Caregiver Acceptance Research Articles

Benefit Finding and Quality of Life in Caregivers of Childhood Cancer Survivors

Benefit finding, or finding positive outcomes in the face of adversity, may play a role in predicting quality of life (QoL) among caregivers, but mixed results suggest that other factors may moderate this relationship. This study examined demographic and psychosocial moderators of the association between benefit finding and QoL among caregivers of childhood cancer survivors. Caregivers of childhood cancer survivors (n = 83) completed measures of benefit finding, QoL, coping, optimism, social support, caregiving demand, posttraumatic stress, and demographics. The relationship between benefit finding and QoL was moderated by caregiver age, marital status, socioeconomic status, geographic location, acceptance and emotion-focused coping, optimism, caregiving demand, and posttraumatic stress. Benefit finding was more strongly related to QoL among caregivers with fewer demographic/psychosocial resources. Results suggest that finding benefits in the cancer experience may have a greater positive impact for caregivers with relatively fewer demographic and psychosocial resources and may have less of an impact for caregivers with relatively greater resources. Findings further point to the complex nature of QoL among caregivers of childhood cancer survivors. Results may aid clinicians in identifying caregivers at particular risk for low QoL. They may be counseled to find benefits in their experience or provided with resources to strengthen other factors that impact QoL.

INFORMATION AND COMMUNICATIONS TECHNOLOGY IN DEMENTIA CARE: ACCEPTANCE AMONG PROFESSIONAL CAREGIVERS

AbstractWhen it comes to dealing with symptoms associated with dementia, a number of studies have established the effectiveness of psychosocial interventions. However, in view of limited financial and human resources, implementing effective interventions in daily practice can be a major challenge for care providers. Recently, there has been a growing interest in the use of Information and Communication Technologies (ICTs) for supporting psychosocial interventions in nursing home settings. ICTs are cost-effective and widely available, and using them could potentially ease the burden of dementia care delivery. Therefore, in order to assess acceptance and attitudes of professional caregivers regarding ICTs in dementia care, a sample of N = 205 professional caregivers (M = 38,81 yrs; 70% female) from 10 residential care facilities located in Berlin completed a standardized questionnaire (TA-EG) on factors associated with technology use and acceptance. Additionally, 11 semi-structured interviews were conducted. Results showed that older and female caregivers, respectively, reported less Competence (z = -4.21, p < .01 and z = -4.44, p < .01, resp.) and Enthusiasm (z = -2.38, p < .05 and z = -4.01, p < .01, resp.) regarding the use of technology in their work environment. Furthermore, qualitative content analysis of the interview transcripts revealed both factors promoting the use of ICTs in residential dementia care, and potential barriers. Important recommendations for the development of ICT-based interventions in dementia care will be reported and general implications for their design and successful adoption will be discussed.

A Qualitative Analysis of Adolescent and Caregiver Acceptability of Universally Offered Gonorrhea and Chlamydia Screening in the Pediatric Emergency Department

We qualitatively explore adolescent and parent or guardian attitudes about benefits and barriers to universally offered gonorrhea and chlamydia screening and modalities for assessing interest in screening in the pediatric emergency department (ED). A convenience sample of forty 14- to 21-year-olds and parents or guardians of adolescents presenting toan urban and community pediatric ED with any chief complaint participated in individual, semistructured, confidential interviews. Topics included support of universally offered gonorrhea and chlamydia screening, barriers and benefits to screening, and modalities for assessing interest in screening. Data were analyzed with framework analysis. Almost all adolescents (37/40; 93%) and parents (39/40; 98%) support offering ED gonorrhea or chlamydia screening. Benefits included earlier diagnosis and treatment, convenience and transmission prevention (cited by both groups), and improved education and long-term health (cited by parents/guardians). Barriers included concerns about confidentiality and cost (cited by both groups), embarrassment (cited by adolescents), and nondisclosure to parents or guardians (cited by parents/guardians). Adolescents preferred that the request for gonorrhea or chlamydia screening be presented in a private room, using tablet technology. Both groups noted that the advantages to tablets included confidentiality and adolescents' familiarity with technology. Adolescents noted that tablet use would address concerns about bringing up gonorrhea or chlamydia screening with clinicians, whereas parents or guardians noted that tablets might increase screening incidence but expressed concern about the lack of personal interaction. Universally offered gonorrhea and chlamydia screening in a pediatric ED was acceptable to the adolescents and parents or guardians in this study. Offering a tablet-based method to assess interest in screening may increase participation.

