Luxembourg and northeastern Portugal toward their experience of caregiving and its repercussions on social and couple relationships, life satisfaction, and socioeconomic characteristics. Participating hospitals identified survivors and consent was sought by letter. Patients (n = 62) and their main caregivers (n = 46 pairs) were interviewed at home. The mean life satisfaction of caregivers was similar, but the experience of providing care differed in terms of family support, and disruptions of the caregivers' family responsibilities. More Portuguese respondents gave activities up, found little time for relaxation, and estimated that their health had deteriorated; more Luxembourgers felt strong enough to cope. More Portuguese spouses reported an impact on their sex lives. Family caregivers represent a "population at risk." Social workers can help them by providing domestic assistance, undertaking coaching activities, fostering favorable attitudes, and offering reassurance. Home-based rehabilitation in Europe involving family care must take account of cultural lifestyle issues.

  18. 3 CFR 8900 - Proclamation 8900 of November 1, 2012. National Family Caregivers Month, 2012

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... caregivers to the ones they love even as they navigate their own health challenges. Mothers and fathers... stability to those they love. Family caregivers have an immeasurable impact on the lives of those...

  19. Linking family dynamics and the mental health of Colombian dementia caregivers.

    PubMed

    Sutter, Megan; Perrin, Paul B; Chang, Yu-Ping; Hoyos, Guillermo Ramirez; Buraye, Jaqueline Arabia; Arango-Lasprilla, Juan Carlos

    2014-02-01

    This cross-sectional, quantitative, self-report study examined the relationship between family dynamics (cohesion, flexibility, pathology/ functioning, communication, family satisfaction, and empathy) and mental health (depression, burden, stress, and satisfaction with life [SWL]) in 90 dementia caregivers from Colombia. Hierarchical multiple regressions controlling for caregiver demographics found that family dynamics were significantly associated with caregiver depression, stress, and SWL and marginally associated with burden. Within these regressions, empathy was uniquely associated with stress; flexibility with depression and marginally with SWL; and family communication marginally with burden and stress. Nearly all family dynamic variables were bivariately associated with caregiver mental health variables, such that caregivers had stronger mental health when their family dynamics were healthy. Family-systems interventions in global regions with high levels of familism like that in the current study may improve family empathy, flexibility, and communication, thereby producing better caregiver mental health and better informal care for people with dementia.

  20. Handbook for Residents of Military Family Housing

    DTIC Science & Technology

    1989-02-01

    THE HOUSING ASSIGNMENT OFFICE FOR USE IN ASSISTING MILITARY PERSONNEL TO OBTAIN GOVERNMENT QUARTERS. EFFECTS OF NONDISCLOSURE - DISCLOSURE OF THIS...of regulations that govern child care in Military Family Housing . a. Occasional babysitting is allowed. Child care on a regular basis is also allowed...Commander Naval Base San Diego, CA. 92132-5100 DJS*MA-1pASEINST.11101.43 February 1989 I HANDBOOK FOR RESIDENTS OF MILITARY FAMILY HOUSING DTIC EECTE

  1. Otolaryngology Training for Family Practice Residents.

    ERIC Educational Resources Information Center

    And Others; Rood, Stewart R.

    1980-01-01

    The faculty of the Department of Otolaryngology, University of Pittsburgh School of Medicine, has designed a rotation in the otolaryngology service, that is a basic clinical orientation to ear, nose and throat medicine, to fit the one-month block committed by the local family practice residency training program. The program is described and its…

  2. Spiritual needs of patients with cancer and family caregivers.

    PubMed

    Taylor, Elizabeth Johnston

    2003-08-01

    The purpose of this descriptive, cross-sectional, qualitative study was to describe the spiritual needs experienced in living with cancer from the perspective of patients with cancer and family caregivers. The sample included 28 African American and Euro-American patients with cancer and family caregivers receiving care from inpatient and outpatient units at two metropolitan hospitals in the southwestern United States. In-depth, tape-recorded, semistructured interviews were analyzed using the process of data reduction, data display, and verification. Seven categories of identified spiritual needs included needs associated with relating to an Ultimate Other; the need for positivity, hope, and gratitude; the need to give and receive love; the need to review beliefs, the need to have meaning; and needs related to religiosity and preparation for death. Informants responded with varying levels of awareness of personal spiritual needs. Caregivers were observed to have spiritual needs similar to those of patients. The findings of this study will inform nurses as they assess and document spiritual needs.

  3. Attachment and caregiving relationships in families affected by parental incarceration.

    PubMed

    Shlafer, Rebecca J; Poehlmann, Julie

    2010-07-01

    This longitudinal, mixed method study focused on 57 families of children who participated in a mentoring program for children of incarcerated parents. Children ranged in age from 4 to 15 years. Monthly interviews were conducted with children, caregivers, and mentors during the first six months of program participation, and questionnaires were administered at intake and six months to assess caregiver-child and incarcerated parent-child relationships, contact with incarcerated parents, and children's behavior problems. Although some children viewed their incarcerated parents as positive attachment figures, other children reported negative feelings toward or no relationship with incarcerated parents. In addition, our assessments of children nine years old and older revealed that having no contact with the incarcerated parent was associated with children reporting more feelings of alienation toward that parent compared to children who had contact. Children's behavior problems were a primary concern, often occurring in a relational context or in reaction to social stigma associated with parental imprisonment.

  4. Caregiver Person-Centeredness and Behavioral Symptoms in Nursing Home Residents With Dementia: A Timed-Event Sequential Analysis

    PubMed Central

    Gilmore-Bykovskyi, Andrea L.; Roberts, Tonya J.; Bowers, Barbara J.; Brown, Roger L.

    2015-01-01

    Purpose: Evidence suggests that person-centered caregiving approaches may reduce dementia-related behavioral symptoms; however, little is known about the sequential and temporal associations between specific caregiver actions and behavioral symptoms. The aim of this study was to identify sequential associations between caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and the temporal variation within these associations. Design and Methods: Videorecorded observations of naturally occurring interactions (N = 33; 724min) between 12 nursing home (NH) residents with dementia and eight certified nursing assistants were coded for caregiver person-centered actions, task-centered actions, and resident behavioral symptoms and analyzed using timed-event sequential analysis. Results: Although caregiver actions were predominantly person-centered, we found that resident behavioral symptoms were significantly more likely to occur following task-centered caregiver actions than person-centered actions. Implications: Findings suggest that the person-centeredness of caregivers is sequentially and temporally related to behavioral symptoms in individuals with dementia. Additional research examining the temporal structure of these relationships may offer valuable insights into the utility of caregiver person-centeredness as a low-cost strategy for improving behavioral symptom management in the NH setting. PMID:26055782

  5. Does Problem-Solving Training for Family Caregivers Benefit Their Care Recipients With Severe Disabilities? A Latent Growth Model of the Project CLUES Randomized Clinical Trial

    PubMed Central

    Berry, Jack W.; Elliott, Timothy R.; Grant, Joan S.; Edwards, Gary; Fine, Philip R.

    2012-01-01

    Objective To examine whether an individualized problem-solving intervention provided to family caregivers of persons with severe disabilities provides benefits to both caregivers and their care recipients. Design Family caregivers were randomly assigned to an education-only control group or a problem-solving training (PST) intervention group. Participants received monthly contacts for 1 year. Participants Family caregivers (129 women, 18 men) and their care recipients (81 women, 66 men) consented to participate. Main Outcome Measures Caregivers completed the Social Problem-Solving Inventory–Revised, the Center for Epidemiological Studies-Depression scale, the Satisfaction with Life scale, and a measure of health complaints at baseline and in 3 additional assessments throughout the year. Care recipient depression was assessed with a short form of the Hamilton Depression Scale. Results Latent growth modeling was used to analyze data from the dyads. Caregivers who received PST reported a significant decrease in depression over time, and they also displayed gains in constructive problem-solving abilities and decreases in dysfunctional problem-solving abilities. Care recipients displayed significant decreases in depression over time, and these decreases were significantly associated with decreases in caregiver depression in response to training. Conclusions PST significantly improved the problem-solving skills of community-residing caregivers and also lessened their depressive symptoms. Care recipients in the PST group also had reductions in depression over time, and it appears that decreases in caregiver depression may account for this effect. PMID:22686549

  6. Accessible support for family caregivers of seniors with chronic conditions: from isolation to inclusion.

    PubMed

    Stewart, Miriam; Barnfather, Alison; Neufeld, Anne; Warren, Sharon; Letourneau, Nicole; Liu, Lili

    2006-01-01

    Accessible support programs can improve health outcomes for family caregivers of older relatives with a chronic condition. Over the course of 6 months, 27 experienced family caregivers provided weekly support via the telephone to 66 individuals, either new family caregivers of seniors recently diagnosed with stroke or newly vulnerable family caregivers (i.e., facing increasing demands from the deterioration of their senior relative's condition) of seniors with Alzheimer's disease. Qualitative data documented the perceived impact of the intervention, including increased satisfaction with support, coping skills, caregiving competence and confidence, and decreased caregiver burden and loneliness. Caregivers identified varied support processes that overcame support deficits in their social networks. These processes can facilitate replication in future research and inform practice, programs, and policies.

  7. Caregiving Statistics

    MedlinePlus

    ... Costs; National Alliance for Caregiving and MetLife Mature Market Institute. February 2010 40% to 70% of family ... Costs; National Alliance for Caregiving and MetLife Mature Market Institute. February 2010 73% of family caregivers who ...

  8. Socialization of Coping with Community Violence: Influences of Caregiver Coaching, Modeling, and Family Context

    ERIC Educational Resources Information Center

    Kliewer, Wendy; Parrish, Katie Adams; Taylor, Kelli W.; Jackson, Kate; Walker, Jean M.; Shivy, Victoria A.

    2006-01-01

    A socialization model of coping with community violence was tested in 101 African American adolescents (55% male, ages 9-13) and their maternal caregivers living in high-violence areas of a mid-sized, southeastern city. Participants completed interviews assessing caregiver coping, family context, and child adjustment. Caregiver-child dyads also…

  9. The Effect of a Family Therapy and Technology-Based Intervention on Caregiver Depression

    ERIC Educational Resources Information Center

    Eisdorfer, Carl; Czaja, Sara J.; Loewenstein, David A.; Rubert, Mark P.; Arguelles, Soledad; Mitrani, Victoria B.; Szapocznik, Jose

    2003-01-01

    Purpose: The majority of persons with Alzheimer's disease (AD) are cared for at home by a family member such as a spouse or daughter. Caregiving places enormous demands on these caregivers, and the negative consequences associated with caregiving are well documented. This paper reports results from the Miami site of the REACH (Resources for…

  10. Family Caregivers' Experiences of Caring for a Relative With Younger Onset Dementia: A Qualitative Systematic Review.

    PubMed

    Cabote, Christy Joy; Bramble, Marguerite; McCann, Damhnat

    2015-08-01

    Family caregiving for people with younger onset dementia affects everyone in the family unit. This article presents findings of a qualitative systematic review exploring the experiences of family caregivers of persons with younger onset dementia. A systematic search resulted in the inclusion of five relevant articles, and two groups within the family unit were identified-child caregivers and adult and spousal caregivers. Using the thematic synthesis approach, five themes emerged: dementia damage, grief for loss of relationship, changes in family roles, positive and negative impacts of family caregiving, and transition to formal care. The review findings support increasing evidence that despite the stress of caring for a person with dementia damage, family members have the capacity to cope, adapt, and grow through their experiences. Nurses can assist families to identify their unique strengths and enhance family resiliency so they can navigate the "lonely road" of younger onset dementia.

  11. Usability of a Wearable Camera System for Dementia Family Caregivers

    PubMed Central

    Matthews, Judith T.; Lingler, Jennifer H.; Campbell, Grace B.; Hunsaker, Amanda E.; Hu, Lu; Pires, Bernardo R.; Hebert, Martial; Schulz, Richard

    2015-01-01

    Health care providers typically rely on family caregivers (CG) of persons with dementia (PWD) to describe difficult behaviors manifested by their underlying disease. Although invaluable, such reports may be selective or biased during brief medical encounters. Our team explored the usability of a wearable camera system with 9 caregiving dyads (CGs: 3 males, 6 females, 67.00 ± 14.95 years; PWDs: 2 males, 7 females, 80.00 ± 3.81 years, MMSE 17.33 ± 8.86) who recorded 79 salient events over a combined total of 140 hours of data capture, from 3 to 7 days of wear per CG. Prior to using the system, CGs assessed its benefits to be worth the invasion of privacy; post-wear privacy concerns did not differ significantly. CGs rated the system easy to learn to use, although cumbersome and obtrusive. Few negative reactions by PWDs were reported or evident in resulting video. Our findings suggest that CGs can and will wear a camera system to reveal their daily caregiving challenges to health care providers. PMID:26288888

  12. [Family Caregivers as a Target Group for Health Promotion and Prevention].

    PubMed

    Budnick, A; Dräger, D; Blüher, S; Kummer, K

    2015-09-01

    Family caregivers are a target group for health promotion, due to the various burdens. Against this background an assessment (ARR) was developed, implemented, and validated in the project "Health Promotion for Elderly Family Caregiver". On the basis of the ARR, family caregivers received an individual, need-oriented, and specific offer for health promotion. In order to reach the target group optimally, a national health insurance company was used.

  13. Understanding caregiving patterns, motivations, and resource needs of subsidized family, friend, and neighbor child care providers.

    PubMed

    Liu, Meirong; Anderson, Steven G

    2010-01-01

    Family, friend, and neighbor (FFN) caregivers play important roles in delivering subsidized noncustodial child care. Yet, little is known about these noncustodial caregivers. This article profiles the caregiving experiences, motivations, and resource needs of these providers, based on a survey of 301 randomly selected FFN providers in one state. Kecommendations are offered for strengthening public supports to enhance the quality of this form of caregiving.

  14. For love, legacy, or pay: legal and pecuniary aspects of family caregiving.

    PubMed

    Kapp, Marshall B

    2013-01-01

    Most caregiving and companionship provided by family members and friends to older individuals in home environments occurs because of the caregiver's feelings of ethical and emotional obligation and attachment. From a legal perspective, though, it might be ill-advised for an informal caregiver to admit such a motivation. Building on a recently published study of relevant litigation, this essay discusses changing cultural and legal aspects of family caregiving when there is some expectation of pay, property, or fuiture financial legacy in return for the caregiver's present work and sacrifices.

  15. Traumatic brain injury: unmet support needs of caregivers and families in Florida.

    PubMed

    Dillahunt-Aspillaga, Christina; Jorgensen-Smith, Tammy; Ehlke, Sarah; Sosinski, Melanie; Monroe, Douglas; Thor, Jennifer

    2013-01-01

    Sustaining a Traumatic Brain Injury results in familial strain due to the significant impact the injury has upon the role and function of individuals and their families at home and in the community. Using the Stress Process Model of Caregiving, a caregiver needs assessment survey was developed and conducted to better understand the needs of individuals with a Traumatic Brain Injury and their caregivers. Survey results indicate that caregivers experience many challenges including unmet needs in areas of relational supports such as maintaining relationships, long-term emotional and financial support for themselves and the survivor, and the need for a patient or caregiver advocate. Implications for future practice are presented.

  16. Patients' and Family Caregivers' Goals for Care During Transitions Out of the Hospital.

    PubMed

    Coleman, Eric A; Min, Sung-Joon

    2015-01-01

    The aims of this study were to (a) describe the nature of patients' goals upon discharge from hospital, family caregivers' goals for their loved ones, and family caregivers' goals for themselves; (b) determine the degree of concordance with respect to the three elicited goals; (c) ascertain goal attainment across the three elicited goals; and (d) examine factors predictive of goal attainment. Our findings support the position that eliciting patient and family caregiver goals and promoting goal attainment may represent an important step toward promoting greater patient and family caregiver engagement in their care.

  17. Development and psychometric testing of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan.

    PubMed

    Sun, Fan-Ko; Chiang, Chun-Ying; Chen, Wei-Jen; Wang, Ruey-Hsia; Huang, Hui-Man; Lin, Hung-Yen

    2014-08-01

    Suicide caring competence is important for family caregivers to care their relatives with suicidal tendencies. The purpose of this study was to develop and test the psychometric properties of the Suicide Caring Competence Scale (SCCS) for family caregivers in Taiwan. A 20-item SCCS was tested on 165 family caregivers. Confirmatory factor analysis indicated that five subscales with 19 items best fit the data. The Cronbach's α and test-retest reliability of the SCCS was 0.90 and 0.81, respectively. The SCCS demonstrated acceptable construct validity and reliability. Nurses can use the SCCS to assess the suicide caring competence of family caregivers.

  18. Home-based music strategies with individuals who have dementia and their family caregivers.

    PubMed

    Hanser, Suzanne B; Butterfield-Whitcomb, Joan; Kawata, Mayu; Collins, Brett E

    2011-01-01

    The purpose of this exploratory study was to test a caregiver-administered music program with family members who have dementia. The music protocol was designed to reduce distress and enhance satisfaction with caregiving, while offering the person with dementia the potential to improve mood and psychological state. Fourteen elders with dementia and their family caregivers were recruited, and 8 completed the protocol. Both caregivers and care recipients improved self-reported relaxation, comfort, and happiness, when mean scores were compared between baseline and music conditions. Caregivers showed the most benefit. While drop-out was high (6 families dropped), and caregiving satisfaction failed to improve over time, caregivers expressed enjoyment in reminiscing and participating in musical activities with their loved ones. More direct intervention by a music therapist is recommended to improve impact.

  19. Conflict Resolution and Distress in Dementia Caregiver Families: Comparison of Cubans and White Non-Hispanics

    PubMed Central

    Mitrani, Victoria B.; Vaughan, Ellen L.; McCabe, Brian E.; Feaster, Daniel J.

    2010-01-01

    This study investigated the role of family conflict resolution as a mediator of the relationship between ethnicity and psychological distress in dementia caregivers. The sample was composed of the families of 182 caregivers who participated in REACH (Resources for Enhancing Alzheimer’s Caregiver Health). The sample consisted of 84 Cuban American and 98 non-Hispanic White American families. Mediation analyses revealed that both income and conflict resolution partially mediated the relationship between ethnicity and caregiver psychological distress. Specifically, Cuban American families were less likely than non-Hispanic White families to reach a resolution to their disagreements, which may have rendered the caregiver at greater risk for psychological distress. These results suggest that Cuban American caregivers may benefit from interventions that improve the family’s ability to resolve conflicts. PMID:20448830

  20. Validation of the Italian Version of the Caregiver Abuse Screen among Family Caregivers of Older People with Alzheimer's Disease

    PubMed Central

    Di Rosa, Mirko; Barbabella, Francesco; Barbini, Norma; Chiatti, Carlos

    2017-01-01

    Introduction. Elder abuse is often a hidden phenomenon and, in many cases, screening practices are difficult to implement among older people with dementia. The Caregiver Abuse Screen (CASE) is a useful tool which is administered to family caregivers for detecting their potential abusive behavior. Objectives. To validate the Italian version of the CASE tool in the context of family caregiving of older people with Alzheimer's disease (AD) and to identify risk factors for elder abuse in Italy. Methods. The CASE test was administered to 438 caregivers, recruited in the Up-Tech study. Validity and reliability were evaluated using Spearman's correlation coefficients, principal-component analysis, and Cronbach's alphas. The association between the CASE and other variables potentially associated with elder abuse was also analyzed. Results. The factor analysis suggested the presence of a single factor, with a strong internal consistency (Cronbach's alpha = 0.86). CASE score was strongly correlated with well-known risk factors of abuse. At multivariate level, main factors associated with CASE total score were caregiver burden and AD-related behavioral disturbances. Conclusions. The Italian version of the CASE is a reliable and consistent screening tool for tackling the risk of being or becoming perpetrators of abuse by family caregivers of people with AD. PMID:28265571

  1. Remediation plans in family medicine residency

    PubMed Central

    Audétat, Marie-Claude; Voirol, Christian; Béland, Normand; Fernandez, Nicolas; Sanche, Gilbert

    2015-01-01

    Abstract Objective To assess use of the remediation instrument that has been implemented in training sites at the University of Montreal in Quebec to support faculty in diagnosing and remediating resident academic difficulties, to examine whether and how this particular remediation instrument improves the remediation process, and to determine its effects on the residents’ subsequent rotation assessments. Design A multimethods approach in which data were collected from different sources: remediation plans developed by faculty, program statistics for the corresponding academic years, and students’ academic records and rotation assessment results. Setting Family medicine residency program at the University of Montreal. Participants Family medicine residents in academic difficulty. Main outcome measures Assessment of the content, process, and quality of remediation plans, and students’ academic and rotation assessment results (successful, below expectations, or failure) both before and after the remediation period. Results The framework that was developed for assessing remediation plans was used to analyze 23 plans produced by 10 teaching sites for 21 residents. All plans documented cognitive problems and implemented numerous remediation measures. Although only 48% of the plans were of good quality, implementation of a remediation plan was positively associated with the resident’s success in rotations following the remediation period. Conclusion The use of remediation plans is well embedded in training sites at the University of Montreal. The residents’ difficulties were mainly cognitive in nature, but this generally related to deficits in clinical reasoning rather than knowledge gaps. The reflection and analysis required to produce a remediation plan helps to correct many academic difficulties and normalize the academic career of most residents in difficulty. Further effort is still needed to improve the quality of plans and to support teachers.

  2. 1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    1. VIEW OF THE SOUTHEAST CORNER OF THE FAMILY RESIDENCE (FEATURE B-10), FACING NORTH. - Nevada Lucky Tiger Mill & Mine, Family Residence, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  3. Caregiving Styles: A Cognitive and Behavioral Typology Associated with Dementia Family Caregiving

    ERIC Educational Resources Information Center

    Corcoran, Mary A.

    2011-01-01

    Purpose: An increasing number of elderly individuals are diagnosed with Alzheimer's disease and related disorders (ADRD), many of whom receive daily caregiving from spouse or adult child. Caregiving is a "cultural activity," and as such it is strongly influenced by sociocultural beliefs about caregiving and how it should be enacted.…

  4. Family caregiving to those with dementia in rural Alabama: racial similarities and differences.

    PubMed

    Kosberg, Jordan I; Kaufman, Allan V; Burgio, Louis D; Leeper, James D; Sun, Fei

    2007-02-01

    This study explored differences and similarities in the experiences of African American and White family caregivers of dementia patients living in rural Alabama. This cross-sectional survey used a caregiving stress model to investigate the interrelationships between caregiving burden, mediators, and outcomes. Random-digit-dialing telephone interviews were used to obtain data on a probability sample of 74 non-Hispanic White and 67 African American caregivers. White caregivers were more likely to be married and older, used acceptance and humor as coping styles, and had fewer financial problems. African American caregivers gave more hours of care, used religion and denial as coping styles, and were less burdened. The authors have developed a methodology for obtaining a representative sample of African American and White rural caregivers. Further investigations are needed of the interactions between urban/rural location and ethnic/racial backgrounds of dementia caregivers for heuristic and applied reasons.

  5. A DVD program on fall prevention skills training for cancer family caregivers.

    PubMed

    Potter, Patricia; Olsen, Sarah; Kuhrik, Marilee; Kuhrik, Nancy; Huntley, Lance R

    2012-03-01

    This feasibility study tested an instructional DVD program for improving cancer family caregivers' knowledge and preparedness in fall prevention and reducing fall occurrence among the patients they care for at home. DVD program features included training caregivers on safe mobility skills. Family caregivers of cancer patients were surveyed before and after viewing the DVD program on "Moving Safely" in the home. Cancer patients were followed 4 months postintervention to determine if fall occurrence was reduced. There was a decrease in the number of patients who fell postintervention compared with those who fell preintervention. Caregivers' perceptions of knowledge about fall prevention improved significantly after viewing the DVD. An instructional DVD program is an effective educational tool for preparing family caregivers with the knowledge and skills needed to reduce the incidence of falls in the home setting. Educators must develop programs for preparing family caregivers to perform nursing skills within the home.

  6. Implications of smart wear technology for family caregiving relationships: focus group perceptions.

    PubMed

    Hall, Scott S; Kandiah, Jayanthi; Saiki, Diana; Nam, Jinhee; Harden, Amy; Park, Soonjee

    2014-10-01

    Technological advances in monitoring vulnerable care-recipients are on the rise. Recent and future development of Smart Wear technology (devices integrated into clothing that monitor care-recipients) might assist family caregivers with tasks related to caring for young children, relatives with disabilities, and frail spouses or parents. However, the development and use of this technology in family caregiving contexts is in its infancy. Focus group interviews of family caregivers were conducted to explore perspectives regarding the potential integration of Smart Wear technology into their family caregiving. Responses were analyzed qualitatively for themes related to perceptions of how Smart Wear could impact relationships between caregivers and care-recipients. Three major themes emerged: quality and quantity of interaction, boundary issues, and implications for anxiety. Implications and recommendations are discussed regarding maximizing the potential benefits of Smart Wear technology in ways that promote and protect healthy relationships among caregivers and care-recipients.

  7. Satisfaction with civilian family medicine residency training

    PubMed Central

    Wolfrom, Brent; Hodgetts, Geoff; Kotecha, Jyoti; Pollock, Emily; Martin, Mary; Han, Han; Morissette, Pierre

    2016-01-01

    Abstract Objective To evaluate satisfaction with civilian residency training programs among serving general duty medical officers within the Canadian Armed Forces. Design A 23-item, cross-sectional survey face-validated by the office of the Surgeon General of the Canadian Armed Forces. Setting Canada. Participants General duty medical officers serving in the Canadian Armed Forces as of February 2014 identified through the Directorate of Health Services Personnel of the Canadian Forces Health Services Group Headquarters. Main outcome measures Satisfaction with and time spent in 7 domains of training: trauma, critical care, emergency medicine, psychiatry, occupational health, sports medicine, and base clinic training. Overall preparedness for leading a health care team, caring for a military population, working in isolated and challenging environments, and being deployed were evaluated on a 5-point Likert scale. Results Among the survey respondents (n = 135, response rate 54%), 77% agreed or strongly agreed that their family medicine residency training was relevant to their role as a general duty medical officer. Most respondents were either satisfied or very satisfied with their emergency medicine training (77%) and psychiatry training (63%), while fewer were satisfied or very satisfied with their sports medicine (47%), base clinic (41%), and critical care (43%) training. Even fewer respondents were satisfied or very satisfied with their trauma (26%) and occupational health (12%) training. Regarding overall preparedness, 57% believed that they were adequately prepared to care for a military patient population, and 52% of respondents believed they were prepared for their first posting. Fewer respondents (38%) believed they were prepared to work in isolated, austere, or challenging environments, and even fewer (32%) believed that residency training prepared them to lead a health care team. Conclusion General duty medical officers were satisfied with many aspects of

  8. Family Caregivers for Veterans with Spinal Cord Injury: Exploring the Stresses and Benefits

    DTIC Science & Technology

    2014-10-01

    Award Number: W81XWH-11-2-0213 TITLE: Family Caregivers for Veterans with Spinal Cord Injury: Exploring the Stresses and Benefits PRINCIPAL...TITLE AND SUBTITLE Family Caregivers for Veterans with Spinal Cord Injury: Exploring the Stresses 5a. CONTRACT NUMBER and Benefits 5b. GRANT NUMBER...Unfortunately, there are few studies that examine the intricacies of caregiving for people with spinal cord injuries. The purpose of this study is to

  9. Family caregiver preferences for patient decisional control among Hispanics in the United States and Latin America

    PubMed Central

    Yennurajalingam, Sriram; Noguera, Antonio; Parsons, Henrique Afonseca; Torres-Vigil, Isabel; Duarte, Eva Rosina; Palma, Alejandra; Bunge, Sofia; Palmer, J. Lynn; Delgado-Guay, Marvin Omar; Bruera, Eduardo

    2013-01-01

    Background Understanding family caregivers’ decisional role preferences is important for communication, quality of care, and patient and family satisfaction. The family caregiver has an important role in a patient’s decisional role preferences. There are limited studies on family caregivers’ preferences of the patient’s decisional control at the end of life among Hispanics. Aims To identify Hispanic caregivers’ preferences of the decision control of patients with advanced cancer and to compare the preferences of caregivers in Latin America (HLA) and Hispanic American (HUSA) caregivers. Design We surveyed patients and their family caregivers referred to outpatient palliative care clinics in the United States, Chile, Argentina, and Guatemala. Caregiver preferences of patient’s decisional control were evaluated using the Control Preference Scale. Caregivers’ and patients’ socio-demographic variables, patient performance status, and HUSA patient acculturation level was also collected. Participants A total of 387 caregivers were surveyed: 100 (26%) in Chile, 99 (26%) in Argentina, 97 (25%) in Guatemala, and 91 (24%) in the United States. The median age was 56 years, and 59% were female. Results Caregiver preference of patients decisions control was passive, shared, and active by 10 (11%), 45 (52%) and 32 (37%) HUSA caregivers and 54 (19%), 178 (62%) and 55 (19%) HLA caregivers (p=0.0023). Caregiver acculturation level did not affect the preferences of the HUSA sample (p=0.60). Conclusions Most Hispanic family caregivers preferred the patient to make shared decisions. HLA caregivers preferred more frequently patients to assume a passive decisional role. Acculturation did not influence the preferences of HUSA caregivers. PMID:23670718

  10. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 24 Housing and Urban Development 5 2011-04-01 2011-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  11. 24 CFR 1710.10 - Single-family residence exemption.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 24 Housing and Urban Development 5 2010-04-01 2010-04-01 false Single-family residence exemption... Requirements § 1710.10 Single-family residence exemption. (a) General. The sale of a lot which meets the... zoned for single-family residences or, in the absence of a zoning ordinance, limited exclusively...

  12. Support Service Use and Interest in Support Services among Distressed Family Caregivers of Lung Cancer Patients

    PubMed Central

    Mosher, Catherine E.; Champion, Victoria L.; Hanna, Nasser; Jalal, Shadia I.; Fakiris, Achilles J.; Birdas, Thomas J.; Okereke, Ikenna C.; Kesler, Kenneth A.; Einhorn, Lawrence H.; Given, Barbara A.; Monahan, Patrick O.; Ostroff, Jamie S.

    2012-01-01

    Objective This study examined support service use and interest in support services among distressed family caregivers of patients recently entering a comprehensive cancer care facility. Methods Primary family caregivers of lung cancer patients (N = 83) were recruited from three medical centers within 12 weeks of the patient’s new visit to the oncology clinic. All family caregivers were screened for psychological distress and those reporting significant anxiety or depressive symptoms were eligible for this study. Caregivers completed a baseline assessment of support service use (i.e., use of mental health services and complementary and alternative medicine [CAM]) and interest in support services. Support service use was also assessed three months later. Results Although all caregivers reported clinically meaningful distress, only 26% used mental health and 39% used CAM services during the 3-month study period. Patients’ receipt of chemotherapy was positively associated with caregivers’ mental health service use, whereas greater education and receiving assistance with caregiving tasks were associated with CAM use. Forty percent of caregivers who did not use CAM at baseline were interested in CAM. In addition, 29% of caregivers who did not receive mental health services at baseline were interested in professional psychosocial support, and 29% of caregivers who did not receive staff assistance with practical needs at baseline were interested in this service. Conclusions Findings suggest that distressed family caregivers of lung cancer patients underuse mental health services and that a sizable minority are interested in professional help with psychosocial and practical needs. PMID:22941782

  13. Understanding Discrepancy in Perceptions of Values: Individuals with Mild to Moderate Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2011-01-01

    Purpose of the Study: We explore discrepancies in perceptions of values and care preferences between individuals with dementia (IWDs) and their family caregivers. Design and Methods: We interviewed 266 dyads consisting of an individual with mild to moderate dementia and his or her family caregiver to determine IWDs' beliefs for 5 values related to…

  14. Respite Utilization and Responses to Loss among Family Caregivers: Relationship Matters

    ERIC Educational Resources Information Center

    DeCaporale, Lauren; Mensie, Lauren; Steffen, Ann

    2013-01-01

    Family caregivers of physically and cognitively impaired older adults face multiple challenges when providing care, including responses to tangible and anticipated losses. However, little is known about the grief experiences of family caregivers and how these might differentially influence the care-related behaviors of spouses and adult children.…

  15. Resolving to go forward: the experience of Latino/Hispanic family caregivers.

    PubMed

    Lucke, Kathleen T; Martinez, Hernando; Mendez, Thomas B; Arévalo-Flechas, Lyda C

    2013-02-01

    Little is known about the experiences and needs of family caregivers of Latino/Hispanic individuals with spinal cord injury (SCI) during the early years of recovery. The purpose of this grounded theory study was to describe the experiences and identify the informational, decisional, interpersonal, and resource support needs of family caregivers of newly injured Latino/Hispanic individuals with SCI during the first 2 years after undergoing rehabilitation. "Resolving to go forward" was the core category that emerged from two simultaneous processes of "learning to care for" and "getting through" during the initial years as the primary informal caregiver. Most caregivers felt alone and abandoned after the injured person returned home, and experienced barriers to services and resources primarily because of language issues and economic status. We recommend that researchers develop and evaluate culturally appropriate, informal caregiving models to improve outcomes for both Latino individuals with SCI and their family caregivers.

  16. Reflections on methodological approaches and conceptual contributions in a program of caregiving research: development and testing of Wuest's theory of family caregiving.

    PubMed

    Wuest, Judith; Hodgins, Marilyn J

    2011-02-01

    Caregiving by family members, particularly women, is a societal expectation that is intensifying in the context of an aging population and health care restructuring. Our program of caregiving research spans two decades, moving from inductive theory development using grounded theory methods to deductive theory testing. In this article, we reflect on the serendipitous development of this program of research methodologically and conceptually. We summarize the key conceptual contributions that the program has made to caregiving knowledge, particularly with respect to the past relationship between care recipient and caregiver, obligation to care, caregiver agency, and relationships between caregivers and the health care system.

  17. Faith, Work, and Reciprocity: Listening to Mexican Men Caregivers of Elderly Family Members.

    PubMed

    Nance, Douglas C; Rivero May, Maria Isabel; Flores Padilla, Luis; Moreno Nava, Mario; Deyta Pantoja, Alma Laura

    2016-06-28

    The purpose of this qualitative study was to examine the role of Mexican men caregivers of older adults. Studies investigating male caregiving practice in Mexico are lacking. Listening events for older adults and family caregivers were held in six cities, obtaining an ethnically and socioeconomically diverse sample of 121 participants-81 older adults and 57 primary caregivers (including 17 older adults). Focus groups discussed end-of-life issues and challenges of care. Discussions were audio recorded and field notes were made. Framework Analysis was used to analyze data. Nationally, 37% of the caregivers were men. In the metropolitan area of Mexico City, 57% of caregivers were men. The men caregivers discussed their roles and experiences. The results were categorized into three themes: (a) reciprocity in family caregiving, (b) a practical work-oriented attitude toward caregiving, and (c) strong religious faith. Caregiving formed an important part of their masculine role. Stereotypes related to gender and care should be reexamined. Further research is needed to explore gender variations in caregiving, evolving gender roles, and needs for support and services.

  18. Age Effects on Cognitive and Physiological Parameters in Familial Caregivers of Alzheimer's Disease Patients

    PubMed Central

    Corrêa, Márcio Silveira; Giacobbo, Bruno Lima; Vedovelli, Kelem; de Lima, Daiane Borba; Ferrari, Pamela; Argimon, Irani Iracema de Lima; Walz, Julio Cesar

    2016-01-01

    Objectives Older familial caregivers of Alzheimer’s disease patients are subjected to stress-related cognitive and psychophysiological dysfunctions that may affect their quality of life and ability to provide care. Younger caregivers have never been properly evaluated. We hypothesized that they would show qualitatively similar cognitive and psychophysiological alterations to those of older caregivers. Method The cognitive measures of 17 young (31–58 years) and 18 old (63–84 years) caregivers and of 17 young (37–57 years) and 18 old (62–84 years) non-caregiver controls were evaluated together with their salivary cortisol and dehydroepiandrosterone (DHEA) levels, as measured by radioimmunoassays and ELISA assays of brain-derived neurotrophic factor (BDNF) in serum. Results Although younger caregivers had milder impairments in memory and executive functions than older caregivers, their performances fell to the same or lower levels as those of the healthy older controls. Decreases in DHEA and BDNF levels were correlated with the cognitive dysfunctions observed in the older and younger caregivers, respectively. Cortisol at 10PM increased in both caregiver groups. Discussion Younger caregivers were prone to cognitive impairments similar to older caregivers, although the degree and the neuropsychological correlates of the cognitive dysfunctions were somewhat different between the two groups. This work has implications for caregiver and care-recipient health and for research on the neurobiology of stress-related cognitive dysfunctions. PMID:27706235

  19. Burden and associated pathologies in family caregivers of Alzheimer’s disease patients in Spain

    PubMed Central

    Cotelo, Natalia Vérez; Rodríguez, N. Floro Andrés; PÉREZ, José A. Fornos; Iglesias, J. Carlos Andrés; Lago, Marcos Ríos

    2014-01-01

    Objectives: To evaluate the profile of family caregivers of Alzheimer’s disease patients, identify any signs of psychopathology, quantify the level of perceived burden on the caregiver, and determine the caregiver’s relationship with their pharmacist. Methods: A cross-sectional study was conducted at a community pharmacy in Pontevedra, Spain. Demographic variables were collected, and the following questionnaires were administered: the Beck Depression Inventory-II, STAI-Anxiety Questionnaire, Zarit Burden Scale, family APGAR scale, and the Duke-UNC questionnaire. Results: The typical caregiver profile consists of a 55-year old first degree relative (mostly daughters) with a primary education who belongs to a functional or mildly dysfunctional family. Nearly one quarter (24%) of caregivers had a high perception of burden, with anxiety in 20% of caregivers and symptoms of depression in 20%. Family caregivers usually went to the same pharmacy as the patients (96%), were treated with psychotropic drugs (68%), and interacted with the pharmacist (92%). Conclusion: This study confirmed that psychological distress and burden is present among family caregivers. Care for caregivers should be integrated into patient care as part of a national plan, including grants and subsidies, which will result in better care of Alzheimer’s patients. Pharmacists are the most accessible health care professionals and can provide information about Alzheimer’s disease management to caregivers to ease the burden of care. PMID:26131040

  20. Starting A Healthy Family: Choosing Parenthood. Starting A Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, explores the impact a baby has on its family. Case studies and activities help high school students in: (1) understanding the responsibilities of parenthood; (2) becoming aware of increasing numbers of adolescent pregnancies; and (3) picturing themselves as…

  1. Effects of Green House nursing homes on residents' families.

    PubMed

    Lum, Terry Y; Kane, Rosalie A; Cutler, Lois J; Yu, Tzy-Chyi

    2008-01-01

    A longitudinal quasi-experimental study with two comparison groups was conducted to test the effects of a Green House (GH) nursing home program on residents' family members. The GHs are individual residences, each serving 10 elders, where certified nursing assistant (CNA)-level resident assistants form primary relationships with residents and family, family is encouraged to visits, and professionals adapted their roles to support the model. GH family were somewhat less involved in providing assistance to their residents although family contact did not differ among the settings at any time period. GH family were more satisfied with their resident's care and with their own experience as family members, and had no greater family burden. Issues in studying family outcomes are discussed as well as implications for roles of various personnel, including social service and activities staff in a GH model.

  2. Experiences of stigma and discrimination faced by family caregivers of people with schizophrenia in India.

    PubMed

    Koschorke, Mirja; Padmavati, R; Kumar, Shuba; Cohen, Alex; Weiss, Helen A; Chatterjee, Sudipto; Pereira, Jesina; Naik, Smita; John, Sujit; Dabholkar, Hamid; Balaji, Madhumitha; Chavan, Animish; Varghese, Mathew; Thara, R; Patel, Vikram; Thornicroft, Graham

    2017-04-01

    Stigma associated with schizophrenia significantly affects family caregivers, yet few studies have examined the nature and determinants of family stigma and its relationship to their knowledge about the condition. This paper describes the experiences and determinants of stigma reported by the primary caregivers of people living with schizophrenia (PLS) in India. The study used mixed methods and was nested in a randomised controlled trial of community care for people with schizophrenia. Between November 2009 and October 2010, data on caregiver stigma and functional outcomes were collected from a sample of 282 PLS-caregiver dyads. In addition, 36 in-depth-interviews were conducted with caregivers. Quantitative findings indicate that 'high caregiver stigma' was reported by a significant minority of caregivers (21%) and that many felt uncomfortable to disclose their family member's condition (45%). Caregiver stigma was independently associated with higher levels of positive symptoms of schizophrenia, higher levels of disability, younger PLS age, household education at secondary school level and research site. Knowledge about schizophrenia was not associated with caregiver stigma. Qualitative data illustrate the various ways in which stigma affected the lives of family caregivers and reveal relevant links between caregiver-stigma related themes ('others finding out', 'negative reactions' and 'negative feelings and views about the self') and other themes in the data. Findings highlight the need for interventions that address both the needs of PLS and their family caregivers. Qualitative data also illustrate the complexities surrounding the relationship between knowledge and stigma and suggest that providing 'knowledge about schizophrenia' may influence the process of stigmatisation in both positive and negative ways. We posit that educational interventions need to consider context-specific factors when choosing anti-stigma-messages to be conveyed. Our findings suggest

  3. Creating patient and family education web sites: design and content of the home parenteral nutrition family caregivers web site.

    PubMed

    Fitzgerald, Sharon A; Macan Yadrich, Donna; Werkowitch, Marilyn; Piamjariyakul, Ubolrat; Smith, Carol E

    2011-11-01

    When managing chronic illnesses, caregivers repeatedly seek online information about providing complex, long-term care but often neglect to find information about how to care for themselves. Poor health among caregivers is not only detrimental to their own well-being but may also result in harm to those for whom they care. For this reason, caregivers need access to information and activities about caring for themselves in addition to the information about managing home care they are already likely to seek. The HPN Family Caregivers Web site was developed to guide caregivers through the process of caring for themselves by establishing a caregiving routine, self-monitoring their mental and physical health, and practicing good sleep hygiene, while also managing the complexities of home care. While Web site information, activities, and algorithms for managing chronic illnesses need to be specific to each population, the content guiding caregivers to care for their own health is universal.

  4. Liminality as a Conceptual Frame for Understanding the Family Caregiving Rite of Passage: An Integrative Review

    PubMed Central

    Gibbons, Susanne W.; Ross, Alyson; Bevans, Margaret

    2014-01-01

    Family caregiving is a significant rite of passage experienced by family caregivers of individuals with protracted illness or injury. In an integrative review of 26 studies, we characterized family caregiving from the sociocultural perspective of liminality and explored associated psychosocial implications. Analysis of published evidence on this dynamic and formative transition produced a range of themes. While role ambiguity resolved for most, for others, uncertainty and suffering continued. The process of becoming a caregiver was transformative and can be viewed as a rebirth that is largely socially and culturally driven. The transition to family caregiving model produced by this review provides a holistic perspective on this phenomenon and draws attention to aspects of the experience previously underappreciated. PMID:25176315

  5. Seeking Medical Information Using Mobile Apps and the Internet: Are Family Caregivers Different from the General Public?

    PubMed

    Kim, Hyunmin; Paige Powell, M; Bhuyan, Soumitra S; Bhuyan, Soumitra Sudip

    2017-03-01

    Family caregivers play an important role to care cancer patients since they exchange medical information with health care providers. However, relatively little is known about how family caregivers seek medical information using mobile apps and the Internet. We examined factors associated with medical information seeking by using mobile apps and the Internet among family caregivers and the general public using data from the 2014 Health Information National Trends Survey 4 Cycle 1. The study sample consisted of 2425 family caregivers and 1252 non-family caregivers (the general public). Guided by Comprehensive Model of Information Seeking (CMIS), we examined related factors' impact on two outcome variables for medical information seeking: mobile apps use and Internet use with multivariate logistic regression analyses. We found that online medical information seeking is different between family caregivers and the general public. Overall, the use of the Internet for medical information seeking is more common among family caregivers, while the use of mobile apps is less common among family caregivers compared with the general public. Married family caregivers were less likely to use mobile apps, while family caregivers who would trust cancer information were more likely to use the Internet for medical information seeking as compared to the general public. Medical information seeking behavior among family caregivers can be an important predictor of both their health and the health of their cancer patients. Future research should explore the low usage of mobile health applications among family caregiver population.

  6. Experience with a Family-Practice-Resident-Directed Obstetrical Clinic.

    ERIC Educational Resources Information Center

    Hunter, Jerry L.; Snyder, Frank

    1980-01-01

    At Toledo Hospital, family practice residents have assumed responsibility for the normal obstetrics clinic. Specialty consultations are provided by the hospital's obstetrics residency program. A medical audit of the clinic indicates that the family practice residents obtained consultations and made referrals at the appropriate times. (JMD)

  7. Family caregivers' perspectives on dementia-related dressing difficulties at home: The preservation of self model.

    PubMed

    Mahoney, Diane F; LaRose, Sharon; Mahoney, Edward L

    2015-07-01

    Alzheimer's caregiving literature acknowledges dressing as a major daily stressor but research on this topic is negligible. A qualitative grounded theory approach was used to explore Alzheimer's family caregivers' perspectives about issues that arise when their family members lose the ability to dress independently. Three focus groups and seven individual interviews were conducted and audio recorded with 25 information rich caregivers. Constant comparative analyses and coding of the transcripts identified six major themes leading to a 'Preservation of Self Model: Care Recipient to Care Giver' that portrays the caregiving trajectory. Initially, caregivers tried to protect the self dignity of the family member by maintaining usual routines and absorbing blame for difficulties. Dressing 'battles' occurred and caregivers learned management through trial and error. Crossing adult-child-gender role boundaries escalated discomfort. When facing unrelenting demands, concern shifted to preservation of the caregivers' health and self. Results suggest that caregivers would benefit from more pro-active dressing counseling to shorten the trial and error periods, dressing aids more relevant to dementia and more knowledgeable helpers. The preservation model can facilitate understanding of the caregiving trajectory and guide intervention support.

  8. [Factors affecting subjective satisfaction with verbal communication among the disabled elderly and their family caregivers].

    PubMed

    Miura, Hiroko; Arai, Yumiko; Yamasaki, Kiyoko

    2005-05-01

    The aims of the present study were to investigate satisfaction with verbal communication among the disabled elderly and their family caregivers; and to find the significantly influential factors of satisfaction with verbal communication. The subjects were 85 disabled elderly and 85 family caregivers. For the disabled elderly, satisfaction with verbal communication, demographic, and physical factors were examined using an interview survey. For the caregivers, satisfaction with verbal communication, demographic factors, and some factors related caregiving were examined using a self-administered questionnaire. In the disabled elderly, 82.4% were satisfied with their verbal communication while 55.3% of family caregivers were satisfied. Satisfaction with verbal communication between the disabled elderly and their caregivers showed low agreement (kappa = 0.17). Bivariate analysis revealed that satisfaction with verbal communication of the disabled elderly was significantly related to ADL (p < 0.01), dysphagia risk (p < 0.05), and ability of comprehension (p < 0.05) while satisfaction with verbal communication of caregivers was significantly related to the gender of the disabled elderly and caregivers' burden. Furthermore, multiple regression analysis showed that the factor most related to satisfaction with verbal communication for the disabled elderly was ability of comprehension (p value = 0.032, odds ratio = 2.960), and the most related factor for their caregivers was the burden evaluated by J-ZBI_8 (p value = 0.004, odds ratio = 0.842). These results suggest that satisfaction with verbal communication of the disabled elderly disagrees with that of the family caregivers, and that some related factors for the disabled elderly are different from those in their family caregivers.

  9. Care Burden and Self-Efficacy Levels of Family Caregivers of Elderly People in Turkey.

    PubMed

    Unver, Vesile; Basak, Tulay; Tosun, Nuran; Aslan, Ozlem; Akbayrak, Nalan

    2016-01-01

    The aim of this research was to determine the level of burden and self-efficacy among family caregivers of elderly people in Turkey. This study is descriptive and cross-sectional. A total of 658 family caregivers of elderly people were included in the study. The data were collected with a caregiver's characteristics form, elderly people's characteristics form, the Zarit Burden Interview, the self-efficacy scale, and the Barthell Index. Data were analyzed using SPSS 16.0 program. What are care burden and self-efficacy levels of the caregivers? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age, duration of care, sex, status of education, type of relationship, and status of employment that belong to the caregiver? Is there a relationship between care burden and self-efficacy levels of the caregivers with variables such as age and Bartell Index that belong to the elderly? The caregiver burden score was 38.65 ± 13.73, which indicates a moderate level of burden. The self-efficacy score was 29.31 ± 6.09, which is in the low range of self-efficacy. There were statistically significant differences between the caregiver burden score and the sex of caregivers, status of education, type of relationship, and the elderly person's score on the Bartell Index (P < .05). The relationship between the employment status of caregivers (P = .01), the age of the elderly (P = .01), and the caregivers' score on the self-efficacy scale (P < .05) was found to be statistically significant. Study revealed that the majority of the caregivers experienced moderate levels of care burden and low levels of self-efficacy. These results will provide beneficial information for nurses to provide the holistic nursing care.

