Attitudes Of Family Members Research Articles

Survey on hospice care attitude of family members of advanced cancer patients at different ages.

Hospice care plays an important role in improving the quality of life of advanced cancer patients, but controversy remains over whether age affects the attitudes of family members toward hospice care. To investigate the attitudes of family members of advanced cancer patients of different ages toward hospice care. The study participants were 175 family members of patients with advanced cancer from January 2020 and October 2022. The participants were divided into youth (< 40 years, n = 65), middle-aged (40-60 years, n = 59), and elderly (> 60 years, n = 51) groups. Researchers investigated and compared the degree of awareness regarding hospice care, attitudes, and whether the family members of patients would choose hospice care. Among the family members of 175 patients, approximately 28% (49/175) were aware of hospice care. Awareness of hospice care, the proportion of hospice care acceptance and adaptation attitudes, and the proportion of those who chose hospice care in the youth group were higher in the middle-aged and elderly groups (P < 0.05). No statistically significant difference was found in these three indicators between the middle-aged and elderly groups (P > 0.05). Hospice care was chosen mainly to relieve pain and reduce unnecessary treatment, whereas the reasons for not choosing hospice care were mainly distrust and ethical concerns. The family members of patients with advanced cancer had relatively low awareness of hospice care, while youth had a higher awareness of hospice care, acceptance, and adaptation attitudes, and were more willing to choose hospice care.

IJCM_325A: A Study on Relationship of Working Status of Rural Adult Women with Their Mental Health in a Rural Block of West-Bengal

Background: Mental health is a major public health concern worldwide. Studies showed that women are impacted at a higher rate than men. There is definite scarcity of studies in public health domain, which reflect the mental health and its correlates among rural women specially in relation to their working status. Objectives: Present study envisages to assess and compare the mental health status of working and non-working adult rural women and find out the factors associated with the mental health status of the study participants. Methodology: A community based; cross-sectional study was done between August 2023 to November 2023 in a rural area of Hooghly district. The sample consists of 394 women (197 working women and 197 non-working women) were selected using Multistage random sampling from 3 villages. Using the predesigned, pretested interview schedule and self-reporting questionnaire, all relevant information was collected. The collected data was analysed using descriptive and inferential statistics using SPSS 16 version. Institutional Ethics Committee clearance was obtained. Results: The mean age of the study participants was 37 (± 10.09) years. Most of them belonged to socio-economic class IV. Majority of them were currently married. Around 22.33% of working women and 28.40% of non- working women had poor mental health. The factors associated with poor mental health among working women were work place atmosphere (p&lt;0.01), attitude of colleagues (p=0.01), attitude of family members (p=0.01), social support satisfaction (p&lt;0.01) and the factors associated with poor mental health among non-working women were satisfaction status of getting financial aid from family members (p=0.016), domestic violence (p&lt;0.01). Conclusion: Awareness program regarding various aspects of mental health for both working and non-working women at family level, community level as well as at workplace could be a useful strategy in reducing this public health problem.

Parenting and family life experiences of mothers diagnosed with schizophrenia within Chinese cultural context.

