The second victim's satisfaction index model.

Dementia with Lewy bodies (DLB) is characterized by neuropsychiatric symptoms, which can be distressing to caregivers. However, little is known about their subjective distress in terms of caregiver self-efficacy. Thus, we examined the differences in caregiver self-efficacy and their associated factors between DLB and Alzheimer's disease (AD) caregivers. We conducted a comprehensive questionnaire for DLB and AD caregivers. Caregiver self-efficacy was evaluated using three domains (Self-Efficacy for Obtaining Respite: SE-OR, Self-Efficacy for Responding to Disruptive Patient Behaviours: SE-RDPB, Self-Efficacy for Controlling Upsetting Thoughts about Caregiving: SE-CUT) of the Revised Scale for Caregiving Self-Efficacy (RSCSE). In addition, data on the following features of caregivers were assessed: depression, sleep disturbance, caregiver burden, executive function, loneliness, social support, and distress associated with neuropsychiatric symptoms. The patients were assessed for general cognitive tasks, executive function, and neuropsychiatric symptoms. Compared with AD caregivers, DLB caregivers experienced a significantly higher burden in terms of not only various clinical factors, but also all three domains of caregiver self-efficacy. Among the caregiver-associated factors, different domains were predictors of self-efficacy in DLB and AD caregivers (distress due to sleep disturbances in DLB patients; distress due to delusions in AD patients). Among the patient-associated factors, different domains were also predictors of self-efficacy in DLB and AD caregivers (sleep disturbances in DLB patients; delusions in AD patients). Among both the caregivers and the patients, executive function was a significant predictor of one RSCSE domain (SE-CUT). A reduction in caregiver self-efficacy may contribute to a severe subjective burden among DLB caregivers. Furthermore, two neuropsychiatric symptoms (delusions and sleep disturbances) affected caregiver self-efficacy differently depending on whether care was being provided to a DLB or AD patient. Understanding the association between specific neuropsychiatric symptoms and caregiver self-efficacy may be useful for conducting interventions for DLB patients.

This study compared Black (n = 97) and White (n = 143) family caregivers regarding the relationship between subjective and objective cognitive assessments of Alzheimer's patients from the Memphis site of the NIA/NINR Resources for Enhancing Alzheimer's Caregivers Health (REACH) randomized clinical trial. Black and White caregivers' subjective ratings (Pearlin Cognitive Status Scale) of their care recipients' cognitive abilities were equivalent, but White Alzheimer's patients had higher objective cognitive performance (Mini-Mental State Examination). In simple regression analysis, race was significantly related to differences between subjective and objective cognitive assessments and remained so when caregiver age, sex, income, education, relationship to care recipient, caregiver bother (burden), and care recipient sex were statistically controlled in multiple regression analysis. Compared to the other group, Black caregivers generally overrated, and White caregivers underrated, their care recipient's cognitive ability. This difference in caregiver's appraisal may affect clinical and behavioral interventions for dementia patients and their caregivers.

Objective Research to the quality of life and its influencing factors of Alzheimer's caregivers.Methods Use of general questionnaire and health questionnaire(SF-36)to measure and evaluate 50 cases of Alzheimer's caregivers'quality of life,using spearman correlation analysis and multiple regression analysis of influencing factors.Results SF-36 score of the families of Alzheimer's patients and eight dimension scores were lower than the normal,the difference was statistically significant(P＜0.05);In which a sense of general health(44.39±17.31)points,mental state(42.99±22.39)points.The factors of influencing caregiver's life quality are their gender, age, education level, economic status,time,cost,payment method,the severity of patients with dementia,mental and behavioral symptoms and relationship.Conclusions The quality life of Alzheimer's caregivers was poor,the factors was extensive.Therefore,it is given our attention to concern with Alzheimer's patients,as well as their caregivers,and connected the medical institutions with community services and home care,in order to reduce the burden of caregivers and improve their quality of life. Key words: Alzheimer disease; Quality of life; Caregivers; Influencing factors

MH Stressors Debilitating in Alzheimer's Caregivers

In relationship to the number of studies on caregiving burden, few studies have assessed the relationship between burden of caregivers and the extent and nature of care given to elderly persons in need of assistance (defined as competence). A study of 96 caregivers of Alzheimer's Disease patients found only a relatively low, and statistically insignificant, relationship between caregiver burden and competence. The development and measurement of competence is described, as is the need to consider both burden and competence as constructs, independent of one another, in work with caregivers of impaired older persons.

Alzheimer's family caregivers suffer from psychological and physical morbidity associated with the care of the Alzheimer's patient. The objectives of the study were to compare stress and psychological morbidity between family caregivers of Alzheimer's disease patients and family caregivers of aged non-demented chronically ill patients and to explore the impact of cognitive and non-cognitive patient symptoms on caregivers.Fifty-eight caregivers of Alzheimer's patients (cases) and 32 caregivers of non-demented chronically ill patients (controls) were studied. A cross-sectional case-control design was employed using validated scales to assess patient symptomatology and self-report questionnaires to measure stress and psychological morbidity in caregivers.Compared to controls, stress and psychological morbidity were higher in caregivers of Alzheimer's patients. Behavioral symptoms and impairment in instrumental activities of daily living were associated with caregiver stress. Length of care was associated with caregiver psychological morbidity.Caregiver stress may be reduced with special attention paid to the treatment and management of behavioral and functional symptoms in the Alzheimer's disease patient. Caregiver education and coping skills should also be included.