  10. Multiple Family Groups for Child Behavior Difficulties Retention Among Child Welfare-Involved Caregivers.

    PubMed

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P

    2015-09-01

    Among children who remain at home with their permanent caregivers following a child welfare investigation, few who manifest emotional and behavioral difficulties actually engage in mental health treatment. The Multiple Family Group service delivery model to reduce childhood disruptive behavior disorders (MFG) has shown promise in engaging child welfare-involved families. This qualitative study examines caregiver perceptions of factors that influence retention in MFGs among child welfare-involved families.

  11. Values and Preferences of Individuals with Dementia: Perceptions of Family Caregivers over Time

    ERIC Educational Resources Information Center

    Reamy, Allison M.; Kim, Kyungmin; Zarit, Steven H.; Whitlatch, Carol J.

    2013-01-01

    Purpose of the Study: Cross-sectional evidence indicates that family caregivers reporting on the importance of daily care values and preferences of individuals with mild-to-moderate dementia consistently report less importance than individuals with dementia (IWDs) self-report. Discrepancy is primarily associated with caregivers' beliefs about…

  12. Kinship Care and Nonrelative Family Foster Care: A Comparison of Caregiver Attributes and Attitudes.

    ERIC Educational Resources Information Center

    Gebel, Timothy J.

    1996-01-01

    Reports the findings of a survey that explored the attitudes and attributes of nonrelative family foster caregivers and kinship caregivers for children adjudicated dependent and placed by a state public welfare agency. Found significant differences on several demographic variables, in the frequency of caseworker contacts and in perceptions and…

  13. Home Centered Care: Designing a Family Day Care Program. A Guide for Caregivers and Parents.

    ERIC Educational Resources Information Center

    Garcia, Ronda

    Consistent in its approach to child development and caregiving concepts, this guide for parents and child caregivers explores aspects of family day care in five sections. Section I discusses the design of physically safe environments for children. Section II describes the developing likes and needs of infants, toddlers, preschool children, and…

  14. Family Caregiving: Impact of Patient Functioning and Underlying Causes of Dependency.

    ERIC Educational Resources Information Center

    Silliman, Rebecca A.; Sternberg, Josef

    1988-01-01

    Notes that diseases affect health and functional status of patients in different ways and have variable impacts on family caregivers. Using hip fracture, dementia, and stroke as examples, illustrates how physical, social, psychological, and cognitive disabilities place different demands on caregivers. (Author)

  15. Strengthening Incarcerated Families: Evaluating a Pilot Program for Children of Incarcerated Parents and Their Caregivers

    PubMed Central

    Miller, Alison L.; Perryman, Jamie; Markovitz, Lara; Franzen, Susan; Cochran, Shirley; Brown, Shavonnea

    2013-01-01

    Parental incarceration can be devastating for families. Children may experience difficulties, and the stress on caregivers who take on unexpected childrearing is high. We implemented and evaluated a family-level intervention with caregivers and children experiencing parental (typically maternal) incarceration, in a community setting. We partnered with a community-based organization serving families with an incarcerated parent to conduct a pilot trial of the Strengthening Families Program (SFP). Process evaluation indicated high implementation fidelity, satisfaction, engagement, and attendance. Outcome evaluation results indicated positive changes in family-level functioning, caregivers’ positive parenting, and caregiver depression symptoms from pre- to post-intervention, with some changes retained at follow-up 4 months later. Implications for preventive interventions with children of incarcerated parents, and their caregivers, are discussed. PMID:24353363

  16. Families and Futures: Helping Self and Others. Starting a Healthy Family Series/Family and Community Health Through Caregiving.

    ERIC Educational Resources Information Center

    Education Development Center, Inc., Newton, MA.

    This student manual, part of the Family and Community Health Through Caregiving program, focuses on the special needs of teenagers with birth defects. Topics include: (1) the effect of informal contacts with the community, neighbors, and school age peers on the special needs adolescent; (2) society's attempts to meet these needs; (3) problems of…

  17. A Qualitative Study of Family Caregiver Experiences of Managing Incontinence in Stroke Survivors

    PubMed Central

    Tseng, Chien-Ning; Huang, Guey-Shiun; Yu, Po-Jui; Lou, Meei-Fang

    2015-01-01

    Background Incontinence is a common problem faced by family caregivers that is recognized as a major burden and predictor of institutionalization. However, few studies have evaluated the experiences of family caregivers caring for stroke survivors with incontinence. Purpose To describe experiences of caregivers managing incontinence in stroke survivors. Design This qualitative descriptive study employed a grounded-theory approach. Methods Semi-structured in-depth interviews with ten family caregivers of stroke survivors with incontinence were conducted during 2011. Audiotaped interviews were transcribed and analyzed using content analysis. Findings Data analysis identified four themes: chaos, hypervigilance, exhaustion, and creating a new life. There were nine related subcategories: fluster, dirtiness, urgency, fear of potential health-hazard, physically demanding and time-consuming, mentally draining, financial burden, learning by doing, and attitude adjustment. Together, these described a process of struggling to cope with the care of stroke survivors with urinary/fecal incontinence. Of the four categories, “creating a new life” developed gradually over time to orient caregivers to their new life, while the other three categories occurred in a chronological order. Conclusion The research highlighted unique caring experiences of family caregivers of stroke patients, which focused solely on the ‘incontinence issue’. Understanding these experiences may help nurses provide better support and resources for family caregivers when caring for stroke survivors with incontinence. PMID:26066345

  18. The Disproportionate Impact Of Dementia On Family And Unpaid Caregiving To Older Adults.

    PubMed

    Kasper, Judith D; Freedman, Vicki A; Spillman, Brenda C; Wolff, Jennifer L

    2015-10-01

    The number of US adults ages sixty-five and older who are living with dementia is substantial and expected to grow, raising concerns about the demands that will be placed on family members and other unpaid caregivers. We used data from the 2011 National Health and Aging Trends Study and its companion study, the National Study of Caregiving, to investigate the role of dementia in caregiving. We found that among family and unpaid caregivers to older noninstitutionalized adults, one-third of caregivers, and 41 percent of the hours of help they provide, help people with dementia, who account for about 10 percent of older noninstitutionalized adults. Among older adults who receive help, the vast majority in both community and residential care settings other than nursing homes rely on family or unpaid caregivers (more than 90 percent and more than 80 percent, respectively), regardless of their dementia status. Caregiving is most intense, however, to older adults with dementia in community settings and from caregivers who are spouses or daughters or who live with the care recipient.

  19. Perception Gap in Quality-of-Life Ratings: An Empirical Investigation of Nursing Home Residents and Caregivers

    ERIC Educational Resources Information Center

    Mittal, Vikas; Rosen, Jules; Govind, Rahul; Degenholtz, Howard; Shingala, Sunil; Hulland, Shelley; Rhee, YongJoo; Kastango, Kari B.; Mulsant, Benoit H.; Castle, Nick; Rubin, Fred H.; Nace, David

    2007-01-01

    Purpose: Several studies have previously documented the existence of a perception gap--the extent to which quality-of-life ratings provided by nursing home residents and caregivers diverge. In this study we use Helson's adaptation-level theory to investigate three types of antecedents: (a) focal factors, (b) background factors, and (c) residual…

  20. Enhancing Mutual Respect among Nursing Assistants, Residents, and Residents' Families.

    ERIC Educational Resources Information Center

    Heiselman, Terry; Noelker, Linda S.

    1991-01-01

    Interviewed nursing assistants (n=40) and nursing facility residents (n=37) regarding ways they experienced respect, disrespect, attachment, and distancing in their relationships with each other. As a result of finding evidence of disrespect, an inservice session on gaining respect as a nursing assistant was presented. (ABL)

  1. Finding Meaning in Written Emotional Expression by Family Caregivers of Persons With Dementia.

    PubMed

    Butcher, Howard K; Gordon, Jean K; Ko, Ji Woon; Perkhounkova, Yelena; Cho, Jun Young; Rinner, Andrew; Lutgendorf, Susan

    2016-12-01

    This study tested the effect of written emotional expression on the ability to find meaning in caregiving and the effects of finding meaning on emotional state and psychological burden in 91 dementia family caregivers. In a pretest-posttest design, participants were randomly assigned to either an experimental or a comparison group. Experimental caregivers (n = 57) wrote about their deepest thoughts and feelings about caring for a family member with dementia, whereas those in the comparison group (n = 34) wrote about nonemotional topics. Results showed enhanced meaning-making abilities in experimental participants relative to comparison participants, particularly for those who used more positive emotion words. Improved meaning-making ability was in turn associated with psychological benefits at posttest, but experimental participants did not show significantly more benefit than comparison participants. We explore the mediating roles of the meaning-making process as well as some of the background characteristics of the individual caregivers and their caregiving environments.

  2. Clinical Evaluation in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Herman, James M.; And Others

    1985-01-01

    A study assessed (1) the validity of the Bowman Gray School of Medicine evaluation instrument regarding the occurrence of halo effects and (2) possible relationships between the faculty's evaluations of the residents and the residents' cognitive knowledge and productivity. (MLW)

  3. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible... training concerning the following core competencies: (1) Medication management; (2) Vital signs and...

  4. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible... training concerning the following core competencies: (1) Medication management; (2) Vital signs and...

  5. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible... training concerning the following core competencies: (1) Medication management; (2) Vital signs and...

  6. 38 CFR 71.25 - Approval and designation of Primary and Secondary Family Caregivers.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... as a Family Caregiver. (3) There must be no determination by VA of abuse or neglect of the eligible... training concerning the following core competencies: (1) Medication management; (2) Vital signs and...

  7. Effects of Family Treatment on Parenting Beliefs Among Caregivers of Youth with Poorly Controlled Asthma

    PubMed Central

    Ellis, Deborah A.; King, Pamela; Naar-King, Sylvie; Lam, Phebe; Cunningham, Phillippe B.; Secord, Elizabeth

    2014-01-01

    Objective Caregiver involvement is critical to ensuring optimal adolescent asthma management. The study investigated whether Multisystemic Therapy (MST), an intensive, home-based family therapy, was superior to family support for changing beliefs regarding asthma-related positive parenting among caregivers of African-American youth with poorly controlled asthma. The relationship between parenting beliefs and asthma management at the conclusion of the intervention was also assessed. Methods A randomized controlled trial was conducted with 167 adolescents with moderate to severe persistent, poorly controlled asthma and their primary caregivers. Families were randomly assigned to MST or FS, a home-based family support condition. Data were collected at baseline and seven month post-test. Changes in caregiver ratings of importance and confidence for engaging in asthma-related positive parenting were assessed via questionnaire. Illness management was assessed by the Family Asthma Management System Scale (FAMSS). Results Participation in MST was associated with more change in caregiver beliefs as compared to FS for both importance (t =2.39, p=.02) and confidence (t =2.04, p=.04). Caregiver beliefs were also significantly related to youth controller medication adherence at the conclusion of treatment (importance: r=.21, p=.01; confidence: r=.23, p=.004). Conclusion Results support the effectiveness of MST for increasing parental beliefs in the value of asthma-related positive parenting behaviors and parental self-efficacy for these behaviors among families of minority adolescents with poorly controlled asthma. PMID:25186121

  8. Health Related Quality of Life in Family Caregivers of Patients Suffering from Mental Disorders

    PubMed Central

    Noghani, Fatemeh; Seyedfatemi, Naiemeh; Akbarzadeh, Arash; Hasanpour-Dehkordi, Ali

    2016-01-01

    Introduction In the light of the advances in treatment measures and early discharge of patients with mental disorders from psychiatric hospitals, families play important role in caring for such patients. Aim The aim of this study is to determine the Quality of Life (QoL) of the family caregivers of patients with mental disorders. Materials and Methods This cross-sectional study was conducted in teaching health care centers affiliated with medical universities in Tehran, Iran. Sampling was conducted by convenience random technique. Participants were 238 family caregivers of mental disorder patients and the Short-Form Health Survey Questionnaire was used to gather data. The data were analyzed by Spearman’s correlation, t-test and ANOVA in SPSS 18.0. Results The women’s mean QoL was lower than the men’s. Regarding family relationship with the patients, the lowest QoL was observed among the mothers. There was a significant relationship between the caregivers QoL and economic status, the caregivers gender, family relationship with the patients and the patients’ gender (p<0.05). Conclusion The caregivers of mental disorder patients have lower QoL compared with general population. Appropriately developed plans should be implemented to improve QoL among the family caregivers of these patients. PMID:28050483

  9. Family-to-work spillover and appraisals of caregiving by employed women caring for their elderly parents in Japan

    PubMed Central

    SAKKA, Mariko; SATO, Iori; IKEDA, Mari; HASHIZUME, Hirofumi; UEMORI, Masayo; KAMIBEPPU, Kiyoko

    2016-01-01

    We examined the differences in family-to-work spillover between employed women who did and did not have caregiving responsibilities for elderly parents and the relationship between family-to-work spillover and negative and positive appraisals of caregiving using moderation analysis. A cross-sectional survey was conducted with middle-aged employed women (age ≥40 years) from four large companies. Negative and positive family-to-work spillover (FWNS and FWPS, respectively) and negative and positive appraisals of caregiving were measured. Data from 386 non-caregivers and 82 caregivers were analyzed using Fisher’s exact tests, Welch’s t-tests, and hierarchical multiple regression. Results showed that FWNS was higher in caregivers than in non-caregivers, while there was no significant difference in FWPS. Caregiver “fulfillment from the caregiving role” (a subscale of positive appraisal) buffered the effects of caregiver “feelings of social restriction” (a subscale of negative appraisal) on FWNS. On the other hand, caregiver “commitment to caregiving tasks” (another positive subscale) intensified the effects of “feelings of social restriction” on FWNS. However, there was no relationship between negative and positive appraisals of caregiving and FWPS. These findings suggest that both negative and positive appraisals of caregiving are important contributors to FWNS among employed women caring for their parents. PMID:26829970

  10. Putting theory to the test: examining family context, caregiver motivation, and conflict in the Family Check-Up model.

    PubMed

    Fosco, Gregory M; Van Ryzin, Mark; Stormshak, Elizabeth A; Dishion, Thomas J

    2014-05-01

    This study examined contextual factors (caregiver depression, family resources, ethnicity, and initial levels of youth problem behavior) related to the effectiveness of the Family Check-Up (FCU) and evaluated family processes as a mediator of FCU intervention response and adolescent antisocial behavior. We followed a sample of 180 ethnically diverse youths of families who engaged in the FCU intervention. Family data were collected as part of the FCU assessment, and youth data were collected over 4 years, from sixth through ninth grade. Findings indicated that caregiver depression and minority status predicted greater caregiver motivation to change. In turn, caregiver motivation was the only direct predictor of FCU intervention response during a 1-year period. Growth in family conflict from sixth through eighth grade mediated the link between FCU response and ninth-grade antisocial behavior. This study explicitly tested core aspects of the FCU intervention model and demonstrated that caregiver motivation is a central factor that underlies family response to the FCU. The study also provided support for continued examination of family process mechanisms that account for enduring effects of the FCU and other family-centered interventions.

  11. The relationship between socio-demographic characteristics, family environment, and caregiver coping in families of children with cancer.

    PubMed

    Gage-Bouchard, Elizabeth A; Devine, Katie A; Heckler, Charles E

    2013-12-01

    The factors that influence caregiver coping mechanism preferences after a child's diagnosis with cancer are not fully understood. This study examines the relationship between caregivers' socio-demographic characteristics and the coping strategies they use to adapt to childhood cancer. Sixty caregivers of pediatric cancer patients completed a socio-demographic questionnaire, the Family Environment Scale, and the COPE inventory. There were no significant differences in family environment by income or education. Caregiver educational attainment was positively associated with use of planning and active coping styles, while income was not associated with caregiver coping style. Mothers were more likely than fathers to use active coping, instrumental support, religious coping, and emotional support. Men with lower education engaged in greater substance use coping and lower planning. The findings show that educational attainment and caregiver gender influence caregiver coping styles following a pediatric cancer diagnosis and suggest that educational attainment rather than financial resources drive the association between SES and coping. Programs that address educational gaps and teach caregivers planning and active coping skills may be beneficial for parents with lower educational attainment, particularly men.

  12. Effect of location on family medicine residents' training.

    PubMed Central

    Lebel, D.; Hogg, W.

    1993-01-01

    A survey of family medicine residents trained at community-based or hospital-based centres suggested differences in experience and in career plans. Community-based residents saw more patients in the same family, believed they knew the community better, made more housecalls, expected to use allied health professionals more frequently, and were more likely to choose a small community practice. PMID:8499787

  13. Caregiver Assessment

    ERIC Educational Resources Information Center

    Feinberg, Lynn

    2008-01-01

    Assessment is a critical step in determining appropriate support services. This article discusses "caregiver assessment," a systematic process of gathering information to describe a caregiving situation. Caregiver assessment identifies the particular problems, needs, resources, and strengths of the family caregiver and approaches issues from the…

  14. Differences in the Experience of Caregiver Strain between Families Caring for Youth with Substance Use Disorders and Families of Youth with Mental Health Problems

    ERIC Educational Resources Information Center

    Heflinger, Craig Anne; Brannan, Ana Maria

    2006-01-01

    This study examined caregiver strain (i.e., burden of care, caregiver burden) among families of adolescents in treatment for substance abuse disorders compared to youth with mental health problems. We used descriptive and regression analyses to compare groups and to examine the youth and family variables associated with caregiver strain across the…

  15. Validity and reliability of the Family Empowerment Scale for caregivers of adults with mental health issues.

    PubMed

    Kageyama, M; Nakamura, Y; Kobayashi, S; Yokoyama, K

    2016-10-01

    WHAT IS KNOWN ON THE SUBJECT?: Empowerment of family caregivers of adults with mental health issues has received increasing attention among mental health nurses in Japan and has been recognized as a new goal of family interventions. The Family Empowerment Scale (FES) was originally developed to measure the empowerment status of parents of children with emotional disorders. However, it was later applied to broader health issues. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: We developed a Japanese version of the FES for family caregivers of adults with mental health issues (FES-AMJ) and examined the validity and reliability among parents. Results showed that the FES-AMJ had acceptable concurrent validity and reliability; however, insufficient construct validity was found, especially for the subscale regarding the service system. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Further studies need to modify the scale. Clarification of ideal family empowerment status in the service system through discussion with mental health nurses and family caregivers may be important.

  16. Linking family cohesion and flexibility with expressed emotion, family burden and psychological distress in caregivers of patients with psychosis: A path analytic model.

    PubMed

    Koutra, Katerina; Simos, Panagiotis; Triliva, Sofia; Lionis, Christos; Vgontzas, Alexandros N

    2016-06-30

    The present study aimed to evaluate a path analytic model accounting for caregivers' psychological distress that takes into account perceived family cohesion and flexibility, expressed emotion and caregiver's burden associated with the presence of mental illness in the family. 50 first-episode and 50 chronic patients diagnosed with schizophrenia or bipolar disorder (most recent episode manic severe with psychotic features) recruited from the Inpatient Psychiatric Unit of the University Hospital of Heraklion, Crete, Greece, and their family caregivers participated in the study. Family functioning was assessed in terms of cohesion and flexibility (FACES-IV), expressed emotion (FQ), family burden (FBS) and caregivers' psychological distress (GHQ-28). Structural equation modelling was used to evaluate the direct and indirect effects of family dynamics on caregivers' psychological distress. The results showed that neither family cohesion nor family flexibility exerted significant direct effects on caregivers' psychological distress. Instead, the effect of flexibility was mediated by caregivers' criticism and family burden indicating an indirect effect on caregivers' psychological distress. These results apply equally to caregivers of first episode and chronic patients. Family interventions aiming to improve dysfunctional family interactions by promoting awareness of family dynamics could reduce the burden and improve the emotional well-being of family caregivers.

  17. Factors associated with caregiver burden among caregivers of children with cerebral palsy in Sri Lanka.

    PubMed

    Wijesinghe, Champa J; Cunningham, Natasha; Fonseka, Pushpa; Hewage, Chandanie G; Østbye, Truls

    2015-01-01

    A cross-sectional study was conducted among 375 caregivers of children with cerebral palsy attending a tertiary care setting in Sri Lanka, to identify factors associated with caregiver burden. Caregiver burden was defined as "caregiver's response to various stressors associated with caregiving" and was measured using Caregiver Difficulties Scale (CDS), developed specifically for this purpose. Multivariate linear regression was used to assess associations between sociodemographic, stressor, and coping factors and caregiver burden; and to examine whether coping reduces the effect of stressors on burden. Low income, rural residence, male sex, and number of functional deficits of the disabled child correlated significantly with higher caregiver burden, while spousal support correlated with lower burden. Seeking social support reduced the increased burden associated with greater functional impairments. Psychosocial interventions focused on evaluating and improving social support for caregivers may help families at high risk for caregiver distress, to minimize negative outcomes.

  18. Multiple Family Groups for Child Behavior Difficulties: Retention Among Child Welfare-Involved Caregivers

    ERIC Educational Resources Information Center

    Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P.

    2015-01-01

    Purpose: The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders has shown promise in engaging child welfare-involved families. This qualitative study examines caregivers' perceptions of factors that influence retention in MFGs among child welfare-involved families. Methods: Twenty-five…

  19. Spousal role and caregiver burden in HIV affected families in Anhui Province, China.

    PubMed

    Hsieh, Julie; Li, Li; Lin, Chunqing; Luo, Sitong; Ji, Guoping

    2017-03-09

    This study examined the burden experienced by various roles of family caregivers of people living with HIV (PLH), in particular spouses vs. non-spouses. A total of 475 family members of PLH were recruited from Anhui Province, China. Participants responded to a survey using the Computer Assisted Personal Interview method. The assessment collected data on demographic characteristics and their perceived caregiver burden, which was compared between spouses and non-spouses. Multiple regression models were built to identify factors associated with caregiver burden. About 64.4% of our study participants were female and the mean age was 42.1 years. Among various relationships to PLH, almost half reported being a spouse. Spouses reported significantly higher caregiver burden than non-spouses. In addition, older age and lower family income were significantly associated with higher level of caregiver burden. Among the subsample of spouses, significantly higher level of caregiver burden was identified among wives. Future studies should give special consideration to address the needs of female spouses in order to reduce their caregiver burden.

  20. Informational needs and related problems of family caregivers of heart failure patients: A qualitative study

    PubMed Central

    Bahrami, Masoud; Etemadifar, Shahram; Shahriari, Mohsen; Farsani, Alireza Khosravi

    2014-01-01

    Background: Heart failure is incurable disease and patients often have an ongoing decline once diagnosed. The symptoms of heart failure may impair the ability of patient to perform activities of daily living. As heart failure progresses, patients normally increase their reliance on family caregivers. Aims: This paper explored the informational needs and related problems of family caregivers of heart failure patients as a part of the findings of a study exploring experiences of family caregivers in the caregiving situation. Setting and Design: Using a qualitative design, 19 family caregivers from three educational hospitals in Isfahan, Iran, were recruited. Materials and Methods: Participants were selected by purposive sampling. Data were collected through semi-structured interviews. Interviews were transcribed verbatim and analyzed concurrently. Results: Four major themes were emerged from the analysis of the transcripts: “Lack of care-related knowledge”, “Inaccessibility to responsible source of information”, “Lack of guidance from healthcare team” and “caring with ambiguity due to unpredictable nature of the disease”. Caregivers believed that they did not have the basic knowledge related to disease and medication administration. They received little guidance and support from the health care team on the caregiving roles. They experienced high level of ambiguity and stress in caregiving tasks due to lack of care-related knowledge and unpredictable nature of disease. Conclusion: The care, which was performed by the caregivers of HF patients, is beyond of their knowledge, capabilities, and resources. Nurses and other healthcare providers can use the findings of this study to develop effective educational and supportive programs to facilitate these needs. PMID:25540786

  1. Intervention to improve social and family support for caregivers of dependent patients: ICIAS study protocol

    PubMed Central

    2014-01-01

    Background Despite the existence of formal professional support services, informal support (mainly family members) continues to be the main source of eldercare, especially for those who are dependent or disabled. Professionals on the primary health care are the ideal choice to educate, provide psychological support, and help to mobilize social resources available to the informal caregiver. Controversy remains concerning the efficiency of multiple interventions, taking a holistic approach to both the patient and caregiver, and optimum utilization of the available community resources. .For this reason our goal is to assess whether an intervention designed to improve the social support for caregivers effectively decreases caregivers burden and improves their quality of life. Methods/design Design: Controlled, multicentre, community intervention trial, with patients and their caregivers randomized to the intervention or control group according to their assigned Primary Health Care Team (PHCT). Study area: Primary Health Care network (9 PHCTs). Study participants: Primary informal caregivers of patients receiving home health care from participating PHCTs. Sample: Required sample size is 282 caregivers (141 from PHCTs randomized to the intervention group and 141 from PHCTs randomized to the control group. Intervention: a) PHCT professionals: standardized training to implement caregivers intervention. b) Caregivers: 1 individualized counselling session, 1 family session, and 4 educational group sessions conducted by participating PHCT professionals; in addition to usual home health care visits, periodic telephone follow-up contact and unlimited telephone support. Control: Caregivers and dependent patients: usual home health care, consisting of bimonthly scheduled visits, follow-up as needed, and additional attention upon request. Data analysis Dependent variables: Caregiver burden (short-form Zarit test), caregivers’ social support (Medical Outcomes Study), and

  2. Teen mothers at midlife: the long shadow of adversarial family caregiving.

    PubMed

    Smithbattle, Lee; Leonard, Victoria

    2014-01-01

    Despite keen interest in teen mothers' outcomes, few studies have followed teen mothers prospectively or examined how outcomes are shaped by family relationships and practices over time. This multigenerational, hermeneutic study began 21 years ago when 16 families were interviewed after the teen's infant reached 8 to 10 months of age. Families were re-interviewed every 4 to 5 years. This article describes the 3 families who exemplified adversarial caregiving at the first study and how their relationships unfolded and shaped long-term outcomes. Findings alert clinicians to the importance of recognizing red flags and intervening early to interrupt adversarial caregiving.

  3. The costs of a family practice residency ambulatory care program.

    PubMed

    Pawlson, L G; Watkins, R

    1979-12-01

    The cost of patient care service and education occurring in a family practice residency unit of a community based prepaid health program was determined from accounting records. The cost of producing the same number of patient visits in comparable family practice units which did not have residents on-site was determined in a similar manner. The cost per visit in the residency unit was $15.53 while that in the nonresidency unit was $13.92. There was an excess cost of $1.61 per visit in the residency, or, based on the number of residents present, a net cost of $7 per resident per day. None of the costs of central residency program administration or of ambulatory based subspecialty rotations were included. While a small increase (ten percent) in productivity or efficiency would result in the residency patient care unit itself being self-sustaining, this study casts considerable doubt on the ability of the model family practice residency unit to offset the full costs of the ambulatory care portion of family practice residency training.

  4. Use of Zarit Burden Interview in analysis of family caregivers' perception among Taiwanese caring with hospitalized relatives.

    PubMed

    Yeh, Pi-Ming; Chang, Yuanmay

    2015-10-01

    This study was conducted to examine the relationships between family caregivers' perception of caregiving and its influencing factors among Taiwanese with hospitalized relatives. The study used a cross-sectional and descriptive correlational design. A convenience sample of 200 primary caregivers of hospitalized patients diagnosed with cancer, stroke and chronic illness was recruited in a Taiwanese Medical Center; this focus was chosen because cancer, stroke and chronic illness generally require long term care. Data were collected by structured questionnaires. Pearson product-moment correlation and stepwise multiple regression analyses were used to analyse the results of this study. Family caregivers who lacked family support and whose patients' ADL (activities of daily living) dependency was increasing experienced a greater caregiving burden. Family caregivers who had better psychological well-being, better quality of relationship and more caregiving knowledge experienced a lower caregiving burden. Quality of relationship, lack of family support and patients' ADL dependency accounted for 43% of the Zarit Burden Interview variance. The results indicated that family caregivers' perception of caregiving included sacrifice, strain, embarrassment, anger and loss of control. It is vital for nurses to understand these caregiving perceptions and their related factors to provide a holistic care plan.

  5. Coping strategies, care manager support and mental health outcome among Japanese family caregivers.

    PubMed

    Yamada, Miho; Hagihara, Akihito; Nobutomo, Koichi

    2008-07-01

    Coping and social support are regarded as major modifiers of the caregiving stress and negative mental health effects experienced by caregivers. Under Japan's Long-term Care Insurance (LTCI) system, care managers have played a major role in providing psychosocial support for family caregivers while coordinating formal and informal care resources for elderly people. However, since the launch of the LTCI system in 2000, no evaluation has examined the role care managers play in buffering the negative effects of the caregiver burden among family caregivers in Japan. This study examined the direct and buffering effects of stress-coping strategies and care manager support on caregiver burden and depression among Japanese family caregivers (n = 371) caring for community-dwelling persons aged 65 or over who were having difficulties with the activities of daily living. A self-administrated questionnaire survey was conducted between February and March 2005 in a rural suburb in south-western Japan. Hierarchical regression analyses revealed the following. (i) Coping strategies and 'social talk' by care managers had direct effects on caregiver burden and depression. (ii) 'Avoidant' coping and 'social talk' by care managers had buffering effects on the care needs-depression relationship. (iii) 'Information giving' by care managers had no significant direct effect, but it had a negative effect on the care needs-depression relationship. Overall, results concerning 'approaching' coping were in line with those of previous studies, while findings concerning 'avoidant' coping were not consistent with findings in Western countries. The type of care manager support appeared to have a variable influence on caregiver burden and depression.

  6. Exploring Spirituality in Family Caregivers of Patients With Primary Malignant Brain Tumors Across the Disease Trajectory

    PubMed Central

    Newberry, Alyssa G.; Jean Choi, Chien-Wen; Donovan, Heidi S.; Schulz, Richard; Bender, Catherine; Given, Barbara; Sherwood, Paula

    2013-01-01

    Purpose/Objectives To determine whether the perceived level of spirituality in family caregivers of patients with primary malignant brain tumors (PMBTs) changes across the disease trajectory. Design Ongoing descriptive, longitudinal study. Setting Southwestern Pennsylvania. Sample 50 family caregivers of patients with PMBT. Methods Caregivers and care recipients were recruited at time of diagnosis. Participants were interviewed at two subse-quent time points, four and eight months following diagnosis. Main Research Variables Care recipients’ symptoms, neuro-psychologic status, and physical function, as well as caregiver social support. Findings Results showed no significant difference in spirituality scores reported at baseline and eight months (p = 0.8), suggesting that spirituality may be a stable trait across the disease trajectory. Conclusions Spirituality remains relatively stable along the course of the disease trajectory. Reports of caregiver depressive symptoms and anxiety were lower when paired with higher reports of spirituality. Implications for Nursing Clinicians can better identify caregivers at risk for negative outcomes by identifying those who report lower levels of spirituality. Future interventions should focus on the development and implementation of interventions that provide protective buffers such as increased social support. Knowledge Translation Spirituality is a relatively stable trait. High levels of spirituality can serve as a protective buffer from negative mental health outcomes. Caregivers with low levels of spirituality may be at risk for greater levels of burden, anxiety, and stress. PMID:23615145

  7. Positive Aspects of Family Caregiving for Dementia: Differential Item Functioning by Race

    PubMed Central

    Dilworth-Anderson, Peggye; Huang, Jin; Gross, Alden L.; Gitlin, Laura N.

    2015-01-01

    Objectives. Due to increasing interest in the positive experiences associated with family caregiving, potential demographic group differences were examined on the Positive Aspects of Caregiving (PAC) scale at both the item and scale levels. Method. Family caregivers (N = 642) completed the PAC as part of their participation in the Resources for Enhancing Alzheimer’s Caregiver Health (REACH II) clinical trial. Multiple indicators, multiple causes models were used to examine potential differential item functioning (DIF) across demographic subgroups. Results. Overall PAC scale scores indicated that both Hispanics and African Americans experienced more PAC than Whites. Two items with statistically significant (p < .004) and practically meaningful (odds ratio > 2.0) DIF were found for African American caregivers. After controlling for the underlying unidimensional construct, African Americans reported that caregiving gave them “a more positive attitude toward life” and enabled them to “appreciate life more” than either Whites or Hispanics. No instances of meaningful DIF were found between Hispanics and Whites, women and men, or spouses and nonspouses. Discussion. PAC scores differ significantly by race. In addition, 2 items with meaningful race DIF identify content areas that are particularly relevant to the cultural experiences of African American caregivers. PMID:26033356

  8. Family response to end-of-life education: differences by ethnicity and stage of caregiving.

    PubMed

    Braun, Kathryn L; Karel, Harumi; Zir, Ana

    2006-01-01

    The authors developed and tested 5 educational booklets to improve end-of-life knowledge, attitudes, intention, and practices in a multiethnic sample of family caregivers of well, homebound, and institutionalized elders. Of 570 participants, 424 (74%) read at least 1 booklet and completed pretests and posttests. At 3-month follow-up, small improvements were seen in completion of advance directives, and significant increases were seen in proportions of caregivers with funeral or burial plans and willingness to consider hospice. The booklets had wide appeal, but end-of-life measures varied by care-giver stage and ethnicity, suggesting that these factors need to be considered in developing education interventions for family caregivers.

  9. Benefits of a poetry writing intervention for family caregivers of elders with dementia.

    PubMed

    Kidd, Lori I; Zauszniewski, Jaclene A; Morris, Diana L

    2011-01-01

    This pilot clinical trial tested effectiveness of a poetry writing intervention for family caregivers of elders with dementia. This paper presents findings from a larger study using mixed methods to examine outcome variables of self-transcendence, resilience, depressive symptoms, and subjective caregiver burden. Findings reported here focus on qualitative analysis of in-depth interviews conducted with participants following their poetry writing experience. A grounded theory approach was used. Themes that arose from the data support a mid-range theory of self-affirmation in caregivers with subthemes of achievement, catharsis, greater acceptance, empathy, self-awareness, reflection, creative and fun, positive challenge, and helping others.

  10. Caregivers

    MedlinePlus

    ... Facts Financial Resources: Healthcare Family Life and Relationships Exercise and Nutrition Mental Health and Wellbeing Personal Stories Finding the Right Doctor Talking to Others About Lupus Financial Resources: Non-Healthcare My Child Has Lupus ...

  11. Attitude Survey of Military Family Housing Residents, Hawaii 1987.

    DTIC Science & Technology

    1987-09-01

    service member. I. Male 2. Female 6. Marital status. 1. Married 2. Separated , divorced or widowed 3. Single, never married 7. Is spouse living with...C) Attitude Suvyof Military Family HousingUP Residents, OlIG- Ha ai18 . ...... .. . .. . -’le 88I C DEPARTMENT OF THE NAVY NAVY P9RSONN r L RESrARC14...ATTITUDE SURVEY OF MILITARY FAMILY HOUSING RESIDENTS, HAWAII, 1937 Enc: (1) NPRDC TN 87-48 I. This survey of residents of military family housing in

  12. Educational needs of family caregivers of persons living with HIV/AIDS in Thailand.

    PubMed

    Maneesriwongul, Wantana; Panutat, Suntharee; Putwatana, Panwadee; Srirapo-ngam, Yupapin; Ounprasertpong, Ladawan; Williams, Ann B

    2004-01-01

    As the AIDS epidemic continues to overwhelm the acute care hospital system in Thailand, an increasing number of family members are required to provide care for persons living with AIDS (PLWA) in their homes. In response to the increasing demand for home care, a qualitative study using focus group methodology was conducted to learn more about the need for education and support for family caregivers of PLWA in Thailand. Eighteen family caregivers and 18 nurses caring for PLWA participated in four focus group discussions. The major themes identified were fear, stigma, sorrow, empathy, hopelessness, and hope. In addition, participants voiced a need for education to improve the knowledge and skills related to care of PLWA. These findings will be used to guide the development of a training program for family caregivers.

  13. Rethinking Family Caregiving: Tailoring Cognitive–Behavioral Therapies to the Hospice Experience

    PubMed Central

    Washington, Karla T.; Wittenberg-Lyles, Elaine; Parker Oliver, Debra; Baldwin, Paula K.; Tappana, Jessica; Wright, Jesse H.; Demiris, George

    2014-01-01

    Hospice family caregivers experience significantly higher rates of psychological distress than demographically similar noncaregivers. Interventions based on cognitive–behavioral therapy have been shown to reduce psychological distress in the general population by providing tools to modify thinking patterns that directly affect emotions and behavior. Such interventions might reasonably be incorporated into hospice social work; however, numerous contextual factors must be taken into account to ensure that any interventions are appropriate to the unique needs of clients. The purpose of the study discussed in this article was to contextualize one aspect of the cognitive–behavioral model based on firsthand accounts of hospice family caregivers. Following a modified grounded theory approach, researchers engaged in a secondary analysis of data from a larger study provided in a subsample of 90 audio-recorded conversations between hospice family caregivers and interventionists. Findings indicated that distressed caregivers engaged in five dominant thinking patterns: (1) “should” statements, (2) catastrophizing or minimizing, (3) personalizing, (4) absolute thinking, and (5) making assumptions. Implementing cognitive–behavioral therapies based on identified caregiver thinking patterns will allow hospice social workers to empower caregivers to cope more effectively with the numerous stressors they encounter while caring for a dying loved one. PMID:25369725

  14. Workplace characteristics and work-to-family conflict: does caregiving frequency matter?

    PubMed

    Brown, Melissa; Pitt-Catsouphes, Marcie

    2013-01-01

    Many workers can expect to provide care to an elder relative at some point during their tenure in the workforce. This study extends previous research by exploring whether caregiving frequency (providing care on a regular, weekly basis vs. intermittently) moderates the relationship between certain workplace characteristics and work-to-family conflict. Utilizing a sample of 465 respondents from the National Study of the Changing Workforce (Families and Work Institute, 2008), results indicate that access to workplace flexibility has a stronger effect on reducing work-to-family conflict among intermittent caregivers than among those who provide care regularly.

  15. Family medicine residency training and burnout: a qualitative study

    PubMed Central

    Rutherford, Kimberly; Oda, Joanna

    2014-01-01

    Background Almost three-quarters of family practice residents in British Columbia (BC) meet criteria for burnout. We sought to understand how burnout is perceived and experienced by family medicine residents, and to identify both contributory and protective factors for resident burnout. Method Two semi-structured focus groups were conducted with ten family practice residents from five distinct University of British Columbia training sites. Participants completed the Maslach Burnout Inventory (MBI). The data were analyzed using a thematic analysis approach. Results Seventy percent of the focus group participants met criteria for burnout using the MBI. The experience of burnout was described as physical and emotional exhaustion, loss of motivation, isolation from loved ones, and disillusionment with the medical profession. Contributory factors included high workload, burned-out colleagues, perceived undervaluing of family medicine, lack of autonomy, and inability to achieve work-life balance. Protective factors included strong role models in medicine, feeling that one’s work is valued and rotations in family medicine. Conclusions The high level of burnout in family medicine residents in BC is a multifactorial and complex phenomenon. Training programs and faculty should be aware of burnout risk factors and strive to implement changes to reduce burnout, including allowing residents increased control over scheduling, access to counseling services and training for resident mentors. PMID:26451218

  16. Training family medicine residents to care for children

    PubMed Central

    Duke, Pauline; Curran, Vernon; Hollett, Ann

    2011-01-01

    Abstract Problem addressed There is a lack of consensus around the optimal way to train family medicine residents to care for children. Objective of program Evaluation of an ambulatory versus an inpatient pediatrics rotation for family medicine residents. Program description A 4-week pediatrics rotation for second-year family medicine residents was introduced involving half-day ambulatory pediatric clinics. A nonequivalent control group evaluation study design was followed. Patient logbook entries, as well as residents’ satisfaction, knowledge, and self-reported confidence outcomes were compared between family medicine residents completing the new ambulatory rotation and those completing a traditional inpatient-ambulatory pediatrics rotation. Conclusion An ambulatory rotation in pediatrics is a feasible option for facilitating family medicine resident learning in child health care. Residents report exposure to more patient cases that reflect a family practice office setting and the same level of knowledge and confidence as residents completing an inpatient-ambulatory rotation. Intraprofessional collaboration, flexibility in scheduling, and the support of pediatric preceptors are key factors in the organization and implementation of an ambulatory rotation. PMID:21321160

  17. Caregiver depressive symptoms and observed family interaction in low-income children with persistent asthma.

    PubMed

    Celano, Marianne; Bakeman, Roger; Gaytan, Osvaldo; Smith, Chaundrissa Oyeshiku; Koci, Anne; Henderson, Sasschon

    2008-03-01

    This study examined the relationship between caregiver depressive symptoms and observed parenting behaviors and family processes during interactions among 101 urban, low-income Africtan American families with children with persistent asthma. Caregivers (primarily female) were assessed on four dimensions (i.e., warmth/ involvement, hostility, consistent discipline, relationship quality) in three videotaped interaction tasks (loss, conflict, cohesion). The results indicated that increased depressive symptoms were significantly associated with lower warmth/involvement and synchrony scores and greater hostility scores during the loss and conflict tasks. In the total sample, the highest levels of hostility and the lowest levels of warmth/involvement were found for the conflict task; nevertheless, caregivers with moderate/severe depressive symptoms showed a significantly greater increase in hostility from the loss to the conflict task than caregivers with minimal/mild depressive symptoms. The findings highlight the salience of considering task content in family observational process research to expand our understanding of depressed and nondepressed caregivers abilities to modulate appropriately their behaviors and affect across various family interactions. Implications for improving asthma management for low-income children with persistent asthma are discussed, including the utility of multidisciplinary interventions that combine asthma education with family therapy.

  18. [Home care for terminal cancer patients from the family and caregiver perspective].

    PubMed

    Ishikawa, Mitsuko; Ogiwara, Miyoko; Yamaoka, Keita; Matsumoto, Ayumi; Fujimaki, Yoko; Watanabe, Mutsuko; Kushida, Kazuki

    2014-12-01

    The progression of home care provision is associated with an increased burden on the family, as patients tend to progressively become more dependent on medicine. In the present case, a family supported a patient by performing medical activities such as taking blood sugar measurements, administering insulin injections, exchanging fluids, managing each tube, handling medical devices, conducting status observations, and attending to emergency calls. Thus, the family caregiver undertakes duties that were previously performed by a nurse and interacts with the various professionals who visit the patient's home daily. Therefore, the caregiver undergoes a considerable amount of stress. Family caregivers with no medical knowledge or nursing experience require plenty of support, in order to fulfill a patient's requirements. The first step is the establishment of trust between the medical professionals and the caregiver. In the present case, because the trust had been established, interprofessional collaboration ensured that the patient received support until the end. Thus, we reported on the perspectives of the family and caregiver on home care for terminal cancer patients.

  19. Formal Service Practitioners' Views of Family Caregivers' Responsibilities and Difficulties

    ERIC Educational Resources Information Center

    Guberman, Nancy; Lavoie, Jean-Pierre; Pepin, Jacinthe; Lauzon, Sylvie; Montejo, Maria-Elisa

    2006-01-01

    This article identifies home care practitioners' perceptions of the responsibilities, difficulties, and needs for support of caregivers. It is based on a study undertaken in Quebec with 55 practitioners and 10 administrators from 10 CLSCs located in rural, urban, and metropolitan areas. The study had a qualitative, multiple-case design and used…

  20. 75 FR 67903 - National Family Caregivers Month, 2010

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-04

    ... across America provide essential attention and assistance to their loved ones. Many individuals in need..., this labor of love can result in physical, psychological, and financial hardship for caregivers, and research suggests they often put their own health and well-being at risk while assisting loved...

  1. Factors Associated with Family Caregivers' Burden and Depression in Korea

    ERIC Educational Resources Information Center

    Yoon, Hyunsook

    2003-01-01

    This study determines the relative effects of functional impairment, cognitive impairment, and duration of care of the elderly on caregivers' depression, and identifies the factors that influence this relationship. The variables were entered individually, based on a logical order in the path modeling. For mediators, the order of three types of…

  2. [Exhaustion of family caregivers: a masked domestic crisis? A psychodynamic and systemic approach].

    PubMed

    Bouati, Noureddine; Sagne, Alain; Hunsicker, Morgane; Gavazzi, Gaëtan; Couturier, Pascal

    2016-03-01

    We try, from our clinical practice in a geriatric medicine department, to identify the processes involved in family crisis, especially in the relationship carer/cared. Psychodynamic and systemic determinants are highlighted to understand how family caregivers may suffer burn out, and suggest preventive measures.

  3. A Learner-Centered Family Literacy Project for Latino Parents and Caregivers

    ERIC Educational Resources Information Center

    Cassidy, Jack; Garcia, Roberto; Tejeda-Delgado, Carmen; Garrett, Sherrye D.; Martinez-Garcia, Cynthia; Hinojosa, Roel V.

    2004-01-01

    Leaders in the field of literacy regard family literacy projects that seek to involve both children and their parents or caregivers as vital. The importance of parents as a child's first teachers has long been acknowledged. Nevertheless, the topic of family literacy is not one of those receiving attention in the field. In an annual survey of…

  4. Use of Equipment and Respite Services and Caregiver Health among Australian Families Living with Rett Syndrome

    ERIC Educational Resources Information Center

    Urbanowicz, Anna; Downs, Jenny; Bebbington, Ami; Jacoby, Peter; Girdler, Sonya; Leonard, Helen

    2011-01-01

    This study assessed factors that could influence equipment and respite services use among Australian families caring for a girl/woman with Rett syndrome and examined relationships between use of these resources and the health of female caregivers. Data was sourced from questionnaires completed by families (n=170) contributing to the Australian…

  5. Stakeholder Perspectives on Policies to Support Family Caregivers of Older Adults with Dementia

    ERIC Educational Resources Information Center

    Putnam, Michelle; Pickard, Joseph G.; Rodriguez, Carroll; Shear, Erin

    2010-01-01

    Persons with dementia are often excluded from consumer-directed home- and community-based service programs because they cannot direct their own care. Surrogates are permitted in some states, thereby allowing program participation. This study explored family caregiver perspectives on policies that support family needs related to providing care to…

  6. Family Caregiving Project. Proceedings of a Conference (Washington, D.C., June 23-24, 1986).

    ERIC Educational Resources Information Center

    Berul Associates, Ltd., Rockville, MD.

