Caregiving Behavior Research Articles

"Good fathers": Community perceptions of idealized fatherhood and reported fathering behaviors in Mwanza, Tanzania.

Globally, perceptions of idealized fatherhood have been expanding beyond men's breadwinning roles to also value men's engagement in nurturing care. While fathers' caregiving behaviors are increasing, most childcare activities are still largely performed by mothers. In this study, we unpacked community members' beliefs about the meaning of "good fathers" and explored the degree to which these values aligned with the main caregiving behaviors reported about fathers with young children under age 2 years in Mwanza, Tanzania. Qualitative data were collected as part of a broader formative research study for which we conducted in-depth interviews with 29 fathers, 23 mothers, 4 village leaders and 4 community health workers as well as 3 focus group discussions with fathers, 2 with mothers, and 6 with both fathers and mothers combined. For this secondary data analysis, we used a grounded theory approach combined with thematic content analysis to investigate the nature of fatherhood. We discovered four key ideals associated with "good fathers": fathers as providers, nurturers, supportive partners, and authoritarians. The primary ideal of fathers as breadwinners was strongly aligned with the main reported practice of fathers trying hard to financially providing for their families. However, paternal behaviors reflecting ideals of fathers as nurturers and supportive partners were less practiced. Although ideals towards good fathers as authoritarian were least explicitly valued, many fathers were reported as engaging in controlling behaviors and using violence. The links between fatherhood ideals and behaviors was influenced by various factors, including poverty, men's limited time availability at home, and restrictive gender norms. Overall, our results reveal some alignment but also inconsistencies between the ideal version of fatherhood and commonly reported paternal practices. These discrepancies highlight the need for further investigation into the underlying factors that both enable and constrain the links between fatherhood ideals and behaviors. Our study results have important implications for the design of interventions that seek to enhance fatherhood to improve the development and wellbeing of children and families.

Parenting Patterns of Substitute Parents for Children of Indonesian Migrant Workers

This research is motivated by the importance of parenting education for the families of Indonesian Migrant Workers (TKI) working abroad, especially in the Donomulyo District, Malang Regency, which has become a major concern for the government. With a focus on strengthening social capital and Spiritual Capital, this study aims to address horizontal conflicts resulting from poverty conditions and conflicts among families and social environments. This dissertation focuses on strengthening social capital in parenting education for the families of Indonesian Migrant Workers (TKI) working abroad, with a study on the behavior of caregivers and children from TKW familiesin the Donomulyo District, Malang Regency. It aims to provide insights and practical recommendations to support the fulfillment of child custody rights in the context of TKI families working abroad by strengthening social capital and Spiritual Capital. The research uses a qualitative method, involving interviews, documentation, and observation, and uses interactive data analysis as a data analysis technique. By exploring how strengthening social capital can influence parenting practices in the context of poverty and horizontal conflicts, as well as how this can support the fulfillment of child custody rights. The results show that poverty conditions drive the choices of migrant laborers, creating closed horizontal conflicts within families and social environments. To create social concern for the children of migrant laborers, strengthening Spiritual Capital in social capital is needed, including Bridging Social Capital and Bonding Social Capital, oriented towards family and community actors in shaping attitudes and behaviors that are friendly to children. Implications include strategies to increase social capital and Spiritual Capital, as well as the importance of developing deep communication and social support between families and communities.

Promoting responsive care and early learning practices in Northern Ghana: results from a counselling intervention within nutrition and health services.

This study assesses change in caregiver practices after integrating responsive care and early learning (RCEL) in nutrition and health services and community platforms in northern Ghana. We trained health facility workers and community health volunteers to deliver RCEL counselling to caregivers of children under 2 years of age through existing health facilities and community groups. We assessed changes in caregivers' RCEL practices before and after the intervention with a household questionnaire and caregiver-child observations. The study took place in Sagnarigu, Gushegu, Wa East and Mamprugu-Moagduri districts from April 2022 to March 2023. Study sites included seventy-nine child welfare clinics (CWC) at Ghana Health Service facilities and eighty village savings and loan association (VSLA) groups. We enrolled 211 adult caregivers in the study sites who had children 0-23 months at baseline and were enrolled in a CWC or a VSLA. We observed improvements in RCEL and infant and young child feeding practices, opportunities for early learning (e.g. access to books and playthings) in the home environment and reductions in parental stress. This study demonstrates the effectiveness of integrating RCEL content into existing nutrition and health services. The findings can be used to develop, enhance and advocate for policies integrating RCEL into existing services and platforms in Ghana. Future research may explore the relationship between positive changes in caregiver behaviour and improvements in child development outcomes as well as strategies for enhancing paternal engagement in care practices, improving child supervision and ensuring an enabling environment.