Alzheimer's family caregivers suffer from psychological and physical morbidity associated with the care of the Alzheimer's patient. The objectives of the study were to compare stress and psychological morbidity between family caregivers of Alzheimer's disease patients and family caregivers of aged non-demented chronically ill patients and to explore the impact of cognitive and non-cognitive patient symptoms on caregivers. Fifty-eight caregivers of Alzheimer's patients (cases) and 32 caregivers of non-demented chronically ill patients (controls) were studied. A cross-sectional case-control design was employed using validated scales to assess patient symptomatology and self-report questionnaires to measure stress and psychological morbidity in caregivers. Compared to controls, stress and psychological morbidity were higher in caregivers of Alzheimer's patients. Behavioral symptoms and impairment in instrumental activities of daily living were associated with caregiver stress. Length of care was associated with caregiver psychological morbidity. Caregiver stress may be reduced with special attention paid to the treatment and management of behavioral and functional symptoms in the Alzheimer's disease patient. Caregiver education and coping skills should also be included.

To compare perceptions on oral health-related quality of life (OHRQoL) between Alzheimer disease (AD) patients and their caregivers by using the Geriatric Oral Health Assessment Index (GOHAI). Correlation between GOHAI and prostheses quality was also performed. GOHAI was applied to 16 AD elders and their caregivers. GOHAI index was compared to objective measures of AD patients' prostheses quality, rated by a researcher. Data were submitted to Wilcoxon signed rank and McNemar tests (α = 5%). Kappa correlations verified the concordance for GOHAI scores between AD patients and caregivers. Spearman's correlation was used to explore concordance between GOHAI scores and prostheses quality indices. Total GOHAI scores from AD patients and caregivers were similar (P = 0.262). Overall Kappa was good (0.62). There were no correlations between GOHAI scores and prostheses quality. AD patients assess and self-report their OHRQoL similarly to their main caregiver.

To investigate the predictors of caregiver's depressive symptoms in a sample of community-dwelling Alzheimer's patients. A cross-sectional study was conducted in an Alzheimer's unit specifically devoted to the care of demented patients in Brescia Province (Italy). One hundred and three dyads were consecutively recruited between July 1994 and July 1995. Caregivers were sons/daughters (65%) or husbands/wives; mean age was 54.6 +/- 13.2. Alzheimer's patients Mini Mental State Examination score was 11.3 +/- 8.3; patients were equally distributed among disease severity levels. The following variables have been collected: (a) background and context variables (caregiver's age, gender, marital status, education, relationship and cohabitation with the patient, employment status, satisfaction with household income);(b) caregiver's personal resources (health, social relationships and social interactions, formal supports use, assistance and vigilance); (d) primary stressors (patient's age and gender, cognitive status, functional status, frequency of behavioural disturbances). Caregiver's depressive symptoms represented the main outcome measure. Being husband or wife, low self-rated health and caregiving competence, high numbers of hours for assistance and patient's behavioural disturbances and younger age were associated caregiver's depressive symptoms. With multivariate analysis only relationship to the patient, caregiver's health and competence were independent predictors of caregiver's depressive symptoms. Factors related to the caregiver--relationship, health and competence--rather than to the patient constitute the main risk factors for caregiver's depressive symptomatology.

Factors associated with high strain in caregivers of Alzheimer's disease (AD) in Malaysia

Depression is ubiquitous in primary family caregivers of Alzheimer's Disease (AD) patients, but its relationship to the overall behavior patterns of these families has received little attention thus far. The focus of the exploratory study reported here was on one aspect of this issue--affective responses between caregiver and other family members as they relate to level of depressive symptoms in the primary caregivers. Family affective responses, especially negative responses, have proven of particular salience in studies of major psychiatric disorders. Would they be equally salient in a study of depressive symptoms in primary caregivers of Alzheimer's patients? Apparently so. Thirty caregivers and extended family members participated in problem-solving family interaction tasks that were videotaped, transcribed, and coded on affect. Two variables representing angry and sad responses of extended family members to the caregiver accounted for over 44% of the variance in caregiver depressive symptoms. The relevance of these findings for treatment approaches and future research efforts are discussed.