    The conference on "Support for Family Caregivers" reported in this document was designed to identify, encourage the development of, and disseminate information about effective approaches for strengthening the capacity of families to care for their impaired relatives. The first of two presentations in the opening plenary session reviews the needs…

  7. A Digital Program Informs Low-Income Caregivers of Preschool-Age Children about Family Meals

    ERIC Educational Resources Information Center

    Lohse, Barbara; Rifkin, Robin; Arnold, Kristen; Least, Christine

    2012-01-01

    Objective: To evaluate the digital program, "Mealtime is Family Time", as a means of educating caregivers of preschoolers on the importance of family meals within the division of feeding responsibility framework. Methods: Descriptive design using 2 approaches: focus group program review and discussion or self-report survey after independent…

  8. The Effect of Home Caregiving Program for Family Members Providing Care for Chronically Ill Relative Client

    ERIC Educational Resources Information Center

    Mohammed, Hussein Jassim; Kamel, Andaleeb Abu

    2015-01-01

    Health care systems in many countries are moving towards outpatient care in which family members are central in providing care for patients with life-threatening illness. Family members and friends haven't knowledge and skills to become caregivers as many studies found that, the need to involve in such program to enhance their ability to be…

  9. Caregivers of Children with Sexual Behavior Problems: Psychological and Familial Functioning.

    ERIC Educational Resources Information Center

    Pithers, William D.; Gray, Alison; Busconi, Aida; Houchens, Paul

    1998-01-01

    Families of 72 children with sexual behavior problems completed a structured interview and psychometric measures. Caregivers manifested stresses across many variables including income, criminal arrest, family violence, sexual abuse, social support, modulation of emotion, and attachment to the child. Foster parents consistently reported lower…

  10. The Impact of Intellectual Disability, Caregiver Burden, Family Functioning, Marital Quality, and Sense of Coherence

    ERIC Educational Resources Information Center

    Al-Krenawi, Alean; Graham, John R.; Al Gharaibeh, Fakir

    2011-01-01

    The present article is the first to consider the impact of intellectual disability on Bedouin-Arab families' caregiver burden, family functioning, marital quality, and sense of coherence. A random sample of 300 Bedouin-Arab parents with one or more intellectually disabled children, and a control group (n = 100) completed the McMaster Family…

  11. Psychometric Properties of the Family Inventory of Resources for Management in a Sample of Iranian Family Caregivers of Cancer Patients

    PubMed Central

    Mirsoleymani, Seyed Reza; Matbouei, Mahsa; Nasiri, Malihe; Vasli, Parvaneh

    2016-01-01

    Objective. The aim of this study was to investigate the psychometric properties of the Family Inventory of Resources for Management (FIRM) in a sample of family caregivers of cancer patients. Methods. In this methodological study, construct validity of the FIRM was evaluated by known groups and convergent validity in a convenience sample of family caregivers of cancer patients (n = 104) referred to the outpatient oncology wards of five educational hospitals in Tehran from January to April 2016. Reliability was determined by assessing the internal consistency and stability of the instrument. Results. The known-groups findings showed that there is a significant difference between the scores of the FIRM in family caregivers with different levels of caregiver burden (p < 0.001). Also, the results of convergent validity showed that there is a moderate negative correlation (r = −0.50; p < 0.001) between the total scores of the FIRM and the scores of the caregiver burden inventory (CBI). The FIRM showed a good internal consistency (α = 0.85) and a good stability of the test-retest reliability result. Conclusions. There is a sound psychometric basis for the use of the Persian translation of the FIRM for family studies in the Iranian population. PMID:28127470

  12. Religious coping and caregiver well-being in Mexican-American families

    PubMed Central

    Lee, Jerry W.; Nanyonjo, Rebecca D.; Laufman, Larry E.; Torres-Vigil, Isabel

    2017-01-01

    Objective We sought to explore the association of religious and spiritual coping with multiple measures of well-being in Latinos caring for older relatives with long-term or permanent disability, either with or without dementia. Methods Using a multi-dimensional survey instrument, we conducted in-home interviews with 66 predominantly Mexican-American Catholic family caregivers near the US–Mexico border. We assessed caregivers' intrinsic, organizational and non-organizational religiosity with the Duke Religiosity Index, as well as Pargament's brief positive and negative spiritual coping scale to determine the association of religiosity with caregivers' mental and physical health, depressive symptomatology and perceived burden. Results Using regression analysis, we controlled for sociocultural factors (e.g. familism, acculturation), other forms of formal and informal support, care recipients' functional status and characteristics of the caregiving dyad. Intrinsic and organizational religiosity was associated with lower perceived burden, while non-organizational religiosity was associated with poorer mental health. Negative religious coping (e.g. feelings that the caregiver burden is a punishment) predicted greater depression. Conclusion Measures of well-being should be evaluated in relation to specific styles of religious and spiritual coping, given our range of findings. Further investigation is warranted regarding how knowledge of the positive and negative associations between religiosity and caregiving may assist healthcare providers in supporting Latino caregivers. PMID:19197693

  13. [Intervention and psychological care for the family caregivers of cancer patients].

    PubMed

    Onishi, Hideki

    2009-01-01

    Recent studies demonstrated that family members of a cancer patient show as much or even higher psychological distress as the cancer patients themselves. There are several reasons for psychological distress among family members. The family of the cancer patient is expected to provide patient care. There are shared responsibilities for decision-making, providing concrete care-giving, meeting the financial and social costs, maintaining stability and adapting to change. In addition, some family caregivers are involved in direct patient care. These responsibilities place both physical and emotional burdens on the family members. It has been shown that spouses demonstrate levels of emotional and functional disruption as great or greater than that of the patient and that these problems often worsen with time, independent of the patient's mood or health. Health problems of caregivers have a very important influence on their ability to meet these demands and it is reported that care-giving affects the physical health of spouse caregivers. Some caregivers may be physically weak or sick, and some may also demonstrate symptoms of cancer. Based on these findings, family members of the cancer patient are called "second-order patients". Therefore, various kinds of care programs are needed to provide support for family members and such interventions are aimed at psychiatric, physical, socio-economic problems. Bereavement is one of the most striking events in human experience. Although bereavement is not a disease, it is associated with excess risk of mortality and morbidity. Bereaved individuals show various physical and psychological symptoms and some of the bereaved individuals develop psychiatric disorders such as bereavement reaction, major depression and post-traumatic stress disorder. Therefore, psychiatric interventions are needed for these bereaved individuals. In the bereavement care clinic, interventions are aimed at psychiatric, physical, socio-economical problems

  14. Reducing the distance in distance-caregiving by technology innovation

    PubMed Central

    Benefield, Lazelle E; Beck, Cornelia

    2007-01-01

    Family caregivers are responsible for the home care of over 34 million older adults in the United States. For many, the elder family member lives more than an hour’s distance away. Distance caregiving is a growing alternative to more familiar models where: 1) the elder and the family caregiver(s) may reside in the same household; or 2) the family caregiver may live nearby but not in the same household as the elder. The distance caregiving model involves elders and their family caregivers who live at some distance, defined as more than a 60-minute commute, from one another. Evidence suggests that distance caregiving is a distinct phenomenon, differs substantially from on-site family caregiving, and requires additional assistance to support the physical, social, and contextual dimensions of the caregiving process. Technology-based assists could virtually connect the caregiver and elder and provide strong support that addresses the elder’s physical, social, cognitive, and/or sensory impairments. Therefore, in today’s era of high technology, it is surprising that so few affordable innovations are being marketed for distance caregiving. This article addresses distance caregiving, proposes the use of technology innovation to support caregiving, and suggests a research agenda to better inform policy decisions related to the unique needs of this situation. PMID:18044143

  15. Structural impact on gendered expectations and exemptions for family caregivers in hospice palliative home care.

    PubMed

    Sutherland, Nisha; Ward-Griffin, Catherine; McWilliam, Carol; Stajduhar, Kelli

    2017-01-01

    Evidence of gender differences in the amount and type of care provided by family caregivers in hospice palliative home care suggests potential inequities in health and health care experiences. As part of a larger critical ethnographic study examining gender relations among clients with cancer, their family caregivers and primary nurses, this article describes gendered expectations and exemptions for family caregivers within the sociopolitical context of end-of-life at home. Data were collected from in-depth interviews (n = 25), observations of agency home care visits (n = 9) and analyses of policy and home care agency documents (n = 12). Employing a critical feminist lens, a gender-based analysis revealed that structural discourses emphasizing an artificial divide between public and private spheres constructed end-of-life at home as private and apolitical. Associated with care of home and family, women were most impacted by these public/private discourses underpinning neoliberal values of cost-efficiency. Findings suggest that a critical perspective is needed to assist policy makers and healthcare providers to view how caregiver experiences are shaped by structures that control the availability of resources. Thus, instead of focusing on caregivers' deficits, interventions should be directed at the social, political and economic conditions that shape gendered experiences.

  16. Caregiver Responsiveness to the Family Bereavement Program: What predicts responsiveness? What does responsiveness predict?

    PubMed Central

    Schoenfelder, Erin N.; Sandler, Irwin N.; Millsap, Roger E.; Wolchik, Sharlene A.; Berkel, Cady; Ayers, Timothy S.

    2013-01-01

    The study developed a multi-dimensional measure to assess participant responsiveness to a preventive intervention, and applied this measure to study how participant baseline characteristics predict responsiveness and how responsiveness predicts program outcomes. The study was conducted with caregivers who participated in the parenting-focused component of the Family Bereavement Program (FBP), a prevention program for families that have experienced parental death. The sample consisted of 89 caregivers assigned to the intervention condition in the efficacy trial of the FBP. Positive parenting, caregiver depression, and child externalizing problems at baseline were found to predict caregivers’ use of program skills outside the group, and more child internalizing problems predicted more positive perceptions of the group environment. Higher levels of skill use during the program predicted increased positive parenting at the 11-month follow-up, whereas positive perceptions of the group environment predicted decreased caregiver depressive symptoms at follow-up. Caregiver skill use mediated the relation between baseline positive parenting and improvements in positive parenting at 11-month follow-up, and skill use and perceived group environment mediated changes in caregiver depression from baseline to 11-month follow-up. PMID:23404661

  17. Neuropsychiatric symptoms of the elderly with Alzheimer's disease and the family caregivers' distress 1

    PubMed Central

    Storti, Luana Baldin; Quintino, Débora Teles; Silva, Natália Michelato; Kusumota, Luciana; Marques, Sueli

    2016-01-01

    ABSTRACT Objective: to analyze the relationship between the distress of the family caregiver and the presence of neuropsychiatric symptoms in elderly patients with Alzheimer's disease or mixed dementia. Method: a descriptive, cross-sectional study conducted in the Geriatric and Dementias Clinic of a general tertiary hospital, with 96 elderly people with Alzheimer's disease or mixed dementia and their family caregivers. Questionnaires to characterize the elderly and caregivers, and the Neuropsychiatric Inventory were used. Descriptive statistics and Pearson correlation test were performed. Results: 68.7% of the elderly were women, average age 80.8 years, 56.2% had Alzheimer's disease and 43.7%, mixed dementia. Among caregivers, 90.6% were women, average age 56, 70.8% took care of parents and 64.6% lived with the elderly. There was a strong (r = 0.82) and significant (p <0.01) correlation between the total score on the Neuropsychiatric Inventory and the total score on the Neuropsychiatric Inventory-Distress and strong (r = 0.80) and significant (p <0 01) correlation between the total score on the Neuropsychiatric Inventory Distress and the number of neuropsychiatric symptoms, i.e., the higher the number, frequency and severity of these symptoms in the elderly, the more intense is the caregiver distress. Conclusion: the presence of neuropsychiatric symptoms in the elderly was related to increased distress in caregivers. PMID:27533264

  18. Measuring social support among kinship caregivers: validity and reliability of the Family Support Scale.

    PubMed

    Littlewood, Kerry; Swanke, Jayme R; Strozier, Anne; Kondrat, David

    2012-01-01

    The scope of research about kinship care has expanded. One area of interest is the impact social support has on kinship caregivers (Kelley, Whitley, & Campos, 2011). The Family Support Scale (FSS) has been used to measure social support among kinship caregivers (Kelley et al., 2011; Leder et al., 2007); however, there has been no rigorous examination of the psychometric properties of the FSS when administered to kinship caregivers. This study used a sample of 255 kinship caregivers to conduct a principal component analysis and developed a four-component structure for the FSS. The results suggest that the four-component structure identifies four sub-scales that have adequate face validity and internal consistency validity with this population.

  19. Military Stress-Busting Program for Family Caregivers

    DTIC Science & Technology

    2014-05-20

    study, we found caregivers who were interested to participate but would not be available for the nine weeks. We amended the protocol to condense the...of facility resources. (4) We “implemented” the program with fidelity to its protocol in both the active duty and veteran settings in the provision...Legacy of Caring.” 35th Annual Conference of the International Association for Human Caring. 26 May, 2014. Kyoto , Japan. Miner-Williams, D & Loomis

  20. Exploring the experience of residents during the first six months of family medicine residency training

    PubMed Central

    Martin, Dawn; Nasmith, Louise; Takahashi, Susan Glover; Harvey, Bart J.

    2017-01-01

    Background The shift from undergraduate to postgraduate education signals a new phase in a doctor’s training. This study explored the resident’s perspective of how the transition from undergraduate to postgraduate (PGME) training is experienced in a Family Medicine program as they first meet the reality of feeling and having the responsibility as a doctor. Methods Qualitative methods explored resident experiences using interpretative inquiry through monthly, individual in-depth interviews with five incoming residents during the first six months of training. Focus groups were also held with residents at various stages of training to gather their reflection about their experience of the first six months. Residents were asked to describe their initial concerns, changes that occurred and the influences they attributed to those changes. Results Residents do not begin a Family Medicine PGME program knowing what it means to be a Family Physician, but learn what it means to fulfill this role. This process involves adjusting to significant shifts in responsibility in the areas of Knowledge, Practice Management, and Relationships as they become more responsible for care outcomes. Conclusion This study illuminated the resident perspective of how the transition is experienced. This will assist medical educators to better understand the early training experiences of residents, how these experiences contribute to consolidating their new professional identity, and how to better align teaching strategies with resident learning needs. PMID:28344713

  1. Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers

    PubMed Central

    Tjia, Jennifer; Ellington, Lee; Clayton, Margaret F.; Lemay, Celeste; Reblin, Maija

    2015-01-01

    Context Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs’ cognitive, social and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. Objectives This study sought to assess the applicability of Lau et al.’s caregiver medication management skills framework in the context of family caregiving in home hospice in order to further the understanding of FCGs’ essential medication management skills. Methods This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. Results An average of four medications (SD 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in the majority of home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the Personhood domain –1) advocacy for the caregiver and 2) skills in discontinuing medications – were proposed. Conclusion These findings support Lau et al.’s framework for caregiver medication management skills and expands upon the existing domains proposed. Future interventions to assess FCGs’ skills are recommended. PMID:26159294

  2. Medical Communication-related Informational Need and Resource Preferences Among Family Caregivers for Head and Neck Cancer Patients.

    PubMed

    Longacre, Margaret L; Galloway, Thomas J; Parvanta, Claudia F; Fang, Carolyn Y

    2015-12-01

    Despite advances in treatment, head and neck cancer (HNC) patients often experience considerable functional impairment during and following treatment. As a result, family caregivers are essential in a patient's recovery; however, few caregivers are well-prepared to handle the extensive caregiving needs of this patient population. To date, little is known about HNC caregivers' informational needs in this role. Thus, we surveyed a sample of HNC caregivers about their informational needs including those related to interacting in the medical context as a caregiver and meeting patient needs. We also asked these caregivers their preferences for obtaining caregiving information. We conducted a cross-sectional study of 59 family caregivers for HNC patients who had completed radiation therapy at a comprehensive cancer center. The majority of caregivers (74.6%) reported having high informational need at diagnosis related to interacting as a caregiver. Although the need for such information decreased over time, over half still had a high need for information at treatment end. Importantly, caregivers who desired information about reducing patient pain and distress also reported having greater informational needs on issues related to interacting in the medical context. Further, the caregivers most often preferred to receive information from health-care professionals as a first source. However, preferring an informal (e.g., Internet) resource at first was significantly associated with needing information on how to talk to a doctor or nurse. The development of evidence-based resources and tools for HNC caregivers as well as clinicians may help caregivers more effectively manage patient symptoms and warrants further attention. Further, Internet resources may represent an effective resource for providing caregivers with strategies toward enhancing communication with healthcare professionals.

  3. The End-of-Life Experience in Long-Term Care: Five Themes Identified from Focus Groups with Residents, Family Members, and Staff

    ERIC Educational Resources Information Center

    Munn, Jean C.; Dobbs, Debra; Meier, Andrea; Williams, Christianna S.; Biola, Holly; Zimmerman, Sheryl

    2008-01-01

    Purpose: We designed this study to examine the end-of-life (EOL) experience in long-term care (LTC) based on input from key stakeholders. Design and Methods: The study consisted of 10 homogeneous focus groups drawn from a purposive sample of LTC residents (2 groups; total n = 11), family caregivers (2 groups; total n = 19), paraprofessional staff…

  4. Procedural skills training. Canadian family practice residency programs.

    PubMed Central

    van der Goes, T.; Grzybowski, S. C.; Thommasen, H.

    1999-01-01

    OBJECTIVE: To survey Canadian family practice residency programs to discover which procedural skills residents are expected to learn. DESIGN: Cross-sectional eight-item questionnaire. SETTING AND PARTICIPANTS: The survey was sent to all 92 program directors and site or unit directors of family practice residency programs across Canada. MAIN OUTCOME MEASURES: Information on procedural skills lists was solicited. We sought date of creation, date of most recent revision, and who was involved in creating the list. A copy of the most recent list available was requested. RESULTS: We received 65 responses, for a 71% return rate. Surveys were received from all provinces and from all Canadian universities offering family practice residency programs. We received 24 unique lists of procedural skills: the shortest listed only 10 procedural skills; the longest, 75 skills; and the average, 36 skills. Only five procedural skills were found on more than 80% of the lists; 30 skills were listed on half or more of the lists. CONCLUSIONS: Canadian family practice residency programs have widely varying expectations of procedural skills for their residents. This survey is a first step in examining the whole issue of procedural skills training in Canadian family medicine programs. PMID:10889860

  5. Leadership training in a family medicine residency program

    PubMed Central

    Gallagher, Erin; Moore, Ainsley; Schabort, Inge

    2017-01-01

    Abstract Objective To assess the current status of leadership training as perceived by family medicine residents to inform the development of a formal leadership curriculum. Design Cross-sectional quantitative survey. Setting Department of Family Medicine at McMaster University in Hamilton, Ont, in December 2013. Participants A total of 152 first- and second-year family medicine residents. Main outcome measures Family medicine residents’ attitudes toward leadership, perceived level of training in various leadership domains, and identified opportunities for leadership training. Results Overall, 80% (152 of 190) of residents completed the survey. On a Likert scale (1 = strongly disagree, 4 = neutral, 7 = strongly agree), residents rated the importance of physician leadership in the clinical setting as high (6.23 of 7), whereas agreement with the statement “I am a leader” received the lowest rating (5.28 of 7). At least 50% of residents desired more training in the leadership domains of personal mastery, mentorship and coaching, conflict resolution, teaching, effective teamwork, administration, ideals of a healthy workplace, coalitions, and system transformation. At least 50% of residents identified behavioural sciences seminars, a lecture and workshop series, and a retreat as opportunities to expand leadership training. Conclusion The concept of family physicians as leaders resonated highly with residents. Residents desired more personal and system-level leadership training. They also identified ways that leadership training could be expanded in the current curriculum and developed in other areas. The information gained from this survey might facilitate leadership development among residents through application of its results in a formal leadership curriculum. PMID:28292816

  6. Needs of family caregivers of advanced cancer patients: a survey in Shanghai of China.

    PubMed

    Cui, J; Song, L J; Zhou, L J; Meng, H; Zhao, J J

    2014-07-01

    It is important to understand the unmet needs of family caregivers of advanced cancer patients for developing and refining services to address the identified gaps in cancer care. To explore their needs in Chinese mainland and the possible factors associated with their needs, a self-developed questionnaire was used to survey a sample of 649 participants in 15 hospitals of Shanghai. The data were analysed using descriptive statistics, factor analysis, t-test, one-way ANOVA, and Fishers least significant difference t-test. All statistical analyses were performed using SPSS 13.0. Seven dimensions of needs (maintaining health, support from healthcare professionals, knowledge about the disease and treatment, support on funeral, information on hospice care, psychological support for patients and symptoms control for patients) were extracted from the results by factor analysis. The dimension with the highest score was 'knowledge about the disease and treatment' (4.37), and that with the lowest score named 'support on funeral' (2.85). The results showed that the factors including burden of payment for treatment, former caregiving experience of family caregivers and length of caregiving time were associated with their needs. Cancer services need to consider how to tailor resources and interventions to meet these needs of family caregivers of advanced cancer patients.

  7. Psychological Distress Among Latino Family Caregivers of Adults With Schizophrenia: The Roles of Burden and Stigma

    PubMed Central

    Magaña, Sandy M.; Ramírez García, Jorge I.; Hernández, María G.; Cortez, Raymond

    2008-01-01

    Objective Little research has focused on the mental health of Latino caregivers with a relative with schizophrenia, despite data showing that up to three-quarters of Latino persons with schizophrenia live with their families. This study examined the relation between caregivers’ mental health and perceived burden and stigma and characteristics of the patient and caregiver. Methods Interviews were conducted in the language of preference (Spanish or English) in Wisconsin, California, and Texas with 85 Latinos caring for an adult with schizophrenia. Measures included the Center for Epidemiologic Studies–Depression Scale, the Zarit Burden Scale, and the Greenley Stigma Scale. Results General population studies of Mexican Americans have found that between 12% and 18% meet the cutoff for being at risk of depression; however, 40% of the sample met this criterion. Younger caregiver age, lower levels of caregivers’ education, and higher levels of the patients’ mental illness symptoms were predictive of higher levels of caregivers’ depressive symptoms. Caregivers’ perceived burden mediated the relation between patients’ psychiatric symptoms and caregivers’ depression. Caregivers’ perceived stigma was significantly related to caregivers’ depressive symptoms, even when the analyses statistically adjusted for psychiatric symptoms and demographic variables. Conclusions The high rates of depressive symptoms among Latino families caring for a relative with schizophrenia suggest that interventions should include attention to the mental health and recovery of family caregivers in addition to the patient’s recovery. Younger Latino caregivers and those with lower levels of education are particularly at risk of depression. PMID:17325112

  8. The experiences of culturally and linguistically diverse family caregivers in utilising dementia services in Australia

    PubMed Central

    2013-01-01

    Background Older people from culturally and linguistically diverse groups are underrepresented in residential aged care but overrepresented in community aged care in Australia. However, little is known about culturally and linguistically diverse family caregivers in utilising dementia services in Australia because previous studies mainly focused on the majority cultural group. Experiences of caregivers from culturally and linguistically diverse groups who are eligible to utilise dementia services in Australia are needed in order to optimize the utilisation of dementia services for these caregivers. Methods The aim of the study was to explore the experiences of family caregivers from Chinese, Greek, Italian and Vietnamese groups in utilising dementia services. Gadamer's philosophical hermeneutics was used to interpret the experiences of the participants. Focus group discussions and in-depth individual interviews were used to collect data. Data collection was conducted over a six month period in 2011. In total, 46 family caregivers who were caring for 39 persons with dementia participated. Results Four themes were revealed: (1) negotiating services for the person with dementia; (2) the impact of acculturation on service utilisation; (3) the characteristics of satisfactory services; and (4) negative experiences in utilising services. The present study revealed that the participation of caregivers from culturally and linguistically diverse groups in planning and managing dementia services ranged markedly from limited participation to full participation. Conclusions The findings of this study suggest that caregivers from culturally and linguistically diverse groups need to be fully prepared so they can participate in the utilisation of dementia services available to them in Australia. PMID:24148155

  9. Depressive symptoms in Chinese family caregivers of patients with heart failure

    PubMed Central

    Hu, Xiaolin; Huang, Wenxia; Su, Yonglin; Qu, Moying; Peng, Xingchen

    2017-01-01

    Abstract Depressive symptoms are related to negative health outcomes in caregivers of patients with HF. Understanding the factors that are associated with depressive symptoms among caregivers is essential to providing appropriate interventions. Little is known about which status and factors are related to depressive symptoms among Chinese caregivers of patients with heart failure. This study aimed to investigate the status of depressive symptoms and to identify the factors that are associated with depressive symptoms in family caregivers of patients with heart failure in China. A cross-sectional design and a convenience sample were used. Participants (N = 134) from 1 hospital in Chengdu were recruited from June 2013 to June 2014. The following measurement tools were used in this study: Center for Epidemiologic Studies Depression Scale, Hospital Anxiety and Depression Scale, Coping Strategies Simplified Coping Style Questionnaire, and Zarit Burden Interview. A hierarchical multiple linear regression analysis was used to determine which factors were associated with depressive symptoms. The results showed that 31% of the caregivers experienced depressive symptoms. The type of payment for treatment (b = −0.312, P < 0.01), readmissions within the last 3 months (b = 0.397, P < 0.01), duration of caregiving (b = −0.213, P < 0.05), caregiver burden (b = 0.299, P < 0.05), active coping (b = −0.235, P < 0.01), and negative coping (b = 0.245, P < 0.05) were related to caregivers’ depressive symptoms. Fifty-four percent of the variance in caregivers’ depressive symptoms was explained by these factors. The caregiver depressive symptoms in China were higher than those reported in studies that were conducted in Western countries. Caregiver depressive symptoms can be improved by providing support for new caregivers (with a caregiving duration of less than 1 year), reducing readmissions, easing caregiver burden, and

  10. Adolescent and caregiver perception of family functioning: relation to suicide ideation and attempts.

    PubMed

    Lipschitz, Jessica M; Yen, Shirley; Weinstock, Lauren M; Spirito, Anthony

    2012-12-30

    This study assessed the relationship between perceived family functioning and two indicators of suicidality in an adolescent sample. A total of 103 adolescents psychiatrically hospitalized for suicidal ideation and/or behavior completed a battery of self-report questionnaires assessing family functioning, negative affectivity, suicidal ideation in the past week assessed by Beck's Scale for Suicide Ideation (BSS; Beck et al., 1979), and past suicide attempts. Participants' primary caregivers also completed a questionnaire on family functioning. A paired samples t-test evaluated overall discrepancy between adolescent- and caregiver-reported family functioning. Linear and logistic regression models were used to evaluate the simple associations between perceived family functioning and suicidal indicators (BSS and previous attempt status), as well as the associations between perceived family functioning and suicidal indicators after controlling for negative affect. Results indicated that adolescents' ratings of family functioning were significantly worse than caregivers' ratings, and positively associated with BSS scores and a history of suicide attempt. When negative affect was controlled for, adolescent-reported family functioning was significantly associated with BSS, but only trended toward significance with attempt status. Findings suggest that adolescents' perceptions of family functioning may be a key contributing factor to suicidal ideation in adolescents with psychiatric disorders.

  11. A Study of 10 States since Passage of the National Family Caregiver Support Program: Policies, Perceptions, and Program Development

    ERIC Educational Resources Information Center

    Feinberg, Lynn Friss; Newman, Sandra L.

    2004-01-01

    Purpose: This study describes the preliminary experiences of 10 states in providing support services to family or informal caregivers of elderly adults and adults with disabilities; it focuses on the newly created National Family Caregiver Support Program, state general funds, Medicaid-waiver programs, and other state-funding streams. Design and…

  12. The Caregiver Strain Questionnaire: Measuring the Impact on the Family of Living with a Child with Serious Emotional Disturbance.

    ERIC Educational Resources Information Center

    Brannan, Ana Maria; Heflinger, Craig Anne; Bickman, Leonard

    1997-01-01

    A study of 984 families of children with emotional and behavioral disturbance used the Caregiver Strain Questionnaire to assess the effects of the shift of primary caregiving to the family due to deinstitutionalization. Results indicate the reliability and validity of the questionnaire, which also identified three related but unique dimensions of…

  13. Family Caregivers of Adults with Intellectual and Developmental Disabilities: Outcomes Associated with U.S. Services and Supports

    ERIC Educational Resources Information Center

    Williamson, Heather J.; Perkins, Elizabeth A.

    2014-01-01

    Individuals with intellectual and developmental disabilities (IDD) in the U.S. predominantly live with their family caregivers. As care delivery and support systems vary widely globally, consideration of caregiver outcomes specifically in the U.S. context is needed. A systematic literature review was conducted to identify U.S. family caregiver…

  14. The Role of Nurses in Coping Process of Family Caregivers of Vegetative Patients: A Qualitative Study

    PubMed Central

    Imanigoghary, Zahra; Peyrovi, Hamid; Nouhi, Esmat; Kazemi, Majid

    2017-01-01

    ABSTRACT Background: Vegetative state (VS) occurs through return of the brain stem after coma state. After hospital discharge, responsibility of caring for VS patients is transferred to their families, which causes a high burden on them. Nurses have an important role in helping the family caregivers to meet their needs and cope with difficulties. To explore the role of nurses during coping process of family caregivers of VS patients. Methods: This study is a part of a larger qualitative study which was performed in Kerman province, Iran during 2014- 2015. Purposive and theoretical sampling was used. 14 caregivers participated in the study. Data were gathered using face-to-face in-depth interviews and managed by MAXQDA 10 software. Analysis was done through constant Comparative Method. Results: Three themes of “nurse as a pursuer teacher”, “nurse as a compassionate caregiver”, and “nurse as a supporter” were derived from analysis that represent various roles of a nurse in the coping process of family caregivers of vegetative patients during the care process. Conclusion: Nurses can play an effective role in improving the caregivers’ well-being by considering the importance of training at discharge time and during home care, helping families in providing care and support them during care process. PMID:28097180

  15. Factors impacting the mental health of the caregivers of children with asthma in china: effects of family socioeconomic status, symptoms control, proneness to shame, and family functioning.

    PubMed

    Zhou, Ting; Yi, Chunli; Zhang, Xuxia; Wang, Yuyin

    2014-12-01

    Caregiver mental health is widely considered to be an important factor influencing children's asthma symptoms. The present study aimed to examine key factors that contribute to caregiver mental health in pediatric asthma with a Chinese sample. Two hundred participants reported their family socioeconomic status (SES), proneness to shame, asthma symptoms control of their child, family functioning, and their depression and anxiety symptoms. Results suggested that low family SES, low family functioning, and a high level of shame proneness were associated with high levels of anxiety and depression for caregivers. Family functioning mediated the effects of SES and shame on caregiver mental health and also moderated the effects of SES and shame on caregiver depression. This study highlights the importance of reducing experience of shame and enhancing family functioning in families affected by pediatric asthma.

  16. Effectiveness of an Interdisciplinary Palliative Care Intervention for Family Caregivers in Lung Cancer

    PubMed Central

    Sun, Virginia; Grant, Marcia; Koczywas, Marianna; Freeman, Bonnie; Zachariah, Finly; Fujinami, Rebecca; Del Ferraro, Catherine; Uman, Gwen; Ferrell, Betty

    2015-01-01

    Background Family caregivers (FCGs) experience significant deteriorations in quality of life while caring for lung cancer patients. This study tested the effectiveness of an interdisciplinary palliative care intervention for FCGs of patients diagnosed with stage I–IV non-small cell lung cancer (NSCLC). Methods FCGs who were identified by patients as the primary caregiver were enrolled in a prospective, quasi-experimental study whereby the usual care group was accrued first followed by the intervention group. FCGs in the intervention group were presented at interdisciplinary care meetings, and they also received four educational sessions organized in the physical, psychological, social, and spiritual domains. The sessions included self-care plans to support the FCG’s own needs. Caregiver burden, caregiving skills preparedness, psychological distress, and FCG QOL were assessed at baseline and 12 weeks using validated measures. Results A total of 366 FCGs were included in the primary analysis. FCGs who received the interdisciplinary palliative care intervention had significantly better scores for social well-being (5.84 vs. 6.86; p<.001) and lower psychological distress (4.61 vs. 4.20; p=.010) at 12 weeks compared to FCGs in the usual care group. FCGs in the intervention group had significantly less caregiver burden compared to FCGs in the usual care group (p=.008). Conclusions An interdisciplinary approach to palliative care in lung cancer resulted in statistically significant improvements in the FCG’s social well-being, psychological distress, and less caregiver burden. PMID:26150131

  17. Integrating family medicine residents into a rural practice.

    PubMed Central

    Kelly, L.

    1997-01-01

    PROBLEM: Integrating residents into community family practices can be challenging for busy doctors, especially when new preceptors have no formal preparation or teaching experience. OBJECTIVE OF PROGRAM: To develop an organized and practical approach to teaching residents in our busy rural group practice. Our seven northern Ontario family doctors have been training elective residents and clerks for 15 years. Recently, we have gone from hosting elective residents and students to teaching core family medicine residents. Our precepting plan allows us to dedicate a reasonable time to teaching while fulfilling our primary care duties. MAIN COMPONENTS: The program involves contracting, teaching, monitoring, feedback, and evaluation. CONCLUSION: We think we have developed a sustainable, workable set of teaching parameters that is applicable by various preceptors in different settings. It has simplified our teaching role and lessened our anxieties. Residents have benefited from the consistent protocol, which can be flexible enough to adapt to individual residents and preceptors, and have valued this teaching approach. Images p278-a p280-a PMID:9040915

  18. A comparison of death anxiety and quality of life of patients with advanced cancer or AIDS and their family caregivers.

    PubMed

    Sherman, Deborah Witt; Norman, Robert; McSherry, Christina Beyer

    2010-01-01

    As an existential crisis, death anxiety may create suffering and impact quality of life. Based on a sample of 101 patients (63 patients with AIDS and 38 with advanced cancer) and 79 family caregivers (43 AIDS patients' caregivers and 36 cancer patients' caregivers), this study examined the death anxiety of patients with advanced cancer and patients with AIDS and that of their family caregivers and the relationship of death anxiety and quality of life. The results indicated that AIDS patients expressed greater death anxiety than cancer patients, but death anxiety was not different among family caregivers. Both AIDS and cancer patients experienced greater death anxiety than their caregivers. Greater death anxiety was associated with lower quality of life, particularly in the psychological domain for AIDS patients. There were significant correlations between the death anxiety subscales and the quality of life subscales for family caregivers, especially for AIDS caregivers. Interventions that lessen death anxiety may enhance quality of life as death approaches, particularly for AIDS patients and their family caregivers.

  19. Negotiating the care-giving role: family members' experience during critical exacerbation of COPD in Norway.

    PubMed

    Aasbø, Gunvor; Rugkåsa, Jorun; Solbraekke, Kari N; Werner, Anne

    2017-03-01

    Healthcare policies often state that complex conditions are to be treated outside hospital in various forms of public-private partnership. Chronic obstructive pulmonary disease (COPD) is a progressive illness that includes episodes of serious acute exacerbations characterised by extreme breathlessness. There is limited knowledge about COPD exacerbations from the perspective of family caregivers and implications of the changing boundary between hospital care and care at home. In this paper, we explore how caregivers negotiate their role as caregivers with patients and healthcare professionals during acute exacerbations. We conducted 10 qualitative interviews with family caregivers of COPD patients in 2011, all were spouses over the age of 60. The participants were recruited through the patient pool of ambulatory pulmonary services of two hospitals in Oslo, Norway. Data were interpreted using thematic analysis. The caregivers described a lack of understanding and support from health professionals in some situations. They shouldered considerable responsibility, but were not always acknowledged as competent carers by professionals. Caregivers had to balance their involvement. They noted that they could lose the professionals' co-operation if their involvement was perceived as interfering or preventing the professionals from exercising their expertise. However, by not sharing their personalised knowledge about the patients, they risked that the professionals would not understand the severity of the exacerbation, which could undermine their own ability to maintain a sense of safety and control. The negotiations caregivers participated in and the uncertainty they experienced shed new light on the complexity of their role, and the discrepancy between practice and ideals in healthcare policy regarding collaboration of care. It is crucial to develop further knowledge about structural, interactional and communicational facilitators and barriers for reaching shared

  20. [Working in multiprofessional teams: the perspectives of family health residents].

    PubMed

    Ferreira, Ricardo Corrêa; Varga, Cássia Regina Rodrigues; da Silva, Roseli Ferreira

    2009-10-01

    Brazilian medical residency is increasingly specializing physicians in his practices undervaluing the multiprofessional practices that guide the integrality in health. Aiming at changing this practice, the multiprofessional residency in family health was proposed to prepare professionals searching for a comprehensive health care to the general public. In this context, in 2003, Faculdade de Medicina de Marília started this residency program having as the main idea the multiprofessional work in family health teams. The study shows the perception of family health residents at Faculdade de Medicina de Marília regarding the multiprofessional work developed in the Family Health Program. The method used in this research was the qualitative approach. The collected data had been interpreted through a thematic content analysis, building three empirical categories: Anchors and markers of an interdisciplinary view on team work that permeate the Family Health residency perspective; Conflicts and paradoxes of team work and the maintenance of an assembly line; Dilemmas of the team work facing an hierarchical structure. The data analysis points to an advancement that multiprofessional team work brings to the medical formation, once it allows perspectives that would not be possible without a team.

  1. Family Caregivers as Lay Trainers: Perceptions of Learning and the Relationship between Life Experience and Learning

    ERIC Educational Resources Information Center

    Conceição, Simone C.O.; Johaningsmeir, Sarah; Colby, Holly; Gordon, John

    2014-01-01

    This article describes an initiative to train lay people, predominantly parents of children and youth with special health care needs (CYSHCN), to teach "Bridge to Independence"--a care coordination curriculum--to other family caregivers of CYSHCN. Using a model based on Kirkpatrick and Kirkpatrick's levels of evaluation, the goal…

  2. Dyadic Intervention for Family Caregivers and Care Receivers in Early-Stage Dementia

    ERIC Educational Resources Information Center

    Whitlatch, Carol J.; Judge, Katherine; Zarit, Steven H.; Femia, Elia

    2006-01-01

    Purpose: The Early Diagnosis Dyadic Intervention (EDDI) program provides a structured, time-limited protocol of one-on-one and dyadic counseling for family caregivers and care receivers who are in the early stages of dementia. The goals and procedures of EDDI are based on previous research suggesting that dyads would benefit from an intervention…

  3. Parenting Attitudes, Family Environments, Depression, and Anxiety in Caregivers of Maltreated Children

    ERIC Educational Resources Information Center

    Mennen, Ferol E.; Trickett, Penelope K.

    2011-01-01

    This study evaluated parenting attitudes, family environments, depression, and anxiety in a sample of primarily minority urban mothers to better understand maltreating mothers (n = 83), who retain custody of their children and how they are similar to and different from foster mothers (n = 50), kin caregivers (n = 52) of maltreated children, and…

  4. Impact of Two Psychosocial Interventions on White and African American Family Caregivers of Individuals with Dementia

    ERIC Educational Resources Information Center

    Burgio, Louis; Stevens, Alan; Guy; Delois; Roth, David L.; Haley, William E.

    2003-01-01

    Purpose: We developed manual-guided, replicable interventions based on common needs and cultural preferences of White and African American family caregivers (CGs) of individuals with dementia, and we evaluated these interventions after a 6-month follow-up. Design and Methods: We randomly assigned White (n = 70) and African American (n = 48) CGs of…

  5. Partners in Dementia Care: A Care Coordination Intervention for Individuals with Dementia and Their Family Caregivers

    ERIC Educational Resources Information Center

    Judge, Katherine S.; Bass, David M.; Snow, A. Lynn; Wilson, Nancy L.; Morgan, Robert; Looman, Wendy J.; McCarthy, Catherine; Kunik, Mark E.

    2011-01-01

    Purpose: This article provides a detailed description of a telephone-based care coordination intervention, Partners in Dementia Care (PDC), for veterans with dementia and their family caregivers. Essential features of PDC included (a) formal partnerships between Veterans Affairs (VA) medical centers and Alzheimer's Association Chapters; (b) a…

  6. Caregiver Emotional Expressiveness, Child Emotion Regulation, and Child Behavior Problems among Head Start Families

    ERIC Educational Resources Information Center

    McCoy, Dana Charles; Raver, C. Cybele

    2011-01-01

    The present study examined the relationships between caregivers' self-reported positive and negative emotional expressiveness, observer assessments of children's emotion regulation, and teachers' reports of children's internalizing and externalizing behaviors in a sample of 97 primarily African American and Hispanic Head Start families. Results…

  7. [Proposal for a survey for assisting the family and caregivers of patients with spinal cord injuries].

    PubMed

    Mancussi e Faro, A C

    1999-12-01

    This study proposes a basis survey for assistance to the family and caregivers because we believe there is necessity of family participation on the treatment, trying to understand and share the disease or deficiency situation. We objectified to sketch the relationship degree and the people's gender that accompanied the spinal cord injured hurt medular patient in nursing consultations and to discuss the necessity of basis survey to the assistance family and to the caregiver. 101 nursing consultations were accomplished, in clinic health, to the spinal cord injured patient and his/her relative and 36 patients were totalized, from this number 26 (72.22%) were male and 10 (27.78%), were female. It was verified that the men with medular lesion, in the greater number (27-80.7 O/o), were accompanied with his relatives specially mother and wife, while the women with medular lesion, in the greater number too (7-70%) were accompanied with her relatives of diversified proximity. In reference to the basis survey that comprehend the care at house and the caregiver necessity, we can affirm its relevance, trying to context the family support identified attending the caregivers.

  8. The psychological well-being of disability caregivers: examining the roles of family strain, family-to-work conflict, and perceived supervisor support.

    PubMed

    Li, Andrew; Shaffer, Jonathan; Bagger, Jessica

    2015-01-01

    We draw on the cross-domain model of work-family conflict and conservation of resources theory to examine the relationship between disability caregiving demands and the psychological well-being of employed caregivers. Using a sample of employed disability caregivers from a national survey, we found that the relationship between caregiving demands and family-to-work conflict was stronger when employees experienced high levels of strain from family. Additionally, we found high levels of family to-work conflict were subsequently associated with decreases in life satisfaction and increases in depression, but only when perceived supervisor support was low. Overall, our findings suggest an indirect relationship between caregiving demands and psychological well-being that is mediated by family-to-work conflict and is conditional on family strain and perceived supervisor support. The theoretical and practical implications of these findings are discussed.

  9. The Caregiving Quandary
.

    PubMed

    Boyle, Deborah A

    2017-04-01

    Long before I became a cancer caregiver, I worried about families. Providing care without a script, expanding their workload, solo decision making, incessant worrying, managing expectations, overseeing medications-that is the lay caregiver's all-consuming world. However, when cancer entered my residence, I started living what I had historically observed from a distance. The double-duty caregiving at work and home overwhelmed me. Years of experience did little to prepare me for the emotional tsunami and physical toll caregiving took on me. I questioned my ability to make decisions, I got my husband's medications mixed up, and I had trouble asking for and accepting help, despite how much I needed it.
.

  10. The Challenge of Teaching Obstetrics to Family Practice Residents

    PubMed Central

    Carroll, June C.

    1986-01-01

    Physicians who incorporate maternity care into family practice experience an increase in job satisfaction and enjoy a more favourable practice profile. Yet many family physicians are opting out of the obstetrical care of their patients. This development presents a major challenge to the teachers of family medicine. In many teaching programs the response of staff has been to move significant portions of residency training in obstetrics to smaller community hospitals. At Mount Sinai Hospital in Toronto, we believe that an integrated program in the tertiary care centre offers definite advantages. Our obstetrical training program integrates four elements: the community, the hospital, the Department of Family and Community Medicine, and the training program offered by that Department. We expect that family practice residents, by participating in this multifaceted, integrated program, will make a better-informed choice about practising obstetrics. PMID:21267328

  11. Female inmates, family caregivers, and young children's adjustment: A research agenda and implications for corrections programming.

    PubMed

    Cecil, Dawn K; McHale, James; Strozier, Anne; Pietsch, Joel

    2008-11-01

    Attendant to the exponential increase in rates of incarceration of mothers with young children in the United States, programming has been established to help mothers attend to parenting skills and other family concerns while incarcerated. Unfortunately, most programs overlook the important, ongoing relationship between incarcerated mothers and family members caring for their children-most often, the inmates' own mothers. Research reveals that children's behavior problems escalate when different co-caregivers fail to coordinate parenting efforts and interventions, work in opposition, or disparage or undermine one another. This article presents relevant research on co-caregiving and child adjustment, highlights major knowledge gaps in need of study to better understand incarcerated mothers and their families, and proposes that existing interventions with such mothers can be strengthened through targeting and cultivating functional coparenting alliances in families.

  12. Female inmates, family caregivers, and young children's adjustment: A research agenda and implications for corrections programming

    PubMed Central

    Cecil, Dawn K.; McHale, James; Strozier, Anne; Pietsch, Joel

    2008-01-01

    Attendant to the exponential increase in rates of incarceration of mothers with young children in the United States, programming has been established to help mothers attend to parenting skills and other family concerns while incarcerated. Unfortunately, most programs overlook the important, ongoing relationship between incarcerated mothers and family members caring for their children—most often, the inmates' own mothers. Research reveals that children's behavior problems escalate when different co-caregivers fail to coordinate parenting efforts and interventions, work in opposition, or disparage or undermine one another. This article presents relevant research on co-caregiving and child adjustment, highlights major knowledge gaps in need of study to better understand incarcerated mothers and their families, and proposes that existing interventions with such mothers can be strengthened through targeting and cultivating functional coparenting alliances in families. PMID:19884977

  13. Changes in Perceived Filial Obligation Norms Among Coresident Family Caregivers in Japan

    PubMed Central

    Tsutsui, Takako; Muramatsu, Naoko; Higashino, Sadanori

    2014-01-01

    Purpose of the Study: Japan introduced a nationwide long-term care insurance (LTCI) system in 2000, making long-term care (LTC) a right for older adults regardless of income and family availability. To shed light on its implications for family caregiving, we investigated perceived filial obligation norms among coresident primary family caregivers before and after the policy change. Design and Methods: Descriptive and multiple regression analyses were conducted to examine changes in perceived filial obligation norms and its subdimensions (financial, physical, and emotional support), using 2-wave panel survey data of coresident primary family caregivers (N = 611) in 1 city. The baseline survey was conducted in 1999, and a follow-up survey 2 years later. Results: On average, perceived filial obligation norms declined (p < .05). Daughters-in-law had the most significant declines (global and physical: p < .01, emotional: p < .05) among family caregivers. In particular, physical support, which Japan’s LTC reform targeted, declined significantly among daughters and daughters-in-law (p < .01). Multiple regression analysis indicated that daughters-in-law had significantly lower perceived filial obligation norms after the policy introduction than sons and daughters (p < .01 and p < .05, respectively), controlling for the baseline filial obligation and situational factors. Implications: Our research indicates declining roles of daughters-in-law in elder care during Japan’s LTCI system implementation period. Further international efforts are needed to design and implement longitudinal studies that help promote understanding of the interplay among national LTC policies, social changes, and caregiving norms and behaviors. PMID:24009170

  14. "The Church of Online Support": Examining the Use of Blogs Among Family Caregivers of Persons With Dementia.

    PubMed

    Anderson, Joel G; Hundt, Elizabeth; Dean, Morgan; Keim-Malpass, Jessica; Lopez, Ruth Palan

    2016-12-04

    Many individuals, including dementia caregivers, use blogs to share their experiences. These blogs contain rich narratives representing an untapped resource for understanding the psychosocial impact of caring for a person with dementia at the family level. The present study used blogs written by caregivers of persons with dementia to explore how these individuals leveraged this medium as part of the caregiving experience. Blogs written by self-identified informal caregivers of persons with dementia were identified using a systematic search method, and data were analyzed using a qualitative thematic analysis. Four themes emerged from the narratives: social support through communication and engagement, information gathering and seeking, reminiscing and legacy building, and altruism. By understanding the ways in which individuals providing care for persons with dementia use social media as part of the caregiving experience, family nurses can develop interventions and services aimed at improving caregiver burden and quality of life.

  15. Education in long-term care for family medicine residents

    PubMed Central

    Oliver, Doug; Emili, Anna; Chan, David; Taniguchi, Alan

    2011-01-01

    Abstract Problem addressed Family medicine residents require more exposure to all aspects of care of the elderly in the community, including care in long-term care (LTC) homes. Objective of program To provide a framework for the development of integrated LTC rotations in family medicine programs. Program description Clear objectives for residents and clinical preceptors provided the foundation for the program. Rotations of 4 half days per year in LTC homes were integrated into core family medicine blocks. Residents worked with family physician preceptors providing LTC in the community. Teaching was case based and aligned with the core competencies set out in the CanMEDS (Canadian Medical Directives for Specialists) framework for medical education. The program was strongly supported by the university’s administration, clinical preceptors in the community, and LTC homes. Conclusion All the residents rated their LTC rotations as useful or extremely useful in preparing them to provide LTC in their future practices. Long-term care homes realized that investing in training medical residents in LTC could help improve care of the elderly in the community. PMID:21841091

  16. Registered Nurses’ Perceptions about the Situation of Family Caregivers to Patients with Heart Failure - A Focus Group Interview Study

    PubMed Central

    2016-01-01

    Introduction Heart failure is a growing public health problem associated with poor quality of life and significant morbidity and mortality. The majority of heart failure care is provided by family caregivers, and is associated with caregiver burden and reduced quality of life. Research emphasizes that future nursing interventions should recognize the importance of involving family caregivers to achieve optimal outcomes. Aims The aims of this study are to explore registered nurses’ perceptions about the situation of family caregivers to patients with heart failure, and registered nurses’ interventions, in order to improve family caregivers’ situation. Methods The study has a qualitative design with an inductive approach. Six focus group interviews were held with 23 registered nurses in three hospitals and three primary health care centres. Data were analysed using qualitative content analysis. Results Two content areas were identified by the a priori study aims. Four categories and nine sub-categories emerged in the analysis process. The content area “Family caregivers' situation” includes two categories: “To be unburdened” and “To comprehend the heart failure condition and its consequences”. The content area “Interventions to improve family caregivers' situation” includes two categories: “Individualized support and information” and “Bridging contact”. Conclusions Registered nurses perceive family caregivers' situation as burdensome, characterized by worry and uncertainty. In the PHCCs, the continuity and security of an RN as a permanent health care contact was considered an important and sustainable intervention to better care for family caregivers' worry and uncertainty. In the nurse-led heart failure clinics in hospitals, registered nurses can provide family caregivers with the opportunity of involvement in their relative's health care and address congruence and relationship quality within the family through the use of "Shared care

  17. Comparison between Camberwell Family Interview and Expressed Emotion Scale in Determining Emotions of Caregivers of Schizophrenic Patients

    PubMed Central

    ÇETİNKAYA DUMAN, Zekiye; KUŞCU, M. Kemal; ÖZGÜN, Serkan

    2013-01-01

    Introduction The aim of the study was to compare the Camberwell Family Interview (CFI) and the Expressed Emotion Scale (EES) in determining the level of expressed emotion in caregivers of patients with schizophrenia. Method The study sample included caregivers of 22 schizophrenic patients followed in two psychiatric clinics. The level of expressed emotion in the caregivers was assessed by the CFI and the EES. CFI was applied to caregivers of the inpatients and the procedure was audio recorded. These records were later used for the ratings. EES was completed by the caregivers. Total EES scores were used to determine the level of expressed emotion in the caregivers. Results Forty point nine percent and 50% of the caregivers had high level of expressed emotion based on the analysis of the data obtained from the CFI and EES. Fifty-nine percent and 50% of the caregivers had low level of expressed emotion based on the data obtained from the CFI and EES. The proportion of the caregivers with high level of expressed emotion as measured by the CFI and the EES were not statistically significantly different within the sample (χ2= 0.727). Conclusion The CFI and the EES were similar in determining the level of expressed emotion in caregivers of schizophrenic patients. It can be suggested that the EES, a user friendly tool, may be preferred to determine the level of expressed emotion in caregivers of patients with schizophrenia. However, further studies with larger samples are needed to obtain more reliable results.