WHAT IS KNOWN ON THE SUBJECT?: Parenting experiences are a great challenge but also a meaningful achievement for mothers diagnosed with schizophrenia (MDWSs). Most previous studies focused on the parenting experiences of Chinese mothers diagnosed with depression rather than those diagnosed with schizophrenia, who usually experience psychiatric symptoms. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Unlike in Western society, Chinese society is characterised by a family-centred culture. This study insightfully explores MDWSs' parenting and family life experiences addressing their intrapersonal mindsets, interpersonal connections with family members across generations and extrapersonal roles such as traditional social expectations as a mother, wife and daughter-in-law. While Western studies have mainly focused on MDWSs' personal resilience, this study insightfully explored MDWSs' resilient dimensions including their personal, familial and cultural issues within the Chinese society. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This study develops a comprehensive and professional understanding of the parenting experiences and family interactions of MDWSs who struggle to achieve their motherly role and re-establish connections with intimate family members. The findings highlight the following important considerations when offering family-based nursing cares: (1) assess power relationships, familial dynamics and cultural influences between MDWSs and their family members; (2) extend family members' involvement, such as parents-in-law, while offering psychoeducation to MDWSs and their family members. ABSTRACT: Introduction In Chinese culture, raising the next generation is recognised as a crucial family matter involving intergenerational participation. Mothers diagnosed with schizophrenia (MDWSs) usually experience high stress due to psychiatric symptoms, different parenting values across generations and traditional expectations associated with motherly roles. MDWSs need urgent professional assistance. Aim To explore MDWSs' parenting experiences and family life in Chinese cultural contexts. Method In-depth interviews were conducted with 20 MDWSs. Data were analysed using interpretative phenomenological analyses. Results The superordinate theme was identified as 'You are not a qualified mother'. Three major themes were elicited: experiencing crises in parenting, family life and self-stability; striving to be a good mother and wife under humiliation; and developing wisdom and courage to move forward. Discussion A dehumanised attitude of family members in a paternalistic culture was found. While Western society focuses on personal resilience and family-based nursing care for nuclear families, Chinese society intensively focuses on MDWSs' relationship with nuclear family members as well as extended family members such as parents-in-law. Implications for Practice The results highlighted the significance of culturally sensitive nursing care for MDWSs and family-centred psychoeducation that clarifies familial dynamics and improves effective communication between MDWSs and their family members.

Attitudes of Family Members and Caregivers Regarding Alzheimer's Disease Pre-Symptomatic Screening.

In recent years, studies have examined the acceptability and attitudes that influence the intention to early screen for Alzheimer's disease (AD) in the general population, older people, carers, and asymptomatic individuals who report a family history of AD. However, it remains unclear what specific factors promote or reduce the acceptability of pre-symptomatic screening. The aim of this study is to explore the attitudes of family and non-family members as well as caregivers and non-caregivers toward the pre-symptomatic screening of AD. A total of 213 participants completed the Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening (PRE-ADS) Questionnaire. Group comparisons using t-test and one-way ANOVA were used to examine differences in attitudes toward pre-symptomatic screening regarding age, family history, knowing someone with AD, influence of depression, and feelings of anxiety. The subscale "Acceptability of Screening" was developed to investigate the willingness to undergo pre-symptomatic screening. Participants with a family history showed greater acceptance of pre-symptomatic screening while both caregivers and non-caregivers had similar attitudes. People with a family history as well as those with personal connections to dementia indicate a greater need for knowledge. The findings suggest that younger adults appear to perceive less harm from testing, whereas those who experience higher levels of anxiety and depression seem to perceive more testing harms. Comparing the attitudes of people with and without a family history as well as caregivers and non-caregivers toward pre-symptomatic screening of AD is critical to understand the differences between these groups and develop comprehensive screening programs.

Trying Perpetrators: Denazification Trials and Support for Democracy in West Germany

We study the effects of transitional justice (TJ) programs that punish large numbers of human rights violators through the lenses of social psychology theories on how individuals respond to punishment in allocative situations, including how defendants in court trials evaluate their verdicts. We analyze subnational variation in procedures and outcomes of denazification trials in West Germany during 1946-1947. Consistently with established findings in social psychology, we find that procedural justice and the distributive fairness of outcomes can compensate for the anti-democratic attitudinal effects of being a defendant in a TJ trial. We also find evidence that procedural justice influences the democratic attitudes of family members of TJ defendants. The study has implications for contemporary cases of TJ programs that affect large numbers of perpetrators.

Attitudes toward pre-symptomatic screening for Alzheimer's dementia in five European countries: a comparison of family members of people with Alzheimer's dementia versus non-family members.