Introduction to the special issue: evolutionary and biopsychosocial perspectives on sickness communication.

Here, we introduce the EMPH special issue on Evolutionary and Biopsychosocial Perspectives on Sickness Communication. This Commentary provides an overview of each article and places them in the wider context of sickness as a social phenomenon with verbal and nonverbal signals. This Commentary, and the special issue, in general, calls for greater attention to these signals that can affect pathogen transmission and may be at the evolutionary root of our caregiving systems and behaviours.

Promoting social, emotional, and cognitive development in early childhood: A protocol for early valuation of a culturally adapted digital tool for supporting optimal childrearing practices.

The Thrive by Five app promotes positive interactions between children and parents, extended family, and trusted community members that support optimal socio-emotional and cognitive development in the early years. This article aims to describe the protocol for a prospective mixed-methods multi-site study evaluating Thrive by Five using surveys, interviews, workshops, audio diaries from citizen ethnographers and app usage data. The study activities and timelines differ by site, with an extensive longitudinal evaluation being conducted at two sites and a basic evaluation being conducted at five sites. The learnings from the more comprehensive evaluations inform the iterative research and development processes while also ensuring ongoing evaluation of usability, acceptability and effectiveness of the app and its content across varying contexts. The study evaluates: (1) the impact of the Thrive by Five content on caregiver knowledge, behaviours, attitudes and confidence; (2) how the content changes relationships at the familial, community and system level; (3) how cultural and contextual factors influence content engagement and effectiveness and (4) the processes that facilitate or disrupt the success of the implementation and dissemination. All in-country partners have been identified and data collection has been completed in Indonesia, Malaysia, Afghanistan, Kyrgyzstan, Uzbekistan, Namibia and Cameroon. Very few digital health solutions have been trialled for usability and effectiveness in diverse cultural contexts. By combining quantitative, qualitative, process and ethnographic methodologies, this innovative study informs the iterative and ongoing optimisation of the cultural and contextual sensitivity of the Thrive by Five content and the processes supporting implementation and dissemination.

Improving psychosocial well-being and parenting practices among refugees in Uganda: Results of the journey of life effectiveness trial.

Caregivers play a critical role in mediating the impacts of forced displacement on children; however, humanitarian programming remains hampered by a lack of evidence-based programming. We present findings from an evaluation of a group-based curriculum delivered over the course of 12 sessions, journey of life (JoL). A waitlist-control quasi-experimental design was implemented in the Kiryandongo refugee settlement (intervention n=631, control n=676). Caregiver mental distress, measured using the Kessler-6, was the primary outcome. Secondary outcomes included (a) functioning, (b) social support and (c) caregiving attitudes and behaviors. Propensity score matching (PSM) and Cohen's d estimates were used to examine the intervention effects. According to our primary PSM analysis, JoL led to significant improvements in mental distress (coef.: 2.33; p<0.001), social support (coef.: 1.45; p<0.001), functioning (coef.: 2.64; p<0.001), parental warmth/affection (coef.: 2.48; p<0.001), parental undifferentiated rejection (coef.: 0.49; p<0.001) and attitudes around violence against children (VAC) (coef.: 1.98; p<0.001). Evidence from Cohen's d analysis underscored the value of the intervention's effect on parental warmth/affection (0.74), mental distress (0.70) and VAC attitudes (0.68). This trial adds to the evidence on holistic parenting programming to improve the mental health and parenting outcomes among refugee caregivers.

The impact of a counselling intervention on nutrition practices among caregivers of children under two in the Kyrgyz Republic.