  18. Predictors of Self and Surrogate Online Health Information Seeking in Family Caregivers to Cancer Survivors.

    PubMed

    Oh, Young Sam

    2015-01-01

    The purpose of this research is to investigate various factors predicting online health information seeking for themselves (self OHIS) and online health information seeking for others (surrogate OHIS) in family caregivers to cancer survivors. To address this purpose, this study applies the comprehensive model of information seeking as a theoretical framework for explaining the relationships between various predictors and two types of OHIS. The data used in this study were taken from the Health Information National Trends Survey 4. A total of 1,113 family caregivers were included in this study. Logistic regression analyses were conducted to examine the effects of predictors on Internet use for health information seeking. Caregivers' self and surrogate OHIS were commonly predicted by their self-rated health and attention to the Internet. However, age, race, and education were significantly associated with self OHIS only, while gender and marital status were significantly associated with surrogate OHIS only. These results suggest that family caregivers' self and surrogate OHIS are predicted by common factors, as well as predicted by different specific factors.

  19. Occupational and environmental medicine in a family medicine residency.

    PubMed

    Eckstein, T E; Teitelbaum, H S

    2001-05-01

    Well-rounded instruction in occupational medicine as part of family medicine residency training is feasible through a program that balances a longitudinal curriculum of monthly occupational and environmental medicine (OEM) lectures, community-based OEM patient care, and worksite assessment. Such training would help equip family medicine residents to integrate occupational medicine into their practices, which, in light of a shortage of board-certified practitioners in OEM, would help fill community needs. The Intern-Resident Training Committee of Carson City Hospital in rural Michigan established both learner and institutional goals and objectives for such a program of instruction. A learner-needs assessment found appreciable interest among the residents for occupational medicine training. In addition, results of a survey of the occupational health community suggested there is inadequate coverage of OEM in medical schools and residencies. Furthermore, a focus group of occupational health managers revealed that clarity of communication and standardization of reporting were paramount concerns. Instruments for standardized OEM history and for OEM case management were developed for use within the residency continuity clinic. The curriculum was implemented with a variety of teaching strategies, including worksite assessment. Practice-based, case-oriented instruction was subsequently phased into the program as residents assumed responsibility for managing cases under the supervision of family medicine preceptors knowledgeable in OEM. An occupational medicine rotation was developed that included focused clinical exposure to OEM patients and studies that would lead to eligibility for a certificate of additional qualification in occupational medicine. Learner evaluations included chart reviews and patient satisfaction surveys. Program evaluations included interviews with occupational health managers. The residents were judged by their preceptors to have performed well. The

  20. Behavioral and Educational Interventions to Support Family Caregivers in End-of-Life Care: A Systematic Review.

    PubMed

    Chi, Nai-Ching; Demiris, George; Lewis, Frances M; Walker, Amy J; Langer, Shelby L

    2016-11-01

    The demand for family caregivers steadily increases as the number of people receiving hospice and palliative care rises. Family caregivers play a significant role in supporting their loved ones in end-of-life care. However, there is limited evidence about the effectiveness of the interventions for supporting family caregivers. This article synthesizes behavioral and educational interventions that support family caregivers in end-of-life care. A systematic review was conducted and searched interventional studies published between 2004 and 2014 in PubMed, CINAHL, Embase, and The Cochrane Library electronic databases. Fourteen studies were identified and analyzed: 4 educational studies, 6 cognitive behavioral therapy studies, and 4 psychoeducational studies. All educational and behavioral interventions had developed structures and treatment manuals and improved family caregivers' outcomes. The cognitive behavioral therapy resulted in more positive outcomes than the other 2 interventions. More rigorous randomized controlled trials are needed to replicate current effective interventions with larger and diverse sample. Future studies need to develop tools for assessing family caregivers' needs, create consistent and specific tools to effectively measure family caregivers' outcomes, incorporate a cost-effectiveness analysis, and find the most efficient intervention format and method.

  1. Family Medicine Residency Program Directors Attitudes and Knowledge of Family Medicine CAM Competencies

    PubMed Central

    Gardiner, Paula; Filippelli, Amanda C.; Lebensohn, Patricia; Bonakdar, Robert

    2013-01-01

    Context Little is known about the incorporation of integrative medicine (IM) and complementary and alternative medicine (CAM) into family medicine residency programs. Objective The Society for Teachers of Family Medicine (STFM) approved a set of CAM/IM competencies for family medicine residencies. We hope to evaluate with an online survey tool, whether residency programs are implementing such competencies into their curriculum. We also hope to assess the knowledge and attitudes of Residency Directors (RDs) on the CAM/IM competencies. Design A survey was distributed by the CAFM (Council of Academic Family Medicine) Educational Research Alliance to RDs via email. The survey was distributed to 431 RDs. Of those who received it, 212 responded for a response rate of 49.1%. Questions assessed the knowledge and attitudes of CAM/IM competencies and incorporation of CAM/IM into residency curriculum. Results Forty-five percent of RDs were aware of the competencies. In term of RD attitudes, 58% reported that CAM/IM is an important component of residents' curriculum yet, 60% report not having specific learning objectives for CAM/IM in their residency curriculum. Among all programs, barriers to CAM/IM implementation included: time in residents' schedules (77%); faculty training (75%); access to CAM experts (43%); lack of reimbursement (43%), and financial resources (29%). Conclusions While many RDs are aware of the STFM CAM/IM competencies and acknowledge their role in residence education, there are many barriers preventing residencies to implementing the STFM CAM/IM competencies. PMID:24021471

  2. Salience of self-identity roles in persons with dementia: differences in perceptions among elderly persons, family members and caregivers.

    PubMed

    Cohen-Mansfield, Jiska; Parpura-Gill, Aleksandra; Golander, Hava

    2006-02-01

    In this study, we explored perceptions of the salience of self-identity in persons suffering from dementia as perceived by the participants themselves, by family, and by staff caregivers. Four types of role-identity were explored: professional, family role, hobbies/leisure activities, and personal attributes. Participants were 104 persons with dementia, 48 of whom attended six adult day care centers while 56 resided in two nursing homes in the Washington, DC metropolitan area. Participants, relatives, and staff members were interviewed to obtain information about past and present self-identity roles of participants and attitudes toward these roles. Findings demonstrate that the importance of role identities decreases over time and with the progression of dementia. The family role was found to be the most important and salient role identity according to all the informant groups. The professional role was the one that showed the steepest decline in importance from past to present. Gender differences were detected for the importance of professional role identity. Participants rated their roles in the past as less important and those in the present as more important compared to family members. Family members reported greater decline in the importance of role identities for those participants with greater cognitive impairment. Participants with moderate cognitive impairment reported greater decline in the importance of role identities than did the participants with severe cognitive impairment. Understanding the past and present self-identities of persons with diminished cognitive abilities is crucial in the effort to provide individualized care and enhance participant experiences.

  3. Evidence for stroke family caregiver and dyad interventions: a statement for healthcare professionals from the American Heart Association and American Stroke Association.

    PubMed

    Bakas, Tamilyn; Clark, Patricia C; Kelly-Hayes, Margaret; King, Rosemarie B; Lutz, Barbara J; Miller, Elaine L

    2014-09-01

    Stroke is a leading cause of severe, long-term disability. Most stroke survivors are cared for in the home by a family caregiver. Caregiver stress is a leading cause of stroke survivor institutionalization, which results in significant costs to the healthcare system. Stroke family caregiver and dyad intervention studies have reported a variety of outcomes. A critical analysis of 17 caregiver intervention studies and 15 caregiver/stroke survivor dyad intervention studies was conducted to provide evidence-based recommendations for the implementation and future design of stroke family caregiver and dyad interventions.

  4. Long Term Caregiving: Helping Families of Persons with Mild Cognitive Impairment Cope

    PubMed Central

    Austrom, Mary Guerriero; Lu, Yvonne

    2010-01-01

    The purpose of the paper is to describe common psychological and caregiving issues that can cause stress in family members of persons with mild cognitive impairment (PwMCI) in order to assist family members in providing care and support to the PwMCI while also caring for themselves over long periods of time. Because PwMCI and their family members have time to prepare for the future should the PwMCI no longer be able to participate in their own care, it is important that clinicians offer support, education, and referrals for services and interventions when needed. The results of a review and synthesis of the caregiving literature found that much information exists from educational and intervention programs designed to help caregivers of Alzheimer disease however little empirical information is available for clinicians to assist PwMCI and their family members. This paper provides valuable and practical information for clinicians and other care providers to assist family members of PwMCI to cope with the uncertainty of the diagnosis, prepare for the future, and manage their stress over the long-term. PMID:19689239

  5. Dying with motor neurone disease, what can we learn from family caregivers?

    PubMed Central

    Ray, Robin A.; Brown, Janice; Street, Annette F.

    2012-01-01

    Abstract Background  Increasingly, people with neurodegenerative illness are cared for at home until close to death. Yet, discussing the reality of dying remains a social taboo. Objective  To examine the ways, family caregivers of people living with motor neurone disease (MND) experienced the dying of their relative and to identify how health practitioners can better prepare families for end‐of‐life care. Design  Secondary analysis was undertaken on data sets generated from two longitudinal qualitative studies employing similar data collection and analysis methods. Combining data sets increased participant numbers in a low incidence disease group. Setting and participants  Primary studies were undertaken with family caregivers in England and Australia. Interview and observational data were collected mostly in home. Participants who discussed dying and death formed the sample for secondary analysis. Results  Combined data revealed four major themes: planning for end of life, unexpected dying, dignity in the dying body and positive end to MND. Despite short survival predictions, discussions among family members about dying were often sporadic and linked to loss of hope. Effective planning for death assisted caregivers to manage the final degenerative processes of dying. When plans were not effectively communicated or enacted, capacity to preserve personhood was reduced. Discussion and Conclusion  Returning death and dying to social discourse will raise the level of community awareness and normalize conversations about end‐of‐life care. Strategies for on‐going, effective communication that facilitates advance care planning among patients, their families and practitioners are essential to improve dying and death for people with MND and their family caregivers. PMID:22512686

  6. Caring for Others: Internet Video-Conferencing Group Intervention for Family Caregivers of Older Adults with Neurodegenerative Disease

    ERIC Educational Resources Information Center

    Marziali, Elsa; Donahue, Peter

    2006-01-01

    Purpose: The aim of this pilot feasibility study was to evaluate the effects of an innovative, Internet-based psychosocial intervention for family caregivers of older adults with neurodegenerative disease. Design and Methods: After receiving signed informed consent from each participant, we randomly assigned 66 caregivers to an Internet-based…

  7. Listening for the Communicative Signals of Humor, Narratives, and Self-Disclosure in the Family Caregiver Interview

    ERIC Educational Resources Information Center

    Sparks, Lisa; Travis, Shirley S.; Thompson, Sharlene R.

    2005-01-01

    The authors' previous work with long-term family caregivers demonstrated the importance of conversational cues, the reliance on humor to convey sensitive information, and the ways in which the interviewer can follow up, with appropriate probes and nonverbal encouragement, to gain necessary insight into the caregiver situation. This article offers…

  8. Resourceful Aging: Today and Tomorrow. Conference Proceedings (Arlington, Virginia, October 9-10, 1990). Volume III. Family/Caregiving.

    ERIC Educational Resources Information Center

    American Association of Retired Persons, Washington, DC.

    This document contains 16 papers on family roles and caregiving presented at a conference on aging. The papers, grouped into themes of trends and implications, resourceful roles (grandparenting and caregiving), and an agenda for the future, include the following: "Demographic Potential and the Quiet Revolution" (Opening Remarks by Robert A.…

  9. Hospital Discharge Planning: A Guide for Families and Caregivers

    MedlinePlus

    ... family member after he or she returns home: Personal care: bathing, eating, dressing, toileting Household care: cooking, ... the other hand, there may be a more personal relationship if you hire an individual directly, and ...

  10. Family structure and mothers' caregiving of children with cystic fibrosis.

    PubMed

    Gayer, Debra; Ganong, Lawrence

    2006-11-01

    The purpose of this investigation is to examine differences in the experiences of mothers of children with cystic fibrosis who are in diverse family structures (first-marriage families, stepfamily households, single-parent households). In particular, mothers' perceptions of children's health, adherence to prescribed treatments, and help received from others were compared and predictors of treatment adherence were examined. Children's health and adherence to treatment regimens were not related to family structure. Mothers had the major responsibility for seeing that cystic fibrosis treatments were followed, regardless of family structure. Single mothers received less help than married and repartnered mothers. Married fathers helped with treatments more than nonresidential divorced fathers and stepfathers. Implications for nursing practice and suggestions for future research are offered.

  11. Imagining the future: Perspectives among youth and caregivers in the trans youth family study.

    PubMed

    Katz-Wise, Sabra L; Budge, Stephanie L; Orovecz, Joe J; Nguyen, Bradford; Nava-Coulter, Brett; Thomson, Katharine

    2017-01-01

    Future perspectives of transgender youth and their caregivers may be shaped by knowledge of discrimination and adverse mental health among transgender adults. Qualitative data from the Trans Youth Family Study were analyzed to examine how transgender and gender nonconforming (TGN) youth and their caregivers imagine the youth's future. A community-based sample of 16 families (16 TGN youth, ages 7-18 years, and 29 caregivers) was recruited from 2 regions in the United States. Participants completed in-person qualitative interviews and surveys. Interview transcripts were analyzed using grounded theory methodology for coding procedures. Analyses yielded 104 higher order themes across 45 interviews, with 8 prominent themes: comparing experiences with others, gender affirming hormones, gender affirming surgery, gender norms, questioning whether the youth is really transgender, expectations for romantic relationships, uncertainty about the future, and worries about physical and emotional safety. A conceptual model of future perspectives in TGN youth and caregivers is presented and clinical implications are discussed. (PsycINFO Database Record

  12. Psychiatry Training in Canadian Family Medicine Residency Programs

    PubMed Central

    Kates, Nick; Toews, John; Leichner, Pierre

    1985-01-01

    Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement—particularly in finding psychiatrists with a better understanding of family practice, in integrating the teaching to a greater degree with clinical work, thereby increasing its relevance, and in utilizing more suitable clinical settings. PMID:21279156

  13. Family caregivers' subjective experiences of satisfaction in dementia care: aspects of burden, subjective health and sense of coherence.

    PubMed

    Andrén, Signe; Elmståhl, Sölve

    2005-06-01

    Family caregivers experience both positive and negative reactions in caregiving situations. There has been considerably less published about the positive aspects, however. The general aim of this study was to explore a previously developed instrument to study rewards gained by caregivers and to determine the factors associated with satisfaction in family members caring for patients with dementia living at home. The study group consisted of 153 such family members. Standardized interview schedules exploring different background characteristics, and instruments for assessment of the degree of dementia in the patients and the caregivers' total burden and degree of satisfaction were used. Factorial analysis of the Caregiver's Assessment of Satisfactions Index was performed and it became more specific for conditions of dementia when it was reduced. Stressors as measured by the Caregiver Burden scale and satisfaction can coexist and assess different aspects of the caregiver's situation. The caregiver can perceive both moderate burden and great satisfaction at the same time, and further studies may help to broaden our understanding of how we can reduce the degree of burden whilst increasing the sense of satisfaction.

  14. Normalization of Neglect: A Grounded Theory of RNs' Experiences as Family Caregivers of Hospitalized Seniors.

    PubMed

    Taverner, Tarnia; Baumbusch, Jennifer; Taipale, Priscilla

    2016-06-01

    Often older people, while maintaining a level of independence, rely on family members to provide care and assistance. Caregivers who are also registered nurses (RNs) may provide a different perspective around the experience when their older relative is admitted to acute care. The aim of our research was to investigate and develop theory regarding nursing care provision as described by RNs, who were family caregivers to older adults, when that older adult was admitted to acute care. Over a six-month period in 2011, RNs meeting this criterion (n = 12) were interviewed individually. We identified two central categories: "Culture of Neglect" and "Vigil by the Bedside". The core category "Normalization of Neglect" was identified as the theory, grounded in the data the participants provided which described a culture of neglect that had normalized poor nursing care. These findings highlight the issue of neglect and abuse, and further investigation is warranted.

  15. Caregivers' moral narratives of their African American children's out-of-school suspensions: implications for effective family-school collaborations.

    PubMed

    Gibson, Priscilla A; Haight, Wendy

    2013-07-01

    In this qualitative study, the authors examined the culturally nuanced meanings of out-of-school suspensions for 30 lower income caregivers of African American children suspended from school. Caregivers were invited to describe their experiences of their children's suspensions during in-depth, individual, audiotaped interviews. Caregivers generally valued their children's school success, recognized when their children had misbehaved, and supported educators' imposition of appropriate consequences. Out-of-school suspensions, however, were rarely viewed as appropriate consequences. On the contrary, caregivers produced emotionally laden moral narratives that generally characterized their children's suspensions as unjust; harmful to children; negligent in helping children with underlying problems such as bullying; undermining parents' racial socialization; and, in general, racially problematic. Suspensions also contributed to some families' withdrawal from participation in their schools. Understanding how caregivers experience children's out-of-school suspensions provides important clues to how families and schools can work together to effectively reduce racial disparities in out-of-school suspensions.

  16. Parental caregiving of children with cancer and family impact, economic burden: nursing perspectives.

    PubMed

    Williams, Phoebe D; Williams, Kirstin A; Williams, Arthur R

    2014-03-01

    Pediatric cancer diagnoses affect the entire family: parents, well siblings, the ill child, and others. The objective of this study was to review nursing studies on parental caregiving of children with cancer, family impact, and costs. The study used inclusion/exclusion criteria and family systems theory, self/dependent-care, and symptom management (monitoring, alleviation) concepts. Regarding "levels of evidence," 3 studies were Level II; 7 were Level IV; 7 were Level VI; 1 review was Level V and the second was Level I. Of 19 studies: 11 were qualitative; 4, quantitative; 2 were mixed methods. Content analysis themes were: Parental caregiving and family impact, economic burden. Conclusions were that (a) qualitative studies are predominant; findings supported quantitative findings; (b) quantitative nursing studies are less common: found one longitudinal, randomized controlled trial (RCT) focused on outcomes of an intervention for well siblings and parents, implemented by Clinical Nurse Specialists, CNSs; (c) few quantitative studies with large samples were found, especially ones with theoretical models of the family system and measures of illness impact on families; and (d) "mixed methods" longitudinal nursing research is illustrated. There is a need for "evidence-based" practice (EBP) nursing studies of interventions focused on parent education/support/assistance; respite care, and increasing family/well sibling knowledge/other information on the child's illness.

  17. The conceptions of care among family caregivers of persons living with HIV/AIDS in Addis Ababa, Ethiopia.

    PubMed

    Aga, Fekadu; Kylmä, Jari; Nikkonen, Merja

    2009-01-01

    This focused ethnographic study explores and describes the conceptions of care among family caregivers of people living with HIV/AIDS (PLWAs) in Addis Ababa, Ethiopia. Leininger's theory of culture care diversity and universality is the conceptual anchor of this ethnographic study. Using semistructured interviews and participant observation, 6 key informants and 12 general informants were interviewed in their home in Amharic language. Data were analyzed in Amharic using Leininger's phases of ethnonursing analysis for qualitative data and then translated to English. Four major themes representing family caregivers' conceptions of care were identified: nourishing the PLWA while struggling with poverty, maintenance of cleanliness and hygiene of the person and surroundings, comforting the PLWA, and sacrificing self to sustain the PLWA. Valuable data were gathered about the family caregivers' conceptions of care. Nurses can use this knowledge to design and provide culturally congruent care to family caregivers and PLWAs in the community.

  18. A Geriatric Clinical Training Model for Social Workers/Students Working Together with the Alzheimer Patient and Family Caregiver(s).

    ERIC Educational Resources Information Center

    Long Island Jewish Medical Center, NY.

    Discussed in this report is a geriatric clinical training model for social workers and students dealing with Alzheimer patients and family caregivers. The project was conceived to develop student interest and competence to work in this specialized area. One goal was to incorporate relevant components in the social work curriculum in both classroom…

  19. Family Caregiving and the Older American Act: Caring for the Caregiver. Hearing before the Special Committee on Aging. United States Senate, One Hundred Seventh Congress, First Session.

    ERIC Educational Resources Information Center

    Congress of the U.S., Washington, DC. Senate Special Committee on Aging.

    This is the report of a congressional hearing on the new National Family Caregiver Support Program. First, it looks at this new program before it is fully implemented in the states and assesses how the states are setting up their programs. Second, it examines whether the States are receiving the clear and effective guidance they need from the…

  20. Lennox–Gastaut syndrome: impact on the caregivers and families of patients

    PubMed Central

    Gibson, Patricia A

    2014-01-01

    Lennox–Gastaut syndrome (LGS) has a major impact on the health-related quality of life (HRQL) of the affected children as well as their caregivers. The primary caregiver in the family is generally the mother, with support from the father and siblings. The burden of care and the effects of the disease on the child necessitate adjustments in virtually all aspects of the lives of their family. These adjustments inevitably affect the physical, emotional, social, and financial health of the whole family. Numerous sources of support for families can help to ease the burden of care. Improvements in the treatment of LGS, in addition to helping the child with LGS, would likely help improve the HRQL of the family members. This pilot parent survey was designed to explore the impact of epilepsy on caregiver HRQL. Parents of children with epilepsy who had contacted the Epilepsy Information Service at the Wake Forest University School of Medicine, Winston-Salem, NC, USA, were sent questionnaires comprising open- and closed-ended questions. A total of 200 surveys were distributed, with a return rate of 48%. The results revealed that 74% of the parents believed that having a child with epilepsy brought them and their partner closer together. However, when the parents were asked to explain the manner in which epilepsy affected their families, answers included continuous stress, major financial distress, and lack of time to spend with other children. Information and resources for the families of children with LGS could help improve the HRQL of both the patients and their relatives. PMID:25336963

  1. The Attitudes of Chinese Cancer Patients and Family Caregivers toward Advance Directives

    PubMed Central

    Zhang, Qiu; Xie, Chuanbo; Xie, Shanghang; Liu, Qing

    2016-01-01

    Advance directives (ADs) have been legislated in many countries to protect patient autonomy regarding medical decisions at the end of life. China is facing a serious cancer burden and cancer patients’ quality at the end of life should be a concern. However, limited studies have been conducted locally to gather information about attitudes toward ADs. The purpose of this study was to investigate the attitudes of Chinese cancer patients and family caregivers toward ADs and to explore the predictors that are associated with attitudes. The study indicated that although there was low awareness of ADs, most cancer patients and family caregivers had positive attitudes toward ADs after related information was explained to them. Participants preferred to discuss ADs with medical staff when they were diagnosed with a life-threatening disease. Preferences for refusing life-sustaining treatment and choosing Hospice-Palliative Care (HPC) at the end of life would increase the likelihood of agreeing with ADs. This suggests that some effective interventions to help participants better understand end-of-life treatments are helpful in promoting ADs. Moreover, the development of HPC would contribute to Chinese cancer patients and family caregivers agreeing with ADs. PMID:27529264

  2. A Yoga and Compassion Meditation Program Reduces Stress in Familial Caregivers of Alzheimer's Disease Patients

    PubMed Central

    Danucalov, M. A. D.; Kozasa, E. H.; Ribas, K. T.; Galduróz, J. C. F.; Garcia, M. C.; Verreschi, I. T. N.; Oliveira, K. C.; Romani de Oliveira, L.; Leite, J. R.

    2013-01-01

    Familial caregivers of patients with Alzheimer's disease exhibit reduced quality of life and increased stress levels. The aim of this study was to investigate the effects of an 8-week yoga and compassion meditation program on the perceived stress, anxiety, depression, and salivary cortisol levels in familial caregivers. A total of 46 volunteers were randomly assigned to participate in a stress-reduction program for a 2-month period (yoga and compassion meditation program—YCMP group) (n = 25) or an untreated group for the same period of time (control group) (n = 21). The levels of stress, anxiety, depression, and morning salivary cortisol of the participants were measured before and after intervention. The groups were initially homogeneous; however, after intervention, the groups diverged significantly. The YCMP group exhibited a reduction of the stress (P < 0.05), anxiety (P < 0.000001), and depression (P < 0.00001) levels, as well as a reduction in the concentration of salivary cortisol (P < 0.05). Our study suggests that an 8-week yoga and compassion meditation program may offer an effective intervention for reducing perceived stress, anxiety, depression, and salivary cortisol in familial caregivers. PMID:23690846

  3. Advance care treatment plan (ACT-Plan) for African American family caregivers: a pilot study.

    PubMed

    Bonner, Gloria J; Wang, Edward; Wilkie, Diana J; Ferrans, Carol E; Dancy, Barbara; Watkins, Yashika

    2014-01-01

    Research is limited on end-of-life treatment decisions made by African American family caregivers. In a pilot study, we examined the feasibility of implementing an advance care treatment plan (ACT-Plan), a group-based education intervention, with African American dementia caregivers. Theoretically based, the ACT-Plan included strategies to enhance knowledge, self-efficacy, and behavioral skills to make end-of-life treatment plans in advance. Cardiopulmonary resuscitation, mechanical ventilation, and tube feeding were end-of-life treatments discussed in the ACT-Plan. In a four-week pre/posttest two-group design at urban adult day care centers, 68 caregivers were assigned to the ACT-Plan or attention-control health promotion conditions. Findings strongly suggest that the ACT-Plan intervention is feasible and appropriate for African American caregivers. Self-efficacy and knowledge about dementia, cardiopulmonary resuscitation, mechanical ventilation, and tube feeding increased for ACT-Plan participants but not for the attention-control. More ACT-Plan than attention-control participants developed advance care plans for demented relatives. Findings warrant a randomized efficacy trial.

  4. Family caregivers: Russian-speaking Australian women's access to welfare support.

    PubMed

    Team, Victoria; Markovic, Milica; Manderson, Lenore

    2007-09-01

    In Australia, rapid population ageing, and government efforts to support people who are chronically ill, elderly or with disabilities to live in their own homes, has led to the primary responsibility of care being undertaken by families. Through its social policies, the Australian government provides income and other types of support to informal caregivers. This article explores how Australian social policy and women's understanding of their roles impact on their access to welfare support. Qualitative research was conducted in Melbourne between February and June 2006. In-depth interviews were undertaken with eight Russian-speaking women involved in caregiving, purposively recruited through ethnic associations, and with four community service providers. Women based their expectations of the gendered and private nature of their role on the social policies in countries of their origin and, hence, did not attempt to access welfare support unless they were referred by health and welfare professionals. In addition, poor referral by professionals, influenced by past societal attitudes that caregiving is a gendered role, contributed to women's limited access to welfare benefits. Changes in the implementation of social policy are proposed to increase caregivers' access to welfare support and efficient utilisation of existing resources.

  5. "Learning to Become a Family Caregiver" Efficacy of an Intervention Program for Caregivers Following Diagnosis of Dementia in a Relative

    ERIC Educational Resources Information Center

    Ducharme, Francine C.; Levesque, Louise L.; Lachance, Lise M.; Kergoat, Marie-Jeanne; Legault, Alain J.; Beaudet, Line M.; Zarit, Steven H.

    2011-01-01

    Purpose: The purpose of this experimental study was to test the efficacy of a psychoeducational individual program conceived to facilitate transition to the caregiver role following diagnosis of Alzheimer disease in a relative. Design and Methods: Caregivers were recruited in memory clinics and randomized to an experimental group (n = 62) or a…

  6. Disutility of illness for caregivers and families: a systematic review of the literature

    PubMed Central

    Wittenberg, Eve; Prosser, Lisa A.

    2013-01-01

    Background Caring for an ill or disabled family member imposes a well-documented burden on the caregiver. The benefits of a health intervention may be underestimated if “spillover” effects on family members are not captured, resulting in inaccurate conclusions of economic evaluations. Objective To provide an estimate of, and to summarize measurement approaches for, the spillover disutility of illness on family members, relatives, and caregivers, through a systematic review of the literature. Methods The medical (PubMED), psychology (PsycINFO) and economics (EconLit) literatures were searched from inception through February, 2012 for published studies measuring spillover disutility of illness on family members and caregivers. Inclusion criteria were (1) studies using preference-based measures of health-related quality of life, and (2) studies reporting spillover disutility, or (3) studies reporting data from which a spillover disutility could be inferred. Results Fifteen studies were included in this review: 7 reported estimates of spillover disutility and 8 reporting data from which disutility could be inferred. Three studies found no disutility associated with spillover while 12 found measurable effects as large as −0.718 (and two found evidence of positive spillover in subsets of their samples). Generic (indirect) utility instruments were primarily used to measure spillover, including the EQ-5D, QWB and HUI (n=13), though two studies used modified versions of the time trade-off technique. Illnesses studied included childhood disorders (e.g., spina bifida, congenital malformations), diseases of the elderly (e.g., Alzheimer’s disease and dementia), physically disabling conditions (e.g., arthritis, multiple sclerosis), and medical conditions such as cancer and stroke. The persons affected by spillover included parents, grandparents, spouses/partners, other family caregivers, and household members. Conclusions There is a limited literature on the spillover

  7. Test ordering for preventive health care among family medicine residents

    PubMed Central

    Fung, Daisy; Schabort, Inge; MacLean, Catherine A.; Asrar, Farhan M.; Khory, Ayesha; Vandermeer, Ben; Allan, G. Michael

    2015-01-01

    Abstract Objective To determine which screening tests family medicine residents order as part of preventive health care. Design A cross-sectional survey. Setting Alberta and Ontario. Participants First- and second-year family medicine residents at the University of Alberta in Edmonton, the University of Calgary in Alberta, and McMaster University in Hamilton, Ont, during the 2011 to 2012 academic year. Main outcome measures Demographic information, Likert scale ratings assessing ordering attitudes, and selections from a list of 38 possible tests that could be ordered for preventive health care for sample 38-year-old and 55-year-old female and male patients. Descriptive and comparative statistics were calculated. Results A total of 318 of 482 residents (66%) completed the survey. Recommended or appropriate tests were ordered by 82% (for cervical cytology) to 95% (for fasting glucose measurement) of residents. Across the different sample patients, residents ordered an average of 3.3 to 5.7 inappropriate tests per patient, with 58% to 92% ordering at least 1 inappropriate test per patient. The estimated average excess costs varied from $38.39 for the 38-year-old man to $106.46 for the 55-year-old woman. More regular use of a periodic health examination screening template did not improve ordering (P = .88). Conclusion In general, residents ordered appropriate preventive health tests reasonably well but also ordered an average of 3.3 to 5.7 inappropriate tests for each patient. Training programs need to provide better education for trainees around inappropriate screening and work hard to establish good ordering behaviour in preparation for entering practice. PMID:25767171

  8. An occupational perspective of the lived experience of familial dementia caregivers: A thematic review of qualitative literature.

    PubMed

    Hooper, Emma K; Collins, Tracy

    2016-10-06

    Dementia caregiving is thought to have a negative impact on health and wellbeing. This critical review of qualitative literature explored the lived experience of familial dementia caregivers from an occupational therapy perspective. The method was informed by systematic review and qualitative research methodologies and was structured within the occupational dimensions framework of doing-being-becoming-belonging. A comprehensive search of major databases was undertaken which identified 484 studies on the topic; 14 met the inclusion criteria and were included in the review. Ten themes emerged within the doing-being-becoming-belonging framework from the analysis of the studies. The occupational participation of caregivers is conveyed within the 'doing' domain. Ways in which caregiving impacts upon opportunities for self-nurture are presented within the 'being' domain. The 'becoming' domain elucidates ways in which caregivers redefine themselves, their values and their priorities through their caregiving role. The 'belonging' domain depicts ways in which caregivers' connections with their care recipient and others are shaped over time. Practice implications for health and social care practitioners who work with familial dementia caregivers are presented in light of the findings.

  9. Health Literacy Needs Related to Incontinence and Skin Damage among Family and Friend Caregivers of Individuals with Dementia

    PubMed Central

    Rolnick, Cheri; Jackson, Jody; Arntson, Casey; Mullins, Jean; Hepburn, Kenneth

    2013-01-01

    Purpose The purpose of this study was to describe health literacy needs related to incontinence and skin care among family or friend caregivers of individuals with Alzheimer’s disease and develop supportive and educational materials that address these needs. Design Descriptive Subjects and Settings The sample included 48 family/friend adult caregivers of individuals who had advanced dementia. Caregivers were spouses (44%), daughters (31%) or extended family members/friends (25%) recruited from community-based agencies, aged 64 (14) years (mean (SD)), and 75% female. Nearly half (48%) had a racially or ethnically diverse background. Methods Focus groups, interviews, and written surveys were conducted to assess health literacy needs of AD caregivers related to incontinence and skin care; verbal responses were audiotaped, transcribed, and summarized. To address these needs, a set of educational and supportive materials were developed whose content was directed by caregiver responses and supported by a literature review of current evidence and consultation with clinical and research experts. Study procedures were guided by advisory committee of AD caregivers. Results Caregivers had numerous health literacy needs related to incontinence and skin care; areas of need were categorized into knowledge, skills, and attitudes. Caregivers expressed a need to validate the health literacy they possessed. Fourteen educational and supportive documents were developed to address these needs. Conclusion Materials developed in this study are suitable to incorporate into interventions that support caregivers of persons with Alzheimer’s disease. They offer the potential to raise health literacy and care capacity of caregivers, increase communication with healthcare providers, and improve health outcomes of care recipients. PMID:24448620

  10. Keeping family physicians in rural practice. Solutions favoured by rural physicians and family medicine residents.

    PubMed Central

    Rourke, James T. B.; Incitti, Filomena; Rourke, Leslie L.; Kennard, MaryAnn

    2003-01-01

    OBJECTIVE: To determine how family medicine residents and practising rural physicians rate possible solutions for recruiting and sustaining physicians in rural practice. DESIGN: Cross-sectional mailed survey. SETTING: Rural family practices and family medicine residency programs in Ontario. PARTICIPANTS: Two hundred seventy-six physicians and 210 residents. MAIN OUTCOME MEASURES Ratings of proposed solutions on a 4-point scale from "very unimportant" to "very important". RESULTS: Rural family physicians rated funding for learner-driven continuing medical education (CME) and limiting on-call duty to 1 night in 5 as the most important education and practice solutions, respectively. Residents rated an alternate payment plan to include time off for attending and teaching CME and comprehensive payment plans with a guaranteed income for locums as the most important education and practice solutions, respectively. CONCLUSION: Residents and physicians rated solutions very similarly. A comprehensive package of the highest-rated solutions could help recruit and sustain physicians in rural practice because the solutions were developed by experts on rural practice and rated by family medicine residents and practising rural physicians. PMID:14526866

  11. The state of the science of family caregiver-care receiver mutuality: a systematic review.

    PubMed

    Park, Esther O; Schumacher, Karen L

    2014-06-01

    This review critically examines the current state of the science on the concept of family caregiver-care receiver mutuality, summarizes accomplishments and gaps and identifies directions for future theory development and research. Mutuality between family caregivers and care receivers is of increasing interest to researchers. However, no analysis of the current state of the science of this important concept has been published. Our literature search revealed 34 research articles that met inclusion criteria. The studies were assessed in terms of conceptualization of mutuality, instrument development, populations studied, research designs and methods and findings. Significant scientific progress during the past 30 years includes the development of clear definitions and new instruments, expansion of research beyond the clinical populations in which mutuality was first studied, the use of a variety of research designs, and increasingly sophisticated methods of data analysis. Growing evidence suggests that mutuality is associated with caregiver emotional health outcomes and may decrease over time in the context of chronic illness. Directions for future research include development of new theoretical frameworks grounded in relational theory, development of theory on the dynamics of mutuality over time, exploration of mutuality in diverse cultures and populations, and intervention studies aimed at enhancing mutuality.

  12. Effectiveness of a stress management program for family caregivers of the elderly at home.

    PubMed

    Mizuno, E; Hosak, T; Ogihara, R; Higano, H; Mano, Y

    1999-12-01

    The aim of this study is to investigate the efficacy of a structured intervention program in emotional and physical states of family caregivers for elderly. This program is a series of five weekly 90-minute sessions including psycho-education, problem-solving techniques, and relaxation training. Subjects were 56 primary caregivers looking after relatives with dementia or disability at home. Psychological inventories, i.e., Profile of Mood States (POMS) and General Health Questionnaire30 (GHQ-30) were administered at the period of 4 weeks before, pre-, post-intervention, and 2 months after intervention. They were taken a blood sample to measure natural killer (NK) cell activity at the 4 weeks before, pre-, and post-intervention. In the waiting list control group, there was no change in the POMS, the GHQ-30 and NK cell activity. The scores for depression, anger-hostility, tension-anxiety, confusion (POMS), and general illness, social dysfunction, anxiety and dysphoria, suicidal depression (GHQ-30) at the post-intervention decreased significantly when compared with pre-intervention scores. Moreover, there was persistence of the improvement during two months after intervention. Post-intervention NK cell activity was significantly higher than the pre-intervention. These results indicated that our program was effective in managing the stress of family caregivers.

  13. Caregiver Objective Burden and Assessments of Patient-Centered, Family-Focused Care for Frail Elderly Veterans

    ERIC Educational Resources Information Center

    Rose, Julia Hannum; Bowman, Karen F.; O'Toole, Elizabeth E.; Abbott, Katherine; Love, Thomas E.; Thomas, Charles; Dawson, Neal V.

    2007-01-01

    Purpose: There is a growing consensus that quality of care for frail elders should include family and be evaluated in terms of patient-centered, family-focused care (PCFFC). Family caregivers are in a unique and sometimes sole position to evaluate such care. In the context of caring for physically frail elders, this study examined the extent to…

  14. Responding to the Needs of Children and Families After a Disaster: Linkages Between Unmet Needs and Caregiver Functioning

    PubMed Central

    Kilmer, Ryan P.; Gil-Rivas, Virginia

    2010-01-01

    Disasters may negatively influence caregivers’ ability to respond to the needs of their families. In this context, service organizations’ response to families’ needs may affect caregivers’ symptoms and parenting. Interviews were conducted with caregivers affected by Hurricane Katrina approximately 12-months (T1; N = 68) and 2 years post-hurricane (T2; N = 52). Caregivers reported high levels of service needs and unmet needs for themselves and their child(ren) and family at both time points. Regression analyses indicated that after accounting for hurricane exposure: (a) child unmet service needs significantly contributed to T1 caregiver distress; (b) caregiver service needs and child unmet needs were associated with higher levels of posttraumatic stress symptoms (PTSS); and (c) caregiver unmet needs related to greater strain at T1. At T2, after accounting for T1 scores, service need variables did not contribute to distress or PTSS. Caregiver strain at T1 and T1 child service needs were associated with greater T2 strain. These findings highlight the importance of extending the availability of services beyond the initial post-disaster recovery period to better meet the needs of caregivers and families. PMID:20397998

  15. Burdens and psychological health of family caregivers of people with schizophrenia in two Chinese metropolitan cities: Hong Kong and Guangzhou.

    PubMed

    Cw Lam, Paul; Ng, Petrus; Tori, Christopher

    2013-12-01

    Family members charged with the care of those suffering from schizophrenia experience considerable stress due to their multiple responsibilities. Research regarding the burdens of caregiving is scant in Hong Kong and China. The present study quantified the association of the duties of caregivers with mental health symptoms in two Asian cities having distinct health care systems (i.e., Hong Kong and Guangzhou, China). Thirty nine caregivers in Hong Kong and 70 caregivers in Guangzhou were recruited from nongovernmental mental health organizations. They were assessed using the Chinese version of the Involvement Evaluation Questionnaire and the General Health Questionnaire. While the Guangzhou family caregivers had a significantly higher burden than the Hong Kong sample, there was no significant difference in the psychological health status of family caregivers in the two cities. Result of correlational analyses, however, revealed high associations between burden of care variables and the psychological health of the caregivers. Findings for the present study have implications regarding the physical and mental health needs of those caring for seriously disturbed relatives.

  16. Health care professionals' perspectives of the experiences of family caregivers during in-patient cancer care.

    PubMed

    Ekstedt, Mirjam; Stenberg, Una; Olsson, Mariann; Ruland, Cornelia M

    2014-11-01

    Being a family member of a patient who is being treated in an acute care setting for cancer often involves a number of challenges. Our study describes Norwegian cancer care health professionals' perceptions of family members who served as family caregivers (FCs) and their need for support during the in-hospital cancer treatment of their ill family member. Focus group discussions were conducted with a multidisciplinary team of 24 experienced social workers, physicians, and nurses who were closely involved in the patients' in-hospital cancer treatment and care. Drawing on qualitative hermeneutic analysis, four main themes describe health professionals' perceptions of FCs during the patient's in-hospital cancer care: an asset and additional burden, infinitely strong and struggling with helplessness, being an outsider in the center of care, and being in different temporalities. We conclude that it is a challenge for health care professionals to support the family and create room for FC's needs in acute cancer care. System changes are needed in health care, so that the patient/FC dyad is viewed as a unit of care in a dual process of caregiving, which would enable FCs to be given space and inclusion in care, with their own needs simultaneously considered alongside those of the patient.

  17. Initial Validation of a Brief Pictorial Measure of Caregiver Aggression: The Family Aggression Screening Tool.

    PubMed

    Cecil, Charlotte A M; McCrory, Eamon J; Viding, Essi; Holden, George W; Barker, Edward D

    2016-06-01

    In the present study, we report on the development and initial psychometric properties of the Family Aggression Screening Tool (FAST). The FAST is a brief, self-report tool that makes use of pictorial representations to assess experiences of caregiver aggression, including direct victimization and exposure to intimate partner violence. It is freely available on request and takes under 5 minutes to complete. Psychometric properties of the FAST were investigated in a sample of 168 high-risk youth aged 16 to 24 years. For validation purposes, maltreatment history was assessed using the Childhood Trauma Questionnaire; levels of current psychiatric symptoms were also assessed. Internal consistency of the FAST was good. Convergent validity was supported by strong and discriminative associations with corresponding Childhood Trauma Questionnaire subscales. The FAST also correlated significantly with multi-informant reports of psychiatric symptomatology. Initial findings provide support for the reliability and validity of the FAST as a brief, pictorial screening tool of caregiver aggression.

  18. Caregiving and Family Support Interventions: Crossing Networks of Aging and Developmental Disabilities.

    PubMed

    Heller, Tamar; Gibbons, Hailee M; Fisher, Dora

    2015-10-01

    This scoping review addressed the following questions: (a) What types of caregiver interventions are being done in both aging and developmental disability research? (b) How are these interventions similar and different? (c) What kinds of outcomes do these interventions have? (d) What innovative approaches are these interventions using? and (e) What can each field (developmental disabilities and gerontology) learn from the other based on this review? The disability review spanned 20 years (1992-2012), resulting in 14 studies; the aging review spanned 5 years (2008-2012), resulting in 55 studies. Data from the final selected studies were then extracted and compared on research design, type of intervention (governmental programs, small-group psychosocial, and other), and outcomes. Generally, in both fields, family-support interventions benefited participants' well-being and improved service access and satisfaction. Increased partnership between the fields of aging and developmental disabilities is critical to future scholarship in caregiving for both populations.

  19. A SMART design to optimize treatment strategies for patient and family caregiver outcomes.

    PubMed

    Song, Mi-Kyung; DeVito Dabbs, Annette; Ward, Sandra E

    2016-01-01

    Sequential multiple randomization trial (SMART) designs are experimental designs used to identify treatment strategies that maximize targeted health outcomes. SMART designs are receiving greater attention in nursing and other health disciplines to develop multicomponent interventions that are tailored to the patient's (or family caregiver's) needs and preferences. A SMART design resembles a traditional randomized controlled trial (RCT) design in that it scientifically examines intervention effects with randomization. However, the two designs address very different research inquiries. In this article, we compare traditional RCT designs and SMART designs, describe the adaptive treatment framework that underlies SMART designs and key features of SMART designs, and illustrate the application of a SMART design to develop an adaptive palliative care treatment to improve patient and caregiver outcomes.

  20. 3 CFR 8593 - Proclamation 8593 of October 29, 2010. National Family Caregivers Month, 2010

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... information, assistance, counseling, training, support groups, and respite care for caregivers across our... safely in their homes and community without the support of their relatives and caregivers. Caregivers... of countless American seniors, bringing comfort and friendship to these treasured citizens....

  1. Family caregiver challenges in dementia care in Australia and China: a critical perspective

    PubMed Central

    2014-01-01

    Background Both Australia and China have a large proportion of people with dementia and the prevalence will triple in Australia and increase five times in China by 2050. The majority of people with dementia are reliant on family caregivers to provide daily care and to maintain the dignity in both countries. As a consequence, caregiver burden has become a major concern because of the negative impact on the care recipients’ and the caregivers’ health. It is strongly recommended that cross-national collaboration should be conducted to share experiences in fighting dementia. The aim of this study was to compare socially and culturally constructed enablers and barriers pertinent to dementia caregivers in one capital city in Australia and one capital city in China through critical reflection on the caregivers’ subjective and objective experiences for the improvement of dementia care services in both countries. Methods Giddens’ Structuration Theory was used as a framework to guide a concurrent mixed methods design with the qualitative strand as a priority. In the qualitative strand, data were collected by focus groups and in-depth interviews while in the quantitative strand, data were collected by questionnaire survey. Results In total 148 caregivers participated in the project with 57 of them from Australia (26 and 31 in the qualitative and quantitative strands respectively) and 91 of them from China (23 and 68 in the qualitative and quantitative strands respectively). Findings from the qualitative and quantitative strands were presented as three categories: A higher objective burden in the Chinese cohort versus a higher subjective burden in the Australian cohort; Unmet need for caregiver support in Australia and China; and Expectations for improving dementia services in Australia and for developing dementia services in China. Conclusions Dementia policy, services and resources need to be grounded on current research evidence in an ever-changing society like

  2. The Impact of a Substance Abuse Disorder on the Well-Being of Family Caregivers of Adults with Mental Illness

    ERIC Educational Resources Information Center

    MacMaster, Samuel A.

    2008-01-01

    The impact that substance use has on an individual with mental illness has been documented; however, little is known about the impact that this may have for a family caregiver. Data was collected in a cross sectional study using mailed questionnaires to a convenience sample of family members of persons with mental illness (n = 110). Hierarchical…

  3. "You must take the medications for you and for me": family caregivers promoting HIV medication adherence in China.

    PubMed

    Fredriksen-Goldsen, Karen I; Shiu, Cheng-Shi; Starks, Helene; Chen, Wei-Ti; Simoni, Jane; Kim, Hyun-Jun; Pearson, Cynthia; Zhao, Hongxin; Zhang, Fujie

    2011-12-01

    China is experiencing a rapid increase in the incidence of HIV infections, which it is addressing proactively with broad implementation of antiretroviral therapy (ART). Within a cultural context extolling familial responsibility, family caregiving may be an important component to promote medication adherence for persons living with HIV in China. Based on 20 qualitative interviews with persons living with HIV and their family caregivers and a cross-sectional survey with 113 adults receiving HIV care at Beijing's Ditan outpatient clinic, this mixed-methods study examines family caregivers' role in promoting adherence to ART. Building upon a conceptual model of adherence, this article explores the role of family members in supporting four key components enhancing adherence (i.e., access, knowledge, motivation, and proximal cue to action). Patients with family caregiving support report superior ART adherence. Also, gender (being female) and less time since ART initiation are significantly related to superior adherence. Since Chinese cultural values emphasize family care, future work on adherence promotion in China will want to consider the systematic incorporation of family members.

  4. Approaches to capturing the financial cost of family care-giving within a palliative care context: a systematic review.