Introduction: Pre-symptomatic screening is getting more attention in healthcare as it detects the risk for developing neurodegenerative diseases like Alzheimer's disease (AD), which is very useful for treatment or prevention. AD screening could play an important role in individuals with at least one affected first-degree relative, but also without family history. As the demand for screening is rising worldwide, it is important to consider possible cross-cultural differences in attitudes toward pre-symptomatic screening in order to tailor healthcare services to the needs of each country. Objective: This study aims to investigate the attitudes of family members and non-family members of people with dementia toward pre-symptomatic screening and explore possible differences in attitudes across five European countries (Belgium, Germany, Greece, Spain, Turkey) using translated versions of the "Perceptions regarding pRE-symptomatic Alzheimer's Disease Screening" questionnaire (PRE-ADS). Methods: The multicultural sample (N = 650) was recruited from samples that were previously used in validation studies of the translated PRE-ADS versions. The subscale "Acceptability of Screening", consisting of five PRE-ADS items to specifically explore willingness to undergo screening, was created. Ιnternal consistency was measured, and structural validity was determined using Confirmatory Factor Analysis (CFA). Group comparisons were performed to investigate differences in attitudes toward pre-symptomatic AD screening regarding family history and country of origin using the PRE-ADS and the "Acceptability of Screening" mean scores. Results: Construct validity was acceptable for the PRE-ADS. Both the PRE-ADS (α = 0.76) and its subscale "Acceptability of Screening" (α = 0.90) had good internal consistency. Overall, 56.9% of the total sample expressed a positive intention toward pre-symptomatic AD screening. T-tests showed significantly higher mean scores of participants with an affected family member. An international comparison revealed differences in the "Acceptability of Screening" mean score across the five European countries. No cross-cultural differences were found for the PRE-ADS mean score after adjusting for confounding variables. Conclusion: The PRE-ADS and its subscale are reliable tools for assessing pre-symptomatic AD screening attitudes. Variations in the acceptability of screening seem to be linked to family history and cultural influences. Further research with larger samples is needed to explore underlying relationships.

Which Psychological and Psychosocial Constructs Are Important to Measure in Future Tendinopathy Clinical Trials? A Modified International Delphi Study With Expert Clinician/Researchers and People With Tendinopathy.

OBJECTIVE: To identify which psychological and psychosocial constructs to include in a core outcome set to guide future clinical trials in the tendinopathy field. DESIGN: Modified International Delphi study. METHODS: In 3 online Delphi rounds, we presented 35 psychological and psychosocial constructs to an international panel of 38 clinician/researchers and people with tendinopathy. Using a 9-point Likert scale (1 = not important to include, 9 = critical to include), consensus for construct inclusion required ≥70% of respondents rating "extremely critical to include" (score ≥7) and ≤15% rating "not important to include" (score ≤3). Consensus for exclusion required ≥70% of respondents rating "not important to include" (score ≤3) and ≤15% of rating "critical to include" (score ≥7). RESULTS: Thirty-six participants (95% of 38) completed round 1, 90% (n = 34) completed round 2, and 87% (n = 33) completed round 3. Four constructs were deemed important to include as part of a core outcome set: kinesiophobia (82%, median: 8, interquartile range [IQR]: 1.0), pain beliefs (76%, median: -7, IQR: 1.0), pain-related self-efficacy (71%, median: 7, IQR: 2.0), and fear-avoidance beliefs (73%, median: -7, IQR: 1.0). Six constructs were deemed not important to include: perceived injustice (82%), individual attitudes of family members (74%), social isolation and loneliness (73%), job satisfaction (73%), coping (70%), and educational attainment (70%). Clinician/researchers and people with tendinopathy reached consensus that kinesiophobia, pain beliefs, pain self-efficacy, and fear-avoidance beliefs were important psychological constructs to measure in tendinopathy clinical trials. J Orthop Sports Phys Ther 2024;54(1):1-12. Epub 20 September 2023. doi:10.2519/jospt.2023.11903.