Relationship of psychological resilience, acceptance and positive feelings of the caregivers of cancer patients

Objective To investigate the relationship of psychological resilience, acceptance and positive feelings of the caregivers of cancer patients, to improve the positive feelings and reduce caregiver burden of caregivers. Methods Totally 201 caregivers of cancer inpatients from a Beijing top three hospital were investigated with Connor-Davidson Resilience Scale (CD-RISC) , Acceptance and Action Questionnaire-2nd Edition (AAQ-II) , Positive Aspects of Caregiving (PAC) . Results The score of 201 caregivers on the CD-RISC was (71.18±14.79) , the score of AAQ-II was (16.14±8.57) , the score of PAC was (37.46±6.64) ; the relationship between the CD-RISC score and the AAQ-II score was negatively correlated (r=-0.381, P<0.01) , and the relationship between the AAQ-II score and the PAC score was negatively correlated (r=-0.175, P<0.05) , the CD-RISC score was closely related to the PAC score (r=0.367, P<0.01) . Conclusions Nurses should increase the psychological resilience and acceptance of caregivers, thus improve their positive feelings. Key words: Resilience, psychological; Cancer patients; Caregivers; Experiential avoidance; Positive feeling

Self- and other-descriptions by individuals with autism spectrum disorder in Los Angeles and New Delhi: Bridging cross-cultural psychology and neurodiversity

Decades of cross-cultural research have shown that self-concepts vary across cultural contexts. However, it is unclear whether individuals with autism spectrum disorder (ASD), who have impairments in self- and other-understanding, will acquire the relevant cultural patterns regarding self- and other-concepts; or whether their social impairments will extend to broader cultural impairments. Here we present the first examination, to our knowledge, of self- and other-concepts in a cross-cultural sample of individuals with ASD in Los Angeles, USA, and New Delhi, India, compared with matched control groups in each culture. We used a modification of the well-known 20 statements description task, and coded participants’ responses according to 28 sub-categories, along the axes of autonomous/social and abstract/specific. When describing themselves and their favorite fictional characters, participants in Los Angeles provided significantly more autonomous and abstract descriptions than participants in New Delhi, as expected from their different locations. Surprisingly, we found no effect of diagnostic group on the content of participants’ responses, suggesting that individuals with ASD are indeed capable of acquiring the cultural scripts that surround them—at least on a cognitive, verbal level—despite their neurocognitive impairments. These results provide an important step towards bridging the study of cross-cultural psychology and global autism research; while simultaneously highlighting the ways in which individuals with ASD can become a part of their local cultures, serving as an important impetus of acceptance for caregivers and policy-makers worldwide.

Long-Acting Growth Hormone: An Update.

After the introduction of recombinant human growth hormone (rhGH) in 1985, a myriad of children and adults have benefited from its growth-promoting and metabolic effects. Nowadays, current therapeutic regimens rely on daily subcutaneous GH injections that could be burdensome and inconvenient to pediatric patients. As expected with any long-term parenteral pharmacological treatment, these daily regimens may promote nonadherence, poor compliance, treatment abandonment and/or suboptimal clinical outcomes. In order to improve patient and caregiver acceptance of proposed regimens, simplified dosing schedules could potentially aid in reducing poor compliance and maximize the therapeutic end results. Long-acting GH formulations have been designed and perfected over the last two decades, and currently there are several formulations in advanced stages of research as a reasonable attempt to improve patient's adherence to GH treatment. A long-acting GH preparation allowing for reduced injection frequency is likely to improve treatment adherence and to decrease the distress and inconvenience associated with daily injections. This review presents an update about the status of current and recent efforts that have enabled the formulation of sustained-release, long-acting rhGH as it has been longed for many years in the pediatric endocrinology field.

Improving care quality and preventing maltreatment in institutional care - a feasibility study with caregivers.