To evaluate the impact of a counselling programme to strengthen the health and nutrition behaviours of caregivers of children under 2 and the sustainability of that impact through reduced intervention intensity one year later. The programme trained community- and facility-based health staff to provide nutrition counselling. We conducted an impact evaluation with a modified stepped-wedge design using difference-in-differences analysis to compare indicator changes in an intervention group to a comparison group (midterm survey) and then a full intervention group to a light intervention group (final survey). Batken and Jalal-Abad oblasts, the Kyrgyz Republic, 2020-2023. Caregivers of children under 2 provided 6253 responses in three telephone surveys. We observed statistically significant differences between the intervention and comparison groups at midterm for the percentage of children consuming vitamin A-rich foods; an increase in the intervention group (58-62 %) and a decrease in the comparison group (61-57 %). We observed similar results with exclusive breastfeeding (51-55 % in the intervention group and 48-40 % in the comparison group). There were also positive differences in other health and nutrition indicators. With the final survey results, in general, we observed statistically significant differences indicating a bigger change in full intervention areas compared to light intervention areas. We observed small negative changes in many indicators in light intervention areas. This evaluation highlights the importance of continued support for local interventions, particularly counselling programmes, to foster optimal nutrition behaviours.

뇌졸중 환자 가족돌봄제공자의 일반적 특성과 보호자의 심리적 요인간의 상관관계

Objective : The role of family caregivers is a very important factor in the patient's recovery. In this study, based on these previous studies, we confirmed the correlation between the general characteristics of family caregivers of stroke patients and psychological factors. Through this, we would like to suggest a method of supporting the caregiving behavior of family caregivers. Methods : This study conducted a paper questionnaire and an online survey targeting 112 family caregivers who are currently caring for their family members. The research period was conducted for 4 weeks from September 30 to October 30, 2023. Descriptive statistics were obtained for the data collected through the questionnaire using spss 23.0 for Windows, and multiple regression analysis was performed to see the correlation between the general characteristics of family caregivers and psychological factors. Results : First, in the caregiver response scale according to general characteristics, there was a relationship between gender, disease period, and age of the family caregiver. Second, the burden of care according to general characteristics was related to gender, disease period, age of family caregiver, place of care, and personal insurance. Third, in terms of stress coping strategies according to general characteristics, there was a relationship between the age of the family caregiver, location&#x0D; of care, and employment of personal care. Fourth, gender, onset period, and age of family caregiver were related to depression according to general characteristics. Conclusion : In this study, we sought to identify independent variables that can be influenced by environmental&#x0D; changes in family caregivers. Support methods that enable changes in the environment, such as location of care, personal insurance, and employment of personal caregivers, were presented to those who provide family caregivers.

Effect of the family-centered program on management of blood glucose levels among children with type 1 diabetes at Tabuk

Background. Diabetes mellitus (DM) is the second most common chronic disease in childhood. Diabetes care is multidimensional and should focus on preventing acute complications and reducing long-term consequences. A family-centered approach conserves the integrity of families and supports unique care for diabetic children. Purpose. The study aimed to determine the effect of a family-centered program on the management of blood glucose levels in children with type 1 diabetes mellitus at Tabuk. Methods. The researcher employed a quasi-experimental design to conduct this study. A purposive sample of diabetic children and their families was included. Tools included a structured questionnaire (sociodemographic data, anthropometric measurements), Supervisory Behaviors of Caregivers, Management Behaviors of Children with DM questionnaires, a Self-efficacy Scale, and a Blood Glucose Levels Record Sheet. The study was conducted in three phases: preparatory, performance, and evaluation. Pre-test and post-test methods were utilized for data collection. Results. There was a significant decrease in the mean scores of blood glucose levels, significant improvement in children’s management behavior for diabetic care, improvement in mothers’ supervisory behavior of management behavior for DM, and higher mean scores of mothers’ self-efficacy post compared to pre-family centered program. Conclusion. Implementing the family-centered program improved children’s diabetic management behavior and hence controlling the blood glucose levels of children with diabetes mellitus and increased mothers’ self-efficacy. Recommendation. Transformation of diabetic management in children with DM to a fully family-centered system of care should be established.