Parental attitudes, beliefs and behaviors toward childhood and COVID-19 vaccines: A countrywide survey conducted in Kazakhstan examining vaccine refusal and hesitancy

BackgroundVaccination rates worldwide have declined in recent years. This decrease is primarily driven by vaccine hesitancy, which remains understudied in Central Asia, including Kazakhstan. Furthermore, there is great concern about parental hesitancy toward COVID-19 vaccines, as previous studies have focused on adult vaccine hesitancy. The current study was conducted by UNICEF and funded by USAID to explore the drivers of routine and COVID-19 immunization behaviors among parents and caregivers in Kazakhstan. MethodsUsing a cross-sectional methodology, researchers conducted 3081 face-to-face interviews with parents and caregivers of children aged 0–17 years across cities and villages in Kazakhstan. A tablet-based questionnaire (CAPI) was utilized, collecting participants’ data on sociodemographic characteristics, childhood and COVID-19 vaccination behaviors, and potential drivers. ResultsTotal of 239 participants (7.8%) were found to previously refuse vaccination due to their own beliefs. Stronger belief that vaccines are efficacious (AdjOR = 0.47), stronger belief that childhood vaccines are safe and danger of vaccine-preventable diseases is high (AdjOR = 0.73), firmer trust in societal factors (AdjOR = 0.77) and positive attitudes of family members toward immunization (AdjOR = 0.6) were significantly associated with parental refusal of childhood vaccines. The large proportion of respondents (N = 2,634, 85.6%) missed the COVID-19 vaccination of their child or were unwilling to get vaccinated. Stronger belief that COVID-19 vaccines are safe and efficacious (AdjsOR = 0.18), lacking important information about COVID-19 vaccines (AdjOR = 1.25) and parents being unvaccinated against COVID-19 (AdjOR = 2.3) were significant predictors of vaccine hesitancy. ConclusionThis study revealed numerous socio-demographic and behavioral factors significantly associated with parental refusal of childhood vaccines and hesitancy toward COVID-19 vaccines. Many parents not refusing vaccination possessed negative attitudes towards vaccines. Potential changes in their attitudes and beliefs of parents were observed compared to findings from pre-COVID era. Continuous monitoring of parental hesitancy, proper interventions and education of healthcare workers are suggested to reduce parental vaccine hesitancy.

Social psychological dynamics of migrant women employment: The experiences of displaced Syrian women in Turkey

In this paper, we examine the social and psychological factors associated with the well-being of Syrian women who migrated to Turkey due to the Syrian civil war, both employing in a paid job and non-employing. For this purpose, semi-structured, in-depth, face-to-face interviews in their mother tongue were carried out with 25 participants. The thematic analysis method was applied to the data, following the guidelines suggested by Braun and Clarke (2006). The well-being of Syrian refugee women was found to be related to two main clusters, which emerged as themes from the analyses: (a) Attitudes of Syrian refugee women and their close relatives toward women's employment; and (b) working conditions and/or domestic responsibilities. The results show that having good working conditions, being supported by family, and being involved in social life positively contributed to the well-being of employed refugee women. Unfavorable working conditions, perceived gender and ethnic discrimination, and negative attitudes of family members toward women working, on the other hand, were found to have a detrimental impact on their well-being. Regarding non-employing women, barriers such as domestic responsibilities and the negative attitudes of spouses that restrain them from working in a paid job or being involved in social life appeared to have a negative impact on their well-being. We discussed our findings in light of the literature.

Better to Be Unpaid than COVID-19 Vaccinated! A Qualitative Study on Italian Nurses Suspended from Work without Salary.