    PubMed

    Gardiner, Clare; Brereton, Louise; Frey, Rosemary; Wilkinson-Meyers, Laura; Gott, Merryn

    2016-09-01

    The economic burden faced by family caregivers of people at the end of life is well recognised. Financial burden has a significant impact on the provision of family care-giving in the community setting, but has seen limited research attention. A systematic review with realist review synthesis and thematic analysis was undertaken to identify literature relating to the financial costs and impact of family care-giving at the end of life. This paper reports findings relating to previously developed approaches which capture the financial costs and implications of caring for family members receiving palliative/end-of-life care. Seven electronic databases were searched from inception to April 2012, for original research studies relating to the financial impact of care-giving at the end of life. Studies were independently screened to identify those which met the study inclusion criteria, and the methodological quality of included studies was appraised using realist review criteria of relevance and rigour. A descriptive thematic approach was used to synthesise data. Twelve articles met the inclusion criteria for the review. Various approaches to capturing data on the financial costs of care-giving at the end of life were noted; however, no single tool was identified with the sole purpose of exploring these costs. The majority of approaches used structured questionnaires and were administered by personal interview, with most studies using longitudinal designs. Calculation of costs was most often based on recall by patients and family caregivers, in some studies combined with objective measures of resource use. While the studies in this review provide useful data on approaches to capturing costs of care-giving, more work is needed to develop methods which accurately and sensitively capture the financial costs of caring at the end of life. Methodological considerations include study design and method of administration, contextual and cultural relevance, and accuracy of cost

  5. Information Needs of Family Caregivers of Persons with Cognitive versus Physical Deficits

    ERIC Educational Resources Information Center

    Koenig, Kelly N.; Steiner, Victoria; Pierce, Linda L.

    2011-01-01

    This study compared information needs of caregivers of persons with dementia with caregivers of those who received rehabilitation treatment. Caregivers were provided a 48-item survey and asked to choose their top ten information needs. Dementia caregivers' (n = 33) top needs were dealing with forgetfulness/confusion (91%) and repeating…

  6. Impact of Spina Bifida on Parental Caregivers: Findings from a Survey of Arkansas Families

    ERIC Educational Resources Information Center

    Grosse, Scott D.; Flores, Alina L.; Ouyang, Lijing; Robbins, James M.; Tilford, John M.

    2009-01-01

    The well-being of caregivers of children with spina bifida and other conditions is an important topic. We interviewed the primary caregivers of 98 children aged 0-17 years with spina bifida sampled from a population-based birth defects registry in Arkansas and the caregivers of 49 unaffected children. Measures of caregiver well-being were compared…

  7. Clinical teachers as humanistic caregivers and educators: perceptions of senior clerks and second-year residents

    PubMed Central

    Beaudoin, C; Maheux, B; Côté, L; Des Marchais, J E; Jean, P; Berkson, L

    1998-01-01

    BACKGROUND: The acquisition and nurturing of humanistic skills and attitudes constitute an important aim of medical education. In order to assess how conducive the physician-learning environment is to the acquisition of these skills, the authors determined the extent to which clinical teachers are perceived by their trainees as humanistic with patients and students, and they explored whether undergraduate and graduate students share the same perceptions. METHODS: A mail survey was conducted in 1994/95 of all senior clerks and second-year residents at Laval University, University of Montreal and University of Sherbrooke medical schools. Of 774 trainees, 259 senior clerks and 238 second-year residents returned the questionnaire, for an overall response rate of 64%. Students' perceptions of their teachers were measured on a 6-point Likert scale applied to statements about teachers' attitudes toward the patient (5 items) and toward the student (5 items). RESULTS: On average, only 46% of the senior clerks agreed that their teachers displayed the humanistic characteristics of interest. They were especially critical of their teachers' apparent lack of sensitivity, with as many as 3 out of 4 declaring that their teachers seemed to be unconcerned about how patients adapt psychologically to their illnesses (75% of clerks) and that their teachers did not try to understand students' difficulties (78%) or to support students who have difficulties (77%). Compared with the clerks, the second-year residents were significantly less critical, those with negative perceptions varying from 27% to 58%, 40% on average. Except for this difference, their pattern of responses from one item to another was similar. INTERPRETATION: This study suggests the existence of a substantial gap between what medical trainees are expected to learn and what they actually experience over the course of their training. Because such a gap could represent a significant barrier to the acquisition of important

  8. Parenting Mediates the Impact of Caregivers' Distress on Children's Well-Being in Families Affected by HIV/AIDS.

    PubMed

    Chi, Peilian; Li, Xiaoming; Tam, Cheuk Chi; Du, Hongfei; Zhao, Guoxiang; Zhao, Junfeng

    2015-11-01

    Parental illness imposes great challenges to children's life and mental health. Having a parent infected by HIV may further challenge children's psychological well-being. Existing studies have demonstrated a negative impact of caregiver's distress on children's well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers' distress and children's well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers' distress indirectly affect children's well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver's distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention.

  9. Parenting Mediates the Impact of Caregivers' Distress on Children's Well-Being in Families Affected by HIV/AIDS

    PubMed Central

    Chi, Peilian; Li, Xiaoming; Tam, Cheuk Chi; Du, Hongfei; Guoxiang, Zhao; Zhao, Junfeng

    2015-01-01

    Parental illness imposes great challenges to children's life and mental health. Having a parent infected by HIV may further challenge children's psychological well-being. Existing studies have demonstrated a negative impact of caregiver's distress on children's well-being. Limited studies examined the potential pathways of the link. This study aims to examine whether parenting stress, parenting competence and parental responsiveness can explain the relationship between caregivers' distress and children's well-being. A community sample of children of parents living with HIV and their current caregivers (n = 754 dyads) was recruited in rural central China. Children completed the measures on their psychological well-being and perceived parental responsiveness of their caregivers. Caregivers reported on their psychological well-being, parenting stress, and parenting competence. Structural equation modeling analysis showed that caregivers' distress indirectly affect children's well-being through parenting stress, parenting competence and parental responsiveness. Parenting stress explained the impact of caregiver's distress on parental responsiveness and showed pervasive effects on parenting competence. Our findings lend credence to family-based intervention for children affected by HIV and affirm the importance of incorporating the cognitive, emotional and behavioral components of parenting practices in such intervention. PMID:26078116

  10. Music therapy with Alzheimer's patients and their family caregivers: a pilot project.

    PubMed

    Brotons, Melissa; Marti, Patricia

    2003-01-01

    The purpose of this paper is to present the results of a pilot project sponsored by a private foundation in Spain ("Fundació la Caixa"), in order to demonstrate some of the applications of music therapy, and to measure more systematically some of its effects on people with a probable diagnosis of Alzheimer's Disease and Related Disorders (ADRD) in early-moderate stages of the disease, and their family caregivers. Subjects for this project were 14 patients (5 women and 9 men) with a probable diagnosis of Alzheimer's disease, and 14 family caregivers (9 women and 5 men) from a rural area outside of Barcelona. Their age range was 70 to 80 years. Prior to the beginning of the project, a neuropsychologist specialized in gerontology administered a series of standardized tests to the participants. These same tests were administered again 2 days before the end of the project and 2 months later for follow-up purposes. The results of the satisfaction questionnaire showed that the caregivers perceived an improvement in the social and emotional areas of their patients, and statistical tests showed significant differences between pre and posttest scores in the following tests: (a) Dementia Scale (X2 = 12.29, p = .002), (b) NPI (X2 = 17.72, p = .001), (c) the Cohen-Mansfield agitation scale (X2 = 11.45, p = .003), (d) Burden Interview (X2 = 9.19, p = .01), (e) Memory and Behavior Problems Checklist (frequency subscale) (X2 = 11.09, p = .004), (f) STAI-S (X2 = 14.72, p = .001), and (g) Beck's Depression Inventory (X2 = 9.38, p = .009). These results and their implications are discussed extensively.

  11. A suicide education programme for nurses to educate the family caregivers of suicidal individuals: a longitudinal study.

    PubMed

    Sun, Fan-Ko; Chiang, Chun-Ying; Yu, Pei-Jane; Lin, Ching-Hsing

    2013-10-01

    Family members lack the ability to care for suicidal relatives. Nurses have a responsibility to improve family members' ability to care for their suicidal relatives. The aims of this study were to design a suicide education programme for nurses to educate family caregivers and to evaluate the longitudinal (12 months after the educational programme) effects of a suicide care education programme on the ability of families to care for suicidal relatives. A randomised controlled trial was conducted. The study population (n=61) was composed of the family caregivers of suicidal individuals. Several caregivers (n=26) were randomly allocated to an experimental group who attended a two-hour suicide care education programme, and the other caregivers (n=35) represented a control group who did not attend the education programme. All of the participants were given a questionnaire at baseline, 3 months, and 12 months during the period from 2009 to 2011. The results of the longitudinal effects of the suicide care education programme demonstrated that there were statistically significant differences after the educational programme as compared to before the programme with regard to "seeking assistance from resources" and the ability to care for those who were once suicidal. The longitudinal results of both groups showed that there was a significant difference in terms of "caring ability" at 12 months. The results of a multiple linear regression analysis indicated that evaluations performed at the three-month time point were able to effectively predict success in "seeking assistance from resources", "caring ability"; caring ability was also significantly improved among those who engaged in the educational programme at the 12-month time point. The suicide care education programme had long-term effects for family caregivers caring for their suicidal relatives. Nurses could employ this suicide care education programme to improve the ability of family caregivers to care for their

  12. Food Insecurity, Hunger, and Obesity Among Informal Caregivers

    PubMed Central

    Dobbertin, Konrad; Kulkarni-Rajasekhara, Sheetal; Beilstein-Wedel, Erin; Andresen, Elena M.

    2015-01-01

    Introduction Increasing numbers of US residents rely on informal caregiving from friends and family members. Caregiving can have substantial health and financial impacts on caregivers. This study addressed whether those impacts include adverse nutritional states. Specifically, we examined household food insecurity, individual hunger, and obesity among caregivers compared with noncaregivers. Methods We analyzed 2012 Behavioral Risk Factor Surveillance System data from Oregon. The Caregiving Module was administered to a random subset of 2,872 respondents. Module respondents included 2,278 noncaregivers and 594 caregivers providing care or assistance to a friend or family member with a health problem or disability. We used multivariable logistic regression to assess associations between caregiving status and each of our dependent variables. Results Caregivers had significantly greater odds of reporting household food insecurity (odds ratio [OR] = 2.10, P = .003) and personal hunger (OR = 2.89, P = .002), even after controlling for income and other correlates of food insecurity. There were no significant differences in obesity between caregivers and noncaregivers. Conclusion Caregiving is associated with increased risk of food insecurity and hunger in Oregon, suggesting that careful attention to the nutritional profile of households with family caregivers is needed in this population. PMID:26447547

  13. Enhancing Resourcefulness to Improve Outcomes in Family Caregivers and Persons with Alzheimer's Disease: A Pilot Randomized Trial

    PubMed Central

    Gonzalez, Elizabeth W.; Polansky, Marcia; Lippa, Carol F.; Gitlin, Laura N.; Zauszniewski, Jaclene A.

    2014-01-01

    This pilot randomized trial tested an intervention aimed at enhancing resourcefulness in family caregivers of persons with dementia, postulating that caregivers' emotional outcomes (anxiety and depression) and role outcomes (reward, strain, mutuality, and preparedness) would be improved, and problem behaviors in the care recipients (persons with dementia) would be reduced as a result of the intervention. Subjects were stratified by race (white or African American) and by baseline resourcefulness (high or low). Family caregivers were randomly assigned to an intervention group in which subjects attended six resourcefulness training sessions, meeting for 2 hours weekly over 6 weeks, or to a control group that received no treatment. Small to medium effects were shown for the intervention program on resourcefulness, anxiety, and preparedness of the caregivers and on frequency of behavior problems in the care recipients. Caregivers in the intervention group reported significantly more resourcefulness skills, with a medium effect at week 6 and a small effect 12 weeks later, compared with the control group. Persons with dementia had fewer behavior problems in the intervention group compared with control, although the difference was not significant. Caregivers' anxiety was reduced in the intervention group at 12 weeks. PMID:25328754

  14. Family Physician–Case Manager Collaboration and Needs of Patients With Dementia and Their Caregivers: A Systematic Mixed Studies Review

    PubMed Central

    Khanassov, Vladimir; Vedel, Isabelle

    2016-01-01

    PURPOSE Dementia case management (CM) in primary care is a complex intervention aimed at identifying the various needs of patients with dementia and their caregivers, as well as the organization and coordination of care. A key element of CM is the collaboration of family physicians with case managers. We conducted a systematic mixed-studies review to identify the needs of the patient-caregiver dyad and the effects of CM. METHODS We searched MEDLINE, PsycINFO, and EMBASE up to October 2014, regardless of the study design. Our main outcomes were needs of patients and their caregivers and the effects of CM on these needs. We used narrative syntheses to develop a taxonomy of needs and to describe the effects of CM on those needs. We used meta-analysis to calculate the prevalence of needs and the standardized mean differences to evaluate the effects of CM on the needs identified. RESULTS Fifty-four studies were included. We identified needs of the patient-caregiver dyad and needs of the patient and caregiver individually. CM addressed the majority of the identified needs. Still, some very common needs (eg, early diagnosis) are overlooked while other needs (eg, education on the disease) are well addressed. Fully establishing the value of CM is difficult given the small number of studies of CM in primary care. CONCLUSIONS There is good evidence that case managers, in collaboration with family physicians, have a pivotal role in addressing the needs of the patient-caregiver dyad. PMID:26951593

  15. Processes of user participation among formal and family caregivers in home-based care for persons with dementia.

    PubMed

    Larsen, Lill Sverresdatter; Normann, Hans Ketil; Hamran, Torunn

    2017-02-01

    Scandinavian health policy supports prolonged home-based care for people with dementia. User participation is expected to reduce family burden. The aim of this study was to explore how formal and family caregivers experience collaboration while providing home-based dementia care, with a focus on user participation. Seventeen qualitative in-depth interviews were conducted among formal and family caregivers in rural municipalities. The theme identified during this process was 'negotiating participation in decisions'. This theme was analysed using positioning theory. Concepts such as user participation are ambiguous, and caregivers negotiate positions during decision-making processes. Such negotiations are caused by the problematic relationships among patients' legal consent, undefined spokespersons and pragmatic care practices. These constant negotiations enable or obstruct collaboration in several situations. User participation as a concept might contribute to conflicts during collaborations. Dialogues about user participation that focus on consent and spokespersons could reduce the burden created by negotiations in practice.

  16. Subjective Experiences of an Art Museum Engagement Activity for Persons with Early Alzheimer’s disease and their Family Caregivers

    PubMed Central

    Flatt, Jason D.; Liptak, Amy; Oakley, Mary Ann; Gogan, Jessica; Varner, Tresa; Lingler, Jennifer H.

    2014-01-01

    Objective To describe the subjective experiences of older adults with early-stage Alzheimer’s disease or related cognitive disorders (ADRD) and their family caregivers who participated in an art museum engagement activity. Methods Four focus groups were conducted with 10 persons with ADRD and 10 family caregivers following the completion one-time, three hour engagement activity. Participants also completed a brief satisfaction survey, and associations were examined using nonparametric statistics. Results Three key themes were identified: cognitive stimulation, social connections, and a sense of self. In addition, we identified programmatic issues such as activity-specific concerns and program logistics that could help improve future art program offerings. Past experience with art and perceived social cohesion were correlated with participants’ overall satisfaction with the program. Discussion Efforts aimed at improving the quality of life of those with Alzheimer’s and their family caregivers should consider the potential role of art museums. PMID:25216658

  17. Measuring the psychosocial characteristics of family caregivers of palliative care patients: psychometric properties of nine self-report instruments.

    PubMed

    Hudson, Peter L; Hayman-White, Karla

    2006-03-01

    Researchers and clinicians have experienced substantial difficulties locating measures that are suitable for use within palliative care settings. This article details the psychometric properties of nine instruments designed to assess the following psychosocial characteristics of family caregivers: competence, mastery, self-efficacy, burden, optimism, preparedness, social support, rewards, and mutuality. Results are based on the responses of 106 primary family caregivers caring for relatives dying of cancer. Principal components extraction with varimax rotation was used to explore the underlying structure of each measure. Following the exclusion of complex variables, suggested components for most measures comprised relatively homogenous items, which were good to excellent measures of each component. Some components comprised only two items; however, Cronbach's alphas typically indicated moderate to high levels of internal consistency. Overall, the results of this study suggest that most of the measures analyzed, excepting the mastery and mutuality scales, can be recommended to examine the family caregiver experience and test supportive interventions.

  18. Karmic quest: Thai family caregivers promoting a peaceful death for people with AIDS.

    PubMed

    Nilmanat, Kittikorn; Street, Annette F

    2007-12-01

    This paper reports the constructions of karma by four Thai family caregivers living with a dying person with AIDS in Southern Thailand. These four families form a subset of a larger ethnographic case study exploring the experiences of families living with a relative with AIDS. Serial interviews, observations, and field journal were used as data collection methods with the four families. The findings indicated that the karmic quest is a dominant theme in the narratives of these families caring for their loved ones dying with AIDS. The 'calm and peaceful' death that is described in the palliative care literature equated with their desire for the Buddhist philosophy of a harmonious death. The families used the law of karma and reincarnation as their main frame of reference and mobilised their religious resources to create meaning and purpose. Karmic healing activities were aimed at ending suffering, promoting a peaceful and calm death and ensuring a better life in the next one. The findings are important for the development of palliative nursing practice in Thailand by acknowledging religious and cultural values to promote peaceful death.

  19. Subjective well-being among family caregivers of individuals with developmental disabilities: the role of affiliate stigma and psychosocial moderating variables.

    PubMed

    Werner, Shirli; Shulman, Cory

    2013-11-01

    Studies have shown that stigmatization is linked to lower quality of life; however, only scant research has examined the association between family caregivers' internalization of stigma (affiliate stigma) and their subjective quality of life (subjective well-being, SWB). Furthermore, studies have rarely examined this association via comparison between caregivers of individuals with different developmental disabilities in addition to examining the influence of psychosocial protective factors. These were the aims of the current study. Family caregivers (N=176) of individuals with autism spectrum disorders (ASD), intellectual disabilities (ID), and physical disabilities (PD) completed a self-report structured questionnaire including scales measuring SWB, affiliate stigma, burden, positive meaning in caregiving, social support and self-esteem. Results showed that SWB of family caregivers was below the average normative level and especially low for caregivers of individuals with ASD. The strongest predictors of SWB were caregivers' self-esteem, social support, positive meaning in caregiving, and affiliate stigma. Furthermore, an interaction was found between affiliate stigma and diagnosis, showing that among caregivers of individuals with ASD, greater levels of stigma were associated with lower ratings of SWB, whereas such an association was not found among caregivers of individuals with ID or PD. Findings from this study point to the importance of supporting caregivers across the life-span in order to decrease stigma, improve social support and self-esteem and improve SWB. Further, findings point to the need to respond differentially to the various developmental disabilities.

  20. Communication between Physicians and Family Caregivers about Care at the End of Life: When Do Discussions Occur and What Is Said?

    PubMed Central

    CHERLIN, EMILY; FRIED, TERRI; PRIGERSON, HOLLY G.; SCHULMAN-GREEN, DENA; JOHNSON-HURZELER, ROSEMARY; BRADLEY, ELIZABETH H.

    2006-01-01

    Background: Few studies have examined physician-family caregiver communication at the end of life, despite the important role families have in end-of-life care decisions. We examined family caregiver reports of physician communication about incurable illness, life expectancy, and hospice; the timing of these discussions; and subsequent family understanding of these issues. Design: Mixed methods study using a closed-ended survey of 206 family caregivers and open-ended, in-depth interviews with 12 additional family caregivers. Setting/Subjects: Two hundred eighteen primary family caregivers of patients with cancer enrolled with hospice between October 1999 and June 2002 Measurements: Family caregiver reports provided at the time of hospice enrollment of physician discussions of incurable illness, life expectancy, and hospice. Results: Many family caregivers reported that a physician never told them the patient’s illness could not be cured (20.8%), never provided life expectancy (40% of those reportedly told illness was incurable), and never discussed using hospice (32.2%). Caregivers reported the first discussion of the illness being incurable and of hospice as a possibility occurred within 1 month of the patient’s death in many cases (23.5% and 41.1%, respectively). In open-ended interviews, however, family caregivers expressed ambivalence about what they wanted to know, and their difficulty comprehending and accepting “bad news” was apparent in both qualitative and quantitative data. Conclusion: Our findings suggest that ineffective communication about end-of-life issues likely results from both physician’s lack of discussion and family caregiver’s difficulty hearing the news. Future studies should examine strategies for optimal physician-family caregiver communication about incurable illness, so that families and patients can begin the physical, emotional, and spiritual work that can lead to acceptance of the irreversible condition. PMID:16351531

  1. Effects of the Home Environmental Skill-Building Program on the Caregiver-Care Recipient Dyad: 6-Month Outcomes from the Philadelphia REACH Initiative

    ERIC Educational Resources Information Center

    Gitlin, Laura N.; Winter, Laraine; Corcoran, Mary; Dennis, Marie P.; Schinfield, Sandy; Hauck, Walter W.

    2003-01-01

    Purpose: We examine 6-month effects of the Environmental Skill-Building Program on caregiver well-being and care recipient functioning and whether effects vary by caregiver gender, race (White or non-White), and relationship (spouse or nonspouse). Design and Methods: We enrolled 255 family caregivers of community-residing persons with Alzheimer's…

  2. Exploring occupation roles of hospice family caregivers from Māori, Chinese and Tongan ethnic backgrounds living in New Zealand.

    PubMed

    Angelo, Jennifer; Wilson, Linda

    2014-06-01

    A major challenge to occupational therapists working in palliative care is determining the best ways to help family caregivers who are caring for family members. The purpose of this study was to explore palliative caregiver occupations among Māori, Chinese and Tongan ethnicities. Six informants participated, one woman and one man from each ethnic group. In each of their homes, informants were asked to discuss what it was like caring for their dying family member. The occupational themes resulting from these interviews were food preparation, spirituality and family gathering. Therapists need to be aware of the differences in how people care for family members within their ethnicity. Implications are that occupational therapists can help families identify activities important to them within the main occupational themes: different types of foods and their preparations, various ways to express spirituality and how families gather together members of their extended family. Further, clinicians need to take on the role of a "not-knowing" but curious health-care provider in order to meet the needs of caregivers. The limitation was the small number of participants who all lived in one geographic area. Future studies should include a wider group of ethnicities.

  3. Caregivers' Reasons for Nursing Home Placement: Clues for Improving Discussions with Families Prior to the Transition

    ERIC Educational Resources Information Center

    Buhr, Gwendolen T.; Kuchibhatla, Maragatha; Clipp, Elizabeth C.

    2006-01-01

    Purpose: This study identifies the relative importance of reasons for institutionalization endorsed by caregivers of patients with dementia; examines the relationship between caregivers' reasons for institutionalization and indicators of caregiver and patient physical and emotional functioning measured in the prior year; and compares, on these…

  4. Making sense of behavioral disturbances in persons with dementia: Latino family caregiver attributions of Neuropsychiatric Inventory domains

    PubMed Central

    Hinton, Ladson; Chambers, Darin; Velásquez, Alexandra

    2010-01-01

    The purpose of this study was to describe the nature and frequency of Latino family caregiver attributions for dementia-related neuropsychiatric symptoms. This is a cross-sectional study conducted in the Sacramento, California area. Participants were 30 Latino family caregivers of community-dwelling Latino elderly meeting research criteria for dementia who were selected from an ongoing cohort study of older Latinos (Sacramento Area Latino Study on Aging). Open-ended probes were used to elicit caregiver attribution for each symptom domain of the Neuropsychiatric Inventory (NPI). Across the 30 caregivers, 121 explanations for neuropsychiatric domains were present. Content analysis of these explanations revealed seven different attribution categories (i.e. Alzheimer’s disease, interpersonal problems, other medical conditions, personality, mental, aging, and genetics). Overall, Alzheimer’s disease was the most frequent attribution category but accounted for less than 30% of the total attributions. In conclusion, this study found that Latino caregivers were more likely to attribute neuropsychiatric symptoms to causes other than Alzheimer’s disease or a related dementia. PMID:19568150

  5. Effect of the act on promotion of personal autonomy and care for dependent persons on their family caregivers

    PubMed Central

    2012-01-01

    Background The need of home care services is becoming an increasingly common scenario. These cares are mainly provided by the dependents’ relatives specifically, by the women part of the family. This situation might take years, decreasing the physical and psychological health of the caregiver. In Spain, the Act of Promotion of Personal Autonomy and Care for dependent persons, guarantees those dependent persons and their caregivers to have access to social services or to financial grants. The aim of this study is to Know the possible effects of the benefits provided by this Act in regards to the mental health, the quality of life and use of health services by the family caregivers assisting their relatives in situation of dependency. Methods and design A longitudinal descriptive study following-up a cohort of patients and caregivers. The study shall be carried out in Andalusia. It shall include the baseline assessment of the variables in those caregivers free from the exposure factor (reception of assistance pursuant to the Act). Following, once the benefits have been received, this cohort shall be followed-up. The study shall take three years, and the starting date for its development as well as its funding is January 2011. Discussion The longitudinal assessment of the rate of change of the variables studied shall allow us to know the implications which might be potentially generated as well as the natural evolution of those. PMID:23244337

  6. A family-oriented treatment program for youths with ketamine abuse and their caregivers: a pilot study in Taiwan

    PubMed Central

    Wang, Liang-Jen; Lu, Shing-Fang; Chou, Wen-Jiun; Chong, Mian-Yoon; Wang, Yao-Hsing; Hsieh, Yu-Lian; Lee, Yi-Hsuan; Chen, Ching

    2015-01-01

    Objective The abuse of ketamine by youths has grown into a serious public health issue. However, a reliable and efficient treatment has still not been found for youths who abuse ketamine. This pilot study investigated the effects of a family-oriented treatment program for ketamine-using youths and their caregivers. Methods To carry out this study, 42 youths with ketamine use (mean age 16.6±1.1 years) who were referred to take part in a 10-week treatment program based on motivational enhancement principles were selected, as were their principal caregivers (mean age 46.4±7.1 years), who were similarly referred to take part in a 10-week training program for parenting skills. The study had the youths complete the Chinese Craving Beliefs Questionnaire, the Adolescents’ Behavior problem Scale, and the Family APGAR both immediately before and after the program. Likewise, the youths’ caregivers completed the Family APGAR, the 12-item version of the Chinese Health Questionnaire, and the Parenting Stress Index. Results Of the 42 youth–caregiver pairs that took part in this study, 37 (88%) completed the 10-week program and both sets of assessments. After the treatment, the participating youths’ substance cravings declined (t=3.88, P<0.001), while family function, as perceived by the participating caregivers, significantly increased (t=2.22, P=0.033). The improvement in caregivers’ perceptions of family function were positively related to the improvement of the caregivers’ health status (r=−0.36, P=0.022). Conclusion According to its results, this pilot study submits that family-oriented treatment programs may be considered a potentially effective treatment option for youths who abuse ketamine. Additional studies with larger sample sizes, as well as longer follow-up periods, are necessary to verify whether this type of treatment also prevents youths using ketamine from relapsing. PMID:26261419

  7. Role of technology in supporting quality control and treatment fidelity in a family caregiver clinical trial.

    PubMed

    Farran, Carol J; Etkin, Caryn D; McCann, Judith J; Paun, Olimpia; Eisenstein, Amy R; Wilbur, Joellen

    2011-11-01

    This article describes how a family caregiver lifestyle physical activity clinical trial uses research technology to enhance quality control and treatment fidelity. This trial uses a range of Internet, Blaise(®) Windows-based software and Echo Server technologies to support quality control issues, such as data collection, data entry, and study management advocated by the clinical trials literature, and to ensure treatment fidelity concerning intervention implementation (i.e., design, training, delivery, receipt, and enactment) as proposed by the National Institutes of Health Behavior Change Consortium. All research staff are trained to use these technologies. Strengths of this technological approach to support quality control and treatment fidelity include the comprehensive plan, involvement of all staff, and ability to maintain accurate and timely data. Limitations include the upfront time and costs for developing and testing these technological methods, and having support staff readily available to address technological issues if they occur.

  8. To Pay or Not to Pay: Examining Underlying Principles in the Debate on Financial Support for Family Caregivers

    ERIC Educational Resources Information Center

    Keefe, Janice

    2007-01-01

    In many countries one approach to supporting family-and-friend caregivers is direct financial or monetary support. Debates about the benefits and consequences of such policies pervade the literature. Building on the premise that values underlie public policy, the paper examines four policy paradoxes in the literature and uses selected examples…

  9. Reducing Problem Behavior during Care-Giving in Families of Preschool-Aged Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    Plant, Karen M.; Sanders, Matthew R.

    2007-01-01

    This study evaluated two variants of a behavioral parent training program known as Stepping Stones Triple P (SSTP) using 74 preschool-aged children with developmental disabilities. Families were randomly allocated to an enhanced parent training intervention that combined parenting skills and care-giving coping skills (SSTP-E), standard parent…

  10. A Tool to Assess Family Medicine Residents' Patient Encounters Using Secure Messaging

    PubMed Central

    Kim, Jung G.; Morris, Carl G.; Heidrich, Fred E.

    2015-01-01

    Background Secure messages exchanged between patients and family medicine residents via an electronic health record (EHR) could be used to assess residents' clinical and communication skills, but the mechanism is not well understood. Objective To design and test a secure messaging competency assessment for family medicine residents in a patient-centered medical home (PCMH). Methods Using the existing literature and evidence-based guidelines, we designed an assessment tool to evaluate secure messaging competency for family medicine residents training in a PCMH. Core faculty performed 2-stage validity and reliability testing (n = 2 and n = 9, respectively). A series of randomly selected EHR secure messages (n = 45) were assessed from a sample of 10 residents across all years of training. Results The secure message assessment tool provided data on a set of competencies and a framework for resident feedback. Assessment showed 10% (n = 2) of residents at the novice level, 50% (n = 10) as progressing, and 40% (n = 8) as proficient. The most common deficiencies for residents' secure messages related to communication rather than clinical competencies (n = 37 [90%] versus n = 4 [10%]). Interrater reliability testing ranged from 60% to 78% agreement and 20% to 44% disagreement. Disagreement centered on interpersonal communication factors. After 2 stages of testing, the assessment using residents' secure messages was incorporated into our existing evaluation process. Conclusions Assessing family medicine residents' secure messaging for patient encounters closed an evaluation gap in our family medicine program, and offered residents feedback on their clinical and communication skills in a PCMH. PMID:26692980

  11. Teaching adaptive leadership to family medicine residents: what? why? how?

    PubMed

    Eubank, Daniel; Geffken, Dominic; Orzano, John; Ricci, Rocco

    2012-09-01

    Health care reform calls for patient-centered medical homes built around whole person care and healing relationships. Efforts to transform primary care practices and deliver these qualities have been challenging. This study describes one Family Medicine residency's efforts to develop an adaptive leadership curriculum and use coaching as a teaching method to address this challenge. We review literature that describes a parallel between the skills underlying such care and those required for adaptive leadership. We address two questions: What is leadership? Why focus on adaptive leadership? We then present a synthesis of leadership theories as a set of process skills that lead to organization learning through effective work relationships and adaptive leadership. Four models of the learning process needed to acquire such skills are explored. Coaching is proposed as a teaching method useful for going beyond information transfer to create the experiential learning necessary to acquire the process skills. Evaluations of our efforts to date are summarized. We discuss key challenges to implementing such a curriculum and propose that teaching adaptive leadership is feasible but difficult in the current medical education and practice contexts.

  12. The relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden

    PubMed Central

    Torabi Chafjiri, Razieh; Navabi, Nasrin; Shamsalinia, Abbas; Ghaffari, Fatemeh

    2017-01-01

    Introduction Stroke is a chronic condition that necessitates multidimensional and overwhelming care. The caregivers of stroke patients are faced with various stressors that can threaten different aspects of their health, especially their mental health. Spiritual attitude and being spiritually oriented contribute significantly to mental health and can be used as a strategy for adapting to the stressful events that are part of the role of caregiving. This study was therefore conducted to investigate the relationship between the spiritual attitude of the family caregivers of older patients with stroke and their burden. Methods This descriptive cross-sectional study was conducted in 2016. The study population consisted of all the family caregivers of older patients with stroke presenting to health care centers and nursing service companies of Gilan Province in Iran. The participants were selected through convenience sampling and consisted of 407 participants. Data were collected using the Spiritual Attitude Scale and the Caregiver Burden Inventory and were then analyzed in SPSS-18 using Pearson’s correlation coefficient at a significance level of 0.05. Results The results showed that 88.9% of the caregivers were females. The mean age of the participants was 38.3±8.8 years. The duration of caregiving was <5 years in 84.4% of the participants, while its mean was 4.2±2.5 years. The mean score of spiritual attitude was 108.77±6.20. The majority of the participants (49.3%) had moderate and relatively favorable spiritual attitude (a score of 72–120), 27.8% had high or favorable spiritual attitude; 8.7% had mild burden, 54.4% had moderate burden and 37% had favorable burden. The mean score of burden was 28±12.75. A statistically significant positive relationship was observed in this study between the mean score of spiritual attitude and the total score of burden in all its dimensions, namely, time dependence, as well as the developmental, physical, social and

  13. Daily Stressors and Adult Day Service Use by Family Caregivers: Effects on Depressive Symptoms, Positive Mood and DHEA-S

    PubMed Central

    Zarit, Steven H.; Whetzel, Courtney A.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Rovine, Michael J.; Klein, Laura Cousino

    2014-01-01

    Objectives This study examines effects of daily use of adult day services (ADS) programs by caregivers of individuals with dementia (IWD) on a salivary biomarker of stress reactivity, dehydroepiandrosterone-sulfate (DHEA-S), and whether these effects on DHEA-S are associated with daily variability in positive mood and depressive symptoms. Design We used a daily diary design of 8 consecutive days with alternation of intervention (ADS) and non-intervention days to evaluate within- and between-person effects of the intervention. Setting Caregivers were interviewed daily by telephone at home. Participants 151 family caregivers of IWD who were using ADS. Measurements Saliva samples were collected from caregivers 5 times a day for 8 consecutive days and were assayed for DHEA-S. Daily telephone interviews assessed daily stressors and mood. Results DHEA-S levels were significantly higher on days following ADS use. Daily DHEA-S levels covaried significantly with daily positive mood, but not depressive symptoms. Conclusions These results demonstrate an association of ADS use by family caregivers and higher DHEA-S levels on the next day. Prior research has found that higher DHEA-S levels are protective against the physiological damaging effects of stressor exposure and may reduce risks of illness. Regular use of ADS may help reduce depletion of DHEA-S and allow the body to mount a protective and restorative response to the physiological demands of caregiving. To our knowledge, this is the first study to examine DHEA-S levels across the day in connection with an intervention that affected daily exposure to stressors. PMID:24566240

  14. Family caregiving for persons with heart failure at the intersection of heart failure and palliative care: a state-of-the-science review.

    PubMed

    Nicholas Dionne-Odom, J; Hooker, Stephanie A; Bekelman, David; Ejem, Deborah; McGhan, Gwen; Kitko, Lisa; Strömberg, Anna; Wells, Rachel; Astin, Meka; Metin, Zehra Gok; Mancarella, Gisella; Pamboukian, Salpy V; Evangelista, Lorraine; Buck, Harleah G; Bakitas, Marie A

    2017-02-04

    Many of the 23 million individuals with heart failure (HF) worldwide receive daily, unpaid support from a family member or friend. Although HF and palliative care practice guidelines stipulate that support be provided to family caregivers, the evidence base to guide care for this population has not been comprehensively assessed. In order to appraise the state-of-the-science of HF family caregiving and recommend areas for future research, the aims of this review were to summarize (1) how caregivers influence patients, (2) the consequences of HF for caregivers, and (3) interventions directed at HF caregivers. We reviewed all literature to December 2015 in PubMed and CINAHL using the search terms "heart failure" AND "caregiver." Inclusion criteria dictated that studies report original research of HF family caregiving. Articles focused on children or instrument development or aggregated HF with other illnesses were excluded. We identified 120 studies, representing 5700 caregivers. Research on this population indicates that (1) caregiving situations vary widely with equally wide-ranging tasks for patients to help facilitate their health behaviors, psychological health and relationships, and quality of life (QoL); (2) caregivers have numerous unmet needs that fluctuate with patients' unpredictable medical status, are felt to be ignored by the formal healthcare system, and can lead to distress, burden, and reduced QoL; and (3) relatively few interventions have been developed and tested that effectively support HF family caregivers. We provide recommendations to progress the science forward in each of these areas that moves beyond descriptive work to intervention development and clinical trials testing.

  15. Structured interviews examining the burden, coping, self-efficacy, and quality of life among family caregivers of persons with dementia in Singapore.

    PubMed

    Tay, Kay Chai Peter; Seow, Chuen Chai Dennis; Xiao, Chunxiang; Lee, Hui Min Julian; Chiu, Helen F K; Chan, Sally Wai-Chi

    2016-03-01

    Dementia is a global health issue and the effects on caregivers are substantial. The study aimed to examine the associations of burden, coping, self-efficacy with quality of life among family caregivers of persons with dementia in Singapore. Structured interviews were conducted in a convenience sample of 84 family caregivers caring and seeking clinical care for the persons with dementia in an outpatient clinic of a public hospital in Singapore. The outcome measures included the Family Burden Interview Schedule, Family Crisis Oriented Personal Evaluation Scale, General Perceived Self-Efficacy Scale, and World Health Organization Quality of Life Scale - Brief Version. In general, significant correlations were observed between the quality of life scores with coping strategy and family burden scores, but not between the coping strategy and family burden scores. Compared to demographic factors such as caregiver age and household income, psychosocial factors including family burden, coping strategies, and self-efficacy demonstrated greater association with quality of life in the participants. However, the dynamics of these associations will change with an increasing population of persons with dementia, decreasing nuclear family size, and predicted changes in family living arrangements for the persons with dementia in future. As such, it necessitates continuous study examining the needs and concerns of family caregivers and the relevance of ongoing interventions specific to caregivers of persons with dementia.

  16. Residency Training and the Later Use of Marital and Family Therapy in Psychiatric Practice.

    ERIC Educational Resources Information Center

    Carter, Ross E.

    1989-01-01

    Compared marital and family therapy training during psychiatry residency to later use among psychiatrists (N=87). Results indicated that respondents reported modest to minimal amounts of training in residency but practiced marital and family therapy with variety of problems, identified spread of effect to other treatment modalities, and preferred…

  17. Psychological well-being of parents and family caregivers of children with hearing impairment in south India: influence of behavioural problems in children and social support.

    PubMed

    van Driessche, Anne; Jotheeswaran, A T; Murthy, G V S; Pilot, Eva; Sagar, Jayanthi; Pant, Hira; Singh, Vivek; Dpk, Babu

    2014-08-01

    Parents of children with hearing impairment are at increased risk of mental health morbidities. We examined the predictive factors associated with caregiver's strain and psychological morbidities in parents and family caregivers of children with hearing impairment. In total, n = 201 parents and family caregivers of children with and without hearing impairment aged 3 to 16 years were recruited. Caregiver's strain and psychological morbidities were measured using the Zarit Burden scale and the World Health Organization's Self-Reporting Questionnaire (SRQ-20). Presence of behavioural problems in children was measured using the Strengths and Difficulties Questionnaire. After adjustment, low educational attainment and domestic violence were found to be associated with caregiving strain, whereas dissatisfaction with social support from family, behavioural problems in children, and domestic violence strongly predicted psychological morbidities. Addressing the mental healthcare needs of parents may help in downsizing the impact of psychological morbidities on the well-being of children with hearing impairment.

  18. Association of Filial Responsibility, Ethnicity, and Acculturation Among Japanese American Family Caregivers of Older Adults

    PubMed Central

    Miyawaki, Christina E.

    2015-01-01

    Challenges of filial caregiving practices by 1st-generation immigrants due to differences in caregiving values between their home and host countries are well documented. This study explored the filial responsibility of later generation Japanese American caregivers of older adults. Acculturation and filial responsibility were measured using the Suinn-Lew Asian Self Identity Acculturation scale and Filial Values Index, respectively. A qualitative interview guide was developed using Gordon’s assimilation theory, and 21 caregivers (M age = 68 years, 86% female, seven in each generation) were interviewed. Despite the 3rd-generation caregivers’ high acculturation level, their filial responsibility scores remained high. Qualitative interviews also revealed later generation caregivers’ strong filial responsibility and continued caregiving involvement. Unexpectedly, caregivers’ own future expectancy of care included placement in mainstream residential facilities rather than ethnicspecific settings. Findings point to the need to develop caregiver services that consider later generation caregivers’ culture and level of assimilation. PMID:25883044

  19. Health Literacy Teaching in U.S. Family Medicine Residency Programs: A National Survey.

    PubMed

    Coleman, Clifford A; Nguyen, Nancy T; Garvin, Roger; Sou, Channbunmorl; Carney, Patricia A

    2016-01-01

    Health care providers, including medical residents, often lack adequate knowledge and skills to work effectively with patients who have limited health literacy. Little is known about the degree to which medical residents are trained to communicate effectively with people who have limited health literacy. This study aimed to assess the status of health literacy training for physicians in U.S. family medicine residency programs. We conducted an online survey of residency directors at 444 U.S. family medicine residencies. Among 138 respondents (31% response rate), 58 programs (42%) reported teaching residents about health literacy as part of the required curriculum. Most instruction occurred during the 1st year of training. Hours of instruction ranged from 2 to 5 during Years 1 through 3. Skills-based training (e.g., plain language techniques) was taught by most programs. Not having access to a faculty authority on health literacy was strongly associated with lack of a required health literacy curriculum. Respondents overwhelmingly agreed that increasing health literacy training for medical students and residents would help improve residents' clinical skills. This study provides a baseline snapshot of health literacy curricula in U.S. family medicine residencies and likely overestimates the prevalence of such curricula. Additional studies are needed to determine the quality of health literacy instruction in U.S. family medicine residencies and the most effective methods for teaching residents about health literacy.

  20. Resident health advocates in public housing family developments.

    PubMed

    Bowen, Deborah J; Bhosrekar, Sarah Gees; Rorie, Jo-Anna; Goodman, Rachel; Thomas, Gerry; Maxwell, Nancy Irwin; Smith, Eugenia

    2015-01-01

    Translation of research to practice often needs intermediaries to help the process occur. Our Prevention Research Center has identified a total of 89 residents of public housing in the last 11 years who have been working in the Resident Health Advocate (RHA) program to engage residents in improving their own and other residents' health status by becoming trained in skills needed by community health workers. Future directions include training for teens to become Teen RHAs and further integration of our RHA program with changes in the health care system and in the roles of community health workers in general.

  1. Pneumonia care and the nursing home: a qualitative descriptive study of resident and family member perspectives

    PubMed Central

    Chan Carusone, Soo; Loeb, Mark; Lohfeld, Lynne

    2006-01-01

    Background Nursing home residents are frequently sent to hospital for diagnostic tests or to receive acute health care services. These transfers are both costly and for some, associated with increased risks. Although improved technology allows long-term care facilities to deliver more complex health care on site, if this is to become a trend then residents and family members must see the value of such care. This qualitative study examined resident and family member perspectives on in situ care for pneumonia. Methods A qualitative descriptive study design was used. Participants were residents and family members of residents treated for pneumonia drawn from a larger randomized controlled trial of a clinical pathway to manage nursing home-acquired pneumonia on-site. A total of 14 in-depth interviews were conducted. Interview data were analyzed using the editing style, described by Miller and Crabtree, to identify key themes. Results Both residents and family members preferred that pneumonia be treated in the nursing home, where possible. They both felt that caring and attention are key aspects of care which are more easily accessible in the nursing home setting. However, residents felt that staff or doctors should make the decision whether to hospitalize them, whereas family members wanted to be consulted or involved in the decision-making process. Conclusion These findings suggest that interventions to reduce hospitalization of nursing home residents with pneumonia are consistent with resident and family member preferences. PMID:16430782

  2. Vita tua, mors mea: The experience of family caregivers of patients in a vegetative state.

    PubMed

    Cipolletta, Sabrina; Pasi, Margherita; Avesani, Renato

    2016-07-01

    This study aims to understand whether, and possibly how, caregivers of patients in a vegetative state experience an emotional paradox between life and death. Individual semi-structured interviews were conducted with 24 (19 females and 5 males) caregivers of vegetative state patients living in northern Italy. Data were analysed using interpretative phenomenological analysis. Caregivers felt they were the only ones able to understand and give answer to patients' needs, but neglected their own lives in their total commitment to the patient. The findings highlight the importance for vegetative state caregivers in considering new possibilities of life that go beyond the assistance of vegetative state patients.

  3. Use of a multiparty web based videoconference support group for family caregivers: Innovative practice.

    PubMed

    Austrom, Mary Guerriero; Geros, Kristin N; Hemmerlein, Kimberly; McGuire, Siobhan M; Gao, Sujuan; Brown, Steven A; Callahan, Christopher M; Clark, Daniel O

    2015-09-01

    This article describes a pilot of a weekly web based videoconference support group for five caregivers of persons with dementia. All participants reported positive views of the group and videoconference medium. Improvements in caregiver anxiety, depression, and physical health scores were observed. Depression scores remained the same with difficulties experienced by the caregiver increasing slightly. Self-efficacy for controlling upsetting thoughts and responding to disruptive behavior improved but worsened slightly for obtaining respite. We concluded that web based support was a positive experience for caregivers, providing them with an acceptable, feasible, low-cost technological alternative to in person support that reduced barriers to attendance by being available in homes.

  4. Caregiving for Frail Elders in Rural America.

    ERIC Educational Resources Information Center

    Bane, Share DeCroix

    This handbook attempts to answer questions about informal caregiving and caregivers, focusing on the rural elderly. The first section presents a national perspective on caregiving. Recipients of caregiving, providers of caregiving, the caregiving dilemma, and psychological, physical, family, and financial issues are discussed. The second section…

  5. Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members.

    PubMed

    Aalgaard Kelly, Gina

    2015-01-01

    Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes. Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC).

  6. Development and Examination of a Family Triadic Measure to Examine Quality of Life Family Congruence in Nursing Home Residents and Two Family Members

    PubMed Central

    Aalgaard Kelly, Gina

    2015-01-01

    Objective: The overall purpose of this study was to propose and test a conceptual model and apply family analyses methods to understand quality of life family congruence in the nursing home setting. Method: Secondary data for this study were from a larger study, titled Measurement, Indicators and Improvement of the Quality of Life (QOL) in Nursing Homes. Research literature, family systems theory and human ecological assumptions, fostered the conceptual model empirically testing quality of life family congruence. Results: The study results supported a model examining nursing home residents and two family members on quality of life family congruence. Specifically, family intergenerational dynamic factors, resident personal and social-psychological factors, and nursing home family input factors were examined to identify differences in quality of life family congruence among triad families. Discussion: Formal family involvement and resident cognitive functioning were found as the two most influential factors to quality of life family congruence (QOLFC). PMID:28138474

  7. Potential Use of Food/Activity, Parenting Style, and Caregiver Feeding Style Measurement Tools with American Indian Families: A Brief Report.

    PubMed

    Hughes, Sheryl O; Hayes, Jenna T; Sigman-Grant, Madeleine; VanBrackle, Angela

    2017-02-01

    Objective To provide preliminary descriptive data on caregiver and child weight status, parenting styles, feeding styles, and feeding practices of a small American Indian sample. Methods Participants included a subsample of American Indian caregivers (n = 23) identified from a larger study that was conducted in five states. Using previously validated instruments, means, standard deviations, and ranges for general parenting styles, feeding styles, and feeding practices were explored. Results In general, most caregivers reported healthy feeding practices. Most caregivers scored higher on responsive compared to restrictive or permissive in general parenting. Of the sample, 12 caregivers (52.2 %) were classified in the indulgent feeding style category, 5 caregivers (21.7 %) were classified as authoritative, 5 (21.7 %) uninvolved, and 1 (4.3 %) authoritarian. Conclusions More investigations are needed to explore questions raised by this study about using common tools that measure childhood obesity with American Indian families.

  8. Pediatrics Residents' Perspectives on Family-Centered Rounds: A Qualitative Study at 2 Children's Hospitals

    PubMed Central

    Mittal, Vineeta; Krieger, Evelina; Lee, Benjamin C.; Kind, Terry; McCavit, Timothy; Campbell, Joyce; Ottolini, Mary C.; Flores, Glenn

    2013-01-01

    Background Many academic hospitals have incorporated family-centered rounds, yet little is known about pediatrics residents' perspectives on the educational impact of these rounds. Objective To identify pediatrics residents' knowledge, attitudes, and beliefs about family-centered rounds, including perceived benefits and barriers. Methods We conducted focus groups of residents exposed to family-centered rounds at 2 university-affiliated, freestanding children's hospitals. Focus group data were analyzed using grounded theory. Results A total of 24 residents participated in 4 focus groups. Residents reported that family-centered rounds enhance education by increasing patient encounters and improving physical exam skills, direct observation, real-time feedback, and attending role modeling; improve parent satisfaction, interpersonal and communication skills, and safety; and reduce length of stay. Physical constraints (large teams and small rooms), lack of uniform approaches to family-centered rounds, variable attending teaching styles, and specific conditions (child abuse, patients on isolation) were cited barriers. Conclusions Pediatrics residents report that well-conducted family-centered rounds improve their education and the quality of patient care, including parent satisfaction, communication with families, and patients' length of stay. Standardizing family-centered rounds and reducing attending variability in teaching style might further enhance residents' educational experiences. PMID:24404232

  9. Weaving public health education into the fabric of a family medicine residency.

    PubMed

    Potts, Stacy E; Deligiannidis, Konstantinos E; Cashman, Suzanne B; Caggiano, Marie E; Carter, Lisa H; Haley, Heather-Lyn; Ferguson, Warren J

    2011-10-01

    Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice. This public health curriculum was designed to integrate new topics within the current residency structure through longitudinal and concentrated experiences. This strategy has substantially improved public health and prevention education without substantial impact on the already strained residency curricular structure. This paper describes the integration of public health and prevention education into a family medicine residency to help residents acquire the fundamental skills necessary to improve a population's health.