Enhancing maternal toddler parenting competence through nurturing care videos

Background: Despite increased global attention to early childhood development, children under 5 in low- and middle-income countries face heightened risks of poor developmental outcomes. In Indonesia, where innovative approaches to nurturing care are needed, video-based interventions show promise.Purpose: This study aimed to elevate maternal competence in parenting and contribute to the holistic development of children aged 0-3 years through video-based nurturing care education.Method: Non-equivalent quasi-experimental design with pre-post-test control groups was employed. This study used a consecutive sampling technique on 89 mothers with children 0-3 years old (intervention group = 40 and control group = 49). The intervention group was given health education using videos via a WhatsApp link, and the control group was given leaflets directly. Data was collected from May to August 2022, four weeks before the intervention (pre-test) and two weeks after the video and leaflets were given (post-test). The instrument was modified from the Knowledge, Attitude, and Practice (KAP) questionnaire developed by UNICEF. The effect of education was analyzed using Wilcoxon and independent t-test.Results: The group that received the intervention showed a notable and positive influence on their knowledge, attitudes, and practices (KAP levels) in contrast to the control group. This suggests the video-based intervention effectively enhanced participants' understanding, attitudes, and caregiving practices.Conclusion: The research emphasizes the positive outcomes of video-based nurturing care intervention for mothers with children aged 0-3 years. The intervention significantly improved maternal attitudes toward parenting, caregiving behaviors, and overall child development. These results emphasize the significance of employing video interventions to encourage effective nurturing care practices.

The Association between Nursing Students' Happiness, Emotional Intelligence, and Perceived Caring Behavior in Riyadh City, Saudi Arabia.

Caring behavior is a major focus of the nursing profession and an important dimension of nursing practice that sets nurses apart from other healthcare professionals. Effective patient-centered care requires ensuring nurses have the emotional intelligence and happiness to address the daily demands of practice. The purpose of this study is to examine the emotional intelligence and happiness among nursing students and their relationship with caring behaviors. A cross-sectional, descriptive correlational study was conducted on nursing students (n = 363) from Riyadh, Kingdom of Saudi Arabia, via an online survey. Measures include demographic data survey, Oxford Happiness Questionnaire, Trait Emotional Intelligence Questionnaire, and Caring Behaviors Inventory scale. Descriptive and multiple regression analyses were conducted for this study. Nursing students reported their highest degree of caring was in terms of 'respectful differences to others', while their lowest was in 'knowledge and skills'. Emotional intelligence and happiness were significant predictors of caring behaviors and explained the variance in assurance of human presence (17.5%), knowledge and skills (17.5%), respectful differences to others (18%), and positive connectedness (12.9%). In the final regression model, emotional intelligence and happiness were significant predictors of caring behaviors and explained 19.5% of the variance. Emotional intelligence and happiness among nursing students were found to be important factors to improve their caregiving behaviors. Therefore, nursing educators should consider integrating emotional intelligence and happiness interventions for students into their curriculum.

A machine learning approach to identifying non-parental caregivers' risk for harsh caregiving towards infants in daycare centers

BackgroundHarsh Caregiving behavior amongst daycare providers (i.e., non-parental Harsh Caregiving) negatively impacts children's development across a variety of domains. As prevalences of non-parental Harsh Caregiving appear to increase worldwide, identifying its predictors is crucial for screening and intervention. ObjectiveThe goal of this study was to identify a set of indicators and predictive rules that may accurately predict women's risk for Harsh Caregiving behavior in daycare environments. Participants and SettingThe study recruited 75 female non-parental caregivers, from the general population, who work with infants aged 0-1. Caregivers filled out self-report questionnaires including a Harsh Caregiving measure as well as a broad variety of potential predictors. MethodsTo elucidate combinations of input variables that are predictive of non-parental Harsh Caregiving, we used machine learning Decision Three Inference and CHAID algorithms. ResultsStudy results revealed a predictive model including 27 questions and four different prediction paths. For example, the first path indicated that women who reported low levels of attention deficit and hyperactivity problems and low levels of rigid-negative caregiving philosophies, had 100 % chance to report low levels of Harsh Caregiving behavior. Overall classification accuracy for "High Harsh Caregiving behavior" was 95.2 %. ConclusionsAfter replication in larger samples, the model can be used as a screening tool for women expressing their wish to work with infants. Women at risk can either be declined employment or alternatively receive targeted supervision throughout their work with small infants.