Institutionalized children in low-income countries often face maltreatment and inadequate caregiving. In addition to prior traumatization and other childhood adversities in the family of origin, abuse and neglect in institutional care are linked to various mental health problems. By providing a manualized training workshop for caregivers, we aimed at improving care quality and preventing maltreatment in institutional care. In Study 1, 29 participating caregivers rated feasibility and efficacy of the training immediately before, directly after, and 3 months following the training workshop. The results showed high demand, good feasibility, high motivation, and acceptance of caregivers. They reported improvements in caregiver–child relationships, as well as in the children’s behavior. Study 2 assessed exposure to maltreatment and the mental health of 28 orphans living in one institution in which all caregivers had been trained. The children were interviewed 20 months before, 1 month before, and 3 months after the training. Children reported a decrease in physical maltreatment and assessments showed a decrease in mental health problems. Our approach seems feasible under challenging circumstances and provides first hints for its efficacy. These promising findings call for further studies testing the efficacy and sustainability of this maltreatment prevention approach.

Validation of the German Version of the Quality of Dying and Death Questionnaire for Informal Caregivers (QODD-D-Ang)

ContextThe quality of dying and death (QOD) influences end-of-life care for patients and their relatives. To the best of our knowledge, there are currently no validated standard instruments for evaluating the QOD of patients in palliative care units (PCUs) in Germany. ObjectivesThis study aimed to validate the German version of the multidimensional questionnaire “Quality of Dying and Death” for informal caregivers (QODD-Deutsch-Angehörige [QODD-D-Ang]) and provide a detailed report on its validity and reliability. MethodsThe QODD was forward/backward translated following the European Organization for Research and Treatment of Cancer guidelines. Data collected in two German palliative care units (N = 226) with the QODD-D-Ang were used to calculate the QODD-D-Ang total score (TS) and to define reliability and validity, as well as acceptance and burden for informal caregivers. Frequencies, means, and SDs of various patient data related to care and disease were calculated to describe the study population and to look at group differences. ResultsThe mean TS of 175 participants was 75.72 (range 38–99; minimum 0 to maximum 100; higher scores indicate better QOD). The QODD-D-Ang showed good internal consistency for 27 items (Cronbach's alpha 0.852). Factors extracted by factor analysis could not be usefully interpreted. The TS of the QODD-D-Ang correlated substantially with the Palliative care Outcome Scale (r = 0.540), indicating good convergent validity. The QODD-D-Ang TS was stable for various demographic and clinical dimensions except for the amount of days on which informal caregivers visited patients, and, therefore, provided good discriminant validity. ConclusionAnalyses of validity and reliability of the QODD-D-Ang showed satisfactory to good psychometric properties, meaning that the QODD can be recommended for standard implementation in German hospices and palliative care institutions to measure the QOD. Feasibility could be improved by adapting the instrument so that it may be administered with minimal demands on staff. When interpreting the results, it should be kept in mind that the QODD-D-Ang does not measure quality of care but the quality of the dying process as estimated by bereaved relatives.

Prototype Development of a Responsive Emotive Sensing System (DRESS) to aid older persons with dementia to dress independently.

Prior research has critiqued the lack of attention to the stressors associated with dementia related dressing issues, stigmatizing patient clothing, and wearable technology challenges. This paper describes the conceptual development and feasibility testing of an innovative 'smart dresser' context aware affective system (DRESS) to enable dressing by people with moderate memory loss through individualized audio and visual task prompting in real time. Mixed method feasibility study involving qualitative focus groups with 25 Alzheimer's family caregivers experiencing dressing difficulties to iteratively inform system design and a quantitative usability trial with 10 healthy subjects in a controlled laboratory setting to assess validity of technical operations. Caregivers voiced the need for tangible dressing assistance to reduce their frustration from time spent in repetitive cueing and power struggles over dressing. They contributed 6 changes that influenced the prototype development, most notably adding a dresser top iPad to mimic a familiar 'TV screen' for the audio and visual cueing. DRESS demonstrated promising overall functionality, however the validity of identification of dressing status ranged from 0% for the correct pants dressing to 100% for all shirts dressing scenarios. Adjustments were made to the detection components of the system raising the accuracy of detection of all acted dressing scenarios for pants from 50% to 82%. Findings demonstrate family caregiver acceptability of the proposed system, the successful interoperability of the built system's components, and the system's ability to interpret correct and incorrect dressing actions in controlled laboratory simulations. Future research will advance the system to the alpha stage and subsequent testing with end users in real world settings.