  10. 3 CFR 8448 - Proclamation 8448 of October 30, 2009. National Family Caregivers Month, 2009

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... unwavering commitment to care for one another. In difficult times, Americans come together to ensure our... Lifespan Respite Care Act include important resources for caregivers of children and adults, with... the wellness of participating care providers. My Administration's dedication to caregivers is...

  11. Managing Your Loved One's Health: Development of a New Care Management Measure for Dementia Family Caregivers.

    PubMed

    Sadak, Tatiana; Wright, Jacob; Borson, Soo

    2016-07-05

    The National Alzheimer's Plan calls for improving health care for people living with dementia and supporting their caregivers as capable health care partners. Clinically useful measurement tools are needed to monitor caregivers' knowledge and skills for managing patients' often complex health care needs as well as their own self-care. We created and validated a comprehensive, caregiver-centered measure, Managing Your Loved One's Health (MYLOH), based on a core set of health care management domains endorsed by both providers and caregivers. In this article, we describe its development and preliminary cultural tailoring. MYLOH is a questionnaire containing 29 items, grouped into six domains, which requires <20 min to complete. MYLOH can be used to guide conversations between clinicians and caregivers around health care management of people with dementia, as the basis for targeted health care coaching, and as an outcome measure in comprehensive dementia care management interventions.

  12. A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis.

    PubMed

    Chien, Wai Tong; Thompson, David R; Lubman, Dan I; McCann, Terence V

    2016-11-01

    Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients' mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers' stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers' problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS.

  13. Caring for Caregivers of People Living with HIV in the Family: A Response to the HIV Pandemic from Two Urban Slum Communities in Pune, India

    PubMed Central

    Kohli, Rewa; Purohit, Vidula; Karve, Latika; Bhalerao, Vinod; Karvande, Shilpa; Rangan, Sheela; Reddy, Srikanth; Paranjape, Ramesh; Sahay, Seema

    2012-01-01

    Introduction In low resource settings, the vast majority of ‘Person/people Living with HIV’ (PLHIV/s) and inadequate healthcare delivery systems to meet their treatment and care needs, caregivers play a vital role. Home based caregivers are often unrecognized with limited AIDS policies and programs focusing on them. We explored the perceptions and norms regarding care being provided by family caregivers of PLHIVs in India. Methodology A community based qualitative study to understand the issues pertaining to home based care for PLHIV was conducted in urban settings of Pune city, in Maharashtra, India. Eight Focus Group Discussions (FGDs) among men, women and peer educators were carried out. A total of 44 in-depth Interviews (IDIs) with PLHIVs (20) and their caregivers (24), were conducted using separate guides respectively. Data was analyzed thematically. Results Home based care was perceived as economically viable option available for PLHIVs. ‘Care’ comprised of emotional, adherence, nursing and financial support to PLHIV. Home based care was preferred over hospital based care as it ensured confidentiality and patient care without hampering routine work at home. Women emerged as more vital primary caregivers compared to men. Home based care for men was almost unconditional while women had no such support. The natal family of women also abandoned. Their marital families seemed to provide support. Caregivers voiced the need for respite care and training. Discussion Gender related stigma and discrimination existed irrespective of women being the primary family caregivers. The support from marital families indicates a need to explore care and support issues at natal and marital homes of the women living with HIV respectively. Home based care training and respite care for the caregivers is recommended. Gender sensitive interventions addressing gender inequity and HIV related stigma should be modeled while designing interventions for PLHIVs and their family

  14. [Voluntary help in dementia - predictors for utilisation and expected quality from a family caregiver's point of view].

    PubMed

    Grässel, E; Luttenberger, K; Römer, H; Donath, C

    2010-09-01

    Although support services are considered cost-effective in the relief of care-giving family members of dementia patients, there has been little research to date on the predictors of use and quality expectations. These two questions are examined for the first time based on cross-sectional data of 404 care-giving family members, users and non-users of voluntary help services. Quantitative data are evaluated using binary logistical regression analysis, qualitative data using content analysis. The rating of how helpful the use of a voluntary help service is in the personal situation was found to be the only significant predictor of use. With respect to quality, it is most important that the persons giving support be punctual and well-trained. To increase the rate of use, care-giving family members must be convinced of the relevant benefits of using a voluntary help service. In addition, attention must be paid to the professional organization and training of voluntary helpers.

  15. Family Support in Nursing Homes Serving Residents with a Mental Health History

    ERIC Educational Resources Information Center

    Frahm, Kathryn; Gammonley, Denise; Zhang, Ning Jackie; Paek, Seung Chun

    2010-01-01

    Using 2003 nursing home data from the Minimum Data Set (MDS) database, this study investigated the role of family support among nursing homes serving residents with a mental health history. Exploratory factor analysis was used to create and test a conceptual model of family support using indicators located within the MDS database. Families were…

  16. Familial and Contextual Influences on Children’s Prosocial Behavior: South African Caregivers as Adult Protective Shields in Enhancing Child Mental Health

    PubMed Central

    Parchment, Tyrone M.; Small, Latoya; Osuji, Hadiza; McKay, Mary; Bhana, Arvin

    2017-01-01

    Background The mental health of children is too frequently overlooked in resource scarce low and middle-income countries. South Africa represents one of many country contexts struggling to meet the mental health needs of large numbers of young people. Family caregivers have been identified as potential protective influences on child mental health, even for those children being reared with high exposure to poverty. Methods This paper explores contextual influences on South African caregiver’s social-emotional health living in communities impacted by poverty and food insecurity as they attempt to support their children’s prosocial skills and behavior. Structural Equation Modeling (SEM) was employed to explore the relationship between neighborhood social cohesion and caregiver report of child’s prosocial behavior as mediated by the caregiver’s mental health (n=478). Results Results indicated that the more caregivers experience their communities as socially cohesive, the better their social-emotional well-being, thus positively related to their reports of children’s prosocial behavior. Furthermore, when there is a male head of household, caregivers reported better social-emotional well-being in comparison to female headed of household. The more food secure caregivers also were likely to report better general health. Conclusion South African community characteristics and caregivers, in particular male caregivers, are integral to child and caregiver mental health. Future research should examine the impact of interventions that mobilize community and caregiver supports for children’s prosocial behavior and mental health.

  17. Cross-national differences in the prevalence and correlates of burden among older family caregivers in the WHO World Mental Health (WMH) Surveys

    PubMed Central

    Shahly, V.; Chatterji, S.; Gruber, M. J.; Al-Hamzawi, A.; Alonso, J.; Andrade, L. H.; Angermeyer, M. C.; Bruffaerts, R.; Bunting, B.; Caldas-de-Almeida, J. M.; de Girolamo, G.; de Jonge, P.; Florescu, S.; Gureje, O.; Haro, J. M.; Hinkov, H. R.; Hu, C.; Karam, E. G.; Lépine, J.-P.; Levinson, D.; Medina-Mora, M. E.; Posada-Villa, J.; Sampson, N. A.; Trivedi, J.K.; Viana, M. C.; Kessler, R. C.

    2014-01-01

    Background Current trends in population aging affect both recipients and providers of informal family caregiving, as the pool of family caregivers is shrinking while demand is increasing. Epidemiologic research has not yet examined the implications of these trends for burdens experienced by aging family caregivers. Methods Cross-sectional community surveys in 20 countries asked 13,892 respondents ages 50+ about the objective (time, financial) and subjective (distress, embarrassment) burdens they experience in providing care to first-degree relatives with 12 broadly-defined serious physical and mental conditions. Differential burden was examined by country income category, kinship status, and type of condition. Results Among the 26.9-42.5% respondents in high, upper-middle, and low/lower-middle income countries reporting serious relative health conditions, 35.7-42.5% reported burden. Of those, 25.2-29.0% spent time and 13.5-19.4% money, while 24.4-30.6% felt distress and 6.4-21.7% embarrassment. Mean caregiving hours/week given any was 16.6-23.6 (169.9-205.8 hours/week/100 people ages 50+). Burden in low/lower-middle income countries was 2-3-fold higher than in higher income countries, with financial burden given any averaging 14.3% of median family income in high, 17.7% in upper-middle, and 39.8% in low/lower-middle income countries. Higher burden was reported by women than men and for conditions of spouses and children than parents or siblings. Conclusions Uncompensated family caregiving is an important societal asset that offsets rising formal healthcare costs. However, the substantial burdens experienced by aging caregivers across multiple family health conditions and geographic regions threaten the continued integrity of their caregiving capacity. Initiatives supporting older family caregivers are consequently needed, especially in low/lower-middle income countries. PMID:22877824

  18. First-year family medicine residents' use of computers: knowledge, skills and attitudes.

    PubMed Central

    Rowe, B H; Ryan, D T; Therrien, S; Mulloy, J V

    1995-01-01

    OBJECTIVE: To identify the computer knowledge, skills and attitudes of first-year family medicine residents. DESIGN: Cross-sectional survey of family medicine residents during the academic year 1993-94; sampling began in July 1993 and ended in October 1993. SETTING: Canada. PARTICIPANTS: All 727 first-year family medicine residents, of whom 433 (60%) responded. OUTCOME MEASURES: Previous computer experience or training, current use, barriers to use, and comfort with and attitudes regarding computers. RESULTS: There was no difference in age or sex between the respondents and all first-year family medicine residents in Canada. French-speaking respondents from Quebec were underrepresented (p < 0.001). Only 56 respondents (13%) felt extremely or very comfortable with computer use. The most commonly cited barriers to obtaining computer training were lack of time (243 respondents [56%]) and the high cost of computers (214 [49%]) but not lack of interest (69 [16%]). Most residents wanted more computer training (367 [85%]) and felt that computer training should be a mandatory component of family medicine training programs (308 [71%]). CONCLUSIONS: Computer knowledge and skills and comfort with computer use appear low among first-year family medicine residents in Canada, and barriers to acquisition of computer knowledge are impressive. Computer training should become an integral part of family medicine training in Canada, and user-friendly applicable computer systems are needed. PMID:7614442

  19. Quality of Life of Families with Children Who Have Severe Developmental Disabilities: A Comparison Based on Child Residence

    ERIC Educational Resources Information Center

    McFelea, Joni Taylor; Raver, Sharon

    2012-01-01

    This study measured the quality of life of two groups of families with children who had severe developmental disabilities-families whose child lived at home and families whose child lived in a residential facility. Participants were 54 primary caregivers of children who had severe intellectual disabilities and who lacked the ability to both…

  20. Cultural aspects within caregiver interactions of ultra-orthodox Jewish women and their family members with mental illness.

    PubMed

    Weiss, Penina; Shor, Ron; Hadas-Lidor, Naomi

    2013-10-01

    The role of cultural dynamics and norms within families of persons with mental illness has been an underexplored subject, although the familial context has been recognized as influential. This subject was studied with 24 ultra-Orthodox Jewish mothers of persons with mental illness who live in a relatively closed religious community. While participating in the Keshet educational program designed for family caregivers in mental health, they wrote Meaningful Interactional Life Episodes that involved a dialogue exchange in their lives. Qualitative analysis of 50 episodes illuminates the significant role that religious and cultural norms have in the perceptions of what are considered stressors and the dynamics in these families surrounding these stressors. The necessity and value of incorporating cultural competence into family educational programs and interventions is emphasized, as this may contribute to the potential use and success of mental health service models within a population that essentially underutilizes these services.

  1. Acting as Standardized Patients Enhances Family Medicine Residents' Self-Reported Skills in Palliative Care

    ERIC Educational Resources Information Center

    Sittikariyakul, Pat; Jaturapatporn, Darin; Kirshen, A. J.

    2015-01-01

    Recent publications have confirmed the use of standardized patients (SPs) in improving clinical skills and enhancing competency. Little research has studied the benefits residents may themselves gain in palliative care playing the role of SPs. Nineteen Family Medicine residents were recruited as standardized patients (FMR-SPs) for a mandatory…

  2. Resident and Family Satisfaction with Incontinence and Mobility Care: Sensitivity to Intervention Effects?

    ERIC Educational Resources Information Center

    Simmons, Sandra F.; Ouslander, Joseph G.

    2005-01-01

    Purpose: This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention. Design and Methods: A randomized, controlled intervention trial with incontinent long-term-care residents was conducted wherein research staff…

  3. Multi-Source Evaluation of Interpersonal and Communication Skills of Family Medicine Residents

    ERIC Educational Resources Information Center

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-01-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and…

  4. Teaching Humanities in Medicine: The University of Massachusetts Family Medicine Residency Program Experience

    ERIC Educational Resources Information Center

    Silk, Hugh; Shields, Sara

    2012-01-01

    Humanities in medicine (HIM) is an important aspect of medical education intended to help preserve humanism and a focus on patients. At the University of Massachusetts Family Medicine Residency Program, we have been expanding our HIM curriculum for our residents including orientation, home visit reflective writing, didactics and a department-wide…

  5. Qualification test procedures and results for Honeywell solar collector subsystem, single-family residence

    NASA Technical Reports Server (NTRS)

    1977-01-01

    The test procedures and results in qualifying the Honeywell single family residence solar collector subsystem are presented. Testing was done in the following areas: pressure, service loads, hail, solar degradation, pollutants, thermal degradation, and outgassing.

  6. 2. VIEW OF FAMILY RESIDENCE (FEATURE B10) FACING SOUTHWEST. PHOTO ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    2. VIEW OF FAMILY RESIDENCE (FEATURE B-10) FACING SOUTHWEST. PHOTO LOOKING UP THE ROAD STABLE (FEATURE B-14). - Nevada Lucky Tiger Mill & Mine, East slope of Buckskin Mountain, Paradise Valley, Humboldt County, NV

  7. The value of resident choice during daily care: do staff and families differ?

    PubMed

    Simmons, Sandra F; Durkin, Daniel W; Rahman, Annie N; Schnelle, John F; Beuscher, Linda M

    2014-09-01

    Allowing long-term care (LTC) residents to make choices about their daily life activities is a central tenet of resident-centered care. This study examined whether staff and family rated care episodes involving choice differently from care episodes not involving choice. Seventeen nurse aide and 15 family participants were shown paired video vignettes of care interactions. Participants were asked to rate their preferred care vignette using a standardized forced-choice questionnaire. Focus groups were held separately for staff and family members following this rating task to determine reasons for their preferences. Both staff and family rated the vignettes depicting choice as "strongly" preferred to the vignettes without choice. Reasons provided for the preference ratings during the focus group discussions related to resident well-being, sense of control, and respondents' own personal values. These findings have implications for LTC staff training related to resident-centered care to promote choice.

  8. An examination of the measurement adequacy of the CES-D among African American women family caregivers

    PubMed Central

    Rozario, Philip A.; Menon, Natasha

    2010-01-01

    The CES-D has been used extensively in community-based surveys to describe and explain the prevalence of depression in the general population. Yet, questions have been raised regarding its adequacy for use among ethnic minority because of its factor variance. Employing a within-gender and race approach, we test the validity of the CES-D for use among a sample of African American women family caregivers. Using data from a cross-sectional community sample of 521 urban and rural African American women family caregivers, this study examines the dimensionality of the CES-D by testing four different measurement models through confirmatory factor analyses. Among the four measurement models tested using Weighted Least Squares estimation, our findings support previous research that has identified four dimensions in the CES-D: depressed affect, positive affect, somatic complaints, and interpersonal relations for our sample. Additionally, a three-factor (somatization) model and a four-factor model were shown to be equivalent. Implications for further measurement and model testing, and the use of the CES-D for research among African American women caregivers are discussed. PMID:20663570

  9. Silent strain of caregiving: exploring the best predictors of distress in family carers of geriatric patients

    PubMed Central

    Bień-Barkowska, Katarzyna; Doroszkiewicz, Halina; Bień, Barbara

    2017-01-01

    Objectives The aim of this article was to identify the best predictors of distress suffered by family carers (FCs) of geriatric patients. Methods A cross-sectional study of 100 FC-geriatric patient dyads was conducted. The negative impact of care (NIoC) subscale of the COPE index was dichotomized to identify lower stress (score of ≤15 on the scale) and higher stress (score of ≥16 on the scale) exerted on FCs by the process of providing care. The set of explanatory variables comprised a wide range of sociodemographic and care-related attributes, including patient-related results from comprehensive geriatric assessments and disease profiles. The best combination of explanatory variables that provided the highest predictive power for distress among FCs in the multiple logistic regression (LR) model was determined according to statistical information criteria. The statistical robustness of the observed relationships and the discriminative power of the model were verified with the cross-validation method. Results The mean age of FCs was 57.2 (±10.6) years, whereas that of geriatric patients was 81.7 (±6.4) years. Despite the broad initial set of potential explanatory variables, only five predictors were jointly selected for the best statistical model. A higher level of distress was independently predicted by lower self-evaluation of health; worse self-appraisal of coping well as a caregiver; lower sense of general support; more hours of care per week; and the motor retardation of the cared-for person measured with the speed of the Timed Up and Go (TUG) test. Conclusion Worse performance on the TUG test was only the patient-related predictor of distress among the variables examined as contributors to the higher NIoC. Enhancing the mobility of geriatric patients through suitably tailored kinesitherapeutic methods during their hospital stay may mitigate the burden endured by FCs. PMID:28203067

  10. Implementation and effects of an individual stress management intervention for family caregivers of an elderly relative living at home: a mixed research design.

    PubMed

    Ducharme, Francine; Lebel, Paule; Lachance, Lise; Trudeau, Denise

    2006-10-01

    The purpose of this project was to evaluate the implementation and effects of a stress management intervention for family caregivers of elderly persons. The intervention was implemented through an action research design with the collaboration of case managers working in community health centers. A total of 81 caregivers participated in the study. The quasi-experimental design used to test the effects of the intervention showed significant effects on perceived challenge associated with caregiver role, control by self, use of social support, and use of problem solving. Qualitative data demonstrate caregiver empowerment with respect to the caregiving role. This study illustrates the relevance of using a mixed research design in order to provide evidence for changes in practice.

  11. "La CLAve" to Increase Psychosis Literacy of Spanish-Speaking Community Residents and Family Caregivers

    ERIC Educational Resources Information Center

    Lopez, Steven R.; Lara, Ma. Del Carmen; Kopelowicz, Alex; Solano, Susana; Foncerrada, Hector; Aguilera, Adrian

    2009-01-01

    The authors developed and tested a 35-min psychoeducational program with the goal of increasing Spanish-speaking persons' literacy of psychosis. The program uses popular cultural icons derived from music, art, and videos, as well as a mnemonic device--La CLAve (The Clue)--to increase (a) knowledge of psychosis, (b) efficacy beliefs that one can…

  12. A Randomized Controlled Trial of Clinician-Supported Problem-Solving Bibliotherapy for Family Caregivers of People With First-Episode Psychosis

    PubMed Central

    Chien, Wai Tong; Thompson, David R.; Lubman, Dan I.; McCann, Terence V.

    2016-01-01

    Family interventions for first-episode psychosis (FEP) are an integral component of treatment, with positive effects mainly on patients’ mental state and relapse rate. However, comparatively little attention has been paid to the effects of family interventions on caregivers’ stress coping and well-being, especially in non-Western countries. We aimed to test the effects of a 5-month clinician-supported problem-solving bibliotherapy (CSPSB) for Chinese family caregivers of people with FEP in improving family burden and carers’ problem-solving and caregiving experience, and in reducing psychotic symptoms and duration of re-hospitalizations, compared with those only received usual outpatient family support (UOFS). A randomized controlled trial was conducted across 2 early psychosis clinics in Hong Kong, where there might be inadequate usual family support services for FEP patients. A total of 116 caregivers were randomly selected, and after baseline measurement, randomly assigned to the CSPSB or UOFS. They were also assessed at 1-week and 6- and 12-month post-intervention. Intention-to-treat analyses were applied and indicated that the CSPSB group reported significantly greater improvements in family burden and caregiving experience, and reductions in severity of psychotic symptoms and duration of re-hospitalizations, than the UOFS group at 6- and 12-month follow-up. CSPSB produces moderate long-term benefits to caregivers and FEP patients, and is a low-cost adjunct to UOFS. PMID:27147450

  13. Psychometric Properties and Correlates of the Beck Hopelessness Scale in Family Caregivers of Nigerian Patients with Psychiatric Disorders in Southwestern Nigeria

    PubMed Central

    Aloba, Olutayo; Ajao, Olayinka; Alimi, Taiwo; Esan, Olufemi

    2016-01-01

    Objectives: To examine the construct and correlates of hopelessness among family caregivers of Nigerian psychiatric patients. Materials and Methods: This is a cross-sectional, descriptive study involving 264 family caregiver-patients’ dyads recruited from two university teaching hospitals psychiatric clinics in Southwestern Nigeria. Results: Exploratory factor analysis revealed a two-factor 9-item model of the Beck Hopelessness Scale (BHS) among the family caregivers. Confirmatory factor analysis of the model revealed satisfactory indices of fitness (goodness of fit index = 0.97, comparative fit index = 0.96, Chi-square/degree of freedom (CMIN/DF) = 1.60, root mean square error of approximation = 0.048, expected cross-validation index = 0.307, and standardized root mean residual = 0.005). Reliability of the scale was modestly satisfactory (Cronbach's alpha 0.72). Construct validity of scale was supported by significant correlations with the family caregivers’ scores on the Zarit Burden Interview, mini international neuropsychiatric interview suicidality module, General Health Questionnaire-12 (GHQ-12), and Patient Health Questionnaire-9. The greatest variance in the family caregivers’ scores on the BHS was contributed by their scores on the psychological distress scale (GHQ-12). Conclusions: The BHS has adequate psychometric properties among Nigerian psychiatric patients’ family caregivers. There is the need to pay attention to the psychological well-being of the family caregivers of Nigerian psychiatric patients. PMID:28163498

  14. Teaching the teachers: helping faculty in a family practice residency improve their informatics skills.

    PubMed

    Cartwright, Cynthia A; Korsen, Neil; Urbach, Lynn E

    2002-05-01

    Faculty members in family practice residencies are increasingly being asked to help residents develop skills in the use of informatics and evidence-based medicine (EBM). In order to do this successfully the teachers themselves must be skilled in the use of these tools. Recognizing the need for such training, the Maine Medical Center Family Practice Residency Program designed a faculty development project to increase knowledge and skills in the use of information technology. This project, which was carried out in 1999-2001, utilized a multifaceted approach that included improving the residency's technology infrastructure, conducting two instructional workshops, and offering EBM mentoring for preceptors. Faculty members also designed and carried out independent informatics projects. Pre- and post-project assessments of faculty members demonstrated a significant improvement in computer and EBM skills, and informal feedback from residents indicates that these skills have been successfully applied to the faculty members' teaching of residents and their practice of family medicine. This project had a positive impact on the faculty members in the residency program, increasing both their ability to employ information technology in individual and group teaching sessions and their use of EBM in clinical practice. Also, the culture within the residency program has been changed to one of utilizing computers and the Internet as principal resources for up-to-date information.

  15. New family medicine residency training programme: Residents’ perspectives from the University of Botswana

    PubMed Central

    Tshitenge, Stephane; Setlhare, Vincent; Tsima, Billy; Adewale, Ganiyu; Parsons, Luise

    2016-01-01

    Background Family Medicine (FM) training is new in Botswana. No previous evaluation of the experiences and opinions of residents of the University of Botswana (UB) Family Medicine training programme has been reported. Aims This study explored and assessed residents’ experiences and satisfaction with the FM training programme at the UB and solicited potential strategies for improvement from the residents. Methods A descriptive survey using a self-administered questionnaire based on a Likert-type scale and open-ended questions was used to collect data from FM residents at the UB. Results Eight out the 14 eligible residents participated to this study. Generally, residents were not satisfied with the FM training programme. Staff shortage, inadequate supervision and poor programme organisation by the faculty were the main reasons for this. However, the residents were satisfied with weekly training schedules and the diversity of patients in the current training sites. Residents’ potential solutions included an increase in staff, the acquisition of equipment at teaching sites and emphasis on FM core topics teachings. They had different views regarding how certain future career paths will be. Conclusions Despite the general dissatisfaction among residents because of challenges faced by the training programme, we have learnt that residents are capable of valuable inputs for improvement of their programme when engaged. There is need for the Department of Family Medicine to work with the Ministry of Health to set a clear career pathway for future graduates and to reflect on residents’ input for possible implementation. PMID:27796117

  16. Resident and family member perceptions of cultural diversity in aged care homes.

    PubMed

    Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

    2017-03-01

    Similar to many developed nations, older people living in residential aged care homes in Australia and the staff who care for them have become increasingly multicultural. This cultural diversity adds challenges for residents in adapting to the care home. This study explores: (i) residents' and family members' perceptions about staff and cultural diversity, and (ii) culturally and linguistically diverse residents' and family members' experiences. An interpretive study design employing a thematic analysis was applied. Twenty-three residents and seven family members participated in interviews. Four themes were identified from interpreting residents and family members' perceptions of the impact of cultural diversity on their adaptation to aged care homes: (i) perceiving diversity as an attraction; (ii) adapting to cross-cultural communication; (iii) adjusting to diet in the residential care home; and (iv) anticipating individualized psychosocial interactions. The findings have implications for identifying strategies to support staff from all cultural backgrounds in order to create a caring environment that facilitates positive relationships with residents and supports residents to adjust to the care home.

  17. Re-focusing the Gender Lens: Caregiving Women, Family Roles and HIV/AIDS Vulnerability in Lesotho

    PubMed Central

    Harrison, Abigail; Short, Susan E.; Tuoane-Nkhasi, Maletela

    2013-01-01

    Gender and HIV risk have been widely examined in southern Africa, generally with a focus on dynamics within sexual relationships. Yet the social construction of women’s lives reflects their broader engagement with a gendered social system, which influences both individual-level risks and social and economic vulnerabilities to HIV/AIDS. Using qualitative data from Lesotho, we examine women’s lived experiences of gender, family and HIV/AIDS through three domains: 1) marriage; 2) kinship and social motherhood, and 3) multigenerational dynamics. These data illustrate how women caregivers negotiate their roles as wives, mothers, and household heads, serving as the linchpins of a gendered family system that both affects, and is affected by, the HIV/AIDS epidemic. HIV/AIDS interventions are unlikely to succeed without attention to the larger context of women’s lives, namely their kinship, caregiving, and family responsibilities, as it is the family and kinship system in which gender, economic vulnerability and HIV risk are embedded. PMID:23686152

  18. Home nursing and home help for dementia patients: Predictors for utilization and expected quality from a family caregiver's point of view.

    PubMed

    Graessel, Elmar; Luttenberger, Katharina; Bleich, Stefan; Adabbo, Raffaela; Donath, Carolin

    2011-01-01

    Little is known about the factors that influence utilization of home nursing and home help or about quality expectations of family caregivers of a dementia patient. These questions are addressed in the following paper. The cross-sectional study was carried out as an anonymous written survey of family caregivers of dementia patients in four regions of Germany. Quantitative and qualitative data from 404 family caregivers were analyzed using binary logistic regression analysis and content analysis. We found that subjective need of home nursing respectively of home help and the age of the dementia patient are significant predictors for utilization. Utilization of home nursing is also predicted by the age of the family caregiver. Punctuality of the staff is the dominant quality criterion. Hence, in order to reduce the number of those Alzheimer's disease (AD) caregivers who think they don't need home nursing or home help compared with the number who really don't need it, caregivers should be transparently informed of the relevant advantages and quality principles of using home nursing respectively home help.

  19. Use of computers and the Internet by residents in US family medicine programmes.

    PubMed

    King, Richard V; Murphy-Cullen, Cassie L; Mayo, Helen G; Marcee, Alice K; Schneider, Gregory W

    2007-06-01

    Computers, personal digital assistants (PDA), and the Internet are widely used as resources in medical education and clinical care. Educators who intend to incorporate these resources effectively into residency education programmes can benefit from understanding how residents currently use these tools, their skills, and their preferences. The researchers sent questionnaires to 306 US family medicine residency programmes for all of their residents to complete. Respondents were 1177 residents from 125 (41%) programmes. Access to a computer was reported by 95% of respondents. Of these, 97% of desktop and 89% of laptop computers could access the Internet. Residents accessed various educational and clinical resources. Half felt they had 'intermediate' skills at Web searches, 23% had 'some skills,' and 27% were 'quite skilled.' Those under 30 years of age reported higher skill levels. Those who experienced a Web-based curriculum in medical school reported higher search skills and greater success in finding clinical information. Respondents preferred to use technology to supplement the didactic sessions offered in resident teaching conferences. Favourable conditions exist in family medicine residency programmes to implement a blend of traditional and technology-based learning experiences. These conditions include residents' experience, skills, and preferences.

  20. Emotional memory deficit and its psychophysiological correlate in family caregivers of patients with dementia.

    PubMed

    Palma, Kayla Araújo Ximenes Aguiar; Balardin, Joana Bisol; Vedana, Gustavo; de Lima Argimon, Irani Iracema; Luz, Clarice; Schröder, Nadja; Quevedo, João; Bromberg, Elke

    2011-01-01

    This study examined the cortisol secretion pattern and declarative memory performance of dementia caregivers. An illustrated story paradigm memory task was used to evaluate the effects of emotional arousal on memory and assess the caregivers' cognitive compensation capacity. Younger (n=19) and elderly (n=24) noncaregivers and elderly caregivers (n=14) took part in 2 experiments to elucidate the effects of aging (experiment 1) and chronic stress (experiment 2) on memory performance and cortisol levels. Each group was divided in 2 subgroups: one that was exposed to an emotionally neutral story, and one that was exposed to a similar, but emotionally arousing story. Participants completed a multiple-choice questionnaire in the test session. Salivary cortisol samples were collected at 8:00 AM, 4:00 PM, and 10:00 PM, 1 day after memory testing. Experiment 1 showed that, despite an age-related memory deficit, arousal manipulation produced a similar effect in both age groups. Experiment 2 showed that, in addition to the characteristic memory decline of aging, elderly caregivers did not benefit from emotionally arousing material as their noncaregiver counterparts did. This impairment correlated with elevated nighttime cortisol levels, indicating a potential worsening impact of caregiver burden on age-related cognitive decline.

  1. Tri‐focal Model of Care Implementation: Perspectives of Residents and Family

    PubMed Central

    Rawson, Helen; O'Connell, Beverly; Walker, Helen; Bucknall, Tracey; Forbes, Helen; Ostaszkiewicz, Joan; Ockerby, Cherene

    2016-01-01

    Abstract Purpose To explore residents’ and family members’ perceptions of partnership‐centered long‐term care (LTC) associated with implementation of the Tri‐focal Model of Care. The Model promotes partnership‐centered care, evidence‐based practice, and a positive environment. Its implementation is supported by a specifically designed education program. Methods The Model was implemented over approximately 12 months in seven LTC facilities in Victoria, Australia. A qualitative exploratory‐descriptive approach was used. Data were collected using individual and focus group interviews with residents and family members prior to and following implementation of the Model. Data were analyzed thematically. Findings Prior to implementation of the Model, residents described experiencing a sense of disempowerment, and emphasized the importance of communication, engagement, and being a partner in the staff–resident care relationship. Following implementation, residents reported experiencing improved partnership approaches to care, although there were factors that impacted on having a good experience. Family members described a desire to remain involved in the resident's life by establishing good communication and rapport with staff. They acknowledged this was important for partnership‐centered care. Following implementation, they described experiencing a partnership with staff, giving them confidence to assist staff and be included in decisions about the resident. Conclusions The Tri‐focal Model of Care can enable residents, family members, and staff to be partners in resident care in LTC settings. Clinical Relevance With an ageing population, an increasing demand for complex, individualized LTC exists. Delivery of high‐quality LTC requires a strategy to implement a partnership‐centered approach, involving residents, family members, and staff. PMID:27871120

  2. Cultural Competency Training in a New-Start Rural/Frontier Family Practice Residency Program: A Cultural Immersion Integrative Model.

    ERIC Educational Resources Information Center

    Doty, Barbara J.; Pastorino, Ray

    The Alaska Family Practice Residency (AFPR) is a graduate medical education training program for family physicians headed for rural and remote practice sites. Located in Anchorage and affiliated with the University of Washington family practice residency network, the program has an integrated curriculum aimed at preparing family physicians to…

  3. The effect of altruism on the spending behavior of elderly caregivers of family members with HIV/AIDS in South African townships.

    PubMed

    Klemz, Bruce R; Boshoff, Christo; Mazibuko, Noxolo-Eileen; Asquith, Jo Ann

    2015-01-01

    HIV/AIDS has led to an enormous demand for health care in the developing world and many governments have opted to capitalize on altruistic home-based caregivers. These caregivers are mainly poor older women and their financial survival is critically important to themselves and their families. We found that as the patient's illness progressed: (a) the altruistic cultural norm "ubuntu" led the caregiver to increase spending and (b) the social pressure (sanction) of stigma led to a very dramatic drop in direct interpersonal assistance. The impact on their spending, health care, and the related public policies are discussed.

  4. Literacy, Education, and Inequality: Assimilation and Resistance Narratives from Families Residing at a Homeless Shelter

    ERIC Educational Resources Information Center

    Jacobs, Mary M.

    2014-01-01

    In this article, I draw on data from my qualitative dissertation study of the literacy practices of five families who resided in a homeless shelter to complicate the relationship between literacy, education, and inequality. Homelessness is examined through the lens of sponsorship to understand the differential access the families have to powerful…

  5. INDISCRIMINATE BEHAVIOR OBSERVED IN THE STRANGE SITUATION AMONG INSTITUTIONALIZED TODDLERS: RELATIONS TO CAREGIVER REPORT AND TO EARLY FAMILY RISK

    PubMed Central

    Oliveira, Paula S.; Soares, Isabel; Martins, Carla; Silva, Joana R.; Marques, Sofia; Baptista, Joana; Lyons-Ruth, Karlen

    2014-01-01

    Socially disinhibited or indiscriminate behavior (IB) has traditionally been investigated using caregiver reports. More recently, an observational measure based on the Strange Situation Procedure (M. Ainsworth, M. Blehar, E. Waters, & S. Wall, 1978), the Rating of Infant and Stranger Engagement (RISE; C. Riley, A. Atlas-Corbett, & K. Lyons-Ruth, 2005), was validated in home-reared at-risk children. The present study aimed to validate the RISE in an institutionally reared sample using the caregiver report, to assess whether IB assessed with the RISE was elevated among the institutionalized children, and to explore potential risk factors associated with IB. The study was conducted among 74 institutionalized toddlers aged 11 to 30 months. Sociodemographic questionnaires were used to assess pre-admission experiences, and aspects of institutional placement were coded from the children’s files in the institution and staff’s report. Institutionalized children displayed high frequencies of IB as assessed on the RISE, and this instrument was validated against caregiver report. Pre-admission experiences of the institutionalized children in their biological families—namely, prenatal risk and maternal emotional neglect risk—predicted IB. Results suggest that the RISE is adequate to use among institutionally reared toddlers and point to aspects of the early familial environment that may be implicated in IB. PMID:25552781

  6. A comparison of surgery and family medicine residents' perceptions of cross-cultural care training.

    PubMed

    Chun, Maria B J; Jackson, David S; Lin, Susan Y; Park, Elyse R

    2010-12-01

    The need for physicians formally trained to deliver care to diverse patient populations has been widely advocated. Utilizing a validated tool, Weissman and Betancourt's Cross-Cultural Care Survey, the aim of this current study was to compare surgery and family medicine residents' perceptions of their preparedness and skillfulness to provide high quality cross-cultural care. Past research has documented differences between the two groups' reported impressions of importance and level of instruction received in cross-cultural care. Twenty surgery and 15 family medicine residents participated in the study. Significant differences were found between surgery and family medicine residents on most ratings of the amount of training they received in cross-cultural skills. Specifically, family medicine residents reported having received more training on: 1) determining how patients want to be addressed, 2) taking a social history, 3) assessing their understanding of the cause of illness, 4) negotiating their treatment plan, 5) assessing whether they are mistrustful of the health care system and÷or doctor, 6) identifying cultural customs, 7) identifying how patients make decisions within the family, and 8) delivering services through a medical interpreter. One unexpected finding was that surgery residents, who reported not receiving much formal cultural training, reported higher mean scores on perceived skillfulness (i.e. ability) than family medicine residents. The disconnect may be linked to the family medicine residents' training in cultural humility - more knowledge and understanding of cross-cultural care can paradoxically lead to perceptions of being less prepared or skillful in this area.

  7. Personality types of family practice residents as measured by the Myers-Briggs type indicator.

    PubMed

    Harris, D L; Ebbert, P

    1985-01-01

    This study was initiated to test the hypothesis that individuals currently choosing family practice as a career are likely to have different personality types than those who previously pursued general practice. Incoming residents to the University of Utah Family Practice Residency Program were compared to a group of private primary care physicians serving rural areas. Personality types were determined by administering the Myers-Briggs Type Indicator to both groups. Results showed that the current resident group differed significantly from the primary care physician group and that the residents' personality types were similar to personality types of faculty in other studies. This raises the concern that many family practice residents may not choose to practice in underserved areas. Further studies need to follow personality types through medical school and residency training and into practice to help determine which prospective physicians are likely to choose a primary care career and a rural practice. This information may be useful in health manpower planning and in examining admissions policies of medical schools and residencies.

  8. An interprofessional approach to shared decision making: an exploratory case study with family caregivers of one IP home care team

    PubMed Central

    2014-01-01

    Background Within the context of an exploratory case study, the authors assessed the perceptions of family caregivers about the decision-making process regarding relocating their relative and about the applicability of an interprofessional approach to shared decision making (IP-SDM). They also assessed perceptions of health professionals and health managers about IP-SDM. Methods From November 2010 to October 2011, we worked with one IP home care team dedicated to older adults (the case) from a large primary health care organization in Quebec City, Canada. We identified six of their clients who had faced a decision about whether to stay at home or move to a long-term care facility in the past year and interviewed their family caregivers. We explored the decision-making process they had experienced regarding relocating their relative and their perceptions about the applicability of IP-SDM in this context. Attitudes towards IP-SDM and potential barriers to this approach were explored using a focus group with the participating IP home care team, individual interviews with 8 managers and a survey of 272 health professionals from the primary care organization. A hybrid process of inductive and deductive thematic analysis was used and data were triangulated across all sources. Results Family caregivers reported lack of agreement on the nature of the decision to be made, a disconnection between home care services and relatives’ needs, and high cost of long-term care alternatives. Factors influencing their decision included their ability to provide care for their relative. While they felt somewhat supported by the IP home care team, they also felt pressured in the decision. Overall, they did not perceive they had been exposed to IP-SDM but agreed that it was applicable in this context. Results from the survey, focus group and interviews with health professionals and managers indicated they all had a favourable attitude towards IP-SDM but many barriers hampered its

  9. Caregivers and Serious Illness

    MedlinePlus

    ... or those we choose to call family. Caregiver Responsibilities When a family member has a serious illness , ... transportation; do housework; handle your loved one’s former responsibilities, such as child care; and provide help with ...

  10. Appraisal of the communication skills of residents in the Family Medicine Program in Central Saudi Arabia

    PubMed Central

    Alsaad, Saad M.; Alshammari, Sulaiman A.; Almogbel, Turki A.

    2016-01-01

    Objectives: To assess patients’ perceptions of the communication skills of family medicine residents. Methods: This is a cross-sectional study. Data were collected from patients, seeing 23 residents from 4 family medicine residency programs in Riyadh, Kingdom of Saudi Arabia namely, King Khalid University Hospital, Riyadh Military Hospital, Security Forces Hospital, and King Abdul-Aziz Medical City. The translated version of the Communication Assessment Tool (CAT) was used. Data were collected during January and February 2013. Results: A total of 350 patients completed the CAT, with an 87.5% response rate. Patients rated each resident differently, but the mean percentage of items, which residents rated as excellent was 71%. In general, male residents were rated higher 72.8 ± 27.2 than female residents 67.8 ± 32.2 with a significant difference; (p<0.005). Also, significant differences were found based on the gender of the residents, when each item of the CAT was compared. Comparing training centers, there were no significant differences found in the overall percentage of items rated as excellent or among items of the CAT. Conclusion: The study identified areas of strength and weaknesses that need to be addressed to improve communication skills of physicians. PMID:27381544

  11. Filial piety and parental responsibility: an interpretive phenomenological study of family caregiving for a person with mental illness among Korean immigrants

    PubMed Central

    2012-01-01

    Background Despite the strong influence of culture on family involvement in disease management, few studies have examined how immigrant families care for persons with mental illness. The purpose of this study was to examine how immigrant families organize their world to care for a mentally ill person in the United States. The current analysis focused on how Confucian notions of filial piety and parental obligation shape caregiving in Korean immigrant families. Methods Participants in this interpretive phenomenological study were comprised of six Korean immigrant women caring for a family member with mental illness. Participants provided narratives that illustrate challenges and opportunities in caring for their mentally ill family member. Results Three family caregiving patterns were discerned. Insulating from the outside world describes a family’s effort to accept a member's illness and to manage it within the family. Prioritizing education over well-being concerns parental commitment to the Confucian priority of educating one’s children. Reciprocating the sacrifice describes how a family adapts and enacts filial piety. Conclusion The findings of this study warrant further study to examine the influence of Confucianism among Korean American families. The three patterns of caregiving are strongly aligned with Confucian notion of family and family engagement. These patterns may help health providers to anticipate the needs of and provide individualized, culturally appropriate mental health care for patients with mental illness and their families of Korean origin. PMID:23256876

  12. Health Profile of Aging Family Caregivers Supporting Adults with Intellectual and Developmental Disabilities at Home

    ERIC Educational Resources Information Center

    Yamaki, Kiyoshi; Hsieh, Kelly; Heller, Tamar

    2009-01-01

    The health status of 206 female caregivers supporting adults with intellectual and developmental disabilities at home was investigated using objective (i.e., presence of chronic health conditions and activity limitations) and subjective (i.e., self-perceived health status) health measures compared with those of women in the general population in 2…

  13. Identity Transformation and Family Caregiving: Narratives of African American Teen Mothers

    ERIC Educational Resources Information Center

    Brubaker, Sarah Jane; Wright, Christie

    2006-01-01

    This article explores connections between informal caregiving and identity transformation as experienced by pregnant teens. Based on in-depth interviews with 51 African American teen mothers, the article examines teens' pregnancy narratives as an example of narrative repair, illuminating how attending to processes that connect one's identity to…

  14. 3 CFR 9053 - Proclamation 9053 of October 31, 2013. National Family Caregivers Month, 2013

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... care, training programs, and caregiver support groups—all shaped with the understanding that the... selfless and unheralded work of delivering care to seniors or people with disabilities or illnesses. The role they play in our healthcare system is one we must recognize and support. During National...

  15. What Every Patient, Family, Friend, and Caregiver Needs To Know about Psychiatry. 2nd Edition.

    ERIC Educational Resources Information Center

    Roukema, Richard W.

    This book is written in a simple, concise style for the layperson--and is packed with need-to-know information on adult psychiatric disorders, including their causes, approaches to treatment, and what caregivers can do to help. The book is promoted as an excellent text for introduction to psychiatry classes in colleges and nursing schools for…

  16. Modeling the Social Determinants of Caregiver Burden among Families of Children with Developmental Disabilities

    ERIC Educational Resources Information Center

    McManus, Beth M.; Carle, Adam; Acevedo-Garcia, Dolores; Ganz, Michael; Hauser-Cram, Penny; McCormick, Marie

    2011-01-01

    This study described predictors of caregiver burden among parents of children with developmental disabilities. The sample, obtained from the 2005-2006 National Survey of Children With Special Health Care Needs, included 12,225 children, aged 5 to 17 years, with a developmental disability. Structural equation modeling assessed the relationships…

  17. Gay, Lesbian, Transgendered and Bisexual Families: The Teacher or Caregiver's Role in the Development of Positive Relationships. Rural, Urban and Minority Education.

    ERIC Educational Resources Information Center

    Meadows, Mikki

    2001-01-01

    Recognizes the importance of the caregiver/parent relationship and presents three steps for developing positive relationships with non-traditional families: (1) develop positive transitions; (2) know the issues; and (3) find resources to share with families. Provides advice and resource lists for general information, legal information, and…

  18. Implementation of a Chronic Illness Model for Diabetes Care in a Family Medicine Residency Program

    PubMed Central

    Beresford, Robin

    2010-01-01

    ABSTRACT INTRODUCTION While the Chronic Care Model (CCM) has been shown to improve the care of patients with chronic illnesses, primary care physicians have been unprepared in its use, and residencies have encountered challenges in introducing it into the academic environment. AIM Our residency program has implemented a diabetes management program modeled on the CCM to evaluate its impact on health outcomes of diabetic patients and educational outcomes of residents. SETTING University-affiliated, community-based family medicine residency program. PROGRAM DESCRIPTION Six residents, two faculty clinicians, and clinic staff formed a diabetes management team. We redesigned the outpatient experience for diabetic patients by incorporating elements of the CCM: multidisciplinary team care through planned and group visits; creation of a diabetes registry; use of guidelines-based flow sheets; and incorporation of self-management goal-setting. Residents received extensive instruction in diabetes management, quality improvement, and patient self-management. PROGRAM EVALUATION We achieved overall improvement in all metabolic and process measures for patients, with the percentage achieving HbA1c, LDL, and BP goals simultaneously increasing from 5.7% to 17.1%. Educational outcomes for residents, as measured by compliance with review of provider performance reports and self-management goal-setting with patients, also significantly improved. DISCUSSION Through a learning collaborative experience, residency programs can successfully incorporate chronic care training for residents while addressing gaps in care for patients with diabetes. PMID:20737237

  19. Medical abortion and family physicians. Survey of residents and practitioners in two Ontario settings.

    PubMed Central

    Raymond, Elin; Kaczorowski, Janusz; Smith, Pat; Sellors, John; Walsh, Allyn

    2002-01-01

    OBJECTIVE: To determine the knowledge, attitudes, and interest in providing medical abortion reported by family physicians and residents in rural and urban settings. DESIGN: A self-administered mailed survey using the modified Dillman method. SETTING: Hamilton and Thunder Bay County in Ontario. PARTICIPANTS: Family medicine residents (n = 93) and physicians (n = 234) in predominantly urban (Hamilton) and rural (Thunder Bay) settings. All faculty family physicians at McMaster University practising general family medicine and all family physicians in Thunder Bay County were surveyed. MAIN OUTCOME MEASURES: Knowledge of, attitudes toward, and interest in providing medical abortion. RESULTS: Overall response rate to the survey was 62.7% (n = 327); 74.2% (69/93) of residents responded; 58.1% (136/234) of physicians responded. Physicians and residents rated their knowledge about medical abortion as poor, but most were interested in receiving more information and training in this area. Many (83.1%, 157/189) reported that medical abortion was an acceptable procedure for family physicians to perform, and 52.0% (64/123) of the physicians would consider providing medical abortions for their patients. Residents training in the more rural Thunder Bay program were less likely to support first-trimester abortions for both medical and nonmedical reasons than those training in Hamilton (P < .05). Male respondents were significantly less supportive of abortion for nonmedical reasons and were less likely to consider providing medical abortions for their patients (P < .05). CONCLUSION: Most family physicians and residents showed interest in receiving more information about and training in medical abortion. PMID:11935718

  20. [Grieving among relatives and caregivers].

    PubMed

    Pascual, Angel María; Santamaría, Juan Luis

    2009-11-01

    This article provides a definition and description of grief, its characteristics, and the current explanatory models of this phenomenon (the stage model, task model, constructivist model and dual process model). The authors argue that a state of mourning in advance is produced in the process of dementia as a result of significant relational loss before death and describe the risk factors for complicated grief in caregivers: overload, lack of personal and material resources, delegation of care, and complex feelings such as guilt. The need for healthcare organizations to provide professional caregivers with the appropriate means to help with grief and to develop their own measures to prevent burnout is stressed. These measures could include protocols that provide bereavement intervention with the family, the primary caregiver, other patients and/or residents and the professional caregiving team. Finally, losses in persons with dementia must be taken into consideration, avoiding phenomena such as silencing and overprotection and encouraging acceptance and emotional support of their pain so that organic and emotional complications do not occur.