DEVELOPING A SCALE TO MEASURE NEGLECT SEVERITY: THE HEALTH-RELATED SEVERITY IN ELDER NEGLECT SCALE

Abstract Caregiver neglect in older persons can vary dramatically in severity, with differential impact on an older adult’s health. Assessing severity is critical for research and clinical practice but has received focus until recently. To address this gap, we developed a scale to describe the health-related severity of elder neglect using an expert consensus method. In development, the experts conceptualized severity as: (1) the level of risk that neglectful behaviors would cause morbidity or mortality and (2) related timeframe. Additionally, the experts recommended that the scale identify risk for future neglect. The scale was designed iteratively, and, after finalization, we assessed face and construct validity. The final scale was found to have validity. It has 5 levels: not present, not present / potential risk, present / mild, present / moderate, present / severe. Each level has a description to guide assessment. For example, present / mild is described as: “caregiving behaviors not optimal, with potential to create morbidity, but low concern for immediate danger,” present / moderate is: “caregiving behaviors with significant potential to create morbidity within the next 4 weeks,” and present / severe is “caregiving behaviors creating immediate danger of morbidity or mortality -- insufficient access to shelter, food, medication – with alternative living situation or ED visit / hospitalization recommended.” The description of not present / potential risk is: “though neglect not currently occurring, factors present that raise concern for future neglect risk.” Assessing neglect severity using this scale may improve understanding of the phenomenon and inform intervention.

BEHAVIORAL CHANGES OF NURSING STAFF AFTER A COACHING-BASED PSYCHOSOCIAL PROGRAM SUPPORTING SELF-DIRECTION IN PLWD

Abstract The psychosocial person-centred intervention “SOCAV-in-primary-care” (SOCAV-PC) offers training and reflective peer-coaching to nursing staff and training and person-centred care-planning to caregivers. SOCAV-PC aims to support persons with dementia (PwD) to maintain/improve their self-direction and daily functioning in meaningful activities with support of their caregivers. This study presents the experiences of the PwD, and changes in attitudes and behaviour of caregivers and nursing staff when following SOCAV. Spread over nine months, caregivers and nursing staff were trained and coached in the person-centred approach by a trained SOCAV-peer coach. Content analysis was performed using qualitative data derived from (1) intervention and coaching diaries from nursing staff, (2) coaching diaries of peer coaches, (3) focus groups among nursing staff, and (4) individual interviews with PwD and their caregivers. PwD felt heard and respected in making their own choices. Caregivers became more aware of the influence of their own behaviour on the mood of the PwD, and started trying to convert their controlling behaviour, meant to provide safety, into supporting wishes and needs of PwD. Among nursing staff, an ongoing process of positive changes in attitudes and behaviours towards person-centred care emerged: from acting on intuition and automatisms, towards learning to reflect on the behaviour of PwD and their own actions. Moreover, they gained a better understanding of the concept of self-direction, and discovered the power of conversation and observation through a more open attitude and behavioural change. Reflective coaching is an essential tool to enhance person-centred attitudes and behaviour among nursing staff.

ALIGNING ASSESSMENTS AND MEASURES OF CAREGIVER NEGLECT WITH INTERVENTION DEVELOPMENT: NEW INSIGHTS AND DIRECTIONS

Abstract As one of the most common forms of elder mistreatment, caregiver neglect is associated with significant morbidity and mortality. The unique stresses, demands, and challenges associated with family caregiving likely increases the risk of neglect. Addressing the multifaceted nature of caregiver neglect in diverse family caregivers of older persons necessitates alignment of meaningful assessments and methodologies with evidence-based intervention development. Gaps in knowledge that urgently need filling include refining conceptual and operational definitions of caregiver neglect, validating novel measurement approaches, and identifying effective caregiver-centered study engagement and recruitment strategies. To address these gaps, this symposium will draw upon insights from four caregiver neglect studies across community and clinical settings. Dr. David Hancock will characterize prevalence and correlates of caregiver neglect using unmet activities of daily living needs in a sample of dementia patients and their caregivers. Dr. E-Shien Chang will test the impact of varying operational definitions of caregiver neglect on prevalence estimates and associated risk and protective factors. Dr. Tony Rosen will present a novel, validated caregiver neglect severity measure to more accurately assess the impact of neglect on older persons’ health and quality of life outcomes. Dr. Farida Ejaz will highlight challenges and successes in identifying and involving family caregivers at risk of neglectful caregiving behaviors to inform intervention. Finally, Dr. Alan Stevens, as policy and advocacy expert for family caregivers, will provide summative comments and recommendations for policy and practice changes to better reduce risk of neglect and improve support for family caregivers.