Neurologist assessment of reactions to the diagnosis of psychogenic nonepileptic seizures: Relationship to short- and long-term outcomes

PurposeTo determine the relationship between neurologist assessment of reactions to the diagnosis of PNESs and outcomes at 6–12months and at 5–10years. MethodsTwo hundred thirty-eight patients with psychogenic nonepileptic seizures (PNES) were recruited into a long-term follow-up study. At diagnosis and 6–12months post diagnosis, doctors recorded their assessments of patient and caregiver reactions to the diagnosis of PNESs. ResultsAt baseline, 92/238 patients (38.7%) and 73/106 caregivers (68.9%) were assessed as having understood and accepted the diagnosis, while 6.7% of patients and 10.4% of caregivers reacted with anger. At 6–12months, patient acceptance rose to 57.7%, with caregiver acceptance static at 70.8%. Attendance at follow-up was predicted by the presence of a caregiver at baseline: only one patient who came with a caregiver at baseline did not attend at 6–12months (OR: 123.80, p<0.001). Outcome at 6–12months was predicted by patient acceptance at baseline (OR: 2.85, p=0.006) and at 6–12months (OR: 13.83, p<0.001) and by caregiver acceptance at 6–12months (OR: 10.77, p<0.001). Presentation to primary or secondary care with attacks at 5–10years was predicted by caregiver acceptance at 6–12months (OR: 3.50, p=0.007). ConclusionPatient understanding and acceptance of the diagnosis of PNESs are linked to outcome at 6–12months. The beliefs of caregivers may be important for outcome in the longer term, particularly with respect to health-care use.

Medical nonadherence in pediatric HIV: Psychosocial risks and intersection with the child protection system for medical neglect

Nonadherence to antiretroviral treatment has serious health implications for HIV-infected children, at times warranting referral to child protective services (CPS). The current study of 134 children with perinatally acquired HIV infection aimed to investigate rates of treatment adherence and CPS involvement, multilevel variables associated with nonadherence, and the manner in which these risks operated together in the prediction of adherence outcomes. Risk factors for nonadherence were grouped on the basis of confirmatory factor models, and factor score regression was carried out to determine which factors were uniquely predictive of adherence. A series of indirect effects models were then tested in order to examine how these factors operated together in the prediction of adherence. Results showed that almost half of the sample demonstrated suboptimal adherence to treatment, and in one-fifth, CPS was involved for medical neglect. Caregiver Health, Caregiver Involvement, Caregiver Acceptance, and Child Adaptation were predictive of nonadherence, and together explained 54% of the variance in treatment adherence. There were significant indirect effects of Caregiver Health on adherence that operated through Caregiver Involvement and Child Adaptation and an indirect effect of Caregiver Involvement on adherence through Child Adaptation. Findings extend current literature that has independently linked various factors predictive of medical adherence in pediatric HIV by showing separate but simultaneous associations with nonadherence and unique pathways to adherence involving multilevel risks. Healthcare and child welfare implications are discussed.

Acceptability of Rapid Diagnostic Test-Based Management of Malaria among Caregivers of Under-Five Children in Rural Ghana

IntroductionWHO now recommends test-based management of malaria (TBMM) across all age-groups. This implies artemisinin-based combination treatment (ACT) should be restricted to rapid diagnostic test (RDT)-positive cases. This is a departure from what caregivers in rural communities have been used to for many years.MethodsWe conducted a survey among caregivers living close to 32 health centres in six districts in rural Ghana and used logistic regression to explore factors likely to influence caregiver acceptability of RDT based case management and concern about the denial of ACT on account of negative RDT results. Focus group discussions were conducted to explain the quantitative findings and to elicit further factors.ResultsA total of 3047 caregivers were interviewed. Nearly all (98%) reported a preference for TBMM over presumptive treatment. Caregivers who preferred TBMM were less likely to be concerned about the denial of ACT to their test-negative children (O.R. 0.57, 95%C.I. 0.33–0.98). Compared with caregivers who had never secured national health insurance cover, caregivers who had valid (adjusted O.R. 1.30, 95% CI 1.07–1.61) or expired (adjusted O.R. 1.38, 95% CI 1.12–1.73) insurance cover were more likely to be concerned about the denial of ACT to their RDT-negative children. Major factors that promote TBMM acceptability include the perception that a blood test at health centre level represents improvement in the quality of care, leads to improvement in treatment outcomes, and offers opportunity for better communication between health workers and caregivers. Acceptability is also enhanced by engaging caregivers in the procedures of the test. Apprehensions about negative health worker attitude could however undermine acceptance.ConclusionTest (RDT)-based management of malaria in under-five children is likely to be acceptable to caregivers in rural Ghana. The quality of caregiver-health worker interaction needs to be improved if acceptability is to be sustained.