In Italy, from April 2021, healthcare workers were required to receive the COVID-19 vaccine; if they refused it, an immediate unpaid suspension was implemented until they received the vaccine. Although there are numerous quantitative studies on the factors that influenced vaccine hesitancy during the COVID-19 pandemic, qualitative research on the causes of vaccine refusal is still missing. This research aimed to investigate the phenomenon of nurses who refused to receive COVID-19 vaccination despite being required to do so, as well as the reasons behind their refusal. Furthermore, the actions of those who abandoned this stance were explored. This was a qualitative study involving the methodological approach of grounded theory. Twenty-four nurses were interviewed virtually via Zoom from May to July 2022. Anti-vax behavior-as emerged from nurses' experiences-was based on seven themes: (1) job satisfaction, (2) the main sources of information on COVID-19, (3) the reasons for refusing the COVID-19 vaccine, (4) the attitudes of family members toward the COVID-19 vaccine, (5) previous experience with other vaccines, (6) firm opposition to the vaccine (unvaccinated nurses), (7) reluctant acceptance (vaccinated nurses). It was shown that it is imperative for health authorities to adopt timely, documented, transparent, and consistent communication when carrying out public health campaigns, especially for vaccination.

Prevalence and characteristics of family history of sudden unexplained death and predictors of negative attitude of family members toward medical autopsy and family screening in Saudi Arabia: A cross-sectional study.

Little is known about sudden unexplained death (SUD) in Saudi Arabia. Moreover, family screening and medical autopsy are not routinely performed due to perceived religious and cultural resistance. However, this has never been systematically examined. We sought to describe the prevalence and characteristics of family history of SUD and the attitude of family members toward medical autopsy and family screening. This was a cross-sectional study utilizing an online survey distributed though social media platforms from August 15 to September 15, 2021. Participants' characteristics, details about SUD cases, and the attitude toward medical autopsy and family screening were collected. Multivariable logistic regression was used to identify independent predictors of negative attitude toward medical autopsy. A total of 11374 were included in the final analysis after excluding children. The prevalence of FHx of at least one first degree relative (FDR) with SUD was found to be 9.4% [95% CI (8.9% - 10%)]. Among participants with any FHx of SUD, 1346/3489 (38.6%) had ≥ 2 family members affected. Only 183 participants with a FHx of SUD visited a physician for the purpose of family screening (183/3489, 5.3%). The total number of SUD cases reported was 5474. Of those, 22% were 35-year-old or younger. Only 22% of participants (2458/11374) had a negative attitude towards medical autopsy, and the most common reason was the perceived lack of benefit. Older age (> 35 years), family history of SUD, female gender, and lack of knowledge about the yield of medical autopsy were associated with negative attitude in the adjusted analysis. SUD occurred at young age and affected multiple family members in a significant proportion of families. Despite that, family screening was seldom performed. There is an urgent need to improve the care of SUD by incorporating medical autopsy and developing clinical pathways to screen family members.

Female Entrepreneurship: from Empiricism and Doctrine to Legal Regulation

The purpose of the study is to determine the role of female entrepreneurship, the level of doctrinal reasoning and the need for legal regulation of this phenomenon. The paper demonstrates the significance of the women’s business segment and its positive dynamics. The author shows the negative impact of COVID-19 and the crisis in the economy concerning the development of women’s entrepreneurship. The data paper provides data concerning the proportion of women among the heads of organizations. The presence of «female» potential for small business is emphasized. The study identifies the trend for women to acquire the status of being self-employed. It is established that in science, representatives of sociology show the greatest interest in studying the problems of women’s entrepreneurship; less often researchers are interested in psychology and economics. Legal research in this field is very limited. It is noted that the legal doctrinal basis of women’s entrepreneurship in Russia has not been formed; there are practically no in-depth developments of the concept of women’s entrepreneurship, its types, and features of implementation. The paper describes the main directions of theoretical research of this problem. These include: the specifics of women’s entrepreneurship and barriers to its development; the «entry» of women into business and its management strategies; the attitude of family members to women’s entrepreneurship and the role balance. The author draws attention to the methodological basis of the study of women’s entrepreneurship, the peculiarity of which is an active appeal to such sociological methods as questionnaires and interviewing. The author performed an independent sociological survey and presented its results. The author expresses an opinion concerning the need to legitimize women’s entrepreneurship, develop a legal mechanism for regulating women’s business and an integral ecosystem of support for women’s entrepreneurship, proposing an algorithm of actions in this direction. It is concluded that when building a system of legal regulation, it is important to take into account the foreign experience that has brought results, while preserving the national differences of Russian women’s entrepreneurship.