  1. Lived Experience of Caregivers of Family-Centered Care in the Neonatal Intensive Care Unit: “Evocation of Being at Home”

    PubMed Central

    Hadian Shirazi, Zahra; Sharif, Farkhondeh; Rakhshan, Mahnaz; Pishva, Narjes; Jahanpour, Faezeh

    2016-01-01

    Background In recent decades, family-centered care (FCC) has come to be known, accepted, and reported as the best care strategy for admitted children and their families. However, in spite of the increasing application of this approach, the experiences of the caregivers have not yet been studied. Objectives The present study aimed at the description and interpretation of the FCC experience in two neonatal intensive care units (NICU) at Shiraz University of Medical Sciences. Methods This study was conducted through the hermeneutic phenomenological approach. Semi-structured interviews were conducted with 17 professional and familial caregivers, and their interactions were observed in three work shifts. The interviews were audiotaped and transcribed verbatim. After observations, field notes were also written. Finally, the data were analyzed through van Manen’s methodology. Results One of the essential themes that emerged in this study was the “evocation of being at home” among familial and even professional caregivers. This theme had three subthemes: i.e., “meta-family interaction,” “comprehensive support,” and “reconstruction of a normal family.” Accordingly, FCC eliminated borders between professional and non-professional caregivers and built close relationships among them in the NICU. It also provided for the needs of neonates, their families, and even professional caregivers through perceived and received support. Conclusions Parents of the neonates admitted to the NICU experience hard moments. They not only play the role of primary caregivers, but they also receive the care. Focusing on the different meanings of this care from the caregivers’ points of view and having managers provide certain requirements can guarantee the establishment of comprehensive care for clients and proper support for the staff in this unit. PMID:28203324

  2. Evaluation of the educational technology "Caring for dependent people" by family caregivers in changes and transfers of patients and tube feeding 1

    PubMed Central

    Landeiro, Maria José Lumini; Peres, Heloísa Helena Ciqueto; Martins, Teresa Vieira

    2016-01-01

    ABSTRACT Objective: to assess the contributions of interactive educational technology "Caring for Dependent People" in the development of knowledge to family caregivers of dependent people in a household context and their satisfaction in its use. Method: quasi-experimental study, not randomized, of the before and after type, with a convenience sample of 65 family caregivers, from two Medicine services of a hospital in Porto, Portugal. The Control Group consisted of 33 family caregivers and the Experimental Group of 32, identified by consecutive sampling. The experimental group had access to educational technology at home. Data were collected by socio-demographic, satisfaction and evaluation of knowledge questionnaire, about how to feed by nasogastric tube, positioning and transferring the dependent person. The assessment in both groups had two moments: initial, during hospitalization and one month after discharge. Results: the experimental group had a larger increase in knowledge related to the use of the educational technology. In the control group the knowledge did not differ in the two evaluation time points. Conclusion: these results confirm the improvement of interactive educational technologies and in the training of family caregivers to care for dependents. This technology successfully met the technical quality and learning needs of caregivers, and was considered easy and stimulating. PMID:27556879

  3. Recognition of client values as a basis for tailored care: the view of Dutch expert patients and family caregivers.

    PubMed

    Schoot, Tineke; Proot, Ireen; ter Meulen, Ruud; de Witte, Luc

    2005-06-01

    In the Netherlands confusion is signalled about the introduction of new care concepts like demand-oriented care. The aim of this article is to explore the phenomenon 'interaction aimed at care tailored to the client demand' as seen by expert clients: patients and their family caregivers. Focus interviews were held with expert patients and expert family caregivers of the 'Dutch Council of the Chronically ill and the Disabled'. Grounded theory methodology was used to analyse the results. Recognition by the professional of client values underlying their demand (uniqueness, comprehensiveness, continuity of life, fairness and autonomy) and underlying the care-relationship (equality, partnership and interdependence) emerged as central element within the interaction. Feelings of recognition with the client seem to reinforce autonomy, self-esteem and participation. Recognition was optimally felt in a dialogue. Four professional competencies could be identified related to recognition: attentiveness (ongoing actions to know and understand the patient); responsiveness (active, committed and responsible care guided by respect of patient identity); being a critical partner in care (giving and grounding professional opinion and discuss boundaries); being a developer of client competencies (facilitating and developing client participation within care). The findings offer possibilities to operationalize care concepts aimed at tailored care. Further research aimed at refining and testing the hypothesis developed is recommended.

  4. "I wouldn't look at it as stress": conceptualizations of caregiver stress among low-income families of children with asthma.

    PubMed

    Sampson, Natalie R; Parker, Edith A; Cheezum, Rebecca R; Lewis, Toby C; O'Toole, Ashley; Zuniga, Adriana; Patton, Jean; Robbins, Thomas G; Keirns, Carla C

    2013-02-01

    Low-income caregivers of children with asthma experience multiple stressors, likely worsening family health. As part of Community Action Against Asthma's community-based participatory research partnership, researchers conducted 40 qualitative semi-structured interviews and quantitative surveys with low-income caregivers of children with asthma in Detroit, Michigan. Participants described daily childhood asthma experiences and completed scales including the Peds Quality of Life Family Impact Module and Zarit Burden Caregiver Scale. Quantitative scale findings suggested participants are moderately stressed or affected by their child's illness. While there was some accordance between qualitative and quantitative findings, qualitative findings additionally captured many relevant life stressors, seemingly overlooked or conflated in scale responses. Many participants described asthma as part of childrearing, rather than as a stressor or burden. Findings encourage improvement of clinical, psychometric assessments used to measure and address stressors that shape health for many families with children with asthma.

  5. Breaking bad news: structured training for family medicine residents.

    PubMed

    Ungar, Lea; Alperin, Mordechai; Amiel, Gilad E; Beharier, Zvi; Reis, Shmuel

    2002-09-01

    Previous research has shown that physicians experience incompetence and difficulty in dealing with patients' feelings after they have broken bad news to them. During the past 10 years, we have implemented a longitudinal training program targeting these issues. The present article describes this training and discusses its contribution to doctors' skills at approaching distressed patients. In order to cope with breaking bad news to patients and their families, physicians should be skilled at crisis intervention and communication techniques. They should also be aware of their personal attitudes and emotional reactions when breaking bad news. Each session encompassed these areas, as well as the most prominent issues arising when breaking bad news. In a 1-5 Likert scale, the course received an overall score of 4.47 (S.D. 0.51). Participants noted that they had gained relevant communication skills for future patient encounters.

  6. Examination outcomes for international medical graduates pursuing or completing family medicine residency training in Quebec

    PubMed Central

    MacLellan, Anne-Marie; Brailovsky, Carlos; Rainsberry, Paul; Bowmer, Ian; Desrochers, Micheline

    2010-01-01

    ABSTRACT OBJECTIVE To review the success of international medical graduates (IMGs) who are pursuing or have completed a Quebec residency training program and examinations. DESIGN We retrospectively reviewed IMGs’ success rates on the pre-residency Collège des médecins du Québec medical clinical sciences written examination and objective structured clinical examination, as well as on the post-residency Certification Examination in Family Medicine. SETTING Quebec. PARTICIPANTS All IMGs taking their examinations between 2001 and 2008, inclusive, and Canadian and American graduates taking their examinations during this same period. MAIN OUTCOME MEASURES Success rates for IMGs on the pre-residency and post-residency examinations, compared with success rates for Canadian and American graduates. RESULTS Success rates on the pre-residency clinical examinations remained below 50% from 2001 to 2008 for IMGs. Similarly, during the same period, the average success rate on the Certification examination was 56.0% for IMGs, compared with 93.5% for Canadian and American medical graduates. CONCLUSION Despite pre-residency competency screening and in-program orientation and supports, a substantial number of IMGs in Quebec are not passing their Certification examinations. Another study is under way to analyze reasons for some IMGs’ lack of success and to find ways to help IMGs complete residency training successfully and pass the Certification examination. PMID:20841596

  7. Conversations about End of Life: Perspectives of Nursing Home Residents, Family, and Staff

    PubMed Central

    Hirschman, Karen B.; Madden, Connie

    2015-01-01

    Abstract Background: Care in nursing homes (NHs) often overlooks individual values and preferences. Residents' voices are critical to discussions about preferences, yet there remains limited research on conversations about the end of life (EOL) from the perspective of older adults who reside in NHs. Objective: The aim of this study was to describe the communication, content and process, related to EOL conversations among residents, family, and staff. Methods: We used semistructured interviews in this qualitative, descriptive study to describe conversations about EOL preferences. We examined participants' conversation, when it occurred, and what was discussed. We queried about barriers to and facilitators in discussing EOL care in the NH setting. We interviewed residents (n=16), family (n=12), and interdisciplinary staff (n=10) from four NHs. Results: The overarching theme—missed conversations—describes EOL-related communication. Residents, families, and staff rarely talked about EOL care preferences, nor did they pass along information about preferences or initiate conversations about EOL care with each other. Three categories explained missed conversations: inquiry (“No one asked”); assumptions (presence of an advance directive [AD], “They know me”); and conveying (lack of conveying information or wishes). Existing barriers and lacking facilitators resulted in missed opportunities to hold conversations about EOL preferences. Conclusions: Not all residents wanted to have conversations, but many wanted to be asked about their preferences. Missed conversations may adversely affect the quality of EOL care. Conversations with residents can be initiated by asking residents who they would like involved in the conversation and drawing upon the experience of others. PMID:25658608

  8. Cultural transition of international medical graduate residents into family practice in Canada

    PubMed Central

    Triscott, Jean A.C.; Waugh, Earle H.; Torti, Jacqueline M.I.; Barton, Martina

    2016-01-01

    Objectives To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. Methods This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Results Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths.  At the same time, IMG residents appeared to experience challenges in the areas of:  (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada’s health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning,  unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles.   Conclusions Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum.  IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning. PMID:27149322

  9. Impact of a family medicine resident wellness curriculum: a feasibility study

    PubMed Central

    Runyan, Christine; Savageau, Judith A.; Potts, Stacy; Weinreb, Linda

    2016-01-01

    Background Up to 60% of practicing physicians report symptoms of burnout, which often peak during residency. Residency is also a relevant time for habits of self-care and resiliency to be emphasized. A growing literature underscores the importance of this; however, evidence about effective burnout prevention curriculum during residency remains limited. Objectives The purpose of this project is to evaluate the impact of a new, 1-month wellness curriculum for 12 second-year family medicine residents on burnout, empathy, stress, and self-compassion. Methods The pilot program, introduced during a new rotation emphasizing competencies around leadership, focused on teaching skills to cultivate mindfulness and self-compassion in order to enhance empathy and reduce stress. Pre-assessments and 3-month follow-up assessments on measures of burnout, empathy, self-compassion, and perceived stress were collected to evaluate the impact of the curriculum. It was hypothesized that this curriculum would enhance empathy and self-compassion as well as reduce stress and burnout among family medicine residents. Results Descriptive statistics revealed positive trends on the mean scores of all the measures, particularly the Mindfulness Scale of the Self-Compassion Inventory and the Jefferson Empathy Scale. However, the small sample size and lack of sufficient power to detect meaningful differences limited the use of inferential statistics. Conclusions This feasibility study demonstrates how a residency wellness curriculum can be developed, implemented, and evaluated with promising results, including high participant satisfaction. PMID:27282276

  10. Protected block time for teaching and learning in a postgraduate family practice residency program

    PubMed Central

    Jung, Piera; Kennedy, Maggie; Winder, Mary J.

    2012-01-01

    Abstract Objective To explore the elements necessary for a high-quality educational experience in a family practice residency program with respect to scheduling, learning environment, and approaches to teaching and learning. Design An interpretative, qualitative study using a generative-inquiry approach. Setting The Nanaimo Site of the University of British Columbia Family Practice Residency Program. Participants Fifteen physician instructors and 16 first- and second-year residents. Methods Data were gathered from 2 qualitative focus group interviews with residents; 2 qualitative focus group interviews with physician instructors; and structured and semistructured observation of 2 in-class seminars, with a focus on residents’ engagement with the class. Results were analyzed and categorized into themes independently and collectively by the researchers. Main findings Protected block time for teaching and learning at the Nanaimo Site has been effective in fostering a learning environment that supports collegial relationships and in-depth instruction. Residents and physician instructors benefit from the week-long academic schedule and the opportunity to teach and learn collaboratively. Participants specifically value the connections among learning environment, collegiality, relationships, reflective learning, and the teaching and learning process. Conclusion These findings suggest that strategic planning and scheduling of teaching and learning sessions in residency programs are important to promoting a comprehensive educational experience. PMID:22700741

  11. Coping strategies and caregiving outcomes among rural dementia caregivers.

    PubMed

    Sun, Fei; Kosberg, Jordan I; Kaufman, Allan V; Leeper, James D

    2010-08-01

    We studied the coping styles by which family caregivers living in rural areas of Alabama deal with the demands of caring for an older relative with dementia. Data were obtained from a sample of 141 caregivers through the random-digit dialing telephone survey. Two coping styles were identified: deliberate coping and avoidance coping. Deliberate coping was related to higher life satisfaction scores and, avoidance coping was related to lower life satisfaction scores and higher caregiver burden scores. Avoidance coping appeared to moderate the effects of caregiver health on caregiver burden. Social workers should pay greater attention to caregivers with dysfunctional coping styles.

  12. Effectiveness of an intervention in groups of family caregivers of dependent patients for their application in primary health centers. Study protocol

    PubMed Central

    2010-01-01

    Background Although Primary Health Care (PHC) Teams are used to deal with prevention and treatment of sanitary problems in adults with chronic diseases, they usually have a lack of experience in development of psychotherapeutic interventions. However, these interventions are the ones that achieve better results to reduce symptomatology and improve emotional state of caregivers. The study aims to evaluate the effectiveness of an intervention of psychotherapy in improving the mental health and Quality of life of caregivers. This intervention is based on theoretical approaches to care adjusted to cognitive theory, in order to be applied in primary health care centres. Methods/Design This is multicentre clinical trials study, randomized in two parallel groups, carry out in two PHC, Study population: 150 caregivers will be included by consecutive sampling and they will be randomized the half to experimental group and the other half to control group. They provide mostly all the assistance to care-dependent familiars receiving attention in PHC Centers. Measurements: Each caregiver will be evaluated on a personal interview. The caregivers' assessment protocol: 1) Assessment of different socio-demographic related to care, and caregiver's personal situation. 2)Care-dependent individuals will also be assessed by Barthel Index and Pfeiffer Questionnaire (SPMSQ). 3)Change in caregivers will be the principal measure: family function (Family APGAR Questionnaire), burden short questionnaire (Short Zarit Burden Interview), quality of life (Ruiz & Baca: 1993 Questionnaire), the Duke-UNK Functional Social Support Questionnaire, the General Health Questionnaire-12, and changes in Dysfunctional Thoughts about caring. 4) Intervention implementation measures will also be assessed. Intervention: A psychotherapeutic intervention will be 8 sessions of 90 minutes in groups. This intervention has been initially developed for family caregivers of patients with dementia. Discussion

  13. Long Distance Caregiving

    MedlinePlus

    ... life, working women with their own major family responsibilities remain our primary caregivers, more and more men are becoming caregivers. However, anyone anywhere can give care—regardless of gender, income, age, social status, and employment. No matter how great the ...

  14. "We Have No Rights, We Get No Help:" The Legal and Policy Dilemmas Facing Grandparent Caregivers

    ERIC Educational Resources Information Center

    Letiecq, Bethany L.; Bailey, Sandra J.; Porterfield, Fonda

    2008-01-01

    Guided by an ecological perspective on family policy, this qualitative study used family life history interviews to document the legal and policy dilemmas faced by 26 grandparent caregivers residing in Montana. Most grandparents (n = 18) were caring for their grandchildren in informal or private care arrangements. Findings revealed four legal or…

  15. Learning behaviour and preferences of family medicine residents under a flexible academic curriculum

    PubMed Central

    Sy, Alice; Wong, Eric; Boisvert, Leslie

    2014-01-01

    Abstract Objective To determine family medicine residents’ learning behaviour and preferences outside of clinical settings in order to help guide the development of an effective academic program that can maximize their learning. Design Retrospective descriptive analysis of academic learning logs submitted by residents as part of their academic training requirements between 2008 and 2011. Setting London, Ont. Participants All family medicine residents at Western University who had completed their academic program requirements (N = 72) by submitting 300 or more credits (1 credit = 1 hour). Main outcome measures Amount of time spent on various learning modalities, location where the learning took place, resources used for self-study, and the objective of the learning activity. Results A total of 72 residents completed their academic requirements during the study period and logged a total of 25 068 hours of academic learning. Residents chose to spend most of their academic time engaging in self-study (44%), attending staff physicians’ teaching sessions (20%), and participating in conferences, courses, or workshops (12%) and in postgraduate medical education sessions (12%). Textbooks (26%), medical journals (20%), and point-of-care resources (12%) were the 3 most common resources used for self-study. The hospital (32%), residents’ homes (32%), and family medicine clinics (14%) were the most frequently cited locations where academic learning occurred. While all physicians used a variety of educational activities, most residents (67%) chose self-study as their primary method of learning. The topic for academic learning appeared to have some influence on the learning modalities used by residents. Conclusion Residents used a variety of learning modalities and chose self-study over other more traditional modalities (eg, lectures) for most of their academic learning. A successful academic program must take into account residents’ various learning preferences and

  16. Clinical Poems and Clinical Conversations: Some Thoughts on Working with Family Medicine Residents

    ERIC Educational Resources Information Center

    Stein, Howard F.

    2006-01-01

    This paper describes an experiment in which Family Medicine residents composed, read, and discussed their poems as a way of bringing to life their often complex relationships with patients. It argues that this approach mobilizes the physicians' own creativity in the service of reflective practice and improved doctor-patient relationships. This…

  17. Modeling the hydrologic and economic efficacy of stormwater utility credit programs for US single family residences

    EPA Science Inventory

    As regulatory pressure to reduce the environmental impact of urban stormwater intensifies, U.S. municipalities increasingly seek a dedicated source of funding for stormwater programs, such as a stormwater utility. In rare instances, single family residences are eligible for utili...

  18. Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.

    ERIC Educational Resources Information Center

    Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.

    2001-01-01

    Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…

  19. Changes in caregiving satisfaction and information needs among relatives of adults with mental illness: results of a randomized evaluation of a family-led education intervention.

    PubMed

    Pickett-Schenk, Susan A; Bennett, Cynthia; Cook, Judith A; Steigman, Pamela; Lippincott, Richard; Villagracia, Ian; Grey, Dennis

    2006-10-01

    The authors examined changes in caregiving satisfaction and information needs among 462 relatives of individuals with mental illness who participated in a study of a family-led education course, the Journey of Hope (JOH). Participants were randomly assigned to receive JOH or to a control group waiting list and followed for 9 months. General linear model repeated measures analysis of variance found that, compared with the control group, the intervention group showed significant improvement in caregiving satisfaction and information needs following course completion and maintained these gains for another 6 months. Education and support from other family members in the form of a structured course is effective in meeting the caregiving needs of relatives of persons with mental illness.

  20. Caregiver Depression

    MedlinePlus

    ... will not sell or share your name. Caregiver Depression Tweet Bookmark this page | Email | Print Many caregivers ... depression See your doctor Treatment Coping Symptoms of depression Caregiving is hard — and can lead to feelings ...

  1. Caregiver distress in parkinsonism.

    PubMed

    Cifu, David X; Carne, William; Brown, Rashelle; Pegg, Phillip; Ong, Jason; Qutubuddin, Abu; Baron, Mark S

    2006-01-01

    This study examined the frequency and degree of caregiver burden in persons with parkinsonism, a group of disorders with four primary symptoms that include tremor, rigidity, postural instability, and bradykinesia. We assessed associations between perceived caregiver burden and physical, cognitive, and functional impairments using well-established tools for persons with parkinsonism. The 49 individuals with parkinsonism ranged in age from 61 to 87 (mean = 75), while their caregivers (N = 49) ranged in age from 48 to 83 (mean = 70). The caregivers were predominantly either wives (82%) or daughters (6%), with other family members, friends, and/or neighbors (12%) making up the rest. The caregivers reported a relatively high ability for coping (mean scores = 4.6/6). Caregiver burden was significantly negatively associated with activities of daily living and motoric difficulties as measured on the Unified Parkinson's Disease Rating Scale (UPDRS). Likewise, caregiver burden was negatively associated with caregiver self-reported sleep and coping ability. Results did not demonstrate an association on the UPDRS among mentation, behavior, and mood. We found a significant negative correlation for mentation between the Folstein Mini-Mental Status Examination and caregiver burden measures; however, we did not find this association with the Dementia Rating Scale-2. Patient's self-reported pain and caregiver burden were not associated.

  2. The Role of Caregiver Strain and Other Family Variables in Determining Children's Use of Mental Health Services.

    ERIC Educational Resources Information Center

    Brannan, Ana Maria; Heflinger, Craig Anne; Foster, E. Michael

    2003-01-01

    A study involving 574 children (ages 5-17) who received mental health services examined whether caregiver variables predicted child mental health service utilization patterns, particularly caregiver strain. Results found caregiver strain to be associated with the combination of services used, sequencing of services, gaps in care, and cost of…

  3. Predicting Desire for Institutional Placement among Racially Diverse Dementia Family Caregivers: The Role of Quality of Care

    ERIC Educational Resources Information Center

    Sun, Fei; Durkin, Daniel W.; Hilgeman, Michelle M.; Harris, Grant; Gaugler, Joseph E.; Wardian, Jana; Allen, Rebecca S.; Burgio, Louis D.

    2013-01-01

    Purpose: Literature on institutionalization of patients with dementia has not considered the role of caregivers' quality of care, which encompasses caregivers' exemplary care (EC) behaviors and caregivers' potentially harmful behaviors (PHBs) toward care recipients. This study sought to understand the role of quality of care in mediating between…

  4. "How Long Are We Able to Go on?" Issues Faced by Older Family Caregivers of Adults with Disabilities

    ERIC Educational Resources Information Center

    Dillenburger, Karola; McKerr, Lyn

    2011-01-01

    Research-informed policy and practice is needed for older caregivers of adult sons/daughters with disabilities. These caregivers are often under tremendous stress because of failing health, financial pressures, bereavement and worry about the future of their sons/daughters. Twenty-nine older parents/caregivers of 27 adults with intellectual and/or…

  5. Effect of nursing care given at home on the quality of life of patients with stomach cancer and their family caregivers' nursing care.

    PubMed

    Bilgin, S; Gozum, S

    2016-12-22

    In Turkey, the high incidences of stomach and oesophageal cancers in East and high incidence of stomach cancer in Northeast regions are remarkable. This study was conducted to identify homecare needs of patients with stomach cancer and their caregivers and the effect of family supportive nursing care on the quality of life of patients and families. The patient and his/her caregiver were assessed with respect to their daily life activities and NANDA was used for the identified nursing diagnoses, NIC for the appropriate interventions and NOC for assessment of the results. This study was conducted in a pre-test, post-test, controlled trial model to identify. The sample of the investigation consisted of 72 patients and 72 caregivers. As a data-collecting instrument, the Quality of Life Scale and Caregiver Quality of Life Index-Cancer were used. The overall quality of life, global health status and emotional and cognitive functions of the patients in the experimental group improved after the interventions. The overall quality of life and global health status was found to be poorer in the control group patients at post-test as compared to pre-test and their physical, role and social functions deteriorated. The caregivers' quality of life in the control group was affected more negatively with respect to the "Disruption in Daily Life" subscale as compared to pre-test values.

  6. Does empowering resident families or nursing home employees in decision making improve service quality?

    PubMed

    Hamann, Darla J

    2014-08-01

    This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses.

  7. "Maintaining connections but wanting more": the continuity of familial relationships among assisted-living residents.

    PubMed

    Tompkins, Catherine J; Ihara, Emily S; Cusick, Alison; Park, Nan Sook

    2012-01-01

    Social support is a key component of well-being for older adults, particularly for those who have moved from independent living to assisted living involving a transformation of roles, relationships, and responsibilities. Twenty-nine assisted-living facility residents were interviewed to understand the perceived continuity of relationships with family and friends. An inductive approach to thematic analysis revealed 1 main theme and 3 subthemes. The main theme that emerged was: maintaining connections but wanting more. Residents appreciated maintaining connections with family and friends, but often expressed feelings of discontentment with the continuity of former relationships. The subthemes included: appreciating family and friends, waiting for more, and losing control. Implications for research and practice are discussed.

  8. The cancer caregiving experience of caregivers of Mexican ancestry.

    PubMed

    Juarez, Gloria; Branin, Joan J; Rosales, Monica

    2014-01-01

    The act of providing care may be the same in all ethnic groups, but the way caregiving is defined by family members is influenced by cultural values and beliefs. This study describes the caregiving experience and challenges of caregivers of Mexican ancestry. Qualitative interviews of 20 family caregivers and thematic analysis of transcribed audiotapes identified four themes that characterized their caregiving experience. These themes include an emphasis on family values, a strong commitment to care, difficulties dealing with everyday life realities, and a reliance on spirituality, all of which added to the meaningfulness and burden of caregiving. Further investigation within a cultural context is warranted in the development of interventions and programs to better assist caregivers in coping with the challenges of providing cancer care.

  9. Child, Caregiver, and Family Characteristics Associated with Emergency Department Use by Children Who Remain at Home after a Child Protective Services Investigation

    ERIC Educational Resources Information Center

    Schneiderman, Janet U.; Hurlburt, Michael S.; Leslie, Laurel K.; Zhang, Jinjin; Horwitz, Sarah McCue

    2012-01-01

    Objectives: To examine emergency department (ED) use among children involved with child protective services (CPS) in the US but who remain at home, and to determine if ED use is related to child, caregiver and family characteristics as well as receipt of CPS services. Method: We analyzed data on 4,001 children in the National Survey of Child and…

  10. Transforming a family medicine center and residency program into a federally qualified health center.

    PubMed

    Cousineau, Michael R; Flores, Hector; Cheng, Scott; Gates, Jerry D; Douglas, James H; Clute, Gerald B; Coan, Carl E

    2013-05-01

    The authors describe a family medicine center before and after a merger between the Keck School of Medicine of the University of Southern California, the California Hospital Medical Center, and the Eisner Pediatric and Family Medical Center in 2012. The merger provided new opportunities to stabilize the financial base of a clinical practice struggling financially and to enhance the training of residents and other health professionals in primary care, which motivated the partners to consider this new model. After 18 months of negotiations, they were able to convert the family medicine center and residency program into a new federally qualified health center. The benefits to this new model include an increase in both patient volume and the quality of education, supporting residency accreditation; a greater number of residents from U.S. medical schools; enhanced education and preparation of primary care physicians for practice in medically underserved communities; enhanced reimbursements and new opportunities for state, local, and federal grants; and quality improvement and new information technology. The partners overcame academic, administrative, legal, and regulatory obstacles, communication barriers, and differences in culture and expectations to achieve this merger. Keys to their success include the commitment of the leaders at the three institutions to the goals of the merger, a dedicated project manager and consultants, opportunities for new revenue sources and reimbursements, and support from a pioneering charitable foundation. The authors conclude by discussing the implications of using community health centers as the focal point for training primary care clinicians and addressing workforce shortages.

  11. Can cultural values help explain the positive aspects of caregiving among Chinese American caregivers?

    PubMed

    Tang, Maggie

    2011-01-01

    This study used an adaptation of the caregivers' stress model to examine the positive aspects of caregiving with 113 Chinese American family caregivers who provided care to their elderly relatives. The hierarchical multiple regression analysis indicated that combination of caregiver background characteristics, stressors, and cultural values had direct effects on positive aspects of caregiving. Unlike previous studies in which cultural values were not measured, this study found that cultural values helped explain positive aspects of caregiving. Specifically, cultural values, caregiver's health, and caregiver's age predicted positive aspects of caregiving. Service implications are discussed based upon the findings.

  12. A program for enhancing medical interviewing using video-tape feedback in the family practice residency.

    PubMed

    Cassata, D M; Conroe, R M; Clements, P W

    1977-04-01

    In an effort to enhance the medical interviewing skills of family practice residents in the clinical setting, the Minnesota Communication Program was developed. The Program, which uses video-tape feedback as the primary teaching method, stresses the integration of biological and psychosocial data as well as the establishment of a therapeutic relationship. A description of the Program including goals, teaching strategies, and guidelines for implementing video-tape feedback is presented. The Medical Interview Skills Checklist (MISC) and its use as an assessment tool are described. Results of a survey eliciting residents' responses to the Program and the implications of video-tape feedback for medical education are also discussed.

  13. Living with HIV in West Bengal, India: perceptions of infected children and their caregivers.

    PubMed

    Das, Aritra; Detels, Roger; Javanbakht, Marjan; Panda, Samiran

    2016-09-09

    Children living with HIV (CLH) face several physical and psychological challenges. The impact of the disease is not limited to the affected CLH, but also affects their caregivers and family members. We qualitatively explored the experiences, knowledge, concerns, and perceptions of primary caregivers and triangulated those aspects with those expressed by their CLH. We conducted 34 in-depth interviews (IDI) with primary caregivers of 8- to 15-year-old CLH residing in West Bengal, India. Four focus group discussions (FGD) with CLH were held, two each with children aged 8-12 and 13-15 years. Participants were recruited with the help of a community-based organization providing need-based services to adults and CLH. Five major themes shared by caregivers and children were identified, including concerns about HIV, medications, discriminatory behaviors, having a "healthy mind", and the advantages and limitations of available HIV-related health services. Two primary themes exclusively from IDI with caregivers were caregiving challenges and concerns about the future of their CLH. Indian CLH and their caregivers face many daily challenges, and there are many unmet but relevant expectations. Caregiving goes beyond the child-caregiver dynamic, and is intertwined with the local community and the healthcare and support system structures. The current study underscores the need for comprehensive care programs focusing on improving support to both CLH and caregivers.

  14. Family cohesion moderates the relationship between acculturative stress and depression in Japanese adolescent temporary residents.

    PubMed

    Roley, Michelle E; Kawakami, Ryoko; Baker, Jessica; Hurtado, Gabriela; Chin, Andrew; Hovey, Joseph D

    2014-12-01

    Acculturative stress is a risk factor for depression, and may be important in the risk for depression among acculturating Japanese adolescents. However, little to no research has been published on the mental health of acculturating Japanese adolescents. Further, although family cohesion has been shown to be protective against depression across ethnic groups, no prior research has examined family cohesion as a protective factor for Japanese adolescents. To examine these relationships, 26 Japanese temporary resident adolescents and 76 parents in the Midwest were recruited to participate. Moderate to strong correlations between acculturative stress, depression, likelihood for and seriousness of family conflict were found. A regression analysis found that likelihood for family conflict moderated the relationship between acculturative stress and depression. Findings broaden our understanding of the role of acculturative stress and family conflict on depression risk for Japanese adolescent immigrants.

  15. Quality of life among caregivers of patients with schizophrenia: a cross-cultural comparison of Chilean and French families

    PubMed Central

    2012-01-01

    Background To our knowledge, no study has examined quality of life (QoL) among caregivers of individuals with schizophrenia between a developing and a developed country. The aim of this study was to assess QoL of the caregivers of individuals with schizophrenia in two countries characterized by different social, economic and cultural conditions, namely Chile and France. Methods Data were collected from public mental health outpatient services in Arica (Chile), and in Marseille (France). QoL was measured with the short-form health survey scale - 36 items (SF36). QoL of 41 Chilean caregivers was firstly compared with 245 French caregivers. Univariate and multivariate analyses using linear regression were then performed to determine variables potentially related to QoL scores. Results The caregivers were primarily mothers in the two groups, but Chilean caregivers were younger, and lived more frequently with the individual with schizophrenia than French caregivers. The SF36 scores were globally low in the two groups, especially on the mental QoL scores. Chilean caregivers reported lower physical SF36 scores than French caregivers. In the multivariate analysis, being mother and Chilean caregivers were the most regular features associating to a lower QoL. Conclusion Despite differences between Chile and France, especially in terms of quality and quantity of mental health services and economic supports, caregivers’ QoL levels remain particularly low for both countries. Future support programmes should address the specific needs of caregivers. PMID:22640267

  16. Family routines within the ecological niche: an analysis of the psychological well-being of U.S. caregivers of children with disabilities

    PubMed Central

    Larson, Elizabeth; Miller-Bishoff, Thomas

    2014-01-01

    Using mixed methods, this study examined the relationship of caregivers of children with disabilities’ psychological well-being (PWB) and their orchestration of daily routines within their ecological niche. Thirty-nine U.S. caregivers completed in-depth interviews, PWB Scales, and Family Time and Routines Index (FTRI). We used a multi-step analysis. Interview data was coded and vignettes created without knowledge of PWB and FTRI ratings. Next, the relationship of quantitative measures was analyzed. Four groups were created using FTRI-extent and PWB means: (1) low routine-low PWB, (2) low routine-high PWB, (3) high routine-low PWB, and (4) high routine-high PWB. We examined qualitative differences in key features between groups. Findings: Total PWB and FTRI scores were not significantly correlated, PWB Purpose in Life and FTRI-extent scores were moderately positively correlated, and PWB Environmental Mastery and FTRI-extent correlation approached significance. Qualitative findings describe caregivers’ structuring of routines, intensity of oversight, support in routines, management of dinner, paid work, and needs for respite. The four groups differed in paid work, household support, degree the child could self-occupy, Environmental Mastery, and opportunities to recuperate. Caregivers with higher levels of well-being and more regular routines did paid work, had supportive spouses, had children who more often could follow routines, had higher Environmental Mastery, could orchestrate a family meal, and had breaks from care in either work or leisure. All Native American caregivers and Mexican American caregivers with spouses were in the high routine-high PWB group. Insight into this complex negotiation between family members within daily routines may provide practitioners a better understanding of how to work within family circles to foster therapeutic alliances, identify focused intervention targets, and promote positive family wide outcomes. PMID:24910625

  17. ‘No matter what the cost’: A qualitative study of the financial costs faced by family and whānau caregivers within a palliative care context

    PubMed Central

    Allen, Ruth; Moeke-Maxwell, Tess; Gardiner, Clare; Robinson, Jackie

    2015-01-01

    Background: There has been significant attention paid in recent years to the economic costs of health service provision for people with palliative care needs. However, little is known about the costs incurred by family caregivers who typically provide the bulk of care for people at the end of life. Aim: To explore the nature and range of financial costs incurred by family caregiving within a palliative care context. Design: In-depth qualitative interviews were conducted with 30 family/whānau caregivers who were currently caring for someone with a life-limiting illness or had done so within the preceding year. Narrative analysis was used to identify impacts and costs at the personal, interpersonal, sociocultural and structural levels. Setting: Auckland, New Zealand. Findings: Costs of caregiving were significant and, for participants, resulted in debt or even bankruptcy. A range of direct (transport, food and medication) and indirect costs (related to employment, cultural needs and own health) were reported. A multi-level qualitative analysis revealed how costs operated at a number of levels (personal, interpersonal, sociocultural and structural). The palliative care context increased costs, as meeting needs were prioritised over cost. In addition, support from statutory service providers to access sources of financial support was limited. Conclusion: Families incur significant financial costs when caring for someone at the end of life. Research is now needed to quantify the financial contribution of family and whānau caregiving within a palliative care context, particularly given attempts in many countries to shift more palliative care provision into community settings. PMID:25680378

  18. How do Ontario family medicine residents perform on global health competencies? A multi-institutional survey

    PubMed Central

    Veras, Mirella; Pottie, Kevin; Ramsay, Tim; Welch, Vivian; Tugwell, Peter

    2013-01-01

    Background There is an increased interest in global health among medical students, family medicine residents, and medical educators. This paper is based on research to assess confidence in knowledge and skills in global health in family medicine residents in five universities across Ontario. Methods A web-based survey was sent to 166 first-year family medicine residents from five universities within Ontario. Descriptive statistics were used to analyze residents’ confidence in their knowledge and skills in global health. The strength of association between each of the self-perceived knowledge and skills variables was assessed by the Spearman correlation coefficient Results The response rate ranged from 29% to 66% across the five universities. Self-perceived knowledge scores revealed that 34.3% of the respondents were very confident, 51.9% were somewhat confident, and 13.8% were not at all confident about their global health knowledge. Participants’ confidence scores were lower in relation to knowledge of access to health care for low income nations (44.3%), and were better on their global health skills related to working in a team (70.9%) and listening actively to patients’ concerns (64.6%). Conclusions The global health competency scale has identified key areas of strengths and weaknesses of family medicine programs in global health education. This can be used to evaluate and analyze progress over time. PMID:26451209

  19. A Web-Based Psychosocial Intervention for Family Caregivers of Older People: Results from a Mixed-Methods Study in Three European Countries

    PubMed Central

    Poli, Arianna; Andréasson, Frida; Salzmann, Benjamin; Papa, Roberta; Hanson, Elizabeth; Efthymiou, Areti; Döhner, Hanneli; Lancioni, Cristina; Civerchia, Patrizia; Lamura, Giovanni

    2016-01-01

    Background Informal caregiving is the main source of care for older people in Europe. An enormous amount of responsibility and care activity is on the shoulders of family caregivers, who might experience problems in their psychological well-being and in reconciling caregiving and their personal sphere. In order to alleviate such burden, there is increasing interest and growing research in Europe on Web-based support addressing family caregivers and their needs. However, the level of development and penetration of innovative Web-based services for caregivers is still quite low and the access to traditional face-to-face services can be problematic for logistic, availability, and quality reasons. Objective As part of the European project INNOVAGE, a pilot study was conducted for developing and testing a Web-based psychosocial intervention aimed at empowering family caregivers of older people in Italy, Sweden, and Germany. The program offered information resources and interactive services to enable both professional and peer support. Methods A mixed-methods, sequential explanatory design was adopted. Caregivers’ psychological well-being, perceived negative and positive aspects of caregiving, and social support received were assessed before and after the 3-month intervention. Poststudy, a subsample of users participated in focus groups to assist in the interpretation of the quantitative results. Results A total of 94 out of 118 family caregivers (79.7%) from the three countries used the Web platform at least once. The information resources were used to different extents in each country, with Italian users having the lowest median number of visits (5, interquartile range [IQR] 2-8), whereas German users had the highest number (17, IQR 7-66) (P<.001). The interactive services most frequently accessed (more than 12 times) in all countries were the social network (29/73, 40%) and private messages (27/73, 37%). The pretest-posttest analysis revealed some changes

  20. Results and Lessons Learned from a Nurse Practitioner-Guided Dementia Care Intervention for Primary Care Patients and Their Family Caregivers

    PubMed Central

    Fortinsky, Richard H.; Delaney, Colleen; Harel, Ofer; Pasquale, Karen; Schjavland, Elena; Lynch, John; Kleppinger, Alison; Crumb, Suzanne

    2014-01-01

    Older adults with dementia care needs often visit primary care physicians (PCPs), but PCP dementia care limitations are widely documented. This study tested the value of employing a nurse practitioner (NP) with geropsychiatric expertise to augment PCP care for newly and recently diagnosed patients and family caregivers. Twenty-one dyads received the NP intervention; 10 dyads were controls. Outcomes included patient neuropsychiatric symptom and quality of life changes, and caregiver depression, burden, and self-efficacy changes. Intervention acceptability by patients, caregivers, and PCPs was determined. No outcome differences were found; however, the NP intervention was deemed highly satisfactory by all stakeholders. Patients experienced no significant cognitive decline during their 12-month study period, helping explain why outcomes did not change. Given widespread acceptability, future tests of this PCP-enhancing intervention should include patients with more progressive cognitive decline at study entry. NPs with geropsychiatric expertise are ideal interventionists for this rapidly growing target population. PMID:24444453

  1. Perspectives of patients, family caregivers and physicians about the use of opioids for refractory dyspnea in advanced chronic obstructive pulmonary disease

    PubMed Central

    Rocker, Graeme; Young, Joanne; Donahue, Margaret; Farquhar, Morag; Simpson, Catherine

    2012-01-01

    Background: A recent national practice guideline recommends the use of opioids for the treatment of refractory dyspnea in patients with advanced chronic obstructive pulmonary disease (COPD). We conducted two qualitative studies to explore the experiences of patients and family caregivers with opioids for refractory COPD-related dyspnea and the perspectives and attitudes of physicians toward opioids in this context. Methods: Patients (n = 8; 5 men, 3 women), their caregivers (n = 12; 5 men, 7 women) and physicians (n = 28, 17 men, 11 women) in Nova Scotia participated in the studies. Semistructured interviews were recorded, transcribed verbatim, coded conceptually and analyzed for emergent themes using interpretive description methodology. Results: Patients reported that opioids provided a sense of calm and relief from severe dyspnea. Family caregivers felt that opioids helped patients to breathe more “normally,” observed improvements in patients’ symptoms of anxiety and depression, and experienced reductions in their own stress. Patients reported substantial improvements in their quality of life. All patients and family caregivers wanted opioid therapy to continue. Most physicians were reluctant to prescribe opioids for refractory dyspnea, describing a lack of related knowledge and experience, and fears related to the potential adverse effects and legal censure. Interpretation: Discrepancies between the positive experiences of patients and family caregivers with opioids and the reluctance of physicians to prescribe opioids for refractory dyspnea constitute an important gap in care. Bridging this gap will require initiatives to improve the uptake of practice guidelines and to increase confidence in prescribing opioids for dyspnea refractory to conventional treatment. PMID:22529167

  2. Validity and reliability of the persian version of templer death anxiety scale in family caregivers of cancer patients

    PubMed Central

    Soleimani, Mohammad Ali; Bahrami, Nasim; Yaghoobzadeh, Ameneh; Banihashemi, Hedieh; Nia, Hamid Sharif; Haghdoost, Ali Akbar

    2016-01-01

    Background: Due to increasing recognition of the importance of death anxiety for understanding human nature, it is important that researchers who investigate death anxiety have reliable and valid methodology to measure. The purpose of this study was to evaluate the validity and reliability of the Persian version of Templer Death Anxiety Scale (TDAS) in family caregivers of cancer patients. Materials and Methods: A sample of 326 caregivers of cancer patients completed a 15-item questionnaire. Principal components analysis (PCA) followed by a varimax rotation was used to assess factor structure of the DAS. The construct validity of the scale was assessed using exploratory and confirmatory factor analyses. Convergent and discriminant validity were also examined. Reliability was assessed with Cronbach's alpha coefficients and construction reliability. Results: Based on the results of the PCA and consideration of the meaning of our items, a three-factor solution, explaining 60.38% of the variance, was identified. A confirmatory factor analysis (CFA) then supported the adequacy of the three-domain structure of the DAS. Goodness-of-fit indices showed an acceptable fit overall with the full model {χ2(df) = 262.32 (61), χ2/df = 2.04 [adjusted goodness of fit index (AGFI) = 0.922, parsimonious comparative fit index (PCFI) = 0.703, normed fit Index (NFI) = 0.912, CMIN/DF = 2.048, root mean square error of approximation (RMSEA) = 0.055]}. Convergent and discriminant validity were shown with construct fulfilled. The Cronbach's alpha and construct reliability were greater than 0.70. Conclusions: The findings show that the Persian version of the TDAS has a three-factor structure and acceptable validity and reliability. PMID:27186206

  3. The Quality of Life of Family Caregivers of Adults with Intellectual Disabilities in Taiwan

    ERIC Educational Resources Information Center

    Chou, Yueh-Ching; Lin, Li-Chan; Chang, Ai-Ling; Schalock, Robert L.

    2007-01-01

    Background: Taiwanese family carers of people with intellectual disabilities not only suffer from long-term stress but also need to cope with social difficulties. The aim of this study is to evaluate the quality of life (QOL) among family carers of people with intellectual disabilities. Materials and methods: A census interview survey was…

  4. Impediments to Family Supports to Dependent Elderly: An Analysis of the Primary Caregivers.

    ERIC Educational Resources Information Center

    Johnson, Colleen L.

    Although studies of social contact and mutual aid between the elderly and their children suggest impressive potentials for family supports, much less is known of this potential in a situation of illness and dependency. The family's potential at that stage when the older person's health deteriorates to the point that some external support is…

  5. The impact of individual Cognitive Stimulation Therapy (iCST) on cognition, quality of life, caregiver health, and family relationships in dementia: A randomised controlled trial

    PubMed Central

    Leung, Phuong; Whitaker, Chris; Burns, Alistair; Knapp, Martin; Leroi, Iracema; Spector, Aimee; Roberts, Steven; de Waal, Hugo; Orgeta, Vasiliki

    2017-01-01

    Background Cognitive stimulation therapy (CST) is a well-established group psychosocial intervention for people with dementia. There is evidence that home-based programmes of cognitive stimulation delivered by family caregivers may benefit both the person and the caregiver. However, no previous studies have evaluated caregiver-delivered CST. This study aimed to evaluate the effectiveness of a home-based, caregiver-led individual cognitive stimulation therapy (iCST) program in (i) improving cognition and quality of life (QoL) for the person with dementia and (ii) mental and physical health (well-being) for the caregiver. Methods and findings A single-blind, pragmatic randomised controlled trial (RCT) was conducted at eight study sites across the United Kingdom. The intervention and blinded assessment of outcomes were conducted in participants’ homes. Three hundred fifty-six people with mild to moderate dementia and their caregivers were recruited from memory services and community mental health teams (CMHTs). Participants were randomly assigned to iCST (75, 30-min sessions) or treatment as usual (TAU) control over 25 wk. iCST sessions consisted of themed activities designed to be mentally stimulating and enjoyable. Caregivers delivering iCST received training and support from an unblind researcher. Primary outcomes were cognition (Alzheimer’s Disease Assessment Scale–cognitive [ADAS-Cog]) and self-reported QoL (Quality of Life Alzheimer’s Disease [QoL-AD]) for the person with dementia and general health status (Short Form-12 health survey [SF-12]) for the caregiver. Secondary outcomes included quality of the caregiving relationship from the perspectives of the person and of the caregiver (Quality of the Carer Patient Relationship Scale) and health-related QoL (European Quality of Life–5 Dimensions [EQ-5D]) for the caregiver. Intention to treat (ITT) analyses were conducted. At the post-test (26 wk), there were no differences between the iCST and TAU groups

  6. Effectiveness of a Fotonovela for Reducing Depression and Stress in Latino Dementia Family Caregivers

    PubMed Central

    Gallagher-Thompson, Dolores; Tzuang, Marian; Hinton, Ladson; Alvarez, Paula; Rengifo, Johanna; Valverde, Irene; Chen, Nancy; Emrani, Tara; Thompson, Larry W.

    2014-01-01

    The clinical need to address stress and depression in Latino dementia caregivers (CGs) combined with low health literacy and less accurate knowledge of dementia motivated the development of a pictorial tool (called a fotonovela {FN}) to teach a) coping skills for CG stress, b) self -assessment of depression, and c) encourage improved utilization of available resources. To test the effectiveness of the FN, 110 of 147 Latino CGs, who were randomly assigned to the Fotonovela Condition (FNC) or the Usual Information Condition (UIC), were included in the final analyses. Self-report measures were given at baseline and post intervention. Results showed that FNC CGs demonstrated significantly greater reductions in level of depressive symptoms than UIC CGs. A significant decrease in level of stress due to memory and behavioral problems exhibited by their loved ones was similar in both groups. The FNC CGs reported that the FN was more helpful and that they referred to it more often than the UIC CGs did with regard to the informational materials they were provided about dementia. In conclusion, a culturally tailored FN can be an effective tool for Latino CGs given their high unmet needs for assistance and various barriers in accessing resources. PMID:25590939

  7. Utility of the Life Course Perspective in Research With Mexican American Caregivers of Older Adults

    PubMed Central

    Evans, Bronwynne C.; Crogan, Neva; FNGNA; Belyea, Michael; Coon, David

    2013-01-01

    Research on caregiving of elders in Mexican American families is urgently needed. We know little about family caregivers, family transitions in relation to the caregiving role, reciprocal impact of caregivers and care recipients on one another, adaptive strategies, positive benefits of caregiving (caregiver gain), specific caregiving burdens, or supportive interventions for family caregiving. Theory derivation using the concepts and structure of life course perspective provides a way to fill the knowledge gaps concerning Mexican American caregiving families, taking into account their ethnic status as an important Hispanic subgroup and the unique cultural and contextual factors that mark their caregiving experiences. PMID:18845694

  8. Agricultural and residential pesticides in wipe samples from farmworker family residences in North Carolina and Virginia.