Virtual Caregiver: An Ambient-Aware Elderly Monitoring System

The growing number of elderly population at home and abroad necessitates improved approaches to elderly care provision. Elders, often with cognitive and physical impairment, need assistance in their activities of daily living (ADLs), which is usually provided by human caregivers. As the demand for caregivers assistance increases, the shortage of traditional care resources becomes obvious. In this paper, we present the Virtual Caregiver (ViCare) framework that supports a human caregiver to monitor continuously the elderly by being aware of their surroundings. The ViCare system attempts to understand the elderly persons activities and contexts based on the data captured by the sensors placed in their environment and dynamically decides what services to provide them or whether there is a need to interrupt human caregiver depending on the type of activities. It not only minimizes the cognitive load of the human caregiver but also provides a seamless assistance to the elderly toward their improved health and well-being in their living environment. We conducted the experiments in an instrumented home environment and obtained positive results in terms of the satisfaction of the elderly, interaction event handling, caregivers acceptance and their engagement.

Caregiver acceptability and preferences for preventive dental treatments for young African-American children.

Our prior research focused on parental treatment acceptability (TA) and treatment preferences (TPs) for preventive dental treatments for young Hispanic children. We adapted the interview for administration to parents of young African-American children. In a sample of African-American parents, determine parental TA and TP for five dental treatments to prevent early childhood caries. Interviewed 48 parents/caregivers of African-American children attending Head Start, assessing TA and TP for three treatments for children: toothbrushing (TB) with fluoride toothpaste, fluoride varnish (FV), and xylitol in food (XF); and two treatments for mothers: xylitol gum (XG) and chlorhexidine (CHX) rinse. The interview included verbal information, illustrated treatment cards, photos/video clips, and samples. Parents provided TA of each treatment (one to five scale), TP between each of 10 pairs of the five treatments, and open-ended reasons for their preferences. TPs were summed (zero to four) to create overall preference. All treatments were acceptable (means 4.4-4.9). TB was more acceptable than FV and XF (P < 0.05). Summed TP revealed a strong preference for TB (mean 3.1) above other treatments (all P < 0.01). Primary reasons for preferring TB were the following: promotes healthy habits; child focused; and effectiveness. All treatments were acceptable, however, parents/guardians strongly preferred TB. Parents' emphasis on healthy habits and child-focused treatment supports efforts for oral health education programs in early childhood settings. Some parents expressed concerns about FV, XF, and CHX. Results may be useful in planning prevention programs for young children in African-American communities.

Gerontechnology: Providing a Helping Hand When Caring for Cognitively Impaired Older Adults—Intermediate Results from a Controlled Study on the Satisfaction and Acceptance of Informal Caregivers

The incidence of cognitive impairment in older age is increasing, as is the number of cognitively impaired older adults living in their own homes. Due to lack of social care resources for these adults and their desires to remain in their own homes and live as independently as possible, research shows that the current standard care provisions are inadequate. Promising opportunities exist in using home assistive technology services to foster healthy aging and to realize the unmet needs of these groups of citizens in a user-centered manner. ISISEMD project has designed, implemented, verified, and assessed an assistive technology platform of personalized home care (telecare) for the elderly with cognitive impairments and their caregivers by offering intelligent home support services. Regions from four European countries have carried out long-term pilot-controlled study in real-life conditions. This paper presents the outcomes from intermediate evaluations pertaining to user satisfaction with the system, acceptance of the technology and the services, and quality of life outcomes as a result of utilizing the services.