Caring about bequest, so caring for parents? Evidence from China's housing sector

AbstractThis article reveals an informal eldercare arrangement in China by focusing on how the value of housing owned by aging parents affects adult children's caregiving behavior. Using three waves of national survey data in 2011–2015, we find that when the potential housing‐bequest value increases, adult children from multi‐child households provide more emotional support for their parents, demonstrating the role of the intergenerational‐exchange mechanism in China's current eldercare arrangement. However, such an informal mechanism is weakened by the prevalent social norms of son preference and is also less effective among emerging only‐child households. Therefore, we call for more market‐oriented arrangements.

Predicting Help-Seeking Behaviors in Caregivers of Children Newly Diagnosed with ADHD

ABSTRACT Children with attention-deficit/hyperactivity disorder (ADHD) often do not receive the standard of care which includes behavioral and pharmacological treatment. Understanding characteristics associated with treatment-seeking may inform ADHD assessment and treatment practices. This study used the ADHD Help-Seeking Behavior model to explore predictors of behavioral (parent training, classroom behavior management) and pharmacological treatment-seeking following a child’s ADHD diagnosis. Parents (N = 171) seeking an ADHD evaluation for their child (ages 7–12 years) and teachers completed ratings at various time-points. Following feedback, where diagnosis and treatment recommendations were provided, caregivers completed questionnaires regarding treatment-seeking initiation. The majority (91.1%) reported seeking treatment. Most reported seeking pharmacological treatment (MED; 82.9%), with fewer seeking behavioral parent training (BPT; 33.9%) or classroom behavior management (CBM; 70.7%). Treatment-seeking predictors varied by treatment modality. Higher parenting stress, agreement with the ADHD diagnosis, and knowledge of ADHD were significant independent predictors of seeking BPT. Greater child externalizing behaviors were a significant independent predictor of seeking CBM. Higher child ADHD inattention, parenting stress, and the parent not having ADHD were significant independent predictors of MED. These results may inform discussion points in communicating diagnostic feedback and treatment recommendations. Clinicians may improve BPT uptake by providing ADHD psychoeducation, thus promoting knowledge and an understanding of the diagnosis. Likewise, inquiring about parental attitudes and experiences with medication among caregivers diagnosed with ADHD may increase MED uptake for children. These results add to the literature indicating that ADHD treatment-seeking is a complex, nuanced process and set the stage for future studies exploring help-seeking behaviors.

P174: Project Connect 80+

Introduction:-Patients with a memory deficit, as well as patients with small deficits in various cognitive areas, with the requirement that there is no functional impairment in their domestic or work life, do not meet the criteria to be diagnosed with dementia, but they do meet the criteria for a diagnosis of mild cognitive impairment (MCI), which constitutes a transitional state between normal aging and mild dementia.-Every year, 15% of patients with MCI with involvement only in the memory section, go on to be diagnosed with dementia.In recent years, the use of a food for special medical purposes (FSMP), Souvenaid®, has been introduced into clinical practice, which, due to the composition of its active ingredient, Fortasyn connect (omega-3 fatty acids, uridine, choline, vitamins C, E, B6 and B12, selenium and folic acid) helps to: •Promote the development of neuronal synapses, demonstrating that it maintains the integrity of white and gray matter.•Reduce loss of functional connectivity.•Increase hippocampal cholinergic synapses and cholinergic neurotransmission.•Improve cognitive performance dependent on the hippocampusObjective:A survey has been developed to explore the impact of a nutritional intervention, through the use of an FSMP in the areas related to cognition, functionality, and behavior, in a geriatric cohort with MCI older than 80 years. (Connect - Survey in the environment of mild cognitive impairment).Survey: Each Geriatrics and Neurology professional had to select 5 cases that met the following characteristics: Presence of MCI, Age ≥ 80 years, and Receiving Souvenaid.The professional sent CRO Alpha Bioresearch the list of caregivers with their contact details. The CRO contacted the subjects by telephone 3, 6, and 12 months after starting Souvenaid to carry out the survey.Methodology:The survey collects the perception of the patient and caregiver's cognition, functionality, and behavior, through a Likert scale with 5 possible response alternatives. The questionnaire is divided into two different parts: –Data about the treatment (questions 1 to 5)–Questions about the patient's health (questions 1 to 12);The last one is divided into three parts: data on cognition 3 questions (questions 1 to 3), data on functional abilities with 5 questions (questions 4 to 8), and data on behavior 4 questions (questions 9 to 12).Results:Regarding the treatment at 12 months, there is a tolerance that reaches 76%, and 88% do not present problems with the administration of what is prescribed. The most common time of day for administration is breakfast and snacks. The most used flavor was vanilla and cappuccino. The most common way to acquire it was the direct route.Regarding cognitive functions, the ability to remember is improved by 20%, orientation by 12%, and recognition by 8%, maintaining stability without changes by around 60-70%. Functional capacities improved between 8 and 16%, presenting no changes between 68-80%. Regarding the behavior, the improvement is between 12 to 28% in the evaluated items, presenting no changes between 60-84%.Conclusions:There is stabilization at 3, 6, and 12 months both in cognition, functionality, and behavior. The positive impression of the perceived improvement in memory (around 20%) and apathy (exceeding 20% and reaching 28% per year) are striking.