Model for the success of family business succession in Bangkok and its metropolitan

Family businesses in Thailand are part of the country's economic development and are essential for Thailand's GDP. For many years, the family businesses have been strengthened by a family constitution that focuses on the succession of the business to a new generation that comes from family members. The study was conducted in Bangkok and its metropolitan to assess the considering factors that impact the business success of the family. The leaders of the traditional family business have no business succession planning, their successors lack potential, and they have no positive attitudes towards the family business. As a consequence, the succession of the family business was unsuccessful. Both quantitative and qualitative methods were utilized to achieve this study’s set objective. This study used multi-stage sampling as a quantitative research method. The sample comprised 560 people who were heirs of family business entrepreneurs from the second generation to the present age in Bangkok and its metropolitan areas. The study results found that the technology, innovation, attitude of family members, responsibility of family members, leadership, potential, and family constitution significantly participate in the family business succession process. The study contributes practically and also to literature.

Knowledge of Diet and Dietary Pattern in Pregnant Women Attending Antenatal Clinic in Community Based Medical College, Bangladesh

A cross-sectional, descriptive study was conducted in Community Based Medical College, Bangladesh (CBMC,B) Hospital during August and September 2018 to identify knowledge, attitude and practice regarding diet among pregnant women attending antenatal checkup. This study was done as a part of Residential Field Site Training by 3rd year MBBS students under Community Medicine curriculum. Data were collected on a predesigned questionnaire by direct interviewing a total of 116 pregnant women. Data analysis was done by SPSS version 20.0. Age distribution of respondents ranged from 18 years to 35 years; mean age 24.45±4.69 years. Most of the respondents 99(85.34%) belonged to age group 18 years to 29 years. Most of them were Muslim 99(85.34%), literate 93(80.17%), and housewives 96(82.76%), belonged to middle class family 65(56.03%). 46(39.66%) were found at risk, based on risk assessment. Knowledge regarding diet and nutrition was found in optimum level. Majority 55(47.41%) had excellent score, while 49(42.24%) had good score and 12(10.34%) were not up to the mark. Attitude of family members regarding care of pregnant woman was positive in most cases, 113(97.41%). Majority 55(47.41%) had excellent dietary practice, 23(19.83%) were good and 38(32.76%) were bad. Barriers of implementation of good dietary practice include lack of knowledge 12(10.34%), poverty 17(14.66%) and lack of cooperation from husband and in-laws 9(7.76%).&#x0D; CBMJ 2022 January: vol. 11 no. 01 P: 46-51

Psychoeducational programs for relatives of patients with dementia

In the last decade, dementia has been recognized as one of the four major medical and social problems of modern humanity. This is explained by the fact that the number of old and elderly people is steadily growing every year. This population is prone to both the development of the disease itself and to increase the duration of the disease. This contingent also has a large number of people with disabilities. A comprehensive clinical, psychopathological and psychodiagnostic examination of 97 relatives of patients with dementia (56 women and 41 men) was conducted. Against the background of the psychoeducational program in the families of patients there was a positive dynamics of family functioning — the predominance of adequate attitude of relatives to the disease. There was a high level of family support, which was characterized by a positive attitude of family members to the need and opportunity for emotional and social support of the patient, willingness to cooperate and constructively solve new problems in everyday life, recognizing the limits of their capabilities without illusions and unjustified expectations.

Perceived barriers and facilitators of physical activity in adults living in activity-friendly urban environments: A qualitative study in Sri Lanka.