Family Acceptance in Adolescence and the Health of LGBT Young Adults

the role of family acceptance as a protective factor for lesbian, gay, bisexual, and transgender (LGBT) adolescents and young adults has not been established. a quantitative measure with items derived from prior qualitative work retrospectively assessed family accepting behaviors in response to LGBT adolescents' sexual orientation and gender expression and their relationship to mental health, substance abuse, and sexual risk in young adults (N= 245). family acceptance predicts greater self-esteem, social support, and general health status; it also protects against depression, substance abuse, and suicidal ideation and behaviors. family acceptance of LGBT adolescents is associated with positive young adult mental and physical health. Interventions that promote parental and caregiver acceptance of LGBT adolescents are needed to reduce health disparities.

Invasive Beatmung und nicht-invasive Beatmung im Konflikt mit bester palliativer Versorgung bei schwerer COPD

This example of an 80-year-old patient with severe lung disease and respiratory failure demonstrates the difficult relationship between the patient's needs, physical symptoms, and social problems. This man decides after a prolonged and difficult in-patient treatment actively for home ventilation rather than die of respiratory failure. He opts for tracheostomy and invasive ventilation because he cannot handle non-invasive mask-ventilation sufficiently by himself. It requires professional communication and support to gain the acceptance of family and caregivers for home ventilation. A survey of existing data on end of life decision-making in end-stage lung disease is given.

Caregiver acceptability and preferences for early childhood caries preventive treatments for Hispanic children.

The objective of this study was to determine caregiver treatment acceptability and preferences for five preventive dental treatments for early childhood caries in young Hispanic children. We interviewed 211 parents/caregivers of Hispanic children attending Head Start programs regarding their acceptability of, and preferences for, five standard preventive dental treatments for young children. Treatments assessed were toothbrushing with fluoride toothpaste, fluoride varnish, and xylitol in food for children, and xylitol gum and chlorhexidine rinse for mothers. The interview assessment included presentation of illustrated cards with verbal description of treatment, photograph/video clip, and treatment samples. Parents rated the acceptability of each treatment (1-5 scale) and treatment preferences within each of 10 possible pairs. Individual treatment preferences were summed to create overall preference scores (range 0-4). All treatments were rated as highly acceptable, however, there were differences (range 4.6-4.9; Friedman chi-square = 23.4, P < 0.001). Chlorhexidine, toothbrushing, and varnish were most acceptable, not different from each other, but more acceptable than xylitol in food (P < 0.05). Summed treatment preferences revealed greater variability (means ranged 1.4-2.6; Friedman chi-square = 128.2, P < 0.001). Fluoride varnish (2.6) and toothbrushing (2.5) were most highly preferred, and differences between preferences for xylitol in food (1.4), xylitol gum (1.5), and chlorhexidine (2.1) were all significant (P < 0.001). Preferences for chlorhexidine were also significantly greater than those for the xylitol products (P < 0.001). All five treatments were highly acceptable, however, when choosing among treatments overall, fluoride varnish and toothbrushing were favored over other treatments.

An experience of psychological support at home for aged and dependent people and their families. Assesment of the PsyAdom programme

The PsyAdom project has been initiated by the Clinical Psychologist Working in Gerontology Association. It consists in setting up an at home psychological follow-up for aged dependent subjects and their caregivers. Families are often isolated, and being kept up in their homes involves a risk of exhaustion. Psychological help is usually offered outside home, and cannot be available or very costly for some people. Eighteen couples were included in the study. Anxiety of the patients and caregivers was assessed by the Goldberg's anxiety scale, depression by the MADRS, experienced stress by the Mini-Zarit scale and attitude towards psychological help by the NPI. A qualitative assessment of the intervention was performed by recording semi-directed interviews of the involved psychologists to assess the patients and caregivers acceptance of the intervention, their compliance with participating, and reasons for stopping the intervention. No significant difference was found in the caregivers' burden and anxiety following the intervention. However, the results showed a lower level of depression in the caregivers, and a better attitude of the patients towards the caregivers. Analysis of the initial application for help and acceptance of the follow-up shows that possibility and relevance of psychological intervention at home depend on accurate indications. Initial application should be very unequivocal and the therapy protocol clearly explicited from the start to allow a good understanding of the goals of the therapy by the patients and caregivers.

Acceptance and Expressed Emotion in Mexican American Caregivers of Relatives with Schizophrenia

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.