Effectiveness of oral health education in enhancing oral care knowledge,attitudesand behaviors for family caregivers of persons with dementia

AbstractBackgroundDue to the loss of cognitive function and memory, persons with dementia gradually lose their self‐care and social skills, and the weakening of their oral care ability can easily lead to periodontal disease, dry mouth, and root caries. Studies have shown that oral health maintenance can help prevent dementia and delay functional deterioration. Therefore, it is important to provide oral hygiene guidance to family caregivers to improve the quality of oral health care for persons with dementia.Oral care questionnaires and oral health assessment scales were used to assess the knowledge, attitude and behavior of family caregivers towards oral care for the person with dementia. Based on the assessment results, an oral health education program was designed, including: 1. immediate oral care health education at the outpatient clinic; 2. mailing of dementia oral care health education leaflets; and 3. individual health education and discussion by telephone one week after mailing. A post‐test was conducted one week after the intervention to evaluate the effectiveness of the program.ResultsFamily caregivers' oral care knowledge correctness increased from 49% to 88.9%, attitude correctness increased from 29% to 71.45%, and behavior correctness increased from 84% to 100%.ConclusionThe results showed that a multicomponent oral health education program could improve the oral care knowledge, attitude, and behavior for family caregivers of persons with dementia. In particular, the use of telephone health education and assessment during the COVID‐19 epidemic may provide a reference.

Acceptance of and Adherence to a Four-Dose RTS,S/AS01 Schedule: Findings from a Longitudinal Qualitative Evaluation Study for the Malaria Vaccine Implementation Programme.

The WHO recommended the use of the RTS,S/AS01 malaria vaccine (RTS,S) based on a pilot evaluation in routine use in Ghana, Kenya, and Malawi. A longitudinal qualitative study was conducted to examine facilitators and barriers to uptake of a 4-dose RTS,S schedule. A cohort of 198 caregivers of RTS,S-eligible children from communities where RTS,S was provided through the pilot were interviewed three times over a ≈22-month, 4-dose schedule. The interviews examined caregiver perceptions and behaviors. Children's vaccination history was obtained to determine dose uptake. 162 caregivers remained at round 3 (R3); vaccination history was available for 152/162 children. Despite early rumors/fears, the uptake of initial doses was high, driven by vaccine trust. Fears dissipated by R2, replaced with an enthusiasm for RTS,S as caregivers perceived its safety and less frequent and severe malaria. By R3, 98/152 children had received four doses; 34 three doses; 9 one or two doses; and 11 zero doses. The health system and information barriers were important across all under-dose cases. Fears about AEFIs/safety were important in zero-, one-, and two-dose cases. Competing life/livelihood demands and complacency were found in three-dose cases. Regardless of the doses received, caregivers had positive attitudes towards RTS,S by R3. Findings from our study will help countries newly introducing the vaccine to anticipate and preempt reasons for delayed acceptance and missed RTS,S doses.