Objective: As estimated in a report of global Alzheimer's disease published by Alzheimer's Disease International in 2015, there will be 9.9 million new patients worldwide with Alzheimer's disease in 2015, with a new Alzheimer's patient diagnosed, on average, every 3 seconds. Since Alzheimer's disease is an irreversible disease, the most that can be done for Alzheimer's patients is to merely delay the onset of disease, which to date cannot be completely cured. Therefore, even though great effort is put into caring for the patient, caregivers should not expect any substantial changes. The caring process is a dynamic process that contains negative and positive experiences. During the caring period, not only do caregivers spend a lot of effort and work very hard to help the patient, but in fact care recipients themselves also give energy to caregivers. This study attempts to take a positive energy viewpoint to explore and design a program that is suitable for Alzheimer's caregivers. The aims of the study were as follows: (a) to explore the needs and burdens of Alzheimer's caregivers in the treatment process of patients, (b) to design a program that meets the needs of the caregivers, and (c) to evaluate the effects of implementing a program. Methods: The study is a qualitative study employing in-depth interviews. Interviews were conducted from September 2015 to December 2015; the interview results were reviewed and a positive energy group program was designed. Pre-test and post-test interviews were carried out for the program so as to evaluate the effects of the program. Results: According to the caregiver interview results, we understand the caring needs and caring process of caregivers. From the interview results, we now know that caregivers' continuous care mainly comes from positive energy in psychological, social and relationship aspects. Positive energy seems to have been affecting caregivers' caring ability and willingness. Therefore, a two-stage group activity program was designed to provide a recollective handmade craft group and an art therapy group. Research results of the study show that when the main caregivers of Alzheimer's patients took part in group activities, positive energy in social and relationship aspects increased for the caregiver group too. Conclusions: From these intervention programs caregivers could obtain more knowledge of patient care and these activities could effectively lighten caregivers' burdens.

Objective As estimated in a report of global Alzheimer's disease published by Alzheimer's Disease International in 2015, there will be 9.9 million new patients worldwide with Alzheimer's disease in 2015, with a new Alzheimer's patient diagnosed, on average, every 3 seconds. Since Alzheimer's disease is an irreversible disease, the most that can be done for Alzheimer's patients is to merely delay the onset of disease, which to date cannot be completely cured. Therefore, even though great effort is put into caring for the patient, caregivers should not expect any substantial changes. The caring process is a dynamic process that contains negative and positive experiences. During the caring period, not only do caregivers spend a lot of effort and work very hard to help the patient, but in fact care recipients themselves also give energy to caregivers. This study attempts to take a positive energy viewpoint to explore and design a program that is suitable for Alzheimer's caregivers. The aims of the study were as follows: (a) to explore the needs and burdens of Alzheimer's caregivers in the treatment process of patients, (b) to design a program that meets the needs of the caregivers, and (c) to evaluate the effects of implementing a program. Methods The study is a qualitative study employing in-depth interviews. Interviews were conducted from September 2015 to December 2015; the interview results were reviewed and a positive energy group program was designed. Pre-test and post-test interviews were carried out for the program so as to evaluate the effects of the program. Results According to the caregiver interview results, we understand the caring needs and caring process of caregivers. From the interview results, we now know that caregivers' continuous care mainly comes from positive energy in psychological, social and relationship aspects. Positive energy seems to have been affecting caregivers' caring ability and willingness. Therefore, a two-stage group activity program was designed to provide a recollective handmade craft group and an art therapy group. Research results of the study show that when the main caregivers of Alzheimer's patients took part in group activities, positive energy in social and relationship aspects increased for the caregiver group too. Conclusions From these intervention programs caregivers could obtain more knowledge of patient care and these activities could effectively lighten caregivers' burdens.

Satisfaction with a particular good or service represents an affective state in response to an individual's evaluation of the performance of that good or service. This evaluation involves a comparison between perceived actual performance and prior expectations. The current study used this theoretical idea to study violent crime victims' levels of satisfaction with services provided by a Dutch state compensation scheme. One hundred and seventy-seven victims of violent crime who had applied for compensation from the Dutch Violent Offences Compensation Fund (DVOCF) participated in two brief telephone interviews: one before receipt of the fund's decision upon their request for compensation and one after receipt of that decision. Based on the theories of distributive and procedural justice, measurement of prior expectations was differentiated in expectations about receipt of compensation, treatment by fund workers, and information provision. Results suggested that satisfaction with the DVOCF depended on fulfillment of expectations about treatment by fund workers and information provision, but not on fulfillment of expectations about receipt of compensation. Other predictors of victim satisfaction were as follows: duration of the application procedure, approval upon request for compensation, and satisfaction assessed during the first interview. Results were discussed in light of theory, policy implications, study limitations, and future research.

PurposeThe overall purpose of this study was to develop an understanding of the mediating effect of organizational reputation on service recommendation and customer loyalty.Design/methodology/approachFour models were developed that were variations of the American Customer Satisfaction Model (ACSM). These models were then tested by using the Partial Least Squares (PLS) procedure on a data collected from a survey that yielded 8,098 respondents.FindingsIt was found that customer satisfaction enhances reputation in the service environment. It was also discovered that reputation partially mediates the relationship between satisfaction and loyalty, and that reputation partially mediates the relationship between satisfaction and recommendation.Research limitations/implicationsMore research needs to be undertaken to explore the role of reputation within the ACSM. It is necessary to conduct research employing experimental design with longitudinal data captured from across industries using robust measures.Originality/valueThe findings suggest that the relationship between corporate reputation and profitability may reside in reputation's influence on customer loyalty, and that reputation plays an important role within the ACSM. This study is one of the first documented attempts to use PLS to test a mediation effect.