BackgroundDespite reforming health policies to create more enabling environments, insufficient physical activity in Sri Lanka remains a major public health issue. Socio-culture specific determinants underlying the physical activity of adults living in such environments need to be identified. The aim of this study was to explore the barriers and facilitators for physical activity, as perceived by adult urban dwellers in activity-friendly environments in Colombo District, Sri Lanka.MethodsA qualitative study using in-depth interviews was conducted among adults aged 20–60 years living in an urban area which has been recently re-designed for recreational and rejuvenating purposes in Sri Lanka. Recruitment targeted varying socio-economic status and risk of non-communicable diseases; and was continued until the data saturation point was reached. Interviews were conducted in homes, primary healthcare units and fitness centres, and were transcribed verbatim and analysed using framework analysis.ResultsA total of 31 eligible and consenting adults were interviewed. Of the reported barriers to physical activity, lack of time was very common. Other frequently reported barriers included unpleasant experiences following exercise and misconceptions about exercise, whereas physical environmental factors, weather and road safety were reported less frequently. All participants reported at least one facilitator for engaging in exercise. Expectations of preventing diseases, improving health, physical fitness, psycho-social wellbeing, optimising body functions and increasing lifespan were frequently cited as reasons to be active, while social factors such as positive attitudes of family members and the influence of peers were found to be motivating.ConclusionsThe study showed that while participants valued the health benefits of physical activity and refurbished activity-friendly urban environments, these were not sufficient to support them to overcome key perceived barriers to being physically active.

Lay Health Workers in Community-Based Care and Management of Dementia: A Qualitative 'Pre' and 'Post' Intervention Study in Southwestern Uganda.

Background The global need for efficient and cost-effective use of healthcare resources in low-income countries has led to the introduction of lay health workers (LHWs) as a link of the community to healthcare services. As such, the LHWs perform a variety of tasks such as education, support for care delivery, and social support across all disease types. However, little is known about their ability to support dementia care and management in the community. Purpose The goal of the pilot intervention was to evaluate the 5-day training intervention for LHWs in rural southwestern Uganda in community-based care and management of people with dementia, and implementation of the knowledge and skills gained. Methods This was a “pre” and “post” pilot intervention study which involved a qualitative assessment of LHWs' knowledge on community-based management and care for people with dementia. We focused on four core competency domains in the WHO dementia toolkit. The intervention included a five-day training of the LHWs on dementia care, eight weeks of implementation, and an evaluation of the experiences. Analysis focused on the needs assessment, early detection and management, community engagement, support for people with dementia; and evaluation of the eight weeks implementation. Results Before the training, the LHWs did not know much about what dementia-related support to provide in the community. Activities were limited to general support, including nutrition, and health education. After the training, LHWs had a basic understanding of dementia and began sensitizing the communities. They felt more comfortable working with people with dementia and reported a notable change in the attitude of family members. However, they reported challenges in differentiating the signs of early dementia from superstitious beliefs. Conclusion With enhanced capacity, LHWs may be able to support community-based management for people with dementia. A larger study is needed to explore potential roles for LHWs and further assess effectiveness of the LHWs' skills.

Psychotropic medication deprescribing in residential aged care facilities: An exploratory study of the knowledge and attitudes of family members of residents with dementia.

General practitioners face many barriers to deprescribing psychotropic medications in people with dementia in nursing homes, including a lack of knowledge about their medication histories. This study explored the knowledge of family members about residents' medications and their willingness to support deprescribing. Sixty-six family members of residents from seven residential aged care facilities participated in this cross-sectional study. Participation involved nomination of recognised medications, rating their effectiveness and rating level of support for deprescribing. Fifty-five per cent of medications were recognised by family members; significantly fewer psychotropics were recognised than non-psychotropic medications. Though rated as just as effective, support for deprescribing psychotropics was significantly higher. Most family members were agreeable to deprescribing with general practitioner support. Although there is a gap in family members' knowledge about psychotropic medications, overall they are supportive of deprescribing. Findings emphasise the need for psychoeducation among family members. Providing family members with a list of prescribed medications, specifying the type of and reason for prescription and side effects of each, is recommended to facilitate their advocacy for deprescribing on behalf of nursing home residents.