    PubMed Central

    Quandt, Sara A; Arcury, Thomas A; Rao, Pamela; Snively, Beverly M; Camann, David E; Doran, Alicia M; Yau, Alice Y; Hoppin, Jane A; Jackson, David S

    2004-01-01

    Children of farmworkers can be exposed to pesticides through multiple pathways, including agricultural take-home and drift as well as residential applications. Because farmworker families often live in poor-quality housing, the exposure from residential pesticide use may be substantial. We measured eight locally reported agricultural pesticides and 13 pesticides commonly found in U.S. houses in residences of 41 farmworker families with at least one child < 7 years of age in western North Carolina and Virginia. Wipe samples were taken from floor surfaces, toys, and children's hands. We also collected interview data on possible predictors of pesticide presence, including characteristics of the household residents, cleaning practices, and characteristics of the home. All families were Spanish-speaking, primarily from Mexico. Results indicate that six agricultural and 11 residential pesticides were found in the homes, with agricultural, residential, or both present in 95% of homes sampled. In general, residential pesticides were more commonly found. Presence of both types of pesticides on the floor was positively associated with detection on toys or hands. Agricultural pesticide detection was associated with housing adjacent to agricultural fields. Residential pesticide detection was associated with houses judged difficult to clean. Although the likelihood of agricultural pesticide exposure has been considered high for farmworker families, these results indicate that residential pesticide use and exposure in this population merit further study. PMID:14998757

  9. Meeting the Challenge of Practice Quality Improvement: A Study of Seven Family Medicine Residency Training Practices

    PubMed Central

    Chase, Sabrina M.; Miller, William L.; Shaw, Eric; Looney, Anna; Crabtree, Benjamin F.

    2011-01-01

    Purpose Incorporating quality improvement (QI) into resident education and clinical care is challenging. This report explores key characteristics shaping the relative success or failure of QI efforts in seven primary care practices serving as family medicine residency training sites. Method The authors used data from the 2002–2008 Using Learning Teams for Reflective Adaptation (ULTRA) study to conduct a comparative case analysis. This secondary data analysis focused on seven residency training practices' experiences with RAP (reflective adaptive process), a 12-week intensive QI process. Field notes, meeting notes, and audiotapes of RAP meetings were used to construct case summaries. A matrix comparing key themes across practices was used to rate practices' QI progress during RAP on a scale of 0 to 3. Results Three practices emerged as unsuccessful (scores of 0–1) and four as successful (scores of 2–3). Larger practices with previous QI experience, faculty with extensive exposure to QI literature, and an office manager, residency director, or medical director who advocated for the process made substantial progress during RAP, succeeding at QI. Smaller practices without these characteristics were unable to do so. Successful practices also engaged residents in the QI process and identified serious problems as potential crises; unsuccessful practices did not. Conclusions Larger residency training practices are more likely to have the resources and characteristics that permit them to create a QI-supportive culture leading to QI success. The authors suggest, however, that smaller practices may increase their chances of success by adopting a developmental approach to QI. PMID:22030767

  10. A Randomized Trial of a CAM Therapy for Stress Reduction in American Indian and Alaskan Native Family Caregivers

    ERIC Educational Resources Information Center

    Korn, Leslie; Logsdon, Rebecca G.; Polissar, Nayak L.; Gomez-Beloz, Alfredo; Waters, Tiffany; Ryser, Rudolph

    2009-01-01

    Purpose: Although it is widely recognized that caregivers of individuals with dementia experience elevated stress that places them at increased risk for health problems, little is known about how caregiving stress may be alleviated among underserved ethnic minority populations. The purpose of this study was to compare a complementary and…

  11. The Link between Professional Caregiving and Childrens Rights in the Family Day Care Program.

    ERIC Educational Resources Information Center

    Clyde, Margaret

    The growth of family day care is assessed from a personal viewpoint. Observations on trends since the United Nations Declaration of the Rights of the Child and the International Year of the Child are offered. A review of historical, moral, and legal perspectives on children's rights covers views on childhood during the middle ages and into the…

  12. Support for Alzheimer's Caregivers: Psychometric Evaluation of Familial and Friend Support Measures

    ERIC Educational Resources Information Center

    Wilks, Scott E.

    2009-01-01

    Objective: Information on the shortened, 20-item version of the Perceived Social Support Scale (S-PSSS) is scarce. The purpose of this study is to evaluate the psychometric properties of the S-PSSS Family (SSfa) and Friends (SSfr) subscales. Method: Because of their common coping method of social support, a cross-sectional sample of Alzheimer's…

  13. 3 CFR 8748 - Proclamation 8748 of November 1, 2011. National Family Caregivers Month, 2011

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... friends provide care and support for their loved ones during times of need. With profound compassion and... Class Task Force has focused on the importance or investing in respite care, counseling, and training... obligation by extending additional assistance to family members who care for severely wounded veterans...

  14. Quality of Life of Nursing Home Residents with Dementia: A Comparison of Perspectives of Residents, Family, and Staff

    ERIC Educational Resources Information Center

    Crespo, Maria; Bernaldo de Quiros, Monica; Gomez, M. Mar; Hornillos, Carlos

    2012-01-01

    Purpose: Quality of Life (QoL) has become increasingly valued as a key outcome in dementia both in clinical practice and in research. This study compares the QoL of long-term residents with dementia as assessed by the individuals, their relatives, and their care staff. Design and Methods: Data on residents with dementia were collected in 11…

  15. Solar project description. Houston Construction Company single family residence, Eden Prairie, Minnesota March 19, 1982

    NASA Astrophysics Data System (ADS)

    The Houston Construction Company solar energy system is designed to provide 62 percent of the space heating and domestic hot water energy requirements for a single-family detached residence containing 1796 square feet. The residence is in Eden Prairie, MN. Energy collection is accomplished by 468 square feet of Solaron flat-plate collectors which face south at an angle of 60 degrees from the horizontal. air is the medium for transfer of solar energy from the collectors to either the conditioned space or storage. Storage is a 314 cubic foot bin containing approximately 24,000 lbs of crushed rock located in a utility room. when solar energy is inadequate to satisfy the requirements of the space heating subsystem, auxiliary thermal energy is supplied from an 80,000 Btu per hour natural gas furnace. Domestic hot water is provided by a 30,000 Btu per hour natural gas water heater if the solar contribution is insufficient.

  16. Re-examining the relationships among dementia, stigma, and aging in immigrant Chinese and Vietnamese family caregivers

    PubMed Central

    Liu, Dandan; Hinton, Ladson; Tran, Cindy; Hinton, Devon; Barker, Judith C.

    2010-01-01

    Prior literature emphasizes that Asian Americans with dementia may be particularly vulnerable to the stigma of chronic mental illness. However, there is a dearth of empirical research to support this claim. This study examines the relationship of stigma and dementia in 32 qualitative interviews with Chinese and Vietnamese family caregivers. Stigma was a common theme in the interviews (91%). Further analysis of stigma revealed two sources: chronic mental illness stigma and stigma reflecting negative stereotypes of aging or the aged. Chinese and Vietnamese cultural views of normal aging are not a unitary category but accommodate different trajectories of aging, some more and some less desired. When applied to persons with dementia, a “normalized” but negative trajectory of aging carried with it significant stigma that was distinct from but in addition to the stigma of chronic and severe mental illness. Older Chinese and Vietnamese with dementia are thus at risk of experiencing multiple stigmas that include but go beyond the stigma associated with chronic and severe mental illness. PMID:18665444

  17. The Dangers of Involving Children as Family Caregivers of Palliative Home-Based-Care to Advanced HIV/AIDS Patients

    PubMed Central

    Kangethe, Simon

    2010-01-01

    The aim of this research paper is to explore the dangers of involving children as family caregivers of palliative care and home-based-care to advanced HIV/AIDS patients, while its objective is to discuss the dangers or perfidiousness that minors especially the girl children face as they handle care giving of advanced HIV/AIDS patients. The article has relied on eclectic data sources. The research has foundminors disadvantaged by the following: being engulfed by fear and denied rights through care giving; being emotionally and physiologically overwhelmed; being oppressed and suppressed by caring duties; being at risk of contracting HIV/AIDS; and having their education compromised by care giving. The paper recommends: (1) strengthening and emphasizing on children’s rights; (2) maintaining gender balance in care giving; (3) implementation and domestication of the United Nations conventions on the rights of children; (4) community awareness on equal gender co participation in care giving; (5) and fostering realization that relying on child care giving is a negative score in fulfilling global Millennium Development Goals. PMID:21218000

  18. Community Reaction to Older-age Parental AIDS Caregivers and their Families

    PubMed Central

    Knodel, John; Williams, Nathalie; Kim, Sovan Kiry; Puch, Sina; Saengtienchai, Chanpen

    2009-01-01

    Accounts of community reaction to persons with HIV/AIDS and their families typically focus only on negative reactions stemming from stigmatization with little acknowledgement of variation over time and across settings. To usefully guide local interventions, a broader view is needed that also encompasses attitudes and actions stemming from sympathy and friendship. We examine community reaction in Cambodia to families from the perspective of parents of adults who died of AIDS or currently receive antiretroviral therapy. Survey evidence and open-ended interviews reveal a mixture of reactions with respect to social relations, interactions with local officials, gossip, business patronage, funeral participation, and orphaned grandchildren. Positive support is often dominant and reactions typically improve substantially over time. Misplaced fears of contagion through casual contact underlie most negative reactions. Moral condemnation or blame is not evident as a source of negative reactions. Overall a sufficiently supportive atmosphere likely exists in many localities to facilitate community based efforts to mitigate the epidemic’s impact on affected families. PMID:20161630

  19. Multi-source evaluation of interpersonal and communication skills of family medicine residents.

    PubMed

    Leung, Kai-Kuen; Wang, Wei-Dan; Chen, Yen-Yuan

    2012-12-01

    There is a lack of information on the use of multi-source evaluation to assess trainees' interpersonal and communication skills in Oriental settings. This study is conducted to assess the reliability and applicability of assessing the interpersonal and communication skills of family medicine residents by patients, peer residents, nurses, and teaching staffs and to compare the ratings with the objective structured clinical examination (OSCE). Our results revealed instruments used by staffs, peers, nurses, and self-evaluation have good internal consistency reliability (α > 0.90), except for the behavioral checklist (α = 0.57). Staffs', peers', and nurses' evaluations were highly correlated with one another (r = 0.722 for staff- and peer-rating, r = 0.734 for staff- and nurse-rating, r = 0.634 for peer- and nurse-rating). However, residents' self-rating and patients-rating were not correlated to ratings by any other raters. OSCE evaluation was correlated to peer-rating (r = 0.533) and staff-rating (r = 0.642), but not correlated to self- or patient-rating. The generalizability study revealed the major sources of variance came from the types of rater and the interaction of residents and types of rater. This study found self-rating and patient-rating were not consistent with other sources of rating on residents' interpersonal and communication skills. Whether variations among different types of rater in a multi-source evaluation should be regarded as measurement errors or complementary information is worth further study.

  20. Effects of Rational-Emotive Hospice Care Therapy on Problematic Assumptions, Death Anxiety, and Psychological Distress in a Sample of Cancer Patients and Their Family Caregivers in Nigeria

    PubMed Central

    Onyechi, Kay Chinonyelum Nwamaka; Onuigbo, Liziana N.; Eseadi, Chiedu; Ikechukwu-Ilomuanya, Amaka B.; Nwaubani, Okechukwu Onyinye; Umoke, Prince C.I.; Agu, Fedinand U.; Otu, Mkpoikanke Sunday; Utoh-Ofong, Anthonia N.

    2016-01-01

    This study was a preliminary investigation that aimed to examine the effects of rational emotive hospice care therapy (REHCT) on problematic assumptions, death anxiety, and psychological distress in a sample of cancer patients and their family caregivers in Nigeria. The study adopted a pre-posttest randomized control group design. Participants were community-dwelling cancer patients (n = 32) and their family caregivers (n = 52). The treatment process consisted of 10 weeks of full intervention and 4 weeks of follow-up meetings that marked the end of intervention. The study used repeated-measures analysis of variance for data analysis. The findings revealed significant effects of a REHCT intervention program on problematic assumptions, death anxiety, and psychological distress reduction among the cancer patients and their family caregivers at the end of the intervention. The improvements were also maintained at follow-up meetings in the treatment group compared with the control group who received the usual care and conventional counseling. The researchers have been able to show that REHCT intervention is more effective than a control therapy for cancer patients’ care, education, and counseling in the Nigerian context. PMID:27657099

  1. The influence of caregiving stressors, social support, and caregiving appraisal on marital functioning among African American wife caregivers.

    PubMed

    Chadiha, Letha A; Rafferty, Jane; Pickard, Joseph

    2003-10-01

    Using a stress and coping framework, we examined the influence of caregiving stressors, social support, and caregiving appraisal on the marital functioning of 100 African American wife caregivers. Results of separate multivariate analyses revealed received church support, caregiving burden, and caregiving satisfaction significantly predicted wives' marital functioning, when caregivers' background characteristics (age and education), length of caregiving, whether first marriage, and urban versus rural location were controlled. Receiving church support was associated with increased marital functioning. Lower levels of caregiving burden were associated with increased marital functioning. Higher levels of caregiving satisfaction were associated with increased marital functioning. Findings illuminate wives' caregiving and marital experiences, and have implications for family therapy and future research.

  2. Disruptions in the Organization of Meal Preparation and Consumption Among Older Cancer Patients and Their Family Caregivers

    PubMed Central

    Locher, Julie L.; Robinson, Caroline O.; Bailey, F. Amos; Carroll, William R.; Heimburger, Douglas C.; Saif, M. Wasif; Tajeu, Gabriel; Ritchie, Christine S.

    2009-01-01

    Objectives The purpose of this paper is to analyze the social organization of caring as gendered work as it relates to meal preparation and consumption activities surrounding older adult cancer patients and their caregivers. Methods Qualitative methods consisting of in-depth, semi-structured, face-to-face interviews with 30 older cancer patients (17 women and 13 men aged 70 to 90) and their caregivers were conducted separately. Participants were diagnosed with pancreatic, colon, breast, lymphoma, skin, and head and neck cancer. Results Major findings were that both patients and caregivers experienced distress surrounding food preparation and mealtime activities, and these varied according to the gender of both patients and caregivers and the relationship that existed between patients and caregivers. Of particular note, female patients experienced distress over not being able to fully participate in meal planning and cooking activities that were central to their self-identity. Related to this, male spouses experienced frustration over not being able to engage in cooking activities that met their wives’ expectations. Female caregivers expressed tremendous discontent that the one they were caring for did not eat like they “should.” Discussion Matters related to the organization of meals and food consumption activities may be a source of significant distress for patients and caregivers. Further research and greater attention from health care providers are warranted to evaluate the extent of such distress. PMID:19950254

  3. Recovery and outcomes after the acute respiratory distress syndrome (ARDS) in patients and their family caregivers.

    PubMed

    Herridge, Margaret S; Moss, Marc; Hough, Catherine L; Hopkins, Ramona O; Rice, Todd W; Bienvenu, O Joseph; Azoulay, Elie

    2016-05-01

    Outcomes after acute respiratory distress syndrome (ARDS) are similar to those of other survivors of critical illness and largely affect the nerve, muscle, and central nervous system but also include a constellation of varied physical devastations ranging from contractures and frozen joints to tooth loss and cosmesis. Compromised quality of life is related to a spectrum of impairment of physical, social, emotional, and neurocognitive function and to a much lesser extent discrete pulmonary disability. Intensive care unit-acquired weakness (ICUAW) is ubiquitous and includes contributions from both critical illness polyneuropathy and myopathy, and recovery from these lesions may be incomplete at 5 years after ICU discharge. Cognitive impairment in ARDS survivors ranges from 70 to 100 % at hospital discharge, 46 to 80 % at 1 year, and 20 % at 5 years, and mood disorders including depression and post-traumatic stress disorder (PTSD) are also sustained and prevalent. Robust multidisciplinary and longitudinal interventions that improve these outcomes are still uncertain and data in our literature are conflicting. Studies are needed in family members of ARDS survivors to better understand long-term outcomes of the post-ICU family syndrome and to evaluate how it affects patient recovery.

  4. Associations Between Family Ratings on Experience With Care and Clinical Quality-of-Care Measures for Nursing Home Residents.

    PubMed

    Li, Yue; Li, Qinghua; Tang, Yi

    2016-02-01

    Several states are currently collecting and publicly reporting nursing home resident and/or family member ratings of experience with care in an attempt to improve person-centered care in nursing homes. Using the 2008 Maryland nursing home family survey reports and other data, this study performed both facility- and resident-level analyses, and estimated the relationships between family ratings of care and several long-term care quality measures (pressure ulcers, overall and potentially avoidable hospitalizations, and mortality) after adjustment for resident characteristics. We found that better family evaluations of overall and specific aspects of care may be associated with reduced rates of risk-adjusted measures at the facility level (range of correlation coefficients: -.01 to -.31). Associations of overall experience ratings tended to persist after further adjustment for common nursing home characteristics such as nurse staffing levels. We conclude that family ratings of nursing home care complement other types of performance measures such as risk-adjusted outcomes.

  5. Cancer Caregivers Information Needs and Resource Preferences

    PubMed Central

    Longacre, Margaret L.

    2013-01-01

    This study sought to characterize the need for information about personal psychosocial care, providing direct care, and managing care among cancer caregivers, and explore preferred resources for caregiving information. Methods Data comes from cross-sectional telephone interviews of 1,247 family caregivers, which included 104 cancer caregivers. Results A majority of cancer caregivers expressed one or more information need for each of the three content categories. Four out of ten caregivers expressed needing information about managing physical and emotional stress. A significantly higher percentage of male caregivers reported needing more information pertinent to providing direct care than females. Heightened objective burden was significantly associated with caregivers preferring to receive information from health professionals than informal sources (e.g., Internet), while the opposite was found among caregivers with lower objective burden. Conclusion These findings suggest that specific types of information and resources may be most relevant to specific subgroups of cancer caregivers. PMID:23553000

  6. Quantifying riverine and storm-surge flood risk by single-family residence: application to Texas.

    PubMed

    Czajkowski, Jeffrey; Kunreuther, Howard; Michel-Kerjan, Erwann

    2013-12-01

    The development of catastrophe models in recent years allows for assessment of the flood hazard much more effectively than when the federally run National Flood Insurance Program (NFIP) was created in 1968. We propose and then demonstrate a methodological approach to determine pure premiums based on the entire distribution of possible flood events. We apply hazard, exposure, and vulnerability analyses to a sample of 300,000 single-family residences in two counties in Texas (Travis and Galveston) using state-of-the-art flood catastrophe models. Even in zones of similar flood risk classification by FEMA there is substantial variation in exposure between coastal and inland flood risk. For instance, homes in the designated moderate-risk X500/B zones in Galveston are exposed to a flood risk on average 2.5 times greater than residences in X500/B zones in Travis. The results also show very similar average annual loss (corrected for exposure) for a number of residences despite their being in different FEMA flood zones. We also find significant storm-surge exposure outside of the FEMA designated storm-surge risk zones. Taken together these findings highlight the importance of a microanalysis of flood exposure. The process of aggregating risk at a flood zone level-as currently undertaken by FEMA-provides a false sense of uniformity. As our analysis indicates, the technology to delineate the flood risks exists today.

  7. Caregiver Well-Being

    PubMed Central

    Dujela, Carren; Smith, André

    2015-01-01

    We know much about caregiving women compared with caregiving men and caregiving spouses compared with caregiving adult children. We know less about the intersections of relationship and gender. This article explores this intersection through the well-being (burden and self-esteem) of caregivers to family members with dementia. Throughout British Columbia, Canada, 873 caregivers were interviewed in person for on average, over 1½ hours. The results reveal that daughters experience the highest burden but also the highest self-esteem, suggesting the role is less salient for their self-identities. Wives emerge as the most vulnerable of the four groups when both burden and self-esteem are considered. The data confirm the usefulness of the intersectionality framework for understanding co-occupancy of more than one status and indicate that positive cognitive well-being and negative affective well-being can be differentially related. Multivariate analyses confirm the importance of caregiver, not patient, characteristics for burden and self-esteem. PMID:25651586

  8. Sleep Loss and Its Effects on Health of Family Caregivers of Individuals with Primary Malignant Brain Tumors

    PubMed Central

    Lee, Shih-Yu; Clark, Patricia C.; Sherwood, Paula R.

    2013-01-01

    Sleep loss places caregivers at risk for poor health. Understanding correlates of sleep loss and relationships to health may enable improvement of health of caregivers of individuals with primary malignant brain tumors (PMBT). In this cross-sectional, descriptive study of 133 caregivers, relationships were examined between sleep loss and physical, mental, emotional, and social health at time of patient diagnosis. Sleep loss was not related to physical health. Shorter total sleep time was associated with greater fatigue and social support. Sleep quality was positively associated with quality of life. Further study is needed of the role of sleep loss in the PMBT caregiving trajectory and its long-term relationship with health outcomes. PMID:23633116

  9. Evaluation of the educational environment of the Saudi family medicine residency training program

    PubMed Central

    Khoja, Abdullah T.

    2015-01-01

    Objectives: The study was conducted to evaluate the educational environment (EE) in Family Medicine Training Programs. Materials and Methods: A cross-sectional survey, The Postgraduate Hospital Educational Environment Measure (PHEEM), was distributed to all residents at the four training centers in the central region. Cronbach's alpha was used to test the reliability. The mean and standard deviation (SD) for each item, the overall score and the three domains were calculated. A multiple linear regression model was developed with PHEEM scores as an outcome. The Mann–Whitney–Wilcoxon test was used to compare each item based on the selected factors. Results: The overall score was 67.1/160 (SD: 20.1). The PHEEM's domains scores: 24.2/56 (SD: 7.13) for perception of role autonomy; 25.3/60 (SD: 8.88), for perception of teaching; and 17/44 (SD: 5.6), for perception of social support. Training center and Level of training were the significant outcome predictors. Centre 1 (Joint Program) significantly had better scores than Centre 2. The instrument showed great reliability with a Cronbach's alpha of 0.92. Conclusions: There are many problems in the training program. Urgent actions are needed to improve the residents' learning experience particularly during rotations. Also, the curriculum should be restructured, and effective training methods introduced using the Best Evidence in Medical Education to meet the expectations and learning needs of family physicians. PMID:25657612

  10. VA Health Care: Actions Needed to Address Higher-Than-Expected Demand for the Family Caregiver Program

    DTIC Science & Technology

    2014-09-01

    we contacted pointed out that their catchment area covers 147,000 square miles, and some of their caregivers live over 8 hours away, requiring...geographical area . A caregiver whose veteran is rated tier 2 receives the equivalent of 25 hours per week of the wage for a home health aide, and a...location we contacted told us that home visits to remote areas require long driving times, which are challenging to accommodate. Staff at one VAMC

  11. Carbon isotopes in otolith amino acids identify residency of juvenile snapper (Family: Lutjanidae) in coastal nurseries

    NASA Astrophysics Data System (ADS)

    McMahon, K. W.; Berumen, M. L.; Mateo, I.; Elsdon, T. S.; Thorrold, S. R.

    2011-12-01

    This study explored the potential for otolith geochemistry in snapper (Family: Lutjanidae) to identify residency in juvenile nursery habitats with distinctive carbon isotope values. Conventional bulk otolith and muscle stable isotope analyses (SIA) and essential amino acid (AA) SIA were conducted on snapper collected from seagrass beds, mangroves, and coral reefs in the Red Sea, Caribbean Sea, and Pacific coast of Panama. While bulk stable isotope values in otoliths showed regional differences, they failed to distinguish nursery residence on local scales. Essential AA δ13C values in otoliths, on the other hand, varied as a function of habitat type and provided a better tracer of residence in different juvenile nursery habitats than conventional bulk otolith SIA alone. A strong linear relationship was found between paired otolith and muscle essential AA δ13C values regardless of species, geographic region, or habitat type, indicating that otolith AAs recorded the same dietary information as muscle AAs. Juvenile snapper in the Red Sea sheltered in mangroves but fed in seagrass beds, while snapper from the Caribbean Sea and Pacific coast of Panama showed greater reliance on mangrove-derived carbon. Furthermore, compound-specific SIA revealed that microbially recycled detrital carbon, not water-column-based new phytoplankton carbon, was the primary carbon source supporting snapper production on coastal reefs of the Red Sea. This study presented robust tracers of juvenile nursery residence that will be crucial for reconstructing ontogenetic migration patterns of fishes among coastal wetlands and coral reefs. This information is key to determining the importance of nursery habitats to coral reef fish populations and will provide valuable scientific support for the design of networked marine-protected areas.

  12. Disorders of consciousness and disordered care: families, caregivers, and narratives of necessity.

    PubMed

    Fins, Joseph J

    2013-10-01

    By their nature, care decisions for patients with severe disorders of consciousness must involve surrogates. Patients, so impaired, have lost their decision-making capacity and the ability to direct their own care. Surrogates-family members, friends, or other intimates-must step in and make decisions about ongoing care or its withdrawal. This article shares the narrative experiences of these surrogate decision makers as they encounter the American health care system and accompany patients from injury through rehabilitation. Through their perspectives, the article considers challenges to ongoing care and rehabilitation that are a function of a prevailing medical infrastructure and reimbursement framework better suited to patients with acute care needs. Specific attention is paid to the ethical challenges posed by reimbursement strategies such as "medical necessity" as well as those proposed for the Affordable Care Act. The argument concludes that when it comes to care for a disorder related to consciousness, its provision is not discretionary, and its receipt is not an entitlement but a civil right.

  13. The American Indian Family in Los Angeles: A Comparison of Premigration Experience, Postmigration Residence and Employment Mobility, and Coping Strategies.

    ERIC Educational Resources Information Center

    Weibel, Joan

    Urban adaptation patterns of male and female American Indians were investigated via comparison of premigration statistics (48 Navajo and 40 Oklahoma families) with postmigration statistics on a sample of 23 Navajo and 21 Oklahoma families now living in Los Angeles. The premigration variables were residence patterns; population density;…

  14. The experiences and needs of Chinese-Canadian stroke survivors and family caregivers as they re-integrate into the community.

    PubMed

    Yeung, Emily H L; Szeto, Amy; Richardson, Denyse; Lai, Suk-han; Lim, Eva; Cameron, Jill I

    2015-09-01

    Stroke is a leading cause of adult disability and community re-integration is a priority for stroke rehabilitation. In North America, we have a growing population of individuals whose first language is not English. Little is known about the experiences of visible minorities living in North America as they re-integrate into the community post stroke or how these experiences change over time. Specifically, this research aimed to explore the experiences and needs of Chinese stroke survivors and family caregivers as they return to community living using the Timing it Right Framework as a conceptual guide. We recruited Cantonese-speaking stroke survivors and family caregivers from outpatient rehabilitation programmes. Using qualitative interviews conducted in Cantonese or English, we examined their experiences and needs as they return to community living and explored the influence of culture and time on their experiences. The interviews were transcribed and translated, and then analysed using framework analysis. Using framework analysis, we coded the data corresponding to the phases of the Timing it Right framework to determine the influence of time on the themes. We interviewed five Cantonese-speaking stroke survivors and 13 caregivers in 2009. We identified two main themes: (i) Participants' education and support needs change over time and (ii) Chinese resources are needed across care environments. These resources include access to care in their preferred language, traditional Chinese medicine, and Chinese food during their recovery and rehabilitation. To optimise Chinese stroke survivors' and caregivers' community re-integration, healthcare professionals should provide timely and accessible education and be aware of the role of Chinese diet and traditional medicine in stroke survivors' rehabilitation.

  15. Patient safety principles in family medicine residency accreditation standards and curriculum objectives

    PubMed Central

    Kassam, Aliya; Sharma, Nishan; Harvie, Margot; O’Beirne, Maeve; Topps, Maureen

    2016-01-01

    Abstract Objective To conduct a thematic analysis of the College of Family Physicians of Canada’s (CFPC’s) Red Book accreditation standards and the Triple C Competency-based Curriculum objectives with respect to patient safety principles. Design Thematic content analysis of the CFPC’s Red Book accreditation standards and the Triple C curriculum. Setting Canada. Main outcome measures Coding frequency of the patient safety principles (ie, patient engagement; respectful, transparent relationships; complex systems; a just and trusting culture; responsibility and accountability for actions; and continuous learning and improvement) found in the analyzed CFPC documents. Results Within the analyzed CFPC documents, the most commonly found patient safety principle was patient engagement (n = 51 coding references); the least commonly found patient safety principles were a just and trusting culture (n = 5 coding references) and complex systems (n = 5 coding references). Other patient safety principles that were uncommon included responsibility and accountability for actions (n = 7 coding references) and continuous learning and improvement (n = 12 coding references). Conclusion Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID:27965349

  16. Helio-Thermics, Inc., lot no. 8, single family residence, Greenville, South Carolina

    NASA Astrophysics Data System (ADS)

    Beers, D.

    1981-03-01

    The Helio-Thermics Inc. House Lot No. 8 is one of two instrumented single-family residence in Greenville, South Carolina. The home has approximately 1086 square feet of conditioned space. Solar energy is used for space heating and for preheating domestic hot water. The attic space is used as the solar energy collector. It has a 416 square foot aperture and is painted black inside to maximize absorption. Warm air accumulates in the peak of the attic roof and circulates through the conditioned space or through storage by an air handler. Heat is stored in an 870 cubic foot rock bin under the house. Cold water is preheated in the attic by thermosiphoning water from the 82 gallon preheat tank through a manifold system of copper tubes. The instrumentation for the National Solar Data Network is described briefly. Original cost estimates for provisioning and installation of the solar system, with the exception of instrumentation costs, are given.

  17. Interprofessional education: a nurse practitioner impacts family medicine residents' smoking cessation counselling experiences.

    PubMed

    Mitchell, Joan; Brown, Judith Belle; Smith, Carrie

    2009-07-01

    This qualitative research paper describes a successful example of interprofessional education with family medicine residents (FMR) by a nurse practitioner (NP) colleague. The educational impact of the NP role in regard to smoking cessation counselling is revealed by the analysis of 16 semi-structured interviews using a phenomenological approach. The key themes depicted the NP as an educator and mentor, encourager and referral resource. Outcomes of improved knowledge, skills, and motivation towards providing smoking cessation counselling are described. This research provides some understanding of how professional students' learning and practice can be affected by a member of another profession through direct and indirect approaches. The experiences identified how interprofessional education and collaborative clinical practice can affect FMRs' attitudes, knowledge and behaviours. This learning can guide us in enhancing the quality of education provided to all health care professionals.

  18. [A Long Way Home: The Current State of Care Provided by Family Caregivers and Public Health Nurses to Persons With Mental Illness in the Community].

    PubMed

    Huang, Yu-Chu; Wang, Yu-Hui

    2015-08-01

    According to Taiwan's Health and Welfare Ministry statistics, Taiwan had a total of 122,538 people who were officially registered as mentally disabled at the end of December 2013. Worldwide, schizophrenia ranks as the sixth most burdensome disease in terms of total expenditures. The present paper uses the two actual care stories of the families of mental illness patients and compares and contrasts these with the community mental illness care models used in other countries. The hospital-based psychiatric and community-based mental illness care that is practiced in Taiwan presents dilemmas and has long focused on "disease-orientated care" rather than holistic care. The gap between institutional and community mental rehabilitation services in Taiwan are examined. We recommend that policy makers create an open space for mental illness family caregivers and public health nurses to engage in dialogue in order to effectively integrate the care resources available to community mental illness patients and to break down the care barriers that currently separate community mental illness patients, family caregivers, and public health nurses.

  19. Caregiver Stress

    MedlinePlus

    ... may take your loved one to an adult day care center or day hospital) The National Eldercare Locator , a service of the U.S. Administration on Aging, can help you find caregiving services in your area. You also can ... care and other caregiving services? Medicare, Medicaid, and private ...

  20. Teletherapy Delivery of Caregiver Behavior Training for Children with Attention-Deficit Hyperactivity Disorder

    PubMed Central

    Tse, Yuet Juhn; McCarty, Carolyn A.; Stoep, Ann Vander

    2015-01-01

    Abstract Background: Preliminary studies suggest that videoteleconferencing (VTC) may be an effective means to deliver behavioral interventions to families. Subjects consisted of a subsample of children (n=37) and caregivers who participated in the Children's Attention-Deficit Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS) (n=223), a randomized trial testing the effectiveness of delivering treatments for ADHD to families residing in their home communities using distant technologies. Families randomized to the CATTS intervention arm received pharmacotherapy and caregiver behavior training. Materials and Methods: Thirty-seven families from the CATTS intervention arm participated. All families received pharmacotherapy through VTC. Twelve families received the caregiver behavior training through VTC, or teletherapy, and 25 received the intervention in-person. We assessed children's outcomes at 25 weeks with the Vanderbilt ADHD Parent Rating Scale and the Columbia Impairment Scale. We assessed caregivers' outcomes using measures of distress in caring for a child with ADHD, including depression, stress, strain, and empowerment. We used analysis of covariance to assess outcomes from baseline to 25 weeks. Results: Families in the two conditions showed comparable attendance at sessions and satisfaction with their care. Caregivers in both conditions reported comparable outcomes for their children's ADHD-related behaviors and functioning, but caregivers in the teletherapy group did not report improvement in their own distress. Conclusions: Findings support the feasibility, acceptability, and effectiveness of treating children with ADHD through teletherapy. Future work should investigate how teletherapy may improve caregivers' distress. Teletherapy is a promising modality for delivering behavioral interventions for children with ADHD. PMID:25719609

  1. Family Caregivers' Perspectives on Barriers and Facilitators of Cervical and Breast Cancer Screening for Women with Intellectual Disability

    ERIC Educational Resources Information Center

    Swaine, Jamie G.; Dababnah, Sarah; Parish, Susan L.; Luken, Karen

    2013-01-01

    Women with intellectual disability do not receive cervical and breast cancer screening at the same number as women without disabilities. Numerous barriers to receipt of screening have been reported by individuals with intellectual disability, paid caregivers, nurses, and other medical professionals. This study utilized semi-structured qualitative…

  2. Fear of Death, Mortality Communication, and Psychological Distress among Secular and Religiously Observant Family Caregivers of Terminal Cancer Patients

    ERIC Educational Resources Information Center

    Bachner, Yaacov G.; O'Rourke, Norm; Carmel, Sara

    2011-01-01

    Previous research suggests that caregivers and terminally ill patients face substantial difficulties discussing illness and death. Existing research, however, has focused primarily on the experience of patients. The current study compared responses as well as the relative strength of association between mortality communication, fear of death, and…

  3. Caring for the caregiver: evaluation of support groups for guardians of orphans and vulnerable children in Kenya.

    PubMed

    Thurman, Tonya R; Jarabi, Ben; Rice, Janet

    2012-01-01

    HIV and AIDS have altered the context in which millions of children in sub-Saharan Africa are raised. Many are under the care of a widowed or ill parent, and others are residing with their extended family. Caregivers of orphans and other vulnerable children (OVC) face a variety of stressors that may adversely affect children. This study explores potential benefits of caregivers' membership in support groups on their own psychosocial wellbeing, and on the treatment and psychosocial well-being of OVC aged 8-14 under their care. A post-test study design comparing members and non-members was applied, drawing upon random samples of current and prospective beneficiaries from a rural community in Kenya. With up to two children per caregiver eligible for study inclusion, the sample comprised 766 caregivers and 1028 children. Three-quarters of children had lost at least one parent. Nearly 90% were cared for by a female, often their natural mother or grandmother. Half of the caregivers were widowed and one-fifth had a chronic illness. Over one-third of caregivers were members of support groups, more commonly female caregivers. Regression analyses assessed the effect of support group membership after controlling for household, caregiver and child characteristics. Members reported less social marginalization, better family functioning and more positive feelings towards the children in their care than nonmembers. Children with caregivers in support groups exhibited fewer behavioral problems, higher rates of prosocial behavior and reported lower incidence of abuse from adults in their household. The psychological state of caregivers, however, was not associated with support group membership. Results underscore that quality care of vulnerable children hinges on interventions that address the psychosocial challenges facing their caregivers.

  4. Training Family Medicine Residents in Effective Communication Skills While Utilizing Promotoras as Standardized Patients in OSCEs: A Health Literacy Curriculum.

    PubMed

    Pagels, Patti; Kindratt, Tiffany; Arnold, Danielle; Brandt, Jeffrey; Woodfin, Grant; Gimpel, Nora

    2015-01-01

    Introduction. Future health care providers need to be trained in the knowledge and skills to effectively communicate with their patients with limited health literacy. The purpose of this study is to develop and evaluate a curriculum designed to increase residents' health literacy knowledge, improve communication skills, and work with an interpreter. Materials and Methods. Family Medicine residents (N = 25) participated in a health literacy training which included didactic lectures and an objective structured clinical examination (OSCE). Community promotoras acted as standardized patients and evaluated the residents' ability to measure their patients' health literacy, communicate effectively using the teach-back and Ask Me 3 methods, and appropriately use an interpreter. Pre- and postknowledge, attitudes, and postdidactic feedback were obtained. We compared OSCE scores from the group that received training (didactic group) and previous graduates. Residents reported the skills they used in practice three months later. Results. Family Medicine residents showed an increase in health literacy knowledge (p = 0.001) and scored in the adequately to expertly performed range in the OSCE. Residents reported using the teach-back method (77.8%) and a translator more effectively (77.8%) three months later. Conclusions. Our innovative health literacy OSCE can be replicated for medical learners at all levels of training.

  5. Directory of Education Programs for Caregivers of Elders.

    ERIC Educational Resources Information Center

    Missouri Univ., Kansas City. Center on Rural Elderly.

    Caregiver education and support programs help decrease the stress and burden on family caregivers of the elderly. This directory profiles 72 programs for caregivers of elders. Programs are grouped into the categories of education, respite, and support. Education programs address skills and techniques for caregiving and include program…

  6. Caregivers' attentional bias to pain: does it affect caregiver accuracy in detecting patient pain behaviors?

    PubMed

    Mohammadi, Somayyeh; Dehghani, Mohsen; Khatibi, Ali; Sanderman, Robbert; Hagedoorn, Mariët

    2015-01-01

    Attentional bias to pain among family caregivers of patients with pain may enhance the detection of pain behaviors in patients. However, both relatively high and low levels of attentional bias may increase disagreement between patients and caregivers in reporting pain behaviors. This study aims to provide further evidence for the presence of attentional bias to pain among family caregivers, to examine the association between caregivers' attentional bias to pain and detecting pain behaviors, and test whether caregivers' attentional bias to pain is curvilinearly related to patient and caregiver disagreement in reporting pain behaviors. The sample consisted of 96 caregivers, 94 patients with chronic pain, and 42 control participants. Caregivers and controls completed a dot-probe task assessing attention to painful and happy stimuli. Both patients and caregivers completed a checklist assessing patients' pain behavior. Although caregivers did not respond faster to pain congruent than pain incongruent trials, caregiver responses were slower in pain incongruent trials compared with happy incongruent trials. Caregivers showed more bias toward pain faces than happy faces, whereas control participants showed more bias toward happy faces than pain faces. Importantly, caregivers' attentional bias to pain was significantly positively associated with reporting pain behaviors in patients above and beyond pain severity. It is reassuring that attentional bias to pain was not related to disagreement between patients and caregivers in reporting pain behaviors. In other words, attentional bias does not seem to cause overestimation of pain signals.

  7. Solar project description for Helio-Thermics, Inc., lot 6 single family residence; Greenville, South Carolina

    NASA Astrophysics Data System (ADS)

    Moore, D.

    1981-03-01

    An instrumented single family residence in Greenville, South Carolina, has approximately 1086 square feet on conditioned space. Solar energy is used for space heating the home and preheating domestic and water (DHW). Solar energy enters the attic through a 416 square foot aperture which is double glazed with corrugated, translucent, fiberglass reinforced, acrylic panels. Warm air accumulates in the peak of the attic roof and circulates through the conditioned space or through storage by an air handler. Solar energy is stored in an 870 cubic foot storage bin containing 85,460 pounds of crushed rock located under the house. cold water is preheated in the attic by thermosiphoning water from the 80 gallon preheat tank through a manifold system of copper tubes. These tubes are attached to black sheet metal plates. Preheated city water is stored in the preheat tank and supplied, on demand, to a conventional 80 gallon DHW tank. When solar energy is insufficient to satisfy the space heating load, a water to air heat exchanger in the hot air supply duct provides auxiliary energy for space heating. A gas fired water heater provides auxiliary energy for the water to air heat exchanger and the DHW.

  8. Modeling the hydrologic and economic efficacy of stormwater utility credit programs for US single family residences.

    PubMed

    Kertesz, Ruben; Green, Olivia Odom; Shuster, William D

    2014-01-01

    As regulatory pressure to reduce the environmental impact of urban stormwater intensifies, US municipalities increasingly seek a dedicated source of funding for stormwater programs, such as a stormwater utility. In rare instances, single family residences are eligible for utility discounts for installing green infrastructure. This study examined the hydrologic and economic efficacy of four such programs at the parcel scale: Cleveland (OH), Portland (OR), Fort Myers (FL), and Lynchburg (VA). Simulations were performed to model the reduction in stormwater runoff by implementing bioretention on a typical residential property according to extant administrative rules. The EPA National Stormwater Calculator was used to perform pre- vs post-retrofit comparisons and to demonstrate its ease of use for possible use by other cities in utility planning. Although surface slope, soil type and infiltration rate, impervious area, and bioretention parameters were different across cities, our results suggest that modeled runoff volume was most sensitive to percent of total impervious area that drained to the bioretention cell, with soil type the next most important factor. Findings also indicate a persistent gap between the percentage of annual runoff reduced and the percentage of fee reduced.

  9. M. F. Smith and Associates single family residence. Solar project description

    SciTech Connect

    Not Available

    1981-06-04

    M.F. Smith Associates is a single-family residence in Jamestown, Rhode Island. The home has approximately 2240 square feet of conditioned space. Solar energy is used for space heating the home and preheating domestic hot water (DHW). The solar energy system has an array of flat-plate collectors with a gross area of 51.2 square feet and a 3150-gallon concrete storage tank. Preheated water is supplied, on demand, to a conventional 82-gallon DHW tank. Solar-heated water from the storage tank is directed to a heat pump or to a hydronic heat exchanger to provide space heating. When the storage water temperature is insufficient to satisfy the heat pump input requirements, an electrical heating element (booster unit ERH-1) in the line between storage and the heat pump provides auxiliary energy. During the cooling season, heat is removed from the conditioned space and discharged into storage, which sould be maintained below 100/sup 0/F by operating the collector system at night. An electrical heating element in DWH-1 provides auxiliary energy for water heating.

  10. Solar project description for Greenmoss Builders Incorporated single-family residence, Waitsfield, Vermont

    NASA Astrophysics Data System (ADS)

    1981-10-01

    A solar installed in a two story single-family residence in Vermont is discussed. Passive solar space heating and active solar domestic hot water preheating are the outputs. The space heating system includes a Trombe wall with 278 square feet of window, gas fired auxiliary units, and air distribution. The heating modes are: solar only; solar plus supplemental heat sources (gas fired furnace and/or wood stoves) with thermal curtain open; residual (stored) solar plus supplemental sources with thermal curtain closed; and heating by furnace and/or stove only. An array of 88 sq. ft. of flat plate collectors with water as the working fluid preheats the potable hot water supply before it is fully heated by a gas fired water heater. Freeze protection is by drain down. Modes of operation are collector to preheat, preheat to domestic hot water, and draindown. The instrumentation for the National Solar Data network is described. Original cost estimates for provisioning and installation of the solar system are given.

  11. End-of-Life Caregiver's Perspectives on Their Role: Generative Caregiving

    ERIC Educational Resources Information Center

    Phillips, Linda R.; Reed, Pamela G.

    2010-01-01

    Purpose: To describe caregivers' constructions of their caregiving role in providing care to elders they knew were dying from life-limiting illnesses. Design and Methods: Study involved in-depth interviews with 27 family caregivers. Data were analyzed using constant comparative analysis. Results: Four categories were identified: centering life on…

  12. Associations between family ratings on experience with care and clinical quality-of-care measures for nursing home residents

    PubMed Central

    Li, Qinghua; Tang, Yi

    2015-01-01

    Several states are currently collecting and publicly reporting nursing home resident and/or family member ratings of experience with care in an attempt to improve person-centered care in nursing homes. Using the 2008 Maryland nursing home family survey reports and other data, this study performed both facility- and resident-level analyses, and estimated the relationships between family ratings of care and several long-term care quality measures (pressure ulcers, overall and potentially-avoidable hospitalizations, and mortality) after adjustment for resident characteristics. We found that better family evaluations of overall and specific aspects of care may be associated with reduced rates of risk-adjusted measures at the facility level (range of correlation coefficients: −0.01 to −0.31). Associations of overall experience ratings tended to persist after further adjustment for common nursing home characteristics such as nurse staffing levels. We conclude that family ratings of nursing home care complement other types of performance measures such as risk-adjusted outcomes. PMID:26199288

  13. Two-year outcomes of the Early Risers prevention trial with formerly homeless families residing in supportive housing.

    PubMed

    Gewirtz, Abigail H; DeGarmo, David S; Lee, Susanne; Morrell, Nicole; August, Gerald

    2015-04-01

    This article reports 2-year outcomes from a cluster randomized, controlled trial of the Early Risers (ER) program implemented as a selective preventive intervention in supportive housing settings for homeless families. Based on the goals of this comprehensive prevention program, we predicted that intervention participants receiving ER services would show improvement in parenting and child outcomes relative to families in treatment-as-usual sites. The sample included 270 children in 161 families, residing in 15 supportive housing sites; multimethod, multi-informant assessments conducted at baseline and yearly thereafter included parent and teacher report of child adjustment, parent report of parenting self-efficacy, and parent-child observations that yielded scores of effective parenting practices. Data were modeled in HLM7 (4-level model accounting for nesting of children within families and families within housing sites). Two years' postbaseline, intent-to-treat (ITT) analyses indicated that parents in the ER group showed significantly improved parenting self-efficacy, and parent report indicated significant reductions in ER group children's depression. No main effects of ITT were shown for observed parenting effectiveness. However, over time, average levels of parenting self-efficacy predicted observed effective parenting practices, and observed effective parenting practices predicted improvements in both teacher- and parent-report of child adjustment. This is the first study to our knowledge to demonstrate prevention effects of a program for homeless families residing in family supportive housing.

  14. Drug Testing Incoming Residents and Medical Students in Family Medicine Training: A Survey of Program Policies and Practices

    PubMed Central

    Bell, Paul F.; Semelka, Michael W.; Bigdeli, Laleh

    2015-01-01

    Background Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. Objective We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. Methods The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. Results A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Conclusions Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training. PMID:26217424

  15. 41 CFR 303-70.403 - When a family member, residing with the employee, dies while in transit to or from the employee's...

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 41 Public Contracts and Property Management 4 2012-07-01 2012-07-01 false When a family member, residing with the employee, dies while in transit to or from the employee's duty station outside CONUS... Members § 303-70.403 When a family member, residing with the employee, dies while in transit to or...

  16. 41 CFR 303-70.403 - When a family member, residing with the employee, dies while in transit to or from the employee's...

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 41 Public Contracts and Property Management 4 2011-07-01 2011-07-01 false When a family member, residing with the employee, dies while in transit to or from the employee's duty station outside CONUS... Members § 303-70.403 When a family member, residing with the employee, dies while in transit to or...

  17. 41 CFR 303-70.403 - When a family member, residing with the employee, dies while in transit to or from the employee's...

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 41 Public Contracts and Property Management 4 2013-07-01 2012-07-01 true When a family member, residing with the employee, dies while in transit to or from the employee's duty station outside CONUS... Members § 303-70.403 When a family member, residing with the employee, dies while in transit to or...

  18. The Role of the Primary Caregiving Father.

    ERIC Educational Resources Information Center

    Frank, Robert A.

    This dissertation examined primary caregiving father families and how they construct their roles in contrast to primary caregiving mother families. A Self-report survey instrument was constructed. and administered to a sample of 93 married couples in the United States with children under the age of 6. Surveys were coded by couple, analyzed, and…

  19. Caregiving and Sibling Relationships: Challenges and Opportunities

    MedlinePlus

    ... source of sibling friction is the legacy of family dynamics. Invariably, the demands of caregiving bring out old ... find themselves replaying their historical roles in the family, recreating old dynamics of competition and resentment as they vie for ...

  20. Outcomes of Clinicians, Caregivers, Family Members and Adults with Spina Bifida Regarding Receptivity to use of the iMHere mHealth Solution to Promote Wellness

    PubMed Central

    Fairman, Andrea D.; Dicianno, Brad E.; Datt, Nicole; Garver, Amanda; Parmanto, Bambang; McCue, Michael

    2013-01-01

    The purpose of this study was to gather information regarding the receptivity of clinicians, caregivers and family members, and adults with spina bifida (SB) to the use of a mHealth application, iMobile Health and Rehabilitation (iMHere) system. Surveys were administered to end user groups in conjunction with a conference presentation at the Spina Bifida Association’s 38th Annual Conference. The survey results were obtained from a total of 107 respondents. Likert scale and qualitative results are provided in consideration of future application of the iMHere system in clinical practice. The results of this survey indicate respondents were receptive and supportive with regard to adopting such a system for personal and professional use. Challenges likely to be encountered in the introduction of the iMHere system are also revealed and discussed. PMID:25945209