POS-432 PRIMARY HYPEROXALURIA, A TOO OFTEN MISSED DIAGNOSIS AND CAUSE OF END STAGE KIDNEY DISEASE IN ADULTS : A MONOCENTRIC TUNISIAN STUDY

Primary hyperoxaluria (PH) is a rare hereditary metabolic disorder of oxalate overproduction. Persistently high plasma oxalate concentrations lead to potential life-threatening complications. The major objective of this study is to investigate this condition which is frequent in our country but under diagnosed. In a retrospective descriptive study, we reviewed the record of 9 patients who were diagnosed with primary hyperoxaluria hospitalized at a nephrology department during the period 2001-2020. Their demographics, clinical and investigations parameters were documented. Nine patients were enrolled and followed up. Mean age of patients was 21, 2 ± 12, 3 years with predominance of male (88, 8%). Consanguinity was noted in 28, 5%. All our patients were from Tunisian center (55, 5% were from Gafsa). Renal colic and urolithiasis were the most common symptoms in our study (100%). Ultrasonography and CT scans showed nephrocalcinosis in 5 cases (55, 55%). Urinary tract infections were observed in 2 cases (22, 2%). Renal failure was noted in almost all cases; serum creatinine level ranged from 144 to 986 µmol/L. Seven patients reached end-stage renal disease and were treated with hemodialysis at a median age of 23 years. The extra renal manifestations were bone impairment (4 cases), bone marrow fibrosis (2 cases), cardiac dysfunction (1case), digestive wall calcifications (1 case) and adrenal insufficiency (1 case). The diagnosis was based on Hyperoxaluria (1 case), positive crystalluria (1 case), kidney stone analysis (2 cases) and oxalate crystal deposition identified in both renal and bone marrow biopsy respectively in one and four cases. Mutational analysis of AGXT gene was carried out in five out of nine patients. We identified a novel frameshift mutation in the AGXT gene, the c.406_410dupACTGC resulting in a truncated protein (p.Gln137Hisfs*19). It was found in homozygous state in two related patients from the Tunisian center. Primary hyperoxaluria is not rare in the Tunisian population. In our study it was lately diagnosed in most cases. Awareness campaign to change attitude of family members to screening should be conducted.

English

BACKGROUND Due to various factors, elderly population is growing rapidly worldwide and also in India. Changing socio-economic patterns, such as women becoming economically active and participating in the workforce, and increasing mobility are all leading to more nuclear households, altering social norms of elder care in the family. Old age homes which were not common are now growing rapidly to fulfil needs of these needy elderly people. It is important to understand socio demographic factors of persons living in care homes. The purpose of this study was to assess and compare socio demographic variables between elderly people living in old age home and within the family setup. METHODS A descriptive research design was adopted for the study. The study was conducted at two old age homes and various local areas of Kota, Rajasthan. The sample comprised of 100 participants who were further divided into 50 participants from old age homes and 50 participants from family. A tool such as socio-demographic data sheet was administered to obtain the data. RESULTS Significant difference was found between these groups in age wise, regarding marital status (case - 66 % widow or widower, control - 82 % married), literacy (case - illiterate 52 % middle 30 % secondary or higher 18 % while in control these figures are 34 %, 18 %, 34 %) employment (case - 86 % unemployed while in control it is 30 %), family type (case - 36 % joint family, control - 80 % joint family), socio-economic status (case – lower - 72 % control - upper 84 %) having own house (case - 14 % control - 86 %) attitude of family members (case - attitude of their family members perceived as bad 50 %, normal - 11 %, good - 39 % while in control group these figures are 85, 18 %, 74 %). CONCLUSIONS Socio-demographic factors like marital status, employment status, housing and attitude of family members play a major role in elderly population for which they had to stay in care homes. KEYWORDS Old Age Homes, Socio-demographic Variables, India